• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3827-3833
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• 2015

Background: Positive para-aortic lymph node (PALN) at diagnosis in cervical cancer patients confers an unfavorable prognosis. This study reviewed the outcomes of extended field radiotherapy (EFRT) and concurrent chemotherapy with extended field RT (CCEFRT) in patients with positive PALN at diagnosis. Materials and Methods: Medical records of 407 cervical cancer patients between 1st January 2002 to 31st December 2012 were reviewed. Some 32 cases with positive PALN were identified to have received definitive extended field radiotherapy with or without chemotherapy. Treatment outcomes, clinicopathological factors affecting survival and radiotherapy related acute and late effects were analyzed. Results: Totals of 13 and 19 patients underwent EFRT and CCEFRT respectively during the period of review. The median follow-up was 70 months. The 5-year overall survival (OS) was 40% for patients who underwent CCEFRT as compared to 18% for patients who had EFRT alone, with median survival sof 29 months and 13 months, respectively. The 5-years progression free survival (PFS) for patients who underwent CCEFRT was 32% and 18% for those who had EFRT. Median PFS were 18 months and 12 months, respectively. Overall treatment time (OTT) less than 8 weeks reduced risk of death by 81% (HR=0.19). Acute side effects were documented in 69.7% and 89.5% of patients who underwent EFRT and CCEFRT, respectively. Four patients (12.5%) developed radiotherapy late toxicity and there was no treatment-related death observed. Conclusions: CCEFRT is associated with higher 5-years OS and median OS compared to EFRT and with tolerable level of acute and late toxicities in selected patients with cervical cancer and PALN metastasis.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.145-152
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• 2015

Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta-synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system.

• Imaging Science in Dentistry
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• 제50권3호
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• pp.209-216
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• 2020

Purpose: In India, the age of 14 years is the legal age threshold for child labour. Therefore, in suspected instances of child labour, age assessment plays a crucial role in determining whether a violation of the law on the employment of children has occurred. The aim of this retrospective cross-sectional study was to assess the discriminatory ability of stages of cervical vertebral maturation (CVM) in predicting the legal age threshold of 14 years. Materials and Methods: Routinely taken lateral cephalograms from 408 subjects aged 10 to 18 years were evaluated retrospectively using the CVM stages described by Baccetti et al. Descriptive statistics, accuracy, sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated for stages 2, 3, and 4 of CVM. Results: Real age increased as the CVM stage gradually increased. The results of 2×2 contingency tables showed that CVM stage 4 produced an accuracy of 71% and 73%, a false positive rate of 7% and 18%, and a post-test probability of 59% and 68% for boys and girls, respectively. Conclusion: Based on these findings, it can be concluded that the stages of CVM are of limited use for predicting the attainment of the legal age threshold of 14 years. Future studies should investigate whether combinations of skeletal and dental methods could achieve better accuracy and post-test probability.

• 한국항만경제학회지
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• 제19권2호
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• pp.1-32
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• 2003

The purpose of this study is to identify and evaluate the competitiveness of ports in ASEAN(Association of Southeast Asian Nations), which plays a leading role in basing the hub of global logistics strategies as a countermeasure in changes of logistics environments. This region represents most severe competition among Mega Hub ports in the world in terms of container cargo throughput at the onset of the 21st century. The research method in this study accounted for overlapping between attributes, and introduced the HFP method that can perform mathematical operations. The scope of this study was strictly confined to the ports of ASEAN, which cover the top 100 of 350 container ports that were presented in Containerization International Yearbook 2002 with reference to container throughput. The results of this study show Singapore in the number one position. Even when we compare with major ports in Korea (after getting comparative ratings and applying the same data and evaluation structure), the number one position still goes to Singapore and then Busan(2) and Manila(2), followed by Port Klang(4), Tanjung Priok(5), Tanjung Perak(6), Bangkok(7), Inchon(8), Laem Chabang(9) and Penang(9). In terms of the main contributions of this study, it is the first empirical study to apply the combined attributes of detailed and representative attributes into the advanced HFP model which was enhanced by the KJ method to evaluate the port competitiveness in ASEAN. Up-to-now, none has comprehensively conducted researches with sophisticated port methodology that has discussed a variety of changes in port development and terminal transfers of major shipping lines in the region. Moreover, through the comparative evaluation among major ports in Korea and ASEAN, the presentation of comparative competitiveness for Korean ports is a great achievement in this study. In order to reinforce this study, it needs further compensative research, including cost factors which could not be applied to modeling the subject ports by lack of consistently quantified data in ASEAN.

• Restorative Dentistry and Endodontics
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• 제44권1호
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• pp.8.1-8.7
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• 2019

Objectives: Irrigants are imperative in endodontic therapy for the elimination of pathogens from the infected root canal. The present study compared the antimicrobial efficacy of octenidine dihydrochloride (OCT) with chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against Staphylococcus epidermidis (S. epidermidis) for root canal disinfection. Materials and Methods: The minimum inhibitory concentration (MIC) was obtained using serial dilution method. The agar diffusion method was then used to determine the zones of inhibition for each irrigant. Lastly, forty 6-mm dentin blocks were prepared from human mandibular premolars and inoculated with S. epidermidis. Samples were randomly divided into 4 groups of 10 blocks and irrigated for 3 minutes with saline (control), 2% CHX, 3% NaOCl, or 0.1% OCT. Dentin samples were then collected immediately for microbial analysis, including an analysis of colony-forming units (CFUs). Results: The MICs of each tested irrigant were 0.05% for CHX, 0.25% for NaOCl, and 0.0125% for OCT. All tested irrigants showed concentration-dependent increase in zones of inhibition, and 3% NaOCl showed the largest zone of inhibition amongst all tested irrigants (p < 0.05). There were no significant differences among the CFU measurements of 2% CHX, 3% NaOCl, and 0.1% OCT showing complete elimination of S. epidermidis in all samples. Conclusions: This study showed that OCT was comparable to or even more effective than CHX and NaOCl, demonstrating antimicrobial activity at low concentrations against S. epidermidis.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3941-3944
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• 2013

Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.

