• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.925-928
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• 2014

Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6571-6574
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• 2014

Background: Alcohol is well established as a risk factor for cancer development in many organ sites. To assess the reliability and validity of the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) for detecting alcohol use disorders or risky drinking in Japanese adults the present study was conducted. Materials and Methods: A test-retest method was applied with a 2-week interval with 113 health care employees. The k coefficient, Cronbach's coefficient alpha, Spearman's correlation coefficient, and intraclass correlation coefficient (ICC) were determined and the validity of the AUDIT-C was analyzed using the data from a nationwide survey on adult alcohol use conducted in 2008 (n=4,123). Results: The reliability of the AUDIT-C score was high (${\kappa}$ coefficient=0.63, Cronbach's alpha=0.98, correlation coefficient=0.95, and ICC=0.95). According to the likelihood ratio and Youden index, appropriate cutoffs for the AUDIT-C were ${\geq}5points$ in men and ${\geq}4$ points in women. The sensitivity and specificity of these cutoffs for identifying ${\geq}8$ points on the AUDIT were 0.88 and 0.80, respectively, for men (positive likelihood ratio [LR+]=4.5) and 0.96 and 0.87, respectively, for women (LR+=7.7). The sensitivity and specificity of the cutoffs for identifying ${\geq}12$ points on the AUDIT were 0.90 and 0.84, respectively, for men (LR+=5.8) and 0.93 and 0.94, respectively, for women (LR+=15.8). The sensitivity and specificity of the cutoffs for identifying ${\geq}16$ points on the AUDIT were 0.93 and 0.80, respectively, for men (LR+=4.7) and 0.92 and 0.98, respectively, for women (LR+=55.6). With higher scores on the AUDIT, the specificity decreased and false-positives increased. The appropriate cutoffs for identifying risky drinking were the same for both genders. Conclusions: The reliability and validity of the AUDIT-C are high, indicating that it is useful for identifying alcohol use disorders or risky drinking among the general population in Japan, a group at high risk of cancer development.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3057-3063
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• 2014

Background: Anaplastic lymphoma kinase (ALK) gene rearrangement in non-small cell lung cancer (NSCLC) has been intensively studied. The gold standard for ALK detection is FISH, but this is not routinely conducted in clinical practice, so that the IHC method has a role. The aim of this study was to identify the incidence of ALK rearrangement and risk or prognostic factors for ALK positivity using both of IHC and FISH methods. Materials and Methods: From January 2008 to December 2012, 267 completely resected NSCLC patients in Chiang Mai University Hospital were enrolled in this study. Clinical and pathological variables and outcomes of treatment were retrospectively reviewed. IHC and FISH were used to evaluate ALK rearrangement. Sensitivity and specificity of IHC were analyzed. Multivariable analysis was used to identify clinico-pathological correlations with positive results of IHC and clinical outcomes. Results: Twenty-two (8.2%) of 267 specimens were IHC-positive for ALK with intense cytoplasmic staining, whereas only 10 (3.8%) were FISH-positive. Sensitivity, specificity and the positive likelihood ratio with IHC were 80.0%, 94.9%, and 15.8 respectively. Age less than 55 years (RR 4.4, 95%CI 1.78-10.73, p value=0.001) and presence of visceral pleural invasion (VPI) (RR 2.9, 95%CI 1.21-6.78, p value =0.017) were identified as risk factors for ALK rearrangement with FISH. There were no statistically significant differences in other clinical and pathological variables. ALK rearrangement was not a prognostic factor for tumor recurrence or overall survival. Conclusions: The incidences of ALK positivity in completely resected NSCLCs in northern Thailand were 8.2% by IHC and 3.8% by FISH. IHC with mouse monoclonal, Ventana D5F3 antibody can be used as a screening tool before FISH method because of high specificity and high positive likelihood ratio. Age less than 55 years and VPI are risk factors for ALK positivity.

