한국인 여성 유방암 발생률 추정에 관한 역학적 연구 -충북지역을 대상으로-

유근영,박수경,성주헌,노동영,최국진,Yoo, Keun-Young,Park, Sue-Kyung,Sung, Joo-Hun,Noh, Dong-Young,Choe, Kuk-Jin 대한예방의학회 1998 예방의학회지 Vol.31 No.4

This study was conducted to estimate incidence rate of female breast cancer in a defined area of Chungchongbuk-do in Korea. The presumptive breast cancer cases were selected from two different sources, i.e., medical utilization database of the National Health Insurance Corporation and the database from the National Cancer Registry. Medical students visited each hospital where the presumptive cases had been treated as a breast cancer patient, and made a dictation of medical record of each patient based on the claims stored in the Insurance Corporation from January to December 1995. The diagnoses in the claims included one of the following diagnostic codes; ICD-9 174-175(malignant neoplasms of the breast), 233(carcinoma in situ of the breast and genito-urinary system)or ICD-10 C50(malignant neoplasms of the breast), D05(carcinoma in situ of the breast and genito-urinary system). Each case has been confirmed as having a breast cancer by a breast surgeon through a medical record review. Age-standardized incidence rate of female breast cancer to the Korean population was estimated to be 10.5(95%confidence interval : 8.1-12.9)per 100,000 persons in 1995. Age-standardized rate to the world population was 9.8 per 100,000 persons, and the truncated rate for ages 35-64 was 27.2 per 100,000 persons. Validity of these estimates is discussing in comparison with previous methods of incidence estimation in Korea.

정상 성인에 있어서의 B형 간염 바이러스 감염에 관한 혈청역학적 연구

유근영,박병주,안윤옥,Yoo, Keun-Young,Park, Byung-Joo,Ahn, Yoon-Ok 대한예방의학회 1988 Journal of Preventive Medicine and Public Health Vol.21 No.1

While there have been not a few reports on the seroepidemiological characteristics of hepatitis B virus (HBV) infection in Korea, most of them, however, have had several limitations; operational definition of HBV infection, validity of detection methods of HBV serologic markers, size of the study population, and confirmation of the vaccination history against HBV, etc. In order to avoid such limitations, authors randomly selected 1,495 healthy adults among the 217,511 insured (target population) of Korean Medical Insurance Corporation, living in seoul, and tested HBV serologic markers by RIA method and conducted direct interview to them. Although HBV serologic markers (HBsAg, anti-HBs and anti-HBc) of all the subjects were tested, 392(26.2%) of interview failure cases and 361 vaccinee were excluded from the actual population. Finally, the serologic markers tested of 742 nonvaccinee (study population) only were analysed for the seroepidemiologic observation of the natural infection of HBV. The seroepidemiological characteristics of HBV infection in Korea were as follows ; 1. Point prevalence of HBs antigenemia was 11.7(9.1{\sim}14.3)% in male, which was slightly higher than that of female, 9.5($3.7{\sim}15.3$)%. This level was one of the highest among those of Asian-Pacific countries. Decreasing tendency of HBsAg prevalence alter the age of 50 was observed, which seems to be due to selective attrition of HBV chronic carriers among the healthy adults and/or to the limited-lasting duration of the HBs antigenemia, in part. 2. Point prevalence of anti-HBc(78.8% in male,50.9% in female) was higher than that of anti-HBs(65.2% in male,46.6% in female), respectively. And both of them were higher in male than in female. Increasing tendency of the prevalence of both antibodies was observed by age, which seems to be largely due to recurrent infection in adults and to some cumulative effect, in part, of their relatively longer-lasting duration. 3. The level of HBV infection defined by positive for at least one of the 3 serologic markers of HBV by RIA method was 84.7($81.8{\sim}87.6$)% in male and 61.2($51.9{\sim}70.5$)% in female, which was also one of the highest among those of Asian-Pacific countries. The proportion of susceptible population to HBV infection among healthy adults was 15.3% in male and 38.8% in female. 4. The relative frequency of current or past infection and chronic carrier among HBV infected person was estimated. The currently or past infected was estimated 75.7% in male and 71.8% in female, and chronic carrier state, 13.8% in male and 14.1% in female. The analysis of the geometric mean of the antibody titer in anti-HBs positive sera indicated also to be compatible with the above findings, suggesting that active, even though inapparent, infection of HBV occur so frequently among healthy adults in Korea.

