지역 간 건강수준 비교를 위한 표준화율 적용의 적절성 평가: 2008년 지역사회건강조사를 바탕으로

권근용,임도상,박은자,정지선,강기원,김윤아,김호,조성일,Kwon, Geun-Yong,Lim, Do-Sang,Park, Eun-Ja,Jung, Ji-Sun,Kang, Ki-Won,Kim, Yun-A,Kim, Ho,Cho, Seong-Il 대한예방의학회 2010 예방의학회지 Vol.43 No.2

Objectives: This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. Methods: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. Results: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. Conclusions: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

Imported Melioidosis in South Korea: A Case Series with a Literature Review

김승우,권근용,김봉영,권동혁,신재승,배근량 질병관리본부 2015 Osong Public Health and Research Persptectives Vol.6 No.6

Objectives: Melioidosis is a potentially fatal infectious disease caused by the environmental anaerobic Gram-negative bacillus Burkholderia pseudomallei. Melioidosis is endemic to areas of northern Australia and Southeast Asia. With increasing international travel and migration, imported cases of melioidosis are being reported regularly. Here, we summarize the 11 cases of melioidosis reported in South Korea from 2003 to 2014. Methods: Tracing epidemiological investigations were performed on every patient reported to the National Surveillance System since 2011. A systematic literature search was performed to identify melioidosis cases that occurred prior to 2011. Results: The overall fatality rate was 36.4%. All the patients had visited Southeast Asia where melioidosis is endemic. The stay in the endemic region ranged from 4 days to 20 years. Of the seven patients who developed initial symptoms after returning to South Korea, the time interval between returning to South Korea and symptom onset ranged from 1 day to 3 years. The remaining four patients developed symptoms during their stay in the endemic region and were diagnosed with melioidosis in South Korea. Seven (63.6%) patients possessed at least one risk factor, all of whom were diabetic. Pneumonia was the most frequent clinical manifestation, but the patients showed a wide spectrum of clinical features, including internal organ abscesses, a mycotic aneurysm of the aorta, and coinfection with tuberculosis. Conclusion: An early diagnosis and initiation of the appropriate antibiotics can reduce the mortality of melioidosis. Consequently, increased awareness of the risk factors and clinical features of melioidosis is required.

Comparison of the 3D Digital Photogrammetry and Direct Anthropometry in Unilateral Cleft Lip Patients

석효현,권근용,백승학,최태현,김석화,Seok, Hyo Hyun,Kwon, Geun-Yong,Baek, Seung-Hak,Choi, Tae Hyun,Kim, Sukwha Korean Cleft Palate-Craniofacial Association 2013 Archives of Craniofacial Surgery Vol.14 No.1

Background: In cleft lip patients, the necessity of a thorough preoperative analysis of facial deformities before reconstruction is unquestioned. The surgical plan of cleft lip patient is based on the information gained from our preoperative anthropometric evaluation. A variety of commercially available three-dimensional (3D) surface imaging systems are currently introduced to us in plastic surgery for these use. However, few studies have been published on the soft tissue morphology of unrepaired cleft infants described by these 3D surface imaging systems. Methods: The purpose of this study is to determine the accuracy of facial anthropometric measurements obtained through digital 3D photogrammetry and to compare with direct anthropometry for measurement in unilateral cleft lip patients. We compared our patients with three measurements of dimension made on both sides: heminasal width, labial height, and transverse lip length. Results: The preoperative measurements were not significantly different in both side of labial height and left side of heminasal width. Statistically significant differences were found on both side of transverse lip length and right side of heminasal width. Although the half of preoperative measurements were significantly different, trends of results showed average results were comparable. Conclusion: This is the first study in Korea to simultaneously compare digital 3D photogrammetry with traditional direct anthropometry in unilateral cleft lip patients. We desire this study could contribute the methodological choice of the many researchers for proper surgical planning in cleft lip reconstruction field.

