• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.589-594
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• 2013

Background: Prospective cohort studies to determine cofactors with oncogenic HPV-infections for cervical cancer are very rare from developing countries and such data are limited to the few screening trials. Large screening trials provide such data as a by product. Some of the cases are prevented by screening and do not surface as invasive cancers at all. Also, pre-invasive lesions are detected almost entirely by screening. Screening causes selection bias if attendance in or effectiveness of screening is correlated with the risk factors. The aim of this study was to quantify the influence of screening on risk factors for cervical cancer. Materials and Methods: Our material stems from a rural cohort of 80,000 women subjected to a randomised screening trial. The effect of screening on the incidence of cervix cancer was estimated with reference to socio-demographic and reproductive risk factors of cervical cancer. We compared these risks with the incidence of cancer in the randomised control population by the same determinants of risk. Results: The results in the screening arm compared to the control arm showed that the women of low SES and young age were benefitting more than those of high SES and old age. The relative risk by age (30-39 vs 50-59) was 0.33 in the control arm and 0.24 in the screening arm. The relative risk by education (not educated vs educated) was 2.8 in the control arm and 1.8 in the screening arm. The previously married women did not benefit (incidence 113 and 115 per 100,000 women years in control vs screening arms) whereas the effect was substantial in those married (86 vs 54). Conclusions: The results in controls were consistent with the general evidence, but results in attenders and nonattenders of the screening arm showed that screening itself and self-selection in attendance and effectiveness can influence the effect estimates of risk factors. The effect of cervical cancer screening programmes on the estimates of incidence of cervical cancer causes bias in the studies on etiology and, therefore, they should be interpreted with caution.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.209-215
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• 2013

Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and need many types of assistance. In the present study we interviewed terminally ill cancer patients and caregivers to determine how much burden they experienced and to find out what factors are most important for satisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced, and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitals and 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregivers completed the questionnaire. Care burden was not insubstantial in both and the caregiver group felt more burden than the patient group (P<0.001). While the patient group needed financial support most (39.0%), the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwise multiple logistic regression analyses showed that in the patient group, patient's health status (OR, 2.03; 95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care, while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI, 1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our study showed that burden was great in both terminal cancer patients and their caregivers and was perceived to be more severe by caregivers. Our study also showed that burden was the factor most predicting satisfaction about overall care in both groups.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3971-3977
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• 2016

Background: Breast cancer, the commonest cancer among women in the world, ranks top in India with an incidence rate of 1,45,000 new cases and mortality rate of 70,000 women every year. Chemotherapy outcome for breast cancer is hampered due to poor response and irreversible dose-dependent cardiotoxicity which is determined by genetic variations in drug metabolizing enzymes and transporters. Pregnane X receptor (PXR), a member of the nuclear receptor superfamily, induces expression of drug metabolizing enzymes (DMEs) and transporters leading to regulation of xenobiotic metabolism. Materials and Methods: A genomic region spanning PXR 3' UTR was amplified and sequenced using genomic DNA isolated from 96 South Indian breast cancer patients. Genetic variants observed in our study subjects were queried in miRSNP to establish SNPs that alter miRNA binding sites in PXR 3' UTR. In addition, enrichment analysis was carried out to understand the network of miRNAs and PXR in drug metabolism using DIANA miRpath and miRwalk pathway prediction tools. Results: In this study, we identified SNPs rs3732359, rs3732360, rs1054190, rs1054191 and rs6438550 in the PXR 3; UTR region. The SNPs rs3732360, rs1054190 and rs1054191 were located in the binding site of miR-500a-3p, miR-532-3p and miR-374a-3p resulting in the altered PXR level due to the deregulation of post-transcriptional control and this leads to poor treatment response and toxicity. Conclusions: Genetic variants identified in PXR 3' UTR and their effects on PXR levels through post-transcriptional regulation provide a genetic basis for interindividual variability in treatment response and toxicity associated with chemotherapy.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제4권1호
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• pp.98-105
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• 1993

