• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5343-5348
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• 2014

Background: A meta-analysis was performed to examine the benefit/risk ratio for the addition of anti- HER MoAbs to chemotherapy in patients with advanced gastric and gastroesophageal cancer from six randomized phase II/III trials. Materials and Methods: We searched relative trials from Pubmed, EMBASE, Cochrane library databases, China National Knowledge Infrastructure databases, Google Scholar and the NIH ClinicalTrials. Primary outcomes were overall response rate (ORR), progression-free survival (PFS), overall survival (OS). Secondary outcomes were toxicities. All analyses were performed using STATA 12.0. Results: This meta-analysis included six randomized controlled trials (RCTs) with 2, 297 patients and we demonstrated that the anti-HER MoAbs arm did have a positive effect on ORR in the anti-HER MoAbs arm (OR 1.28, 95% CI 1.00-1.64, p=0.01). There was an increasing benefit regarding OS (HR 0.74, 95% CI 0.60-0.88, p<0.05) and PFS (HR 0.72, 95% CI 0.60-0.84, p<0.05) in the anti-HER2 subgroup, but a reduction of OS (HR 1.11, 95% CI 0.87-1.36, p<0.05) and PFS (HR 1.13, 95% CI 0.98 -1.28, P<0.05) in anti-EGFR subgroup. Some grade 3-4 toxicity had a significantly higher incidence in the anti-HER MoAbs arm. There was no significant publication bias for all endpoints. Conclusions: The addition of trstuzumab MoAb to chemotherapy for gastric and gastroesophageal cancer significantly improved outcome of OS and PFS endpoints, while other MoAbs led to no improvement in results. Some adverse events were increased in anti-HER MoAbs arm compared with the control.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4699-4704
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• 2013

Background: MicroRNAs have been demonstrated to play important roles in the development and progression of colorectal cancer. Several studies utilizing microRNAs as diagnostic biomarkers for colorectal cancer (CRC) have been reported. The aim of this meta-analysis was to comprehensively and quantitatively summarize the diagnostic value of microRNAs for detecting colorectal cancer. Methods: We searched PubMed, Embase and Cochrane Library for published studies that used microRNAs as biomarkers for the diagnosis of colorectal cancer. Summary estimates for sensitivity, specificity and other measures of accuracy of microRNAs in the diagnosis of colorectal cancer were calculated using the bivariate random effects model. A summary receiver operating characteristic (SROC) curve was also generated to summarize the overall effectiveness of the test. Result: Thirteen studies from twelve published articles met the inclusion criteria and were included. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odd ratio of microRNAs for the diagnosis of colorectal cancer were 0.81 (95%CI: 0.79-0.84), 0.78 (95%CI: 0.75-0.82), 4.14 (95%CI: 2.90-5.92), 0.24 (95%CI: 0.19-0.30), and 19.2 (95%CI: 11.7-31.5), respectively. The area under the SROC curve was 0.89. Conclusions: The current evidence suggests that the microRNAs test might not be used alone as a screening tool for CRC. Combining microRNAs testing with other conventional tests such as FOBT may improve the diagnostic accuracy for detecting CRC.

• Journal of Hospice and Palliative Care
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• 제23권2호
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• pp.71-84
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• 2020

Purpose: The purpose of this systematic review and meta-analysis was to investigate the effects of advance care planning on end-of-life decision-making. Methods: Databases including RISS, KISS, KMbase, KoreaMed, PubMed (MEDLINE), Embase, and CINAHL were searched for studies that examined the effects of advance care planning interventions. The inclusion criteria were original studies in English or Korean; adults ≥18 years of age (population); advance care planning (intervention); completion of advance directives (AD) or advance care planning (ACP) (outcomes); and randomized or non-randomized controlled trials (RCTs and non-RCTs, respectively) (design). Study quality was measured using the checklists of the Joanna Briggs Institute. Meta-analyses were conducted with the Comprehensive Meta-Analysis program. Results: Nine RCTs and nine non-RCTs were selected for the final analysis. The effect sizes (ES) of the outcome variables in nine RCTs were meta-analyzed, and found to range from 0.142 to 0.496 for the completion of AD and ACP (ES=0.496, 95% CI: 0.157~0.836), discussion of end-of-life care (ES=0.429, 95% CI: -0.027~0.885), quality of communication (ES=0.413, 95% CI: 0.008~0.818), decisional conflict (ES=0.349, 95% CI: -0.059~0.758), and congruence between preferences for care and delivered care (ES=0.142, 95% CI: -0.267~0.552). Conclusion: ACP interventions had a positive effect on the completion of AD and ACP. To apply AD or ACP in Korea, it is necessary to develop ACP interventions that reflect aspects of Korean culture.

