• Journal of Chest Surgery
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• 제22권3호
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• pp.425-435
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• 1989

The solitary pulmonary nodule is considered as a round or ovoid lesion with sharp, circumscribed borders, surrounded by normal appearing lung parenchyme on all sides, and found on a simple chest X-ray without any particular symptoms or signs. There is a wide spectrum of pathologic conditions in the solitary pulmonary nodules prove to be malignant tumors, either primary or metastatic. Most Benign granulomas and other benign conditions can also be seen as solitary nodules. The resection of solitary malignant nodules results in a surprisingly high 5-year survival rate. On the contrary, most benign nodules do not need to be resected and a period of prolonged observation and nonsurgical management is usually indicated. Therefore, the best approach to the controversial management of solitary pulmonary nodules depends on finding factors affecting the probability of malignancy. In this article, clinical records and chest roentgenographies of 60 patients operated on over the past 8 years at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital were reviewed. There were 15 malignant nodules and 45 benign nodules and the prevalence of malignancy was 25%. The most common pathologic entity was tuberculoma [21 cases]. The mean age was 55.5*9.6 years in the malignant group, 45.8>12.5 years in the benign group and there was a significant statistical difference between the two groups [P < 0.05]. The malignant ratio in each age group increased with advancing age. The average smoking amount was 35.6*12.9 cigarettes per day in malignant smokers, 20.9* 12.0 cigarettes per day in benign smokers, and there was a significant statistical difference between the two groups [p< 0.05]. The malignant ratio also increased with the increasing smoking amount. Comparing the appearance of the nodule on chest films, 6 calcifications and 7 cavitations were found only in benign nodules, not in malignant nodules. Therefore, calcification and cavitation can be considered as preferential findings for benignity. Previous cancer history was also a significant factor deciding the prognosis of the nodule [p< 0.05]. The average diameter on chest X-ray was 3.07*0.82 cm in malignant nodules, 3.25*1.04 cm in benign nodules and there was no significant statistical difference between the two groups [p< 0.05]. The author used Bayes theorem to develop a simple method for combining individual clinical or radiological factors of patients with solitary nodules into an overall estimate of the probability that the nodule is malignant. In conclusion, patient age, smoking amount, appearance of nodule on chest film such as calcification and cavitation, and previous cancer history were found to be strongly associated with malignancy, but size of nodule was not associated with malignancy. Since these prognostic factors have been found retrospectively, prospective controlled studies are needed to determine whether these factors have really prognostic significance.

• 대한간호학회지
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• 제29권2호
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• pp.314-327
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• 1999

In this study, domains, contents, and effects of pre-existed intervention programs for individuals with arthritis were meta-analyzed to develop arthritis health promotion program based on Holistic Model. The developed program includes strategies of cognition, environment, and behavior. and also generates positive changes in the physical, psychological, and social demensions. Then needs assessment on conveniently selected 153 women who visited a university hospital in Seoul or in Inchon are conducted to identify the objective domains of arthritis health promotion program According to the study results. target health problems of the arthritis health promotion program were shown as pain, disability, depression, and role impediment in social domain. These objectives could be achieved by including the strategies of changing cognition, the strategies of changing behavior through learning the skill related to the health promoting behavior. and the strategies of changing environment in the health promotion program. That is, it is analyzed that the contents of program are not exclusive one another in physical. psychological. and social demensions, and also are not exclusive one another in aspect of cognition, behavior, and environment. The necessary methods to achieve the desired objectives for the developed arthritis health promotion program and evaluation subjects are as follows : (1) In the arthritis health promotion program, knowledge on management of arthritis, efficacy related to arthritis management, skill for pain management, skill for exercise, establishment of positive self-concept, enhancement of positive thinking, stress management. skill for problem solving, skill for setting goals. skill for requesting help, and skill for communication are all included. Through the improvement of all those strategies, intermediate objectives, such as “joint protection, and maintenance of pain management behavior”, “maintenance of regular exercise”, and “promotion of coping skill in psychosocial dimension” are achieved. (2) These intermediate objectives are also the methods for achieving objectives in next stage. It implies that through the intermediate objectives. the final objectives such as “minimization of physical symptoms and signs”, “maximization of psychological function”, and “maximazation of role performance in social domain” could be achieved. Each of these final objectives reflects the different dimension of quality of life, respectively. When these objectives are achieved, the quality of life that client perceives is improved. Therefore, through evaluation of these final objectives, the level of achieving final outcome of arthritis health promotion such as quality of life is determined.

