• Title/Summary/Keyword: 흡연환자

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Loss of Heterozygosity at 3p in Korean Non-Small Cell Lung Cancer (한국인 비소세포폐암에서의 3p의 소실)

  • Lee, Choon-Taek;Kim, Mi-Hee;Park, Kyung-Ho;Park, Jong-Ho;Baek, Hee-Jong;Zo, Jae-Ill;Kim, Jin-Kyoo;Kim, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.975-983
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    • 1998
  • Purpose: Frequent deletion of 3p in numerous cancer including lung cancer suggests the presence of tumor suppressor gene. 3p has been analysed by RFLP and PCR-LOH of microsatellite locus. In this study, we observed the deletion of 3p in Korean NSCLC by PCR-LOH of 4 microsatellite loci and investigated the clinical significance. Method: 62 surgically resected NSCLC DNA and normal lung DNA have been analysed by PCR-LOH at three dinucleotide[D3S1228 (3p14.1-14.3), D3S1067 (3p14.3-21.1), D3S1029 (3p21.1-21.3)] and one tetranucleotide[D3S1537 (3p 22-24.2)] repeat microsatellite loci. Results: Among 59 informative cases, 3p deletion by PCR-LOH at four microsatellite loci was found in 31 patients(52.5%). 3p deletion were found in 55% of squamous cell lung cancer and 47% of adenocarcinoma patients. No significant difference has been found in clinical parameters such as staging, smoking and survival according to the status of 3p deletion. Conclusion: Deletions in 3p have played an important role in Korean NSCLC though no clinical significance was detected.

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Group Classification on Management Behavior of Diabetic Mellitus (당뇨 환자의 관리행태에 대한 군집 분류)

  • Kang, Sung-Hong;Choi, Soon-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.2
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    • pp.765-774
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    • 2011
  • The purpose of this study is to provide informative statistics which can be used for effective Diabetes Management Programs. We collected and analyzed the data of 666 diabetic people who had participated in Korean National Health and Nutrition Examination Survey in 2007 and 2008. Group classification on management behavior of Diabetic Mellitus is based on the K-means clustering method. The Decision Tree method and Multiple Regression Analysis were used to study factors of the management behavior of Diabetic Mellitus. Diabetic people were largely classified into three categories: Health Behavior Program Group, Focused Management Program Group, and Complication Test Program Group. First, Health Behavior Program Group means that even though drug therapy and complication test are being well performed, people should still need to improve their health behavior such as exercising regularly and avoid drinking and smoking. Second, Focused Management Program Group means that they show an uncooperative attitude about treatment and complication test and also take a passive action to improve their health behavior. Third, Complication Test Program Group means that they take a positive attitude about treatment and improving their health behavior but they pay no attention to complication test to detect acute and chronic disease early. The main factor for group classification was to prove whether they have hyperlipidemia or not. This varied widely with an individual's gender, income, age, occupation, and self rated health. To improve the rate of diabetic management, specialized diabetic management programs should be applied depending on each group's character.

Proving Causation With Epidemiological Evidence in Tobacco Lawsuits (담배소송에서 역학적 증거에 의한 인과관계의 증명에 관한 소고)

  • Lee, Sun Goo
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.2
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    • pp.80-96
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    • 2016
  • Recently, a series of lawsuits were filed in Korea claiming tort liability against tobacco companies. The Supreme Court has already issued decisions in some cases, while others are still pending. The primary issue in these cases is whether the epidemiological evidence submitted by the plaintiffs clearly proves the causal relationship between smoking and disease as required by civil law. Proving causation is difficult in tobacco lawsuits because factors other than smoking are involved in the development of a disease, and also because of the lapse of time between smoking and the manifestation of the disease. The Supreme Court (Supreme Court Decision, 2011Da22092, April 10, 2014) has imposed some limitations on using epidemiological evidence to prove causation in tobacco lawsuits filed by smokers and their family members, but these limitations should be reconsidered. First, the Court stated that a disease can be categorized as specific or non-specific, and for each disease type, causation can be proven by different types of evidence. However, the concept of specific diseases is not compatible with multifactor theory, which is generally accepted in the field of public health. Second, when the epidemiological association between the disease and the risk factor is proven to be significant, imposing additional burdens of proof on the plaintiff may considerably limit the plaintiff's right to recovery, but the Court required the plaintiffs to provide additional information such as health condition and lifestyle. Third, the Supreme Court is not giving greater weight to the evidential value of epidemiological study results because the Court focuses on the fact that these studies were group-level, not individual-level. However, group-level studies could still offer valuable information about individual members of the group, e.g., probability of causation.

