• 성인간호학회지
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• 제21권6호
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• pp.705-717
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• 2009

Purpose: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). Methods: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. Results: Two distinct clusters were identified: A gastrointestinal- fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. Conclusion: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.

• 임상간호연구
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• 제14권1호
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• pp.61-70
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• 2008

Purpose: Women with gynecologic cancer often experience various physical and psychological symptoms relating to the cancer and its treatment. The purpose of this study was to identify symptom clusters. Method: A survey was conducted on 184 women with diagnoses of cervical, ovarian or endometrial cancer. Fifty symptoms were assessed for prevalence, severity and interference, and symptom clusters were identified. Cluster analysis was done using SPSS version 12.0. Results: Fatigue was identified as the most prevalent symptom (81.52%), lack of vaginal lubrication (2.26) as the most severe symptom, and lack of vaginal lubrication as the most interfering one (2.15). Identified six clusters were: Anorexia-pain cluster (loss of appetite, taste change, weight loss, appearance change, alopecia, weakness, pain), Fatigue cluster (lack of concentration, lack of memory, fatigue, dry mouth), Urinary-bowel distress cluster (urinary difficulty, constipation), Abdominal discomfort cluster (lower abdominal pain, abdominal pain, bloating), Emotional distress (sadness, anxiety-worry, nervousness, restlessness), and Menopausal cluster (sweating, hot flush, fever). Conclusion: The result of this study provides fundamental data to health care professionals in developing interventions for effective symptom management for women with gynecologic cancer by understanding identified 6 symptom clusters.

• 종양간호연구
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• 제3권1호
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• pp.66-74
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• 2003

Purpose: This study is designed to identify clusters according to the causal attribution that people make about the cancer and to determine influences of coping behavior and depression as output of causal attribution. Method: The subjects were 192 patients who had been diagnosed cancer one year ago and attended an outpatient clinic. For cancer patients to be classified homogenious groups according to causal attribution, cluster analysis of subjects' ratings on the Causal Dimension Scale was been made. Results: Cluster 1(n=71) had patients with having external, stable and uncontrollable attribution. Cluster 2(n =70) had patients with having unstable and external controllable attribution regarding cause of cancer. They were not important whether cause of cancer was self or other. Cluster 3(n=51) had patients with having internal, unstable and internal controllable attribution. Coping behaviors between cluster 1 and 3 were significant difference. However, depression was not significant difference among clusters. Conclusion: Based upon these results, it is recommended that the developing training program to be changed to the more positive attribution is necessary.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.455-460
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• 2014

Background: The purpose of the present study was to determine geographic clustering of breast cancer incidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the association between socio-economic factors and any identified cluster. Materials and Methods: Incidence data were collected for women who were first diagnosed with breast cancer during the period from January to December 2006 in Kanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa Cancer Registration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio (SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities (e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female population data. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, persons per household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and other regions. Results: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of 11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that of the remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women was significantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancer deaths were detected (p=0.53). Conclusions: There was a statistically significant cluster of high breast cancer incidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related to the tendency to marry later. This study methodology will be helpful in the analysis of geographical disparities in cancer deaths and incidence.

• 종양간호연구
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• 제9권2호
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• pp.77-85
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• 2009

Purpose: The purpose of this study was to identify symptom cluster experienced by patients with advanced non-small cell lung cancer (NSCLC) on gefitinib treatment. In addition, this study assessed the patterns in severity of the symptom cluster and differences in quality of life (QOL) and function among subgroups by the severity of symptom cluster. Methods: This study was conducted as a secondary analysis of symptoms of 72 patients from a mother study. Factor analysis was used to identify symptom clusters measured with EORTC QLQ-C30 and LC13 symptom related items. Results: Three symptom clusters were identified: cluster 1 was comprised of fatigue, anorexia and dysphagia; cluster 2 of dyspnea, cough and insomnia; and cluster 3 of pain, constipation and nausea/vomiting. These three symptom clusters were improved one week after gefitinib administration. The group with more severe symptom clusters showed significantly lower QOL and function than the group with less severe symptom clusters. Conclusion: Since symptom clusters experienced by the patients with advanced NSCLC influenced on the QOL and function, it is important for nurses to understand and observe their symptom clusters. In addition, there is an necessity to develop nursing interventions to effectively care patients with the symptom clusters.

• 성인간호학회지
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• 제23권5호
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• pp.434-445
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• 2011

Purpose: This study was conducted to identify the impact of the symptom cluster of pain, fatigue, sleep disturbance, depression on the quality of life (QOL) among breast cancer patients receiving chemotherapy. Methods: One hundred and thirteen patients were recruited from five hospitals in Korea. The instruments used in this study were the fatigue, depression, sleep disturbance, pain and the quality of life scale for patients with breast cancer. The influence of the symptom cluster on patients' QOL was analyzed by using multiple regression. Results: Most patients reported a moderate level of pain, fatigue, sleep disturbance and depression. Eighty percent of patients reported three of the four symptoms. Among the four symptoms, there was no correlation between pain and sleep disturbance. Quality of life was negative correlated with the four symptoms in the cluster. Symptom cluster of pain, fatigue, and depression accounted for 51.2% of variance in QOL. Conclusion: The findings supported that there is a symptom cluster that negatively influences quality of life and needs to be addressed as we are caring for patients and are promoting quality of life.