• 한국한의학연구원논문집
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• 제5권1호
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• pp.81-100
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• 1999

The result from the research on the disease classifications of the traditional medicine in China, Japan, Taiwan, and North Korea are followings: 1. It is remarkable that China has two different classifications. One is of the diseases named by western medicine and the other is of the syndromes compounded with parts, characters, and pathology of the diseases. The Traditional Chinese Medicine has 615 codes for diseases in 7 departments, and 1684 codes for syndromes. It seems that they have tried to match each disease named by the traditional chinese medicine to each one named by western medicine. But, they have left the diseases impossible to be equivalent to the ones in western medicine themselves and used the same codes of western medicine when the diseases are the same ones in western medicine. 2. In Taiwan, they try to connect the diseases named by the traditional medicine to the ones named by western medicine based on ICD-9. But, they did not attempt to classify the diseases of the traditional medicine by its own ways. The names of diseases in Taiwan medicine include both diseases and syndromes. It is limited to name syndromes by the traditional medicine. And, Taiwan medicine follows ICD in naming injuries. 3. Japan has not got the disease classification for the causes of death, but only the Japanese disease classification for the causes of death, a translation 'The international disease classification for the causes of death. Therefore, The diseases named by traditional medicines are excluded in the public medicine by some Japanese medicines which diagnose through the western medicine and treat by Wa Kang medicine. 4. I can't find out the data over the disease classification for the causes of death by traditional medicine in North Korea. Instead, I can refer to case histories in which differentiation of symptoms and signs and points about them by traditional medicine and the final diagnoses and report about examination by the western medicine has been recorded. In conclusion, It is a distinctive feature that they connect the diseases and the syndromes by the traditional medicine to the ones by the western medicine, and don't tell the diseases from the syndromes.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.851-856
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• 2016

Background: Breast cancer is a major health problem among women around the world. Recent developments in screening and treatment have greatly improved the prognosis of patients with breast cancer in developed countries. However, in developing countries breast cancer mortality remains high.Breast cancer awareness is a first and important step in reducing breast cancer mortality. The development of a validated instrument to measure breast cancer awareness is crucial for the understanding and implementation of suitable health education programs to facilitate early deletion and minimize mortality. Objective: The objective of this study was to develop an instrument for the assessment of breast cancer awareness in Thai women. Materials and Methods: This methodological study was conducted in two stages: (1) literature searches and semi-structured interviews were conducted to generate items of the breast cancer awareness scale (B-CAS) which were subsequently examined for content and face validity, and (2) an exploration of the factor structure of the resulting instrument and an examination of its reliability. Data were collected using a self-administered questionnaire in Thai women aged 20-64 in August, 2015. Results: A total of 219 women (response rate 97.4 %) participated in this validation study. The B-CAS contains five domains with 53 items on breast cancer awareness: 1) knowledge of risk factors, 2) knowledge of signs and symptoms, 3) attitude to breast cancer prevention, 4) barriers of breast screening, and 5) health behavior related to breast cancer awareness. Items with a content validity index < 0.80 were excluded, and factor structure for the remaining items reflected the hypothesized five factor model. The scales based on all retained items was shown to have strongly internal consistency reliability (Cronbach's ${\alpha}=0.86$). Conclusions: The B-CAS provides good psychometric properties to assess breast cancer awareness in women. It can be used to examine breast cancer awareness in Thai women and it could lead to the development and evaluation of suitable educational interventions for raising breast cancer awareness. Future research should focus on further validating the B-CAS including an assessment of construct and criterion-based validity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권4호
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• pp.447-455
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• 1995

Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3335-3340
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• 2016

