• 자원ㆍ환경경제연구
• /
• 제17권4호
• /
• pp.845-873
• /
• 2008

이 연구에서는 회피행위의 다목적성(결합생산) 문제를 최소화할 수 있는 암 검진 행위라는 회피행위 자료에 대해 표본선택편의를 극복할 수 있는 모형을 적용하여, 사망위험 감소에 대한 지불의사금액의 도출과 더불어 확률적 인간생명가치(value of statistical life : VSL)를 추정하였다. 간암 사망위험을 감소시키기 위한 비용 및 시간 등과 관련된 자료를 이용하여 건강 및 안전에 대한 가계생산함수모형의 틀에서 사망위험 감소를 위한 한계편익을 추정하였다. 간암 검사를 받을 확률을 높아지도록 하는 변수는 남성인 경우, 연령이 많을수록, 교육받은 기간이 길수록, 유배우자인 경우, 현재 흡연자인 경우, 가구소득이 높을수록, 건강염려 정도가 높을 때인 것으로 나타났다. 간암 검진과 관련된 비용은 조기 검진으로 인하여 감소하는 사망위험의 크기 및 성별, 교육받은 기간, 유배우자 여부, 가구 소득에 의해서도 예상한 대로 유의한 영향을 받았다. 암 검진에 의한 사망위험 감소 크기(risk)의 한계효과는 321,097원이다. 교육년수(edu)의 경우 1년 증가하면 간암 검진비용이 905원, 가구 소득(hinc)이 100만 원 증가하면 간암 검진비용이 1,743원 증가한다. 한편 남성인 경우가 여성에 비해 간암 검진비용으로 12,310원을, 유배우자가 무배우자에 비해 7,969원을 더 부담하고 있다. 암 검진으로 인한 조기사망위험 감소로부터 도출된 확률적 인간생명가치는 평균 사망위험 감소 수준 및 평균 암 검진 비용 수준에서 3억 2,110만 원이다. 또한 암 검진 소요비용과 암 검진 효과에 대한 불확실성을 위해 민감도 분석의 결과에서는 확률적 인간생명가치가 1억 6,055만 원~6억 4,219만 원으로 추정되었다.

• 한국산학기술학회논문지
• /
• 제19권4호
• /
• pp.362-373
• /
• 2018

본 연구는 남성 흡연자들의 금연에 대한 관심도와 그에 관련된 요인을 규명하고자 시도하였다. 조사대상은 D광역시청에 근무하고 있는 남성 공무원 중 조사시점에서 현재 흡연자인 593명으로 하였다. 조사는 2015년 10월에 구조화된 무기명 자기기입식 설문조사에 의하였다. 연구결과, 조사대상자의 금연에 대한 관심도는 "관심 없음" 28.3%, "관심이 있으나 6개월 이내에 금연할 생각 없음" 45.7%, "관심이 있으며 6개월 이내에 금연할 것임" 26.0%로 나타났다. 다중회귀분석 결과, 조사대상자의 금연에 대한 관심도에 영향을 미치는 요인으로는 "고용형태", "최초 흡연 연령", "1일 흡연량(담배 개피 수)", "아침에 일어나서 첫 번째 담배를 피울 때까지 걸리는 시간", "폐암 이환 가능성 인지", "금연에 대한 행동실천의 인지된 이익"이 유의한 변수로 선정되었다. 로지스틱 회귀분석 결과, 금연에 대한 관심도가 "관심 없음"군보다 "관심이 있으며 6개월 이내에 금연할 것임"군에서 "폐암 이환 가능성 인지", "금연에 대한 행동실천의 인지된 이익" 및 "금연에 대한 행동실천의 인지된 장애"가 높게 나타날 위험비가 유의하게 상승하는 것으로 나타났다. 위와 같은 연구결과는 흡연에 의한 건강장애의 심각성의 인식이 금연에 대한 관심을 높이는 주요 요인이 되고 있음을 시사한다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권10호
• /
• pp.4349-4352
• /
• 2014

