has been the highest among all types of cancer. There- fore, as a health screening program of the Korean National Health Insurance System, all people can receive one of EGD or UGI series every two years from the age of 40 years. Nevertheless there might be a selection bias since symptomatic patients are likely to receive a diag- nostic test. Definition of COPD was based on both of diagnosis codes and prescription data, which were exclu- sively determined by physicians. Although 37% of our subjects performed spirometry, this figure includes both general physicians and specialists. To exclude asthma patients, we excluded those receiving only LTRA or only ICS or only SABA. Nevertheless, there was still a possi- bility that some of our subjects may have asthma. As considering this, we additionally analyzed each data from only male or from subjects with prescription including LAMA, which is specific for COPD (Additional file 1:
2) Dermatology Life Quality Index(DLQI) 9) Finlay와 Khan이 개발한 DLQI는 피부병 환자들의 질환 특이 삶의 질 평가도구로서 (disease specific quality of life measure) 이 등이 한국어로 번역하여 임상적 유용성을 평가하였다. DLQI는 증상과 감정상 태, 일상생활, 여가생활, 직장과 학교, 대인관계와 치 료의 6개 항목을 평가하는 10점 문항으로 구성되어 있다. 각 10문항에서 가장 높은 점수는 3점, 가장 낮 은 점수는 0점으로 하여 최고 점수는 30점이고 높은 점수일수록 아토피 피부염이 환자의 삶의 질에 더 큰 악영향을 주는 것으로 해석한다 하였다.
Several significant findings emerged from this pilot study. First, echocardiographic parameters during follow-up showed that AS had progressed significantly. Second, the anti-P. gingivalis IgG antibody titer showed a negative correlation with the progression of degenerative AS in this population. Third, despite the absence of any significant correlationbetweenthe hs-CRP level and ΔAVA/year, the hs-CRP level increased significantly in the rapid AS progression group compared with the non-rapid AS progression group. Finally, the DNA of periodontal bacteria was not detected in the 2 aortic valve specimens, which is in line with a previous pilot study reporting lack of periodontal pathogens in the aortic valve specimens and blood samples of patients with AS . Therefore, irrespective of the progression of degenerative AS, these bacteria did not emerge as significant risk factors in our cohort.
household catastrophic health expenditure. This informa- tion may have policy implications in terms of elucidating how financial security can be enhanced according to the diseases present in a household. A second advantage of this study is that we employed a method of calculation very similar to that introduced by Xu et al.  in their analysis of Korea Health Panel data. Due to the fact that food expenses could not be calculated in a few studies, some research defined catastrophic health expenditure by comparing medical expenditures to a household’s total income [21,30-32]. However, we were able to utilize Korea National Statistics data to calculate a household’s average food expenses in this study. We estimated Korea’s cata- strophic health expenditure rate by utilizing proportionate food expenses applied to two sources of data, total income and medical expenditures. Third, unlike previous data analysis that was conducted solely at the household level, we were able to consider the characteristics of individual family members. For example, we could take into account not only whether household members suffered from chronic diseases but also the socioeconomic factors of the head of household.
The blood pressure, fasting glucose, and total choles- terol were significantly lower in the shift group than in the normal group. There are two possible explanations, however, in regards to these results. First, on account of its statistic nature that the larger thestudy population, the smaller the standard deviation, a relatively small dif- ference in the level of continuous variables can be inter- preted as a significant difference in the level of these variables in a large population size. In this study, the number of the weighted study population is 6,469,033, which is relatively a large sample size. Thus, although the differences in the mean value of the blood pressure, fast- ing glucose, and total cholesterol level were less than 1 between day work group and shift work group, the results showed statistically significant differences betweenthe two groups. Since the indices are very sensitive, the dif- ference of 1 or less in these indices is not considered clin- ically significant. Therefore, although the values of these indices were significantly different statistically, they were not considered clinically different. Second, it is difficult to explain clearly how the adverse outcome betweenthe CKD prevalence andthe blood pressure occurred. How- ever, because the blood pressure is affected by several fac- tors (aging, smoking, alcohol intake, obesity, andthe medical condition that can cause secondary hyperten- sion) besides overactivation of RAAS by circadian rhythm disruption, hypertension can be caused by various factors.
