• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.93-100
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• 2005

Background : Cancer is the leading cause of death and one of the largest burdens of disease in Korea. In 1996, the Ten year Plan for Cancer Control was formulated and the government then adopted the plan as a national policy. As part of this plan, the National Cancer Screening Program (NCSP) for Medicaid recipients was formulated, and the government adapted this in 1999. For low-income beneficiaries of the National Health Insurance Corporation (NHIC), the screening program has been in place since 2002. In 2002, the target cancers of NCSP were stomach, breast and cervical cancer. This study was conducted to examine the relationships between the participation rate, the abnormal screening rate and the socio-demographic factors associated with participation in the screening program. Methods : To analyze the participation rate and abnormal rate for the NCSP, we used the 2002 NCSP records. The information on the socio-demographic factors was available from the database of the beneficiaries in the NHIC and Medicaid. Results : The participation rate of the Medicaid beneficiaries for the stomach, breast and cervical cancer screening were 9.2%, 15.5% and 15.0%, respectively, and 11.3% and 12.5%, except cervical cancer which wasn't be included in the NCSP, for the beneficiaries of the NHIC. The abnormal rate of stomach, breast and cervical cancer screening were 25.7%, 11.2% and 21.0%, respectively, for the beneficiaries of Medicaid and 42.6% and 19.4% for the beneficiaries of the NHIC. On the multiple logistic regression analysis, gender, age and place of residence were significantly associated with participation rates of the NCSP. For stomach cancer, women participated in the NCSP more than men. The participation rate was higher among people in their fifties and sixties than for those people in their forties and those people over seventy years in age. For the breast and cervical cancer, people in their fifties were more likely to participate in the NCSP than people in their forties and people over sixty. For the place of residence, people in the rural areas participated more than those people in any other places. Conclusions : The above results show that the participation rate and abnormal rate were significantly associated with the socio-demographic factors. To improve the participation rate for the NCSP, more attention should be given to the underserved groups.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.379-388
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• 2001

Background : Cervix cancer is the most common form of cancer among Korea women. in spite of proof that cervical cancer screening could reduce death rates substantially, the screening rates reported by previous Korean studies remain stubbornly very low. Behavioral studies to increase the cervix cancer screening rate are essential in order to develop the cancer screening program. Objective : To evaluate the factors which are related to the intention and behavior for cervix cancer screening using the Theory of Planned Behavior (TPB) and the Theory of Reasoned Action (TRA). Methods : The survey was conducted from July 21 st to 26th in 1998. Of 3,218 women, 303(12.2%) between 30 and 55 years old, voluntarily participated in the survey in the 3 Myeons in Choongju city. Charge-free cervix cancer screening was provided for the subjects 3 months later. Results : The R-square of both TPB and TRA to the intention (30% and 42%, respectively) was greater than the actual behavior (21% and 13%, respectively. TPB and TRA were found to provide an appropriate framework for the study of cervix cancer screening behavior. However, TRA was more powerful in explaining the intention, not only because the perceived behavioral control component exhibited lower reliability and validity than other components(altitude and subjective norm), but also because there may have been a few limitations in this study design. Consequently, the use of TRA is preferred in attempting to explain intention and actual behavior in this study. Conclusions : This study suggests that a successful intervention program should focus on changing attitudes and reducing psychologic barriers, rather than on just providing information. Physician recommendations, and the support of family members and friends are also very important factors in cervix cancer program participation. Physicians, friends, family members, and opinion leaders in rural areas, all of whom could affect the individual subjective norm, may all have the potential to play great roles as facilitators.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.346-352
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• 2006