Background: Pancreatic cancer has a high mortality rate because it is usually diagnosed late. Since little is known about this cancer in Iran, with the aim of improving this knowledge deficiency, we evaluated clinical, laboratory biomarkers, imaging findings and treatment modalities in Iranian patients with pancreatic adenocarcinoma. Materials and Methods: 131 cases of pancreatic adenocarcinoma in 2010-2013 were obtained from the Taleghani Hospital Record Department. Cases confirmed by histopathology from CT-guided biopsy, EUS-FNA and surgery examination were included. We excluded those with incomplete medical records. Results: The study included 131 subjects between 24 and 97 years of age and a mean age of $63{\pm}13.4$ years. Eighty (61.1%) were male and 51 (38.9%) female. Previous history included diabetes mellitus in 36 (27.5%), alcohol drinking in 5 (3.9%), smoker in 28 (21.4%) and opium addiction in 13 (10%). The common presenting history included weight loss in 79 (60.3%), abdominal pain in 77 (58.8%), fever in 11 (8.4%), nausea in 30 (22.9%), jaundice in 72 (55%), pruritus in 52 (39.7) and anemia in 33 (25.2%). CA19-9 levels with cut offs of 50, 100 and 200 U/ml were increased in 81%, 72% and 66% of patients, respectively. Tumor staging was: stage I, 3 (2.3%); stage II, 10 (7.6%); stage III, 58 (44.3%); and stage IV, 60 (45.8%). From 45 patients, 17 received ERCP inserted metallic stents and 22 plastic stents, the remaining 6 failed that PTC was done. Whipple surgery and chemotherapy were conducted for 10 and 29 patients, respectively. Conclusions: This disease affected older people and there was a male preponderance. The commonest risk factors were diabetes mellitus, smoking and cholelithiasis. The majority of patients presented with loss of appetite, loss of weight, jaundice, abdominal pain and discomfort. Almost all presented at late stages of the disease so that curative surgery was impossible. Also chemotherapy was only performed in a few patients as a neoadjuant treatment.

• 대한한방내과학회지
• /
• 제29권1호
• /
• pp.149-159
• /
• 2008

Background and Purpose : This study was to assess characteristics in acute stroke patients according to obesity and abdominal obesity. Methods : From1 Oct. 2005 to 31 Jul. 2007, 629 patients with a stroke were included. Patients were hospitalized within 30 days after the onset of stroke at Kyungwon University Incheon Oriental Hospital, DongGuk University International Hospital and Department of Cardiovascular and Neurologic Disease (Stroke Center), or Kyung Hee University Oriental Hospital. We investigated general characteristics preferences according to general obesity and abdominal obesity. Results : 629 acute stroke patients were included in the final analysis. Male, young age, hypertension, heart disease in the family history, hypertension in the past history, care of invalids or grandchildren and Taeumin in the Sasang constitution were higher among obese patients. Male, transient ischemic attack in the past history, smoker and Soyangin in the Sasangconstitution were higher among patients with abdominal obesity. The incidence of abdominal obesity corresponded to lower education level. Conclusions : In our study, we observed the general disposition of various characteristic distributions according to obesity and abdominal obesity in acute stroke patients.