Comparison of Control Methods for Estimation Bias in Unmatched Analysis of Matched Data

유근영,Yoo, Keun-Young The Korean Society for Preventive Medicine 1990 Journal of Preventive Medicine and Public Health Vol.23 No.3

짝짓기 방법은 교란변수를 통제하기 가장 좋은 방법으로 알려져 있으나, 모수추정시 그 계산방법이 복잡하고, 포함된 모든 정보를 이용할 수 없다는 단점을 갖고 있다. 그럼에도 불구하고, conditional 모델을 이용한 matched 분석법은 짝지은 자료 분석시 가장 좋은 방법으로 인정되고 있다. 그러나 명확한 confounding 현상을 통제할 목적이 아닌 상태에서 짝지워진 자료를 matched 분석법으로 모수추정하는 경우나, 올바로 짝지워진 자료를 분석법의 편이성 때문에 unmatched 분석을 시도하는 경우, 오히려 estimation bias가 야기될 수 있다. 이러한 estimation bias의 통제능력을 몇 가지 분석방법을 이용하여 비교하고자, 1:2로 대응된 한 환자-대조군 자료를 이용하여 Mantel-Haenszel 분석법, 두가지의 unconditional model을 이용한 다변량분석법의 결과를 conditional model을 이용한 matched 분석법의 결과와 비교하였다. 1. Matched 분석법의 대용방법으로 사용된 세 가지 방법들은 모수추정면에서나 가설검정능력면에서 차이를 서로 보이지 않았다. 2. 짝짓기에 사용된 변수가 분석자료내에서 confounder나 effect modifier로 작용되지 않았음이 명백한 경우에는 이들 세 가지 통제 방법과 matched 분석법간에 차이가 없었다. 3. 짝짓기에 사용된 변수가 분석자료내에서 effect modifier로 작용하지는 않았으나, Confounder로 작용한 것으로 추정되는 경우, unmatched 분석법으로 인해 야기된 estimation bias의 통제능력이 이들 세 가지 대용방안 모두에서 인정되었다. 4. 짝짓기에 사용된 변수가 분석자료내에서 effect modifier로 작용하고 있음을 직접 확인할 수 있는 경우에는, overmatching에 의한 estimation bias를 의심할 수 있었으며, 이들 세 가지 통제방법은 오히려 unmatched 분석 방법에 가까운 모수를 추정하였다.

시안화물중독(化物中毒)에 있어서 Thiosulfate 해독효과에 미치는 산소(酸素)의 영향(影響)

유근영,Yoo, Keun-Young 대한예방의학회 1982 예방의학회지 Vol.15 No.1

Cyanide poisoning is expected to be antagonized by the administration of oxygen, when it is administered in combination with the conventional cyanide antidote, sodium thiosulfate. However, the antidotal efficacy and its exact mechanism of oxygen in cyanide poisoning is still a controversial one. To test the effect of oxygen on the antidotal action of thiosulfate in cyanide poisoning, author designed this study on the dose-mortality patterns for potassium cyanide in mice. Potency ratios derived from $LD_{50}$ values were compared in groups of mice treated with sodium thiosulfate alone and sodium thiosulfate with oxygen. These results indicated that oxygen enhances the antidotal effect of sodium thiosulfate, effectively. This fact demonstrates that oxygen is of importance in the treatment of cyanide poisoning.

저선량 방사선 노출에 대한 생물학적 지표로서 Glycophorin A 변이발현율 측정의 유용성 평가

하미나,유근영,하성환,김동현,조수헌,Ha, Mi-Na,Yoo, Keun-Young,Ha, Sung-Whan,Kim, Dong-Hyun,Cho, Soo-Hun 대한예방의학회 2000 예방의학회지 Vol.33 No.2

Objectives : To assess the availability of the glycophorin A (GPA) assay to detect the biological effect of ionizing radiation in workers exposed to low-doses of radiation. Methods : Information on confounding factors, such as age and cigarette smoking was obtained on 144 nuclear power plant workers and 32 hospital workers, by a self-administered questionnaire. Information on physical exposure levels was obtained from the registries of radiation exposure monitoring and control at each facility. The GPA mutant assay was performed using the BR6 method with modification by using a FACScan flow cytometer. Results : As confounders, age and cigarette smoking habits showed increasing trends with GPA variants, but these were of no statistical significance. Hospital workers showed a higher frequency of the GPA variant than nuclear power plant workers in terms of the NO variant. Significant dose-response relationships were obtained from in simple and multiple linear regression models. The slope of the regression equation for nuclear power plant workers was much smaller than that of hospital workers. These findings suggest that there may be apparent dose-rate effects. Conclusion : In population exposed to chronic low-dose radiation, the GPA assay has a potential to be used as an effective biologic marker for assessing the bone marrow cumulative exposure dose.

