• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5753-5759
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• 2013

Curcumin and curcumin containing polyherbal preparations have demonstrated anti-microbial and antiviral properties in pre-clinical studies. Till date no therapeutic intervention has been proved to be effective and safe in clearing established cervical human papillomavirus (HPV) infection. The present study evaluated the efficacy of Basant polyherbal vaginal cream (containing extracts of curcumin, reetha, amla and aloe vera) and of curcumin vaginal capsules to eliminate HPV infection from cervix. Women were screened by Pap smear and HPV DNA test by PCR. HPV positive women without high grade cervical neoplasias (N=287) were randomized to four intervention arms to be treated with vaginal Basant cream, vaginal placebo cream, curcumin vaginal capsules and placebo vaginal capsules respectively. All subjects were instructed to use one application of the assigned formulation daily for 30 consecutive days except during menstruation and recalled within seven days of the last application for repeat HPV test, cytology and colposcopy. HPV clearance rate in Basant arm (87.7%) was significantly higher than the combined placebo arms (73.3%). Curcumin caused higher rate of clearance (81.3%) than placebo though the difference was not statistically significant. Vaginal irritation and itching, mostly mild to moderate, was significantly higher after Basant application. No serious adverse events were noted.

• Journal of Cancer Prevention
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• 제23권4호
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• pp.176-182
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• 2018

Background: Family physicians (FPs) play an important role in cancer control. The aim of this study was to understand the functions of FPs in cancer control and to explore FPs' perceptions of their own roles and the difficulties they face in cancer control in Karabuk province, Turkey. Methods: The study consisted of two methodological parts. The qualitative part included a descriptive study in which data were collected from 87.5% (n=56) out of all FPs in Karabuk using a questionnaire. In the quantitative part, in-depth interviews with 15 FPs were conducted and analyzed through content analysis. Results: Half of the FPs (50.0%) provided cancer prevention information for their registered people, focusing on especially smoking cessation. In the last three months, the proportion of FPs who had not invited anyone to screenings was 37.5% for the pap test, 26.8% for the mammography, 19.0% for the fecal occult blood test and 34.5% for the colonoscopy. Only 16.1% of them reported that they made home visits for cancer patients. In the qualitative part of study, the following themes were highlighted: the perceived responsibilities of FPs regarding cancer control; the effect of geographically undefined working area of FPs; the issues with coordination between FPs and specialists; the effect of the number of primary care team members. Conclusions: Cancer control services provided by FPs have significant problems in terms of the FPs' approach to the services and their content, continuity and coordination.

• 대한세포병리학회지
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• 제18권1호
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• pp.1-12
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• 2007

Approximately 70% of cervical cancers are caused by HPV types 16/18 and thus the implementation of vaccination programmes with vaccines against HPV types 16/18 will have a major impact on the incidence of cervical cancer worldwide. However, this reduction will not be seen until several decades after full implementation of such vaccination programmes since the vaccines must be given to young adolescents before exposure to the virus and women who are already sexually active are not likely to be protected. Both GSK and Merck insist that even vaccinated women must continue to participate in regular cervical screening by the most sensitive method available since the vaccine can only give protection against up to 70% of cervical cancers. It is unlikely that the current vaccines will be modified to include additional high risk HPV types in the foreseeable future. While HPV testing is highly sensitive, it is not recommended for women under 30 years of age nor for vaccinated women. Additionally, HPV testing has poor specificity. The Digene Hybrid Capture 2 test is licensed for use only in conjunction with a cytology test, not as a stand-alone test, and the high risk panel has recognised cross reactivity with low risk HPV types. None of the other HPV test methods currently commercially available are FDA approved and all must be internally validated before use. This makes comparison of test results between laboratories difficult. The most sensitive and specific screening test currently available for women of all ages is the Cytyc ThinPrep System consisting of the ThinPrep Pap Test (TPPT) and the ThinPrep Imaging System (Imager). The TPPT was the first LBC system approved by the US FDA in 1996 and there are about 4,000 processors in use worldwide. The Imager was FDA approved in 2003 and over 350 systems are in routine use, mainly in the US. 40% of TPPT in the US are processed on Imager. There is clear evidence in peer reviewed literature that the Imager increases laboratory productivity by 100% and growing evidence that Imager detects more high grade SIL than the conventional smear or manual evaluation of TPPT. This aspect is particularly important since the number of cytological abnormalities will decrease as vaccination programmes are implemented. Cytotechnologists will see fewer and fewer abnormal smears and their skills will be put at risk. By doubling throughput, Imager will allow cytotechnologists to maintain their skills.

