한국인 위암 사망률의 장기 예측

곽진(Jin Gwack),최윤희(Yun-Hee Choi),신해림(Hai-Rim Shin),홍윤철(Yun-Chul Hong),유근영(Keun-Young Yoo) 한국역학회 2005 Epidemiology and Health Vol.27 No.1

Purpose : This study was carried out to predict the mortality rate for gastric cancer up to 2020 in Korea with forecasting model, Methods : The trends of the age-adjusted mortality rate was calculated from 1983 to 2003 using the mortality data of the past 20 years in Korea, and projected up to the year of 2020 with log-linear models for each gender. The number of deaths from gastric cancer was calculated from the predicted mortality rate. Results : Age-adjusted mortality rates for gastric cancer per 100,000 persons were 32.13 in 1983, 23.95 in 1990, and 15.99 in 2003 for women, and 70.37, 58.74, 41.04 for men, respectively. The expected age-adjusted mortality rates for gastric cancer were 16.50 in 2005, 14.27 in 2010, and 10.66 in 2020 for women, and 39.14, 33.83, 25.28 for men, respectively. In contrast to this decreasing trend, it is predicted that mortality rates for those aged 75 or over would increase steadily. The predicted number of deaths from gastric cancer was 6,519 for women and 13,743 for men in 2020. Conclusions : This study suggests that gastric cancer mortality rate would decrease continuously except for some aged groups. The declining trends in gastric cancer mortality are regarded as a result of lifestyle changes, improvements in screening methods and treatments. Strategies for aged groups should be developed in order to control increasing mortality rates.

A cluster of lung injury cases associated with home humidifier use: an epidemiological investigation

Kim, Hwa Jung,Lee, Moo-Song,Hong, Sang-Bum,Huh, Jin Won,Do, Kyung-Hyun,Jang, Se Jin,Lim, Chae-Man,Chae, Eun Jin,Lee, Hanyi,Jung, Miran,Park, Young-Joon,Park, Ji-Hyuk,Kwon, Geun-Yong,Gwack, Jin,Youn, S BMJ Publishing Group Ltd 2014 Thorax Vol.69 No.8

<P><B>Background</B></P><P>In April 2011 a tertiary hospital in Seoul, Korea reported several cases of severe respiratory distress of unknown origin in young adults.</P><P><B>Methods</B></P><P>To find the route of transmission, causative agent and patient risk factors of the outbreak, an investigation of the epidemic was initiated. Clinicopathological conferences led to the suspicion that the cases related to an inhalation injury. An age- and sex-matched case–control study was therefore performed to examine the inhalation exposure of the patients to various agents.</P><P><B>Results</B></P><P>Of the 28 confirmed cases, 18 agreed to participate. A total of 121 age- and sex-matched controls with pulmonary, allergic or obstetric disease were selected. All patients and controls completed questionnaires with questions about exposure to various inhalants. The crude ORs for patient exposure to indoor mould, humidifier use, humidifier detergent use and insecticide use were 4.4 (95% CI 1.5 to 13.1), 13.7 (95% CI 1.8 to 106.3), 47.3 (95% CI 6.1 to 369.7) and 3.9 (95% CI 1.3 to 11.7), respectively. However, when considered concurrently, indoor mould and insecticide use lost statistical significance. Moreover, humidifier use was ruled out as the cause because of a lack of biological plausibility and the weak strength of the association. This suggested that humidifier disinfectant was the cause of the outbreak. This information led the Korean government to order the removal of humidifier detergents from the market. In the years following the ban, no additional cases were detected.</P><P><B>Conclusions</B></P><P>Epidemiological evidence strongly suggests that the lung injury outbreak was caused by humidifier detergent use at home.</P>

Viral Hepatitis and Liver Cancer in Korea: an Epidemiological Perspective

Yeo, Yohwan,Gwack, Jin,Kang, Seokin,Koo, Boyeon,Jung, Sun Jae,Dhamala, Prakash,Ko, Kwang-Pil,Lim, Young-Khi,Yoo, Keun-Young Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.11

