이중구간중도절단된 생존자료의 생존함수 비교를 위한 검정: 한국인 암 예방연구 중 당뇨병에의 응용

지선하,남정모,김진흠,Jee, Sun-Ha,Nam, Chung-Mo,Kim, Jin-Heum 한국통계학회 2009 응용통계연구 Vol.22 No.3

이중구간중도절단된 자료의 생존함수를 비교하기 위한 두 검정법을 소개하고 한국인 암 예방연구 (Jee 등, 2005) 자료에 적용하여 당뇨병 잠복시간의 분포를 성별과 연령에 따라 비교하였다. Kim 등 (2006)의 검정법을 이중구간중도절단된 자료로 확장한 검정법은 위험집합의 크기에만 의존하는 가중값을 사용하기 때문에 대용량 자료의 분석에서 Sun (2006)의 검정법보다 계산 시간을 대폭 줄일 수 있으며, 이산형 생존자료뿐만 아니라 연속형 생존자료에도 적용가능한 장점이 있다. 당뇨병의 잠복시간이 성별에 따라 매우 유의하게 달랐으며 여자의 잠복시간이 남자보다 긴 것으로 나타났다. 4개 연령그룹 간 당뇨병의 잠복시간도 성별에 관계 없이 매우 유의하게 달랐으며 여자의 경우가 남자의 경우보다 그 차이가 훨씬 더 유의했다. 한편, 소표본 모의실험을 통해 제안한 검정법과 Sun (2006)의 검정법의 검정력을 비교하였으며 제안한 검정법의 검정력이 Sun (2006)의 검정법보다 더 좋은 것으로 나타났다. Two tests were introduced for comparing several survival functions with doubly interval-censored data and illustrated with data surveyed by Korean Cancer Prevention Study (Jee et al., 2005). The test which extended Kim et al. (2006)'s test to the doubly interval-censored data has an advantage over Sun (2006)'s test in terms of saving computation time because the proposed test only depends on the size of risk set, and also the proposed test is applicable to continuous failure time data as well as discrete failure time data unlike Sun's test. Comparing male with female groups on the incubation time of diabetes was highly different and the survival of female group was longer than that of male one. Regardless of gender, the difference in survival functions of four age groups was highly significant with p-value of less than 0.001. This trend was more remarkable for female group than for male one. Simulation results showed that the significance level of both tests was well controlled and the proposed test was better than Sun's test in terms of power.

정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

허혈성심질환 예측모형을 이용한 사회경제적 위치와 허혈성심질환 위험도의 연관성

고동희,한순실,지선하,김형렬,Koh, Dong-Hee,Han, Sun-Shil,Jee, Sun-Ha,Kim, Hyoung-Ryoul 대한예방의학회 2006 예방의학회지 Vol.39 No.4

Objectives: The object of this study is to assess the relationship between socioeconomic factors and the predicted 10-year risk of cardiovascular disease by using health risk appraisal of ischemic heart disease. Methods: The study population was taken from The 2001 Korea National Health and Nutrition Survey, and it consisted of 1,566 men and 1,984 women aged 30-59. We calculated 10-year risk using the risk function of ischemic heart disease as developed by Jee. The educational level and equivalized household income were dichotomized by a 12 years education period and the median income level. Occupation was dichotomized into manual/non-manual work. We stratified the population by age(10 years) and sex, and then we rated the risk differences according to socioeconomic factors by performing t-tests for each strata. Results: There were gradients of the predicted 10-year risk of ischemic heart disease with the educational level and the equivalized household income, and thet was an increasing tendency of risk differences with age. Manual workers didn't show significant risk difference from non-manual workers. Conclusions: There was definite relationship between low socioeconomic position and the predicted risk of ischemic heart disease in the future.

Metabolomics Profiles of Hepatocellular Carcinoma in a Korean Prospective Cohort: The Korean Cancer Prevention Study-II

Jee, Sun Ha,Kim, Minjoo,Kim, Minkyung,Yoo, Hye Jin,Kim, Hyungyoon,Jung, Keum Ji,Hong, Seri,Lee, Jong Ho American Association for Cancer Research 2018 CANCER PREVENTION RESEARCH Vol.11 No.5

<P>In the prospective Korean Cancer Prevention Study-II (KCPS-II), we investigated the application of metabolomics to differentiate subjects with incident hepatocellular carcinoma (HCC group) from subjects who remained free of cancer (control group) during a mean follow-up period of 7 years with the aim of identifying valuable metabolic biomarkers for HCC. We used baseline serum samples from 75 subjects with incident HCC and 134 age- and gender-matched cancer-free subjects. Serum metabolic profiles associated with HCC incidence were investigated via metabolomics analysis. Compared with the control group, the HCC group showed significantly higher serum levels of aspartate aminotransferase (AST), alanine aminotransferase, and γ-glutamyl transpeptidase. At baseline, compared with the control group, the HCC group showed significantly higher levels of 9 metabolites, including leucine, 5-hydroxyhexanoic acid, phenylalanine, tyrosine, arachidonic acid, and tauroursodeoxycholic acid (TUDCA), but lower levels of 28 metabolites, including oleamide, androsterone sulfate, L-palmitoylcarnitine, lysophosphatidic acid (LPA) 16:0, LPA 18:1, and lysophosphatidylcholines (lysoPC). Multiple linear regression revealed that the incidence of HCC was associated with the levels of tyrosine, AST, lysoPCs (16:1, 20:3), oleamide, 5-hydroxyhexanoic acid, androsterone sulfate, and TUDCA (adjusted <I>R<SUP>2</SUP></I> = 0.514, <I>P</I> = 0.036). This study showed the clinical relevance of the dysregulation of not only branched amino acids, aromatic amino acids, and lysoPCs but also bile acid biosynthesis and linoleic acid, arachidonic acid, and fatty acid metabolism. In addition, tyrosine, AST, lysoPCs (16:1, 20:3), oleamide, 5-hydroxyhexanoic acid, androsterone sulfate, and TUDCA were identified as independent variables associated with the incidence of HCC. <I>Cancer Prev Res; 11(5); 303–12. ©2018 AACR</I>.</P>