• 대한간호
• /
• 제36권5호
• /
• pp.91-100
• /
• 1998

This study aims to investigate smoking patterns in high school student and to give student smoker effective information. The sample of 250 male highschool students out of two different schools in Tae-Jon was questioned from July 10th to 15th. 1995. In analyzing these date. the statistics shows the realities by means of number of students. The results are summarized into 17 items as follows. Regarding the level of smoking. 140 students out of 250 admit that they have ever smoked. 52.1% of smoking students say that the motivation of beginning smoking is mainly curiosity. The survey shows that 22.9% of smoking students feel very good when smoking. It also shows that 30.0% of smoking students began smoking in the first grade of high school. With regard to the volume of smoking per day. 41.4% of smoking students smoke variably. 42.1% drink when smoking. 15.0% spend more than W 70.000 a month. About the question who knows the fact of their smoking. 51.5% answer that their friends know the fact of their smoking. In regard to the resaltionship between smoking and school per-formance. 18.2% of non smoking students make poor grades as compared with 40% of smoking students. 9.3% of smoking students say that they are satisfied with the school life. but 35.7% of them are not satisfied. Regarding the attitude to smoking teachers. 35% of smoking students state that they are affected by them. 69.3% of smoking students say that they will stop smoking. while the remaining 30.7% say that they will keep smoking. The reason of 63.9% to stop smoking is that smoking is bad for the health. The reason of 46. 5% to keep smoking is the acquired habit of smoking. 97.2% know the fact that the major element of cigarettes is nicotine and it is very harmful to the health. 40.8% recognize the harmful effect of smoking by TV and radio programs. 97.2% know that smoking could cause lung cancer. From the above results. I propose as follows We should make specific plan to keep smoking by simple curiosity from being developed into habitual smoking. We should teach them how harmful smoking is and make them stop smoking by themselves. It is very essential for family members and teachers to give continuous interest since childhood. As the teacher affect the students very much, they should give up smoking first. The incidence of smoking should be identified in each of the middle and high schools. smoking prohibition programs relevant to each school should be developed and implemented. The local community should ban cigarette vending machines. Cigarettes should not be sold to adolescents. By setting every place where adolescents gather including schools nonsmoking area. we should decrease their impulse to smoke. then smoking opportunities. and harmful effects to them caused by passive smoking.

• Tuberculosis and Respiratory Diseases
• /
• 제82권2호
• /
• pp.118-125
• /
• 2019

Background: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results: The median age was 69 years (interquartile range, 60-74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.

• 한국식생활문화학회지
• /
• 제23권3호
• /
• pp.318-327
• /
• 2008

This study examined the cultural dietary habits as well as attitudes toward food, within other life pattern elements, of students living in Gwangju City and Chonnam Province, Korea. Questionnaires from 1,000 student respondents were analyzed. The survey consisted of questions regarding physical condition and health status, dietary consciousness, food preference, knowledge of food and nutrition, and dietary culture. The results showed that 1.6% of the students considered their own physical condition to be extremely poor, and 2.7% and 2.1% also considered their father's and mother's physical conditions as extremely poor, respectively. Among the respondents, 18.3% were smokers and consumed an average of 14.8 cigarettes per day. With regard to their dietary habits, the students answered that they preferred to eat meals with friends rather than with family members, fruit was chosen for eating over health food supplements, and there was very little participation or interest in various food and cultural festivals. The female students had a tendency to alleviate mental stresses by eating, while the male students performed more physical activity to deal with stress. The female students also preferred cereal, fruit, fast food, and sweetened foods more than the male students. Between the smokers and non-smokers, significantly more non-smokers chose fruit (p<0.01), ethnic foods (p<0.05), and sweetened foods (p<0.05) as compared to the smokers. Body mass index (BMI) had significant positive correlations with soft drink (p<0.01), health food supplement (p<0.01), and alcoholic beverage (p<0.001) consumption, while BMI was negatively correlated with cereal (p<0.01), fruit (p<0.001), and sweetened food (p<0.01) intake. The health status of students was positively correlated with their father's health status (p<0.01), mother's health status (p<0.001), and BMI (p<0.05), as well as cereal (p<0.001), high protein side dish (p<0.01), fruit (p<0.01), vegetable (p<0.01), and traditional food (p<0.001) intake. The average body weight for female students was approximately 5 kg less than the Korean Nutrition Society's standardized weight, therefore, it is strongly recommended that measures be taken to develop a systematic nutrition education program that would help those students who often unintentionally skip breakfast or go on extreme diets to improve body image.

