• 성인간호학회지
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• 제17권1호
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• pp.149-159
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• 2005

Purpose: The purpose of this study was to examine the relationship among the levels of total serum cholesterol level, blood pressure, body mass index, and lifestyle. Method: This study was designed as a descriptive correlation study. Subjects were 972 adults participated voluntarily living in GyeongNam. The height, weight, blood pressure and fasting serum cholesterol were measured. Body mass index was caculated. Information on general characteristics (age, gender, education, job, family history) and life style(cigarette, alchol, sleeping time, regular exercise, meal pattern, peppery, salty, sweetness, vegetable diet, meat diet) were collected using a questionnaire by interviewing method. Result: The mean value of total serum cholesterol was $197{\pm}36.4mg/dl$(mean; $189{\pm}36.7mg/dl$, women; $202{\pm}35.1mg/dl$). By simple analysis, the serum total cholesterol according to general characteristics features was statistically significant in age(F= 6.765, p=000) and gender (t=5.372, p=.000). Total serum cholesterol levels increased significantly with increasing BMI. The serum total cholesterol according to life style features was statistically significant in cigarette(${\chi}^2=12.12$, p=.016), exercise(${\chi}^2=6.335$, p=.042), salty taste(${\chi}^2=18.801$, p=016), vegetable diet (${\chi}^2=19.488$, p=012). The most affecting factor which total serum cholesterol factor was BMI(${\beta}=.151$, p=.000). Conclusion: The significant risk factors relating to serum total cholesterol were age, gender, BMI, smoking, and exercise. Therefore, for the reduction of serum total cholesterol level, it is recommended that nursing intervention for the prevention of obesity, change of life style should be implemented.

• Journal of Chest Surgery
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• 제32권1호
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• pp.32-37
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• 1999

배경: 폐암의 완치를 위한 가장 효과적인 치료 방법은 조기 진단과 외과적인 절제술이다. 고령의 환자군에서는 젊은 환자군에 비하여 폐암으로 진단된 경우 전신 건강 상태, 잔여 폐기능의 제한에 의하여 사용 가능한 모든 유용한 치료 방법을 최대한 이용하는 것이 불가능한 경우가 많다. 저자들은 외과적인 폐절제술을 시행한 환자군을 대상으로 후향적인 연구를 통하여 연령인자가 폐암의 병기, 조직학적 진단, 수술 방법, 합병증의 이환율과 사망률에 어떤 영향을 미치는 지 조사하였다. 대상 및 방법: 비소세포 폐암으로 진단받고 외과적인 절제술을 시행한 211명의 환자를 대상으로 하였다. 환자는 1994년 10월부터 1997년 6월까지 수술 받은 환자였다. 환자들을 인위적으로 70세 이상군(35명)과 미만군(176 명)으로 나누어 두 군을 의무기록을 참조로 비교 조사하였다. 결과: 폐암의 병기및 조직학적 진단은 두 군에서 차이가 없었다. 그러나 수술 방법, 합병증의 이환율, 사망률은 두 군 사이에 차이가 있었고, 70세 이상군에서 합병증의 이환율이 높은 것으로 나타났다(p = 0.02). 수술 방법에서 70세 이상군에서는 가능한 잔여 폐기능을 보존하는 덜 침습적인 시술이 선호되었다. 결론: 수술후 합병증의 이환율과 사망률은 70세이상 군에서 높아서 수술의 위험도가 높은 것으로 나타났다. 흉부 수술이 폐암의 완치를 목적으로 권유되어 질 수 있는 최선의 치료 방법이다. 그렇지만, 고령의 환자에서는 합병증의 이환율 및 사망률이 높게 발생한다. 따라서, 고령의 폐암 환자의 수술을 결정할 때, 수술 적응증과 수술 방법을 신중히 고려하여야 된다고 생각한다.

• 한국임상약학회지
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• 제23권1호
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• pp.42-48
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• 2013

Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.

• Toxicological Research
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• 제27권4호
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• pp.253-259
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• 2011

Transforming growth factor ${\beta}$ (TGF-${\beta}$) is involved in cellular processes including growth, differentiation, apoptosis, migration, and homeostasis. Generally, TGF-${\beta}$ is the inhibitor of cell cycle progression and plays a role in enhancing the antagonistic effects of many growth factors. Unlike the antiproliferative effect of TGF-${\beta}$, E2, an endogeneous estrogen, is stimulating cell proliferation in the estrogen-dependent organs, which are mediated via the estrogen receptors, $ER{\alpha}$ and $ER{\beta}$, and may be considered as a critical risk factor in tumorigenesis of hormone-responsive cancers. Previous researches reported the cross-talk between estrogen/$ER{\alpha}$ and TGF-${\beta}$ pathway. Especially, based on the E2-mediated inhibition of TGF-${\beta}$ signaling, we examined the inhibition effect of 4-tert-octylphenol (OP) and 4-nonylphenol (NP), which are well known xenoestrogens in endocrine disrupting chemicals (EDCs), on TGF-${\beta}$ signaling via semi-quantitative reverse-transcription PCR. The treatment of E2, OP, or NP resulted in the downregulation of TGF-${\beta}$ receptor2 (TGF-${\beta}$ R2) in TGF-${\beta}$ signaling pathway. However, the expression level of TGF-${\beta}1$ and TGF-${\beta}$ receptor1 (TGF-${\beta}$ R1) genes was not altered. On the other hand, E2, OP, or NP upregulated the expression of a cell-cycle regulating gene, c-myc, which is a oncogene and a downstream target gene of TGF-${\beta}$ signaling pathway. As a result of downregulation of TGF-${\beta}$ R2 and the upregulation of c-myc, E2, OP, or NP increased cell proliferation of BG-1 ovarian cancer cells. Taken together, these results suggest that E2 and these two EDCs may mediate cancer cell proliferation by inhibiting TGF-${\beta}$ signaling via the downregulation of TGF-${\beta}$ R2 and the upregulation of c-myc oncogene. In addition, it can be inferred that these EDCs have the possibility of tumorigenesis in estrogen-responsive organs by certainly representing estrogenic effect in inhibiting TGF-${\beta}$ signaling.

