• Asian Pacific Journal of Cancer Prevention
• /
• 제14권2호
• /
• pp.1141-1145
• /
• 2013

Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권9호
• /
• pp.5055-5060
• /
• 2013

Objective: Twist, a basic helix-loop-helix transcription factor, plays a key role in the metastatic progression of human cancer. Matrix metalloproteinase (MMP)-9 is an endopeptidase that digests basement membrane type IV collagen, therefore being possibly related to tumor progression. It has been reported that Twist and matrix metalloproteinase-9 (MMP-9) are expressed in gastric cancers. However, the exact roles of Twist and MMP-9 in tumor metastasis and prognosis remain unclear. The aim of this study was to casts light on this question. Methods:Twist and MMP-9 expression in tissue sections of 37 gastric carcinomas was evaluated with immunohistochemistry. The staining results were compared with clinicopatholgic features and to patients' outcome. Results: Twist positive expression was significantly increased in gastric cancer cases with lymph node metastasis (P=0.023). But no correlations were found between MMP-9 overexpression and clinicopathologic features, such as recurrence, TNM stage, and lymph node metastasis. Overall survival (OS) was significantly correlated with recurrence, serosa invasion, TNM stages, distant metastasis, and MMP-9 (P=0.027, 0.021, 0.000, 0.024 and 0.036, respectively). Disease-free survival (DFS) was prominently related to recurrence location, serosa invasion and TNM stages (P=0.000, 0.038 and 0.003, respectively). In the Cox regression multivariate analysis, TNM stage, distant metastasis and MMP-9 were significantly associated with prognosis of gastric cancer (P=0.002, 0.019, and 0.032, respectively). Conclusions: This study showed Twist positive expression to be significantly correlated with lymph node metastasis in gastric cancer. MMP-9 overexpression is associated with OS, suggesting that MMP-9 is a prognostic indicator for survival in patients with gastric cancer.

• 응용통계연구
• /
• 제16권2호
• /
• pp.407-426
• /
• 2003

본 연구에서는 범주형 반복측정자료의 일반화추정방정식(GEE)모형에서 결측이 발생할 경우 결측값 대체(imputation)방법들에 대한 성능을 비교하고자 한다. 설명변수 X가 부분적으로 결측을 갖는 경우 GEE추정량을 계산할 수 없다. 본 논문에서는 시점에 따라 값이 변하는 설명변수에 결측이 있는 경우 GEE모형에서 결측값을 추정하는 7가지의 대체방법을 다루며, 실제자료와 모의실험을 통하여 대체방법별 GEE추정량의 성질을 연구한다. 대체방법별 GEE추정량의 성능을 비교하기 위해 우리는 반응변수가 범주형인 반복측정모형에서 완전자료의 GEE추정량과 완전자료에서 결측을 생성하여 결측값에 각 대체방법을 적용하여 대체한 후 구한 GEE추정량을 비교한다. 대체방법으로는 (1) 단순삭제 (2) 표본 평균대체 (3) 행 평균대체 (4) 횡 시점 회귀대체 (5) 이월대체 (6) 베이지안 붓스트랩 (7) 근사적 베이지안 붓스트랩에 대해서 살펴본다. 결측과정(missing mechanism)은 무시할 수 있는 무응답(ignorable nonresponse)을 가정하며, 결측 발생에 대해서는 원자료의 시점 무응답 패턴(wave nonresponse pattern)을 고려하여 발생시키거나 또는 시점 무응답 패턴을 고려하지 않고 단순임의추출로 결측을 발생시키는 방법을 각각 고려한다.

