• Journal of Preventive Medicine and Public Health
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• 제52권3호
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• pp.179-187
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• 2019

Objectives: In the USA, certain races and ethnicities have a disproportionately higher gastric cancer burden. Selective screening might allow for earlier detection and curative resection. Among a USA-based multiracial and ethnic cohort diagnosed with non-cardia gastric cancer (NCGC), we aimed to identify factors associated with curable stage disease at diagnosis. Methods: We retrospectively identified endoscopically diagnosed and histologically confirmed cases of NCGC at Mount Sinai Hospital in New York City. Demographic, clinical, endoscopic and histologic factors, as well as grade/stage of NCGC at diagnosis were documented. The primary outcome was the frequency of curable-stage NCGC (stage 0-1a) at diagnosis in patients with versus without an endoscopy negative for malignancy prior to their index exam diagnosing NCGC. Additional factors associated with curable-stage disease at diagnosis were determined. Results: A total of 103 racially and ethnically diverse patients were included. Nearly 38% of NCGC were stage 0-Ia, 34% stage Ib-III, and 20.3% stage IV at diagnosis. A significantly higher frequency of NCGC was diagnosed in curable stages among patients who had undergone an endoscopy that was negative for malignancy prior to their index endoscopy that diagnosed NCGC, compared to patients without a negative endoscopy prior to their index exam (69.6% vs. 28.6%, p=0.003). A prior negative endoscopy was associated with 94.0% higher likelihood of diagnosing curable-stage NCGC (p=0.003). No other factors analyzed were associated with curablestage NCGC at diagnosis. Conclusions: Endoscopic screening and surveillance in select high-risk populations might increase diagnoses of curable-stage NCGC. These findings warrant confirmation in larger, prospective studies.

• Communications for Statistical Applications and Methods
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• 제22권6호
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• pp.665-674
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• 2015

Lack of a general matrix formula hampers implementation of the semi-partial correlation, also known as part correlation, to the higher-order coefficient. This is because the higher-order semi-partial correlation calculation using a recursive formula requires an enormous number of recursive calculations to obtain the correlation coefficients. To resolve this difficulty, we derive a general matrix formula of the semi-partial correlation for fast computation. The semi-partial correlations are then implemented on an R package ppcor along with the partial correlation. Owing to the general matrix formulas, users can readily calculate the coefficients of both partial and semi-partial correlations without computational burden. The package ppcor further provides users with the level of the statistical significance with its test statistic.

• Journal of Nutrition and Health
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• 제38권9호
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• pp.777-785
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• 2005

Health outcomes are strongly associated with dietary factors. Poor dietary intake increases health risks and can have adverse affects throughout all stages of live and can be passed onto next generations. Korea faces a double burden of nutritional problems. One one side health problems are related to an inadequate diet including underweight, osteoporosis or anemia etc. On the other side the health problems are related to over consumption, including obesity, hypertension, diabetes, cancer, cardiovascular disease and etc. Improving the national health and nutritional status requires adjustments of nutrition policies that have primarily focused on under nutrition, to accommodate all nutrition concerns within the country. Nutrition research specific to Korean people must be promoted to produce scientific evidences on which to base nutrition policies. The creation of a nutrition-specialized institute is an important starting point.

• Tuberculosis and Respiratory Diseases
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• 제76권1호
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• pp.1-7
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• 2014

Maintenance therapy has emerged as a novel therapeutic paradigm for advanced non-small-cell lung cancer (NSCLC). Maintenance therapy that aims to sustain a clinically favorable state after first-line chemotherapy has two strategies. Switch maintenance therapy entails switching to a new and non-cross-resistant agent in an alternating or sequential manner, on completion of first-line chemotherapy. Continuous maintenance therapy keeps ongoing administration of a component of the current regimen after four to six cycles of chemotherapy, if there is a stable disease, or better response. Both maintenance therapies can be continued, until disease progression. The potential evidence regarding maintenance therapy includes providing the opportunity to receive additional treatment, through sustaining tumor shrinkage, and delayed emergence of tumor-related symptom. Thus far, debates over the parameters used to predict the effectiveness of maintenance therapy, financial burden, and uncertainty of improving the quality of life exist. Despite many debates, maintenance therapy, which is currently recommended, has been disclosed to be beneficial.

