• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.136-144
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• 2017

Objectives : Cognitive complaints are reported frequently after breast cancer treatments. The causes of cognitive decline are multifactorial, a result of the effect of cancer itself, chemotherapy, and psychological factors such as depression and anxiety. However, cognitive decline does not always correlate with neuropsychological test performance. The purpose of this study was to examine the relationship of subjective cognitive decline with objective measurement and to explore associated factors of cognitive function in breast cancer survivors. Methods : We included 29 breast cancer survivors who complain cognitive decline at least 6 months after treatment and 20 age-matched healthy controls. Neuropsychological tests were performed in all participants. Multivariable regression analysis evaluated associations between neuropsychological test scores and psychological distress including depression and anxiety, also considering age, education, and comorbidity. Results : There were no statistically significant differences in neuropsychological test performances. However, the breast cancer survivors showed a significantly higher depression(p=0.002) and anxiety(p<0.001) than the healthy controls did. Among the cancer survivors, poorer executive function was strongly associated with higher depression(${\beta}=-0.336$, p=0.001) and anxiety(${\beta}=-0.273$, p=0.009), after controlling for age, education, and comorbidity. In addition, poorer attention was also significantly related with depression(${\beta}=-0.375$, p=0.023) and anxiety (${\beta}=-0.404$, p=0.013). Conclusions : The results of this study showed the discrepancies between subjective complaints and objective measures of cognitive function in breast cancer survivors. It suggests that subjective cognitive decline could be indicators of psychological distress such as depression and anxiety.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1037-1041
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• 2006

Purpose : The prevalence of obesity and nonalcoholic steatohepatitis(NASH) was increased in adolescents. This study was performed to observe the prevalence of elevated aminotransferase levels in adolescents and to assess the correlations between aminotransferase levels and obesity related parameters(body mass index, waist circumference, hip circumference, waist to hip ratio and insulin level). Methods : We obtained weight, height, waist circumference and hip circumference from 2,417 male and 1,219 female adolescents. Mean age was $15.7{\pm}0.7$ years old. We measured fasting insulin, aspartate aminotransferase(AST) and alanine aminotransferase(ALT). Obese and overweight were defined as body mass indices(BMI) of more than the 95th, and 85th-94th percentiles, respectively, for age and sex. Results : The number of adolescents with obesity is 324(8.9 percent). 414(11.4 percent) subjects belonged to the overweight group. The average ALT level of obese, overweight and control groups were significantly different(obese : $32.1{\pm}34.3U/L$, overweight : $19.6{\pm}13.6U/L$, control : $12.7{\pm}6.7U/L$, P<0.001). The average AST level was also different according to group(obese : $27.8{\pm}16.5U/L$, overweight : $22.8{\pm}8.6U/L$, control : $20.8{\pm}8.5U/L$, P<0.001). AST and ALT were correlated with anthropometric parameters and insulin level. After multiple regression analysis, waist circumference was the significant predictive value for AST(r=0.234, P<0.001). Waist circumference, BMI and insulin levels were significant predictive values for ALT(r=0.435, P<0.001). Conclusion : The prevalence of abnormal aminotransferase was higher in the obese and overweight groups than control group. Waist circumference was useful to predict abnormal aminotransferase levels.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.8
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• pp.3958-3970
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• 2013

This study was carried out to grasp the job stress and intention to change their jobs of nurses at general hospitals by their socio-demographic, job-related and health-related behavior characteristics and especially to investigate their relationship to the job stress and intention to change their jobs. The subjects were 355 nurses working at three university hospitals located in Daejeon City, and data were collected by a survey using self-administered questionnaires structured from April 1 to May 31, 2012. As a results, the average point of the nurses' intention to change jobs by the causes for job stress was significantly higher in the boss group with low support than in that with high support while it was higher in colleague group with low support than in that with high support. To look into the correlation between the points of intention to change their jobs and the causes for job stress, their intention to change their jobs showed a significant negative correlation to the boss's support and colleagues' support while there was no significant relationship with job demands and job autonomy. As a result of hierarchical multiple regression, age, drinking coffee, department, job satisfaction, the boss's support and colleagues' support were selected as significant related variables affecting the nurses' intention to change their jobs and these variables' descriptive power was 29.4%. Viewed from the above results, it is suggested that the nurses' job stress and intention to change their jobs has a significant relationship with various variables such as socio-demographic, health-related behavior and job-related characteristics. In addition, there were a significant positive correlation between the causes for the job stress cause and intention to change their jobs, and among the causes for the job stress, support by their boss or colleagues turned out to be those affecting their intention to change their jobs. Thus, it is considered that it is necessary to minimize the nurses' job stress and at the same time to seek for specific measures for preventing their turnover.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.549-556
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• 2017