In the past, hepatitis B virus (HBV) infection was endemic in the general Korean population. The association of HBV infection with the occurrence of liver cancer has been well demonstrated in several epidemiologic studies. While the mortality rates of liver cancer in Korea have decreased steadily over the last decade, the presence of hepatitis B surface antigen (HBsAg) in mothers remains high at 3-4%, and 25.5% of these HBsAg positive mothers are positive for hepatitis B e antigen (HBeAg). HBV infection caused almost a quarter of hepatocellular carcinoma (HCC) cases and one-third of deaths from HCC. These aspects of HBV infection prompted the Korean government to create a vaccination program against HBV in the early 1980s. In 1995, the Communicable Disease Prevention Act (CDPA) was reformed, and the government increased the number of HBV vaccines in the National Immunization Program (NIP), driving the vaccination rate up to 95%. In 2000, the National Health Insurance Act (NHIA) was enacted, which provided increased resources for the prevention of perinatal HBV infection. Then in 2002, the Korean government, in conjunction with the Korean Medical Association (KMA), launched an HBV perinatal transmission prevention program. The prevalence of HBsAg in children had been high (4-5%) in the early 1980s, but had dropped to below 1% in 1995, and finally reached 0.2% in 2006 after the NIP had been implemented. After the success of the NIP, Korea finally obtained its first certification of achievement from the Western Pacific Regional Office of the World Health Organization (WPRO-WHO) for reaching its goal for HBV control. An age-period-cohort analysis showed a significant reduction in the liver cancer mortality rate in children and adolescents after the NIP had been implemented. In addition to its vaccination efforts, Korea launched the National Cancer Screening Program (NCSP) for 5 leading sites of cancer, including the liver, in 1999. As a consequence of this program, the 5-year liver cancer survival rate increased from 13.2% (1996-2000) to 23.3% (2003-2008). The development of both the primary and secondary prevention for liver cancer including HBV immunization and cancer screening has been of critical importance.

Long Term Trends and the Future Gastric Cancer Mortality in Korea: 1983~2013

Yunhee Choi,Jin Gwack,Yeonju Kim,Jisuk Bae,Jae-Kwan Jun,Kwang-Pil Ko,Keun-Young Yoo 대한암학회 2006 Cancer Research and Treatment Vol.38 No.1

Purpose: In spite of gastric cancer's decreasing incidence and mortality rates, it is still the most common cancer in Korea. In the present study, we examined the temporal trends of gastric cancer mortality during the past 20 years in Korea by using an age-period-cohort model, and we predicted the mortality rates for the next 10 years.Materials and Methods: Data on the annual number of deaths due to gastric cancer and data on population statistics from 1984 to 2003 were obtained from the Korean National Statistical Office. A log-linear Poisson ageperiod-cohort model was used to estimate age, period and birth cohort effects. To project two periods (10 years) into the future, the new cohort values were estimated by performing linear regression that was applied to a chosen number of the most recent cohort values.Results: The trends of gastric cancer mortality were predominantly explained by the cohort effect; the risk of gastric cancer death decreased since the 1919 birth cohort for both genders. The predicted, expected age-adjusted mortality rates per 100,000 for males and females are 45.72 and 23.75, respectively, during 2004~2008, and 34.62 and 17.93 respectively, during 2009~2013. During 2004~2008 and 2009~2013, the predicted numbers of deaths due to gastric cancer in males are 36,922 and 27,959, respectively, whereas those in females are 19,698 and 14,869, respectively.Conclusions: Not only the mortality, but also the incidence of gastric cancer in Korea is expected to further decrease in both men and women if the trends of the past 20 years continue. (Cancer Res Treat. 2006;38:7-12)

