• Title/Summary/Keyword: 다변량분석법

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Prognostic Significance of Cyclin E and p27 in Stage 1 Non-Small Cell Lung Cancer (제1병기 비소세포폐암에서 Cyclin E와 p27의 발현과 예후)

  • 조봉균;조성래;천봉권
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.7-14
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    • 2003
  • Cyclin I plays a pivotal role in the regulation of G1-S transition and could consequently be a deregulated molecule in tumors. The activity of the cdk2-cyclin E complex is increased by degradation of cdk inhibitor p27kip1. Little is known about the expression and prognostic significance of cyclin E and p27 in non-small cell lung cancer(NSCLC). Material and Method: The expression of cyclin E and p27 in eighty-one cases of resected stage I NSCLC tissues and its relation to major clinico-pathological factors, including histology, differentiation, size of tumor, pleural invasion and survival rate were studied and analyzed. Immunohistochemical analysis with monoclonal antibodies specific for cyclin E and p27 were performed by ABC method. Result: Expression rates of cyclin E and p27 in stage I NSCLC tissues were 29.6% and 28.4% respectively. Cyclin E was expressed higher in cases of pleural invasion(p=0.04), and p27 was expressed higher in diameter of tumor less than 3cm(p=0.015). The 5-years survival rate was lower in cases of Positive expression of cyclin E than in cases of negative expression of cyclin E(44.4% vs 68.2%, p=0.015), and the 5-years survival rate was 72.2% in positive expression of p27 and 56.2% in negative expression of p27(p=0.09). The 5-years survival rate was higher in negative expression of cyclin E and positive expression of p27 than in cases of positive expression of cyclin I and negative expression of p27 (73.5% vs 36.3%, p=0.0029). In multivariate analysis, expression of cyclin I was an unfavorable prognostic factor(RR=3.578, p=0.006) and p27 was a favorable prognostic factor(RR=0.183, p=0.019) independently. Conclusion: Cyclin E and p27 may play a pivotal role for the biological behavior of stage I NSCLC, so that the expressions of cyclin I and p27 nay be new prognostic markers.

A Survey on the Understanding of Breast-feeding in Pregnant Woman (임신시 모유수유에 대한 인식조사)

  • Seo, Jeong Wan;Kim, Yong Joo;Lee, Kee Hyoung;Kim, Jae Young;Sim, Jay G;Kim, Hae Soon;Ko, Jae Sung;Bae, Sun Hwan;Park, Hye Sook;Park, Beom Soo
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.575-587
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    • 2002
  • Objective : To investigate the understanding of breast-feeding in pregnant woman and the proper way of encouraging breast-feeding. Methods : Each questionnaire included items about demographic characteristics and the understanding of breast-feeding. The questionnaires were filled up by pregnant women visiting obstetric clinics in Seoul and its vicinities, Busan, Choongjoo and Chungjoo from July 2001 to August 2001. One thousand, two hundred ninety questionnaires were analysed by Chi square tests and multiple logistic regressions. Results : The majority of pregnant women(87.4%) planned breast-feeding. Forty three percent of them had plans to breast-feed for 4-6 months. There were no differences in the level of education, the family size and the source of information about breast-feeding in planning to breast-feed (P>0.05). The main reasons for not choosing to breast-feed were returns to work(41.3%), previous failures of breast-feeding(17.4%), concerns about insufficient amount of breast milk(10.9%), breast and nipple problems(10.3%) and maternal illness(9.4%). The average score on the test of the understanding about breast-feeding was 59.7/100. The average scores on the understanding about the methods and advantages of breast-feeding were 45.3/100 and 86.1/100, respectively. The maternal status of employment, previous history of breast-feeding, the time of decision to breastfeed, person advocating breast-feeding and the understanding on the advantages of breast-feeding were significant determinant factors in planning to breast-feed(P<0.05). Conclusion : Pediatricians should take steps to make an effort to increase the breast-feeding rate and to encourage breast-feeding by timely education. Beyond the medical field, political and social supports for breast-feeding are urgently needed.

