• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.7-11
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• 1994

Twenty years ago, the American Journal of Epidemiology published David Sackett's brief description of. clinical epidemiology and its practitioners [1]. This commentary was a useful focal point for an emerging discipline. By 1983, with clinical epidemiology already thriving in many academic medical centres, Walter Holland called into question both the term, 'clinical epidemiology', and the nature of the discipline [2]. More recently, clinical epidemiology has drawn strong criticism from John Last, a noted academician whose contributions include the editorship of the Maxcy-Rosenau Textbook of Public Health. Writing in the Journal of Public Health Policy in 1988 [3], Last referred to the 'uncritical enthusiasm' for clinical epidemiology in medical schools as 'a danger to health', and staked. a claim to the term 'epidemiology' as appropriate only to the description of what classical or population epidemiologists do. Faced with such views, practitioners and proponents of clinical epidemiology can respond in three ways. They can ignore the criticism, and go on about their business. They can reaffirm their differences and resort to defensive rhetoric. Or, the critique can become an opportunity for reflection about the nature of clinical epidemiology and its relations with sister disciplines in modem medical schools. The latter course is followed here by four physicians who-despite diverse backgrounds and interests-all consider their work to be in the field of clinical epidemiology.

• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.180-187
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• 1994

A slightly modified version of the Quality-of-Life after Myocardial Infarction (QLMI) questionnaire developed by Oldridge and colleagues was applied in a self-administered mode to patients with suspected acute myocardial infarction (AMI) in a randomized controlled trial of secondary prevention. Acceptability of the questionnaire was good, with 93% of responders answering all items. Factor analysis suggested three quality-of-life (QL) dimensions which we called 'emotional', 'physical' and 'social'. These differed somewhat from the dimensions proposed by Oldtidge and colleagues. However, a sensitivity analysis showed relative invariance of results to weighting schemes. Scores on our three dimensions were responsive to differences between the treatment groups, and demonstrated construct validity based on associations between the measured QL and variables expected to affect QL. We conclude that the QLMI questionnaire has good potential as an instrument for assessing QL in post-AMI patients and that it can be successfully self-administered.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.6-13
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• 2009

Recent advances in perinatal care have resulted in improved survival of extremely low birth weight infants (ELBWI). However, bronchopulmonary dysplasia (BPD) remains one of the major complications in ELBWI. BPD was originally described over 40 years ago; the clinical characteristics, epidemiology, and pathogenesis of BPD have changed markedly through this period. In this article, I have reviewed recent progress in research concerning the clinical presentation and characteristics, epidemiology, and pathogenesis of BPD.

• BMB Reports
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• v.41 no.4
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• pp.334-337
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• 2008

MCL1 expression has been found to be up-regulated during infection with virulent Mycobacterium tuberculosis. We investigated the genetic polymorphisms in MCL1 as potential candidate gene for a host genetic study of clinical TB infection. We have sequenced exons and their boundaries of MCL1, including the 1.5 kb promoter region, to identify polymorphisms, and eight polymorphisms were identified. The genetic associations of polymorphisms in MCL1 with clinical TB patients (n=486) and normal controls (n=370) were analyzed. Using statistical analyses, one common promoter polymorphism (MCL1-324C>A) which is absolutely linked with three other SNPs in the promoter and 3'UTR regions, were found to be significantly associated with increased risk of clinical TB disease. The frequency of the A-bearing genotype of -324C>A was higher in clinical TB patients than in normal controls (P=0.0008, OR=1.68). Our findings suggest that polymorphisms in MCL1 might be one of genetic factors for the risk of clinical tuberculosis development.

• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.38-39
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• 1994

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2685-2686
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• 2013

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1197-1203
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• 2014

Background: Adenocarcinoma (ADC) is the most common histological type of lung cancer and its proportion is rising, especially in Asian non-smoking women. Recent studies suggest miR-25 may have diverse effects on the pathogenesis of different types of cancer. However, the role of miR-25 in lung cancer is still unknown. The aim of this study was to investigate the potential clinical value of miR-25 in non-smoking women with lung ADC. Patients and Methods: Quantitative RT-PCR was performed to evaluate the expression of miR-25 in 100 lung ADC tumor tissues and matched plasma samples and Pearson correlation tests were used to analyze the relationship between values. Associations of miR-25 expression with clinicopathological features were determined using the Student's t-test. To determine prognostic value, overall survival (OS) was evaluated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazard model. Results: Expression of miR-25 in tissue was found to be associated with lymph node metastasis (P=0.021) and disease stage (P=0.012). Moreover, high miR-25 expression was also associated with poorer overall survival of women with lung ADC (P=0.008). Conclusion: Tissue miR-25 expression may be associated with tumor progression and have prognostic implications in female lung ADC patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4769-4774
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• 2016

