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1.  Trends in Body Mass Index and Associations With Physical Activity Among Career Soldiers in South Korea 
Objective
This study was designed to describe the trends in body mass index (BMI) during 6 years (2002 - 2008) and to identify associations between these trends and the amount of physical activity of South Korean career soldiers.
Method
This study targeted the 40 993 (38 857 men and 2136 women) of the 58 657 career soldiers who had undergone four (2002, 2004, 2006, and 2008) biennial medical examinations conducted by the National Health Insurance Corporation; 17 664 soldiers with missing data on height, weight, and physical activity were excluded. A linear mixed-regression model was used to categorize changes in BMI due to age versus those due to amount of physical activity.
Results
Career soldiers experienced significant increases in BMI compared with baseline data gathered in 2002. The increases in each age group were as follows: men aged 20- 29: 1.16, men aged 30 - 39: 0.61, men aged 40 - 49: 0.05, women aged 20- 29: 0.35, women aged 30- 39: 0.30, women aged 40-49: 0.26, and women aged 50- 59: 0.21. However, men aged 50 or older showed significant decreases (as high as 0.5) in BMI compared with baseline data obtained in 2002. They also experienced significant decreases in BMI compared with those who reported no physical activity. The differences between baseline and final BMIs were: 0.02 for men exercising 1- 2 times per week, -0.07 for men exercising 3-4 times per week, -0.19 for men exercising 5-6 times per week, -0.21 for men exercising seven times per week, -0.05 for women exercising 1- 2 times per week, -0.19 for women exercising 3- 4 times per week, -0.30 for women exercising 5-6 times per week, and -0.30 for women exercising seven times per week.
Conclusions
Obesity in South Korean career soldiers increased markedly between 2002 and 2008, and our data showed that the amount of physical activity was inversely related to increases in BMI. Policies to prevent obesity are needed to reduce this trend.
doi:10.3961/jpmph.2011.44.4.167
PMCID: PMC3249253  PMID: 21894065
Obesity; BMI; Trend; Career soldier; Physical activity; Exercise
2.  Time Trend and Age-Period-Cohort Effects on Acute Myocardial Infarction Mortality in Korean Adults from 1988 to 2007 
Journal of Korean Medical Science  2011;26(5):637-641.
We examined time trend and age-period-cohort effects on acute myocardial infarction (AMI) mortality in Korean adults from 1988 to 2007. Annual AMI mortality data and population statistics from 1988 to 2007 were obtained from the STATISTICS KOREA website. Age adjusted mortality for four 5-yr calendar periods (1988-1992 to 2003-2007) was calculated by direct standardization using the Year 2000 WHO world standard population. A log-linear Poisson regression model was used to estimate age, period, and cohort effects on AMI mortality. In both genders, age-adjusted AMI mortality increased from period one (1988-1992) to period three (1998-2002) but decreased in period four (2003-2007). An exponential age effect was noted in both genders. The rate ratio of the cohort effect increased up to the 1943 birth cohort and decreased gradually thereafter, and the rate ratio of the period effect increased up to period three (1998-2002) and decreased thereafter. Our results suggest that AMI mortality in Korean adults has decreased since the period 1998-2002 and age, period, and cohort effects have influenced on AMI mortality.
doi:10.3346/jkms.2011.26.5.637
PMCID: PMC3082115  PMID: 21532854
Myocardial infarction; Mortality; Trends
3.  Galectin-8 Expression in Laryngeal Squamous Cell Carcinoma 
Objectives
Despite the ongoing development of treatment protocols for laryngeal squamous cell carcinoma (LSCC), the patients suffering with this malady have shown only a modestly improved outcome. This poor outcome has been attributed to the lack of therapy that's individualized to the tumor's biological properties. Various studies have showed that galectin-8 is widely expressed in tumor tissues as well as in normal tissues, and the level of the galectin-8 expression may correlate with the malignancy of human squamous cell carcinoma. The purpose of this study is to evaluate the expression of galectin-8 and to investigate its correlations with the primary stage, the nodal involvement, the clinical stage and the histologic grade of squamous cell carcinoma of the larynx.
Methods
The paraffin-embedded tissue specimens from 77 patients who were diagnosed as LSCC between 1993 and 2007 were immunohistochemically stained for galectin-8.
Results
Immunohistochemical analysis showed that a strong positive expression of galectin-8 was correlated with the T-stages, the nodal stages and the clinical stages. However, the histopathologic grades were not correlated with the galectin-8 expression in LSCC.