Objectives: The purposes of this study were to propose a screening schedule for the early detection of breast cancer among Korean women, as based on the statistical model, and to compare the efficacy of the proposed screening schedule with the current recommendations. Methods: The development of the screening schedule for breast cancer closely followed the work of Lee and Zelen (1998). We calculated the age-specific breast cancer incidence rate from the Korea Central Cancer Registry (2003), and then we estimated the scheduling of periodic examinations for the early detection of breast cancer, using mammography, and based on the threshold method. The efficacy of the derived screening schedule was evaluated by the schedule sensitivity. Results: For estimating the screening schedule threshold method, we set the threshold value as the probability of being in the preclinical stage at age 35, the sensitivity of mammography as 0.9 and the mean sojourn time in the preclinical stage as 4 years. This method generated 14 examinations within the age interval [40, 69] of 40.0, 41.3, 42.7, 44.1, 45.4, 46.7, 48.0, 49.3, 51.0, 53.2, 55.3, 57.1, 59.0 and 63.6 years, and the schedule sensitivity was 75.4%. The proposed screening schedule detected 85.2% (74.5/87.4) of the cases that could have been detected by annual screening, but it required only about 48.7% (14.0/30.0) of the total number of examinations. We also examined the threshold screening schedules for a range of sensitivities of mammography and the mean sojourn time in the preclinical stage. Conclusions: The proposed screening schedule for breast cancer with using the threshold method will be helpful to provide guidelines for a public health program for choosing an effective screening schedule for breast cancer among Korean women.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.5
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• pp.359-363
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• 2007

Purpose: Incidental parotid lesions on F-18 FDG-PET can mimic distant metastasis of underlying malignancy. The prevalence and the clinico-pathologic findings of PET positive parotid lesions have not been known. We investigated how often incidental parotid lesions are found on clinical FDG-PET studies and what the clinico-pathologic characteristics of those parotid lesions are in the present study. Materials and Methods: We retrospectively reviewed 3,344 cases of FDG-PET which had been obtained in our hospital from May 2003 to Dec 2006. The indications of FDG-PET were: evaluation of known/suspected cancer (n= 3,212) or screening of cancer in healthy subjects (n=132). Incidental parotid lesion on FDG-PET was defined as an un-expected FDG uptake in one of parotid glands which was not primary target lesion of current FDG-PET. FDG uptake was represented by maximum standardized uptake value (maxSUV). Final diagnosis was made by pathologic analysis or clinical follow-up assessment. Results: Fifteen (0.45% = 15/3,344) incidental parotid lesions were found and they were all benign lesions. The maxSUV ranged from 1.7 to 8.6 (mean${\pm}$s.d. = $3.7{\pm}1.9$). Final diagnoses of the incidental parotid lesions were; Warthin's tumor (n=2), pleomorphic adenoma (n=1), other un-specified benign lesion (n=1), and benign lesions under bases of imaging studies (n=3) and of clinical follow-up (n=8). Conclusion: All of incidentally found parotid lesions in clinical FDG-PET studies were confirmed as benign lesions with prevalence of 0.45%. Close follow up using PET or CT might be a reasonable approach for determining the nature of incidentally found parotid lesions.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.4
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• pp.301-306
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• 2008