• 한국식품영양과학회지
• /
• 제34권6호
• /
• pp.840-849
• /
• 2005

본 연구는 농어촌과 섬지역을 포함하고 있으며, 노령화가 가속화되고 있는 통영시 거주지역주민들을 대상으로 올바른 건강식품의 선택과 섭취를 위한 정보제공 및 영양교육의 기초자료를 마련하고자, 도시지역인 동지역, 농어촌 지역인 읍면지역 및 섬지역으로 구분하여 거주지역별, 성별 건강식품의 이용실태와 건강관련 제요인과의 상관성을 조사하였다. 조사대상자는 남자 $44.7\%$, 여자 $55.3\%$였고, 연령은 남녀모두가 3, 40대까지의 비율이 가장 높은 분포를 보였다 직업은 무직, 주부, 판매직 순이었으며, 농어업에 종사하는 사람은 적었다. 교육수준은 무학, 고등학교졸업, 중학교졸업, 전문대졸이상, 초등학교 순이었다. 섬지역주민들의 건강자각 상태가 읍면지역, 동지역에 비해 좋지 않은 것으로 나타났다. 개인적인 스트레스 원인유형을 보면 경제문제, 직장문제, 건강문제 순으로 나타났으며, 남녀 모두 경제문제가 스트레스의 주요 원인이었다. 피로도의 경우 특히 섬지역에서 피로를 항상 느낀다는 비율이 동지역보다 2배 정도 높았다. 조사대상자의 $31.8\%$가 흡연을 한다고 했으며, 남자 $57.5\%$,여자 11.0$\%$로서 남자가 여자에 비해 횔씬 높은 흡연율을 보여 성별간 유의 적인$(p\leq0.001)$ 차이를 나타내었다. 섬지역의 경우 흡연시작 연령이 20세미만의 경우가 $34.8\%$였고, 음주를 처음으로 경험해본 연령은 20세미 만의 경우가 $35.2\%$로 나타났으며 $94.4\%$가 적어도 1주일에 $1\~2$회 이상 술을 마시며, 1회 음주량도 다른 지역에 비해 유의적$(p\leq0.001)$으로 많은 것으로 나타났다. 건강식품과 스트레스 및 피로도와의 상관성을 살펴본 결과 영양제 복용은 섬지역이 동, 읍면지역 보다 2배 가까이 높게 나타나 유의적인$(p\leq0.01)$ 결과를 보였으며 자신의 건강에 대한 건강자각상태가 좋을수록 더 많이 복용하는 것으로 나타났다. 또한 피로도와의 상관성의 경우 피로도를 느끼는 회수가 많을수록 건강보조식품의 섭취가 증가하였다. 건강식품과 흡연 및 음주와의 상관성을 본 결과 흡연의 경우 영양제와 보신식품의 섭취는 흡연자와 비흡연자간의 유의적인 차이$(p\leq0.05)$를 나타내었지만, 건강보조식품의 섭취는 흡연자와 비흡연자와의 관련성은 나타나지 않아 흡연의 여부에 관계없이 복용하는 것으로 나타났다 음주의 경우 음주자와 비음주자 모두에서 영양제, 건강보조식품, 보신식품의 복용과는 관련성이 없는 것으로 나타났다 특히 노인인구의 비율이 높은 읍면지역 및 섬지역의 음주문화는 주로 식사를 하면서 반주로 마시는 경우가 많아 음주가 일상화 되어 있다고할 수 있다. 따라서 음주로 인한 질병 예방이나 치료를 목적으로 건강식품을 섭취한다는 인식은 하지 않고 있다. 본 연구결과 통영시에 포함되어 있는 읍면 및 섬지역은 노령화가 가속화되고 있으며,도시의 생활권에서 벗어나 의료혜택을 충분히 받지 못하는 열악한 환경에 놓여 있는 실정 이다. 또한 이 지역은 노인인구의 비율이 높으며 , 교육수준도 낮아 건강식품에 대한 정확한 영양지식과 영양에 관한 정보를 충분히 갖지 못할 뿐아니라, 균형잡힌 식생활을 실천하기보다는 손쉽게 이용할 수 있는 건강식품을 통해 건강을 유지하려는 경향이 높은 것으로 나타났다. 따라서 도시를 중심으로 한 획일적인 영양교육보다는 각 지역의 특성을 배려한 영양교육이 이루어져야 할 것으로 생각된다.

