지방간의 위험요인에 관한 단면적 연구

엄상화,유병철,김성준,이채언,배기택,김성천,신해림,Ohm, S.H.,Yoo, B.C.,Kim, S.J.,Lee, C.U.,Pai, K.T.,Kim, S.C.,Shin, H.R. 대한예방의학회 1993 Journal of Preventive Medicine and Public Health Vol.26 No.2

Generally fatty liver is attributed either to chronic alcoholism, diabetes mellitus, or obesity. Based upon this commonly held clinical brief, this study was conducted to investigate the contributing factors of fatty liver and odds ratio (OR) of known contributing factors. A sample of 310 male participants, who visited at Seoul Paik Automated Multiphasic Health Testing System from November 1991 to December 1991, was separated into 112 cases and 198 controls by ultrasonographic fin ding. There were statistically significant difference between fatty liver and normal in triglyceride (TG), body mass index (BMI), alanine aminotransferase (ALT), high density lipoprotein cholesterol (HDL-C), fasting blood sugar (FBS), alcohol consumption, low density lipoprotein cholesterol (LDL-C), total cholesterol, gamma-glutamyl transferase ($\gamma$-GT), duration of alcohol intake and alkaline phosphatase (Alk.P)(P<0.01, P<0.05). The statistically significant elevated odds ratio were noted for TG (4.48, confidence interval (CI) 2.66-7.55, P=0.000), alcohol consumption(3.24, CI 1.56-6.23, P=0.002), BMI(3.05, CI 1.87-4.97, P=0.000), and FBS (2.59, CI 1.53-4.40, P=0,000). In summary, it is suggested that the fatty liver could be preventive by avoiding such deleterious factors as high fat diet, alcohol and obesity.

전립선암 진단을 위한 전립선 특이 항원 선별검사의 의의

엄상화,손혜숙,전진호,장석창,민권식,이종태 대한임상건강증진학회 2004 Korean Journal of Health Promotion Vol.4 No.3

Background Incidence and death rate of prostate cancer of male are increased gradually in Korea. For care of prostate cancer, it isneeded to observe the results of PSA test in screening and the illness behaviour after screening test.Methods For 11,061 health examinee, PSA level was checked. Among the cases with abnormal PSA, the rate of visiting urologydepartment, the performed rates of special tests for the diagnosis of cancer and the results of these tests were measured.Results The abnormal rate of PSA was 1.4% and was increased with aging in health examinee. Among 153 cases with abnormalPSA in health examinee, 17.0% had visited the urology department for more evaluation. 3 cases among 7 cases whoreceived prostate biopsy were confirmed as prostate cancer. -연구배경 우리나라 남성 암 중 빠른 속도 그 발생과 사망률이 증가하고 있는 전립선 암의 관리를 위하여 전립선 암 조기 진단 을 목적으로 실시되는 전립선 특이항원 (prostate specific antigen, PSA)의 선별검사 결과와 그 결과에 따른 전립선 암 확진을 위한 질병행태의 관찰이 필요하다 .방 법 건강검진자 11,061명을 대상으로 전립선 특이항원 검사 결과 이상률을 관찰하고 , 결과에 따른 외래 방문 정도와 전립선 암 확진을 위한 비뇨기과 외래에서의 추가적인 임상검사 실시 정도 및 암 진단 정도를 관찰하였다 .결 과 전립선 특이 항원 (PSA)가 4ng/ml 이상인 율은 1.4%였으며, 연령이 증가할수록 많았다 . 전립선 특이항원이 4ng/ml 이상인 153명 중 17% 인 26명만 전립선암을 확진하기 위하여 비뇨기과 외래를 방문하였다 . 외래를 방문한 26명 중 전립선 생검을 실시하여 전립선 암 확진된 자는 3명이었다.

비궤양성 소화불량에서 Helicobacter pylori 박멸치료후 증상개선에 대한 메타분석

엄상화,정귀원,신원창,조종래,손혜숙,배기택,김성준,Ohm, Sang-Hwa,Jeong, Ki-Won,Shin, Won-Chang,Cho, Jong-Rae,Shon, Hye-Suk,Pae, Ki-Taek,Kim, Sung-Jun 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.4