There are several limitations in the present study. First, the number of samples was small and therefore insufficient for the results to be statistically significant. In particular, the number of smokers was extremely small. Recently, Hancock et al. 38 performed a genome- wide joint meta-analysis to examine the association between genetic variations and lung function, following the investigation of SNP-by-smoking interactions. In another study, stratified genetic association analyses were conducted, according to smoking intensity, to evaluate the association between SNPs andthe susceptibility to COPD. 39 However, because of the small number of samples, these analyses were not performed in this study. Second, all participants in this study were of East-Asian descent. Therefore, the types and frequencies of the genetic variations could be ethnic-specific. Finally, we could not measure whether the ability of MERTK to remove apoptotic cells is affected in its variants. It is well known that the function of proteins such as enzymes, transporters, and receptors can be impaired, even when their expression remains unaffected. For example, Gautherot et al. 40 reported that two nonsynonymous mutations in the multidrug resistance 3 (MDR3) transporter, encoded by the ATP-binding cassette, subfamily B, member 4 gene (ABCB4) led to a significant decrease in its transport ability, although none of these variations affected the expression of MDR3. It was subsequently found that the phosphorylation of ABCB4 was impaired by these mutations.
in women, respectively .
Although plausible biological mechanisms for the re- lationship between short sleep duration and CKD have been proposed, it is less clear as to how long sleep du- ration is associated with CKD prevalence. The temporal associations between sleep duration and CKD are likely to be bi-directional; nevertheless, as long sleep duration could be either an initial symptom or a consequence of unmeasured diseases and conditions among CKD pa- tients, any causality cannot be inferred from the pres- ent data. Previous studies have also suggested that the association of long sleep duration with CKD could be explained by residual confounding and comorbidities [3,23]. Accordingly, potential confounders could predis- pose individuals to both long sleep duration and poor kidney function. Thus, to reduce the effects of unmea- sured confounders on our results, we adjusted for so- ciodemographic status, socioeconomic status, health behaviors, comorbidities, and sleep quality, which may link long sleep duration to CKD. Even after adjusting for these confounders, the association between a long sleep duration and CKD remained significant. Notwithstand-
deviation  . Data for categorical variables are presented as the numbers and percentages. Differences in baseline characteristics and comorbidities betweenthe COPD group and non-COPD controls were analyzed with independent t-tests and χ 2
tests, as appropriate. Incidence rates of IBD were calculated by dividing the number of events by 1000000 person-years of follow-up for each group. Cox proportional hazard regression models considering time-varying covariates were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the risk of IBD in patients with COPD compared to controls  . The cumulative incidences of IBD were compared betweenthe groups with the Kaplan-Meier method andthe log-rank test. A P value < 0.05 was considered statistically significant.
