• Title/Summary/Keyword: Clinical factor

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Utilization Rate and Related Factors of Unified Health Sub-center Among Rural Residents (통합보건지소 설치 전후 주민들의 보건지소 이용율 변화 및 관련요인)

  • Hwang, Tae-Yoon;Kang, Pock-Soo;Kim, Seok-Beom;Lee, Kyeong-Soo;Kang, Young-Ah
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.107-126
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    • 2002
  • Health sub-centers(HSCs) have played an important role in primary health care in rural area in Korea. The unification of neighboring HSCs was a strategy to improve the role of HSCs. This study was conducted to reveal the efficacy of the unified HSC established in Yangbuk-myeon, Gyeongju-si in1997. The utilization patterns of HSC and its related factors, and satisfaction of consumer on HSC were compared before and after unification of two HSCs in Gampo-eup, Yangnam-myeon using questionnaire survey, and also the statistics of medical care services and public health services were compared. Four hundred forty nine subjects were questioned in survey, 156 from Gampo-eup, 147 from Yangbuk-myeon, and 146 from Yangnam-myeon. Following unification, the utilization rates and the frequency of visits in Gampo-eup declined. In all three areas, chronic illness was the common factor influencing the utilization and change in frequency of visits to the unified HSC. Following unification, aspects of consumer satisfaction, for example; accessibility and affordability decreased in Gampo-eup, but increased in both Yangbuk-myeon and Yangnam-myeon. The statistics relating to medical care, X-ray examination, home visiting service, vaccination, and health education showed an increase for the unified HSC when compared to the sum of the statistics for the previous two. The execution rates for other public health services were the same, or a little decreased. Clinical laboratory examinations and the issuing of civil affair documents were new services offered by the unified HSC. It is concluded, the overall consumer satisfaction with the unified HSC was improved. In Gampo-eup, where after unification there was no HSC, it seemed to be a barrier to accessing the unified HSC. The effect of the unified HSC, in the respect of medical care and public health services, was not as significant as expected at the time of being established. Therefore, the strategies to reenforce the unified HSC should be developed to provide all residents with comprehensive primary health care services.

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Expression of RUNX3 in Human Gastric Cancer (위암에서 RUNX3 발현의 임상적 의의)

  • Jang, Sung-Hwa;Shin, Dong-Gue;Kim, Il-Myung;You, Byung-Ook;Yoon, Jin;Park, Sang-Su;Kang, Sung-Gu;Lee, Yun-Kyung;Heo, Su-Hak;Cho, Ik-Hang
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.185-192
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    • 2007
  • Purpose: RUNX3, a novel tumor suppressor, is frequently inactivated in gastric cancer. In the present study, we examined the pattern of RUNX3 expression in gastric cancer cells from gastric cancer specimens and the impact of its alteration on clinical outcome. Materials and Methods: A total of 124 samples of both gastric cancer and normal tissue were obtained from 124 patients who underwent curative gastrectomy at the Seoul Medical Center from January 2001 to December 2005. RUNX3 expression was determined by immunohistochemical staining, and the results were analyzed. Statistical analysis wabased on clinicopathological findings and differences in survival rates. Results: The mean age of the patients was 61 years, and the male:female ratio was 1.9:1. The expression rate of RUNX3 was 59.7% (74/124). The expression rate was higher in differentiated gastric cancers (nucleus: 9.1%, cytoplasm: 57.6%) than in the undifferentiated types (nucleus: 5.2%, cytoplasm: 46.6%) (P=0.133). The 5-year survival rates according to RUNX3 expression determined from cancer tissue were 88.9% for the nucleus $\pm$ cytoplasm(+) group of patients, 76.1% for the cytoplasm only (+) group of patients, and 65.3% for the RUNX3 negative expression group of patients (P=0.626). Only UICC TNM staging showed statistical significance related to the survival rate, as determined by multivariate analysis. Conclusion: The RUNX3 expression rate was higher in differentiated gastric cancer than in the undifferentiated types without significance. Although RUNX3 expression predicted better survival, based on multivariate analysis, the finding was not statistically significant. More cases should be further evaluated.

