• Asian Pacific Journal of Cancer Prevention
• /
• 제14권9호
• /
• pp.5095-5099
• /
• 2013

Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was $34.6{\pm}5.0$ years among younger patients compared to $54.1{\pm}9.9$ for those ${\geq}40$ years. The mean age at menarche was also significantly lower ($13.5{\pm}1.5$ vs $14.2{\pm}1.5$ years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women ($5.0{\pm}2.5$ vs $4.5{\pm}2.4cm$, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, $p{\leq}0.05$). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.

• Journal of Nutrition and Health
• /
• 제36권2호
• /
• pp.154-166
• /
• 2003

To investigate the effects of isoflavone supplementation on both bone mineral density and hormone variation in premenopausal women who had decreased bone mass, the 24 subjects were divided into two groups: one was the underweight group, consisting of 13 subjects, and the other was the normal weight group consisting of 11 subjects. For each group, we investigated the effects of isoflavone supplementation of 90 mg/day on both bone mineral density and hormone variation during 3 menstrual cycles. Anthropometric measurements, dietary recall, and analyses of blood and urine were assessed from baseline to post-treatment. The results were as follows: The average age of the underweight group was 21.8 years old and that of the normal weight group was 23.2 years old. The comparative results for the two groups at baseline were as follows: Onset of menarche, menstrual cycle, and menstrual length were not significantly different between the groups. Serum protein, total, HDL-, LDL-cholesterol, triglyceride, Ca, P, Mg, Cu, and Zn level were not significantly different between the groups. Serum estradiol, SHBG, LH, and FSH level were also not significantly different between the groups. Lumbar spine BMD by T scores of the underweight group was significantly lower than that of the normal weight group. Serum osteocalcin, urinary DPD, and urinary pH were not significantly different between the groups. The comparative results for the two groups at post-treatment were as follows: From baseline to post-treatment, the intake of energy, nutrients and isoflavone in food did not significantly change in either group. Serum protein, total cholesterol, HDL-, LDL-cholesterol, and triglyceride levels did not significantly change in either group. Serum Ca, Cu, and Zn levels were significantly lower in both groups and serum Mg level significantly decreased only in the underweight group. Serum estradiol levels were significantly lower in both groups, but serum SHBG, LH, and FSH levels did not significantly change in either group. Lumbar spine BMD by T score of the underweight group significantly increased to 15%, but that of the normal weight group did not significantly change. Serum osteocalcin of the underweight group significantly increased to 28%, while that of the normal weight group significantly increased to 40%. Urinary DPD of the normal weight group significantly increased to 12%. The results show that the BMD of the underweight group was lower than that of the normal weight group. Therefore, the underweight group had a disadvantage in obtaining maximum bone mineral density. The results also show that isoflavone supplementation during 3 menstrual cycles was effective in increasing the bone mineral density of the lumbar spine and affected bone metabolism markers in premenopausal underweight women. Therefore, it can be concluded that sufficient intake of isoflavone could be helpful in preventing decreases in bone mass among premenopausal women, especially underweight women.

• 보건교육건강증진학회지
• /
• 제8권2호
• /
• pp.74-86
• /
• 1991

This study tried to clear the characteristics of height growth pattern depending on Peak Height Velocity age in early, average and late groups. And in it, height growth tendency of girl students in age 7 to 18 years old was compared and investigated in order to know influencing factors, menarcheal age relation. The samples were senior girl students at high school in Seoul. Longitudinal data and survey data were collected in August, 1990. The results could be summarized as follows: 1. On distance curve, the height growth line in early group tended to be the highest and in late group the lowest. On the other hand, on velocity curve late group showed the highest peak and early group showed the lowest peak. In late group, velocity curve was too steep. Of course, these early, average and late groups were classified by PHV age. 2. In these three groups, late group showed the most growth amount per year. However, on distance curve, early group showed higher line than late group. Perhaps this means that peak growth amount in late group might have an effect on mean. 3. Growth amount of adolescence spurt age in these three groups was 6.86cm at age 9(early group), 7.27cm at l1(average group) and 7.65cm at 13(late group). In early group, because. PHV age came too early, it was difficult to find exact adolescence spurt period. In early group, the adolescence spurt period is considered to come at about age 7 to 9. In average group, at 9 to 11 and at 12 to 13 in late group. Especially, spurt of late group was remarkable. 4. When the growth amount of PA, before PA and after PA was compared, growth amount of PA in all three groups was about 20%. In early group, growth amount of APV tended to be large and in late group, that of APV tended to be large and in late group, that of BPV was large. In average group, growth amount of BPV was larger than that of APV. 5. For the purpose of comparing total height growth amount of these groups at age 18, the height growth was assumed to be over. And then, the difference of three groups was studied but it's not significant. 6. Although the difference between height growth and family environment, dietary habits, exercise, disease history in these three groups was investigated, only the income was significant. The significance of all the other factors was not approved. 7. When menarcheal age was compared with PA, generally we know menarche appeared after 1∼2 years of PHV age. But in case of early group, the difference between PHV age and menarcheal age was 5.34 years. In average group, 2.45 years and 0.82 years in late group.