Objectives: This study was conducted to determine, by reviewing the literature, whether treatment of Helicobacter pylori infection in patients with non-ulcer dyspepsia affects symptoms. Methods: We retrieved the literature using MEDLINE search, with nonulcer dyspepsia and Hericobacter pylori and treatment as key words, which were reported from 1984 to 1998, and manual literature search. The criteria for inclusion was as follows; 1) The paper should have confirmed nonulcer dyspepsia as case definition. 2) The paper should have peformed a randomized, blind trial. 3) Confirmation of Helicobacter pylori eradication should be done 4 weeks after treatment. 4) studies with no information on measurement of symptoms after treatment were not accepted. The percentage of patients with symptom improvement after eradication therapy for Helicobacter pylori infection was calculated. Cumulative odds ratio was compared by fixed effect model and random effect model as sensitivity and funnel plot was used to evaluate publication bias. Results: The overall effect size of symptom improvement was calculated by cumulative odds ratio. Cumulative odds ratio of random effect model was 4.16(95% CI: 1.55-11.19). Before integrating each effect sizes into common effect size, the homogeneity test was conducted and random effect model was selected(Cochran's Q=41.08 (d.f=10, p<0.001)). The heterogeneity across studies was evaluated and the different methodological aspects of studies led to differences between study results Conclusions: The results suggest that the eradication of Helicobacter pylori in patients with non-ulcer dyspepsia results more symptom improvement. In studios that shows the opposite results there are methodological aspects explaining the heterogeneity.

만성 간질환 환자의 삶의 질 평가 (논평)

엄상화 ( Sang Hwa Urm ) 대한간학회 2007 Clinical and Molecular Hepatology(대한간학회지) Vol.13 No.1

보건예방사업을 위한 B형간염 표면항체 검사방법 비교

이정녀,엄상화,이종태,전진호,손혜숙,Lee, Jeong-Nyeo,Urm, Sang-Hwa,Lee, Jong-Tae,Chun, Jin-Ho,Sohn, Hae-Sook 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.2

Objectives : The purpose of this study was to suggest a proper method for the detection of heaptitis B surface antibody(anti-HBs) in a screening program for hepatitis B vaccination. Methods : Sensivitity, specificity and predictive values were compared between Immunochromatographic assay (ICA) and passive hemagglutination(PHA) in 978 subjects(565 males, 413 females, 19-78 years ranging in age, mean 46.5 years old). EIA was used as a standard method for the detection of HBsAb. Results : Sensitivity in the detection of anti-HBs of PHA and ICA was 88.7%, and 94.9%, specificity was 94.3% and 96.6%, negative predictive value was 96.5%, and 98.0%, and positive predictive value was 82.3%, and 91.3%,, respectively. False negative rate(11.3%) of PHA was higher than that(5.1%) of ICA. The higher the titer of anti-HBs in EIA was, the lower the false negative rate was. There was no false negative result in the cases with $101mIU/{\beta}c$ or more in EIA Conclusion : We suggest that ICA should be the choice of screening method in the detection of anti-HBs in Hepatitis B vaccination program.

2009년 학동 전기 소아에서 알레르기질환의 유병률과 위험인자

김영휘,엄상화,김우경 대한 소아알레르기 호흡기학회 2011 Allergy Asthma & Respiratory Disease Vol.21 No.3

Purpose:In Korea, there have been many epidemiologic studies about allergic diseases of school children, but so far only a few studies of preschool children have been done. Research on preschool children will be a great help to understand the epidemiology of the allergic diseases in the pediatric population. In this perspective, we researched the prevalence and risk factors of allergic diseases in preschool children in Jung-gu, Seoul. Methods:A modified International Study of Asthma and Allergies in Childhood questionnaire survey was done on 917 (male, 492; female, 425) preschool children in Jung-gu area of Seoul in June, 2009. Parents or caregivers answered the questionnaires that asked about the prevalence of allergic diseases and the risk factors. Results:For asthma, the prevalence of “wheeze, ever”, “diagnosis” and “treatment, last 12 months” were 18.4%, 5.8% and 2.8%, respectively. For allergic rhinitis (AR), the prevalence of “rhinitis, ever”, “diagnosis” and “treatment, last 12 months” were 31.8%, 16.2% and 12.9%, respectively. For atopic dermatitis (AD), the prevalence of “itchy rash, ever”, “diagnosis” and “treatment, last 12 months” were 26.1%, 34.3% and 19.0%, respectively. The risk factors of asthma were cesarean section delivery, use of antibiotics and history of bronchiolitis before the age of 2 years. The risk factor of AR was history of asthma. The risk factor of AD was parent allergy. Conclusion:In comparison to preceding studies of preschool children in Seoul, the prevalence of allergic diseases is similar. In comparison to the studies of school children, the prevalence of AR was lower and the prevalence of AD was higher. 목적:우리나라에서 International Study of Asthma and Allergies in Childhood (ISAAC)를 토대로 한 역학조사 연구가 학동기와 청소년기 연령대를 대상으로 많이 이루어졌으나, 학동전기 소아에 대한 알레르기질환의 연구는 미흡하였다. 학동전기 소아에 대하여 조사하는 것은 소아청소년과 환자의 알레르기질환 역학을 파악하는데 큰 도움이 된다. 이에 본 논문의 저자들은 학동전기 소아를 대상으로 알레르기질환의 유병률과 이에 영향을 미치는 위험인자를 조사하였다. 방 법:2009년 6월 한달 간 서울시 중구에 위치한 11곳의 어린이집 원생 917명(남 492명, 여 425명)을 대상으로 설문 조사를 실시하였다. ISAAC를 토대로 만든 설문지에 소아의 부모나 보호자가 응답하였다. SAS ver. 9.1 (SAS Institute Inc., Cornelius, NC, USA)로 통계분석하였다. 결 과:본 연구에서 천식의 일생동안 증상 유병률, 진단 유병률, 치료받은 유병률은 각각 18.4%, 5.8%, 2.8% 이었다. 알레르기비염의 일생동안 증상 유병률, 진단 유병률, 치료받은 유병률은 각각 31.8%, 16.2%, 12.9%이었다. 아토피피부염의 일생동안 증상 유병률, 진단 유병률, 치료받은 유병률은 각각 26.1%, 34.3%, 19.0%이었다. 천식의 위험인자는 제왕절개 분만으로 출생한 경우, 항생제를 1세 이전에 3일 이상 사용한 경험이 5회 이상인 경우와 2세 이전에 세기관지염의 과거병력이 있는 경우이었다. 알레르기비염의 위험인자는 천식 진단을 받은 경우이었다. 아토피피부염의 위험인자 연구에서는 부모에게 알레르기질환 병력이 있는 경우에 위험도가 증가하였다. 결 론:서울지역 학동전기 소아를 대상으로 한 선행 연구와 비교하였을 때, 알레르기질환의 유병률은 전반적으로 비슷한 수치를 보였다. 학동기 소아의 결과와 비교하였을 때, 알레르기비염의 유병률은 그보다 낮았고, 아토피피부염의 유병률은 높았다.