Conclusion
The expression of galectin-8 protein can be used as a prognostic factor for patients with LSCC.
doi:10.3342/ceo.2009.2.1.13
PMCID: PMC2671827  PMID: 19434286
Galectin-8; Immunohistochemistry; Larynx; Squamous cell carcinoma
5.  Effects of 17β-Estradiol and Estrogen Receptor Antagonists on the Proliferation of Gastric Cancer Cell Lines 
Journal of Gastric Cancer  2013;13(3):172-178.
Purpose
The aims of this study were as follow: 1) to de scribe the expression status of estrogen receptor-α and -β mRNAs in five gastric carcinoma cell lines; 2) to evaluate in vitro the effects of 17β-estradiol and estrogen receptor antagonists on the proliferation of the cell lines.
Materials and Methods
Detection of estrogen receptor-α and estrogen receptor-β mRNA in five human gastric cancer cell lines (AGS, KATO III, MKN28, MKN45 and MKN74) was made by the reverse transcription-polymerase chain reaction system. To evaluate the effect of 17β-estradiol and estrogen receptor antagonists on the proliferation of gastric cancer cell line, the cell lines which expressed both es trogen receptors were chosen and treated with 17β-estradiol and estrogen receptor antagonists (methyl-piperidino-pyrazole and pyrazolo [1,5-a] pyrimidine). Cell proliferation was assessed with the methylthiazol tetrazolium test.
Results
Estrogen receptor-α and estrogen receptor-β mRNAs were expressed in three (KATO III, MKN28 and MKN45) and all of the five gastric cancer cell lines, respectively. At higher concentrations, 17β-estradiol inhibited cell growth of MKN28, MKN45 and KATO III cell lines. Neither estrogen receptor-α nor estrogen receptor-β antagonist blocked the anti-proliferative effect of 17β-estradiol.
Conclusions
Our results indicate that estrogen receptor-β mRNAs are preferentially expressed in gastric cancers and also imply that hormone therapy rather than estrogen receptor blockers may be a useful strategy for the treatment of estrogen receptor-β positive gastric cancer. Its therapeutic significance in gastric cancer are, however, limited until more evidence of the roles of estrogen receptors in the gastric cancer are accumulated.
doi:10.5230/jgc.2013.13.3.172
PMCID: PMC3804676  PMID: 24156037
Estrogens; Receptors, estrogen; Stomach neoplasms; Cell line
6.  Mechanisms of Hearing Loss after Blast Injury to the Ear 
PLoS ONE  2013;8(7):e67618.
Given the frequent use of improvised explosive devices (IEDs) around the world, the study of traumatic blast injuries is of increasing interest. The ear is the most common organ affected by blast injury because it is the body’s most sensitive pressure transducer. We fabricated a blast chamber to re-create blast profiles similar to that of IEDs and used it to develop a reproducible mouse model to study blast-induced hearing loss. The tympanic membrane was perforated in all mice after blast exposure and found to heal spontaneously. Micro-computed tomography demonstrated no evidence for middle ear or otic capsule injuries; however, the healed tympanic membrane was thickened. Auditory brainstem response and distortion product otoacoustic emission threshold shifts were found to be correlated with blast intensity. As well, these threshold shifts were larger than those found in control mice that underwent surgical perforation of their tympanic membranes, indicating cochlear trauma. Histological studies one week and three months after the blast demonstrated no disruption or damage to the intra-cochlear membranes. However, there was loss of outer hair cells (OHCs) within the basal turn of the cochlea and decreased spiral ganglion neurons (SGNs) and afferent nerve synapses. Using our mouse model that recapitulates human IED exposure, our results identify that the mechanisms underlying blast-induced hearing loss does not include gross membranous rupture as is commonly believed. Instead, there is both OHC and SGN loss that produce auditory dysfunction.
doi:10.1371/journal.pone.0067618
PMCID: PMC3698122  PMID: 23840874
7.  Heritabilities of Facial Measurements and Their Latent Factors in Korean Families 
Genomics & Informatics  2013;11(2):83-92.