This study investigated the importance of social cognitive intervention and the cognitive rehabilitation intervention by comparing the difference and examining the relationship between neurological cognitive function and social cognitive function of stroke patients in the acute phase and chronic stroke before returning to the community. LOTCA, cartoon intention inference task, and social behavior sequence task were performed on 30 acute stroke inpatients and 30 chronic stroke patients from May 2015 to June 2016. A two sample t test was conducted to examine the differences between the groups. The Pearson's correlations test was performed to examine the correlation among the variables in each group. As a result, there were statistically significant differences between the neurological cognitive function and social cognitive function of acute stroke patients and chronic stroke patients who were undergoing rehabilitation training before returning to the community (p<0.05). A linear relationship was found between the thinking operation and social behavior sequence task in the acute stroke group (r=0.539, p<0.05). In the chronic stroke group, visual perception (r=0.530, p<0.05), visual motor organization (r=0.655, p<0.05) and thinking operation (r=0.534, p<0.05) were correlated with the cartoon intention inference task. In addition, the social behavior sequence task were correlated with visual organization (r=0.534, p<0.05) and thinking operation (r=0.764, p<0.05). As a result of multiple regression analysis, the neurological cognitive functions influencing the social cognitive function in the cartoon task was found to be the thinking operation (B = 0.431) in acute stroke patients and the thinking operation (B=0.272) and visuomotor organization (B = 0.218) in the case of chronic stroke. In addition, the results of the social behavior sequence task revealed the thinking operation (B=0.417) in the acute stroke patients, and thinking operation (B=0.267), visual motor organization(B=0.274) and visual perception(B=151) in chronic stroke patients to be significant. According to this result, there is a difference in the neurological and social cognitive levels between the two groups. Therefore, the social cognition is strongly related to the high level cognitive function as thinking operation of the neurological cognitive function. Therefore, in further research, it would be necessary to determine if there is a change in higher cognitive function in neurological cognitive function after applying a social cognition intervention program for stroke.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.147-159
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• 2001

A questionnaire survey of 568 women over the age of 30 in 11 dongs of Goryeong- gun was performed to identify the practice rate of breast self- examination and its related factors. It was found that the practice rate of breast self- examination was 28.2%, with 9.7% of those surveyed performing breast self- examinations more than once a month. The practice rate of breast self- examination showed significant differences according to factors, such as age, presence of spouse, educational level, occupation, economic status, smoking, regular exercise and chronic disease. According to age, the highest practice rate of breast self-examination was between the ages of 40-49 and the lowest over the age of 60. The practice rate increased with higher the educational level and presence of spouse. According to occupation, administrative and managerial occupations presented the highest practice rate of breast self- examination. Higher economic status, regular exercise and positive family history of breast cancer each presented high practice rates of breast self- examination. The practice rate revealed higher in those who did not smoke and who had no chronic diseases than others. The greatest reason for performing breast self- examination was decided by myself for health reasons, followed by effect of mass media and promotion by health center. The most common reasons for not performing breast self- examination were don't feel the need, followed by don't know how to perform the exam and don't know about the exam itself. Multiple logistic regression analysis showed that factors, such as over the age of 60, less education, and no experience with mammography all lowered the practice rate of self-breast examination. Inconclusion, the rates of breast self- examination and regular check-ups of people in rural areas, who are characteristically older and have low educational backgrounds, were 28.2% and 9.7%. These results show the immediate need for the education of the methods for breast self- examination to be carried out by health centers in these areas. Such efforts and programs could increase the practice rate of breast self- examination and thereby improve health and enhance the quality of life of women in rural areas.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.133-146
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• 2001

The purpose of this study was to investigate the treatment status and its related factors of the newly detected rural hypertensives through community health promotion program. A questionnaire survey and blood pressure measurement were performed to 6,977 residents of a rural area, and 282 hypertensives detected by blood pressure measurement were selected as subjects of the study. The study employed the health belief model as a hypothetical model. The major results of this study were as follows: The proportion of person experienced treatment among hypertensives was 12.0%. Treatment experience rate was significantly related with age and educational level(p<0.01). That is, if they were older, lower educational level, the treatment experience rate was higher. The major reasons of no treatment were 'they had not hypertensive symptoms ' (45.6%), 'their blood pressure was not high so much that they received treatment ' (43.2%). The chief facilities for treatment were public health institutions(57.9%) such as health center and health subcenter, and hospital/ clinics(29.8%). The treatment experience rate was higher when they had higher perceived severity for hypertension, lower perceived barrier to treatment, although statistically not significant. Treatment experience rate was significantly related with cues to action and health education experience(p<0.05). That is, if they had hypertension related symptoms such as headache previously, patients suffered from hypertension complication and health education experience for hypertension, the treatment experience rate was higher. In multiple logistic regression analysis for treatment experience, having a cerebrovascular patient in their acquaintance and the experience of health education for hypertension were significant variables. On consideration of above findings, it would to be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• Investigative Magnetic Resonance Imaging
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• v.18 no.2
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• pp.133-143
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• 2014