한국인 여성에서 자궁경부암의 위험요인에 관한 환자-대조군 연구

구혜원,유근영,김동현,송용상,박노현,강순범,이효표,안윤옥,이채언,Koo, Hye-Won,Yoo, Keun-Young,Kim, Dong-Hyun,Song, Yong-Sang,Park, No-Hyun,Kang, Soon-Beom,Lee, Hyo-Pyo,Ahn, Yoon-Ok,Lee, Chae-Un 대한예방의학회 1996 예방의학회지 Vol.29 No.2

A hospital-based case-control study was carried out to investigate the risk factors of uterine cervical cancer in Korea. Information on a wide-range of life-styles, which might be related with uterine cervix cancer, has been routinely collected through a dual application of the self-administered questionnaire and the direct interview by a well-trained nurse at the Department of Gynecology, Seoul National University Hosiptal since 1992. The number of cervical cancer cases, histologically confirmed at the hospital, were 284. Included were 939 women as controls, who were free of past history of any malignancies. Adjusted odds ratio and 95% confidence limits were based on the unconditional logistic regression model. The multivariate logistic model was constructed under the consideration of biologic characteristics on the natural history of the malignancy. In the multivariate results, the uterine cervical cancer risk was higher in women of shorter height$(P_{trend}<0.05)$, less educated spouse$(P_{trend}<0.001)$(0.001), multiple marriages(adjusted OR=2,70, 95% C.I. $1.64\sim4.47$), ever had a family history (adjusted OR=2.14., 95% C.I. $1.18\sim3.89$), multiparity$(P_{trend}<0.001)$, and early age at first $(P_{trend}<0.001)$. These results strongly suggest that the uterine cervix cancer might be related to the reproductive factors, and probably with sexual behaviour of both women and men in Korea.

여성 대장암 발생과 비만의 관련성에 관한 환자-대조군 연구

신애선,윤하정,유근영,Shin, Ae-Sun,Yoon, Ha-Chung,Yoo, Keun-Young 대한예방의학회 2002 예방의학회지 Vol.35 No.2

Objectives : A hospital-based case-control study was conducted to evaluate the role of obesity in the development of colorectal cancer. Methods : Three hundred and twenty four histologically confirmed female colorectal cancer cases and 26,998 non-cancer controls were selected from patients invited to the Aichi Cancer Center, Nagoya, Japan between 1989 and 1995. Information concerning demographic factors, medical history, family medical history, reproductive factors and dietary factors were obtained from self-administered questionnaires and medical records. The effects of weight and body mass index to colorectal cancer were examined using multiple logistic regression to control for other risk factors. Results : There was no significant association between female colorectal cancer and obesity. Heavier weight adjusted for height or body mass index did not increase the risk of colorectal cancer. Conclusions : These results suggest that there is no association between colorectal cancer risk and obesity in women.

전립선염 증상지수를 이용한 전립선염 증상의 규모와 삶의 질에 미치는 영향

변석수,강대희,유근영,박수경,곽철,조문기,이종욱,김현회,Byun, Seok-Soo,Kang, Dae-Hee,Yoo, Keun-Young,Park, Sue-Kyung,Kwak, Cheol,Jo, Moon-Ki,Lee, Chong-Wook,Kim, Hyeon-Hoe 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.4

