• Journal of Preventive Medicine and Public Health
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• 제51권5호
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• pp.227-233
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• 2018

Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

• 대한한방부인과학회지
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• 제31권3호
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• pp.152-163
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• 2018

Objectives: In recent studies, increased AMH level has been suggested as objective surrogate marker for diagnosis PCOS, one of the major causes of oligomenorrhea. The purpose of this study is to report the clinical effect of Korean medicine treatment on oligomenorrhea patient with increased Anti-mullerian hormone level, who can be diagnosed who can be ruled out PCOS. Methods: A 27 year old woman with oligomenorrhea was enrolled in this study. We measured serum hormone levels and ruled out PCOS. The patient received Korean medicine treatment for 3 months, we assessed the result of treatment through observation of the menstrual cycle and follow-up measurements of serum hormone levels. Results: 1. The patient had menstrual cycle regularly. 2. Increased serum AMH level of the patient decreased from 12.16 ng/ml to 8.51 ng/ml. 3. The other serum hormone levels such as testosterone, LH/FSH ratio decreased Conclusion: This case shows that Korean medicine treatment could have a beneficial effect on menstrual cycle and decrease the increased serum hormone levels of ruled out PCOS patient.

• 한국환경보건학회지
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• 제46권3호
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• pp.335-343
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• 2020

Objectives: The Korean Ministry of Environment has identified cases of people suspected of suffering lung disease potentially caused by polyhexamethylene guanidine (PHMG) used in humidifier disinfectants (HDs). Exposure assessment for the HDs was conducted using a questionnaire during face-to-face interview. The main purposes of this study were to develop a methodology to effectively classify levels of exposure to HDs based on a questionnaire. Methods: We first identified the overall participants' exposure characteristics by HD exposure levels; Second, we selected misclassified subjects and investigated characteristics of overestimated and underestimated subjects, focusing on exposure cases to PHMG-containing HDs. An inhalation reference concentration (RfC) for PHMG was produced on the basis of inhalation toxicity values. We made a cross-tabulation of the exposure classes (Exposure classes 1-to-4) by clinical classes based on the RfC. When the value of the exposure class minus the clinical class was 0 or 1, we assumed these were true values. When the value was ≥2 and ≤ -2, we assigned these cases to the overestimation group and underestimation group, respectively. Results: The overestimated group may have already recovered and responded excessively due to psychological anxiety or in order to receive compensation. On the other hand, relatively high mortality rates and surrogate responses for those under 10 years of age may have resulted in inaccurate exposure assessment for underestimated groups. For the characteristics of exposure, it was shown that for the underestimated group, the exposure was relatively weaker than the overestimated group, even though a high overall clinical rating was determined. Conclusions: This study may suggest ways to reduce bias and overcome the limitations of current HD exposure assessment.

• Journal of Preventive Medicine and Public Health
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• 제33권3호
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• pp.306-312
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• 2000

Background : Polycyclic aromatic hydrocarbons (PAH) are well known environmental pollutants. The measurement of PAH in ambient air is not commonly used, because it is quite difficult to perform and is unreliable. Using biomarkers of PAH can be an alternative approach to this problem. The PAH in ambient air is absorbed in particulate matter. Total suspended particulate(TSP) or particulate matter of less than $10{\mu}m$ in diameter (PM10) can be easily measured. Therefore, TSP or PM10 can be used as a surrogate measurements of ambient air PAH. Objectives : We investigated whether the urinary concentration of two biomarkers of PAH, 1-hydroxypyrene (1-OHP) and 2-naphthol, could reflect the total suspended particulate in the general population. Methods : In order to exclude the effects of occupational exposure and smoking, first grade middle school students were included in this study. Four middle schools within a one kilometer boundary of ambient air monitoring stations were selected. Total suspended particulate was regarded as the marker of airborne PAH. Diet and smoking data were collected by self administered questionnaires, and spot urine samples were collected. Urinary 1-OHP and 2-naphthol were analyzed by high performance liquid chromatography. Results : The correlation between urinary 1-OHP, 2-naphthol and passive smoking was not statistically significant. The correlation between urinary 1-OHP and TSP indices was not statistically significant. The correlations between urinary 2-naphthol and TSP of two lag days, one lag day, and zero lag days were statistically significant. The statistical significance of two lag days was the strongest (p=0.001), one lag day was the next (p=0.0275), and zero lag days was the weakest (p=0.0349). Conclusion : Our results imply that the urinary concentration of 2-naphthol can be applied as a PAH exposure marker for the general population with low PAH exposure.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2393-2398
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• 2012

