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Six year national trend of childhood aseptic meningitis incidence in Korea, 1996-2001.
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Hae Kwan Cheong, Sue Kyung Park, Moran Ki, Kwan Lee
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Korean J Epidemiol. 2008;30(2):252-262. Published online December 31, 2008
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DOI: https://doi.org/10.4178/kje.2008.30.2.252
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Abstract
BACKGROUND AND OBJECTIVES: Aseptic meningitis is a disease of children with seasonal outbreak in summer. In spite of high morbidity, it is not notifiable without reported nationwide morbidity. The authors estimated incidence of aseptic meningitis and its descriptive characteristics and time- and space-clustering pattern.
SUBJECTS AND METHODs: Cases of aseptic meningitis were extracted from National Health Insurance payment request data of National Health Insurance Corporation from January 1996 to December 2001. Cases were classified by region, institution, and hospitalization. Standardized incidence was calculated and compared by the region, month of the year whether there is any clustering.
RESULTS Nationwide incidence of aseptic meningitis among children under 15 years old over the six year period was 3.48 per 1,000 per year. Incidence was higher in female (2.80/1,000) compared to male (4.02/1,000). Age-specific incidence was highest in 5 years old. Annual incidence was highest in 1997 (8.44/1,000) and lowest in 2000 (0.79 /1,000) with outbreak every 3 or 4 years. Outbreak was mostly confined in summer months, between May and Septe- mber. However, seasonal pattern was variable by year.
Southern provinces and metropolitan areas had higher incidences and pattern was more prominent in the years with higher outbreak. Time-dependent pattern of the disease from south to north was not prominent.
DISCUSSIONS AND CONCLUSIONS: We have calculated the nationwide incidence of the aseptic meningitis over six year period. In terms of aseptic meningitis, using National Health Insurance data for the estimation of the incidence is a plausible method for the surveillance of the disease.
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- Changes in the Diagnostic Efficiency of Thyroid Fine-Needle Aspiration Biopsy during the Era of Increased Thyroid Cancer Screening in Korea
Young Ki Lee, Kyeong Hye Park, Young Duk Song, Taemi Youk, Joo Young Nam, Sun Ok Song, Dong Yeob Shin, Eun Jig Lee Cancer Research and Treatment.2019; 51(4): 1430. CrossRef - Burden of Disease Attributable to Inadequate Drinking Water, Sanitation, and Hygiene in Korea
Jong-Hun Kim, Hae-Kwan Cheong, Byoung-Hak Jeon Journal of Korean Medical Science.2018;[Epub] CrossRef - Impact of Drinking Water Quality on the Development of Enteroviral Diseases in Korea
Yadav P. Joshi, Jong-Hun Kim, Ho Kim, Hae-Kwan Cheong International Journal of Environmental Research and Public Health.2018; 15(11): 2551. CrossRef - Associations between Meteorological Factors and Aseptic Meningitis in Six Metropolitan Provinces of the Republic of Korea
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Examples and outlook of family-based cohort study.
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Jae Woong Sull, Sue Kyung Park, Heechoul Ohrr, Sun Ha Jee
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Korean J Epidemiol. 2008;30(1):49-59. Published online June 30, 2008
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DOI: https://doi.org/10.4178/kje.2008.30.1.49
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Family-based designs are commonly used in genetic association studies to identify and to locate genes that underlie complex diseases. In this paper, we review two examples of genome-wide association studies using family-based cohort studies, including the Framingham Heart Study and International Multi-Center ADHD Genetics Project.
We also review statistical methods of family-based designs, including the transmission disequilibrium test (TDT), linkage analysis, and imprinting effect analysis. In addition, we evaluate the strengths and limitations of the family-based cohort design. Despite the costs and difficulties in carrying out this type of study, a family-based cohort study can play avery important role in genome wide studies. First, the design will be free from biases due to population heterogeneity or stratification.
Moreover, family-based designs provide the opportunity to conduct joint tests of linkage and association. Finally, family-based designs also allow access to epigenetic phenomena like imprinting. The family-based cohort design should be given careful consideration in planning new studies for genome-wide strategies.
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Outbreak of Measles among School Ages in Yeongju in 2000.
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Hae Kwan Cheong, Geun Ryang Bae, Jin Hwa Jeong, Sue Kyung Park, Byung Chan Park, Jee Hee Kim, Joo Yeon Lee, Byung Kuk Na, Woo Joo Kim
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Korean J Epidemiol. 2004;26(1):69-80.
