• 제목/요약/키워드: cancer care

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한 대학병원 부속 건강검진센터 이용자의 만족도와 재이용 의사에 미치는 요인 (Factors Affecting the Satisfaction and Revisit Intension of Health Promotion Center In A University Hospital)

  • 김희경;류황건
    • 한국병원경영학회지
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    • 제6권3호
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    • pp.5-24
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    • 2001
  • The purpose of this study was to serve as a basis for providing quality medical service and mapping out consumer-centered marketing strategies to successfully cope with the rapidly changing medical environment and meet consumer needs, by examining what affected the satisfaction and revisit of health Promotion center Client. The subjects in this study were 186 of visitor to health Promotion center in a university hospital in the city of Busan. A survey was conducted with structured questionnaire from March 2 to 30, 2001. The collected data were analyzed with SPSS for Windows (ver10.0). For more statistical analysis, frequency analysis, component analysis, t-test, ANOVA and correlation analysis procedures were utilized. Results of the study can be summarized as follows: 1. Regarding demographic characteristics, 51.6% of the Client investigated were male, and 48.4% were female. The greatest number of them were in their 40s(38.9%). 86.5% were married, and 34.2% were self-employed. 44% were a high-school graduate, and the monthly mean income of 59.4% was one to three million Won. And, the residential area of 46.8%, the largest percentage, was a half-an-hour distance from health Promotion center. 2. The most common motivation of their selection of the health Promotion center was a recommendation by Staff and neighborhood(59.7%), followed by excellent facilities and services(17.2%), the tradition and reputation of the hospital(7.5%), and its publicity pamphlets(7.5%). 3. 45.9%, the largest percentage, acquired health-related information from their friends or acquaintances. 43.8%, the greatest percentage, visited there because they felt there's something wrong with their body. 53.4% worried about the possibility of being attacked by cancer, and 57.5% wanted to take a precise cancer examination. For health maintenance, 50.1% got regular exercise. Regular exercise was considered most crucial for health maintenance or promotion. 4. The largest reason they used that examination center again was the kindness of employees(52.7%), followed by the tradition and reputation of the hospital(21%) and excellent examination setting and equipment(10.8%). 5. By demographic factor, there was no significant difference between the man and women in satisfaction level with examination and expenses. The women expressed more satisfaction at facilities, and the high-school graduate group were more contented with expenses. 6. As a result of investigating their satisfaction level according to the motivation of selecting that examination center, the group that chose the center due to excellent facilities and services were more satisfied with examination and expenses. 7. As for the relationship of total examination satisfaction to revisit. intention, there was a higher correlational relationship between total health examination satisfaction and expense satisfaction. Especially, the more they were satisfied with examination, the more they were willing to revisit there for another examination.

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동백꽃 추출물의 신생혈관생성 및 세포부착 억제 효과 (Anti-Angiogenic and Anti-Cell Adhesion Effect of the Camellia japonica Flower Extract)

  • 허인도;서효진;김종덕
    • 생명과학회지
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    • 제17권8호통권88호
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    • pp.1152-1156
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    • 2007
  • 본 실험은 동백꽃의 효능을 알아보기 위하여, 동백꽃을 에틸알콜로써 추출한 후 극성이 다른 다양한 유기용매로 분획하여 나온 fraction으로 신생혈관생성 억제, cell cytotoxity, 세포부착분자에 대한 기능을 ELISA, westen blot 등으로 조사하였다. 신생혈관생성 억제 효과는 특히butanol 층에서 70.2%로 가장 높았으며, acetone층이 54.2%, 그리고 ethylacetate층이 37.0%, chloroform층이 21.2%로 유의성 있는 억제효과가 있었다. 특히 동백꽃의 butanol층은 신생혈관생성억제제로서 좋은 효과가 있는 것으로 판단된다. 그리고, 추출물의 농도별로 cell cytotoxity를 조사한 결과 농도가 200 ug/ml 이하에서 세포독성은 나타나지 않았다. Cell adhesion 저해율은 추출물의 농도 200 μg/mL 에서 ICAM-1은 52.9%, VCAM-1은 62.5%, 그리고 E-selectin은 35.7%로 나타났으며 동백꽃의 추출물의 성분 증가에 따라 발현이 감소됨으로써 cell adhesion을 저해하는 것으로 확인되었다. Westen blot 에서 첨가한 동백꽃 추출물의 농도가 높아질수록 신호전달분자의 발현이 약해지는 것을 관찰할 수 있었다. 따라서 신호전달 분자는 동백꽃 추출물에 의해서 신호전달이 차단되며, NF-KB를 억제함으로서 신생혈관생성을 저해하는 것으로 확인되었다. 따라서 동백꽃 추출물은 항암제 및 항비만제제로서 유용할 것으로 판단된다.