Background: Oral submucous fibrosis (OSF) is a precancerous condition with a 4 to13% malignant transformation rate. Related to the habit of areca nut chewing it is mainly prevalent in South-east Asian countries where the habit of betel quid chewing is frequently practised. On chewing, alkaloids and polyphenols are released which undergo nitrosation and give rise to N-nitrosamines which are cytotoxic agents. CYP450 is a microsomal enzyme group which metabolizes various endogenous and exogenous chemicals including those released by areca nut chewing. CYP1A1 plays a central role in metabolic activation of these xenobiotics, whereas CYP2E1 metabolizes nitrosamines and tannins. Polymorphisms in genes that code for these enzymes may alter their expression or function and may therefore affect an individuals susceptibility regarding OSF and oral cancer. The present study was therefore undertaken to investigate the association of polymorphisms in CYP1A1 m2 and CYP2E1 (RsaI/PstI) sites with risk of OSF among areca nut chewers in the Northern India population. A total of 95 histopathologically confirmed cases of OSF with history of areca nut chewing not less than 1 year and 80, age and sex matched controls without any clinical signs and symptoms of OSF with areca nut chewing habit not less than 1 year were enrolled. DNA was extracted from peripheral blood samples and polymorphisms were analyzed by PCR-RFLP method. Gene polymorphism of CYP1A1 at NcoI site was observed to be significantly higher (p = 0.016) in cases of OSF when compared to controls. Association of CYP1A1 gene polymorphism at NcoI site and the risk of OSF (Odd's Ratio = 2.275) was also observed to be significant. However, no such association was observed for the CYP2E1 gene polymorphism (Odd's Ratio = 0.815). Our results suggest that the CYP1A1 gene polymorphism at the NcoI site confers an increased risk for OSF.

• Journal of Oral Medicine and Pain
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• 제21권2호
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• pp.305-315
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• 1996

This study was performed to investigate the changes of head posture according to natural standing or sitting posture. Twenty seven healthy dental students without any signs and symptoms of temporomandibular disorders participated in this study. Cervical resting posture (CRP) of the head in sagittal plane was measured by Cervical-Range-of-Motion $^\textregistered$(CROM, U.S.A.) and lateral cephalograph was taken in natural posture. The items related to angle in cephalograph were the angles of cranial and cervical inclination to true vertical line(VER/NSL, VER/AML), the angles of cervical inclination to nasion-sella line(CVT/NSL, OPT/NSL), the angles of comical inclination to horizontal line(CVT/HOR, OPT/HOR), the angle of cervical lordosis(CVT/OPT). The items related to line measurement were the distance from subocciput to Cl(Dl), Cl to C2(D2), C2 to C3(D3), C3 to C4(D4), the upper(PNS to posterior pharyngeal wall) and the lower(tongue base to posterior pharyngeal wall) pharyngeal space, the distance from nation to mention(Na-Me), and the radius of comical curvature from the first comical vertebra(Cl ) to the fifth cervical vertebra(C5). The data were analyzed with SAS/STAT program. The obtained results were as follows : 1. Most items related to angular measurement showed significant difference between in standing and sitting posture. The angles of CRP, CVT/NSL, OPT/NSL, CVT/HOR, OPT/HOR, and CVT/OPT were high in sitting posture, but the angles of VER/NSL, VER/NSL were low in sitting posture. 2. In vertebral distance, only the distance between C3 and C4 was differed by the posture, which decreased in sitting posture. In sitting posture, the distance from nasion to menton(Na-Me) was longer, but the radius was shorter than in standing posture. 3. Correlationship in angular measurements was almost same in both postures. Ceervical resting posture(CRP) was correlated with VER/NSL, VER\ulcornerNSL was correlated with CRP, CVT/NSL, and OPT/NSL, VER/AML was correlated with CVT/HOR, OPT/HOR, CVT/OPT, and the angle of cervical lordosis(CVT/OPT) was correlated with the radius. 4. Correlationship in linear measurement was observed only in among D3, D4, and radius. And the Na-Me was not correlated with any other items. From this results, The author concluded that the head posture in sitting was mote backward extended than in standing.

• 대한한방내과학회지
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• 제28권3호
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• pp.453-463
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• 2007

Backgrounds : Glutathione-s-transferase (GST) is a kind of phase II metabolism enzyme and plays an important role in the detoxification of various toxic chemicals. It was reported that the genetic polymorphism of GSTM1 and GSTT1 genes may be responsible for asthma development and susceptibility to allergy. Traditional oriental medicine uses a unique diagnostic technique. differentiation-syndrome. to analyze signs and symptoms of patients synthetically. Through differentiation-syndrome. asthma patients can be divided into two groups: the deficiency syndrome group (DSG) and the excess syndrome group (ESG). Objectives : The purpose of this study was to investigate the possible association of GST gene polymorphism with clinical phenotype by differentiation-syndrome of bronchial asthma patients. Materials and Methods : One hundred and ten participants were evaluated by pulmonary function test. Patients with 53 DSG and 31 ESG by differentiation-syndrome were assessed for genetic analysis. GSTM1 and GSTT1 deletion polymorphism was performed by polymerase chain reaction (PCR). Results : GSTM1 gene deletion was detected in 43.4% of individuals in the DSG and in 38.71 % in the ESG. The distribution of GSTM1 polymorphism between DSG and ESG was not significantly different [$x^2$=0.1767, p=0.6742; OR(95% CI)=1.2139(0.4915-2.9979)]. The proportion of GSTT1 null genotypes was 41.51% in the DGS and 45.16% in the ESG. The distribution of GSTT1 polymorphism between DSG and ESG was also not significantly different [$x^2$=0.1065, p=0.7442; OR(95% CI)=0.8618(0.3525-2.1065)]. In the combined analysis of GSTM1 and GSTT1 genes, the frequency of both null type of GSTM1/GSTT1 genes was not significantly different from both positive type of GSTM1/GSTT1 genes[$x^2$=0.0768, p=0.7817; OR(95% CI)=1.2000(0.3303-4.3602)] Conclusions : These results indicate that polymorphism of the GST gene might not be associated with the symptomatic classification of DSG and ESG by differentiation-syndrome in Korean asthmatics.