• 한국콘텐츠학회논문지
• /
• 제20권3호
• /
• pp.671-677
• /
• 2020

우리나라에서 발생하는 여성암 중 1위는 유방암으로 또한 지속적으로 발생률이 증가하고 있다. 이는 경제성장과 함께 좌식 생활이 증가한 영향 때문이라는 의견이 다수다. 본 연구는 경기도 소재 암 전문병원을 내방한 환자와 정상군을 대상으로 국제표준 운동상태 설문을(IPAQ) 실시하였고 설문의 운동 상태를 표준 점수화(MET) 하여 환자군과 정상군의 표준점수 차이에 따른 유방암 발생의 영향 정도를 비교하였다. 연구 대상자의 나이는 환자군과 정상군과의 통계적 차이를 벗어나지 않는 대상자로 선정 하였고 유방암 발병의 운동 상태외의 요소에 의한 유방암 발생 영향 파악을 위하여 체질량, 가족력, 초경 연령, 출산력, 교육 정도 등을 함께 설문하였다. 대체로 유방암 환자군이 정상군 대비 낮은 MET 점수 결과를 나타났고 폐경 전 여성보다 폐경 후 여성에서의 운동에 의한 유방암 발생 영향이 더 크게 나타났다. 또한 체질량 크기와도 유사한 유방암 발생영향 결과를 나타났다. 운동을 통한 적정 체중 유지는 체내 유방암의 발암 물질 축적을 낮출 수 있어서 유방암 발생을 낮출 수 있는 효과가 있다.

• 대한영양사협회학술지
• /
• 제9권4호
• /
• pp.307-315
• /
• 2003

This study was to investigate the relation of nutrients intake, health status, and bone mineral density in middle-aged women. Daily nutrients intake were analyzed by convenient method. The BMD of subjects were measured by Dual Energy X-ray Absorptiometry(DEXA). BMD was measured at the spine(vertebrae L2-L4) and femur(neck, Ward's triangle and trochanter). The nutrients intake of subjects were higher than recommended dietary allowances(RDA) except for calorie, iron, calcium, vitamin B1. Nutrients intake of vitamin A(p<0.05), iron(p<0.01), vitamin $B_2$(p<0.05), niacin(p<0.05), and vitamin C(p<0.05) between $\leq$49 yr group and $\geq$50 yr group. Mean daily intake of calcium was much less than the Korean RDA, 78.5% in $\leq$49 yr group and 77.3% in $\geq$50 yr group. 35.8% of the subjects under 50 years of age($\leq$49 yr group) and 77.4% of the subjects from 50 years up($\geq$50 yr group) were classified as osteopenia or osteoporosis. BMD of L2-L4 were positively correlated with height(p<0.05), weight(p<0.05) and BMI(p<0.05). BMD of femoral neck was positively correlated with BMI(p<0.05), BMD of Ward's triangle was positively correlated with weight(p<0.001). But BMD of L2-L4 and femoral neck were negatively correlated with age(p<0.05), menarche(p<0.05). BMD of Ward's triangle was negatively correlated with age(p<0.001). The BMD of L2-L4 were positively correlated with animal protein(p<0.05), calcium(p<0.05) and iron(p<0.05). The BMD of femoral neck was positively correlated with animal protein(p<0.05). The BMD of Ward's triangle was positively correlated with animal protein(p<0.001) and iron(p<0.001). The above results suggest that it should be difficult to prevent middle-aged women's bone destruction through nutrients intake. Further investigation is necessary to prove the mutual relations between BMD, exercise, and calcium intake. Therefore, middle-aged women will need proper exercise as well as Ca supplementation in order to prevent osteoporosis with aging.