주의력결핍과잉운동장애의 병인론에 대한 여러 가설중 알레르기가 그 원인의 하나로 대두되고 있다 주의력결핍장애아동의 21${\sim}$47%에서 알레르기 질환이 보고되고 있으며, 음식 알레르기가 있는 환자의 음식에서 알레르기원을 줄인 결과 82%의 아동이 과잉운동 및 학업문제가 줄었다는 보고가 있어 주의력결핍과잉운동장애의 일부 증상이 알레르기와 어떤 연관관계를 가지고 있음을 시사하고 있다. 또한 알레르기의 생화학적 이론의 하나로써 연구되고 있는 ${\beta}$-아드레날린성 과소반응 및 콜린성 과다반응의 생화학적 불균형의 가설은, 주의력결핍과잉운동장애의 병리중 콜린성 활동의 불균형에 의한 각성의 장애와 연관이 되어 있다 이에 본 연구에서는 알레르기질환이 행동장애를 유발하는지 알아보고자, 알레르기 질환의 진단을 받은 80명의 환아와 알레르기가 없는 정상아동 80명의 일반적 행동 양상을 아동행동조사표(부모형)를 통하여 비교하여 보았다 비교결과 알레르기 환아가 우울척도, 신체화척도, 공격성 척도, 비행행동 척도상 정상아동에 비해 높은 점수를 보였으며, 은둔행동척도는 의의있게 낮게 나타났다 알레르기의 임상요인들중에서 가족력의 유무에 따라 행동양상의 차이가 나타났는데, 알레르기의 가족력이 있는 경우에 총 문제점수 및 외면화행동, 과잉행동, 공격성행동척도 점수가 가족력이 없는 경우에 비해 의의있게 높았다 이러한 결과는 알레르기 환아의 부모가 아동이 문제성을 가지고 있다고 평가함을 의미하며, 알레르기의 유전적 소인과 주의력결핍과잉운동장애의 특성을 가진 행동장애는 유전적요인과 연관될 가능성이 있음을 시사하고 있다.

• 대한영양사협회학술지
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• 제6권2호
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• pp.136-147
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• 2000

The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.

• 한국의학물리학회지:의학물리
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• 제23권1호
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• pp.54-61
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• 2012

중합체 겔 선량계를 제작하여 사이버나이프의 광자선의 소조사면에서의 3차원적 선량측정 실험을 수행하였다. 겔 선량계는 아크릴로 제작된 두경부 팬텀내에 설치하여 선량측정에 사용하였다. 두경부 팬텀의 영상은 사이버나이프의 두경부 환자 치료를 위해 사용하는 전산화단층촬영장치(CT)의 프로토콜을 사용하여 획득하였고 치료계획 시스템에 전달되었다. 겔 선량계에 치료계획에서 수립한 방사선을 조사하였으며, 24시간 경과 후에 선량분석을 위하여 3.0T 자기공명영상장치(MRI)로 영상을 획득하였다. 측정된 겔 팬텀의 선량분포는 MATLAB을 이용하여 분석하였고 측정된 결과를 치료계획에서의 계산값과 비교하였다. 선량분포는 축상(axial) 방향의 등선량곡선의 80% 고선량 영역에서 치료계획 선량곡선과 측정된 선량곡선과의 차이가 0.76 mm이었으며, 40% 저선량 영역에서는 차이가 1.29 mm로 저선량 영역보다 고 선량영역에서 잘 일치함을 알 수 있었다. 본 연구에서 중합체 겔 선량계와 자기공명영상을 이용하여 소조사면에 대해 3차원적으로 선량을 분석할 수 있을 뿐 아니라 치료방사선 정도관리에도 활용될 수 있는 가능성을 확인하였다.

