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Concurrent Chemoradiotherapy in Locally Advanced Esophageal Cancer (국소적으로 진행된 식도암에서 동시항암화학방사선치료의 결과)

  • Byun, Sang-Jun;Kim, Jin-Hee;Kim, Ok-Bae;Song, Hong-Suk
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.20-27
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    • 2011
  • Purpose: This study was designed to evaluate the results of local control, survival rate, prognostic factors, and failure pattern in locally advanced esophageal cancer. Materials and Methods: We retrospectively studied 50 patients with locally advanced esophageal cancer treated with concurrent chemoradiotherapy at Keimyung University Dongsan Medical Center from June of 1999 to August of 2008. Seven patients with inappropriate data were excluded, and 43 patients were analyzed. There were 39 males and four female patients ranging in age from 43 to 78 years (median, 63 years). There were seven patients with stage IIA and 36 with stage III. Irradiation from 46 Gy to 63 Gy (median, 54 Gy) was carried out 5 days per week, 1.8 Gy once a day. There were eight patients with neo-adjuvant chemotherapy, and we mostly used 5-fluorouracil, cisplatin with 3 cycles for concurrent chemotherapy. The range of follow up periods was from 2 to 82 months (median, 15.5). Results: There were nine patients that exhibited a cornplete response, 23 that exhibited a partial response, 9 that exhibited no response, and 2 that exhibited disease progression. The median survival time was 15 months. Two-year and 5-year survival rates were 36.5% and 17.3%, respectively. Two-year and 5-year disease-free survival rates were 32.4% and 16%, respectively. Treatment failure occurred in 22 patients (51.2%). Patterns of failure were categorized as local failure in 18 patients and distant metastasis in four patients. In a univariate analysis for prognostic factors related to overall survival and disease-free survival, the hemoglobin levels during chemoradiotherapy (${\geq}$ 12 vs. <12, p=0.02(p=0.1) and the response to the treatments (CR/PR vs. NR/PD, p=0.002/p< 0.0001) were statistically significant. In a multivariate analysis, only response to the treatments was revealed to be statistically significant. There was no statistical significance associated with patient age, gender, disease stage, T-stage, smoking history, tumor location, or neo-adjuvant chemotherapy. Conclusion: Our survival rate was similar to those of other institutions. Local recurrence was the main reason for failure. It is suggested that further prospective studies should be performed to improve local control.

Association of Lifestyle with Blood Pressure (생활양식과 혈압의 관련성)

  • Joo, Ree;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.497-507
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    • 1997
  • This study was conducted to evaluate the association of various lifestyle with blood pressure. The data were obtained from the individuals who got routine health examination in Department of Occupational Medicine, Yeungnam University Hospital from June to September, 1996. Among these people, we selected 130 cases of hypertensives (97 males, 33 females) and 150 normotensives(70 males, 80 females) and study was conducted. The authors collected the information of the risk factors related to hypertension such as age, family history of hypertension, fasting blood sugar, serum total cholesterol, alcohol consumption(g/week), smoking history, relative amount of salt intake (low, moderate, high), the frequency' of weekly meat consumption, BMI, daily coffee consumption(cups/day) and the frequency of regular exercise(frequency/week) through questionnaire and laboratory test. By simple analysis, BMI was significantly associated with hypertension in male(p<0.05), and the frequency of weekly meat consumption was significantly associated with hypertension in female(p<0.05). Using logistic regression model, elevated odds ratio was noted for fasting blood sugar, serum total cholesterol, family history of hypertension, alcohol consumption, salt intake and BMI, and reduced odds ratio was noted for coffee consumption and exercise in male but fasting blood sugar(odds ratio=1.022, 95% CI=1.000-1.044), family history in both of parents(odds ratio=3.301, 95% CI=1.864-4.738), salt intake(odds ratio=1.690, 95% CI=1.082-2.298) and BMI(odds ratio=1.204, 95% CI=1.065-1.343) were statistically significant(p<0.05). In female, elevated odds ratio was noted in serum total choles terol, family history of hypertension, BMI and meat consumption. Of all these variables, the family history of hypertension in either of parents(odds ratio=4.981, 95% CI=3.650-6.312), family history in both of parents(odds ratio=16.864, 95% CI=14.577-19.151), BMI(odds ratio=1.167, 95% CI=1.016-1.318) and meat consumption(odds ratio=2.045, 95% CI=1.133-2.963) showed statistically significant association with hypertension in female(p<0.05).