• Journal of Microbiology and Biotechnology
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• 제31권12호
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• pp.1643-1655
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• 2021

Recent studies have reported dysbiosis of the microbiome in breast tissue collected from patients with breast cancer and the association between the microbiota and disease progression. However, the role of the microbiota in breast tissue remains unclear, possibly due to the complexity of breast cancer and various factors, including racial and geographical differences, influencing microbiota in breast tissue. Here, to determine the potential role of microbiota in breast tumor tissue, we analyzed 141 tissue samples based on three different tissue types (tumor, adjacent normal, and lymph node tissues) from the same patients with breast cancer in Korea. The microbiota was not simply distinguishable based on tissue types. However, the microbiota could be divided into two cluster types, even within the same tissue type, and the clinicopathologic factors were differently correlated in the two cluster types. Risk of regional recurrence was also significantly different between the microbiota cluster types (p = 0.014). In predicted function analysis, the pentose and glucuronate interconversions were significantly different between the cluster types (q < 0.001), and Enterococcus was the main genus contributing to these differences (q < 0.01). Results showed that the microbiota of breast tissue could interact with the host and influence the risk of regional recurrence. Although further studies would be recommended to validate our results, this study could expand our understanding on the breast tissue microbiota, and the results might be applied to develop novel prediction methods and treatments for patients with breast cancer.

• Molecules and Cells
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• 제43권2호
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• pp.198-202
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• 2020

Comprehensive inhibition of RUNX1, RUNX2, and RUNX3 led to marked cell suppression compared with inhibition of RUNX1 alone, clarifying that the RUNX family members are important for proliferation and maintenance of diverse cancers, and "cluster regulation of RUNX (CROX)" is a very effective strategy to suppress cancer cells. Recent studies reported by us and other groups suggested that wild-type RUNX1 is needed for survival and proliferation of certain types of leukemia, lung cancer, gastric cancer, etc. and for their one of metastatic target sites such as born marrow endothelial niche, suggesting that RUNX1 often functions oncogenic manners in cancer cells. In this review, we describe the significance and paradoxical requirement of RUNX1 tumor suppressor in leukemia and even solid cancers based on recent our findings such as "genetic compensation of RUNX family transcription factors (the compensation mechanism for the total level of RUNX family protein expression)", "RUNX1 inhibition-induced inhibitory effects on leukemia cells and on solid cancers through p53 activation", and "autonomous feedback loop of RUNX1-p53-CBFB in acute myeloid leukemia cells". Taken together, these findings identify a crucial role for the RUNX cluster in the maintenance and progression of cancers and suggest that modulation of the RUNX cluster using the pyrrole-imidazole polyamide gene-switch technology is a potential novel therapeutic approach to control cancers.

• Journal of the Korean Data and Information Science Society
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• 제27권5호
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• pp.1193-1201
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• 2016

공간 또는 시공간 데이터에서 다른 지역에 비해 유난히 높은 위험률을 보이는 소위 핫 스팟 (hot spot)으로 불리는 클러스터 (cluster)를 찾으려고 하는 경우가 많다. 기존의 많은 방법들은 이러한 클러스터 패턴이 존재하는지에 대한 해답만 주었지만, 최근의 많은 방법들은 클러스터의 위치, 모양, 크기뿐만 아니라 찾아진 클러스터가 통계적으로 유의한지까지 검정해준다. 본 논문에서는 이러한 다양한 방법 중 가장 많이 사용되는 클러스터 탐색 방법 중 하나인 스캔 통계량을 이용한 방법을 소개하고 그 방법이 구현된 무료 소프트웨어 SaTScan을 이용한 결과를 보여주고 장단점을 논하고자 한다. 미국 국립암센터의 SEER 프로그램에서 제공하는 미국의 각 카운티별 암 사망자 자료 중 2006년 여성 폐암 사망자 데이터를 예시 데이터로 사용하여 스캔 통계량을 이용하여 구한 클러스터 탐색 결과를 제시하고 비슷한 연구를 하고자는 연구자에게 도움을 주고자 한다.

• 정보처리학회논문지B
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• 제16B권2호
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• pp.165-172
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• 2009

최근 ACS에 따르면 여성에게 유방암은 가장 많이 발병하는 암으로서 그 사망자 수도 두 번째로 많은 암이다. 유방 X선 영상의 종괴나 석회 환부는 진단을 위한 가장 중요한 단서로서 알려져 있으므로 유방암의 조기진단을 위하여 디지털 유방 X선 영상을 컴퓨터에서 처리하는 연구가 진행되고 있다. 본 논문에서는 퍼지 클러스터 지식베이스에 기반을 둔 진단시스템을 제안한다. 제안된 시스템은 듀얼 OFUN-NET에 두 가지 종류의 특징 데이터를 처리하여 진단결과와 그 가능성을 알려준다. 실세계 의료기관으로부터 수집되고 공개적으로 제공되는 유방 X선 데이터베이스 DDSM으로부터 획득한 종괴와 석회 환부의 데이터를 사용하여 실험한다. 실험결과는 제안된 시스템이 기존의 방법보다 높은 분류 정확도와 유방 X선 영상 진단시스템으로서 전문가의 의사 결정을 도울 수 있는 타당한 결과를 보여준다.