• Advances in pediatric surgery
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• 제1권1호
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• pp.18-26
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• 1995

For the prevention of later contralateral hernia as well as unnecessary contralateral exploration in pediatric patients with unilateral inguinal hernias, a reasonable indication of contralateral exploration is required. To examine the contralateral positivity, a prospective selective contralateral exploration has been performed by the author from Sept. 1985 to Dec. 1993, at Pediatric Surgical Section of the Department of Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College. Among the total 1200 cases of pediatric inguinal hernias, 580 cases of contralateral side were explored at hernia operations, by the indications as; male with infant onset, 2)female of all age, 3)prematurity, 4)profuse ascites due to cirrhosis, nephrotic syndrome, and ventriculoperitoneal shunt, and 5)remarkable silk sign. Overall positive rate was 71.4%, and positive rates of each indication were 80.7%, 70.4%, 73.1%, 66.7%, and 72.0%, respectively. Right side hernia showed 67.0%, left s ide 75.7%, and positive familial history 71.8% of contralateral positivities. In male, getting older revealed lower positive rates and the rate suddenly dropped after 12 years of age. Birth order, mother's age at delivery, postmaturity did not show any significant differences between the rates. Recurrence was seen in 3(0.5%) ipsilateral and 2(0.3%) contralateral, both of which were negative esplorations on previons operations. Overall complication rate was 3.8%, including 1 infection, 14 fluid or blood accumulation, 5 edemas, 3 temporary testicular edemas, 2 persisting fevers, 2 enures is and one delayed recovery from anesthesia. Among 38 cases with contralateral hernias developed after unilateral surgery by authors(6 cases) or surgeons in other institutions, 14 were males with infant onset, 4 were prematurities and 9 were females. Therefore, 27(71.7%) cases were originally under the contralateral exploration indications. The primary site of the hermia was right in 25 and left in 13. With above results, the following indications for contralateral exploration could be suggested ; 1)under one year of age, both sex, 2)prematurity, 3) remarkable silk sign, 4)in the double checked suspicions among males with infant onset, all age females, ascites, left hernia and familial history. After 12 years of age, exploration is not required. Considering complications, contralateral explorations could be considered only in the following situations; 1)expert, experienced pediatric surgeon, 2)experienced pediatric anesthesiologist, 3)operations could be done smoothly in an hour, 4)good general condition of the patient.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.167-171
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• 2009

목적: 정상인과 위암 환자의 혈중 Pepsinogen (PG)농도를 비교 분석하여 선별검사로서 이용가능성 및 위암의 임상 조직학적 요소와의 상관 관계를 알아보고자 하였다. 대상 및 방법: 2008년 11월부터 2009년 5월까지 대구가톨릭대학병원에서 내시경상 특이소견이 없는 정상인과 위선암 환자의 수술 전 혈중 PG농도를 측정하였다. 위암진단의 선별검사로서의 이용가능성을 알아 보기 위해 receiver operator characteristics (ROC) curves를 이용하여 가장 유용한 검사법을 선별하였고, 위암 조직과의 상관관계를 알아보기 위해 특정 기준치에 따라 임상 조직학적 요소를 비교 분석하였다. 결과:선별검사로서 혈중 PG I/II 비율이 가장 유용하였고, 기준치에 따른 민감도, 특이도는 81.8%, 82%로 나타났다. 임상 조직학적 요소 중 Lauren분류에 따른 종양의 아형(P=0.003), TNM 병기의 T 병기(P=0.001), 및 종양주위의 만성 위축성 위염(P=0.036)을 동반한 위선암이 특정기준치(cut off point)값에 의미 있는 관련을 보였다. 결론: 본 연구는 정상 대조군의 수가 적어 선별검사로서 혈중 PG측정의 유용성을 논하기에는 부족하나, 위암의 선별검사로서 이용 가능성 및 임상 조직학적 요소와 의미 있는 관련을 보여 차후 추가연구가 필요할 것으로 생각한다.