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Association of Liver Dysfunction with Self-Medication History in Korean Healthy Male Adults (건강한 한국 성인남성의 자가약물복용력에 따른 간기능 장애 발생여부 조사)

  • Bae, Jong-Myon;Park, Byung-Joo;Lee, Moo-Song;Kim, Dong-Hyun;Shin, Myung-Hee;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.801-814
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    • 1996
  • Background: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. Methods: Study subjects were drawn from male members of Seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hunderd per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. Results: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. Conclusion: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.

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Comparison of dietary habits, perception and consumption frequency of fast foods between youths working part-time at fast food restaurants and other food-related services (패스트푸드점 아르바이트생과 그 외 음식관련 서비스업 아르바이트생의 식습관, 패스트푸드에 대한 인식 및 섭취빈도 비교)

  • Jo, Mi Yang;Hyun, Taisun
    • Journal of Nutrition and Health
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    • v.47 no.3
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    • pp.206-213
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    • 2014
  • Purpose: The purpose of the study was to compare dietary habits, perception, and consumption frequency of fast foods between part-time working youths at fast food restaurants and those at other food-related services. Methods: The study subjects were part-time working youths in 13 fast food restaurants (n = 118) and in 25 other places including bakeries, cafes, convenience stores, and other restaurants (n = 115) in Cheongju. Demographic characteristics, dietary habits, perception regarding fast foods, and consumption frequencies of food groups and fast foods were assessed using a self-administered questionnaire. Results: Female youths working at fast food restaurants had unhealthier dietary habits, such as meal skipping and night snacking compared to those working at other places. Consumption frequencies of fruits in males and beans/bean products in females working at fast food restaurants were significantly lower than those working at other places. Perception score on fast foods was significantly lower in males working at fast food restaurants than in males working at other places. However, the consumption frequencies of hamburgers, pizzas, and a total of six fast foods among both males and females working at fast food restaurants were significantly higher than those working at other places after adjusting for confounding variables including age, status, type of residence, allowance, alcohol, smoking, working hours, and hourly pay. Conclusion: Part-time working youths at fast food restaurants had worse dietary habits, such as meal skipping and night snacking, and consumed fast foods more frequently than those working at other places. Interventions for part-time working youths at fast food restaurants may be needed in order to reduce fast food consumption and increase the intake of fruits and vegetables.

Existential Consciousness and the Meaning of Characters in André Malraux's Literary Works (앙드레 말로의 문학작품에 나타난 등장인물의 실존의식과 존재의미)

  • Oh, Se-jung
    • Cross-Cultural Studies
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    • v.47
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    • pp.191-216
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    • 2017
  • Among 20th century Western ideologies (Western civilization), existentialism is a spirit of the times to restore humanity as rationality and advanced technology have driven mankind to impoverishment and death, experiencing the First and Second World War, Great Depression, Fascism and the Spanish Civil War. In his literature, $Andr{\acute{e}}$ Malraux records his existential agony of how mankind lives and faces death by questioning the fateful life and death of characters. For Malraux's characters, the absurdity of existence related to the human identity means self-examination. Malraux explores existential consciousness and actions of characters in the presence of a concept known as death relative to terror, revolution, and adventure. Malraux deftly addresses the concept of death in his literary works, and it has being emphasized as a central subject for philosophical speculation. In Les $Conqu{\acute{e}}rants$(1928), La Voie Royale(1930), La Condition Humaine (1933), L'Espoir(1937), Malraux suggested a philosophical thesis of the meaning of life through characters in tragic situations, and sought out the consciousness of being and the existential meaning through how the characters control their fate. Malraux, in such a tragic perspective of the world, portrays humanity, affirmation of life, and characters' consciousness and actions in denying death. The agony of death triggers escapist behavior such as having unpredictable instinctual desires such as gambling or smoking opium, but these are desperate struggles to flee from frustration and related to the question of one's existence. What is always emphasized with respect to Malraux's existentialism is the tragic metaphysics of the inevitable destiny of the human condition eventually leading to the question of how humans ultimately confront death. But as characters unite in times of war, revolution and adventure in the novel, such cooperative actions symbolizes a keen sense of solidarity reflecting a camaraderie that transcends individualism. Fellowship among people who voluntarily gather for the common cause of philanthropy and restoring humanity is possible because of the underlying human greatness to sacrifice for such a noble cause. Therefore, Malraux's camaraderie includes the victory of existentialism in creating a world of humanism.