Genetic studies on facial morphology targeting healthy populations are fundamental in understanding the specific genetic influences involved; yet, most studies to date, if not all, have been focused on congenital diseases accompanied by facial anomalies. To study the specific genetic cues determining facial morphology, we estimated familial correlations and heritabilities of 14 facial measurements and 3 latent factors inferred from a factor analysis in a subset of the Korean population. The study included a total of 229 individuals from 38 families. We evaluated a total of 14 facial measurements using 2D digital photographs. We performed factor analysis to infer common latent variables. The heritabilities of 13 facial measurements were statistically significant (p < 0.05) and ranged from 0.25 to 0.61. Of these, the heritability of intercanthal width in the orbital region was found to be the highest (h2 = 0.61, SE = 0.14). Three factors (lower face portion, orbital region, and vertical length) were obtained through factor analysis, where the heritability values ranged from 0.45 to 0.55. The heritability values for each factor were higher than the mean heritability value of individual original measurements. We have confirmed the genetic influence on facial anthropometric traits and suggest a potential way to categorize and analyze the facial portions into different groups.
doi:10.5808/GI.2013.11.2.83
PMCID: PMC3704931  PMID: 23843774
facial bones; genetic research; statistical factor analysis
8.  Weight Change as a Predictor of Incidence and Remission of Insulin Resistance 
PLoS ONE  2013;8(5):e63690.
Objective
The objective of this study was to assess the longitudinal relationship of weight change on incidence and remission of insulin resistance (IR).
Methods
We performed a cohort study in apparently healthy Korean men, 30 to 59 years of age, who underwent a health checkup and were followed annually or biennially between 2002 and 2009. The computer model of homeostasis model assessment, HOMA2-IR, was obtained at each visit, and IR was defined as HOMA2-IR ≥75th percentile.
Results
For IR development, 1,755 of the 6,612 IR-free participants at baseline developed IR (rate 5.1 per 100 person-years) during 34,294.8 person-years of follow-up. The hazard ratios (95% confidence intervals) for incident IR with weight changes of <−0.9 kg, 0.6–2.1 kg and ≥2.2 kg from visit 1 to visit 2 (average 1.8 years) compared to weight change of −0.9–0.5 kg (reference) were 0.78 (0.68–0.90), 1.19 (1.04–1.35) and 1.26 (1.11–1.44), respectively. This association persisted in normal-weight individuals or those without any metabolic syndrome traits and remained significant after introducing weight categories and confounders as time-dependent exposures (P-trend <0.001). For IR remission, 903 of 1,696 IR participants had no IR (remission rate 10.3 per 100 person-years) during 8,777.4 person-years of follow-up. IR remission decreased with increasing quartiles of weight change (P-trend <0.001) and this association persisted in normal-weight individuals.
Conclusions
Weight gain was associated with increased IR development and decreased IR remission regardless of baseline BMI status. Preventing weight gain, even in healthy and normal-weight individuals, is an important strategy for reducing IR and its associated consequences.
doi:10.1371/journal.pone.0063690
PMCID: PMC3661661  PMID: 23717466
9.  Prevalence and Risk Factors of Atrophic Gastritis and Intestinal Metaplasia: A Nationwide Multicenter Prospective Study in Korea 
Gut and Liver  2013;7(3):303-310.
Background/Aims
Atrophic gastritis (AG) and intestinal metaplasia (IM) are premalignant gastric lesions. The aims of this study were to evaluate the prevalence of endoscopic AG and IM and to document the risk factors for these lesions.
Methods
In total, 4,023 subjects were enrolled at eight hospitals in Korea. AG and IM were diagnosed by endoscopy. Helicobacter pylori immunoglobulin G antibodies were measured.
Results
The prevalences of endoscopic AG and IM were 40.7% and 12.5%. In a multivariate analysis, the risk factors for AG were age groups of 40 to 59 years and >60 years, male sex, positive H. pylori serology, IM, and education below the college level (odds ratio [OR], 2.55, 5.00, 1.38, 1.41, 4.29, and 1.35, respectively). The risk factors for IM were age groups of 40 to 59 years and >60 years, male sex, positive H. pylori serology, AG, having relatives with gastric cancer, education below the college level and consumption of dairy products (OR, 3.16, 3.25, 1.88, 2.17, 3.68, 1.48, 1.47, and 1.40, respectively).
Conclusions
A nationwide survey regarding the prevalence of endoscopic AG and IM and their risk factors in Korea supports the hypothesis that endoscopic diagnosis of these premalignant lesions could be helpful to describe a group at high risk for gastric cancer.
doi:10.5009/gnl.2013.7.3.303
PMCID: PMC3661962  PMID: 23710311
Atrophic gastritis; Intestinal metaplasia; Prevalence; Risk factors; Endoscopy
10.  Comparison of Cardiovascular Risk Factors for Peripheral Artery Disease and Coronary Artery Disease in the Korean Population 
Korean Circulation Journal  2013;43(5):316-328.