Psychological Characteristics of Psychiatric outpatients with High Suicide Risk : Using MMPI-2-RF (정신건강의학과 외래 환자 중 자살 고위험 집단의 심리적 특성 : MMPI-2-RF를 이용하여)

  • Nam, Jisoo;Kim, Daeho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.8-19
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    • 2020
  • Objectives : The purpose of this study was to examine whether the MMPI-2-RF serves as a useful tool to differentiate between the subtypes of high risk of suicide among psychiatric outpatients. Methods : Patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. Their medical records were reviewed retrospectively. And participants were put into 4 groups (Suicide ideation, Suicide attempt, Non-suicidal self-injury, and general psychiatric diagnosis as a control group). For statistical comparison, the MANCOVA with gender as a covariate was used. Results : The results indicated that as previous research with non-clinical sample suggested, psychiatric outpatients with high suicide risk also have significantly higher Emotional/Internalizing Dysfunction, Helplessness/Hopelessness, Suicidal/Death Ideation, Demoralization, Cognitive complaints, Cynicism, Dysfunctional negative thoughts than general psychiatric patients group. But group differences within the high suicide risk patients have not been observed. However, suicide attempt group and NSSI group has higher Behavioral/Externalizing Dysfunction, RC4, AGG than general psychiatric patients group. But there was no difference between suicidal idea group and general psychiatric patients group. Conclusions : There was no group difference observed between all three subtypes, which mean the MMPI2-RF may not be the useful diagnostic tool to navigate high suicide risk subtypes. Even though there was no difference observed in the suicide ideation group, suicide attempt group and NSSI group have higher aggression and externalization. So those indexes could serve as a useful marker to investigate riskiness of suicide related symptoms.

Analysis of Prenatal and Postnatal Factors Associated with Complications and Prognosis in Premature Infants with Leukemoid Reaction (백혈병양반응을 보인 미숙아의 합병증과 예후에 관한 산전과 산후 인자에 대한 분석)

  • Kwon, Se-Ho;Lee, Byoung-Kook;Lee, Heun-Ji;Na, So-Young;Lee, Jung-Ha;Park, Su-Yeon;Kang, Eun-Kyeung;Kim, Do-Hyeon;Lee, Kwan;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.151-159
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    • 2008
  • Purpose : This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. Methods : We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/$mm^3$. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. Results : Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. Conclusion : Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.

Frequency, Clinical Characteristics and Correlates of Premenstrual Syndrome in High School Students (여고생에서 월경전 증후군의 빈도와 임상적 특징 및 관련요인)

  • Chang, Hyung-Joo;Jeong, Hyun-Ghang;Ko, Young-Hoon;Han, Chang-Su;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.44-54
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    • 2013
  • Objectives : To investigate the frequency and clinical characteristics of premenstrual syndrome(PMS)/premenstrual dysphoric disorder(PMDD) in high school students, and determine the correlates of PMS/PMDD in association with comorbid depression and anxiety. Methods : A total of 1688 students were recruited from 5 high schools in Seoul, Korea. Subjects completed the questionnaire composed of scales to measure premenstrual symptoms, depression, and anxiety, as well as sociodemographic and reproductive variables. Subjects were categorized into 3 groups by using the Premenstrual Symptom Screening Tool(PSST) to determine the frequency and clinical characteristics of PMS/PMDD. Multivariate logistic regression was used to identify the correlates of PMS/PMDD. Results : The frequency of moderate to severe PMS and PMDD was 20.1% and 6.4%, respectively. Irritability(78.8%), fatigue(76.4%), and emotional sensitivity(69.8%) were common premenstrual symptoms, and functional impairment in academic performance(67.1%) was dominant. Dysmenorrhea[odd ratio(OR)=3.68, 95% confidence interval(CI) 2.45-5.55], family history of PMS(OR=1.91, 95% CI 1.35-2.71), and use of oral contraceptive (OR=1.85, 95% CI 1.16-2.94) were associated with the increased risk of PMS/PMDD after adjustment for depression and anxiety. Negative attitude to menses(OR=15.60, 95% CI 3.61-67.42) was associated with the increased risk of PMS/PMDD, particularly in subjects without depression and anxiety. Conclusions : PMS was common, as the frequency of PMS more than moderate severity including PMDD exceeded 25%, and disrupted daily functioning in adolescents. PMS is associated with various sociodemographic and menstrual characteristics, and these associations are affected by comorbid depression and anxiety.