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Incidence of hearing loss and importance of risk factors in the neonatal intensive care unit (신생아 중환자실에서 난청의 발생빈도 및 위험요소의 중요성)

  • Kong, Seung Hyun;Kang, Jang Hee;Hwang, Kwang Su;Kim, Joong Pyo;Lee, Hyeon Jung;Choi, Hyeon;Mok, Ji Sun;Kim, Jung Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.845-850
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    • 2006
  • Purpose : To assess the incidence of neonatal hearing loss in a neonatal intensive care unit and the relative importance of risk factors for hearing imparement in a neonatal intensive care unit which the Joint Committee on Infant Hearing(JCIH) had recommended. Methods : One thousand, two hundred and one newborns admitted to the Good Moonhwa Intensive Care Unit from May 2003 to December 2005 were assesed using the automated auditory brainstem response(AABR). The screening was performed on those aged more than 36 weeks and weighing more than 2,200 g. We divided the infants into two groups, 'pass' and 'refer'. The 'refer' group were retested one month later, and if classified as 'refer' during the retest, were referred to a hearing impairment clinic. Results : From the 1,201 neonates, 1,187(98.8 percent) passed the test and 14(1.2 percent) failed. 293(24.4 percent) of the 1,201 neonates had a risk factor for hearing impairment; 282(96.2 percent) passed the test and 11(3.8 percent) failed. The group with risk factors were shown to have a higher incidence of hearing loss(P<0.001). The neonates in the refer group were shown to have a higher incidence of ototoxic drugs(P<0.001), low birth weight(<1,500 g)(P<0.001) and craniofacial anomalies(P=0.007). On the other hand, there were no statistical differences between the pass and refer groups in congenital infection, hyperbilirubinemia, bacterial meningitis, low Apgar scores, prolonged mechanical ventilation and syndromes known to include hearing loss. Conclusion : In order to identify hearing-impaired infants within an appropriate period, neonatal hearing screening tests and identification of the risk factors for neonatal hearing loss are important.

A Study of the Relationship between Childhood Obesity and Beverage Intake (소아비만과 음료 섭취량의 관계에 대한 연구)

  • Oh, Ji Hyun;Kwak, In Keun;Yang, Seung;Hwang, Il Tae;Jung, Ji Ah;Lee, Hae Ran
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1061-1066
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    • 2003
  • Purpose : The rising prevalence of childhood obesity may be due to an energy imbalance between food intake and energy expenditure. Recently, consumption of beverages in children has increased. The aim of this study is to provide useful information for the prevention and the control of childhood obesity by assessment of variable beverage consumption. Methods : Fight hundred seventy seven children(M : F=1 : 1.02, mean age; 9.7 years) from two primary schools in Seoul in May 2003 were enrolled. Body mass index(BMI) was calculated and the degree of obesity was classified into normal, overweight and obese groups by BMI percentile. Parental BMI, socio-economic factor, 3-day dietary intake, calory intake and beverage intake were examined by questionnaires. We researched beverages and classified them into six categories, milk, other milk products, soda, sports beverage, other beverage. Results : The prevalence of obesity was 7.2%. The parental BMI of the obese group were higher than those of the other groups. There was no significant difference in birth weight, or parents' intellectual and economic levels between the obese group and the other groups. There was no significant difference in daily total calory intake between the obese group and the other groups. The obese group of 7-9 year-old-males was higher than the other groups in sodas, and sports beverages intake. The obese group of 10-12 year-old-males was higher than the other groups in total beverage intake and other beverage intakes. The obese group of 10-12 year-old-females was higher than the other groups in other milk products. Conclusion : Excessive intake of beverages is associated with childhood obesity. Efforts to decrease intake of beverages may be important approaches to counter the rise in the prevalence of obesity.