Background and Objectives
The objective of this study was to analyze and compare risk factors for peripheral artery disease (PAD) and coronary artery disease (CAD).
Subjects and Methods
The sample included 7936 Korean patients aged ≥20 years who were hospitalized from 1994 to 2004. Of the 7936 subjects, PAD (n=415), CAD (n=3686), and normal controls (Control) (n=3835) were examined at the Health Promotion Center, Samsung Medical Center.
Results
The mean age (years) of PAD subjects was 64.4 (±9.3), while CAD subjects was 61.2 (±9.9), and Control subjects was 59.9 (±9.1) (p<0.01). The proportion of males was 90.6% for PAD, 71.4% for CAD, and 75.5% for Control subjects (p<0.01). The adjusted odds ratios (ORs) for hypertension, diabetes mellitus, hypercholesterolemia, smoking, metabolic syndrome and chronic kidney disease were significantly higher in subjects with PAD or CAD compared to those in Control. However, the ORs for high density lipoprotein, being overweight, and being obese were significantly lower in PAD subjects compared to those in Control.
Conclusion
We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.
doi:10.4070/kcj.2013.43.5.316
PMCID: PMC3675306  PMID: 23755078
Peripheral artery disease; Coronary artery disease; Risk factors
11.  Intensive Exercise Reduces the Fear of Additional Falls in Elderly People: Findings from the Korea Falls Prevention Study 
Background/Aims
Falls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously.
Methods
A randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks.
Results
After the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p < 0.001). When asked whether they were afraid of falling, more participants in the EG than in the CG responded "not at all" or "a little."
Conclusions
The 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.
doi:10.3904/kjim.2012.27.4.417
PMCID: PMC3529241  PMID: 23269883
Fear; Accidental falls; Aging; Exercise; Prevention
12.  Epidemiological Characteristics of Novel Influenza A (H1N1) in Antiviral Drug Users in Korea 
PLoS ONE  2012;7(10):e47634.
Soon after the first novel influenza A (H1N1) death was documented in Korea on August 15, 2009, prompt treatment with antiviral drugs was recommended when an infection was suspected. Free antiviral drugs were distributed to patients who met the case definition in the treatment guidelines, and patients prescribed the antiviral drugs were included in the Antiviral Drug Surveillance System (ADSS). A total of 2,825,821 patients were reported to the ADSS from September 1 to December 31, 2009. Odds ratios were calculated to compare the risks of severe diseases, as indicated by general hospital admissions or intensive care unit (ICU) admissions according to demographic characteristics, underlying medical conditions, and behavioral factors. Approximately 6% of the total population received antiviral drugs during the study period. Of these, 2,709,611 (95.9%) were outpatients, 114,840 (4.06%) were hospitalized, and 1,370 (0.05%) were admitted to the ICU. Children aged 0–9 yr accounted for 33.94% of all reported cases, whereas only 3.89% of the patients were ≥ 60 yr. The estimated incidence of novel influenza A (H1N1) during the pandemic was 5.68/100 of all reported cases. Mortality due to influenza A (H1N1) during the pandemic was 0.33/100,000, with the highest mortality of 1.31/100,000 for patients aged ≥ 60 years. Severe pandemic H1N1 influenza was associated with the presence of one or more underlying medical conditions in elderly aged ≥ 60 years and with lower economic status. Moreover, influenza A (H1N1) appeared to be age-specific in terms of mortality. Although the incidence and admission rates of influenza A (H1N1) were higher in younger age groups, fatal cases were much more likely to occur in the elderly (≥60 years). In contrast to earlier influenza A (H1N1) reports, the risks of a severe outcome were elevated among those who were underweight (body mass index < 18.5 kg/m2).
doi:10.1371/journal.pone.0047634
PMCID: PMC3474727  PMID: 23082184
13.  Nasal Hemangiopericytoma Causing Oncogenic Osteomalacia 
Oncogenic osteomalacia is a rare cause that makes abnormalities of bone metabolism. Our case arose in a 47-year-old woman presenting a nasal mass associated with osteomalacia. We excised the mass carefully. After surgery, it was diagnosed as hemangiopericytoma and her symptoms related with osteomalacia were relieved and biochemical abnormalities were restored to normal range. We report and review a rare case of nasal hemangiopericytoma that caused osteomalacia.
doi:10.3342/ceo.2012.5.3.173
PMCID: PMC3437420  PMID: 22977716
Nasal hemangiopericytoma; Osteomalacia
14.  Increasing Prevalence of Metabolic Syndrome in Korea 
Diabetes Care  2011;34(6):1323-1328.