• 디지털융복합연구
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• 제18권6호
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• pp.237-244
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• 2020

본 연구의 목적은 한국거래소에 상장되어 있는 KOSPI기업과 KOSDAQ기업을 대상으로 최대주주의 변경과 관련된 정보가 적자보고에 미치는 영향을 실증분석하는 것이다. 구체적으로, 최대주주 변경 유형 중에서 최대주주의 잦은 변경이 나타난 기업의 적자보고를 살펴보기 위하여 기업의 적자보고에 미치는 영향을 통제하고 로짓 회귀분석의 방법을 적용하여 실증분석한다. 분석결과, 회계기간 내 2회 이상 최대주주가 변경된 기업은 적자보고의 기업위험이 다른 기업 보다 더 높은 것으로 나타났다. 이는 한국거래소의 투자위험 공시사항인 최대주주의 잦은 변동이 적자보고와 같은 투자위험 상황으로 나타날 수 있음을 나타낸다. 본 연구는 상장기업을 대상으로 최대주주 변경과 관련한 변동이 시장위험에 영향을 미친다는 증거를 제시하여 한국거래소 전자공시(KIND) 투자유의사항의 정보적 역할을 확인하였다는 점에서 선행연구에 추가적인 공헌점을 가진다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권1호
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• pp.33-40
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• 2020

Objectives: There is an increasing number of North Korean adolescents in South Korea. These adolescents need clinical attention as they experience a high risk of suicidal behavior because of the childhood adversity and acculturative challenges that they face before and after arriving in South Korea. This study assessed the risk of suicide attempts among North Korean adolescents compared to South Korean adolescents, and investigated the contributing factors for each group. Methods: We used data from the Korean Youth Risk Behavior Web-Based Survey (KYRBS) spanning 2011 to 2018, in which 404 adolescents had a father and/or mother who was a North Korean native. Data on 1,212 propensity-matched South Korean adolescents were extracted from the 2011 to 2018 KYRBS. Prevalence was calculated and compared by group. Separate odds ratios were calculated by group. Results: The North Korean group had a significantly higher suicide attempt rate [unadjusted odds ratio (OR)=8.27; adjusted OR=8.45]. Multivariate analysis indicated that having a low or high socioeconomic status and depressive symptoms were significantly associated with suicide attempts in North Korean adolescents, while being female, having a high socioeconomic status, alcohol use, and depressive symptoms were significantly related to suicide attempts in South Korean adolescents. Conclusion: The results found similarities and differences in the factors associated with the likelihood of suicide attempts in the two groups. From these results, different approaches are needed when planning interventions for each group.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1765-1770
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• 2015

Background: Oral cancer presents with high mortality rates, and the likelihood of survival is remarkably superior when detected early. Health care providers, particularly dentists, play a critical role in early detection of oral cancers and should be knowledgeable and skillful in oral cancer diagnosis. Purpose: The aim of the present study was to assess the current knowledge of future Yemeni dentists and their opinions on oral cancer. Materials and Methods: A pretested self-administered questionnaire was distributed to fourth and fifth year dental students. Questions relating to knowledge of oral cancer, risk factors, and opinions on oral cancer prevention and practices were posed. Results: The response rate was 80%. The vast majority of students identified smoking and smokeless tobacco as the major risk factors for oral cancer. Most of the students (92.6%) knew that squamous cell carcinoma is the most common form of oral cancer, and 85.3% were aware that tongue and floor of the mouth are the most likely sites. While the majority showed willingness to advise their patients on risk factors, only 40% felt adequately trained to provide such advice. More than 85% of students admitted that they need further information regarding oral cancer. As expected, students of the final year appeared slightly more knowledgeable regarding risk factors and clinical features of the disease. Conclusions: The findings of the present study suggest that here is a need to reinforce the undergraduate dental curriculum with regards to oral cancer education, particularly in its prevention and early detection.

• International Journal of Quality Innovation
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• 제7권3호
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• pp.1-14
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• 2006

Economic value added (EVA) is introduced on two levels: as index for evaluation of corporation and as index for evaluation of business unit. In the latter case, application of one and the same cost of capital to all business units of a business corporation may be possible, but it is a fundamental policy for EVA to apply different cost of capital to business units with different risks. Estimate of cost of capital of business units is a problem to be resolved. The author, focusing on the question of the estimate of cost of capital of business units, has conducted a demonstrative study on risk structure of cost of capital estimates by using financial indices of Japanese manufacturers (37 automotive industries, 141 electrical and electronic machinery industries, 63 food processing industries, 98 chemical industries, 125 general machinery industries) for a period of 5 years from 1995 to 1999. The author presumes that $\beta$ is explained by a regression formula ${\beta}=B_0+{\Sigma}B_iY_i+{\alpha}$ ($Y_i$: financial indices) and selects 40 explanatory variables from financial statements as risk components. Using their financial indices, the author concludes through a series of statistical analyses that there is a good likelihood of estimating cost of capital for Japanese industries and is convinced that it will lead to more reliable and practical results by assigning averages and variances to 40 primary financial indices for a period of 3 to 5 years selected in this demonstrative study.