• Radiation Oncology Journal
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• 제22권2호
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• pp.115-123
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• 2004

목적 : 조기 유방암에서 유방보존치료(유방보존수술+방사선치료) 혹은 유방전절제술로 치료했던 환자의 초기 치료성적과 실패양상을 비교하고자 후향적으로 분석하였다. 대상 및 방법 : 1989년 3월부터 1996년 8월까지 강남성모병원에서 AJCC병기 I, II로 치료를 받았던 유방암 환자를 대상으로 하였다. 88명은 유방전절제술을 시행하였고 85명은 유방보존술 후 방사선치료를 시행하였다. 방사선치료는 50 Gy 전 유방조사 후 원발부위에 10$\~$15 Gy 추가 조사하였다. 유방보존치료 환자의 34.1%$\%$ 유방전절제 환자의 45.5$\%$에서 항암화학요법이 병용되었다 양 치료군의 5년생존율과 5년무병생존율, 실패양상을 비교하였으며 치료실패와 연관된 위험인자를 Log-rank test를 이용하여 분석하였다. 중앙 추적기간은 63개월이 었다. 결과 : 양 치료군 간에 5년생존율, 5년무병생존율의 유의한 차이(p>0.05)는 없었으며 국소재발 및 원격전이의 치료실패양상에도 차이가 없었다. 추적기간 중, 유방전절제군에서 11명(12.5$\%$) 유방보존치료군에서 10명(11.8$\%$) 재발하였다. 초기 실패양상은 국소재발이 각각 6명, 5명이었고 원격전이가 각각 5명, 4명으로 차이가 없었다. 국소재발 단독의 경우 양 치료군에서 구제치료 후 대부분의 환자가 무병생존 (5/6 유방전절제술, 3/5 유방보존치료)하였다 그러나 원격전이 환자의 경우 양 치료군 모두에서 방사선-항암화학요법의 구제치료에도 불구하고 대부분의 환자가 진행 혹은 사망하였으며 유방보존치료군의 1명의 환자만이 원격전이 후 구제치료에 성공하여 무병생존하였다. 양 치료군 간에 반대편유방암 발생률 및 다른 장기의 2차 원발암 발생률의 차이는 없었고 유방암으로 인한 사망률도 차이가 없었다. Log-rank 단변량분석에서 치료 실패와 관련된 유의한 위험인자는 양 군 모두에서 N 병기, 액와 림프절 전이 숫자였으며 유방보존치료군에서는 수술절연침범유무가, 유방전절제군에서는 high nuclear grade가 치료실패와 관련된 위험인자였다(p<0.05). 결론 : 분석결과 AJCC 병기I, II 조기유방암에서 유방보존치료와 유방전절제술은 생존율뿐 아니라 치료 실패양상에도 차이가 없었으며 향후 이와 같은 결과를 확인하기 위한 장기간의 추적연구가 필요하다.

• 대한방사선기술학회지:방사선기술과학
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• 제39권1호
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• pp.81-88
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• 2016

인체의 지방조직이 증가하여 비만해지면 심혈관계 질환, 당뇨병, 대사성질환과 이상지질혈증 등의 위험인자로 나타난다. 이러한 대사성질환에는 심혈관 및 뇌혈관질환, 고혈압, 고지혈증 등이 있고, 췌장의 지방조직 증가는 이러한 질환의 위험요인으로 알려져 있다. 그리고 췌장암에 대한 진단과 치료에 대한 연구는 활발히 이루어졌으나, 췌장지방증에 관한 연구 사례는 많지 않다. 본 연구에서는 초음파 검사의 결과로 진단된 췌장지방군과 정상대조군으로 나누어 신체 특성과 혈청학적 검사와 혈압 및 동맥경화도검사를 평가하였다. 정상대조군과 췌장지방군 사이에서 연령이나 허리둘레, 체질량 지수, 총 콜레스테롤, HDL 콜레스테롤과 LDL 콜레스테롤, 수축기와 이완기혈압, 공복혈당, 대동맥 맥파전파속도는 췌장지방군에서 높게 나타났다. 그리고 족관절상완협착비와 HDL-콜레스테롤은 낮을수록 혈관에 유해하므로 췌장지방군이 정상대조군보다 낮게 나타났다(p < 0.05). 정상대조군과 췌장지방군의 차이가 통계적으로 유의함을 확인할 수 있었다. 결론적으로 복부초음파 검사에서 췌장지방증은 대사성 질환의 위험을 예측할 수 있으며 심혈관계 질환과 연관성이 있었다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6883-6888
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• 2015