• 대한지역사회영양학회지
• /
• 제8권6호
• /
• pp.927-937
• /
• 2003

This study was conducted to investigate dietary and other factors affecting bone mineral density (BMD) in Korean premenopausal women. Seventy-eight premenopausal women who visited the Health Promotion Center for health examinations volunteered to participate in this study. They were divided into two groups according to their bone status as shown by their T-scores: a non-osteoporotic group and a osteoporotic group. The results are as follows: The mean BMDs of the lumbar spine and femoral neck were 1.21$\pm$0.02$g/cm^2$ and 0.97$\pm$0.04$g/cm^2$, respectively. The BMD levels of the osteoporotic group were significantly lower than those of the non-osteoporotic group (p<0.001, respectively). The heights of the women in the osteoporotic group were significantly lower than those of the non-osteoporotic group (p<0.01) however, their body weights did not show any significant differences although they tended to be lower. The mean daily intake of energy was 1720$\pm$52㎉. When the nutrient intake was compared with the Korean recommended dietary allowances (RDA), calcium, Fe, vitamin A and riboflavin intakes were lower than the RDA. Their was no significant difference in the nutrient intake of the non-osteoporotic group and osteoporotic group except for the intakes of protein, fat and niacin. Their was no significant difference between the non-osteoporotic group and the osteoporotic group and all were within the normal range. However, the serum alkaline phosphatase level of the osteoporotic group was significantly higher than that of the non-osteoporotic group (p<0.001). Height measurements showed positive correlations with lumbar spine bone mineral density (LBMD, r=0.332, p<0.01) however there was no correlation with femoral neck bone mineral density (NBMD). Age, age at menarche, body weight, body mass index (BMI) and obesity showed no correlation with BMD. The BMD of the lumbar spine was significantly and positively related to the intake of niacin and vitamin C (r=0.236, p<0.05; r=0.274, p<0.05). Serum levels of calcium and phosphorus showed negative correlations with LBMD (r=-0.698, p=0.0001, r=-0.503, p=0.0001, respectively). The results suggested that the BMD of the lumbar spine was positively related to the intake of niacin and vitamin C in premenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss would be have a higher intake of niacin and vitamin C rich foods and engaging habitually in physical activity may have a beneficial effect on BMD in the Premenopausal Period.

• 대한간호학회지
• /
• 제7권1호
• /
• pp.30-38
• /
• 1977

Breast cancer is one of the most feared health problems in women ; Recent studies revealed that it had come up to be the second most in this country and high prevalent disease in the western countries among breast disease in women. However, early detection of the cancer mass is known to be easier than in many other malignancies. This study was performed to investigate the various characteristics of patients of breast cancer ; by the structural variables, menstrual, marital, and child bearing, and also their understandings and attitude towards the disease. A hundred any in- and out- patients of 51. Mary's Hospital and National Atomic Institute, Seoul were sampled. Data were gathered through direct interview by the researcher from February 1976 to January 1977 and the clinical records were used as references. Results are as follows ; 1. Breast cancer revealed to be most prevalent in the forties ; average age of 45.2 years. 2. The average age of menarche revealed to be 15.4 years ; the largest group were the 16-20 years (N=75, 68.2%). In 55 cases (50%) menstruation were normal, 38 (34.5%) postmenopausal and only in 17 (15.5%), menstruation revealed irregularity. 3. The average marital age revealed to be 22.3 years ; the largest group were 21-25 group (N=43, 39.1%). The average duration of marital life revealed to be 24.7 years ; 11-20 years group were the largest (M=34, 30.9%). 4. Most of the patients revealed to have pregnancy experiences(N=100, 90.9%) ; the average rate of experience were 5, 3 times the largest group were 3.4 times group(N= 32, 29.1%). 54 patients (49.1%) revealed to have had abortion experience ; the average were 3.4 times. 5. The largest group(N=77, 70%) had been breast feeding : followed by mixed feeding (N=12, 10.9%) and artificial feeding(N=10, 9.1%). 6. Personal health history revealed that in 20 patients (18.2%) revealed to have the past history of Purulent mastitis, 5 patients(4.5%) of breast cancer and 3 patients(2.7%) of uttering cancer family history. 7. In the one half (N=56, 50.9%, they had some information about breast cancer :27 (24.5%) by mass media, 12 (10.9%) through personal contacts and 17 (15.5%) were not able to classify the source of information. 8. In 55 cases (50%) the canoe, mass were discovered incidentally, in 39 cases (35.5%) by manual detection by self, in 10 cases (9%) by others and in 6 cases(5.5%) by observing subjective symptoms. 9. The average duration lapsed between the discovery of cancer mass and the visit to the hospital revealed to be 9.4 month. Chief reason for the delay revealed to be the non-chaplaincy due to the absence of pain(N=50, 45.5 %) followed by the administration of herb and commercial medication (N=19, 17.3%). 10. The left side breast was more affected than the right side breast, represent by 60 cases in the left and 39 cases in the right. The most frequent site of the breast cancer was the upper- outer quadrant in 53 cases (47.7%), and followed by the center in 20 cases(18 %), and the upper inner quadrant, in 19 cases (17.1%). There was / cases of bilateral carcinoma. The most prominent symptom was painless mass.