• Child Health Nursing Research
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• 제19권1호
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• pp.49-58
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• 2013

목적 보육교사를 대상으로 보육시설에서 아토피 피부염 아동을 관리하고 있는 현황과 보육교사의 지식수준 및 실천 정도를 확인하고 현재의 관리 현황이 보육교사의 지식과 실천에 어떻게 영향을 주는지 파악하는 데에 있다. 방법 대상자는 G광역시 1개구 소재의 보육시설에서 근무하는 보육교사 107명이다. 인구학적 특성, 아토피 피부염 아동의 관리 현황, 그리고 지식수준과 실천 정도(Park, 2011)로 구성된 설문지를 이용하여 자료를 수집하였고 서술적 분석, 일원분산분석 및 사후검정 그리고 상관관계로 분석하였다. 결과 대상자의 대부분이 아토피 피부염 아동을 지도할 때 단순히 부모의 요구에 따른다고 답했다. 절반이상은 아토피 피부염 아동 지도에 대한 지식 부족으로 어려움을 겪고 있었으며 교육과 관리 지침의 제공을 희망하였다. 지식은 75% 수준이었고, 하위영역 중 증상 및 징후에 대한 지식 점수가 가장 높았고 관리에 대한 지식 점수가 가장 낮았다. 실천은 84.3%정도였고, 4개 하위영역 중 음식 관리점수가 가장 높았고 의복 및 침구 관리점수가 가장 낮았다. 그러나 지식과 실천 사이의 통계적으로 유의한 상관관계는 보여주지 않았다(r=.141, p =.149). 결론 대상자는 아토피 피부염 아동을 지도할 때 부모의 요구에 반응하는 소극적 태도를 보였고 지식과 실천은 충분하지 못한 수준이었다. 그들은 지식부족의 어려움을 호소하면서 지침의 제공과 교육을 원한다는 것을 확인할 수 있었다. 따라서 보육교사의 아토피 피부염에 대한 지식과 구체적 실천 방법을 포함한 교육프로그램의 개발이 필요하며 다양한 방법으로 접근할 수 있는 전략을 수립할 필요가 있다.

• 생명과학회지
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• 제17권3호통권83호
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• pp.396-401
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• 2007

천식이 유발된 Balb/c마우스와 동일한 조건의 IL-10 KO 마우스에 천식의 원인으로 알려진 DEP와 지하철역내에서 채집한 PM (10 ${\mu}g/m^3$)을 inhalation chamber,에 넣고 하루 4시간씩 흡입시킨 후 시료들을 채취하여 ICAM-1, VCAM-1의발현을 살펴 천식증상의 악화에 DEP와 PM이 어데한 영향을 미치는지 확인하였다. 본 실험의 결과 천식이 유발된 일반 Balb/c 마우스에 있어서는 DEP와 PM의 노출에 의하여 ICAM-1 및 VCAM-1의 발현이 세기관지 주위 조직들에서 미약하게 증가하였다. 그러나 IL-10 KO 마우스의 경우 DEP와 PM을 노출시켰을 때 ICAM-1 및 VCAM-1의 발현이 아주 강하게 증가하였다. 따라서, 본 결과는 IL-10에 대한 항체요법이 천식증상의 완화에 쓰일 수 있는 가능성을 암시하며, 한편 자동차 배기가스와 지하철 미세분진의 발생을 예방할 경우 천식과 관련한 세기관지의 염증을 완화시킬 수 있음을 간접적으로 증명한 것이라 할 수 있다.