Directed Causal Network Construction Using Linkage Analysis with Metabolic Syndrome-Related Expression Quantitative Traits

김기주,민진영,권근용,성주헌,조성일 한국유전체학회 2011 Genomics & informatics Vol.9 No.4

In this study, we propose a novel, intuitive method of constructing an expression quantitative trait (eQT) network that is related to the metabolic syndrome using LOD scores and peak loci for selected eQTs, based on the concept of gene-gene interactions. We selected 49eQTs that were related to insulin resistance. A variance component linkage analysis was performed to explore the expression loci of each of the eQTs. The linkage peak loci were investigated, and the "support zone" was defined within boundaries of an LOD score of 0.5 from the peak. If one gene was located within the "support zone" of the peak loci for the eQT of another gene, the relationship was considered as a potential "directed causal pathway" from the former to the latter gene. SNP markers under the linkage peaks or within the support zone were searched for in the database to identify the genes at the loci. Two groups of gene networks were formed separately around the genes IRS2 and UGCGL2. The findings indicated evidence of networks between genes that were related to the metabolic syndrome. The use of linkage analysis enabled the construction of directed causal networks. This methodology showed that characterizing and locating eQTs can provide an effective means of constructing a genetic network.

독사교상 환자에서 응급 처치와 합병증의 연관성

전재천,이동하,권근용,김성진,Jeon, Jae-Cheon,Lee, Dong-Ha,Kwon, Geun-Yong,Kim, Sung-Jin 대한임상독성학회 2009 대한임상독성학회지 Vol.7 No.2

Purpose: There have been local wound complications in patients who have received first aid after venomous snake bites. Yet first aid in relation to local wound complications has not been well studied. Methods: We conducted a 5-year retrospective study of 111 snake bite patients who visited the emergency departments of several medical centers between January 2004 and December 2008. We categorized the patients into those who had complications with inadequate first aid, those who had complications without first aid those who had complications with adequate first aid. We compared the genera characteristics and the laboratory and clinical findings of the three groups. Results: The ale o female ratio was 1.36. The most common bite site was fingers. The most common systemic symptom was dizziness (6.3%) and the most common complication was rhabdomyolysis (23.4%). The inadequate first aids group had more local complications (cellulitis, skin necrosis) than did the group with adequate first aid or the group with no first aids. Conclusion: Inadequate first aid after snake bite leads to local complications, so we must be careful to administer first aid after snake bite and evaluate this first aid in elation to local complications.

Emerging Pathogens and Vehicles of Food- and Water-borne Disease Outbreaks in Korea, 2007–2012

문신제,손일웅,홍영선,이형민,박지혁,권근용,이상원,윤승기 질병관리본부 2014 Osong Public Health and Research Persptectives Vol.5 No.1

Objectives: Food- and water-borne disease outbreaks (FBDOs) are an important public health problem worldwide. This study investigated the trends in FBDOs in Korea and established emerging causal pathogens and causal vehicles. Methods: We analyzed FBDOs in Korea by year, location, causal pathogens, and causal vehicles from 2007 to 2012. Information was collected from the FBDOs database in the Korean Centers for Disease Control and Prevention. Results: During 2007e2012, a total of 1794 FBDOs and 48,897 patients were reported. After 2007, FBDOs and patient numbers steadily decreased over the next 2 years and then plateaued until 2011. However, in 2012, FBDOs increased slightly accompanied by a large increase in the number of affected patients. Our results highlight the emergence of norovirus and pathogenic Escherichia coli other than enterohemorrhagic E. coli (EHEC) in schools in 2012. We found that pickled vegetables is an emerging causal vehicle responsible for this problem. Conclusion: On the basis of this study we recommend intensified inspections of pickled vegetable manufacturers and the strengthening of laboratory surveillance of relevant pathogens.