Correction: Long Term Trends and the Future Gastric Cancer Mortality in Korea: 1983~2013

Yunhee Choi,Jin Gwack,Yeonju Kim,Jisuk Bae,Jae-Kwan Jun,Kwang-Pil Ko,Keun-Young Yoo 대한암학회 2007 Cancer Research and Treatment Vol.39 No.1

Regional Distribution of Hepatitis C Virus Infection in the Republic of Korea, 2007-2011

( Geun Yong Kwon ),( Hyung Min Lee ),( Jin Gwack ),( Sang Won Lee ),( Moran Ki ),( Seung Ki Youn ) 대한소화기학회 2014 Gut and Liver Vol.8 No.4

Background/Aims: In Korea, hepatitis C is included as an infectious disease in a sentinel surveillance system. Recently, a large variation in hepatitis C incidence between different regions in Korea has been noticed. The current study verified the nationwide distribution of hepatitis C infection for effective prevention and management. Methods: We counted the number of hepatitis C patients who visited a hospital per county using the National Health Insurance database from 2007 to 2011. The age-adjusted prevalence ratio was used, and the age adjustment method was used as an indirect standardization method. Disease mapping and spatial analysis were conducted using a geographic information system. Results: The annual prevalence of diagnosed hepatitis C was approximately 0.12% to 0.13% in Korea. The age-adjusted prevalence ratios in Busan, Jeonnam, and Gyeongnam were high (1.75, 1.4, and 1.3, respectively). The three regions in the southern coastal area of the Korean Peninsula were identified as a high-prevalence cluster (Moran`s index, 0.3636). Conclusions: The present study showed that hepatitis C infection has very large regional variation, and there are several high-risk areas. Preventive measures focusing on these areas should be applied to block the transmission of hepatitis C and reduce the disease burden. (Gut Liver 2014;8:428-432)

Impact of Nonpharmacological Interventions on Severe Acute Respiratory Infections in Children: From the National Surveillance Database

Yoon Yoonsun,Lee Hye Sun,Yang Juyeon,Gwack Jin,Kim Bryan Inho,Cha Jeong-ok,Min Kyung Hoon,Kim Yun-Kyung,Shim Jae Jeong,Lee Young Seok 대한의학회 2023 Journal of Korean medical science Vol.38 No.40

Background: Nonpharmacological interventions (NPIs) reduce the incidence of respiratory infections. After NPIs imposed during the coronavirus disease 2019 pandemic ceased, respiratory infections gradually increased worldwide. However, few studies have been conducted on severe respiratory infections requiring hospitalization in pediatric patients. This study compares epidemiological changes in severe respiratory infections during pre-NPI, NPI, and post-NPI periods in order to evaluate the effect of that NPI on severe respiratory infections in children. Methods: We retrospectively studied data collected at 13 Korean sentinel sites from January 2018 to October 2022 that were lodged in the national Severe Acute Respiratory Infections (SARIs) surveillance database. Results: A total of 9,631 pediatric patients were admitted with SARIs during the pre-NPI period, 579 during the NPI period, and 1,580 during the post-NPI period. During the NPI period, the number of pediatric patients hospitalized with severe respiratory infections decreased dramatically, thus from 72.1 per 1,000 to 6.6 per 1,000. However, after NPIs ceased, the number increased to 22.8 per 1,000. During the post-NPI period, the positive test rate increased to the level noted before the pandemic. Conclusion: Strict NPIs including school and daycare center closures effectively reduced severe respiratory infections requiring hospitalization of children. However, childcare was severely compromised. To prepare for future respiratory infections, there is a need to develop a social consensus on NPIs that are appropriate for children.