The Immunohistochemical Analysis for the Expression of Survivin, HSP, and Bcl-2 in Non-small Cell Lung Carcinoma (비소세포폐암에서 Survivin, HSP 및 Bcl-2 발현에 관한 면역조직화학적 분석)

  • Hong, Hyun-Ju;Hong, Seok-Gyun;Lee, Kye-Young;Kim, Woo-Ho;Lee, Choon-Taek;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Young-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.441-452
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    • 2002
  • Background : Anti-apoptotic proteins may be involved in tumor development, progression and the response to treatment, Bcl-2 is by far the most studied anti-apoptotic protein. A novel inhibitor of apoptosis, designated survivin, and the heat shock proteins (HSPs) have recently been found in many human cancers. Immunohistochemical methods were used to determine the expression level of survivin, HSP70 and bcl-2 in non-small cell lung cancer (NSCLC) to evaluate their clinical significance. Materials and Methods : Tissue array slides were obtained from 99 surgically resected NSCLCs. Immunohistochemical staining was performed by an immuno-peroxidase technique using an avidin-biotinylated horseradish peroxidase complex. Anti-survivin rabbit polyclonal antibodies, anti-HSP70 mouse monoclonal antibodies and anti-bcl-2 mouse monoclonal antibodies were used as the primary antibodies. Results : Positive staining of survivin was detected in 33.3% of the cases. Survivin positivity is associated with to females and recurrence. A nonstatistically significant trend toward increased survivin expression was observed in non-smokers, and its expression inversely correlated with the number of cigarettes smoked in smokers. HSP70 was detected in 84.8% but this did not correlated with the clinicopathologic characteristics. Bcl-2 was detected in 18.2% and its expression correlated to tumor recurrence. No significant difference in the median survival time was noted in a comparison of all cases with survivin expression and those without. There was no association between HSP70 or bcl-2 expression and survival. Conclusion : Survivin expression was significantly associated with females and tumor recurrence. In addition its expression was inversely associated with the number of cigarettes smoked. However, HSP70 and bcl-2 expression were not associated with the clinical parameters or survival. This suggests that measuring the survivin levels may be useful in identifying patients at high risk for disease recurrence. Therefore, survivin might be a new diagnostic/therapeutic target in cancer.

The GSTT1 Genotype as A Marker for Susceptibility to Lung Cancer in Korean Female Never-Smokers (한국인 비흡연 여성에서 폐암의 유전적 감수성 표지자로서의 GSTT1 유전자형)

  • Jang, Sang Soo;Jung, Chi Young;Lee, Sin Yeob;Lee, Jae Hee;Jeon, Hyo-Sung;Park, Sun Ha;Son, Ji-Woong;Lee, Eung Bae;Kim, Chang Ho;Kam, Sin;Park, Rang Woon;Kim, In-San;Jung, Tae Hoon;Park, Jae Yong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.5
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    • pp.485-494
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    • 2003
  • Background : Most previous studies regarding the role of GSTMl and GSTT1 on lung cancer risk have been focused mainly on male smokers. However, epidemiological characteristics, histologic types and risk factors are different in female and male lung cancers, we investigated the association between these genotypes and lung cancer risk in males and females separately. Materials and Methods : The study population consisted of 253 lung cancer (153 males and 100 females) and 243 controls (140 males and 103 females). GSTM1 and GSTT1 genotypes were determined by a multiplex PCR. Results : In the male population, neither GSTM1 nor GSTT1 null genotype showed significant difference between cases and controls. In the female population, the frequencies of GSTM1 null genotype showed no significant difference between cases and controls. However, the frequencies of GSTT1 null genotype was significantly higher in cases (70.3%) than controls (55.3%, odds ratio (OR)=2.18; 95% confidence interval (CI=l.21-3.93). When the female population was stratified by age and smoking status, the ORs for GSTT1 null genotype were significantly higher in subgroups of ${\leq}60$ years (OR=4.82; 95% CI=l.61-14.4) and never-smokers (OR=4.29; 95% CI=1.94-9.48) but not in subgroups of >60 years or smokers. When stratifying the female never-smokers by age, the ORs for GSTT1 null genotype were significantly higher in both age groups of ${\leq}60$ years (OR=7.64; 95% CI=2.00-29.2) and >60 years (OR=2.89; 95% CI=1.05-7.94). Conclusion : We found that GSTT1 null genotype was associated with an increased risk of lung cancer in Korean female never-smokers. This result suggests that GSTT1 null genotype could be used as a biomarker for genetic susceptibility to lung cancer in Korean female never-smokers.

Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia (지역사회에서 소화불량 환자의 Helicobacter pylori 감염에 대한 집단검진 및 치료효과)

  • Kim, Seong-Ho;Hong, Dae-Yong;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Sang-Kyu;Suh, Jeong-Ill;Kim, Mee-Kyung;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.285-298
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    • 2000
  • Objectives : To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. Methods : A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. Results : Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.1%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). Conclusions : When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.

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The Resting and Exercise Related Oxygen Desaturation as the Associated Factor for Sleep Related Oxygen Desaturation in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 수면 중 산소포화도 감소에 대한 예측인자로서 안정시 및 운동시 산소포화도)

  • Shin, Chang-Jin;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.231-238
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    • 1999
  • Background: Nocturnal hypoxemia occurs in patients with chronic obstructive pulmonary disease(COPD) and the detection and treatment of nocturnal hypoxemia should be part of the management of COPD patients. We performed this study to evaluate the factors influencing to sleep related arterial oxygen desaturation($SaO_2$) in patients with COPD. Methods: Resting and exercise cardiopulmonary function test, polysomnography, and $SaO_2$ during resting, exercise and sleep were measured in 12 patients with COPD. Results: The $SaO_2$ fell twice as much during sleep as during maximal exercise($13.1{\pm}9.3%$ fall in nocturnal $SaO_2$ vs. $6.4{\pm}3.3%$, p<0.05). Fall in nocturnal $SaO_2$ was well correlated with mean exercise $SaO_2$(r=-0.78, p<0.05), minimum exercise $SaO_2$(r=-0.90, p<0.01), and resting $SaO_2$(Cr=-0.82, p<0.05). Lowest sleep $SaO_2$ was well correlated with mean exercise $SaO_2$(r=0.80, p<0.05), lowest exercise $SaO_2$(r=0.90, p<0.01), and resting $SaO_2$(r=0.84, p<0.05). Conclusion: Resting and exercise $SaO_2$ was well correlated with nocturnal $SaO_2$, but exercise study add no additional information to predicting the nocturnal oxygen desaturation in patients with COPD.

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Clinical Study of Bronchioloalveolar Cell Carcinoma (기관지 폐포암의 임상적 특성)

  • Choi, Jin-Won;Park, Ik-Soo;Kim, Jin-Ho;Yoon, Ho-Joo;Shin, Dong-Ho;Kim, Tae-Wha;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.1
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    • pp.26-35
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    • 1994
  • Background: Bronchioloalveolar cell carcinoma today needs further studies as an early diagnosis will drastically improve the chances of cure. Methods: Twenty-four cases of bronchioloalveolar cell carcinoma for the period of 5 years were studied in terms of incidence, age, sex, underlying diseases, symptoms, radiographic findings, methods of diagnosis, clinical and pathologic staging, methods of treatment, and survival retrospectively. Results: No correlation was found between patients' age, sex and underlying diseases. Most common symptoms were cough(62.5%), chest pain(29.2%), and sputum(29.2%). Of the 24 cases, 13 patients(54.2%) had solitary nodule, 6 patients(25%) had multiple nodules. At the time of diagnosis, 3 patients(12.5%) had the stage I diseases, 3 patients(12.5%) had the stage II diseases, 4 patients(16.7%) had the stage IIIa diseases, 3 patients(12.5%) had the stage IIIb diseases, and 11 patients(45.8%) had the stage IV diseases. 14 cases(58.3%) were found inoperable at the time of admission; they all died within 17 months. In 7 cases with stage I, II, IIIa diseases curative resection were attempted, in 1 case with stage IV disease wedge resection for palliative management was performed, and in 4 cases patients were still alive at the time of conclusion of this study. Conclusion: We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.