Background: Tobacco smoking is a major cause of preventable disease and death worldwide. Kreteks are clove-flavored cigarettes made from a combination of tobacco and ground-clove mixed with a sauce, smoked widely in Indonesia. Because health and social consequences of kretek smoking are potentially as great as those of traditional cigarettes, this study examines the prevalence of kretek smoking in Indonesia and associated risk factors. Materials and Methods: The study used nationally representative Indonesia Global Adult Tobacco Survey data. Multiple logistic regression analysis was employed to identify correlates of kretek smoking. Results: One-third of Indonesian adults smoked tobacco of which about 90.0% smoked kreteks. Prevalence of kretek smoking among men (60.9%) was more than 25 times the rate among women (2.3%). Overall, the highest prevalence of kretek use was in the age group 45-54 years (36.5%), followed by 34-44 (35.1%), 25-34 (34.2 %), and 55-64 years (32.8%). By wealth index, prevalence of kreteks smoking among those in the middle index was almost 50% above the rate for the wealthiest group (36.4% vs 24.8% respectively). Logistic regression results showed that being male, being older, having less education, and being less wealthy were significant predictors of kretek smoking, while urban vs rural residence was not. Conclusions: Kretek smoking is common in Indonesia and is entrenched in the sociocultural fabric of the country. However, potential consequences of kretek smoking, particularly as risks for noncommunicable diseases, underscore the importance of a comprehensive approach to tobacco control as outlined in the World Health Organization's MPOWER strategies.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8391-8396
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• 2016

Thailand is becoming an aging society, this presenting as a serious problem situation especially regarding health. Chronic diseases found frequently in the elderly may be related to dietary intake and life style. Surin province has been reported as a risk area for liver fluke with a high incidence of cholangiocarcinma especially in the elderly. Therefore, this study aimed to determine the nutritional status and associated factors among elderly in Surin province, northeast of Thailand. A community-based cross-sectional study was conducted among 405 people aged 60 years and above, between September 2012 and July 2014. The participants were selected through a randomized systematic sampling method and completed a pre-designed questionnaire with general information, food recorded, weight, height, waist circumference, and behavior regarding to food consume related to liver fluke infection. The data were analyzed using descriptive statistics and Spearman's rank correlation coefficients. The majority of participants was female (63.5%), age between 60-70 years old (75.6%), with elementary school education (96.6%), living with their (78.9%), and having underlying diseases (38.3%). Carbohydrate (95.3%) was need to improve the consumption. The participants demonstrated under-nutrition (24.4%), over-nutrition (16.4%), and obesity (15.4%). Elderly had a waist circumference as the higher than normal level (34.0%). Gender, female, age 71-80 years old, elementary school and underlying diseases were significantly associated with poor nutritional status. The majority of them had a high knowledge (43.0%), moderate attitude (44.4%), and moderate practice (46.2%) regarding food consumption related to liver fluke infection. In conclusion, these findings data indicated that elderly age group often have an under- or over-nutritional status. Carbohydrate consumption needs to be improved. Some elderly show behavior regarding food consumption that is related to liver fluke infection hat needs to be improved, so that health education pertaining good nutrition is required.

• Journal of Gastric Cancer
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• 제7권4호
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• pp.254-260
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• 2007

목적: 위와 소장에 발생한 위장관 간질종양의 임상병리학적 특징을 비교하여 예후 인자 및 적절한 치료의 방침을 알아보고자 하였다. 대상 및 방법: 대진의료재단 분당제생병원에서 1998년 8월부터 2006년 5월까지 위장관 간질종양으로 진단된 38명의 환자 중 분석 및 추적 조사가 가능했던 29명의 환자에서 임상 양상을 조사하고, 면역조직화학적 염색을 시행하였으며, NIH 합의안에 따라 위험도를 분류하여 각각 위와 소장에서 발생한 위장관 간질종양을 비교하였다. 결과: 위와 소장에 발생한 위장관 간질종양의 임상병리학 적 차이 및 재발 양상의 차이는 없었으며, NIH 위험도 분류에 따라 나눈 고위험군과 저위험군 간에 재발의 차이는 있었다(P=0.030). 결론: 위장관 간질종양에서 원발 부위인 위와 소장간에 임상병리학적 양상이나 예후에 통계학적으로 유의한 차이는 없었으나, NIH 분류에 의한 고위험군에서는 재발 가능성이 높으므로 치료 지침에 따른 적절한 추적관찰이 필요하며, 앞으로 여러 기관의 예를 통합한 큰 모집단을 대상으로 지속적인 연구를 시행하여 국내 실정에 맞는 정확한 진단 기준 및 치료지침이 만들어져야 될 것으로 사료된다.

• 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.