다형성 가변성 연쇄반복을 중합효소연쇄반응법으로 분석한 키메리즘에 따른 이식편대 숙주병 및 백혈병 재발의 양상

조종래,엄상화,김성준 大韓血液學會 1999 大韓血液學會誌 Vol.35 No.1

2002년 부산, 울산 및 경상남도 19세 남자의 근시 유병률

이상준,엄상화,안기수,이용환,김신동,김정민,유병철 대한안과학회 2009 대한안과학회지 Vol.50 No.9

목적: 부산, 울산 및 경남지역 19세 남자의 근시 및 고도근시 유병률을 추정하고 거주지역, 학력수준, 신장, 체중 등의 영향을 분석하였다. 대상과 방법: 2002년 1월에서 12월까지 부산, 울산, 경남지역에 거주하는 징병신체검사자 중 시력이 0.8 이하인 사람 50,243명에게 시행된 자동굴절검사 결과를 분석대상으로 하였다. 굴절이상이 -0.5D 이상이면 근시로, -6.0D 이상이면 고도근시로 정의하였으며 거주지역, 학력수준, 신장, 체중 등에 따라 표준화하여 유병률을 비교하고 굴절검사 누락자를 활용하여 추정 유병률을 계산하였다. 결과: 조사대상자의 근시 유병률과 고도근시 유병률은 각각 45.60% (95% CI: 45.17~46.03), 11.50% (95% CI: 11.23~11.77)로 나타났으 며 1차 시력검사 결과 0.5 이하이면서 2차 굴절검사를 시행하지 않은 자 9,575명을 고려한 추정 근시 유병률은 54.31% (95% CI: 53.88~ 54.74)이었다. 결론: 부산, 울산 및 경남지역 만19세 남성의 근시 유병률은 45.60%, 추정 근시 유병률은 54.31%, 고도근시 유병률은 11.50%로 나타났다. Purpose: To investigate the prevalence of myopia and its influencing factors in an epidemiologic study of conscripts living in Gyeongsangnam-do, Ulsan and Busan. Methods: A cross-sectional study was conducted in 19-year-old conscripts in Gyeongsangnam-do, Ulsan and Busan. Health checkup data of the conscripts were collected and analyzed along with subjective visual acuity, noncycloplegic autorefraction test, biometric data, and social factors such as education level and residence area. Myopia and high myopia were defined as having a refractive error of more than -0.5D, -6.0D, respectively. To analyze the social and biometric effects, we classified social factors into three groups and biometric factors into five groups. The estimated myopic prevalence was calculated adding excluded conscripts who scored under 0.5 on the subjective visual acuity test and missed autorefraction data. Data analysis was performed with descriptive analysis and the chi square test for trends using the Statistical Package for the Social Sciences (SPSS) version 14.0K. Results: From 66,917 eligible conscripts, 50,243 were analyzed. The prevalence of myopia and high myopia in 19-year-old men in Gyeongsangnam-do, Ulsan and Busan were 45.60% (95% CI: 45.17~46.03) and 11.50% (95% CI: 11.23~11.77). The estimated myopic prevalence using 66,917 eligible conscripts was 54.31% (95% CI: 53.88~54.74). Conclusions: The prevalence of myopia and high myopia and the estimated prevalence of myopia in 19–year-old men in Gyeongsangnam-do, Ulsan and Busan were 45.60%, 11.50% and 54.31%, respectively.