OBJECTIVE
The number of people with metabolic syndrome is increasing worldwide, and changes in socioenvironmental factors contribute to this increase. Therefore, investigation of changes in metabolic syndrome and its components in South Korea, where rapid socioenvironmental changes have occurred in recent years, would be foundational in setting up an effective strategy for reducing this increasing trend.
RESEARCH DESIGN AND METHODS
We compared the prevalence and pattern of metabolic syndrome among participants in the Korean National Health and Nutrition Examination Surveys for 1998, 2001, 2005, and 2007. In each survey, stratified, multistage, probability–sampling designs and weighting adjustments were conducted to represent the entire Korean population. The revised National Cholesterol Education Program criteria were used as the definition of metabolic syndrome. All biochemical parameters were measured in a central laboratory.
RESULTS
A total of 6,907 (mean ± SE age 45.0 ± 0.2 years), 4,536 (45.5 ± 0.2), 5,373 (47.1 ± 0.2), and 2,890 (49.9 ± 0.3) Koreans over 20 years of age have participated in the studies in 1998, 2001, 2005, and 2007, respectively. The age-adjusted prevalence of metabolic syndrome increased significantly from 24.9% in 1998, 29.2% in 2001, and 30.4% in 2005 to 31.3% in 2007. Among the five components, the level of low HDL cholesterol increased the most, by 13.8% over the 10 years. Abdominal obesity and hypertriglyceridemia followed, with 8.7 and 4.9% increases, respectively.
CONCLUSIONS
Because dyslipidemia and abdominal obesity were major factors in increasing the prevalence of metabolic syndrome in Koreans for the past 10 years, lifestyle interventions should be conducted at the national level to reduce the burden and consequences of metabolic syndrome.
doi:10.2337/dc10-2109
PMCID: PMC3114326  PMID: 21505206
15.  Prevalence of Positive Carriage of Tuberculosis, Methicillin-resistant Staphylococcus aureus, and Vancomycin-resistant Enterococci in Patients Transported by Ambulance: A Single Center Observational Study 
Objectives
An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE) in patients transported by ambulance.
Methods
This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection.
Results
The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively.
Conclusions
A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.
doi:10.3961/jpmph.2012.45.3.174
PMCID: PMC3374967  PMID: 22712044
Prevalence; Infection; Tuberculosis; Resistance; Emergency medical services
16.  Health Conditions Sensitive to Retirement and Job Loss Among Korean Middle-aged and Older Adults 
Objectives
This study was conducted to examine the association between health condition and leaving the labor market among middle-aged and older adults in South Korea.
Methods
Data was obtained from individuals aged 45 years and older participating in the 2006 and 2008 Korean Longitudinal Study of Ageing. We used various health measures including chronic diseases, comorbidities, traffic accident injuries, disabilit of instrumental activities of daily living, depressive symptoms, and self-rated health. The odds ratios of job loss, and retirement, versus employment were calculated using multinomial logistic regression by each health measure.
Results
In our cross-sectional and longitudinal analysis, health problems related to physical disabilities had the greatest effect on leaving the worksite. A shift in health condition from good to poor in a short period was a predictor of increased risk of unemployment but a persistent pattern of health problems was not associated with unemployment. Women with health problems showed a high probability of retirement, whereas among men, health problems instantly the possibility of both job loss and retirement.
Conclusions
Health problems of middle aged and older workers were crucial risk factors for retirement and involuntarily job loss. Especially functional defect and recent health problems strongly and instanty affected employment status.
doi:10.3961/jpmph.2012.45.3.188
PMCID: PMC3374969  PMID: 22712046
Chronic disease; Disability; Depression; Wounds and injuries; Retirement; Job loss
17.  Trends in Gender-based Health Inequality in a Transitional Society: A Historical Analysis of South Korea 
Objectives
This study examined the trends in gender disparity in the self-rated health of people aged 25 to 64 in South Korea, a rapidly changing society, with specific attention to socio-structural inequality.