• 대한지역사회영양학회지
• /
• 제13권3호
• /
• pp.418-425
• /
• 2008

The purpose of this study was to investigate correlations between bone mineral density (BMD) and dietary and non-dietary factors in female college students. The BMD of the subjects (n = 38) was measured using DEXA (Dual Energy X-ray Absorptiometry) at lumbar spine and three femoral sites including femoral neck, ward's triangle, and femoral trochanter. Three-day 24-hour dietary recall data were collected from each subject to assess consumption levels of nutrients and food groups. The mean (${\pm}SD$) values of age, age of menarche, height, weight, body mass index (BMI), waist-to-hip ratio (WHR), fat mass, and % body fat of the subjects were 21.34 (${\pm}1.73$) years, 13.1 (${\pm}1.2$) years, 161.3 (${\pm}5.0$) cm, 53.7 (${\pm}7.2$) kg, 20.6 (${\pm}2.6$) $kg/m^2$, 0.80 (${\pm}0.04$), 15.4 (${\pm}4.4$) kg, and 28.2 (${\pm}4.7$), respectively. The BMD values of lumbar spine, femoral neck, ward's triangle, and femoral trochanter as T-value were $1.150{\pm}0.13\;g/cm^2$, $0.932{\pm}0.11\;g/cm^2$, $0.850{\pm}0.13\;g/cm^2$, and $0.721{\pm}0.10\;g/cm^2$, respectively. The daily mean energy intake of the subjects was 1660.6 kcal. The intake levels of carbohydrate, calcium, iron, vitamin C, and folic acid were lower than the KDRIs, while those of fat, phosphorus, sodium, vitamin A, and vitamin $B_6$ were higher than the KDRIs. Significantly negative correlation were detected between consumption of fat and oils and the BMD of all sites measured (p < 0.05). Potato and starch intake was negatively correlated to the BMD of femoral neck and word's triangle (p < 0.05). The intake of cereals was found to be negatively correlated to the BMD of ward's triangle (p v 0.05). There was also negative correlation of intake of soybeans and products with the BMD of lumbar spine (p < 0.05). Weight and muscle mass were positively correlated to the BMD of both lumbar spine and femurs (p < 0.01). Significantly positive correlations between BMI, and fat mass and the BMD of lumbar spine were observed (p < 0.001). Additionally fat mass was positively correlated to the BMD of femoral neck. WHR and % body fat were positively correlated to the BMD of lumbar spine (p < 0.05). Negative correlation was found between a serum calcium level and the BMD of femoral neck (p < 0.05). In summary non-dietary factors generally showed significant correlations with the BMD of lumbar spine, while several dietary factors showed significant correlations with the BMD of femurs.

• 문화기술의 융합
• /
• 제7권2호
• /
• pp.107-116
• /
• 2021

본 연구는 중년기여성의 골다공증 지식, 예방행위, 자기효능감 및 건강관련 삶의 질 관계를 확인하고 관련 요인을 파악하기 위한 서술적 조사연구이다. 연구대상자는 .G시에 소재한 2개 종합병원의 40~60세 중년기성인으로 총 230명이며, 구조화된 설문지를 이용하여 2018년 1월부터 3월까지 자료를 수집하였다. 수집된 자료는 SPSS/WIN 23.0 프로그램을 이용해 서술적 통계, t-test, ANOVA, Pearson's correlation coeffickent, Multiple linear regression analysis로 분석하였다. 연구결과는 골다공증 대한 지식은 12.50±3.47, 골다공증 건강관련 삶의 질 중 EQ-5D Index에 미치는 영향요인은 동반질환유무(β=.288, p<.001), 골다공증 예방행위(β=.139, p=.014), 골다공증 지식(β=.138, p=.013), 월 평균 수입(β=.136, p=.013)순으로 나타났으며(F=7.522, p<.001), EQ-5D VAS에 미치는 영향요인은 골다공증 예방행위(β=.301, p<.001), 골다공증 자기효능감(β=.201, p<.001), 골다공증 지식(β=.170, p=.001), 초경연령(β=.139, p=.005)순으로 나타났다. 따라서 중년기 여성의 건강관련 삶의 질을 향상시키기 위해서는 중년기 여성의 골다공증 지식, 예방행위 및 자기효능감을 증진시키는 프로그램의 개발과 적용이 요구된다.