Diagnostic Role of F-18 FDG PET/CT in the Follow-up of Patients with Colorectal Cancer: Comparison with Serum CEA, CA 19-9 Levels and Computed Tomography (대장암 치료 후 추적 검사로서 F-18 FDG PET/CT의 역할: 혈청 CEA, CA 19-9 및 Computed Tomography와의 진단 성능 비교)

  • Kang, Sung-Min;Song, Bong-Il;Lee, Hong-Je;Seo, Ji-Hyoung;Lee, Sang-Woo;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae;Choi, Kyu-Suk;Jun, Soo-Han
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.120-128
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    • 2009
  • Purpose: Early detection of recurrence is an important factor for long term survival of patients with colorectal cancer. Measurement of serum levels of CEA, CA 19-9, CT and PET/CT has been commonly used in the postoperative surveillance of colorectal cancer. The purpose of this study was to compare the diagnostic ability of PET/CT, tumor marker and CT for recurrence in colorectal cancer patients after treatment. Materials and Methods: F-18 FDG PET/CT imaging was performed in 189 colorectal cancer patients who underwent curative surgical resection and/or chemotherapy. Measurement of serum levels of CEA, CA 19-9 and CT imaging were performed within 2 months of PET/CT examination. Final diagnosis of recurrence was made by biopsy, radiologic studies or clinical follow-up for 6 months after each study. Results: Overall sensitivity, specificity of PET/CT was 94.7%, 91.1%, while those of serum CEA were 44.7% and 97.3%, respectively. Sensitivity and specificity were 94.2%, 90.4% for PET/CT and better than those of combined CEA and CA 19-9 measurement(52.1%, 88.5%) in 174 patients measured available both CEA and CA 19-9 data. In 115 patients with both tumor markers and CT images available, PET/CT showed similar sensitivity but higher specificity(92.9%, 91.3%) compared to combination of tumor markers and CT images(92.9%, 74.1%). Conclusion: PET/CT was superior for detection of recurred colorectal cancer patients compared with both CEA, CA 19-9, and even with combination of both tumor markers and CT. Therefore PET/CT could be used as a routine surveillance examination to detect recurrence or metastasis of colorectal cancer.

Regional Differences of Proteins Expressing in Adipose Depots Isolated from Cows, Steers and Bulls as Identified by a Proteomic Approach

  • Cho, Jin Hyoung;Jeong, Jin Young;Lee, Ra Ham;Park, Mi Na;Kim, Seok-Ho;Park, Seon-Min;Shin, Jae-Cheon;Jeon, Young-Joo;Shim, Jung-Hyun;Choi, Nag-Jin;Seo, Kang Seok;Cho, Young Sik;Kim, MinSeok S.;Ko, Sungho;Seo, Jae-Min;Lee, Seung-Youp;Chae, Jung-Il;Lee, Hyun-Jeong
    • Asian-Australasian Journal of Animal Sciences
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    • v.29 no.8
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    • pp.1197-1206
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    • 2016
  • Adipose tissue in the loin muscle area of beef cattle as a marbling factor is directly associated with beef quality. To elucidate whether properties of proteins involved in depot specific adipose tissue were sex-dependent, we analyzed protein expression of intramuscular adipose tissue (IMAT) and omental adipose tissue (OMAT) from Hanwoo cows, steers, and bulls of Korean native beef cattle by liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based proteomic analysis, quantitative polymerase chain reaction (PCR) and western blot analysis. Two different adipose depots (i.e. intramuscular and omental) were collected from cows (n = 7), steers (n = 7), or bulls (n = 7). LC-MS/MS revealed a total of 55 and 35 proteins in IMAT and OMAT, respectively. Of the 55 proteins identified, 44, 40, and 42 proteins were confirmed to be differentially expressed in IMAT of cows, steers, and bulls, respectively. In OMAT of cows, steers, and bulls, 33, 33, and 22 were confirmed to be differentially expressed, respectively. Tropomyosin (TPM) 1, TPM 2, and TPM3 were subjected to verification by quantitative PCR and western blot analysis in IMAT and OMAT of Hanwoo cows, steers, and bulls as key factors closely associated with muscle development. Both mRNA levels and protein levels of TPM1, TPM2, and TPM3 in IMAT were lower in bulls compared to in cows or steers suggesting that they were positively correlated with marbling score and quality grade. Our results may aid the regulation of marbling development and improvement of meat quality grades in beef cattle.