• 한국산학기술학회논문지
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• 제15권6호
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• pp.3706-3713
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• 2014

본 연구의 목적은 성인 근로자의 치주질환 유병 여부와 관련하여 인구학적, 구강 행태적 위험 요인을 알아보고자 시행하였다. 연구대상 및 방법은 제5기 3차 국민건강영양조사 자료를 활용하여 20-64세 한국 성인 근로자 1650명을 대상으로 시행하였다. 연구결과, 치주조직 유병자에 대해서 성별, 연령, 소득수준, 교육수준, 전신질환, 수면시간, 구강건강수준, 씹기 문제 및 저작 불편함이 위험요인으로 나타났다. 이중 가장 많은 영향력은 씹기 문제와 저작불편에 문제가 있는 근로자에서 3.5배 이상 치주조직병에 이환될 가능성이 높게 나타났다. 본 연구 결과를 통해서 한국 근로자에 있어서 치주질환 유병의 다양한 위험요인이 존재하고 있음 알 수 있었으며, 향후 치주질환의 유병율을 줄이기 위해서는 정기적인 구강검진과 건강검진, 충분한 수면을 취하고 스트레스를 낮추어야 할 뿐만 아니라, 소득수준과 교육수준의 차이와 같은 사회경제적 불평등 해결을 위한 제도적인 노력이 필요할 것으로 보인다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3527-3531
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• 2015

Background: Serbia is one of the countries with highest incidence and mortality rates for cervical cancer in Central and South Eastern Europe. Introducing a risk index could provide a powerful means for targeting groups at high likelihood of having an abnormal cervical smear and increase efficiency of screening. The aim of the present study was to create and assess validity ofa index for prediction of an abnormal Pap test result. Materials and Methods: The study population was drawn from patients attending Departments for Women's Health in two primary health care centers in Serbia. Out of 525 respondents 350 were randomly selected and data obtained from them were used as the index creation dataset. Data obtained from the remaining 175 were used as an index validation data set. Results: Age at first intercourse under 18, more than 4 sexual partners, history of STD and multiparity were attributed statistical weights 16, 15, 14 and 13, respectively. The distribution of index scores in index-creation data set showed that most respondents had a score 0 (54.9%). In the index-creation dataset mean index score was 10.3 (SD-13.8), and in the validation dataset the mean was 9.1 (SD=13.2). Conclusions: The advantage of such scoring system is that it is simple, consisting of only four elements, so it could be applied to identify women with high risk for cervical cancer that would be referred for further examination.

• 대한지역사회영양학회지
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• 제15권5호
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• pp.656-669
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• 2010

Rapid shift to western dietary patterns and social drive of thinness would lead to increase the likelihood of developing eating disorders. This study was performed to analyze the associated factors between dietary pattern and self visualization in terms of body shape, which may increase the risk of disturbed eating attitudes among high school students in Korea. A cross-sectional study was conducted from 2009 to 2010 for high school students including both male and female students, from 6 schools in Gyunggi Province, Korea. A total of 766 students self-reported a questionnaire, including weight control practice, perceptions of self body image and ideal body image, dietary habit, and EAT-26 (Eating Attitude Test-26). Logistic regression analysis was used to fine the factors potentially associated with disturbed eating attitudes. Statistical analysis was conducted using SAS program (version 9.1). Results showed that disturbed eating attitudes were found in 8.7% of male high school students, and in 20.8% of female high school students. Experience of body weight control was reported by 56.2% of male students and by 87.3% of female students. According to multiple logistic regression analysis, obesity was independently associated with high risk of disturbed eating attitudes in male students [Odds Ratios (OR) 2.96, 95% Confidence Interval (CI) 0.90-9.71]. Body image dissatisfaction (OR 2.77, 95%CI 1.37-5.62) and extended family type (OR 2.70, 95%CI 1.05-6.90) were independently associated with high risk of disturbed eating attitudes, especially in female students. In conclusion, proper efforts in education for obesity and developing self-esteem to reduce the risks of disturbed eating attitudes should be implemented in high school nutrition program.