• 대한간호학회지
• /
• 제3권3호
• /
• pp.1-14
• /
• 1973

This study is designed to meet the following objectives: (1) To study attitude and behavior regarding marriage and age at marriage, (2) To learn correlates of age at marriage and to examine their relations, (3) To measure relative importance of the correlates of age at marriage, and (4) To study relations of age at marriage and family planning practice to fertility and their relative importance as correlates of fertility. The data are obtained by an independent cross-sectional survey in three study areas purposively selected to represent metropolitan. semihuman. rural population. The study population is confined to women age 17-50 as of survey. The overall response rate is 90%. Reliability of data is measured by . individual and aggregate inconsistency based upon a 15% subsample of the original interviews. The individual inconsistency (31%) is found to be high compared to the aggregate inconsistency (6%) for all 85 variables. However, the magnitude of differences between means is small, and the mean absolute shifts and proportional shifts are also small on the whole. In a word respondents did not change their answers too extremely or radically. The study populations of each study area are compared on some basic characteristics. It is found that the three study populations have more dissimilarities than similarities. The findings on seven different attitudinal positions of women toward marriage indicate that there have been tremendous changes in all study areas Iron "traditional" attitudes which have been prevalent for a long time in Korean society to "liberalized" or "modernized" attitudes. An apparent tendency is that women generally take a position of a "golden mean" attitude by not preferring either extreme of marriage attitudes. Nevertheless, the young, single, educated, and urbanite appears more "liberalized. " There has been some increase in ideal age at marriage from 1958 to 1970 for both sexes. No age group, marital status, or study area differentials in ideal age at marriage are found, the average ideal age at marriage in every sub-group being 24-25. Awareness of existing legal marriageable ages is low; only 4.4% are aware that "with parental permission: minimum age for males is 18 years and for females 16 years,"and only 3.7% are aware that "without parental permission: 27 years for males and 23 years for females." People in Korra tend to marry spouses who are in various social ways like themselves: the similarities include (a) education, occupational status of father, (c) economic status, (d) usual residence before marriage, and (e) religion. Both singulars and actual mean ages at marriage in this study confirm the trend of rising age at marriage previously established by other independent studies. The urban-rural differential in age at marriage is observed, but the differential narrows down gradually from 1935 to 1970. All socio-economic, demographic, and other variables pertaining to wife before and at first marriage, excluding (a) religion, (b) father′s of occupation, and (c) as: of menarche, are correlated with respondent's age at first marriage, whereas only three variables out of all socio-economic variables relating to husband before and at wife′s first marriage, viz., (a) education, (b) usual residence, and (c) economic level of his old home, are correlated with respondent′s age at marriage. Among socio-economic and modernity variables related to either husband or wife at the time of survey, only education and duration of residence are correlated with wife′s age at first marriage. Among the correlates of respondent′age at first marriage, education is in general the most important variable. However, it is found that wife′s education is more important than husband′s. The combined effects or the correlates studied explain no more than about 40% of variance for any of the selected groups of variables. Points which might counteract the effects of late marriage on fertility are not serious in Korea. For each of the correlates of the three fertility indices chosen for this study. namely, (a) number of living children, (b) number of live births, and (c) number of pregnancies, age at marriage is the major contributor to the variance in all age groups except the age group of 20-29 in which the index of family planning practice is the major contributor. The proportion of variability in fertility indices accounted for by the correlates is never more than 40% of the total variance in any age group. Based upon the findings from this study, it could be concluded that in the foreseeable future (a) celibate group will no! be increased to a point that would slow down population growth rate in Korea, (b) age at marriage will not increase continually, (c) although education stands out as the major contributing variable which independently explains the variation in age at marriage, it seems probable that education may not be the major variable in the near future, and (d) despite the fact found by this study that age at marriages has been the major contributor to the variance of each of the fertility indices used, family planning practice will play a more important role in the reduction of fertility in the Korean society. Therefore, factors interrupting practice of family planning must be eliminated and family planning program should be strengthened if further fertility reduction is needed.