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BACKGROUND The outbreak of measles from 2000 to 2001 was the biggest epidemic since measles vaccination was introduced in Korea. Outbreak of measles in Yeongju was one of the earliest milestones of the nationwide outbreak in the year 2000. The authors investigated epidemiologic characteristics of the outbreak in this area.METHODS The authors estimated attack rate through the investigation of all the school age cases of measles reported to local health authority between March and May, 2000. Case investigation was done to trace the source of the outbreak. One hundred seventy two cases were examined with medical examination, with interview on their clinical manifestations, and with serologic examination on the anti-measles IgM and IgG antibody.RESULTS Overall attack rate among the school children was 4.3%, with highest attack rate in middle school students (8.5%). The outbreak began in March in middle schools, which spread to elementary and high schools. IgG was positive in 160(93.0%) cases and IgM was positive in 94(54.6%) cases, among which 90 cases (95.7%) were also positive for IgG. IgM positive cases had higher prevalence of rash (91.5%) compared to those without IgM (70.5%). Diagnostic criteria based on the clinical manifestation and contact history showed the highest sensitivity (92.6%) compared to conventional diagnostic criteria in outbreak (40.4-44.7%) CONCLUSIONS: High proportion of susceptible children in the population due to primary or secondary vaccine failure played a key role in this outbreak. Clinical manifestation was milder than classical measles and adjustment of diagnostic criteria can be helpful in the management of outbreak.
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Is Breast Cancer Incidence Rate Further Increasing in Korea?.
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Keun Young Yoo, Hai Rin Shin, Sue Kyung Park, Ha Chung Yoon, Ae Sun Shin, Dae Hee Kang, Dong Young Noh, Kuk Jin Choe
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Korean J Epidemiol. 2001;23(2):1-7.
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Breast cancer ranks second to stomach cancer as a primary cancer site. An increasing trend in mortality and morbidity of breast cancet has been shown since 1980s. Studies on migrant populations, in which higher incidences were shown than population in their motherlands, indicated the importance of environmental factors on breast cancer development. Older age, family history of breast cancer, early menarche, late menopause, late full-term pregnancy, never-having had a breast-fed child, and postmenopausal obesity were idenrified as risk factors in Korea. These are not different from risk factors detected in western countries. Nevertheless, a ^-shape age-specific incidences surve is shown in Korea shose incidence is relatively low.
In western countries, where incidence rates are high, the incidences increase with age in a straight line. This difference may be explained by the "Estrogen-Augmented-:rogesterone Hypothesis" that is relevant to sex hormones. In fact, a nuch lower estradiol levels was reported in Korean women compared to those in American. On the other hand, genetic polymorphism is expected for future research on breast cancer etiology. Only preventive strategies based on epidemiology of breast cancer in Korea may effective to counter this malignancy in Korean women.
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Glutathione S-transferase(GST) M1 and T1 Genetic Polymorphism in Benign Breast Disorders of Korean Women.
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Sue Kyung Park, Mina Ha, Sook Un Kim, Daehee Kang, Keun Young Yoo
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Korean J Epidemiol. 2000;22(1):52-58.
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PURPOSE A hospital-based case-control study was conducted to evaluate the role of glutathione-S-transferase(GST)M1 and GSTT1 genetic polymorphism for developing benign breast disorders(fibrocystic diseases and fibroadenoma) in Korea.
MATERIALS AND METHODS: Histologically confirmed incident cases of benign breast disorder(n=56) were selected from inpatients at the Department of General Surgery, Seoul National University Hospital since 1994. Women with free of self-reporting past history of any malignancies were regarded as controls who were selected from the inpatients at the same department at three hospitals during 1994 to 1998(n=180). Information on life-styles including reproductive factors were obtained by direct interview using questionnaire. Age and menopausal status were matched and 51 cases and 102 controls were finally selected. Odds ratio and 95% confidence interval were estimated by multiple logistic regression after adjusting for age, education, body mass index, smoking history, drinking history, menstrual regularity, age at menarch, age at first pregnancy, frequency of fullterm pregnancy, breast feeding history, duration of breast feeding, and family history of breast cancer.RESULTS GSTM1-null type showed no significance related to the risk of benign breast disorder(adjusted OR=0.8, 95% CI=0.38-1.83) and GSTT1-null type was also not significant(adjusted OR=1.4, 95% CI=0.63-3.29). Increasing tendency of disease risk by the number of GSTs null type was not observed (ptrend>0.1) after adjusting for all other variables.DISCUSSIONS Further investigation with larger sample size should be needed to provide more concrete information on the role of GST genetic polymorphism in benign breast cancer and a lots of studies relation in normal level of GST genetic polymorphism in general population should be performed.
