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흡연이 임신 여성의 태반 혈류 장애에 미치는 영향에 대한 연구
박해용 ( Haeyong Pak ),윤지선 ( Ji Sun Yoon ),백혜원 ( Hae Won Baek ),정재은 ( Jae Eun Chung ) 한국모자보건학회 2019 한국모자보건학회 학술대회 연제집 Vol.2019 No.2
Purpose: This study aims to investigate the effects of smoking on the development of placenta-associated syndromes, including preeclampsia, abruptio placentae, and placenta previa, which share the common pathophysiology of vascular compromise of the placenta. Methods: A total of 966,629 pregnancies identified from the Korean National Insurance Claims Database and the National Health Information Database were analyzed from 2010 to 2014. The adjusted odds ratio and attributable risk of smoking for the development of placenta-associated syndromes, such as preeclampsia, placenta previa, and abruptio placentae, were analyzed. Maternal age, alcohol consumption, exercise habit, and economic status were controlled as confounding variables. A binary logistic regression model was used, and simple and multiple logistic regression analyses were performed. Results: Among 966,629 pregnancies, 11.86% of women were ever smokers. Ever smokers had a higher risk of developing placenta previa (adjusted odds ratio, 1.23; 95% confidence interval [CI], 1.18-1.29; adjusted attributable risk, 18.70%). The adjusted odds ratio of developing placenta-associated syndromes in ever smokers compared to nonsmokers over the age of 35 years with a low economic status was 1.32 (95% CI, 1.18-1.47), with an adjusted attributable risk of 23.95%. Conclusion: The risk of developing placenta-associated syndromes, such as preeclampsia, placenta previa, and abruptio placentae, is high in ever smokers. Pregnant ever smokers who are >35 years and belong to the lower one-third of the economic division require special care to prevent the development of placentaassociated syndromes.
Lee Hyun Jung,Pak Haeyong,Han Jae Joon,Chang Myung Hee 대한의학회 2023 Journal of Korean medical science Vol.38 No.37
Background: Menorrhagia is a common cause of iron deficiency anemia (IDA) in premenopausal women. However, the effects of menorrhagia on IDA in premenopausal women have been underestimated compared to those on other IDA-related disorders (IRDs) such as gastrointestinal malignancies (GIMs). To better understand the relationship between menorrhagia and IDA in premenopausal women, we analyzed the National Health Insurance Service-National Health Information Database (NHIS-NHID). Methods: From 2005 to 2008, data about women between the age of 20 and 59 years were extracted from the NHIS-NHID to create a propensity score-matched case (IDA) and control group. The annual incidence of IDA was calculated per age group. A 10-year follow up of the study population was determined to detect IRDs in case and control groups. We compared the risk of detection (ROD) of IRDs, including GIM and gynecological disorders associated with menorrhagia - leiomyoma of uterus (LM) and adenomyosis (AM), in the case and the control group. Results: From 2005 to 2008, women diagnosed with IDA (n = 535,249) and healthy women as a control group (n = 1,070,498) were identified from the NHIS-NHID. The annual incidence of IDA was 767.4 (2005), 948.7 (2006), 981.6 (2007), and 897.7 (2008) per 100,000 women. The age distribution of IDA was similar each year; IDA was common in women aged 30–39 years (36–37%) and 40–49 years (30–32%), and its incidence was significantly decreased in women aged 50–59 years (< 10%). The ROD of IRDs were significantly higher in the IDA group than in the control group (LM: 20.8% vs. 6.9%, AM: 5.6% vs. 1.6%, and GIM: 2.6% vs. 0.7%). The corresponding hazard ratios were 3.89 (95% confidence interval [CI], 3.85–3.93) for LM, 4.99 (95% CI, 4.90–5.09) for AM, and 3.43 (95% CI, 3.32–3.55) for GIM. The ROD of the IRDs varied; the ROD of LM in the IDA group increased with age and decreased in the age group 50–59 years. AM was more frequently detected in women with IDA aged 30–39 years and less in women older than 40 years. The frequency of GIM increased with age. Conclusion: In this study, we found that the gynecologic disease is the main cause of IDA in premenopausal women. Gynecological evaluations should be performed more actively in the clinic to prevent and control IDA and IRDs.
Uric Acid and Risk of Cardiovascular Disease and Mortality: A Longitudinal Cohort Study
Kim Jae Young,Seo Changhwan,Pak Haeyong,Lim Hyunsun,Chang Tae Ik 대한의학회 2023 Journal of Korean medical science Vol.38 No.38
Background: This study aimed to examine the association of serum uric acid levels with incident cardiovascular disease and mortality in Korean adults without gout. Methods: This large longitudinal cohort study included adults aged > 19 years who had serum uric acid levels measured at least once at the National Health Insurance Service Ilsan Hospital from January 1, 2006 to December 31, 2015. Longitudinal data on person-level cardiovascular disease and cardiovascular mortality were linked to the National Health Insurance Service claims database and National Death Index. Results: Among a total of 92,454 study participants with a median follow-up of 4.7 years, 7,670 (8.3%) composite events of cardiovascular disease or cardiovascular mortality were observed. Multivariable Cox proportional-hazards models revealed that each 1 mg/dL increment in uric acid level was associated with a 6% higher risk of composite outcomes. Compared with that for the uric acid level category of 4.0 to < 5.0 mg/dL, adjusted hazard ratios (95% confidence interval) for uric acid level categories of 5.0 to < 6.0, 6.0 to < 7.0, and ≥ 7.0 mg/dL were 1.10 (1.04–1.18), 1.20 (1.11–1.30), and 1.36 (1.25–1.47), respectively. In the secondary analyses for cardiovascular disease or cardiovascular mortality examined separately, a higher uric acid level was similarly associated with a higher risk of each adverse outcome. These associations were generally consistent across clinically relevant subgroups. Conclusion: A graded association was noted between serum uric acid levels and cardiovascular risk, suggesting that higher uric acid levels may adversely affect cardiovascular health and survival in individuals without gout.