• 한국조사연구학회:학술대회논문집
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• 한국조사연구학회 2003년도 춘계학술발표대회
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• pp.140-160
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• 2003

본 연구는 21세기 급변하는 국제물류환경의 대책으로서 국제물류 중심화를 위한 로지스틱스 전략의 근간이 되는 ASEAN의 주요 컨테이너항만의 경쟁력 파악과 평가에 목적이 있으며 나아가 한국항만과의 경쟁력 비교를 통하여 전략적 대책을 위한 비교연구에 긍극적 목적이 있다. 연구방법론은 항만경쟁력이라는 정성적인 속성을 정량화하여 평가하는 계층퍼지분석(HFP)기법을 도입하여 실증분석을 하였다. 연구의 범위는 최근 치열한 항만간 경쟁이 전개되고 있고 국제물류전략상 연구의 관심이 고조되고 있는 ASEAN을 연구대상으로 하였다 연구의 결과 제 1 차 분석에서는 싱가포르항만이 연구대상지역에서 가장 경쟁력이 높게 나타났으며, 동일한 자료와 구조를 한국항만에 적용하여 비교 연구한 결과 싱가포르가 1위, 부산항이 2위로 평가되었다. 본 논문의 기여도는 한국과 ASEAN의 항만경쟁력 비교연구를 통해 사회과학분야의 첨단연구기법이라 할 수 있는 HFP방법론을 도입하여 정책적 관점에 응용한 최초의 실증적인 연구접근에 있다 현재까지 당 연구에서 발표된 바와 같이 정교한 모델로 한국과 ASEAN의 주요 항만개발과 세계 주요선사의 터미널 이전에 따른 역동적인 해운항만 및 로지스틱스 활동을 분석한 논문은 전무한 상태이다. 향후 연구과제로 HFP의 모델링에 ASEAN에 있어서 주요항만간 일관성 있는 항만비용자료의 미비로 적용하지 못한 비용적인 요소를 포함시켜 보다 더 심층적인 보완적 연구로 본 논문의 질을 제고 시킬 수 있을 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3017-3021
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• 2013

Background: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients. Materials and Methods: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0. Results: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 ($SD{\pm}13$) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 494%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p-0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001). Conclusions: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.

• 한국항만경제학회지
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• 제32권1호
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• pp.17-28
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• 2016

본 연구는 SNA(Social Network Analysis)를 이용하여 아시아 지역 크루즈 항로의 네트워크 구조와 항만의 중심성 파악을 연구의 목적으로 하였다. 크루즈 항로의 네트워크 분석을 위해 아시아 항만을 운항하는 크루즈 선사 항로의 데이터를 Cruise Lines International Association 보고서를 통해 수집하였으며, 이를 활용하여 크루즈 항로의 네트워크를 구성하였다. 아시아 크루즈항로의 구조분석결과, 노드 수는 249개, 링크 수는 54, 밀도는 0.009, 평균거리는 2.180으로 분석되었다. 네트워크 중심성 분석결과, 연결 중심성의 경우 Out degree와 In degree 모두 Singapore가 1위를 기록했으며, 매개 중심성 분석결과, Singapore가 1위로 분석되었다, 아이겐 벡터 중심성이 가장 높은 항만은 Hong Kong으로 분석되었으며, 그 뒤로 Ho Chi Minh, Singapore, Shanghai, Danang이 분석되었다. 국내항만인 Incheon, Busan, Jeju의 경우 연결 중심성, 매개 중심성, 아이겐벡터 지표 모두 경쟁 항만이라 할 수 있는 동남아지역 항만과 중국항만보다 순위가 낮은 것으로 나타났다.

• 동남아시아연구
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• 제26권3호
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• pp.91-118
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• 2016

말레이시아 사바주(Sabah)의 12대(2008)와 13대(2013) 총선의 결과는 독립 이후 말레이시아에서 여당 연합을 형성해 온 국민전선(Barisan Nasional: BN)은 서서히 사바주의 정치에서 지배력이 이전과 다름을 보여주는 의미있는 결과를 보여준다. 12대 총선 이후 사바주는 국민전선의 정치적 텃밭에서 서서히 정치적 영향력(특히 주의회 선거)이 약해됨을 보여준다. 비록 13대 총선에서 국민전선(BN)이 겉으로는 사바주의 연방의회 의원 의석을 가져가는 등 정치적 텃밭으로 보여주지만, 이전에 비해 득표력이 떨어졌음을 알 수 있다. 본 연구는 사바주의 13대 총선 결과는 사바주를 여당 연합인 국민전선(BN)의 텃밭(fixed-deposit state)로 부를 수 있는지를 말레이 총선 결과를 토대로 살펴보았다. 이를 위해 본 연구는 문헌 연구를 중심으로 하여 말레이시아의 12대와 13대 총선 결과를 토대로 하여 이전의 총선의 결과와 비교하여 정치적인 변화와 함께 사바주의 사회문화적 종교적 환경을 바탕으로 한 변화의 조짐을 분석하였다.