Differences in Grip Strength by Living Conditions and Living Area among Men and Women in Middle and Later Life (독거여부와 거주지역에 따른 중년기와 노년기 남성과 여성의 악력 차이)

  • Joo, Susanna;Jun, Hey Jung;Park, Hayoung
    • 한국노년학
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    • v.38 no.3
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    • pp.551-567
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    • 2018
  • Demographic and socio-structural information is useful to identify potential welfare recipients who are in need of disease-prevention and intervention services. Thus, the present study aims to explore the differences in grip strength among middle and old-aged adults by living conditions and by living area. The 5th wave data of Korean Longitudinal Study of Aging was utilized. The dependent variable was grip strength, and the independent variables were living alone (living alone or not) and living area (city or non-city). Covariates were age, education, log-transformed household income, spouse existence, body mass index, self-rated health conditions, depressive symptoms, cognitive function, smoking, regular exercise, frequency of meeting with friends, and the number of social participation. Regression analysis was performed for middle-aged men, middle-aged women, old-aged men, and old-aged women, respectively. ANOVA and Chi-test were additionally used to specifically discuss significant results. Cross-sectional weight was applied to all analyses. According to the results, living alone and living area did not have significant effects on grip strength among middle-aged men, old-aged men, and old-aged women. In middle-aged women, however, living alone and living area were significantly associated with grip strength. To be specific, middle-aged women who lived alone in rural areas had the lowest grip strength compared to other middle-aged women. Additional analysis showed that middle-aged women who lived alone in rural areas had risk factors, such as low education level, low income, or high depressive symptoms. It implies that middle-aged women living alone in rural areas may have physical health risks, so they might be in need of disease prevention. This study is meaningful in that it can provide reliable information on the latent welfare recipients by using representative panel data and applying weight values.

Female Gender is a Poor Predictive Factor of Functional Dyspepsia Resolution after Helicobacter pylori Eradication: A Prospective, Multi-center Korean Trial (기능성 소화불량증 환자에서 헬리코박터 파일로리 제균 치료 효과 및 관련 요인: 국내 전향적, 다기관 연구)

  • Kim, Sung Eun;Kim, Nayoung;Park, Seon Mee;Kim, Won Hee;Baik, Gwang Ho;Jo, Yunju;Park, Kyung Sik;Lee, Ju Yup;Shim, Ki-Nam;Kim, Gwang Ha;Lee, Bong Eun;Hong, Su Jin;Park, Seon-Young;Choi, Suck Chei;Oh, Jung Hwan;Kim, Hyun Jin
    • The Korean Journal of Gastroenterology
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    • v.72 no.6
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    • pp.286-294
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    • 2018
  • Background/Aims: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. Methods: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing H. pylori eradication therapy. Results: A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent H. pylori infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing H. pylori eradication therapy. Conclusions: Female gender was found to predict poor response in FD patients despite H. pylori eradication. Furthermore, successful H. pylori eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.

A Systematic Study on the Multifaceted Lifestyle Assessment Tools For Community-dwelling Elderly: Trend and Application Prospect (지역사회 거주 고령자의 라이프스타일 측정도구에 관한 조사: 경향과 활용전망)

  • Park, Kang-Hyun;Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.8 no.3
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    • pp.7-29
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    • 2019
  • Objective: The purpose of this study is to analyze comprehensive lifestyle assessment and other assessments which evaluate essential lifestyle factors, including physical activity, nutrition and activity participation. Methods: To analyze the comprehensive lifestyle assessment, from January 2001 to June 2019, a literature search was conducted using the CINANL, NDSL, PubMed, and RISS databases. The search terms were 'lifestyle assessment' OR 'lifestyle profile' OR 'lifestyle test'. In terms of other assessments of essential factors of lifestyle, from January 2010 to June 2019, articles were searched using similar databases. The search terms were 'physical activity assessment' OR 'physical activity participation profile', 'nutrition assessment', 'activity participation assessment' OR 'activity participation and lifestyle'. Results: A total of 4,165 articles were obtained, and finally 31 articles were selected according to the inclusion criteria. Among 31 articles, there were five with comprehensive lifestyle assessments, and all of them were self-report questionnaires. The most popular assessments were the Health Enhancement Lifestyle Profile (HELP) and the Health-Promoting Lifestyle Profile (HPLP), which were used in three articles (33%). In terms of assessment of physical activity, the most frequently used evaluation method was the self-report questionnaire, which was used in seven articles (58%) followed by objective assessments, which were used in four articles (33%). It was demonstrated that the Mini-Nutritional Assessment (MNA) was the most frequently used for nutrition assessment in the elderly. There were five types of assessment tool used for activity participation. Among them, meaningful activity participation assessment (MAPA) was the most frequently used tool. Conclusion: As a result of the systematic review, it was found that there are 21 assessments related to the evaluation of lifestyle in the elderly. Most assessments employed the self-report questionnaire method and mainly evaluated frequency and duration of participation in drinking, smoking, exercise, nutrition and social activities. Assessments of essential lifestyle factors were the self-report questionnaire method and the participation and frequency of activity. Therefore, by analyzing assessment tools, types of items and measurement methods of comprehensive lifestyle assessments and other assessment of essential lifestyle factors, this study provides the basic data on which to develop a standardized assessment tool that can evaluate the multifaceted lifestyle profile of the elderly.