• 보건행정학회지
• /
• 제23권4호
• /
• pp.358-368
• /
• 2013

Background: There are some data to support the theory of a protective effect of parenthood against suicide, as proposed by Durkheim in 1897. We conducted this study to examine the relationship between children characteristics and suicidal ideation among Korean married women. Methods: The data were obtained from the Korean National Health and Nutrition Examination Surveys IV, conducted in 2007-2009, respectively (3,202 married women aged 20-49 years). The children characteristics are the age of the youngest child and the number of children living with subject. Data were analyzed by using logistic regression with SAS 9.2. Results: The risk for suicidal ideation was higher among married women having a young child (aged <7 years). It had strong effect on suicidal ideation in non-employee subjects. The odds ratio for suicidal ideation of women having a youngest child aged 2-3 years compared with reference groups was 1.673 with statistical significance. But the association of suicidal ideation with number of children shows insignificant. Conslusion: The findings suggest a different result with the theory, the protective effect of being a parent of young child on suicide risk for women, first suggested by Durkheim and supported by previous studies and the need for further prospective investigation that lead to policies according children characteristics aimed at improving married women's life.

• Journal of Preventive Medicine and Public Health
• /
• 제53권5호
• /
• pp.371-380
• /
• 2020

Objectives: This study investigated the effects of socio-demographic factors on the decreasing trend in the sex ratio at birth from 1997 to 2017 in Korea. Methods: Data from 10 349 602 live births registered with Statistics Korea from 1997 to 2017 were analyzed. The secondary sex ratio (SSR), defined as the ratio of male to female live births, during the study period (1997-1999 [phase I], 2000-2002 [phase II], 2003-2005 [phase III], 2006-2008 [phase IV], 2009-2011 [phase V], 2012-2014 [phase VI], and 2015-2017 [phase VII]) was calculated according to selected socio-demographic factors, such as parental age, education, occupation, and birth order. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals for a male birth after adjusting for potential confounders. Results: The SSR gradually decreased from 1.10 (in 1998-2000 and 2002) to 1.05 (in 2013-2016). While a decreasing trend in the SSR was not noted among first births, male-biased sex ratios were prominent among third and higher-order births, for which the highest SSR was 1.46 in 1998. Higher birth order was significantly associated with an excess of male births in phases I-VI (≥third vs. first, OR range, 1.03 to 1.35). Advanced maternal age was significantly associated with an excess of female births in phases II, III, and V (≥40 vs. 20-24 years, OR range, 0.92 to 0.95). Conclusions: This study demonstrated that advanced maternal age and reduction of the artificially-biased SSR among third and higher-order births may partially explain the decreasing trend in the SSR from 1997 to 2017 in Korea.

• 대한불안의학회지
• /
• 제10권1호
• /
• pp.17-23
• /
• 2014

Objective : Panic disorders are frequently accompanied by major depressive disorder (MDD). There is insufficient information about which clinical factors in panic disorder are associated with comorbid MDD. The aim of this study is to identify clinical factors related with comorbid MDD in patients with panic disorder. Methods : Two experienced psychiatrists diagnosed panic disorder based on DSM-IV criteria. This diagnosis in the 275 subjects was confirmed again by Mini-International Neuropsychiatric Interview (MINI). Lifetime comorbid psychiatric diagnoses were examined by MINI. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Panic Disorder Severity Scale (PDSS) were used to assess the severity of depressive, anxiety and panic symptoms. Results : The result of MINI showed that 95 patients (34%) with panic disorder satisfied the diagnosis of MDD. Multivariate logistic regression model showed that comorbid generalized anxiety disorder (GAD) and the symptom of "fear of losing control or going crazy" were associated with MDD in patients with panic disorder. In female patients, the "chills or hot flushes" symptom was also associated with comorbid MDD. Conclusion : These results showed that coexisting GAD and certain symptoms of panic are associated with comorbid MDD.

• 한국초지조사료학회지
• /
• 제11권1호
• /
• pp.60-67
• /
• 1991

This experiment was conducted to investigate the effects of starch addition on the fermentative quality and dry matter digestibility(DMD) of Kudzu(Puerari~ thzmbergii Bentham) silage. The herbages was ensiled by the conventional methods in small plastic silo of 7.5 liters with addition of starch of 0 %, 2 %, 4 74, 6 % and 8 %, respectivery. The samples of kudzu silage were separated into leaf and stem, and was determined the pH, organic acid and characteristics of fiber such as neutral detergent fiber(NDF), acid detergent liber(ADF) and acid detergent lignin(ADL). The DMD of leaf and stem silage were evaluated by pepsin-cellulase technique method. The energy values(tota1 digestible nutrients, TDN; digestible energy, DE; metaboliz;~bie energy. ME) were calculated by DMD. The results obtained were as follows: 1. The fiberous meterials(such as NDF, AIIF and ADL) of leaf and stem were decreased with increasing levels of starch(p