DNA Ploidy and S-phase Fraction Analysis in Paediatric B-cell Acute Lymphoblastic Leukemia Cases: a Tertiary Care Centre Experience

  • Kumar, Banothu Kiran;Bhatia, Prateek;Trehan, Amita;Singh, Ajit Pal;Kaul, Deepak;Bansal, Deepak
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7917-7922
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    • 2015
  • DNA ploidy is an important prognostic parameter in paediatric B-ALL, but the significance of the S-phase fraction is unclear. In present study, DNA ploidy was assessed in 40 pediatric B-ALL cases by flow cytometry. The DI (DNA index) and percentage of cells in S-phase were calculated using Modfit software. Aneuploidy was noted in 26/40 (65%) cases. A DI of 1.10-1.6 (hyperdiploidy B) was noted in 20/40 (50%) and 6/40 (15%) had a DI>1.60 (triploid and tetraploid range). Some 14/40 (35%) cases had a diploid DI between 0.90-1.05. None of the cases had a DI <0.90 (hypodiploid) or in the 1.06-1.09 (hyperdiploid A) range. The mean S-phase fraction was 2.6%, with 24/40 (60%) having low and 16/40 (40%) high S-phase fractions. No correlation was noted with standard ALL risk and treatment response factors with DI values or S-phase data, except for a positive correlation of low S-phase with high NCI risk category (p=0.032). Overall frequency of hyperdiploidy in our cohort of B-ALL patients was very high (65%). No correlation between hyperdiploidy B and low TLC or common B-phenotype was observed in our study as 42% cases with DI 1.10-1.6 had TLC> $50{\times}10^9$ and 57.1% CD 10 negativity. The study also highlighted that S-phase fraction analysis does not add any prognostic information and is not a useful parameter for assessment in ALL cases. However, larger studies with long term outcome analysis are needed to derive definitive conclusions.

Silent High Grade Cervical Intraepithelial Neoplasia in Atypical Smears from Liquid Based Cervical Cytology - Three Years Experience in Thammasat University Hospital

  • Lertvutivivat, Supapen;Chanthasenanont, Athita;Muangto, Teerapat;Nanthakomon, Tongta;Pongrojpaw, Densak;Bhamarapravatana, Kornkarn;Suwannarurk, Komsun
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권9호
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    • pp.4353-4356
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    • 2016
  • Purpose: To study the prevalence of CIN2+ diagnosis in women with atypical Papaniculoau (Pap) smears to suggest appropriate management option for Thai health care. Materials and Methods: Data from all patients with liquid based cytology with human papillomavirus (HPV) testing between May 2013 - May 2016 were collected from medical records. Women with atypical cervical Pap smears were recruited. Results for age, HPV testing, HPV 16, 18, 45 and other genotypes tested, colposcopic examination and histopathological assessment were all collected. Atypical smears were defined as atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells cannot be exclude high grade squamous intraepithelial lesion (ASC-H). Results: A total of 2,144 cases were recruited. Twenty six women with ASC-US on cytology had high risk (HR) HPV detection while eight cases with ASC-H had HR-HPV (40.0% VS 72.7%, p=0.005). Among the 26 women with ASC-US cytology and positive HR-HPV, HPV type 16 (n=8, 30.8%), type 18 (n=1, 3.8%), type 45 (n=1, 3.8%) and other HPV types (n=17, 65.4%) were found. Eight women with ASC-H and positive HR-HPV demonstrated type 16 (n=6, 75%) and other HPV types (n=2, 25%). Fifty seven women with ASC-US had normal colposcopy, CIN1 and CIN2+ at percentages of 80.7 (46/57), 14.0 (8/57) and 5.3 (3/57), respectively. In the ASC-H group, 7 out of 10 women had normal colposcopy and three (30%) had CIN2+ results. Conclusions: In women with ASC-US cytology, immediate colposcopy is highly recommended. HPV testing can be performed if colposcopy is not an available option because there was high prevalence (5.3%) of CIN2+ in our findings. ASCCP recommendations for ASC-H that colposcopy should be performed on all ASC-H cases regardless of HPV result are thereby supported by the findings of this investigation.