Clinical outcomes of remdesivir-treated COVID-19 patients in South Korea

Mi Yu,Bryan Inho Kim,Jungyeon Kim,Gwack Jin 질병관리본부 2022 Osong Public Health and Research Persptectives Vol.13 No.5

Objectives: This study analyzed the clinical outcomes of remdesivir treatment in coronavirus disease 2019 (COVID-19) patients in South Korea.Methods: This retrospective cohort study involved the secondary analysis of epidemiological data. Among patients diagnosed with COVID-19 from July 2, 2020 to March 23, 2021 (12 AM), 4,868 who received oxygen therapy and were released from isolation after receiving remdesivir treatment were assigned to the treatment group, and 6,068 patients who received oxygen therapy but not remdesivir were assigned to the untreated group. The study subjects included children under the age of 19. The general characteristics and severity were compared between the groups. Differences in the time to death and mortality were also compared.Results: In the untreated group, the hazard ratio [HR] for mortality was 1.59 among patients aged ≥70 years and 2.32 in patients with severe disease in comparison to the treatment group. In a comparison of survival time among patients with severe disease aged ≥70 years, the HR for mortality before 50 days was 2.09 in the untreated group compared to the treatment group.Conclusion: Patients with remdesivir treatment showed better clinical outcomes in this study, but these results should be interpreted with caution since this study was not a fully controlled clinical trial.

The Changes in Respiratory and Enteric Adenovirus Epidemiology in Korea From 2017 to June 2022

Kim Kyung-Ran,Won Jisu,Kim Hyungjun,Kim Bryan Inho,Kim Mi Jin,Kim Jae Young,Gwack Jin,Kim Yae-Jean 대한의학회 2023 Journal of Korean medical science Vol.38 No.9

Since October 2021, severe acute hepatitis of unknown etiology in pediatric patients has been observed in many countries around the world. Adenovirus (mainly enteric adenovirus) was detected in more than 50% of the cases. Nationwide surveillance on acute hepatitis of unknown etiology in pediatric patients was started in May 2022 in Korea. Taking into account the severity of the illness and the urgency of the epidemiological situation worldwide, we report a summary of changes in adenovirus epidemiology during the past five years and six months in Korea.

공복 혈당과 위암 발생 위험에 관한 코호트 내 환자-대조군 연구

전재관,곽진,박수경,최윤희,김연주,신애선,장성훈,신해림,유근영,Jun, Jae-Kwan,Gwack, Jin,Park, Sue-Kyung,Choi, Yun-Hee,Kim, Yeon-Ju,Shin, Ae-Sun,Chang, Soung-Hoon,Shin, Hai-Rim,Yoo, Keun-Young 대한예방의학회 2006 예방의학회지 Vol.39 No.6

Objectives : Diabetes has been reported as a risk factor for several cancers. However, the association between diabetes and gastric cancer has been inconsistent. The aim of this study was to evaluate the association between the fasting serum glucose level and gastric cancer risk in Korea. Methods : Among the members of the Korean Multi-Center Cancer Cohort (KMCC) from 1993 to 2004, a total of 100 incident gastric cancer cases were ascertained until December 31, 2002 and 400 controls were matched according to age, sex, and year and area of enrollment. Of the eligible subjects, those without fasting serum glucose level information were excluded, with a total of 64 cases and 236 controls finally selected. On enrollment, all subjects completed a baseline demographic and lifestyle characteristics questionnaire, and had their fasting serum glucose level measured. The Helicobacter pylori infection status was determined by an immunoblot assay using long-term stored serum. The odds ratios (ORs) were estimated using conditional and unconditional logistic regression models adjusted for the H. pylori infection status, smoking, drinking, education, follow-up period and matching variables. Results : The ORs for risk of gastric cancer according to the serum glucose level were 1.33 [95% CI=0.50-3.53] and 1.66 [95% CI=0.55-5.02] for the categories of 100-125 and 126 mg/dL or greater, respectively, compared to the category of less than 100 mg/dL. No increased risk of gastric cancer according to the serum glucose level was found (p-trend=0.337). Conclusions : This study provides no evidence for an association of the serum glucose level with gastric cancer.