임플란트 완성 환자의 구강건강관련 삶의 질과 관련 요인

박정현,엄상화,권현숙,조갑숙,허승주,이소영,유병철,Park, Jung-Hyun,Urm, Sang-Hwa,Kwun, Hyeon-Sook,Cho, Gab-Suk,Heo, Seung-Ju,Lee, So-Young,Yu, Byeng-Chul 한국치위생학회 2011 한국치위생학회지 Vol.10 No.2

Objectives : This study was purposed to estimate the level of oral health quality of life and the relationship between health-related factors and oral health quality of life in patients with successful dental implants. Methods : This questionnaire survey was conducted during the period from December 2009 to March 2010 with 126 patients confirmed successful dental implants in Busan. The oral health related quality of life and oral health-related factors were estimated with OHIP-14 and 8 oral health characteristics, respectively. Data analysis was performed with descriptive analysis, t-test, ANOVA, multiple regression analysis using SAS(ver 9.1) program. Results : The score of oral health quality of life in patients with successful dental implants was $12.25{\pm}7.82$. The scores of subscale of the oral health quality of life were $1.24{\pm}1.35$ in social disability, $1.60{\pm}1.37$ in handicap, $1.60{\pm}1.44$ in psychological disability, $1.70{\pm}1.38$ in functional limitation, $1.81{\pm}1.35$ in physical disability, $2.14{\pm}1.46$ in physical pain, $2.17{\pm}1.46$ in psychological discomfort, respectively. The related factors of oral health quality of life in patients with successful dental implants were absence of other type prosthesis and experience of tooth brushing education. Conclusions : The oral health related quality of life in patients with successful dental implants was relatively good condition. Social supports and chances for high quality denture and tooth brushing educations are needed to improve oral health related quality of life in patients with dental implants.

서울 일부 지역 사무직 근로자들의 고혈압 유병률 및 고혈압 근로자들의 정밀 검사에 대한 조사

정귀원,엄상화,최순석,김정호,이종태,전진호,이채언,배기택 인제대학교 1997 仁濟醫學 Vol.18 No.1

근로 기준법 및 근로자 건강진단 실시 지침(노동부)에 의거 매년 건강진단을 받아야 하는 서울 일부 지역 근로자 1,480명(남:1.028명, 여:452명)을 조사 대상으로 고혈압의 유병률을 조사한 결과 남녀에서 각 18.8%, 6.0%였으며, 연령별로 구분한 고혈압의 비교 위험도는 40세 이상이 40세 미만보다 약 2배 높았다. 고혈압 정밀 대상자(160명)의 심전도와 안저 검사 이상율은 두항목 모두에서 정상군에 비해 높은 비율을 보였으며, 검사 항목들 간의 상관 관계에서 수축기 혈압은 이완기 혈압과, 혈청 콜레스테롤은 비만도, 중성 지질과 유의한 양(陽)의 상관 관계를 보인반면, 고밀도 지단백질은 중성 지질과 혈청 콜레스테롤과 음(陰)의 관계를 시현하였다. To determine the prevalence rate of hypertension by aging and hypertension-related factors, the authors carried out the survey of the on 1480 clerical employees and the results of detailed clinical examination (Lab data, echocardiography, fundoscopic finding) on 160 persons with hypertension in Seoul area from Jan 1, 1993 through Dec 31, 1993 The results are as follows : 1.The prevalence rate of hypertension among total subjects was 11.9% (male : 18.8%, female:6.0%), and it was gradually increasing with aging in male. 2.A prevalence rate of hypertension in subjects over 40 years old was about two times as large as that under the age of 40. 3.The prevalence rates of hypertension in obesity group(120% and over of standard body weight) and normal group(under 109% of standard body weight) were 14.1% and 6.1%. 4.The mean concentration of total cholesterol, HDL and triglyceride level in the hypertensive group were 223.7 37.1 mg/dl, 42.6 9.7 mg/dl. 197.4 61.0 mg/dl, respectively. 5.The abnormality rate in echocardiographic finding in the hypertensive group was 62.5%, and it was gradually increased as blood pressure increased. 6.The abnormality rate in fundoscopic finding of the hypertensive group was 42.5%, and it was gradually increased as systolic blood pressure increased. 7.The positivity rates of urinary protein in uristix were 1.5%(male:1.3%, female:1.7%) in normal group and 2.6% (male : 2.4%, female : 2.7% ) in hypertensive group. 8.There were positive correlation between systolic blood pressure and diastolic blood pressure; total cholesterol and index of obesity, triglyceride: and negative correlation between HDL and total cholesterol and triglyceride.