Establishing a Nomogram for Stage IA-IIB Cervical Cancer Patients after Complete Resection

  • Zhou, Hang;Li, Xiong;Zhang, Yuan;Jia, Yao;Hu, Ting;Yang, Ru;Huang, Ke-Cheng;Chen, Zhi-Lan;Wang, Shao-Shuai;Tang, Fang-Xu;Zhou, Jin;Chen, Yi-Le;Wu, Li;Han, Xiao-Bing;Lin, Zhong-Qiu;Lu, Xiao-Mei;Xing, Hui;Qu, Peng-Peng;Cai, Hong-Bing;Song, Xiao-Jie;Tian, Xiao-Yu;Zhang, Qing-Hua;Shen, Jian;Liu, Dan;Wang, Ze-Hua;Xu, Hong-Bing;Wang, Chang-Yu;Xi, Ling;Deng, Dong-Rui;Wang, Hui;Lv, Wei-Guo;Shen, Keng;Wang, Shi-Xuan;Xie, Xing;Cheng, Xiao-Dong;Ma, Ding;Li, Shuang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3773-3777
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    • 2015
  • Background: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. Materials and Methods: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Results: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. Conclusions: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.

Effect of Trichostatin A on Anti HepG2 Liver Carcinoma Cells: Inhibition of HDAC Activity and Activation of Wnt/β-Catenin Signaling

  • Shi, Qing-Qiang;Zuo, Guo-Wei;Feng, Zi-Qiang;Zhao, Lv-Cui;Luo, Lian;You, Zhi-Mei;Li, Dang-Yang;Xia, Jing;Li, Jing;Chen, Di-Long
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7849-7855
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    • 2014
  • Purpose: To investigate the effect of deacetylase inhibitory trichostatin A (TSA) on anti HepG2 liver carcinoma cells and explore the underlying mechanisms. Materials and Methods: HepG2 cells exposed to different concentrations of TSA for 24, 48, or 72h were examined for cell growth inhibition using CCK8, changes in cell cycle distribution with flow cytometry, cell apoptosis with annexin V-FTIC/PI double staining, and cell morphology changes under an inverted microscope. Expression of ${\beta}$-catenin, HDAC1, HDAC3, H3K9, CyclinD1 and Bax proteins was tested by Western blotting. Gene expression for ${\beta}$-catenin, HDAC1and HDAC3 was tested by q-PCR. ${\beta}$-catenin and H3K9 proteins were also tested by immunofluorescence. Activity of Renilla luciferase (pTCF/LEF-luc) was assessed using the Luciferase Reporter Assay system reagent. The activity of total HDACs was detected with a HDACs colorimetric kit. Results: Exposure to TSA caused significant dose-and time-dependent inhibition of HepG2 cell proliferation (p<0.05) and resulted in increased cell percentages in G0/G1 and G2/M phases and decrease in the S phase. The apoptotic index in the control group was $6.22{\pm}0.25%$, which increased to $7.17{\pm}0.20%$ and $18.1{\pm}0.42%$ in the treatment group. Exposure to 250 and 500nmol/L TSA also caused cell morphology changes with numerous floating cells. Expression of ${\beta}$-catenin, H3K9and Bax proteins was significantly increased, expression levels of CyclinD1, HDAC1, HDAC3 were decreased. Expression of ${\beta}$-catenin at the genetic level was significantly increased, with no significant difference in HDAC1and HDAC3 genes. In the cytoplasm, expression of ${\beta}$-catenin fluorescence protein was not obvious changed and in the nucleus, small amounts of green fluorescence were observed. H3K9 fluorescence protein were increased. Expression levels of the transcription factor TCF werealso increased in HepG2 cells following induction by TSA, whikle the activity of total HDACs was decreased. Conclusions: TSA inhibits HDAC activity, promotes histone acetylation, and activates Wnt/${\beta}$-catenin signaling to inhibit proliferation of HepG2 cell, arrest cell cycling and induce apoptosis.