Objectives: The objective of thestudy was to review thecorrelationbetween self-perceived oral health status and periodontal diseases in elderly Koreans, using data from the 6 th (2nd year) Korea National Health and Nutrition Examination Survey (2014). Methods: The subjects for this study were a total of 1,454 elderly people aged 65 years or older who responded to the health questionnaires of the 6 th (2nd year) Korea National Health and Nutrition Examination Survey conducted in 2014. Their general characteristics were analyzed using frequency analysis, while a cross-tabulation analysis ( 2 -test) was performed to understand thecorrelation with periodontal diseases. To clarify any effect of self-perceived oral health status on periodontal diseases, the selected variables were controlled and subsequently analyzed according to the logistic regression analysis. Results: In terms of the difference between elderly people with periodontal diseaseand those without periodontal disease, higher prevalence rates of periodontal diseases were found in women, those of younger age, those with lower educational and income levels, those with poorer subjective oral health status, those in the presence of chewing discomfort, those who had a toothbrushing frequency of twice per day, and/or those who had received no oral examination over the previous one year. Regarding the effect of self-perceived oral health status on periodontal diseases, 1.78-fold and 1.74-fold higher prevalence rates of periodontal diseases were shown with poorer subjective oral health status and in the presence of chewing discomfort, respectively. Conclusions: Based upon the results above, it is considered that a better understanding of self-perceived oral health status is necessary for a healthy life of the elderly. Furthermore, constant relevant studies and effective prevention programs intended to moderate the progress of or prevent periodontal diseases in the elderly in communities should be performed and implemented for the sake of better quality of life and oral health.
Objectives: The purpose of this study was to examine the impact of chronicdiseaseon oral health behavior.
Methods: The subjects were 317 adults over 30-years old living in urban and rural areas. They were selected by convenience sampling method and filled out the self-reported questionnaire. The questionnaire consisted of general characteristics, dental treatment, chronicdisease, and oral health behavior including oral health self-care behavior and professional oral health care. Results: The self-care oral health behavior andthe professional oral health care had a negative correlation with thechronic diseases. Especially, the self-care oral health behavior andthe professional oral health care had a statistically significant negative correlation with hypertension and osteoporosis. Multiple regression analysis was performed after including general characteristics, dental treatment, chronicdisease. Meanwhile the presence of chronicdisease had a significant influence onthe self-care oral health behavior andthe professional oral health care. Hypertension and Osteoporosis were the most influential factors of chronic diseases and had a significant influence onthe oral health behavior. In conclusion, thechronic diseases aggravated the oral health behavior practice. Conclusions:
This study has several limitations. First, food frequency question- naire (FFQ) was surveyed only at baseline. Therefore, the diet pattern changes over time could not be considered in the analysis. Second, serum zinc concentration level was not available. However, serum zinc level has been found to be a poor surrogate of body zinc ho- meostasis . This is supported by the fact that serum zinc level is not associated with chronic metabolic disease, although there is an accumulation of reports showing a positive link between dietary zinc and poor outcome. Third, data on zinc supplementation was not available. However, information on vitamin & mineral supplemen- tation in general was included in the analyses which would have Fig. 2. Restricted cubic spline plot for incident chronic kidney disease according to dietary zinc density. Note: Adjusted for age, sex, eGFR, BMI, SBP, vitamin & mineral supplement use, education, income, diabetes, CVD, CRP, HDL-C, BMI, smoking status, HOMA-IR score, alcohol consumption, and physical activity. Mean zinc intake amount was considered as reference. Abbreviations: eGFR, estimated glomerular ﬁltration rate; BMI, body mass index; SBP, systolic blood pressure; CVD, cardiovascular disease; CRP, C-reactive protein; HDL- C, high-density lipoprotein cholesterol; BMI, body mass index; HOMA-IR, homeostatic model assessment for insulin resistance.
Clinical and laboratory measurements
All participants underwent comprehensive health examinations and interviews according to the site visit schedule. The health examination included an anthropo- metric index evaluation and biological specimen collec- tion. Participants completed interviewer-administered questionnaires including questions on age, current smoking, alcohol intake (at least once per month), mari- tal status, and educational level. BMI was calculated as follows: weight (kg)/height (m 2 ). Waist circumference was measured along a horizontal plane midway betweenthe inferior margin of the ribs and superior border of the iliac crest. Participants also completed interviewer- administered questionnaires regarding their medical his- tories including medication use, family disease history, and lifestyle factors, such as smoking status and alcohol intake. Blood pressure was measured using mercury sphygmomanometers (Baumanometer-Standby; W. A.