Cohort Profile: The Korean Cancer Prevention Study-II (KCPS-II) Biobank

Jee, Yon Ho,Emberson, Jonathan,Jung, Keum Ji,Lee, Sun Ju,Lee, Sunmi,Back, Joung Hwan,Hong, Seri,Kimm, Heejin,Sherliker, Paul,Jee, Sun Ha,Lewington, Sarah Oxford University Press 2018 International journal of epidemiology Vol.47 No.2

Clinical relevance of glycerophospholipid, sphingomyelin and glutathione metabolism in the pathogenesis of pharyngolaryngeal cancer in smokers: the Korean Cancer Prevention Study-II

Jee, Sun Ha,Kim, Minjoo,Kim, Minkyung,Kang, Miso,Seo, Yoon Wook,Jung, Keum Ji,Lee, Sun Ju,Hong, Seri,Lee, Jong Ho Springer-Verlag 2016 METABOLOMICS Vol.12 No.11

Adiponectin Concentrations: A Genome-wide Association Study

Jee, Sun Ha,Sull, Jae Woong,Lee, Jong-Eun,Shin, Chol,Park, Jongkeun,Kimm, Heejin,Cho, Eun-Young,Shin, Eun-Soon,Yun, Ji Eun,Park, Ji Wan,Kim, Sang Yeun,Lee, Sun Ju,Jee, Eun Jung,Baik, Inkyung,Kao, Lind Elsevier 2010 American journal of human genetics Vol.87 No.4

<P>Adiponectin is associated with obesity and insulin resistance. To date, there has been no genome-wide association study (GWAS) of adiponectin levels in Asians. Here we present a GWAS of a cohort of Korean volunteers. A total of 4,001 subjects were genotyped by using a genome-wide marker panel in a two-stage design (979 subjects initially and 3,022 in a second stage). Another 2,304 subjects were used for follow-up replication studies with selected markers. In the discovery phase, the top SNP associated with mean log adiponectin was rs3865188 in <I>CDH13</I> on chromosome 16 (p = 1.69 × 10<SUP>−15</SUP> in the initial sample, p = 6.58 × 10<SUP>−39</SUP> in the second genome-wide sample, and p = 2.12 × 10<SUP>−32</SUP> in the replication sample). The meta-analysis p value for rs3865188 in all 6,305 individuals was 2.82 × 10<SUP>−83</SUP>. The association of rs3865188 with high-molecular-weight adiponectin (p = 7.36 × 10<SUP>−58</SUP>) was even stronger in the third sample. A reporter assay that evaluated the effects of a <I>CDH13</I> promoter SNP in complete linkage disequilibrium with rs3865188 revealed that the major allele increased expression 2.2-fold. This study clearly shows that genetic variants in <I>CDH13</I> influence adiponectin levels in Korean adults.</P>

The effect of smoking on health service utilization

Jee, Sun Ha,Kim, Il Soon,Suh, Il Yonsei University, College of Medicine 1993 Yonsei medical journal Vol.34 No.3

한국인의 심혈관질환 위험 예측보고

지선하 ( Sun Ha Jee ) 한국지질동맥경화학회(구 한국지질학회) 2008 한국지질동맥경화학회 추계학술발표논문집 Vol.2008 No.-

한국인 흡연과 사망위험에 대한 11년 추적연구

지선하(Sun-Ha Jee),조인호(In-Ho Jo),윤지은(Ji-Eun Yun),박정용(Jung-Yong Park),설재웅(Jae-Woong Sull),오희철(Hee-Choul Ohrr),이상이(Sang-Vi Lee),윤유식(Yoo-Sik Yoon),Jonathan M Samet, 김일순(II-Soon Kim) 한국역학회 2005 Epidemiology and Health Vol.27 No.1

Objective : In Korea, male smoking prevalence is among the world's highest and mortality rates from smoking-caused cancers, particularly lung cancer, are escalating. This cohort study examined the effects of cigarette smoking on the risk of mortality from all causes, cancers and cardiovascular diseases(CVD), and characterized the relationship of the risk with the amount and duration of cigarette smoking. Method : A eleven-year prospective cohort study was carried out of on 1,207,592 Koreans, 30 to 95 years of age. The study population includes participants in a national insurance program, who completed a questionnaire on smoking and other risk factors. The main outcome measures were death from all causes, cancer and CVD, obtained through record linkage. At baseline, 482,997 men(60.0%) and 19,755(5.3%) women were current cigarette smokers. Results : In multivariate Cox proportional hazards models, controlling for age, alcohol drinking, exercise, and obesity, current smoking among men increased the risks of mortality from all cause death (relative risk[RR], 1.56; 95% confidence interval[CI], 1.52~1.59), all cancer (1.75, 1.68~1.82), and CVD(1.46, 1.38~1.55). Similar results were found for mortality among women. Smoking also increased the risks of mortality for cancer of the lung(4.60, 4.09~5.33) and other cancers, including larynx, bile duct, esophagus, liver, stomach, pancreas, bladder, and also leukemia. Current smoking among women increased the risk of lung cancer mortality(RR=2.83, 95% CI 2.38~3.36). Conclusion : In Korea, smoking is an independent risk factor for death from all causes, CVD and a number of major cancers. The findings affirm the need for aggressive tobacco control in Korea in order to minimize the epidemic of smoking-caused disease.