Objectives : To determine the prevalence of prostatitis symptoms in the general population by questionnaire survey and to measure the effect of prostatitis symptoms on quality of life(QOL). Materials & Methods : A cross sectional community-based epidemiologic study was performed on 2,034 men, living in the Seoul metropolitan area using stepwise random sampling. Out of 2,034 interviewees, 1,356 men who were older than 40 and provided sufficient information were selected for this study. The questionnaires were completed by well trained interviewers. Contents of the questionnaires included demographic data, the Prostatitis Symptom Index(PSI), the International Prostate Symptom Score(IPSS), a general health questionnaire section and a sexual health questionnaire section. The PSI was composed of a sum of the scores from three questions about dysuria, penile pain and perineal pain and it ranged 0 to 12. Incidence of prostatitis symptoms was defined by a score of 4 or more and the reference group was defined as consisting of those with a score of 3 or less. The rate of incidence of prostatitis symptoms was assessed according to age and the difference of QOL between the prostatitis symptoms group and the reference group. Results : The overall positive rate of prostatitis symptoms measured by the PSI, in men older than 40, living in the Seoul metropolitan area, was 4.5%(61/1,356), adjusted to 4.8% by the relative proportion of this age group in the general population of the Seoul metropolitan area as compared to Korea and the World. The proportion of the group with prostatitis symptoms assessed by the PSI did not increase with age although the proportion of participants with moderate to severe lower urinary tract symptoms (LUTS) did increase with age. The group with prostatitis symptoms suffered from a much greater incidence of LUTS compared to the reference group (p<0.05). The QOL scores of the IPSS, and the general health and sexual health status of the group with prostatitis symptoms, were worse than those of the reference group.(p<0.05). Conclusions : The positive rate of prostatitis symptoms in men older than 40, living in the Seoul metropolitan area, was 4.8% and it didn't increase with age. The general QOL of the group with prostatitis symptoms was much worse than that of the reference group.

간 질환력과 원발성 간암에 관한 환자-대조군 연구

김동현,박병주,유근영,안윤옥,이효석,김정룡,이상일,이무송,안형식,김헌,박태수,Kim, Dong-Hyun,Park, Byung-Joo,Yoo, Keun-Young,Ahn, Yoon-Ok,Lee, Hyo-Suk,Kim, Chung-Yong,Lee, Sang-Il,Lee, Moo-Song,Ahn, Hyung-Sik,Kim, Heon,Park, Tae-Soo 대한예방의학회 1994 Journal of Preventive Medicine and Public Health Vol.27 No.2

The relationship between past liver disease history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Seoul on 165 patients with histologically or serologically confirmed hepatocellular carcinoma and individually age- and sex-matched 165 controls in hospital for ophthalmologic, otologic, or nasopharyngeal problems. Significant association were observed for liver deseases occurring 5 or more years before liver cancer diagnosis [OR,4.9;95% confidence interval (CI), $1.6{\sim}14.0$) and family history of liver disease(OR, 9.0;95% CI, $2.1{\sim}38.8$). These associations were not appreciably modified by allowance for major identified potential confounding factors. From these results, it is possible to speculate that liver cell injuries caused by various factors might be a common pathway to developing primary liver carcinoma. Considering the significant effect of family history of liver diseases on PLCA risk after adjusting past liver disease history, there might be genetic susceptibility in the carcinogenic mechanism of liver cancer. Further investigations are needed to clarify the effect of family history of liver disease on PLCA risk.

델파이법을 적용한 암연구수준의 평가

강영호,윤석준,강길원,김창엽,유근영,신영수,Khang, Young-Ho,Yoon, Seok-Jun,Kang, Gil-Won,Kim, Chang-Yup,Yoo, Keun-Young,Shin, Young-Soo 대한예방의학회 1998 Journal of Preventive Medicine and Public Health Vol.31 No.4

Globally, cancer research has been considered one of the most important field of biomedical researches. Recently, in Korea, there are increasing concerns about cancer research and the development of national cancer control programme. For the efficient investment in cancer research at the national level, strategic approach is needed based on the nationwide information about current status of research. However even the basic data on cancer research have not been systematically collected, and are not available when necessary. The aim of this study is to assess current status of cancer research. For this purpose, this study applied two round Delphi method in which fifteen experts in cancer research fields participated. They rated each items on the initial list at the first round, and modified their responses at the second round. Panels responded that pathogenesis of cancer, research & development of cancer drug, and oncogene, etc. are the most urgent and important research Holds. They assessed national level of cancer research as being 49.6% of the world highest level. Coefficient of variation tended to be lowered with the iteration. Predictive stability was evaluated to be lower in items of urgency than in items of importance and research level. Although this study shares the same limitations in the selection of the experts with many other Delphi studies, it provides a primary data that would be required to plan the national strategy of the cancer research.