• Journal of Preventive Medicine and Public Health
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• 제50권3호
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• pp.165-176
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• 2017

Objectives: This study aimed to estimate the risk of bleeding following minor oral surgical procedures and uninterrupted aspirin therapy in high-risk patients or patients with existing chronic diseases compared to patients who did not use aspirin during minor oral surgery at a public hospital. Methods: This retrospective cohort study analyzed the data of 2912 patients, aged 20 years or older, who underwent 5251 minor oral surgical procedures at a district hospital in Thailand. The aspirin group was comprised of patients continuing aspirin therapy during oral surgery. The non-aspirin group (reference) included all those who did not use aspirin during surgery. Immediate and late-onset bleeding was evaluated in each procedure. The risk ratio of bleeding was estimated using a multilevel Poisson regression. Results: The overall cumulative incidence of immediate bleeding was 1.3% of total procedures. No late-onset bleeding was found. A significantly greater incidence of bleeding was found in the aspirin group (5.8% of procedures, p<0.001). After adjusting for covariates, a multilevel Poisson regression model estimated that the bleeding risk in the aspirin group was 4.5 times higher than that of the non-aspirin group (95% confidence interval, 2.0 to 10.0; p<0.001). However, all bleeding events were controlled by simple hemostatic measures. Conclusions: High-risk patients or patients with existing chronic diseases who continued aspirin therapy following minor oral surgery were at a higher risk of hemorrhage than general patients who had not used aspirin. Nonetheless, bleeding complications were not life-threatening and could be promptly managed by simple hemostatic measures. The procedures could therefore be provided with an awareness of increased bleeding risk, prepared hemostatic measures, and postoperative monitoring, without the need for discontinuing aspirin, which could lead to more serious complications.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2839-2843
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• 2015

Background: MDR1, one of the most important drug-transporter genes, encodes P- glycoprotein (P-gp)-a transporter involved in protecting against xenobiotics and multi-drug resistance. The significance of the genetic background in childhood acute lymphoblastic leukemia (ALL) is not well understood. Materials and Methods: To evaluate whether C3435T and C1236T MDR1 polymorphisms are associated with the occurrence and outcome of ALL, 208 children with ALL (median age 5.0 yr) and 101 healthy Thai children were studied by polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) assay. Results: C3435T and C1236T MDR1 polymorphism are significantly associated with the high-risk group (OR= 2.6, 95%CI =1.164-5.808; P=0.028 and OR= 2.231, 95%CI =1.068-4.659; p=0.047, respectively), indicating that both may be candidates for molecular markers in the high-risk group of ALL.

• 대한간호학회지
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• 제12권2호
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• pp.31-44
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• 1982

The purpose of this study was to analyze the relationship between maternal attachment and discharge against advice in high risk infants and determine the factors which affect discharge against advice. Data of this study were collected by means of reviewing the medical records of 127 in-patients who were diagnosed as high risk infants in admission and interviewing of the mothers of these patients was done by telephone. The high risk categories were neonatal hyperbilirubinemia, congenital anomaly, congenital heart disease, blood disorder, neonatal infection and birth injury. Maternal attachment was measured by deviding the subjects into 2 groups, the one the continuing treatment group and the other the discharge against advice group. Maternal attachment is determined by an interplay of maternal attitude and specific infant behaviors. Maternal attachment developes through continuous physical and psychological contact between mother and infants. Later it developes into maternal love. The results were as follows: 1. There was a significant association between maternal attachment and discharge against advice, that is, the attachment score was higher in the continuing treatment group. 2. Inspite of controlling medical insurance, severity of disease and the length of stay, it was found that there continued to be either a partially significant or fully significant relationship between maternal attachment and discharge against advice. Stepwise multiple regression revealed that maternal attachment was second in importance as a predictor of discharge against advice, which indicates that maternal attachment was a significant predictor of discharge against advice. 3. Stepwise multiple regression revealed that in 32.3％ of these cases the significant predictors of discharge against advice were length of stay, maternal attachment, delivery type, feeding type and income.