Purpose: Recently, a number of patients needed total thyroidectomy and high dose radioiodine therapy (HD-RAI) get increased more. The aim of this study is to evaluate whether pathological staging (PS) and serum thyroglobulin (sTG) level could replace the diagnostic I-123 scan for the determination of therapeutic dose of HD-RAI in patients with differentiated thyroid cancer. Materials and Methods: Fifty eight patients (M:F=13;45, age $44.5{\pm}11.5\;yrs$) who underwent total thyroidectomy and central or regional lymph node dissection due to differentiated thyroid cancer were enrolled. Diagnostic scan of I-123 and sTG assay were also performed on off state of thyroid hormone. The therapeutic doses of I-131 (TD) were determined by the extent of uptakes on diagnostic I-123 scan as a gold standard. PS was graded by the criteria recommended in 6th edition of AJCC cancer staging manual except consideration of age. For comparison of the determination of therapeutic doses, PS and sTG were compared with the results of I-123 scan. Results: All patients were underwent HD-RAI. Among them, five patients (8.6%) were treated with 100 mCi of I-131, fourty three (74.1%) with 150 mCi, six (10.3%) with 180 mCi, three (5.2%) with 200 mCi, and one (1.7%) with 250 mCi, respectively. On the assessment of PS, average TDs were $154{\pm}25\;mCi$ in stage I (n=9), $175{\pm}50\;mCi$ in stage II (n=4), $149{\pm}21\;mCi$ in stage III (n=38), and $161{\pm}20\;mCi$ in stage IV (n=7). The statistical significance was not shown between PS and TD (p=0.169). Among fifty two patients who had available sTG, 25 patients (48.1%) having below 2 ng/mL of sTG were treated with $149{\pm}26\;mCi$ of I-131, 9 patients (17.3%) having $2{\leq}\;sTG\;<5\;ng/mL$ with $156{\pm}17\;mCi$, 5 patients (9.6%) having $5{\leq}\;sTG\;<10\;ng/mL$ with $156{\pm}13\;mCi$, 7 patients (13.5%) having $10{\leq}sTG\;<50\;ng/mL$ with $147{\pm}24\;mCi$, and 6 patients (11.5%) having above 50 ng/mL with $175{\pm}42\;mCi$. The statistical significance between sTG level and TD (p=0.252) was not shown. Conclusion: In conclusion, PS and sTG could not replace the determination of TD using I-123 scan for first HD-RAI in patients with differentiated thyroid cancer.

• Journal of Gastric Cancer
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• v.9 no.3
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• pp.143-151
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• 2009

Purpose: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. Materials and Methods: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. Results: The ratio between males and females was 2.29 : 1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. Conclusion: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.

• Journal of Preventive Medicine and Public Health
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• v.19 no.1 s.19
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• pp.85-90
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• 1986

This study was conducted in July-August, 1984, to define the causes of chronic gastrointestinal symptoms in rural population and to provide data for the management of such patients. A household survey was conducted to identify all the residents of Youngchun and Sungiu counties in Kyungpook province who were over 20 years of age, had chronic upper gastrointestinal symptoms for over the last 6 months, never had medical examination for the symptoms, and volunteered to participate in the gastroscopic examination. Gastroscopy was done for 106 males and 108 females. Gastric ulcer was found in 16.8% of all the examinees, duodenal ulcer in 15.4%, gastritis in 14.0%, and gastric cancer in 3.7%. No lesion was found by gastroscopy in 52.3%. Gastric ulcer more common in male(26.4%) than in female(7.4%) (p<0.01) and the same was true for duodenal ulcer(20.8% of male, 10.2% of female). Gastric cancer was found in 7.5% of the male while none of the female had gastric cancer. A higher proportion of the female (68.5%) showed normal finding in the gastroscopy than the male(35.9%) (p<0.01). No significant association was found between the upper gastrointestinal symptoms and the gastroscopic findings. The higher prevalence rate of gastric ulcer than that of duodenal ulcer in this study which is the reverse of the study findings of urban area in Korea and western countries may be related in part with the dietary habit and social environment of the rural population. Although early diagnosis is the most important for the treatment of gastric cancer, many of the people with chronic upper gastrointestinal complaints defer the diagnosis and treatment. It is may be due to lack of the knowledge of diseases and the health care attitude of the rural people. A national program for the health education and mass screening for the gastric cancer should be developed.