Objectives: The purpose of this study was to evaluate the geometric accuracy of thoracic anatomic landmarks as target surrogates of intrapulmonary tumors for manual rigid registration during image-guided radiotherapy (IGRT). Methods: Kilovolt cone-beam computed tomography (CBCT) images acquired during IGRT for 29 lung cancer patients with 33 tumors, including 16 central and 17 peripheral lesions, were analyzed. We selected the "vertebrae", "carina", and "large bronchi" as the candidate surrogates for central targets, and the "vertebrae", "carina", and "ribs" as the candidate surrogates for peripheral lesions. Three to six pairs of small identifiable markers were noted in the tumors for the planning CT and Day 1 CBCT. The accuracy of the candidate surrogates was evaluated by comparing the distances of the corresponding markers after manual rigid matching based on the "tumor" and a particular surrogate. Differences between the surrogates were assessed using 1-way analysis of variance and post hoc least-significant-difference tests. Results: For central targets, the residual errors increased in the following ascending order: "tumor", "bronchi", "carina", and "vertebrae"; there was a significant difference between "tumor" and "vertebrae" (p = 0.010). For peripheral diseases, the residual errors increased in the following ascending order: "tumor", "rib", "vertebrae", and "carina"; There was a significant difference between "tumor" and "carina" (p = 0.005). Conclusions: The "bronchi" and "carina" are the optimal surrogates for central lung targets, while "rib" and "vertebrae" are the optimal surrogates for peripheral lung targets for manual matching of online and planned tumors.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10577-10583
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• 2015

Background: Triple-negative breast cancer (TNBC), characterized by the lack of expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2, is typically associated with a poor prognosis. The majority of TNBCs show the expression of basal markers on gene expression profiling and most authors accept TNBC as basal-like (BL) breast cancer. However, a smaller fraction lacks a BL phenotype despite being TNBC. The literature is silent on non-basal-like (NBL) type of TNBC. The present study was aimed at defining behavioral differences between BL and NBL phenotypes. Objectives: i) Identify the TNBCs and categorize them into BL and NBL breast cancer. ii) Examine the behavioral differences between two subtypes. iii) Observe the pattern of treatment failure among TNBCs. Materials and Methods: All TNBC cases during January 2009-December 2010 were retrieved. The subjects fitting the inclusion criteria of study were differentiated into BL and NBL phenotypes using surrogate immunohistochemistry with three basal markers $34{\beta}E12$, c-Kit and EGFR as per the algorithm defined by Nielsen et al. The detailed data of subjects were collated from clinical records. The comparison of clinicopathological features between two subgroups was done using statistical analyses. The pattern of treatment failure along with its association with prognostic factors was assessed. Results: TNBC constituted 18% of breast cancer cases considered in the study. The BL and NBL subtypes accounted for 81% and 19% respectively of the TNBC group. No statistically significant association was seen between prognostic parameters and two phenotypes. Among patients with treatment failure, 19% were with BL and 15% were with NBL phenotype. The mean disease free survival (DFS) in groups BL and NBL was 30.0 and 37.9 months respectively, while mean overall survival (OS) was 31.93 and 38.5 months respectively. Treatment failure was significantly associated with stage (p=.023) among prognostic factors. Conclusions: Disease stage at presentation is an important prognostic factor influencing the treatment failure and survival among TNBCs. Increasing tumor size is related to lymph node positivity. BL tumors have a more aggressive clinical course than that of NBL as shown by shorter DFS and OS, despite having no statistically significant difference between prognostic parameters. New therapeutic alternatives should be explored for patients with this subtype of breast cancer.