또한 보건복지부 구강보건사업안내(2003)에 의하면 OECD 국가들과의 구강보건현황을 비교해보면 우리나라 우식경험영구치율(12세 아동의 우식경험 영구치지수)에 서 3.3으로 OECD국가 중앙값인 0.9에 비해서 상당히 높 은 수준으로 나타났다(OECD health data. 2003). 따라 서 대부분의 선진국은 치아 우식증이 감소하는데 비해 우 리나라는 늘어나는 추세인 것을 알 수 있다. 한국의 구강 보건학계에서는 국민구강보건실태를 파악하는 노력으로, 학교구강보건과 지역사회구강보건에 관하여 다각적으로 조사 검토하고 있으며, 구강보건지식수준이 높을수록 치 and people with no education, the results of knowledge of oral preventive measure was poor as 1.74 0.44, 1.85 0.40, 1.85 0.44,and 1.60 0.47 separately. Cross analysis showed that p-value was 0.000 andcorrelationbetween knowledge of oral preventive measures and those factors were statistically significant at significance level of 0.05.
1960 년대부터 당뇨병로 인한 합병증으로 치주건강에 대해 많은 연구가 진행되어 당뇨병이 있고 혈당 조절이 잘 안될 수록 치주질환 의 유병률이 높으며, 증상의 경중이 더 심하다는 것은 정설로 여겨 지고 있다. 18) 반대로 치주염 자체가 당뇨병발생을 증가시킬 수 있다 는 논의가 시작되어, 심한 치주염이 있는 당뇨병환자에서 상대적으 로 혈당조절이 잘 되지 않고, 당뇨병 합병증인 심혈관질환 발생 위 험이 증가하여 결국 이로 인한 사망의 위험도 더 높았다는 보고 19) 있 다. 뿐만아니라, 제 2 형 당뇨병환자를 대상으로 비외과적 치주치료 를 집중적으로 시행하고 구강위생관리만 철저히 하여도 고혈당 상 태가 좋아졌다는 임상연구 20) 가 있었으며, 코호트연구를 통해 구강 내 치주염 또는 만성적 감염상태가 있는 사람은 향후 당뇨병이 새롭 게 발생할 위험이 증가됨이 보고되었다 . . 21) 이번 연구에서도 치주염 이 없는 군과 비교했을 때 치주염이 있는 경우에서 당뇨병의 위험 Table 3. Unadjusted prevalence, adjusted odd ratios (OR) and 95% confidence intervals (CIs) for chronicdisease*
요통의 경우 20대부터 발생하기 시작하여 전체 유병률은 65세까지 지속적으로 증가하는 양상을 보이다가 그 이후부 터는 서서히 감소한다[5,6].
급성요통의 경우, 특별한 치료 없이 시간이 경과함에 따 라 호전되는 경우가 대부분인 것으로 알려져 있는데, 여러 가이드라인에서 급성 요통환자의 90%가 6주 내로 호전되 며, 요통이 발생한지 1년이 지난 시점에서 통증이 호전된 비 율은 54-90%에 달하는 것으로 보고되었다[7,8]. 이와 같이 As degenerative spinal disease among spinal diseases causing lumbar and cervical spinal pain is the endless repetition of “the biological healing of mechanical damage” occurring over a lifetime, spinal pain by degenerative spinal disease occurs as a series of successive changes through the repetitive damage-healing process of various spinal structures including the intervertebral disc rather than a temporary phenomenon of any given pathophysiologic change in one moment. Degenerative spinal disease generally begins with degeneration of the intervertebral disc. Then herniation of the intervertebral disc resulting in subsequent radicular pain occurs when the nucleus pulposus with degeneration located in the intervertebral disc tears and penetrates the annulus fibrosus. Subsequently, disc space narrowing occurs and alters the spinal biomechanics, followed by degenerative changes to the vertebral endplate, vertebra itself, and facet joint. Finally, these changes lead to spinal stenosis, which is the final destination of degenerative spine disease.