• 품질경영학회지
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• 제48권1호
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• pp.149-169
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• 2020

Purpose: This study analyzes the characteristics of the Quality Management performed by SMEs in the Defense Industry in supply chains and analyzes the effect of the continuous improvement activities based on cooperation. Especially, for Military Supplies, the suitability of products is usually decided by judging their conformity to the specification, and from this structural characteristic, this study would analyze the structural relationship of systematic improvement activities with Supply Chain Quality Management(SCQM) and Business Performance(BP). Methods: Continuous improvement activities(CI) have significance as the driver force for the promotion of Quality Management. Thus, this study analyzed the causal relationships from the perspective of the process among CI, SCQM and BP. For an analysis of the structural characteristics and causal relationships among the constituents, AMOS was used, and 297 companies in the Defense Industry were utilized as samples. Results: It turned out that CI had significant impacts on Management Infra(MGT_Infra), Process Management(PM), Human Resources Management(HRM) and Communication(COMU) and had an indirect impact on the enterprises' financial performance through the parameters of HRM and Communication. Meanwhile, it turned out that between CI and non-financial performance, there was a direct effect, and there was also an indirect effect through the variables of the Management Infra and Communication. Conclusion: It turned out that CI had a positive effect on SCQM as a proactive driver and that they had significant relationships with BP(financial, Non-financial), both financial performance and non-financial performance. However, PM did not have a significant relationship of effect with BP because of the character appearing by the evaluation method of military supplies for the conformity to the specifications.

• 한국치위생학회지
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• 제19권5호
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• pp.813-824
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• 2019

Objectives: The purpose of this study was to investigate the effects of emotional labor, organizational climate, and job involvement on turnover intention in Korean dental hygienists. Methods: A total of 806 dental hygienists were enrolled in this study. A self-administered questionnaire was used to evaluate the demographic and occupational characteristics, emotional labor, organizational climate, job involvement, and turnover intention of the subjects. A hierarchical multiple regression analysis was performed. All statistical analyses were performed using the Statistical Package for the Social Sciences for Windows (version 23.0) and p-values < 0.05 were considered significant. Results: Highly chronic exposure to emotional labor were more likely to increase the risk of turnover intention among dental hygienists, especially in the sub-scales of "over-load and conflict in customer service" (OR: 1.64; CI: 1.01-2.64), "organizational surveillance and monitoring" (OR: 1.76; 95% CI: 1.21-2.57), and "lack of a supportive and protective system in the organization" (OR: 1.76; 95% CI: 1.36-2.46). Job involvement (OR: 0.91; 95% CI: 0.86-0.96) and organizational climate (OR: 0.82; 95% CI: 0.75-0.90) were negatively associated with turnover intention among dental hygienists. Conclusions: Exposure to chronic and excessive emotional labor might be a contributing factor for turnover intention, and job involvement and a positive organizational climate contribute to protecting the negative impacts of emotional labor on turnover intention in dental hygienists.

• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.53-61
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• 2019

Background: Antiphospholipid antibody syndrome (APS), an important cause of acquired thrombophilia, is diagnosed when vascular thrombosis or pregnancy morbidity occurs with persistently positive antiphospholipid antibodies (aPL). APS is a risk factor for unprovoked recurrence of pulmonary embolism (PE). Performing laboratory testing for aPL after a first unprovoked acute PE is controversial. We investigated if a specific phenotype existed in patients with unprovoked with acute PE, suggesting the need to evaluate them for APS. Methods: We retrospectively reviewed patients with PE and APS (n=24) and those with unprovoked PE with aPL negative (n=44), evaluated 2006-2016 at the Asan Medical Center. We compared patient demographics, clinical manifestations, laboratory findings, and radiological findings between the groups. Results: On multivariate logistic regression analysis, two models of independent risk factors for APS-PE were suggested. Model I included hemoptysis (odds ratio [OR], 12.897; 95% confidence interval [CI], 1.025-162.343), low PE severity index (OR, 0.948; 95% CI, 0.917-0.979), and activated partial thromboplastin time (aPTT; OR, 1.166; 95% CI, 1.040-1.307). Model II included age (OR, 0.930; 95% CI, 0.893-0.969) and aPTT (OR, 1.104; 95% CI, 1.000-1.217). Conclusion: We conclude that patients with first unprovoked PE with hemoptysis and are age <40; have a low pulmonary embolism severity index, especially in risk class I-II; and/or prolonged aPTT (above 75th percentile of the reference interval), should be suspected of having APS, and undergo laboratory testing for aPL.