• Journal of Yeungnam Medical Science
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• 제41권3호
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• pp.150-157
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• 2024

The prevalence of childhood and adolescent obesity has increased and exacerbated during the coronavirus disease 2019 pandemic, both in Korea and globally. Childhood and adolescent obesity poses significant risks for premature morbidity and mortality. The development of serious comorbidities depends not only on the duration of obesity but also on the age of onset. Obesity in children and adolescents affects almost all organ systems, including the endocrine, cardiovascular, gastrointestinal, reproductive, nervous, and immune systems. Obesity in children and adolescents affects growth, cognitive function, and psychosocial interactions during development, in addition to aggravating known adult comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cancer. Childhood and adolescent obesity are highly associated with increased cardiometabolic risk factors and prevalence of metabolic syndrome. The risk of cardiovascular and metabolic diseases in later life can be considerably decreased by even a small weight loss before the onset of puberty. Childhood and adolescent obesity is a disease that requires treatment and is associated with many comorbidities and disease burdens. Therefore, early detection and therapeutic intervention are crucial.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.275-282
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• 2015

Background: Breast cancer (BC) is the most-common malignancy of women worldwide. Though there are differences among developed and developing countries, BC remains the most common cancer type of women in Turkey. Objective: This study aimed to identify the level of knowledge, awareness, and their potential predictors towards BC in Ankara, Turkey. Materials and Methods: The present descriptive study was conducted on 376 females attending a breast health outpatient clinic. A self-administered questionnaire was designed to evaluate knowledge level about BC and predictors effecting its level. Data analysis was performed using the chi-square test. A value of p<0.05 was considered statistically significant. Results: Mean age of the participants was $46.2{\pm}9.93$ (22-75). The majority (92.6 %) were married; 41.5% were educated less than nine years. Most of the women were housewives (82.7%) and, were living in an urban region (86.4%). Predictors of effecting responses to seven knowledge and awareness questions about BC varied from demographic features including older age groups, higher educational levels, being married, living in an urban area, being employee, smoking, having greater BMI to additional attributes associated breast health such as the increased number of births, applying for the purpose of control, positive family history of breast diseases, any diagnoses of breast diseases and performing BSE practice. Conclusions: It was determined that females in Turkey have better knowledge of BC than other developing countries even though it is not at the desired level. These findings revealed that females should be more informed about BC risk factors, prognosis and treatments by primary health-care providers to counteract the ascending burden of this disease.

• 디지털융복합연구
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• 제17권3호
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• pp.291-304
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• 2019

본 연구는 암환자를 돌보는 가족원이 인식하는 암 관련 건강정보이해력과 사회적 지지가 돌봄부담에 미치는 영향을 파악하기 위한 서술적 상관관계 연구이다. 경상남도 J시 G대학교병원에 입원했거나 외래 방문한 암환자를 돌보는 가족원 130명을 대상으로 하여 2018년 7월 17일부터 11월 7일까지 구조화된 설문지를 사용하여 자료수집 후 SPSS/WIN 23.0으로 통계 분석하였다. 회귀분석 결과, 암환자를 돌보는 가족원이 환자의 배우자이면서(${\beta}=.252$, p=.002) 주관적 건강상태(${\beta}=-.207$ p=.012)와 자가간호 건강정보이해력이 낮을수록(${\beta}=-.411$, p<.001), 환자의 요구도와 선호도(${\beta}=.268$, p=.042) 및 의료인과의 적극적 관계에 대한 건강정보이해력(${\beta}=.247$, p=.037)이 높을수록 돌봄부담이 높은 것으로 파악되었으며, 37.9%의 설명력이 있는 것으로 나타났다(F=5.922, p<.001). 본 연구를 통해 암환자 가족의 돌봄부담에 주관적 건강상태와 건강정보이해력이 영향을 미침을 알 수 있었다. 따라서 암환자 가족원의 돌봄부담을 감소시키기 위해서 그들의 건강정보이해력을 향상 시킬 수 있는 개별화된 교육프로그램을 개발하여 적용하는 연구를 제언한다.

• Journal of Hospice and Palliative Care
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• 제10권1호
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• pp.43-47
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• 2007

말기 암 환자에서 감염에 대한 항생제 사용은 의학적 문제에 대해 해결해야 하는 의무와 임종을 앞둔 시점에 생명 연장으로 인한 환자의 고통증가에 대한 부담으로 명확하게 결정하기 어려운 문제이다. 대한가정의학회 완화의학연구회 세미나에서는 65세 남자환자로 직장암 말기에 악취를 동반한 광범위한 피부감염증으로 입원 후 국소 항생제 치료로 증상 호전 중 임종을 맞이한 증례를 토의하였고, 이를 통해 말기 암 환자에서 항생제 치료에 대한 문헌고찰과 토론 후 다음과 같이 의견을 제시하고자 한다. 항생제 치료 목적에 있어 증상조절을 고려해야 하며, 특히 요로계 감염이 있는 경우는 증상조절을 위해 항생제를 사용한다. 또한 감수성 검사를 통해 적절한 항생제를 처방해야 한다. 무엇보다도 우선적으로 고려되어야 할 점은 환자입장에서 무엇이 가장 득이 되는지를 생각하고, 항생제 사용에 대해 환자와 가족들의 의견을 존중하여 판단하며, 환자나 가족이 적극적으로 치료를 요구하는 경우에는 치료로 인한 득실에 대해 환자와 토의를 한 후 사용한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.81-85
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• 2016