• Journal of Korean Neurosurgical Society
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• 제55권4호
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• pp.190-194
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• 2014

Objective : Post-traumatic stress disorder (PTSD) is a group of diseases that are observed in patients who had experienced a serious trauma or accident. However, some experienced it even after only a mild traumatic brain injury (TBI), and they are easily ignored due to the relatively favorable course of mild TBI. Herein, the authors investigated the incidence of PTSD in mild TBI using brief neuropsychological screening test (PTSD checklist, PCL). Methods : This study was conducted on patients with mild TBI (Glasgow coma scale ${\geq}13$) who were admitted from January 2012 to December 2012. As for PCL, it was done on patients who showed no difficulties in communication upon admission and agreed to participate in this study. By using sum of PCL, the patients were divided into high-risk group and low-risk group. PTSD was diagnosed as the three major symptoms of PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, fourth-edifion. Results : A total of 314 TBI patients were admitted and 71 of them met the criteria and were included in this study. The mean age was 52.9 years-old (range : 15--94). The mean PCL score was 28.8 (range : 17--68), and 10 patients were classified as high-risk group. During follow-up, 2 patients (2.7%) of high risk group, were confirmed as PTSD and there was no patient who was suspected of PTSD in the low-risk group (p=0.017). Conclusion : PTSD is observed 2.8% in mild TBI. Although PTSD after mild TBI is rare, PCL could be considered as a useful tool for screening of PTSD after mild TBI.

• 지역사회간호학회지
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• 제7권2호
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• pp.281-293
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• 1996

Breast cancer ranks as one of the major health problems of adult women. Studies have shown that Breast Self-Examination (BSE) is effective in detecting breast cancer in its early stages. To motivate women BSE practicing, a nonequivalent control group pretest-posttest design was conducted. Women 40 years or older who participated in the public education program for BSE from March 11 to April 6, 1996, were randomized in an experimental group(N=50) which received a letter about the Breast Cancer Risk Appraisal and in a control group(N=50) which didn't received a letter about the Breast Cancer Risk Appraisal. After 6 months, a follow-up phone survey was taken on all participants to measure the effectiveness of the intervention. Collected data was analyzed by one, two, and three-way ANOVA with an SAS program. The results are summarized as follows : 1. The level of the Breast Cancer Risk Appraisal of the subjects is high risk(17%), moderate risk(12%), boderline risk(14%), no increased risk (57%). 2. The intervention was effective in increasing the practice scores of BSE for women(F=5.12, P<.05). 3. BSE practice scores according to breast cancer risk appraisal level of the experimental group was not significantly increased after the intervention as contrasted with the control group (F=2.33, P>.05). 4. BSE practice scores according to educational level of the experimental group was significantly increased after the intervention, as contrasted with that of the control group (F=10.09, P<.001) .On the basis of this study it can be concluded that the Breast Cancer Risk Appraisal increases practice of BSE.

• 대한간호학회지
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• 제47권1호
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• pp.39-48
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• 2017

Purpose: The purpose of this study was to verify the relationships among social support, resilience and post traumatic stress disorder (PTSD), and especially to identify factors influencing PTSD in police crime scene investigators. Methods: A cross-sectional design was used, with a convenience sample of 226 police crime scene investigators from 7 Metropolitan Police Agencies. Data were collected through self-report questionnaires during July and August, 2015. Data were analyzed using t-test, ${\chi}^2$-test, Fisher's exact test, and binary logistic regression analysis with SPSS/WIN 21.0 program. Results: The mean score for PTSD in police crime scene investigators was 13.69 .11 points. Of the crime scene investigators 181 (80.1%) were in the low-risk group and 45 (19.9%) in high-risk group. Social support (t=5.68, p<.001) and resilience (t=5.47, p<.001) were higher in the low-risk group compared to the high-risk group. Logistic regression analysis showed that resilience (OR=4.74, 95% CI: 1.57~14.35), and social support (OR=2.13, 95% CI: 1.23~3.69) are effect factors for PTSD low group. Conclusion: For effective improvement of PTSD in police crime scene investigators, intervention programs including social support and strategies to increase should be established.

• 한국건설관리학회논문집
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• 제17권2호
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• pp.90-98
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• 2016

고층 건설 프로젝트는 다양한 위험 요인이 있다. 주요 위험 요인은 시간 지연과 비용의 증가 등의 부정적인 결과이다. 따라서, 본 연구는 PROMETHEE 기법을 사용하여 초고층 건설공사 시공 단계에서의 위험 요인을 분석하였다. 이를 위해, 본 연구는 전문가 표적집단면접법(FGI)을 통해 위험 인자를 확인 하였다. 그리고 PROMETHEE는 초고층 건설공사 위험 분석을 위한 설정 평가기준으로 사용 하였다. 다음으로, 평가지표 계산의 기준은 PDRI에서 정의 레벨을 사용하여 구성하였다. 선호지수 및 평가 지표는 설문을 통해 규명되었다. 이러한 과정을 통해, PROMETHEE 기법을 이용하여 본 연구는 초고층 건설공사 시공 리스크의 중요도를 산정하였다. 그 결과, 높은 수준의 위험 요인은 다음과 같이 나타났다. 이것은 '재료 리프팅 운영 계획', '아웃리거 벨트 트러스 건설', '고층 건물의 기초 작업 계획'과 '고층 건물의 구조 개념을 고려'이다.