Comparison of health care practice, dietary behavior, and nutrient intakes, considering the alcohol drinking status of industrial workers in the Chungnam area (충남지역 일부 산업체 근로자의 알코올섭취 수준에 따른 건강관리 실천, 식행동 및 영양소 섭취상태 비교)

  • Park, Gun Hee;Rho, Jeong Ok
    • Journal of Nutrition and Health
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    • v.54 no.3
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    • pp.277-291
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    • 2021
  • Purpose: This study was undertaken to identify the alcohol drinking status of industrial workers, their health care practice, and dietary behavior, as well as their nutrient intake. Methods: In July 2019, 220 male subjects working in the Chungnam area were enrolled in the study. Their alcohol drinking status was evaluated by applying the Alcohol Use Disorder Identification-K (AUDIT-K) system. Demographic characteristics, status of health care practice, and dietary behaviors were assessed using a self-administered questionnaire; nutrient intakes were analyzed using 24-hour recalls. Data were analyzed by applying χ2-test, ANOVA, Duncan test, and Pearson's correlation analysis with SPSS v. 25.0. Results: Workers were classified by their alcohol drinking status as 'normal' (84, 38.2%), 'problem drinker' (45, 20.5%), 'alcohol dependence I' (60, 27.3%), and 'alcohol dependence II' (31, 16.0%). The alcohol drinking status showed significant differences with age (p < 0.05), monthly income (p < 0.05), smoking status (p < 0.05), and need for weight control (p < 0.05). Moreover, increased alcohol intake resulted in significantly decreased levels of health care practice and dietary behaviors (p < 0.05, p < 0.01, respectively). The energy intake was highest in the 'alcohol dependence I' group, followed by 'alcohol dependence II', 'problem drinker', and 'normal drinker' (p < 0.05). Intakes of vitamin E, vitamin C, and niacin in the 'alcohol dependence I' group were found to be higher than the other groups (p < 0.05). A negative correlation was obtained between alcohol drinking status, health care practice, and dietary behaviors, whereas a positive correlation was determined between alcohol drinking status, energy and water intakes. Conclusion: Considering these results, we conclude the necessity to consider nutritional and alcoholic education programs for improving the quality of work life of industrial workers, based on their alcohol drinking status.

Nutritional status and metabolic syndrome risk according to the dietary pattern of adult single-person household, based on the Korea National Health and Nutrition Examination Survey (국민건강영양조사 자료에 의한 식이 패턴별 1인 가구의 영양 상태와 대사증후군 위험도)

  • Keum, Yu Been;Yu, Qi Ming;Seo, Jung-Sook
    • Journal of Nutrition and Health
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    • v.54 no.1
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    • pp.23-38
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    • 2021
  • Purpose: This study was undertaken to evaluate the health, nutritional status and metabolic syndrome risk according to the dietary pattern of adult single-person households, using information obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data were collected from the 2013-2016 KNHANES, of adults aged 19-64 years, belonging to single-person households. Based on cluster analysis, the dietary patterns of subjects were classified into three groups. The dietary behavior factors, health-related factors, nutritional status, and prevalence of metabolic syndrome obtained from KNHANES questionnaires were compared according to the individual dietary pattern. The nutrient intake data of the subjects were calculated using the semi-food frequency questionnaire. Moreover, blood and physical measurement data of the subjects were analyzed to obtain the prevalence of metabolic syndromes. Results: The major dietary intakes of subjects were classified as 'Rice and kimchi', 'Mixed', and 'Milk·dairy products and fruits' patterns. Characteristics of subjects based on their dietary pattern, gender, age, and education level were significantly different. The 'Milk and fruits' pattern showed low frequency of skipping breakfast and eating out, and had higher intake of dietary supplements. Frequency of alcohol intake and smoking rates were highest in the 'Mixed' pattern. Maximum nutrient intake of fat, vitamin A, riboflavin, vitamin C, niacin, calcium, phosphorus, and potassium was obtained in the 'Milk·dairy products and fruits' pattern. According to dietary patterns adjusted for age and gender, the risk of metabolic syndrome was 0.380 times lower in the 'Milk·dairy products and fruit' pattern than in the 'Rice and kimchi' pattern. However, when adjusted for other confounding factors, no significant difference was obtained between dietary patterns for metabolic syndrome risk. Conclusion: These results indicate that the health and nutritional status of a single-person household is possibly affected by the dietary intake of subjects.