• Toxicological Research
• /
• 제4권1호
• /
• pp.1-12
• /
• 1988

In order to evaluate the effect of cigarette smoking on the pharmacokinetics of theophylline in Koreans, doses of 4.5 to 5.0 mg/kg of theophylline, as injectable aminophylline, were administered to 12 normal young volunteers (male, 22 to 35 yrs;mean, 26 yrs) through intravenous infusion over 30 minutes, and pharmacokinetics of theophylline were tested. Among subjects, six were nonsmokers and the other were smokers (range 1 to 2 packs/day). Also the correlations between plasma and saliva theophylline concentrations were investigated by determining the concentrations of theophylline in saliva simultaneously at each plasma sampling time. The total body clearances of theophylline in smokers (Mean${\pm}$SD, 0.0578${\pm}$0.0092 L/hr/kg)were appreciably higher than thoxe of nonsmokers (Mean${\pm}$SD, 0.0359${\pm}$0.0063 L/hr/kg), and the half-lives of theophylline in smokers averaged 5.36${\pm}$1.22hr, and significantly shorter than those of nonsmokers which averaged 9.14${\pm}$1.73hrs(p<0.005). But the apparent volumes of distribution of theophylline did not show any significant difference between smokers (Mean${\pm}$SD,0.44 ${\pm}$0.05L/kg) and nonsmokers (Mean${\pm}$SD, 0.46${\pm}$0.05L/kg). The average concentration ratios in saliva and plasma were 0.61 in smokers and 0.56 in nonsmokers after 2 hrs following drug administrations, and the smoker group had a slightly higher value of ratio(S/P) than the nonsmoker group (p<0.05). The correlations between saliva and plasma theophylline concentration in smokers were r=0.852(p<0.0005) within 2 hr and r=0.985(p<0.0005) after 2 hrs and also those of nonsmokers were r=0.729(p<0.0005) within 2 hrs and r=0.957(p<0.0005) after 2 hrs starting the infusion. From the results, it was found that smoking cigarettes had significantly increased the clearance of theophylline and that the relationships between saliva and plasma theophylline concentrations in all subjects were better after 2 hrs than within 2 hrs starting the infusion of aminophlline.

• Tuberculosis and Respiratory Diseases
• /
• 제69권4호
• /
• pp.271-278
• /
• 2010

Background: Recent studies have demonstrated that the epidermal growth factor receptor (EGFR) genotype is the most important predictive marker to EGFR-tyrosine kinase inhibitors (TKIs) and first-line gefitinib treatment will be approved in the near future for use in non-small cell lung cancer (NSCLC) patients with the EGFR mutation. Direct sequencing is known to be the standard for detecting EGFR mutations; however, it has limited sensitivity. Peptide nucleic acids (PNA)-mediated PCR clamping method is a newly introduced method for analyzing EGFR mutations with increased sensitivity and stability. Methods: A total of 71 NSCLC patients were analyzed for EGFR mutations using the PNA-mediated PCR clamping technique. Sixty-nine patients were analyzed for clinicopathologic correlation with EGFR genotype; 2 patients with indeterminate results were excluded. In order to determine EGFR-TKI drug response, 57 patients (42 gefitinib, 15 erlotinib) were included in the analysis. Results: The EGFR mutation rate was 47.8%. Being female, a non-smoker, and having adenocarcinoma were favorable clinicopathologic factors, as expected. However, more than a few smokers (33.3%), male (28.1%), and patients with non-adenocarcinoma (28.6%) had the EGFR mutation. Having a combination of favorable clinicopathologic factors did not increase the EGFR mutation rate significantly. Drug response to EGFR-TKIs showed significant differences depending on the EGFR genotype; ORR was 14.3% for wild type vs 69.0% for mutant type; DCR is 28.6% for wild type vs 96.6% for mutant type. The median EGFR-TKI treatment duration is 7.6 months for mutant type group and 1.4 months for wild type group. Conclusion: EGFR genotype determined using the PNA-mediated PCR clamping method is significantly correlated with the clinical EGFR-TKI responses and PNA-mediated PCR.