Purpose : The aim of this study was to determine the magnetic resonance imaging (MRI) features associated with re-excision due to the presence of a positive margin after breast conserving therapy (BCT) in breast cancer patients. Materials and Methods: We reviewed the records of 286 consecutive breast cancer patients who received BCT between January 2006 and December 2007. Among 246 patients who had undergone BCT, 38 (15.4%) underwent immediate further surgery due to positive margin status. We analyzed the MRI findings using ${\chi}^2$ test, Fisher's exact test and t tests. Multivariate logistic regression was conducted for prediction of re-excision. Results: Tumor size (p < 0.001), lesion multiplicity (p = 0.003), and non-mass-like enhancement (NMLE) type on MRI (p < 0.001) were associated with margin involvement in BCT. On preoperative MRI, larger size (${\geq}5cm$) (odds ratio = 2.96), NMLE (odds ratio = 3.81), and multifocal lesions (odds ratio = 2.54) were positively associated with re-excision. In cases involving NMLE, segmental distribution was associated with a greater likelihood of immediate re-excision. Conclusion: Larger size, multiplicity, and NMLE on MRI are significantly associated with re-excision after BCT in breast cancer patients. For NMLE lesions, the segmental distribution pattern was predictive of re-excision.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.143-153
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• 2002

This study was performed to examine the want for home-visit health care of health center and health sub-center in rural olders and to provide the basic data to develop strategies for efficient and effective home-visit health care delivery of public health facilities. The questionnaire survey by interview was conducted to 355 olders whose ages were all over 65 years, residing at a rural community, Myun, Gyeongsangbuk- do. Among study population, 64.5% replied that their self-rated health status were 'poor', 14.1% had low ADL and 14.9% had low IADL. Among study population, 73.5% replied that they had health problem which were in need of medical personnel's care. The existence of health problem were significantly different according to sex, age, marital status, health security status, occupation, economic status, circumstances for medical care, self-rated health status, ADL, and IADL(p<0.05). Among olders with health problem which were in need of medical personnel's care, 19.5% wanted to receive the home-visit health care. The degree of want for home-visit health care was higher significantly in olders whose ages were 75-year old or more(p<0.05), jobless olders(p<0.01), the aged persons who were not in harmony with other family members, olders whose self-rated health status were 'poor' and olders with low IADL. The major reasons why they wanted to receive the home-visit health care services were 'they had no helpers when they were sick' (64.7%), 'long distance to the medical facilities from their residence'(23.5%). The medication service was the most need service among home-visit health care services. The reasons why they didn't want to receive the home-visit health care services were 'we could walk and move' (60.0%), 'we wanted to have a direct contact with doctor' (25.7%) in the order of high rate. In multiple logistic regression analysis, the degree of want for home-visit health care were higher significantly in olders who were not in harmony with other family members and olders whose self-rated health status were 'poor'(p<0.05).

• Neonatal Medicine
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• v.18 no.1
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• pp.49-58
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• 2011

Purpose: The purpose of this study was to evaluate the relationship between cord blood adiponectin and insulin-like growth factor (IGF)-I and their effect on fetal growth and insulin resistance in mothers with gestational diabetes mellitus (GDM). Methods: Cord blood adiponectin and IGF-I were compared between mothers with GDM (GDM group, N=53) and controls (non-GDM group, N=101). Neonates were classified into three groups of small for gestational age (SGA, N=26), appropriate for gestational age (AGA, N=97), and large for gestational age (LGA, N=31) by birth weight. The association between cord adiponectin and IGF-I levels was evaluated in relation to maternal and neonatal clinical data. Results: Cord adiponectin was lower in the GDM group than in the non-GDM group (P<0.001). There was no significant difference in cord adiponectin among the SGA, AGA, and LGA groups in the GDM group (P=0.228). The cord adiponectin of AGA in the GDM group was significantly lower than that in the non-GDM group (P<0.001). The most powerful predictor affecting cord adiponectin was the result of maternal 75 g oral glucose tolerance test. The cord IGF-I values between the GDM group and the non-GDM group were not different (P=0.834). Neonates with the heavier birth weight had the higher cord IGF-I levels. The most powerful predictor affecting cord IGF-I was birth weight and the next was maternal parity. Conclusion: Both cord blood adiponectin and IGF-I were associated with fetal growth, but IGF-I was a more general and direct factor affecting fetal body size, and adiponectin seemed to have more association with insulin sensitivity than growth.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.247-254
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• 2007

Purpose : Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. Methods : We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days-16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). Results : Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation($9.8{\pm}5.3$ vs. $26.7{\pm}7.6$, P<0.0001), (2) maximum pressor number ($2.1{\pm}1.2$ vs. $3.0{\pm}1.0$, P=0.038), and (3) the degree of fluid overload($5.2{\pm}6.0$ vs. $15.0{\pm}8.9$, P=0.002) were significantly lower in survivers than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. Conclusion : CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure. (J Korean Soc Pediatr Nephrol 2007;11:247-254)