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Recurrence Analysis after Video-assisted Thoracic Surgery for the Treatment of Spontaneous Pneumothorax (자연기흉의 비디오흉강경수술 후 재발에 대한 분석)

  • Kim, Sung-Wan;Kim, Duk-Sil;Lim, Chang-Young;Lee, Hyeon-Jae;Lee, Gun;Kong, Joon-Hyuk
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.710-715
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    • 2010
  • Background: Video-assisted thoracic surgery (VATS) became common in the treatment of spontaneous pneumothorax (SP). Therefor we've reviewed the recurrence rate after VATS and analysed the factors affecting recurrent pneumothorax after VATS on this study. Material and Method: This retrospective analysis was performed on 321 patients of SP who had undergone VATS from Jan. 2001 to Dec. 2008. The two groups were divided as follow: group A, non-recurrent group (298 patients: 93%); and group B, recurrent group (26 patients: 7%); the two groups were analysed retrospectively. Result: The average age of the study groups were $20.9{\pm}4.3$ years old in recurrent group vs. $25.9{\pm}11.7$ years old in non-recurrent group with statistical significance (p < 0.05). There were no statistical significance in male to female ratio, height/weight ratio, location of pneumothorax, smoking history, operative time, duration of drain, hospital stay, indication of opertion and incidence rate. Average length of duration in recurrence was 12.9 months. There was 22 (95.7%) recurrent patients after VATS within 4 year period among recurrent group. Treatment methods in 23 of recurrent patients were, 8 (VATS), 2 (Axillary thoracotomy) with 15% or more in amount of pneumothorax and 7 (7 Fr. chest tube), 6 (nasal 02) with 15% or less in amount of pneumothorax. Among 10 cases of reoperation, there were 3 cases of over looking type and 7 cases of new growing type. There was no additional recurrence after these procedures were given. Conclusion: There was higher recurrence rate in younger age after VATS thus for those under 20 yrs old, detailed and possible preoperative warning for recurrence is warranted. Most recurrence occured within 4 year period, thus for this reason, regular interval based follow up with chest x-ray study is suggested during this period.

Lifestyle, Diet, Self-care, and Diabetes Fatalism of Diabetic Patients with and without Diabetic Foot (당뇨병성 족부질환 여부에 따른 당뇨병 환자의 생활습관, 식습관, 자가관리 및 Diabetes fatalism)

  • Choi, Jungha;Kang, Juhee;Lee, Hongmie
    • Korean Journal of Community Nutrition
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    • v.19 no.3
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    • pp.241-249
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    • 2014
  • Objectives: This study was to determine diabetes fatalism of diabetic patients with and without diabetic foot and its association with lifestyle, diet, and self-care. Methods: The subjects were diabetic patients with (male/female 48/21) and without diabetic foot (male/female 33/26). We administered the questionnaires which were designed to determine diabetes fatalism, lifestyle, diet, and self-care. Diabetes fatalism was determined by Diabetes fatalism scale (DFS), which consisted of total 12 items in three subscales namely, emotional stress, religiou spiritual coping, and perceived self-efficacy. Results: The patients with diabetic foot had undesirable diets more frequently (1.37 and 0.91 days/week respectively) and their desirable diets (2.74 and 3.61 days/week respectively) and foot care (4.61 and 5.53 days/week respectively) were less frequent than those without diabetic foot (p < 0.05). An item analysis of the 12 DFS items revealed a Chronbach' ${\alpha}$ of 0.614 and 0.869, respectively in diabetic patients with and without diabetic foot. Perceived self-efficacy related DFS of subjects without diabetic foot was positively associated with smoking (r=0.350, p<0.01), undesirable diet (r=0.295, p<0.05), and drinking (r=0.257, p<0.05), while its negative association with exercise (r=-0.224, p<0.088) and foot care (r=-0.247, p<0.059) did not reach to statistical significance. Conclusions: This work was the first study reporting the potential usefulness of DFS, especially perceived self-efficacy related subscale as a predictor of lifestyle, diet and self-care on the Korean diabetic patients, at least those without severe diabetic foot to screen those who should be the first target for diabetes education.