Dental Practitioners Self Reported Performance of Tobacco Cessation Counseling Interventions: A Cross Sectional Study

  • Parakh, Abhinav;Megalamanegowdru, Jayachandra;Agrawal, Rohit;Hathiwala, Siddhi;Chandrakar, Mayank;Tiwari, Ram;Veeranna, Thippeswamy
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.6141-6145
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    • 2013
  • Background: The objective of the study was to determine the knowledge, attitude and behaviors of the practicing dentists regarding tobacco cessation counseling (TCC) in Chhattisgarh state and also the barriers that prevent them from doing so. Materials and Methods: The study was conducted among dental practitioners of Raipur district, Chhattisgarh state (India). The sampling frame was registration with the State Dental Council and practicing in Raipur district. A questionnaire was personally administered and the practitioners were given explanations regarding how to complete it. Only descriptive statistics were calculated (SPSS version 16 for Windows). Results: Based on the responding dentists' self reports, 76% were not confident in TCC, 48% did not assume TCC to be their responsibility, 17% considered that it might have a negative impact on their clinical practice, whereas 24% considered it might take away precious time from their practice, 25% considered TCC by dentists to be effective to a considerable extent and 80% considered TCC activities are not effective due to lack of formal training, 69% considered dental clinics as an appropriate place for TCC but 82% thought there must be separate TCC centre and 100% of the dentists wanted TCC training to be a part of practice and that it should be included in dental curriculum. Some 95% of them were of the view that tobacco products should be banned in India and 86% responded that health professionals must refrain from tobacco habits so to act as role models for society. Conclusions: Dental professionals must expand their armamentarium to include TCC strategies in their clinical practice. The dental institutions should include TCC in the curriculum and the dental professionals at the primary and the community health care level should also be trained in TCC to treat tobacco dependence.

Effect of Intraoperative Glucose Fluctuation and Postoperative IL-6, TNF-α, CRP Levels on the Short-term Prognosis of Patients with Intracranial Supratentorial Neoplasms