Methods
Representative sample data were obtained from six successive, nationwide Social Statistics Surveys of the Korean National Statistical Office performed during 1992 to 2010.
Results
The results showed a convergent trend in poor self-rated health between genders since 1992, with a sharper decline in gender disparity observed in younger adults (aged 25 to 44) than in older adults (aged 45 to 64). The diminishing gender gap seemed to be attributable to an increase in women's educational attainment levels and to their higher status in the labor market.
Conclusions
The study indicated the importance of equitable social opportunities for both genders for understanding the historical trends in the gender gap in the self-reported health data from South Korea.
doi:10.3961/jpmph.2012.45.2.113
PMCID: PMC3324714  PMID: 22509452
Health gender gap; Self-rated health trend; Society change; Women's status
18.  Aging over 70 Years Is Not a Decisively Dismal Prognostic Factor in Gastric Cancer Surgery 
Journal of Gastric Cancer  2011;11(4):200-205.
Purpose
Gastric cancer has a high incidence and mortality rate in Korea. Despite a growing older population and an increase in the number of older patients with gastric cancer, the older patients are not willing to undergo surgery due to their operative risks. Hence, to determine the clinical characteristics and outcomes of gastric cancer surgery for them, we investigate factors influencing the treatment decision.
Materials and Methods
Between January 1996 and December 2005, a total of 1,519 patients were classified into two groups; the younger age group between 41 and 69 years of age, and the older age group of 70 years or older. The analysis conducted included patient characteristics, accompanying disorders, related American Society of Anesthesiologists (ASA) grade, pathological characteristics and survival rate for each age group.
Results
Significant differences were found in the ASA grade (P<0.001) and the number of accompanying disorders (P<0.001) between the two groups. The average length of hospital stay after surgery was 14.5 days in the younger age group, and 13.3 days in the older age group (P=0.065). The average survival time was 47.5 months in the younger age group, and 43.2 months in the older age group (P<0.001).
Conclusions
This study demonstrated that there was more number of accompanying disorders with a high surgical risk in the older age group. However, there was no significant difference between the older and younger age groups in terms of the incidence of complications, under the given disease conditions and if proper management was provided.
doi:10.5230/jgc.2011.11.4.200
PMCID: PMC3273689  PMID: 22324010
Stomach neoplasms; Aged; Survival
19.  Genome-wide linkage analysis for ocular and nasal anthropometric traits in a Mongolian population 
Experimental & Molecular Medicine  2010;42(12):799-804.
Anthropometric traits for eyes and nose are complex quantitative traits influenced by genetic and environmental factors. To date, there have been few reports on the contribution of genetic influence to these traits in Asian populations. The aim of this study was to determine the genetic effect and quantitative trait locus (QTL) of seven traits eyes- and nose-related anthropometric measurements in an isolated Mongolian population. Frontal and lateral photographs were obtained from 1,014 individuals (434 males and 580 females) of Mongolian origin. A total of 349 short tandem repeat markers on 22 autosomes were genotyped for each individual. Heritability estimates of the seven ocular and nasal traits, adjusted for significant covariates, ranged from 0.48 to 0.90, providing evidence for a genetic influence. Variance-component linkage analyses revealed 10 suggestive linkage signals on 5q34 (LOD = 3.2), 18q12.2 (LOD = 2.7), 5q15 (LOD = 2.0), 9q34.2 (LOD = 1.9), 5q34 (LOD = 1.9), 17q22 (LOD = 1.9), 13q33.3 (LOD = 2.7), 1q36.22 (LOD = 1.9), 4q32.1 (LOD = 2.1) and 15q22.31 (LOD = 2.9). Our study provides the first evidence that genetics influences nasal and ocular traits in a Mongolian population. Additional collaborative efforts will further extend our understanding of the link between genetic factors and human anthropometric traits.
doi:10.3858/emm.2010.42.12.080
PMCID: PMC3015153  PMID: 21150245
anthropometry; eye; genetic linkage; nose; quantitative trait loci
20.  Granular Cell Tumor on Larynx 
Granular cell tumors (GCTs) are uncommon neoplasm. They can originate in any part of the body. The most common sites of origin are in the head and neck, while the larynx is a relatively uncommon location. Patients affected with a laryngeal GCT typically present with persistent hoarseness, stridor, hemoptysis, dysphagia, and otalgia but, the tumor may be asymptomatic. Care must be taken to differentiate this lesion from others due to the presence of pseudo-epitheliomatous hyperplasia which overlies the GCT and may occasionally mimic squamous cell carcinoma. Therefore, a confirmative diagnosis should be made histopathologically and should be supported by immunohistochemical staining. These tumors are treated by complete surgical resection. Examining the complete removal of the tumor through securing a negative free margin is considered to be a consequential procedure. We experienced a 64-yr-old man with a laryngeal granular cell tumor involving the right true vocal cord. He was treated by surgical resection under a fine dissection laryngomicroscope. Here we present this case and a review of literature.