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A Case-Control Study on Risk Factors of Benign Breast Disorders in Korea.
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Sue Kyung Park, Keun Young Yoo, Daehee Kang, Sook Un Kim, Sang Yun Lee, Hyung June Im, Hee Jun Kang, Dong Young Noh, Kuk Jin Choe
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Korean J Epidemiol. 2000;22(1):11-19.
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PURPOSE A hospital-based case-control study was conducted to figure out the risk factors for benign breast disorders in Korea.
MATERIALS AND METHODS: Histologically confirmed incident cases of benign breast disorders(n=54) were selected from inpatients with life-style information at the Department of General Surgery, Seoul National University Hospital during 1994 to 1997. Women with free of self-reporting past history of any malignancies were regarded as controls who were selected from the inpatients at the same department of the same hospital(n=180). Information on life-styles including reproductive factors were obtained by direct interview using questionnaire. Adjusted odds ratios and 95% confidence intervals were estimated by multivariate logistic regression model with matching variables.RESULTS Overall, higher educational level, family history of breast cancer, alcohol drinking, and older age at first fullterm pregnancy related to the risk of benign breast disorders. For premenopausal women, older age, higher educational level, and family history of breast cancer increased the risk of benign breast disorders. For postmenopausal women, alcohol drinking, older age at first fullterm pregnancy, and more frequent experiences of fullterm pregnancy increased the risk. Elder age in postmenopausal women and the experience of breast feeding had, however, protective effect against benign breast disorders.CONCLUSIONS Although the risk factors for benign breast disease may differ from those for breast cancer, these findings are consistent with the hypothesis of excessive circulating estrogen. The present data indicate some risk factors of benign breast disorders are confirmed as risk factors for breast cancer though a substantial agreement between the risk factors for (pathologically confirmed) benign and malignant breast disease.
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Current Status of Multicenter Cancer Cohort Study with Biological Materials Bank in Korea.
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Keun Young Yoo, Hai Rim Shin, Song Hun Chang, Jung Myung Choi, Chang Yup Kim, Kun Sei Lee, Won Jin Lee, Dae Hee Kang, Bu Ok Lee, Duck Hee Lee, Sue Kyung Park, Joo Hon Sung, Yeong Su Ju, Dae Sung Kim, Jong Won Kang, Soo Hun Cho
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Korean J Epidemiol. 1998;20(2):275-278.
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This cohort study is a collaborative effort of 8 institutions. The goal is to establish a large scale cohort that can be followed for 10 or more years to assess the relationship between life-styles and cancer occurrence, and to evaluate the role of environmental exposures in the development of six major sites of cancers(stomach, liver, lung, colorectum, uterine cervix and female breast) in the rural population. Since 1993, 11,304 men and women aged over 35 living in four areas have been recruited. The number of target population is 30,000 persons, which is expected to be successfully recruited until 1999. Each subject has completed a detailed questionnaire on general life-styles, reproductive factors, and agricultural chemical exposures through the interview. Anthropometric measurements with body fat composition and the routine clinical laboratories were examined. For the cancer-free cohort, physical examination by the physicians and serologic tests for hepatitis markers, some tumor markers, and lipid profile have been done, but not all. In order to provide an opportunity to incorporate barious biomarkers of exposure and effect as well as genetic susceptibility, a biologic tissue bank has been established from blood and urine sample(plasma, WBC buffy-coat, RBC clots, and urine supernatant) stored at-70degrees C.
Re-examination of changes in exposere to risk factors will be done periodically. Disease occurrence will be ascertained by the active(mainly through diagnosis by physicians) and the passive surveillance(through both death certificate and screening of medical utilization records).
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Prediction of future breast cancer mortality in Korea.
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Sue Kyung Park, Young Khi Lim, Keun Young Yoo
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Korean J Epidemiol. 1998;20(2):267-274.