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Clinical Characteristics of Intensive Care Unit Patients with Carbapenem Resistant Acinetobacter Baumannii Isolated from Sputum (객담에서 Carbapenem 내성 Acinetobacter baumannii가 동정된 중환자실 환자의 임상적 특징)

  • Lee, Sung Won;Jo, Heui Sug;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.228-234
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    • 2006
  • Background : Acinetobacter baumannii is an important pathogen associated with nosocomial infections in intensive care units, and is responsible for nosocomial pneumonia, UTI, bacteremia, etc. The main concern is that this pathogen is often resistant to many antimicrobial agents, particularly to carbapenem. This study compared the clinical those of ICU admitted patients with the carbapenem resistant A. baumannii isolated from the sputum with characteristics of patients with carbapenem sensitive A. baumannii. Methods : A total of 49 patients with A. baumannii from a sputum culture who were admitted to the ICU from January to December 2003 were enrolled in this study. This study evaluated the demographic variables, mortality, APACHE II score, comorbidity, antibiotics used, hospital and ICU stay, Clinical Pulmonary Infection Score, and mechanical ventilation. A retrospective analysis was made by a review of the patients' medical records. Results : Carbapenem sensitive and resistant A. baumannii was isolated from 23 patients and 26 patients respectively. Univariate analysis revealed renal disease, the use of carbapenem and aminoglycoside to be statistically significant factors for carbapenem resistance. Multivariate analysis revealed carbapenem use(p=0.024; OR, 8.17; CI 1.32 to 50.68) to be positively associated with carbapenem resistance, and aminoglycoside use(p=0.026; OR, 0.18; CI, 0.04 to 0.82) to be negatively associated with carbapenem resistance. There was no significant difference in mortality between the carbapenem sensitive and resistant group(30 vs 42%. P=0.39). Conclusion : The occurrence of carbapenem resistant A. baumannii is positively associated with carbapenem use and negatively associated with aminoglycoside use. Carbapenem resistance in the sputum culture did not affect the mortality rate.

Delayed Treatment of Pulmonary Tuberculosis in a University Hospital (대학병원에서 발생하는 폐결핵 치료지연)

  • Kang, Shin Myung;Lee, Jun Gu;Chung, Jae Ho;Han, Chang Hoon;Byun, Min Kwang;Chung, Wou Youn;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.277-284
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    • 2006
  • Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.

Treatments Results and Prognostic Factors in Locally Advanced Hypopharyngeal Cancer (국소 진행된 하인두암의 치료 결과와 예후 인자 분석)

  • Yoon, Mee-Sun;Ahn, Sung-Ja;Nam, Taek-Keun;Song, Ju-Young;Nah, Byung-Sik;Lim, Sang-Cheol;Lee, Joon-Kyoo;Chung, Woong-Ki
    • Radiation Oncology Journal
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    • v.25 no.3
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    • pp.151-159
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    • 2007
  • Purpose: The purpose of this study is to present the treatment results and to identify possible prognostic indicators in patients with locally advanced hypopharyngeal carcinoma. Materials and Methods: Between October 1985 to December 2000, 90 patients who had locally advanced stage IV hypopharyngeal carcinoma were studied retrospectively. Twelve patients were treated with radiotherapy alone, 65 patients were treated with a combination of chemotherapy and radiotherapy, and 13 patients were treated with surgery and postoperative radiotherapy with or without neoadjuvant chemotherapy. Total radiation dose ranged from 59.0 to 88.2 Gy (median 70 Gy) for radiotherpay alone. Most patients had ciplatin and 5-fluorouracil, and others had cisplatin and pepleomycin or vincristin. Median follow-up period was 15 months. Kaplan-Meier method was used for survival rate and Cox proportional hazard model for multivariate analysis of prognostic factors. Results: Overall 3-and 5-year survival rates were 27% and 17%, respectively. The 2-year locoregional control rates were 33% for radiotherapy alone, 32% for combined chemotherapy and radiotherapy, and 81 % for combined surgery and radiotherapy (p=0.006). The prognostic factors affecting overall survival were T stage, concurrent chemoradiation and treatment response. Overall 3-and 5-year laryngeal preservation rates in combined chemotherapy and radiotherapy were 26% and 22%, respectively. Of these, the 5-year laryngeal preservation rates were 52% for concurrent chemoradiation group (n=11), and 16% for neoadjuvant chemotherapy and radiotherapy (n=54, p=0.012). Conclusion: Surgery and postoperative radiotherapy showed better results than radiotherapy alone or with chemotherapy. Radiotherapy combined with concurrent chemotherapy is an effective modality to achieve organ preservation in locally advanced hypopharyngeal cancer. Further prospective randomized studies will be required.