Objective: To analyze the survival of elderly patients with breast cancer according to the type of treatment used. Methods: A cohort study of women aged 80 or over with breast cancer registered with the Brazilian National Cancer Institute (Instituto Nacional do $C{\hat{a}}ncer$ - INCA) between 2008 and 2009 was conducted. Prognosis was analyzed according to the cancer treatment performed: surgery, radiotherapy, or hormone therapy. Analysis of the overall 5-year survival rate was performed using the Kaplan - Meier method, and comparisons of curves were undertaken using the log-rank test. For multiple regression analysis, Cox regression was used, adjusting for age and clinical stage, considering values of p < 0.05 as significant. Data were all analyzed using the statistical package SPSS version 20. Results: 70 women with a mean age of $84.0{\pm}3.7years$ at diagnosis participated in the study. The median follow-up time was 37.1 months (range 0.5-75.5), and 31 deaths (44.3%) occurred during this time. The median survival time was 51.2 months (95% CI, 44.9-57.4), higher in those who underwent surgery (p = 0.012) and those who had hormone therapy (p=0.001). Treatment with surgery reduced the risk of death by 61.7% (HR 0.3; 95% CI, 0.1-0.6; p = 0.001) when adjusted for clinical stage and age at diagnosis. However, there was no significant benefit from radiotherapy (HR 1.2; 95% CI, 0.5-2.5; p = 0.694). Conclusion: Treatment with surgery and hormone therapy increased the survival of our Brazilian patients with breast cancer aged 80 or over.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1313-1323
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• 2016

To study the full health effects of parental radiation exposure on the children of the atomic bomb survivors, the Radiation Effects Research Foundation developed a cohort of 76,814 children born to atomic bomb survivors (F1 generation) to assess cancer incidence and mortality from common adult diseases. In analyzing radiation-associated health information, it is important to be able to adjust for sociodemographic and lifestyle variations that may affect health. In order to gain this and other background information on the F1 cohort and to determine willingness to participate in a related clinical study, the F1 Mail Survey Questionnaire was designed with questions corresponding to relevant health, sociodemographic, and lifestyle indicators. Between the years 2000 and 2006, the survey was sent to a subset of the F1 Mortality Cohort. A total of 16,183 surveys were completed and returned: 10,980 surveys from Hiroshima residents and 5,203 from Nagasaki residents. The response rate was 65.6%, varying somewhat across parental exposure category, city, gender, and year of birth. Differences in health and lifestyle were noted in several variables on comparison across city and gender. No major differences in health, lifestyle, sociodemographics, or disease were seen across parental exposure categories, though statistically significant tests for heterogeneity and linear trend revealed some possible changes with dose. The data described herein provide a foundation for studies in the future.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6019-6023
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• 2013

Lung cancer, one of the leading causes of cancer-related deaths, usually appears as solitary pulmonary nodules (SPNs) which are hard to diagnose using the naked eye. In this paper, curvelet-based textural features and clinical parameters are used with three prediction models [a multilevel model, a least absolute shrinkage and selection operator (LASSO) regression method, and a support vector machine (SVM)] to improve the diagnosis of benign and malignant SPNs. Dimensionality reduction of the original curvelet-based textural features was achieved using principal component analysis. In addition, non-conditional logistical regression was used to find clinical predictors among demographic parameters and morphological features. The results showed that, combined with 11 clinical predictors, the accuracy rates using 12 principal components were higher than those using the original curvelet-based textural features. To evaluate the models, 10-fold cross validation and back substitution were applied. The results obtained, respectively, were 0.8549 and 0.9221 for the LASSO method, 0.9443 and 0.9831 for SVM, and 0.8722 and 0.9722 for the multilevel model. All in all, it was found that using curvelet-based textural features after dimensionality reduction and using clinical predictors, the highest accuracy rate was achieved with SVM. The method may be used as an auxiliary tool to differentiate between benign and malignant SPNs in CT images.