• 대한간호학회지
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• 제27권3호
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• pp.694-704
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• 1997

This study was designed to assess the body fat distribution, and also to investigate the effects of body fat on glucose tolerance and on insulin secretion pattern by body mass index in offspring of parents with NIDDM. The subjects consisted of twenty parents with NIDDM who had been admitted to the Department of Internal Medicine or had been seen in the outpatient clinic at Kangnam St. Mary's Hospital, Catholic University between February to March, 1995. Twenty offspring were randomly selected from forty six offspring of twenty parents with NIDDM. As a control group, twenty healthy people without a family history of diabetes mellitus were matched by sex, age and body mass index(BMI). The results are as follows : 1. Mean fasting serum glucose and insulin levels and insulin / glucose ratio were significantly greater in offspring than in the control subjects with BMI 25kg /㎡ in the offspring and in the BMI<25kg /㎡ control subjects (P<0.05). 2. The total glucose area and insulin area were significantly greater in both the offsping and the control subjects with BMI≥25kg /㎡ than in both the offspring and the control subjects with BMI<25 kg /㎡(P<0.05). 3. Upper body skinfold thickness, Waist hip ratio(WHR), serum levels of total cholesterol and triglyceride(TG), total dietary calorie intake and protein intake in both the offspring and the control subjects with BMI≥25kg /㎡ were greater than those with BMI<25kg /㎡(P<0.05). On the other hand, HDL-cholesterol in both the offspring and the control subjects with BMI≥25kg /㎡ was lower than those with BMI< 25kg /㎡(P<0.05). 4. The major variables influencing the total glucose area were subscapular skinfold thickness and WHR and the major variables influencing the total insulin area were suprailiac skinfold thickness, WHR, TG and free fatty acid. In the light of the results, glucose intolerance and insulin resistance were affected by body mass index, Upper body fat, WHR and lipids(TG, Free fatty acid), it is implied that these are influencing factors on total glucose area and total insulin area. The identification of these factors might provide a useful tool to identify individuals at high risk of diabetes mellitus. Therefore, various nursing intervention programs to reduce obesity could be given to both the offspring of parents with NIDDM and to the obese healthy controls before diabetes mellitus develops.

• 대한간호학회지
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• 제15권3호
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• pp.62-73
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• 1985

The problems of growth & development due to maladjustment are gradually increasing while need for the treatment of children's diseases is decreasing. The level of developmental deficiency or delay correlates with neonatal birth weight and also with gestational age, i.e. degrees of prematurity. There-fore, developmental defects and potential risk factors' are more Common in premature infants than in full term infants. The purpose of this study is to define the difference in the growth at developmental status between premature and full term infants, and to define the relation between the developmental status and the physical growth during the first 3 years' Data were collected from January 10, 1985 to April 6, 1985 at 3 hospitals including St. Mary's Hospital, and through home visiting. The subjects of this study consisted of 79 Premature infants (G.A. <37wks. & B.W. <2.5kg) and 94 full term infants (G.A.≥37 wks. & B.W.≥2.5kg). The study method used was a questionnaire, anthropometric assessment and DDST for normative data of growth & development. The collected data were analyzed using descriptive statistics, chi-square test and t-test. The results of the study were as follows: Hypothesis: 1 : That the prematures will differ from the full term infants in the physical growth status during the first 3 years was partially supported (p＜0.02) : The prematures reached up the full term infants in the physical growth status in the first 6 months. And, the first hypothesis was supported (P<0.01) : There are more cases which is below‘the Korean children's physical. growth standards’in prematures than in full term infants. Hypothesis 2 : That the prematures will differ from the full term infants in the developmental status during the first 3 years was supported (P< 0.001)；‘Normal’developmental status due to DDST was less in prematures than in full term infants. And, the second hypothesis was Partially supported (P<0.02) : The developmental status of the pre-matures was different from that of the full term infants within the first 3 months by analysis of passed items in DDST, Hypothesis 3 : That the prematures' developmental status will relate to their physical growth during the first 3 years was supported (P<0.001) : If the prematures' developmental status is in delayed status, then, their physical growth status is also in delayed status. This study shows that the prematures differed significantly from the full term infants in the growth at developmental status during their infancy. This means that the nurse can foster the growth & development of the prematures by supportive care during their infancy. Further longitudinal study is needed to verify these findings for the environmental factors.