  • Liu, Tie-Cheng;Liu, Qi-Ran;Huang, Ying
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10879-10882
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    • 2015
  • Objective: To investigate the effect of intraoperative glucose fluctuation and postoperative interlukin-6 (IL-6), tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), C-reactive protein (CRP) levels on the short-term prognosis of patients with intracranial supratentorial neoplasms. Materials and Methods: Eighty-six patients undergoing intracranial excision were selected in The Second Hospital of Jilin University. According to the condition of glucose fluctuation, the patients were divided into group A (glucose fluctuation <2.2 mmol/L, n=57) and group B (glucose fluctuation ${\geq}2.2mmol/L$, n=29). Glucose was assessed by drawing 2 mL blood from internal jugular vein in two groups in the following time points, namely fasting blood glucose 1 d before operation ($T_0$), 5 min after anesthesia induction ($T_1$), intraoperative peak glucose ($T_2$), intraoperative lowest glucose ($T_3$), 5 min after closing the skull ($T_4$), immediately after returning to intensive care unit (ICU) ($T_5$) and 2 h after returning to ICU ($T_6$). 1 d before operation and 1, 3 and 6 d after operation, serum IL-6 and TNF-${\alpha}$ levels were detected with enzyme-linked immunosorbent assay (ELISA), and CRP level with immunoturbidimetry. Additionally, postoperative adverse reactions were monitored. Results: There was no statistical significance between two groups regarding the operation time, anesthesia time, amount of intraoperative bleeding and blood transfusion (P>0.05). The glucose levels in both groups at $T_1{\sim}T_6$ went up conspicuously compared with that at $T_0$ (P<0.01), and those in group B at $T_2$, $T_4$, $T_5$ and $T_6$ were significantly higher than in group A (P<0.01). Serum IL-6, TNF-${\alpha}$ and CRP levels in both groups 1, 3 and 6 d after operation increased markedly compared with 1 d before operation (P<0.01), but the increased range in group A was notably lower than in group B (P<0.05 or P<0.01). Postoperative incidences of hypoglycemia, hyperglycemia and myocardial ischemia in group A were significantly lower than in group B (P<0.05), and respiratory support time obviously shorter than in group B (P<0.01). Conclusions: The glucose fluctuation of patients undergoing intracranial excision is related to postoperative IL-6, TNF-${\alpha}$ and CRP levels and those with small range of glucose fluctuation have better prognosis.

BRAF(V600E) 돌연변이 갑상선 역형성암에서 BRAF(V600E) 억제에 의한 EGFR 발현 증가가 표적치료에 대한 저항성발현과 상피-간질세포이행과정에 미치는 영향분석 (Mechanism of Resistance and Epithelial to Mesenchymal Transition of BRAF(V600E) Mutation Thyroid Anaplastic Cancer to BRAF(V600E) Inhibition Through Feedback Activation of EGFR)

  • 변형권;나휘정;양연주;박재홍;권형주;장재원;반명진;김원식;신동엽;이은직;고윤우;최은창
    • 대한두경부종양학회지
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    • 제30권2호
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    • pp.53-61
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    • 2014
  • Background and Objectives : Anaplastic thyroid carcinoma(ATC) is a rare but highly aggressive thyroid malignancy that is associated with an extremely poor survival despite the best multidisciplinary care. BRAF(V600E) mutation is detected in about a quarter of ATC, but unlike its high treatment response to selective BRAF inhibitor (PLX4032) in metastatic melanoma, the treatment response of ATC is reported to be low. The purpose of this study is to investigate the innate resistance mechanism responsible for this low treatment response to BRAF inhibitor and its effect on epithelial-mesenchymal transition(EMT). Materials and Methods : Two ATP cell lines, 8505C and FRO were selected and treated with PLX4032 and its drug sensitivity and effects on cell migration and EMT were examined and compared. Further investigation on the changes in signals responsible for the different treatment response to PLX4032 was carried out and the same experiment was performed on both orthotopic and ectopic xenograft mouse models. Results : FRO cell line was more sensitive to PLX4032 treatment compared to 8505C cell line. The resistance to BRAF inhibition in 8505C was due to increased expression of EGFR. Effective inhibition of both EGFR and p-AKT was achieved after dual treatment with BRAF inhibitor(PLX4032) and EGFR inhibitor(Erlotinib). Similar results were confirmed on in vivo study. Conclusion : EGFR-mediated reactivation of the PI3K/AKT pathway and MAPK pathway contributes to the relative insensitivity of BRAF(V600E) mutant ATC cells to PLX4032. Dual inhibition of BRAF and EGFR leads to sustained treatment response including cell invasiveness.