( Han Ho Jeon ),( Yong Kang Lee ),( Dong Hyun Kim ),( Haeyong Pak ),( Sang Yun Shin ),( Jeong Hun Seo ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.1
Background/Aims: To investigate whether visceral fat area (VFA) measured by bioelectric impedance analysis (BIA) was associated with metabolic syndrome in subjects with and without obesity. Methods: A total 23,202 participants who underwent medical check-ups were assessed. Participants were stratified by body mass index (BMI) and VFA. We evaluated six different groups for metabolic syndrome: Group 1 (normal weight and low VFA), Group 2 (normal weight and high VFA), Group 3 (overweight and low VFA), Group 4 (overweight and high VFA), Group 5 (obesity and low VFA), and Group 6 (obesity and high VFA). Results: Metabolic syndrome traits and metabolic syndrome were significantly more prevalent in the high-VFA (≥ 100 ㎠) subgroup in each BMI group. Adjusted logistic regression analyses revealed that the odds ratio for metabolic syndrome compared with Group 1 was the highest in Group 6 (24.53; 95% confidence interval [CI], 21.77 to 27.64). Notably, the odds ratio of Group 2 was higher than that of Group 3 (2.92; 95% CI, 2.30 to 3.69 vs. 2.57; 95% CI, 2.23 to 2.97). Conclusions: Our study demonstrates that the combination of BMI assessment and VFA determination by BIA may be a useful method for predicting the risk of metabolic syndrome. The VFA by BIA may be a useful target for interventions to improve metabolic syndrome.
Seung Jae Lee,Sangah Kim,Tyler Hyungtaek Rim,Haeyong Pak,Dong Wook Kim,Jong Woon Park 대한안과학회 2020 Korean Journal of Ophthalmology Vol.34 No.4
Purpose: To report incidence rates of primary congenital glaucoma in Korea and evaluate comorbidity and mortality from2001 to 2015. Methods: This study is a nationwide and retrospective population-based study. We used claims data from the Korean NationalHealth Insurance Service database between 2001 and 2015. Data for all patients diagnosed with primary congenitalglaucoma were retrieved using the Korean Electronic Data Interchange and Korean Standard Classification of Diseases-6codes. Results: The number of patients with primary congenital glaucoma between 2001 and 2015 was 776, of which 437 weremale (56.31%) and 339 were female (43.69%). The annual prevalence demonstrated a general decreasing trend since 2011,but this was not significant. Over the total survey period, the incidence rate was 11.0 per 100,000 births, with 12.0 casesamong males and 10.0 among females. The incidence according to age was 518 (68.78%) patients at age 0, 112 (13.66%) at 1year, 70 (8.39%) at 2 years, and 76 (9.17%) at 3 years. Of the 776 patients diagnosed with primary congenital glaucoma in thestudy population, 27 died. The observed mortality per 100,000 people is about 10 times higher than that of the general infantand child population under the age of 4 years. Visual impairment was the most common accompanying disability, followed bybrain lesion. Conclusions: Our study’s estimates of the nationwide population-based incidence of primary congenital glaucoma in a Koreanpopulation will expand our understanding of the disease and allow healthcare systems to plan for primary congenitalglaucoma.
Implication of ultraviolet B radiation exposure for non-melanoma skin cancer in Korea
Lee, Sang Geun,Yoon, Hong Seok,Bae, Hyunjoo,Ha, Jongsik,Pak, Haeyong,Shin, Yongseung,Son, Sang Wook 대한독성유전단백체학회 2014 Molecular & cellular toxicology Vol.10 No.1
Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two most common subtypes of non-melanoma skin cancer (NMSC). Ultraviolet B radiation (UVB) exposure has been correlated with the occurrence of NMSC in humans. Thus far, studies investigating UVB-associated risk factors for NMSC in Asia have not been completed. The goal of this study was to evaluate the impact of UVB radiation exposure on the incidence of NMSC. Using UVB index and National Health Insurance databases, we performed a regression analysis using a linear model to describe the relationship between UVB measurements and NMSC incidence. The cut-off age at which the number of NMSC patients increased significantly was 60 years old. Our study found that 52.2% of NMSC patients were males, while 47.8% were females. There was a strong positive correlation between the annual UVB index and NMSC incidence rates in individuals 60 years and older. Males, individuals 60 years and older and persons who live in higher UVB index in Korea might be susceptible to NMSC.