• 지식경영연구
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• 제23권3호
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• pp.213-229
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• 2022

본 연구는 기존 연구들에서 언급된 집단지성 발현의 선행요인들을 검증함으로써 관련분야 발전에 기여하는 것을 연구 목적으로 한다. 이를 위해 집단지성 발현의 선행요건으로 과업의 복잡성과 의미성, 다양성, 경험에 대한 개방성, 커뮤니케이션 독립성, 의사결정의 분권화, ICT(Information and Communication Technologies) 활용을 검토하였다. 연구가설 검증을 위해 연구개발 사업부에 속한 구성원을 대상으로 200부의 설문지를 배포하였고, 회수된 198부 중에서 불성실한 13개를 제외한 185개의 데이터를 최종 분석하였다. 분석결과, 과업의 의미성, 경험에 대한 개방성, 의사결정 분권화, ICT활용이 각각 집단지성 발현에 긍정적인 영향을 미치는 것을 확인하였다. 그리고 지각된 비유사성과 가치 다양성은 각각 집단지성 발현에 부정적인 영향을 미쳤으며, 모든 변수들을 함께 고려했을 때, ICT 활용, 과업의 의미, 경험에 대한 개방성, 인지된 비유사성과 가치 다양성 순서로 집단지성 발현에 영향을 미치는 것을 발견하였다. 본 연구결과의 이론 및 실무적 시사점은 토의부분에서 자세히 분석하였다.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1355-1366
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• 2020

Objective: We aimed to evaluate the diagnostic value and prognostic relevance of FDG positron emission tomography/computed tomography (PET-CT) in extrahepatic cholangiocarcinoma patients. Materials and Methods: This study included 234 extrahepatic cholangiocarcinoma patients who underwent FDG PET-CT between June 2008 and February 2016. The diagnostic performance of FDG PEG-CT was compared to that of contrast-enhanced multidetector row CT (MDCT) and MRI. Independent prognosticators for poor survival were also assessed. Results: The sensitivity of FDG PET-CT for detecting primary tumor and regional lymph node metastases was lower than that of MDCT or MRI (p < 0.001), whereas the specificity and positive predictive value for detecting regional lymph nodes metastases was significantly better in FDG PET-CT compared to MDCT and MRI (all p < 0.001). There was no significant difference in the diagnostic yield of distant metastases detection among three diagnostic imaging techniques. In a multivariate analysis, maximum standardized uptake values (SUV_max) of the primary tumor (adjusted hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.13-2.69) and of the metastatic lesions ≥ 5 (adjusted HR, 8.10; 95% CI, 1.96-33.5) were independent contributors to poor overall survival in extrahepatic cholangiocarcinoma patients. In a subgroup analysis of 187 patients with periductal infiltrating type of cholangiocarcinoma, an SUV_max of the primary tumor ≥ 5 was associated with an increased risk of regional lymph node (adjusted odds ratio [OR], 1.60; 95% CI, 0.55-4.63) and distant metastases (adjusted OR, 100.57; 95% CI, 3.94-2567.43) at diagnosis as well as with poor overall survival (adjusted HR, 1.81; 95% CI, 1.04-3.15). Conclusion: FDG PET-CT showed lower sensitivity for detecting primary tumor and regional lymph node involvement than MDCT and MRI. However, the SUV_max of primary tumors and metastatic lesions derived from FDG PET-CT could have significant implications for predicting prognoses in extrahepatic cholangiocarcinoma patients.

• Journal of Preventive Medicine and Public Health
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• 제57권1호
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• pp.8-17
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• 2024

Objectives: The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors. Methods: The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale. Results: Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM. Conclusions: Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.

• 한국병원경영학회지
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• 제16권4호
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• pp.67-84
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• 2011

The open Hospital Attending Physician System has been discussed and operated for developing the efficiency and the substitutes for an increase in medical expenses, for overlapping investment in medical resources, and for normalization of medical delivery system. This study assessed the related factors to the acceptance and introduction of Attending Physicians on ophthalmologist. Data was collected mail response to 179 ophthalmologists in 2005. Applying multilevel logistic regression, we examined the relationship between their acknowledgment, attitude and acceptance of the open Hospital Attending Physicians System. The percentage of participation in Hospital Attending was indicated to be 3.9%. The 44.7% of all participants agreed to adopting the Hospital Attending, 33.5% of doctors are willing to participate in the future. The positive and normal attitude of physician toward the Hospital Attending is 6.6 times (95%CI 1.315, 33.138) and 55.2 times(95%CI 11.352, 268.347) more than that of negative after adjustment for other variables. Attitude was found to be the important factor influencing physicians' participation in the Attending Hospital. Thus, it is need to development and implication for the strategies that lead the practical necessity and positive attitude toward the Attending Hospital.