• 수면정신생리
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• 제22권1호
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• pp.30-34
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• 2015

비만성 저환기 증후군은 체질량지수 $30kg/m^2$ 이상의 비만 환자에서 낮 동안의 저산소혈증 및 고탄산혈증($PaCO_2$ 45 mmHg 이상, $PaO_2$ 70 mmHg 미만) 소견을 보이는 질환으로 90% 이상에서 무호흡-저호흡 지수가 시간 당 5회 이상인 폐쇄성 수면 무호흡이 동반되어 나타난다. 특히 고탄산혈증을 유발할 수 있는 심한 폐쇄성 환기장애나, 간질성 폐질환 혹은 심한 흉벽질환 및 신경근육질환을 배제하는 것이 진단에 필수적이나, 임상적으로 비만성저환기 증후군의 양상을 보인다면 조기에 질환을 의심하는 것이 예후에 매우 중요한 영향을 끼친다. 비만성 저환기 증후군 치료의 목표는 체중감소 및 폐쇄성 수면무호흡의 치료, 고탄산혈증과 저산소혈증의 개선으로 산소치료, 경비적 지속적 상기도 양압술, 비침습적 양압 환기요법 등으로 치료 효과를 얻은 증례들이 보고되어 있다. 특히 만성 호흡 부전의 급성 악화가 동반 환자이거나, 지속적 상기도 양압술로 치료가 실패한 환자, 폐쇄성수면무호흡을 동반하지 않은 비만성저환기 환자의 경우에는 이단 상기도 양압술을 적용하여 더 효과적인 치료 결과를 기대할 수 있다. 저자들은 폐포저환기를 유발할만한 다른 질병이나 상태를 가진 환자의 경우에도 중증 비만, 코골이 및 수면 중 무호흡, 낮 동안의 저산소혈증 및 고탄산혈증 등 비만성저환기증후군의 특징적 임상 양상에 근거하여 조기에 비만성저환기 증후군을 의심하였고 이에 대한 평가를 진행하여 이단 상기도 양압 치료를 통해 치료 효과를 거두고 환자의 예후에 매우 큰 영향을 끼치는 것을 경험하였기에 보고하는 바이다.

• Journal of the Korean Data and Information Science Society
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• 제23권4호
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• pp.787-796
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• 2012

본 연구의 목적은 PAPS를 실시하여 4, 5급에 해당하는 저체력군 학생을 대상으로 16주 복합운동프로그램을 통해 대사증후군과 자율신경계에 어떠한 변화가 나타나는가를 규명하는 것이다. 16주 복합운동프로그램은 주 5회에 걸쳐 준비운동, 본운동, 정리운동으로 구성하고 1회 50분씩 실시하였다. 자료처리는 SPSS 19.0 통계프로그램을 이용하여 모든 종속변인들의 평균과 표준편차를 산출하였다. 샤피로-윌크 검정값을 이용하여 정규성 검정을 실시하였고, 복합운동집단과 통제집단의 모평균 차이를 위하여 독립표본 t-검정을 실시하였으며, 16주 복합운동프로그램 전 후 각 집단 내변인들의 변화를 알아보기 위해 대응표본 t-검정을 실시하였다. 모든 통계치의 유의수준은 ${\alpha}$=.05로 처리하여 다음과 같은 결과를 얻었다. 본 연구 결과 대사증후군 지표에서는 허리둘레, 중성지방, 공복혈당, HDL-C에서 유의한 차이를 나타냈고, 자율신경계 요인에서는 통계적으로 모두 유의한 차이가 나타나 저체력군 고등학생에 긍정적인 영향을 미친 것으로 사료되어 진다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7271-7275
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• 2015