Health Condition Assessment Using the Riparian Vegetation Index and Vegetation Analysis of Geumgang mainstream and Mihocheon (수변식생지수를 이용한 금강본류와 미호천의 건강성 평가 및 식생분석)

  • Lee, Seung-Yeon;Jang, Rae-Ha;Han, Young-Sub;Jung, Young-Ho;Lee, Soo-In;Lee, Eung-Pill;You, Young-Han
    • Korean Journal of Environment and Ecology
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    • v.32 no.1
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    • pp.105-117
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    • 2018
  • This study conducted health assessment and multivariate vegetation analysis using the riparian vegetation index in 30 sites of the Geumgang mainstream and Mihocheon to obtain practical data on the river management of the Geumgang. The result showed that the number of plant communities was 54. The flora was 75 families, 185 genera, 243 species, 2 subspecies, 21 varieties, 2 varieties, and 268 taxa. The riparian vegetation index was 38.3 (3.3; G-D1 ~ 66.7; G-U2, G-U4, and G-M3), and the health of the rivers in this area was evaluated as normal (grade C). The health of rivers was the highest in the upper stream of Geumgang mainstream and lowest in the downstream of Geumgang mainstream. The relationship between riparian vegetation index and chlorophyll-a content was low. The riparian vegetation was divided into five groups of Digitaria ciliaris colony group, Salix gracilistyla colony group, Erigeron annuus colony group, the group dominated by Humulus japonicus, Salix koreensis, Miscanthus sacchariflorus, and Phragmites japonica colonies, and the group dominated by Conyza canadensis and Echinochloa crusgalli var. echinata colonies. They had the similar health conditions. The CCA analysis showed that the environmental factors affecting the distribution of vegetation were physical factors such as vegetation area, artificial structure area, waterway area, branch width, channel width, and bank height and the biological factors such as the number of species. As such, it is necessary to maintain the health condition through continuous monitoring where the health condition is high and to apply active measures such as ecological restoration where the health condition is low.

The Results of Postoperative Radiotherapy for Hypopharyngeal Carcinoma (하인두암 환자에서의 수술 후 방사선치료의 결과)

  • Kim Won Taek;Ki Yong Kan;Nam Ji Ho;Kim Dong Won;Lee Byung Ju;Wang Su Gun;Kyuon Byung Hyun
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.254-264
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    • 2004
  • Purpose: This study was carried out to confirm clinical values and limitations of postoperative radiotherapy for hypopharyngeal carcinoma, to evaluate various prognostic factors which may affect to the treatment results and to use these results as fundamental data for making a new treatment strategy. Methods and Materials:. A retrospective analysis was peformed on 64 previously untreated patients with squamous cell carcinoma of the hypopharynx, seen between 1988 and 1999 at Pusan National University Hospital. Most of patients were treated by laryngopharyngectomy and neck dissection followed by conventional fractionated postoperative radiotherapy on surgical bed and cervical nodal areas. Results: The five-year overall survival rate and cause-specific survival rate were 42.2 percent and 51.6 percent, respectively. Univariate analysis of various clinical and pathologic factors confirmed the overall stage, TN-stage, secondary primary cancers, surgical positive margin, nodal extracapsular extension, total radiation doses as significant prognostic factors of hypopharyngeal carcinomas. But in multivariate analysis, TN-stage, surgical positive margin and extracapsular extesion were only statistically significant. Conclusion: In resectable cases of hypopharyngeal carcinoma, combined surgery and postoperative radio-therapy obtained good treatement results, even though sacrificing the function of larynx and pharynx. But in advanced and unresectable cases, with respect to survivals and qualify of life issues, we were able to confirm some limitations of combined therapy. So we recommend that comparative studies of recent various chemo-radiotherapy methods and advanced radiotherapy techniques with these data should be needed.