• 한국산업보건학회지
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• 제27권3호
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• pp.180-186
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• 2017

Objectives: The purposes of this study were to compare the surface resistance of cassettes according to the material, and to evaluate the wall deposition of carbon nanotubes(CNTs) by electrostatic loss in the inner wall of the cassette. Methods: Surface resistance was measured for three types of cassettes(25 mm polypropylene conductive cowl, 25 mm and 37 mm clear styrene cassettes) with a surface resistance meter. Also, electrostatic wall loss was measured at different weights of CNTs depending on the cassette. CNTs were laid on a weight dish with the cassette for five minutes to provide sufficient time to attach on the wall. Wipe sampling was performed to collect CNTs deposited on the wall and elemental carbon, known as a surrogate for CNTs, was analyzed. Results: The cassette with conductive materials(18% of black carbon) showed the lowest surface resistance($<1.21{\times}10^3{\Omega}$). Cassettes made from clear polystyrene showed the relatively highest surface resistance(25 mm: $10.02{\times}10^9{\Omega}$, 37 mm: $10.59{\times}10^9{\Omega}$). This means that particles are more likely to stick to the internal wall of styrene cassettes due to electrostatic electricity. This may lead to an underestimation of the airborne concentration of CNTs. The experiment showed that EC was not detected when using a 25 mm conductive cowl cassette, while EC was detected at the internal wall of 25 mm and 37 mm polystyrene cassettes. Conclusions: This study confirms that cassettes with a conductive cowl have low surface resistance and are more appropriate for CNT sampling. In addition, this finding could be applied for other types of particulate, especially regarding electrostatic charge and sampling.

• Journal of Preventive Medicine and Public Health
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• 제42권3호
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• pp.160-164
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• 2009

Objectives : The objective of this study was to determine the relationship between past smoking and the risk factors for metabolic syndrome. Methods : From January 2007 to December 2007, a total of 3,916 over thirty years old male health screen examinees were divided into the nonsmoking, smoking, ex-smoking groups. The diagnosis of metabolic syndrome was based on the criteria of the NCEP ATP III(Executive Summary of The Third Report of The National Cholesterol Education Program). Metabolic syndrome was defined as the presence of three or more of the following: a blood pressure $\geq$ 130/85 mmHg, a fasting glucose level $\geq$ 110 mg/dL, a HDL-C (High Density Lipoprotein Cholesterol) level < 40 mg/dL, a triglyceride level $\geq$ 150 mg/dL and, a waist circumference men $\geq$ 102 cm, but a waist to hip ratio > 0.90 was used as a surrogate for the waist circumference. Results : After adjustment for age, alcohol consumption and, exercise in the smokers, for the ex-smokers compared with the nonsmokers, the odds ratio (OR) of a lower HDL cholesterol level (<40 mg/dL) was 1.29 (95% CI=1.03-1.61) in the smokers, the ORs of a higher triglyceride level were 1.35 (95% CI=1.09-1.66) in the ex-smokers and, 2.12 (95% CI=1.75-2.57) in the smokers, and the OR of a waist to hip ratio was 1.25 (95% CI=1.03-1.52) in the ex-smokers. When there were over three components of metabolic syndrome in the ex-smokers and smokers as compared with the nonsmokers, the odds ratio against the risk of metabolic syndrome were 2.39 (95% CI=1.00-6.63) and 2.37 (95% CI=1.02-6.46), respectively. Conclusions : The present study suggested that there is an association of smoking with metabolic syndrome in men.