The objective of this study was to determine the prevalence of significant lesions defined as high grade squamous intraepithelial lesions (HSIL), adenocarcinoma in situ (AIS) and invasive carcinoma in women who had HPV-positive and cytology negative co-testing screening results. This retrospective study was conducted in Chiang Mai University Hospital between May, 2013 and August, 2014. Hybrid capture 2 (HC2) was used for HPV testing and conventional Pap smears for cytologic screening. A repeat liquid-based cytology (LBC) was performed in women with such co-testing results followed by colposcopy. Random biopsy was performed in cases of normal colposcopic findings. Further investigations were carried out according to the biopsy or the repeat LBC results. During the study period, 273 women met the criteria and participated in the study. The mean age of these women was 46.4 years with 30% of them reporting more than one partner. The median interval time to colposcopy was 165 days. About 40% showed an abnormality in the repeat cytology. Significant cervical lesions were found in 20 (7.3%) women, including 2 invasive cancers. Of interest was that only 2 of 20 significant lesions were diagnosed by colposcopic examination while the remainder were initially detected by cervical biopsy and abnormal repeat cytology. In conclusion, the prevalence of significant cervical lesions in HPV positive and cytology negative women in Northern Thailand was 7.3%. Further diagnostic work up with repeat cytology follow by colposcopy is recommended. Random biopsy should be performed even when the colposcopic findings are normal.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4273-4279
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• 2012

Introduction: The aim of the study was to determine the breast, cervical, and colorectal cancer screening rates and the influencing factors in a group of Turkish females. Methods: This descriptive study was conducted in a School of Nursing. The study sample consisted of 603 females who were the mothers/neighbors or relatives of the nursing students. Data collection forms were developed by the investigators after the relevant literature was screened and were used to collect the data. Results: Of the women aged 30 and over, 32.8% had undergone a pap smear test at least once in their life. Of those aged 50 and over, 48.2% had undergone mammography at least once and FOBT had been performed in 12% of these women in their life. Having heard of the screening tests before, knowing why they are done, and having information on the national cancer screening program were important factors influencing the rates of women having these tests done. Discussion: The results of this study show that the rates of women participating in national cervical, breast, and colorectal cancer screening programs are not at the desired levels. Having heard of the screening tests before, knowing why they are done, and having information on the national cancer screening program were important factors influencing the rates of women having these tests done. It is suggested that written and visual campaigns to promote the service should be used to educate a larger population, thus increasing the participation rates for cancer screening programs.

• Journal of the Korean Data and Information Science Society
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• 제21권1호
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• pp.129-138
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• 2010

본 논문에서는 우리나라 자궁경부암 조기검진 권고안을 바탕으로 검진주기 및 검진연령 변화에 따른 다양한 검진전략들의 효율성을 검토하고 비용-효과분석을 통하여 비용-효과적인 대안을 찾아 제시하고자 하였다. 한국중앙암등록본부의 2002년 자료와 확률모형을 이용하여 고려된 검진전략을 검진의 민감도와 무증상 상태에 있는 암 환자를 발견할 확률 및 검진비용을 추정하여 비용-효과분석을 시행하였다. 연구결과 비용-효과적인 측면에서 자궁경부세포검사를 이용한 35세부터 65세까지 3년 주기의 검진전략이 상대적으로 높은 효율성을 나타내었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10071-10077
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• 2015

Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories. Conclusions: Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6887-6892
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• 2014

The oncogenic role of human papillomavirus (HPV) in triggering cervical cancer, the second most common cancer in women worldwide, is well established. Romania ranks in first place in Europe in terms of the incidence of cervical cancer. Geographical widespread data on HPV type-distribution are essential for estimating the impact of HPV vaccines and cervical cancer screening programmes. In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania. A total of 1,000 women aged 17.3-57 years, attending routine cervical examination in the Obstetrics and Gynecology Hospital of Brasov, Romania, and undergoing both cytological examination and HPV genotyping were screened. Infection with 35 different HPV genotypes was detected in 39.6% of cytological specimens. Overall HPV infections were highest in young women under 25 years (p<0.0001), in which cervical cytological abnormalities also reached the highest prevalence. Patients infected by HPV-16 or HPV-18 showed the highest prevalence of cervical cytological abnormalities. Some 48.2% of women with abnormal cytology were infected with high-risk HPV types whereas less than 3% of them were infected only with low-risk HPV types. Our study showed that the prevalence of high-risk HPV infection among Romanian women is higher compared to other studies in other geographic areas. Thus, we consider that in areas where there is an increased prevalence of high-risk HPV infections, HPV genotyping should be performed in all women aged between 18 and 45 years, and Pap test should be performed every 6 months in women with high-risk HPV infection, even those with previous normal cervical cytology.