doi:10.3342/ceo.2010.3.1.52
PMCID: PMC2848320  PMID: 20379404
Granular cell tumor; Larynx
21.  Analysis of genetic and non-genetic factors that affect the QTc interval in a Mongolian population: the GENDISCAN study 
Experimental & Molecular Medicine  2009;41(11):841-848.
The QTc interval is a complex quantitative trait and a strong prognostic indicator of cardiovascular mortality in general, healthy people. The aim of this study was to identify non-genetic factors and quantitative trait loci that govern the QTc interval in an isolated Mongolian population. We used multiple regression analysis to determine the relationship between the QTc interval and non-genetic factors including height, blood pressure, and the plasma lipid level. Whole genome linkage analyses were performed to reveal quantitative trait loci for the QTc interval with 349 microsatellite markers from 1,080 Mongolian subjects. Among many factors previously known for association with the QTc interval, age, sex, heart rate, QRS duration of electrocardiogram and systolic blood pressure were also found to have influence on the QTc interval. A genetic effect for the QTc interval was identified based on familial correlation with a heritability value of 0.31. In a whole genome linkage analysis, we identified the four potential linkage regions 7q31-34, 5q21, 4q28, and 2q36.
doi:10.3858/emm.2009.41.11.090
PMCID: PMC2788738  PMID: 19641374
electrocardiography; linkage (genetics); long QT syndrome; quantitative trait, heritable; quantitative trait loci; regression analysis
22.  Timeliness of national notifiable diseases surveillance system in Korea: a cross-sectional study 
BMC Public Health  2009;9:93.
Background
With the increase of international travels, infectious disease control is gaining a greater importance across regional borders. Adequate surveillance system function is crucial to prevent a global spread of infectious disease at the earliest stage. There have been limited reports on the characteristics of infectious disease surveillance in Asia. The authors studied the timeliness of the Korean National Notifiable Disease Surveillance System with regard to major notifiable diseases from 2001 to 2006.
Methods
Six notifiable infectious diseases reported relatively frequently were included in this study. Five diseases were selected by the criteria of reported cases > 100 per year: typhoid fever, shigellosis, mumps, scrub typhus, and hemorrhagic fever with renal syndrome. In addition, dengue fever was also included to represent an emerging disease, despite its low number of cases. The diseases were compared for the proportion notified within the recommended time limits, median time lags, and for the cumulative distribution of time lags at each surveillance step between symptom onset and date of notification to the Korea Centers for Disease Control and Prevention (KCDC).
Results
The proportion of cases reported in time was lower for disease groups with a recommended time limit of 1 day compared with 7 days (60%–70% vs. > 80%). The median time from disease onset to notification to KCDC ranged between 6 and 20 days. The median time from onset to registration at the local level ranged between 2 and 15 days. Distribution of time lags showed that main delays arose in the time from onset to diagnosis. There were variations in timeliness by disease categories and surveillance steps.
Conclusion
Time from disease onset to diagnosis generally contributed most to the delay in reporting. It is needed to promote public education and to improve clinical guidelines. Rapid reporting by doctors should be encouraged, and unification of recommended reporting time limit can be helpful. Our study also demonstrates the utility of the overall assessment of time-lag distributions for disease-specific strategies to improve surveillance.
doi:10.1186/1471-2458-9-93
PMCID: PMC2676269  PMID: 19331696
23.  A closer look at the increase in suicide rates in South Korea from 1986–2005 
BMC Public Health  2009;9:72.
Background
Suicide rates have recently been decreasing on average among OECD countries, but increasing trends have been detected in South Korea, particularly since the 1997 economic crisis. There have been no detailed analyses about the changes of the suicide rates over time periods in Korea. We examined trends in both absolute and proportional suicide rates over the time period of economic development, crisis, and recovery (1986 – 2005) as well as in birth cohorts from 1924 to 1978.