Factors Related to Serum Vitamin C Level in Terminally Ill Cancer Patients (말기암환자에서 혈청 비타민 C 농도와 연관된 인자들)

  • Kim, Hyung Jun;Hwang, In Cheol;Yeom, Chang Hwan;Ahn, Hong Yup;Choi, Youn Seon;Lee, Jae Jun;Lim, Su Hyuk
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.241-247
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    • 2014
  • Purpose: Serum vitamin C is one of the indicators for antioxidant levels in the body and it is lower in cancer patients compared with the healthy population. However, there have been few studies on the levels of serum vitamin C in terminally ill cancer patients and related factors. Methods: We followed 65 terminal cancer patients who were hospitalized in two palliative care units. We collected data of age, sex, cancer type, functional status, clinical symptoms, history of cancer therapy, and various laboratory findings including serum vitamin C level. Patients were categorized into two groups according to the quartile of serum vitamin C level (Q1-3 vs. Q4), which were compared each other. Stepwise multiple logistic regression analysis was used to identify factors related to serum vitamin C levels. Results: The mean serum vitamin C level was $0.44{\mu}g/mL$, and all patients fell into the category of vitamin C deficiency. Univariate analysis showed that The serum vitamin C level was lower in non-lung cancer patients (P=0.041) and febrile patients (P=0.034). Multivariate analysis adjusted for potential confounders such as lung cancer, fever, dysphagia, dyspnea, C reactive protein, and history of chemotherapy demonstrated that odds for low serum vitamin C level was 3.7 for patients receiving chemotherapy (P=0.046) and 7.22 for febrile patients (P=0.02). Conclusion: Vitamin C deficiency was very severe in terminally ill cancer patients, and it was associated with history of chemotherapy and fever.

Clinical Study about Warning Signs of Patients with Acute Stroke (급성기(急性期) 중풍환자(中風患者)에 대한 중풍전조증(中風前兆症) 조묘(調杳) 연구(硏究))

  • Jung, Jae-Han;Sun, Jong-Joo;Choi, Chang-Min;Kim, Seok-Min;Kim, Chang-Hyun;Min, In-Gyu;Jeong, Dong-Won;Park, Sung-Uk;Jung, Woo-sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Kim, Young-Suk;Bae, Hyung-Sup;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.28 no.1
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    • pp.47-67
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    • 2007
  • Objectives : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : 225 acute stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (Stroke Center) of Kyung Hee University Oriental Hospital from October 2005 to September 2006. We evaluated their stroke type with brain MRI, their warning signs, and general characteristics such as age, sex, past history, risk factors, etc. Results : 225 subjects were included in the final analysis. In the subjects' general characteristics, the most common etiology of stroke was small vessel occlusion. In the assessment of the subjects' warning signs, the frequency of tension felt at the cervical area was highest followed by blepharospasm, sensory dysfunction (one side of numbness, tingling sensation, dead sensation), one side paralysis or weakness, etc. After analyzing etiology, cerebral hemorrhage had more facial spasm sign and hypertension than cerebral infarction. On the other hand, cerebral infarction had more diabetes and sensory dysfunction (one side of numbness, tingling sensation, dead sensation) than cerebral hemorrhage. Among stroke locations, subjects with their brain lesion in the cortex had more warning sings of motor dysfunction such as one side paralysis, or weakness. Multiple lesions showed a close relationship with smoking habit and were more common in males than in females. The under 65 years old group were more commonly associated with alcohol consumption, accidental mental stress and blepharospam than the over 65 years old group. In the group of under 65 years old, males more commonly had lesions in occipital lobe, alcohol consumption and smoking habit than females. Otherwise, females more commonly had vision dysfunction and blepharospasm than males. In the group of over 65 years old, males more commonly had cortex lesion than females. On the other hand, Females more commonly had accidental mental stress than males. Conclusions : We observed various warning signs and their distribution in acute stroke patients. The subjects' brainlesions and their etiology seemed to affect the features of the warning signs. Hypertension, diabetes and hyperlipidemia were also related to etiology of stroke and some habitual problems such as smoking and drinking seemed to reduce the age of stroke ictus. Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which appear among their patients.

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