• Journal of Biomedical Engineering Research
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• v.25 no.5
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• pp.403-414
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• 2004

In the accompanying paper, we proposed a real. time volumetric imaging method using a cross array based on receive dynamic focusing and synthetic aperture focusing along lateral and elevational directions, respetively. But synthetic aperture methods using spherical waves are subject to beam spreading with increasing depth due to the wave diffraction phenomenon. Moreover, since the proposed method uses only one element for each transmission, it has a limited transmit power. To overcome these limitations, we propose a new real. time volumetric imaging method using cross arrays based on synthetic aperture technique with linear wave fronts. In the proposed method, linear wave fronts having different angles on the horizontal plane is transmitted successively from all transmit array elements. On receive, by employing the conventional dynamic focusing and synthetic aperture methods along lateral and elevational directions, respectively, ultrasound waves can be focused effectively at all imaging points. Mathematical analysis and computer simulation results show that the proposed method can provide uniform elevational resolution over a large depth of field. Especially, since the new method can construct a volume image with a limited number of transmit receive events using a full transmit aperture, it is suitable for real-time 3D imaging with high transmit power and volume rate.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.110-114
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• 2012

Purpose : PET/CT is widely used for early checking up of cancer and following up of pre and post operation. Image reconstruction method is advanced with mechanical function. We want to evaluate image quality of each reconstruction program based on time of flight (TOF). Materials and Methods : After acquiring phantom images during 2 minutes with Gemini TF (Philips, USA), Biograph mCT (Siemens, USA) and Discovery 690 (GE, USA), we reconstructed image applied to Astonish TF (Philips, USA), ultraHD PET (Siemens, USA), Sharp IR (GE, USA) and not applied. inside of Flangeless Esser PET phantom (Data Spectrum corp., USA) was filled with $^{18}F$-FDG 1.11 kBq/ml (30 Ci/ml) and 4 hot inserts (8. 12. 16. 25 mm) were filled with 8.88 kBq/ml (240 ${\mu}Ci/ml$) the ratio of background activity and hot inserts activity was 1 : 8. Inside of triple line phantom (Data Spectrum corp., USA) was filled with $^{18}F$-FDG 37 MBq/ml (1 mCi). Three of lines were filled with 0.37 MBq (100 ${\mu}Ci$). Contrast ratio and background variability were acquired from reconstruction image used Flangeless Esser PET phantom and resolution was acquired from reconstruction image used triple line phantom. Results : The contrast ratio of image which was not applied to Astonish TF was 8.69, 12.28, 19.31, 25.80% in phantom lid of which size was 8, 12, 16, 25 mm and it which was applied to Astonish TF was 6.24, 13.24, 19.55, 27.60%. It which was not applied to ultraHD PET was 4.94, 12.68, 22.09, 30.14%, it which was applied to ultraHD PET was 4.76, 13.23, 23.72, 31.65%. It which was not applied to SharpIR was 13.18, 17.44, 28.76, 34.67%, it which was applied to SharpIR was 13.15, 18.32, 30.33, 35.73%. The background variability of image which was not applied to Astonish TF was 5.51, 5.42, 7.13, 6.28%. it which was applied to Astonish TF was 7.81, 7.94, 6.40 6.28%. It which was not applied to ultraHD PET was 6.46, 6.63, 5.33, 5.21%, it which was applied to ultraHD PET was 6.08, 6.08, 4.45, 4.58%. It which was not applied to SharpIR was 5.93, 4.82, 4.45, 5.09%, it which was applied to SharpIR was 4.80, 3.92, 3.63, 4.50%. The resolution of phantom line of which location was upper, center, right, which was not applied to Astonish TF was 10.77, 11.54, 9.34 mm it which was applied to Astonish TF was 9.54, 8.90, 8.88 mm. It which was not applied to ultraHD PET was 7.84, 6.95, 8.32 mm, it which was applied to ultraHD PET was 7.51, 6.66, 8.27 mm. It which was not applied to SharpIR was 9.35, 8.69, 8.99, it which was applied to SharpIR was 9.88, 9.18, 9.00 mm. Conclusion : Image quality was advanced generally while reconstruction program which is based on time of flight was used. Futhermore difference of result compared each manufacture reconstruction program showed up, however this is caused by specification of instrument of each manufacture and difference of reconstruction algorithm. Therefore we need further examination to find out appropriate reconstruction condition while using reconstruction program used for advance of image quality.