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A recent increase in the number of deaths and mortality rates of breast cancer occurred in Korean women. The increases shows a indirect increase in incidence of breast cancer. The number of deaths from breast cancer and the mortality rate in the future would be of use in the perspectives of breast cancer control and management in Korea. This study is to forecast cancer deaths and age-adjusted death rates in the future(2000-2015 year) by fitting modelling, assuming present trends continue. The number and mortality rate of breast cancer were fitted and estimated by simple linear regression mode. Estimated crude death rates for breast cancer per 100,000 persons were 5 person in 2000, 5.99 person in 2005, 6.98 person in 2010, and 7.79 person en 1015. The observed age-adjusted death rates per 100,000 persons were 1.08 person in 1980, 2.03 person in 1985, 2.49 person in 1990, and 3.29 person in 1995 and the estimated age-adjusted death rates per 100,000 persons were 4.01 person in 2000, 4.72 person in 2005, 5.42 person in 2010, and 6.14 person in 2015. Future estimated increase rate of the number of death is 2 times as many as the estimated rate in population-increase. Particularly noteworthy was an increasing tendency of the age-specific death rate with the ages in death, as like a mortality pattern of breast cancer in western females. These findings suggest that cohort effect might significantly contribute to the increase of the number and mortality of breast cancer in Korean women.
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Reproductive Factors Related to Serum Estrogen, Progesterone, and Sex Hormone Binding Globulin in Postmenopausal Women in Korea.
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Chul Hwan Kim, Sue Kyung Park, Heon Kim, Mi Na Ha, Hai Rim Shin, Bu Ok Lee, Dae Sung Kim, Dae Hee Kang, Keun Young Yoo
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Korean J Epidemiol. 1998;20(1):70-81.
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The etiology of breast cancer is not yet clear. Several epidemiologic studies have supported the concepts that endogenous female sex hormones, i.e., estrogen and progesterone, may play a central role in the development of breast cancer. Female reproductive factors such as menstruation, pregnancy, and breast feeding are well-known risk factors of breast cancer. There have been many suggestions that all these factors are midiated by female sex hormeones. However, only a few studies have evaluated the relationship between the reproductive factors and endogenous female sex hormones. This study was designed to evaluate the relationship between the reproductive factors and endogenous female sex hormones in Korean women. We analyzed the relationship between reproductive factors and female sex hormones in 153 premenopausal women 153 postmenopausal women who participated in a community health promotion program in Haman County, Korea. The questionnaires about reproductive factors were completed by personal interview. Serum level of total estradiol(E2), progesterone(:g), and sex hormone binding globulin(SHBG) were measured by radioimmunoassay. There was no significant correlation between age at menarche and E2 in both premenopausal and postmenopausal groups. In postmenopausal subjects, E2 level increased significantly with the age at menopause increasing(r=0.25, p=0.009), adjusting for the potential confounding effect of both age and body mass index. There was a positive correlation between E2 and the intervals between age at menarche and age at menopause(r=0.25, p=0.009). Moreover, the serum level of SHBG was significantly correlated with total months of breast feeding(r=0.19, p=0.048), as well as with age at first fullterm pregnancy(r=-0.24, p=0.01). However, Pg was correlated with none of reproductive factors in both groups.
This study observed that female reproductive factors, e.g., age at menopause, breast feeding, age at first fullterm pregnancy, were correlated with serum female hormones, particularly E2 and SHBG. The results provide an evidence that the relationship between the reproductive factors and breast cancer risk may be mediated, at least in part, through serum female hormones, especially estradiol in Korean women.
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Cigarette Smoking, Alcohol Consumption, and Breast Cancer in Korea.
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Dae Hee Kang, Keun Young Yoo, Sue Kyung Park, Hye Won Koo, Jun Suk Suh, Young Chul Kim, Dong Young Noh, Kuk Jin Choe
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Korean J Epidemiol. 1998;20(1):60-69.
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A hospital-based case-control study was conducted to assess the relationship between cigarette smoking, alcohol consumption, and the risk of bgreast cancer in Korea.
Histologically confirmed incident cases of breast cancer(n=146) were selected from the inpatients at the Department of Surgery, Seoul National University Hospital and Borame Hospital during 1994 to 1997. Women ithout self-reported past history of any malignandies were regarded as controls and selected at the same hospitals during the same period(n-153). Information on life-styles including cigarette smoking, alcohol drinking, and reproductive history were obtained by direct interview using standardixed questionnaire. Each case was matched with one control by 5-year age category(n=146). Adjusted odds ratios and 90% confidence intervals were estimated by unconditional linear logistic regression model. For smokers, age at first smoking was significantly associated with the breat cancer risk(adjusted OR=14.1, 90% CI=1.24-364.2). Particularly noteworthy was an increasing tendency of the breast cancer risk with the duration of alcohol consumtion in years aong alcohol drinkers(ptrend<0.1). These findings suggest that cigarette smoking at an earlier age and alcohol intake might contribute to the risk factor of breast cancer in Korean women. Further investigation on the association between genetic polymorphism of xenobiotic metabolism enxymes of environmental carcinogens and breast cancer should be needed.
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