농촌과 도시 중년여성의 건강실태와 생활양식에 관한 비교 (A Comparison on the Life Style and Health Status of Middle Aged Women in Rura and Urban Areal)

  • 이순희;김숙영;이영주
    • 한국간호교육학회지
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    • 제8권1호
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    • pp.120-130
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    • 2002
  • This study was attempted to identify and compare in developing a health promotion program for extending healthy life expectancy of the middle-aged women and protecting health of women in the vulnerable class by comparing and researching life-style and actual conditions of health for the middle-aged women in rural and urban areas. Subjects of this study were 160 middle-aged urban women in Seoul city and chongju city and 155 middle-aged rural women in rural community goisangun. For collecting data, questionnaire was performed with structured questionnaires was used to know their actual conditions of health and life-style. Findings of this study were as follows. 1. In comparing life-style of the urban middle- aged women with the rural community, the percentage of regularly checked-up were higer urban women (46.4%) than the rural women (35%); women who have not checked up were 21.3% and 11.4% in the rural community and cities respectively, but it had a statistically significant difference (p=0.009). For the types of checkup, the rate of uterine cancer checkup than that of breast cancer self-examination or cholesterol test was higher both in the rural community(75.6%) and cities(77.4%). 2. The results of comparing actual conditions of the middle-aged women in the rural urban area were as follows; the recognition of health of the urban women was 'Very healthy (7.2%),' 'Healthy (35.5%),' 'Moderate (46.5%),' and 'Not healthy (10.3%), while the recognition of the rural women was 'Very healthy (2.5%),' 'Healthy (30.0%),' 'Moderate (36.3%),' and 'Not healthy (30.6%)'. These results showed a statistically significant difference (p=.000). Women having any problems in health were 48.1% and 36.8% in the rural and the urban respectively and it had a statistically significant difference (p=.042). For the most of health problems, arthritis accounted for 29.4% in the rural community and arthritis and constipation accounted for 21.3% in the urban. According to findings of this study, it can be concluded that rural women had more health problems, felt they were not healthy themselves and were checked up regularly less than the urban women, and their health care was poor. Therefore, more effective nursing intervention plans should be designed to enhance the performance level of health promotion for rural women.

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유전자와 생명의 사유화, 그리고 반공유재의 비극: 미국의 BRCA 인간유전자 특허 논쟁 (The Anticommons: BRCA Gene Patenting Controversy in the United States)

  • 이두갑
    • 과학기술학연구
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    • 제12권1호
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    • pp.1-43
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    • 2012
  • 이 글은 BRCA1과 BRCA2 두 인간유전자에 관련된 특허들에 대한 최근의 소송에서 제기된 인간유전자 특허의 여러 경제적, 법률적, 그리고 윤리적 쟁점들을 분석한다. 기존의 인간유전자 특허관련 연구들이 이의 법률적 논리와 윤리적 정당성에 대한 규범적인(normative) 분석에 초점을 두었다면, 이 글은 BRCA 관련 특허소송에의 기저에는 반공유재의 비극(the tragedy of the anticommons)이라 불리는 지적재산권과 경제혁신, 공공의 이익의 관계에 대한 새로운 이해가 존재하고 있음을 보일 것이다. 첫 부분에서는 2001년 미 특허청의 인간유전자 특허에 대한 정책의 형성과정에 대한 역사적인 분석을, 다음으로는 생명과학에서 지적재산권의 확대를 가져온 여러 경제적 가정들과 제도적 변화, 그리고 법적 판결들에 대한 비판적 논의를 소개할 것이다. 지적재산권의 한계와 생명의 사유화에 대한 비판을 통해서 BRCA 소송은 지적재산권의 정의와 그 범주, 그리고 이의 소유권을 둘러싼 논쟁이 공공의 이익, 과학과 의학 공동체의 창조적 지적활동과 환자들의 인권과 윤리의 문제가 복잡다단하게 얽혀있음을 보여주고 있다.

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High Prevalence of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Infection in Thailand

  • Wanich, Nattawat;Vilaichone, Ratha-Korn;Chotivitayatarakorn, Peranart;Siramolpiwat, Sith
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2857-2860
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    • 2016
  • Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.