• 한국물환경학회지
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• 제28권5호
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• pp.704-716
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• 2012

본 논문은 California의 South Lake Tahoe, 서울 뚝섬정수장 그리고 성남 복정정수장에서 2010년 2월에서 2012년 2월까지 수행된 파일럿 실험에 대한 분석결과를 기초로 작성되었다. 본 실험의 목적은 첫째, 한강을 원수로 하는 모래여과 처리수에 대한 오존 및 과산화수소(Peroxone)의 반응특성을 파악하고, 둘째는 AOP(고도산화공정)을 통해 맛 냄새 유발물질인 2-methylisoborneol(MIB)를 제거하기위한 경험적인 오존 및 과산화수소의 투입량을 결정하고자 하였다. 또한 셋째로, 처리공정이후 인체에 안전한 잔류오존농도로 감소시키기 위한 최적 투입량을 결정하고자 하였다. 본 실험은 계절의 기온변화에 따라 저수온 및 고수온의 조건하에서 실시간으로 수행되었다. 본 실험을 통해 오존의 분해속도는 온도와 pH에 영향을 받는 것으로 나타났으며, 이는 다른 연구결과와 일치한다. 원수로 모래여과수에 MIB를 40~50ng/L의 농도로 투입하였으며, 모든 경우에서 7ng/L 이하로 처리되었으며 대부분의 경우에서 검출(ND)되지 않았다. Peroxone은 MIB을 제거할 뿐아니라 오존을 단독으로 사용한 경우보다 오존+과산화수소 동시에 투입한 경우에 잔류오존농도가 더 낮았다. 저수온에서 상당량의 오존이 반응 및 분해를 통해 감소된다. 본 실험을 통해 "Pre-Conditioned" 과산화수소를 적용함으로써 초기 반응율을 향상시키고 잔류오존농도를 낮출 수 있었으며, 약품의 과투입 및 효율저하를 방지하는 과산화수소의 투입 위치 및 구성 그리고 투입방법을 제시하였다.

• Clinical and Experimental Reproductive Medicine
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• 제34권2호
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• pp.75-85
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• 2007

목 적: 뮬러관 기형과 같이 자궁이 없는 환자들에 있어 시행되어지는 체외수정을 통한 대리모 출산에 대한 사회적 인식을 조사하기 위하여 이 연구를 계획하였다. 연구방법: 본원 산부인과를 방문한 불임 환자 및 본원에 근무하는 간호사, 사무직 여직원을 대상으로 설문지 조사를 통하여 이루어졌다. 배포된 설문지 중 회수된 211명, 즉 불임 환자 60명을 포함하여 기혼 여성이 152명, 미혼 여성이 58명을 대상으로 하였다. 대리모에 찬성한 군과 반대한 군으로 나누어 윈도우용 SPSS 10.0을 이용하여 Pearson x$^2$ test, Fisher's exact test 등으로 비교하였으며 통계적인 유의성의 판정은 p-value<0.05를 기준으로 하였다. 결 과: 전체 응답자 중 17명 (8.1%)만이 자궁이 없는 불임여성의 대리모 시술에 찬성하였으며, 125명 (59.2%)에서는 입양을 선택하였다. 대리모에 찬성하는 군은 반대한 군에 비하여 나이, 결혼 여부, 교육 정도, 수입 정도뿐만 아니라 불임 여부에 따라서도 유의한 차이가 없었다. 그러나 종교에 따라서는 기독교인에게서 찬성률이 유의하게 높았다 (p=0.023). 대리모의 대상으로는 혈연관계가 아닌 제 3자를 선택한 경우가 66.5%로 가장 많았고 친구가 0.6%로 나타났으며, 혈연관계로는 자매 24.5%, 시누이 3.9%이었으며 어머니를 선택한 경우도 4.5% 있었다. 결 론: 체외수정을 통한 대리로 출산은 뮬러관 기형과 같은 자궁이 없는 불임 부부에게는 분명한 치료 방법이 될 수 있지만, 본 연구에서 보듯이 한국 사회에서는 부정적인 시각이 더 많다고 하겠다. 앞으로 광범위 의식 조사가 이루어진 뒤, 이 시술에 대한 의사의 역할 및 여러 문제에 관한 법적, 윤리적 지침이 마련되어야 할 것으로 생각된다.