Methods
We used data on total mortality and suicide rates from 1986 to 2005 published online by the Korean National Statistical Office (NSO) and extracted data for individuals under 80 years old. The analyses of the trends for 1) the sex-age-specific total mortality rate, 2) the sex-age-specific suicide rate, and 3) the sex-age-specific proportional suicide rate in 1986–2005 were conducted. To demonstrate the birth cohort effect on the proportional suicide rate, the synthetic birth cohort from 1924 to 1978 from the successive cross-sectional data was constructed.
Results
Age standardized suicide rates in South Korea increased by 98% in men (from 15.3 to 30.3 per 100,000) and by 124% in women (from 5.8 to 13.0 per 100,000). In both genders, the proportional increase in suicide rates was more prominent among the younger group aged under 45, despite the absolute increase being attributed to the older group. There were distinct cohort effects underlying increasing suicide rates particularly among younger age groups.
Conclusion
Increasing suicide rates in Korea was composed of a greater absolute increase in the older group and a greater proportional increase in the younger group.
doi:10.1186/1471-2458-9-72
PMCID: PMC2667417  PMID: 19250535
24.  A genome-wide Asian genetic map and ethnic comparison: The GENDISCAN study 
BMC Genomics  2008;9:554.
Background
Genetic maps provide specific positions of genetic markers, which are required for performing genetic studies. Linkage analyses of Asian families have been performed with Caucasian genetic maps, since appropriate genetic maps of Asians were not available. Different ethnic groups may have different recombination rates as a result of genomic variations, which would generate misspecification of the genetic map and reduce the power of linkage analyses.
Results
We constructed the genetic map of a Mongolian population in Asia with CRIMAP software. This new map, called the GENDISCAN map, is based on genotype data collected from 1026 individuals of 73 large Mongolian families, and includes 1790 total and 1500 observable meioses. The GENDISCAN map provides sex-averaged and sex-specific genetic positions of 1039 microsatellite markers in Kosambi centimorgans (cM) with physical positions. We also determined 95% confidence intervals of genetic distances of the adjacent marker intervals.
Genetic lengths of the whole genome, chromosomes and adjacent marker intervals are compared with those of Rutgers Map v.2, which was constructed based on Caucasian populations (Centre d'Etudes du Polymorphisme Humain (CEPH) and Icelandic families) by mapping methods identical to those of the GENDISCAN map, CRIMAP software and the Kosambi map function. Mongolians showed approximately 1.9 fewer recombinations per meiosis than Caucasians. As a result, genetic lengths of the whole genome and chromosomes of the GENDISCAN map are shorter than those of Rutgers Map v.2. Thirty-eight marker intervals differed significantly between the Mongolian and Caucasian genetic maps.
Conclusion
The new GENDISCAN map is applicable to the genetic study of Asian populations. Differences in the genetic distances between the GENDISCAN and Caucasian maps could facilitate elucidation of genomic variations between different ethnic groups.
doi:10.1186/1471-2164-9-554
PMCID: PMC2612022  PMID: 19025666
25.  Heritability and linkage study on heart rates in a Mongolian population 
Experimental & Molecular Medicine  2008;40(5):558-564.
Elevated heart rate has been proposed as an independent risk factor for cardiovascular diseases, but their interrelationships are not well understood. In this study, we performed a genome-wide linkage scan in 1,026 individuals (mean age 30.6 years, 54.5% women) from 73 extended families of Mongolia and determined quantitative trait loci that influence heart rate. The DNA samples were genotyped using deCODE 1,039 microsatellite markers for 3 cM density genome-wide linkage scan. Correlation analysis was carried out to evaluate the correlation of the covariates and the heart rate. T-tests of the heart rate were also performed on sex, smoking and alcohol intake. Consequently, this model was used in a nonparametric genome-wide linkage analysis using variance component model to create a multipoint logarithm of odds (LOD) score and a corresponding P value. In the adjusted model, the heritability of heart rate was estimated as 0.32 (P < .0001) and a maximum multipoint LOD score of 2.03 was observed in 77 cM region at chromosome 18. The second largest LOD score of 1.52 was seen on chromosome 5 at 216 cM. Genes located on the specified locations in chromosomes 5 and 18 may be involved in the regulation of heart rate.
doi:10.3858/emm.2008.40.5.558
PMCID: PMC2679351  PMID: 18985014
cardiovascular diseases; chromosome mapping; genomics; heart rate; Mongolia

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