• 한국환경생태학회지
• /
• 제18권2호
• /
• pp.210-220
• /
• 2004

본 연구의 목적은 미선나무 자생지의 환경특성과 생육특성을 분석함으로써 보전 및 복원의 기초자료 제공을 위한 것이다. 토양의 종류는 사양토, 식양토, 미사질양토이고 화학적 특성간 상관성은 전질소량과 양이온치환용량이 높게 나타났다. 생육특성의 경우 수고와 줄기직경은 I지역에서, 수관폭은 II지역에서, 엽수는 V지역에서, 종자수는 IV지역에서 타 지역에 비해 양호하였다. 생육특성에 대한 상관성에서는 수폭과 줄기직경이 높게 나타났다. 생장특성과 토양의 화학적 특성은 전기전도도와 수고가 높은 상관성을 보였다. 생육특성과 토양의 화학적 특성에 대한 회귀분석 결과, 수고와 전기전도도의 설명력은 약 70.4%. 엽수와 전질소량은 약 70.2%였다. 미선나무 자생지 보전 및 복원을 위해서 광도, 온도, 유전형질 등 다양한 인자들이 고려된 정밀 환경분석이 요구되어진다.

• 대한영양사협회학술지
• /
• 제24권2호
• /
• pp.169-180
• /
• 2018

Depression is a major health problem that can lead to mortality. This study was conducted to assess the risk factors associated with depression in a group aged over 65 years by analyzing nationally representative Korean survey data. A total of 1,209 subjects were analyzed among the participants of the 2014 Korean National Health and Nutrition Examination Survey. Statistical methods for a complex sample were applied by using SPSS program(windows ver. 24.0). Depression assessments were carried out by using the 9-item depression module of the Patient Health Questionnaire-9 (PHQ-9). Depression ($PHQ-9{\geq}5$) was more frequently found in females (33.2%) compared to males (16.1%). However, there was no evidence suggesting that characteristics such as residence area, income level and age, except for educational level, were related with depression. The results of the logistic regression analysis showed that i) health habits such as smoking (OR: 2.26) and lack of aerobic physical activity (OR: 1.62), ii) mental health status such as bad self-rating of health status (OR: 4.30), more stress (OR: 8.31), and bad health-related quality of life (by EQ_5D, OR: 3.41), iii) chronic diseases such as obesity (OR: 0.66), hypercholesterolemia (OR: 1.57), anemia (OR: 1.91), and iv) low intake of energy (OR: 1.84) and calcium (OR: 1.71) were significantly associated with depression. This study suggests that certain characteristics of health habits, mental health status, chronic diseases and nutrient intake may be associated with depression. Prospective research on long-term control is needed to establish causal connections among those factors with depression.

• Tuberculosis and Respiratory Diseases
• /
• 제77권1호
• /
• pp.13-17
• /
• 2014

Background: This study analyzed the negative prognostic factors in patients who received second-line chemotherapy for advanced inoperable non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed the records of 137 patients with inoperable stage III-IV NSCLC who received second-line chemotherapy. The effects of clinical parameters on survival were analyzed and the hazard ratios (HR) for mortality were identified by a Cox regression analysis. Results: Sex, age older than 65 years, smoking history, cell type, T-stage, best response to first-line chemotherapy and first-line chemotherapy regimen were significant negative predictors in univariate analysis. The multivariate analysis showed that patients older than 65 years (HR, 1.530; 95% confidence interval [CI], 1.020-2.297), advanced T stage (T4 vs. T1; HR, 2.273; 95% CI, 1.010-5.114) and non-responders who showed progression with first-line chemotherapy (HR, 1.530; 95% CI, 1.063-2.203) had higher HR for death. Conclusion: The age factor, T stage and responsiveness to first-line chemotherapy were important factors in predicting the outcome of patients with advanced NSCLC who received second-line chemotherapy. The results may help to predict outcomes for these patients in the future.