아파트 주민의 건강상태에 거주 환경이 미치는 영향

강기원(Ki-Won Kang),김화준(Hwa-Joon Kim),권근용(Geun-Yong Kwon),정민수(Min-Soo Jung) 한국농촌의학 지역보건학회 2009 농촌의학·지역보건 Vol.34 No.3

이 연구는 우리나라 대표적 주거형태인 아파트 입주민들을 대상으로 입주자들의 주거환경 만족도와 관련이 높은 건강상태 변수가 무엇인지 밝히고 어떠한 주거환경이 건강상태에 영향을 주는지 평가하고자 하였다. 주거환경에 대한 설문조사는 사회자본에 대한 국제적인 조사도구인 SC-IQ를 바탕으로 하되 Chun[2]의 아파트 주거환경 조사 척도를 첨가하였다. 설문조사는 2007년 12월부터 2008년 1월까지 7주간 이루어졌으며, 조사방법은 사전조사 차원을 통해 반응도 및 수거율 등을 고려하여 2회에 걸쳐 수행되었다. 수집된 설문지는 총 276부로서 수거율은 28%였으며 이 중 6부는 변수의 결측값이 많아 제거하여 총 270부의 설문지를 대상으로 분석을 시행하였다. 주성분 분석을 통해 기존에 알려진 주거환경과 관련된 건강 관련 변수들 중에 1년 전 대비 주관적 건강상태 변수가 가장 관련도가 높음을 파악했고, 요인 회전 및 요인 추출을 통해 27가지 주거환경 만족도에 대한 문항을 5가지 요인들로 구분할 수 있었다. 여기서 요인 1은 아파트 관리와 관련된 요인으로 요인 2는 아파트 개별 가구 환경과 관련된 요인으로 요인 3은 아파트 단지 환경(근린)과 관련된 요인으로 요인 4는 이웃관계와 관련된 요인으로 요인 5는 아파트 단지 시설환경과 관련된 요인이었다. 로지스틱 회귀분석의 결과를 보면, 주거환경 요인 중 이웃관계 관련 요인 및 아파트 단지 시설환경 요인의 경우 만족도가 높을수록 1년 대비 주관적 건강상태가 양호 하지만, 아파트 단지 환경(근린) 관련 요인은 만족도가 낮은 경우가 1년 전 대비 주관적 건강상태에 안 좋은 영향을 주는 것으로 나타났다. 이것은 근린공간 및 이와 결합되어 있는 사회적 지지 변수가 건강이 악화되는 것을 방지한다는 ‘완충효과’ 이론을 입증하는 결과이다. 결국 이 연구는 주거환경이 건강의 악화방지에 영향을 주는 요인일 수 있음을 밝히고 기존에는 고려되지 못한 물리적이고 정서적인 주거환경과 건강과의 관련성을 제시했다는데에 그 의의가 있다. Objectives: WHO insisted on that we should study about association between residential environment and health status and make ‘health city’ concept as practical motto. This study analyzed about that how community environment affected their health. Methods: We surveyed residential environment satisfaction and health status of a apartment complex residents. We transformed Chun’s index about housing environment study and social capital index of WHO and used as community health survey. We analyzed the association between health status and related factor by using principal compound analysis and logistic regression analysis. Results: We found out that the perceived health status 1 years ago was highly related to the residential environment and also extracted five residential environment component (APT maintenance, House, APT complex, Neighbor, APT building) by principal component analysis. After residential environment component, demographic and socioeconomic variable were controlled, the high satisfaction group of APT complex and neighbor relationship was in lower risk of perceived health status 1 years ago than the low satisfaction group. Conclusions: Recently, the importance of residential environment and neighborhood is shaped as community capacity. Therefore, social relationship and residential environment should be the core variable for health promotion of community. After all, we should know the relationship of residential environment and perceived health status 1 years ago. This helps the concept of health city clearly.

2018년 중부지방 일개 대학에서 집단 발생한 클로스트리듐 퍼프린젠스 감염증

배은주(Eun-Joo Bae),황세민(Se-Min Hwang),권근용(Guen-Yong Kwon),이무식(Moo-Sik Lee) 한국농촌의학 지역보건학회 2020 농촌의학·지역보건 Vol.45 No.2