Globally, the burden of breast cancer (BC) continues to increase. BC related lymphedema (BCRL) is currently non curable and as a life time risk it affects at least 25% of BC patients. Knowing more about BCRL and appropriate control of its modifiable risk factors can improve quality of life (QOL) of the affected patients. In this case control study to detect factors, 400 women with BCRL (as the case group) and 283 patients with BC without lymphedema (as the control group) that were referred to Shiraz University of Medical Sciences affiliated BC clinic center were assessed. The data were analyzed in SPSS. The mean age of the case group was $52.3{\pm}11.0years$ and of the control group was $50.1{\pm}10.9years$. In patients with BCRL, 203(50.7%) had left (Lt) side BC and in non- lymphedema group 151 (53.3%) had Lt side BC. Out of all BCRL patients, 204 (51%) had lymphedema in all parts of their affected upper extremities, 100 (25%) had swelling in the arm and forearm and 23 (5.7%) had edema in both the upper extremity and trunk. Edema, heaviness, concern about changing body image, pain and paresthesia were the most common signs/symptoms among patients with BCRL. In BCRL patients, the difference of circumference between the affected upper limb and non-affected limb was $4.4{\pm}2.5cm$ and the difference in volume displacement was $528.7{\pm}374.4milliliters$. Multiple variable analysis showed that moderate to severe activity (OR; odds ratio =14, 95% CI :2.6-73.3), invasiveness of BC (OR =13.7, 95% CI :7.3-25.6), modified radical mastectomy (OR=4.3, 95% CI :2.3-7.9), BMI =>25 (OR=4.2, 95% CI :2-8.7), radiotherapy (OR=3.9, 95% CI :1.8-8.2), past history of limb damage (OR=1.7, 95% CI :0.9-3.1) and the number of excised lymph nodes (OR=1.06, 95% CI :1.02-1.09) were the significant predictors of lymphedema in women with BC. Modifiable risk factors of BCRL such as non-guided moderate to severe physical activity, high BMI and trauma to the limb should be controlled as early as possible in BC patients to prevent development of BCRL and improve QOL of these patients.

• 한국직업건강간호학회지
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• 제13권2호
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• pp.104-117
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• 2004

Objectives: To propose the basic data for the development of the optimum health promotion program (HPP) for the workers in a petrochemical industry complex. Methods: The subjects were 553 workers who worked at the six plants in a petrochemical industry complex. From February to March 2003, questionnaire survey was conducted by the nurses with occupational health specialty about the life styles, interests, self-cognitions, practices of health behavior, subjective symptoms thought to be related the working environments, burden to the own health, needs and intentions to participation of the HPP. Data analysis was done using SPSS program (ver 10.0) with ${\alpha}=0.05$ of statistical significance. Results: The mean age and tenure of the subjects were 39.7 years and 14.2 years, respectively, and proportion of smokers was around 50%. Two of third (66%) satisfied their own job, and 58% recognized themselves healthy. The most frequent health behavior were exercise (60%) and regular health check (87%) in individual and job based, respectively. About half of them (58%) had at least one of the symptoms thought to be related the working environments, and the most frequent one was odor (21%). These symptoms were more frequent in case of the shorter career. The needs of HPP was relatively higher in exercise (66%), cancer prevention (51%), stress control (47%), and intention to participation was also the highest in exercise (64%). Job satisfaction was higher in case of the higher interests and cognitions to their own health, and thought that the ownership's interest to workers' health be high (p<0.01), but no associations with the subjective symptoms. The mean level of burden to the own health were $14.1{\pm}13.9$ of physical, $11.7{\pm}13.6$ of emotional, $9.1{\pm}10.7$ of behavioral as out of one hundred. They felt the more burden in case of office workers, the lower interests and cognitions to their own health, the lower satisfaction to their job, the frequent drinking group, and complained the subjective symptoms (p<0.05). Abnormal results of the regular health check was higher in the frequent drinking group (p=0.083). Conclusions: For the optimum HPP for the workers in the petrochemical complex, the ownership's interest to workers' health would be enhanced, and the priority would be focused on exercise and drinking habits control.