• 대한세포병리학회지
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• 제16권1호
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• pp.18-24
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• 2005

The objective of this study was to ascertain whether or not the high-risk human papillomavirus (HPV) test, when coupled with Papanicolaou (Pap) smears, would prove useful in the screening and management of patients in whom abnormal Pap smear results had been obtained. Concomitant high-risk HPV detection using the hybrid capture II test and colposcopy with a Pap smear were performed with 176 patients, all of whom had been screened for both cervical carcinoma and precancerous lesions. We concomitantly performed colposcopies on these patients. Upon the follow-ups, the histologic diagnoses of these patients were confirmed via either biopsy or hysterectomy. The rate of high-risk HPV detection was correlated with cytologic diagnoses and colposcopic findings. The group composed of the high-risk HPV-positive ASCUS patients exhibited a 55.7% rate of cervical intraepithelial neoplasia (CIN), a significantly higher rate than the 7.5% result obtained in the high-risk HPV-negative ASCUS group. HPV test showed high sensitivity (87%) and low specificity (62.6%) in detection of CIN and colposcopy also showed high sensitivity (88%) and low specificity (22%). Any combination of these tests improve sensitivity, but not specificity. High-risk HPV tests, when coupled with Pap smears, constituted a useful triage approach with regard to colposcopy-directed biopsies in patients in whom a cytologic diagnosis of ASCUS had been rendered.

• 지역사회간호학회지
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• 제28권3호
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• pp.240-250
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• 2017

Purpose: In South Korea, suicide mortality has rapidly increased, so it has become a major public health concern. Multicultural adolescents are regarded as a high-risk group due to their situation. In this study, we compared the prevalence and risk factors of suicide ideation between Korean and multicultural adolescents. Methods: Data from the eleventh Korean Youth Risk Behavior Web-based Survey (2015), collected by the Korean Centers for Disease Control and Prevention, were statistically analyzed using the descriptive statistics and multivariate logistic regression. The total participants were 63,376 in numbers. They were composed of 62,649 (98.9%) Korean and 727 (1.1%) multicultural adolescents. Results: I found that the prevalence of suicide ideation was significantly higher among the multicultural adolescents (15.8%) compared with those of Korean (11.3%). The risk factors of suicide ideation in the Korean group were co-residence without family, poor perceived health status, depressive mood, high stress level, poor perceived happiness level, and experience of violence. Conversely, the risk factors of the multicultural group were smoking, depressive mood, and experience of violence. Conclusion: These findings suggest that appropriate and practical prevention strategies should focus on psychological and environmental factors in order to prevent suicide ideation and reduce suicide behavior in Korean and multicultural adolescents.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1707-1710
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• 2014

Background: The objective of this study was to evaluate baseline use and positive rates of staging images (bone scan, CT) in newly diagnosed patients with prostate cancer (PCa) and to improve staging image overuse. Materials and Methods: This retrospective study covered a consecutive series of patients with PCa who underwent stage imaging at our institution between 2006 and 2011. Various clinical and pathological variables (age, PSA, biopsy Gleason score, clinical T stage, positive biopsy core rate) were evaluated by multivariate logistic regression analysis for their ability to predict a positive staging image. All patients were stratified according to the NCCN risk stratification and positive rates were compared in each risk group. Results: 410 patients (100%) underwent a bone scan and 315 patients (76.8%) underwent a CT scan. Some 51 patients (12.4%) had a positive bone scan, clinical T3 and T4 being significant independent predictors. Positive bone scan rates for low-, intermediate-, high-, and very high-risk groups were 0%, 0%, 8.25%, and 56.6%. Some 59 (18.7%) patients had a positive CT scan, with elevated PSA and clinical T3, T4 as significant independent predictors. Low-, intermediate-, high- and very high-risk group rates were 0%, 0%, 13.8% and 80.0%. Conclusions: The incidences of positive staging image in low- and intermediate- risk group were reasonably low. Following feedback on these results, staging in low- and intermediate- risk groups could be omitted.