2018년 5월 25일 10:00경 세종시 소재 일개 대학교 학생 40여명 정도가 설사 및 구토 증상 등을 주된 증상으로 하는 집단 발생으로 시청콜센터와 보건소를 통해 발생 신고가 접수되었다. 우리는 즉각 역학조사반을 구성(위생과 포함)하여 당일 14:30분에 현장 역학조사를 실시하였다. 역학조사결과, 최종 발생규모는 153명중 86명(56.2%) 등 이었다. 추정위험 노출시간은 전날 12시로, 원인은 체육대회 당일 점심으로 제공된 도시락의 유통·저장 과정에서 오염된 것으로 추정되었으며, 평균잠복기 13시간이었다. 발생은 5월 28일 종결되었으며, 검사결과는 6월 11일 통보 되었는데 동정된 세균은 클로스트리듐 퍼프린젠스(Clostridium perfringens)이었다. 이러한 조사결과를 통하여 클로스트리듐 퍼프린젠스에 의한 식중독이 집단 급식, 도시락의 유통 및 저장과 전달과정에서 오염 가능성과 발생이 가능함을 확인하였다. 세종특별자치시의 검사의뢰전달체계의 구축이 필요하고, 향후 보건환경연구원 등 지역지원 임상병리 검사기관의 설치운영이 시급한 과제이다. 아울러 충분한 검사 예산과 이에 따른 신속한 검사지원체계의 구축이 필요하다. 클로스트리듐 퍼프린젠스에 의한 식중독이 집단 급식, 즉 도시락의 유통 및 저장과 전달과정에서 오염 가능성과 발생이 가능함을 확인하였다. Purpose: This study was conducted to provide the results of the epidemiological investigation for outbreak of Clostridium perfringens enteritis among students at a college in Sejong City. Methods: This investigation was performed between May 25 and May 28, 2018. The Sejong City public health authority received a complaint which was about 40 university students experienced vomiting or diarrhea. We immediately set up an epidemiological investigation team and conducted a field epidemiological investigation. Results: The overall incidence was 86 out of 153 (56.2%). The estimated risk exposure time was 12 o"clock on the previous day, and the cause was contaminated during distribution and storage of the lunch box provided for lunch on the day of the athletic competition, with 13 hours of average incubation period. The outbreak was closed on May 28, and the identified pathogen was Clostridium perfringens. Conclusions: It was proposed that food poisoning by Clostridium perfringens was likely and contaminated during group meal.

Results of Tuberculosis Contact Investigation in Congregate Settings in Korea, 2013

권윤형,김소정,김지은,김설이,송은미,이은정,최윤,김예진,임병옥,김다설,최덕선,김혜성,박지은,윤지은,박진아,정종락,김주경,강성희,홍서연,이승재,박수진,박선화,윤선혜,김윤선,최윤정,서윤정,서율아,박지선,성민희,신민장,손현진,이연경,고은영,권근용 질병관리본부 2014 Osong Public Health and Research Persptectives Vol.5 No.-

Objectives: This study aimed to check the status of the contact investigation in congregate settings to eradicate tuberculosis (TB) in the Republic of Korea. Methods: The “Integrated System for Disease and Public Health Management” is used for care and follow-up for patients and contacts of TB. We downloaded data for contact investigations conducted from January to December 2013. Results: A total of 1,200 contact investigations in congregate settings were carried out by 25 field investigators in 2013. We performed the status of contact investigation, TB, and LTBI rate by age, accept rate of LTBI treatment, and complete rate of LTBI treatment during 2013. A total of 1,547 index TB patients, 149,166 contacts, and 259 additional TB patients were found through the investigation. Kindergartens showed the highest LTBI rate, 19.8%, among educational facilities. The second highest was in elementary schools and the subtotal LTBI rate of educational facilities was 7.8%. Social welfare/correctional facilities and workplaces showed relatively high LTBI rates of 23.8% and 23.6%, respectively. By age, individuals >35 years showed the highest LTBI rate, followed by those aged 0-4 years, 30-34 years, and 5-9 years, with rates of 18.1%, 16.4%, and 15.4% respectively. When comparing the tuberculin skin test (TST) positive conversion ratio by facility, middle school and high school were relatively high compared to the others. The accept rate of LTBI treatment in the workplace was lowest at 63% and the complete rate in elementary schools was lowest at 76.5%. Conclusion: TB contact investigation is considered as a meaningful strategy for preventing TB outbreaks in congregate settings and decreasing the prevalence of TB in young people. Results of this study could be used to establish the LTBI management policy.