• 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.

• Journal of Gastric Cancer
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• v.17 no.1
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• pp.74-87
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• 2017

Purpose: Neoadjuvant chemotherapy has been shown to improve survival in locally advanced gastric cancer, but it is associated with significant toxicity. Sarcopenia and sarcopenic obesity have been studied in several types of cancers and have been reported to be associated with higher chemotherapy toxicity and morbi-mortality. The aim of this study was to assess the prevalence of sarcopenia/sarcopenic obesity in patients with gastric cancer, as well as its association with chemotherapy toxicity and long-term outcomes. Materials and Methods: A retrospective analysis was performed using an academic cancer center patient cohort diagnosed with locally advanced gastric cancer between January 2012 and December 2014 and treated with neoadjuvant chemotherapy. We analyzed body composition (skeletal muscle and visceral fat index) in axial computed tomography images. Results: A total of 48 patients met the inclusion criteria. The mean age was $68{\pm}10years$, and 33 patients (69%) were men. Dose-limiting toxicity was observed in 22 patients (46%), and treatment was terminated early owing to toxicity in 17 patients (35%). Median follow-up was 17 months. Sarcopenia and sarcopenic obesity were found at diagnosis in 23% and 10% of patients, respectively. We observed an association between termination of chemotherapy and both sarcopenia (P=0.069) and sarcopenic obesity (P=0.004). On multivariate analysis, the odds of treatment termination were higher in patients with sarcopenia (odds ratio=4.23; P=0.050). Patients with sarcopenic obesity showed lower overall survival (median survival of 6 months [95% confidence interval {CI}=3.9-8.5] vs. 25 months [95% CI=20.2-38.2]; log-rank test P=0.000). Conclusions: Sarcopenia and sarcopenic obesity were associated with early termination of neoadjuvant chemotherapy in patients with gastric cancer; additionally, sarcopenic obesity was associated with poor survival.

• Journal of Korean Society of Forest Science
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• v.109 no.2
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• pp.211-222
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• 2020

This study tried to find out whether there is a change over time in the functional classification of forests in relation to human demand for forests. The level in which the concept of ecosystem services has been considered in national forest management plans was also examined. A total of 98 current and previous national forest management plans were available for this study. The composition ratios of the six functions of forests in both the current and previous national forest management plans were surveyed. We used a parametric t-test when the mean values of two (current and previous) groups were normally distributed and used nonparametric Wilcoxon code rank test when the assumption of normality was not met. Timber production forests were shown to follow a normal distribution, while five others, including water regeneration forests, disaster prevention forests, natural environment conservation forests, recreation forests, and living environment conservation forests were not shown to follow a normal distribution. Timber production forests and natural environment forests showed significant changes in the proportion of forest area between previous and current forest management plans. The concept of 'ecosystem services' began to actively appear in the 6th Basic Forest Plan, which started in 2018. However, the level of frequency of the ecosystem services mentioned varied by Regional Forest Services.

• Investigative Magnetic Resonance Imaging
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• v.21 no.2
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• pp.71-81
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• 2017

Purpose: To compare three, motion-resistant, T1-weighted MR sequences on the hepatobiliary phase for gadoxetic acid-enhanced MR imaging of the liver. Materials and Methods: In this retrospective study, 79 patients underwent gadoxetic acid-enhanced, 3T liver MR imaging. Fifty-nine were examined using a standard protocol, and 20 were examined using a motion-resistant protocol. During the hepatocyte-specific phase, three MR sequences were acquired: 1) gradient recalled echo (GRE) with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA); 2) radial GRE with the interleaved angle-bisection scheme (ILAB); and 3) radial GRE with golden-angle scheme (GA). Two readers independently assessed images with motion artifacts, streaking artifacts, liver-edge sharpness, hepatic vessel clarity, lesion conspicuity, and overall image quality, using a 5-point scale. The images were assessed by measurement of liver signal-to-noise ratio (SNR), and tumor-to-liver contrast-to-noise ratio (CNR). The results were compared, using repeated post-hoc, paired t-tests with Bonferroni correction and the Wilcoxon signed rank test with Bonferroni correction. Results: In the qualitative analysis of cooperative patients, the results for CAIPIRINHA had significantly higher ratings for streak artifacts, liver-edge sharpness, hepatic vessel clarity, and overall image quality as compared to, radial GRE, (P < 0.016). In the imaging of uncooperative patients, higher scores were recorded for ILAB and GA with respect to all of the qualitative assessments, except for streak artifact, compared with CAIPIRINHA (P < 0.016). However, no significant differences were found between ILAB and GA. For quantitative analysis in uncooperative patients, the mean liver SNR and lesion-to-liver CNR with radial GRE were significantly higher than those of CAIPIRINHA (P < 0.016). Conclusion: In uncooperative patients, the use of the radial GRE sequence can improve the image quality compared to GRE imaging with CAIPIRINHA, despite the data acquisition methods used. The GRE imaging with CAIPIRINHA is applicable for patients without breath-holding difficulties.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.516-539
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• 1998

The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.8-17
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• 1996

The purpose of this study is a comparative evaluation of range motion, especially extension deficit between the group of total patellectomy and that of intact patella, after reconstruction of the patellar tendon in the prosthetic replacement of a proximal tibia. Between 1990 and 1994, 15 patients who had a primary malignancy on proximal tibia were operated on. All patients were evaluated clinically and radiographically. Two patients were excluded because one had a deep infection treated with arthrodesis of the knee and the other was a composite allograft. The mean follow-up of the 13 patients was 27 months(15-47), including 10 osteosarcomas, 1 chondrosarcoma, 1 malignant fibrous histiocytoma and 1 malignant giant cell tumor. Eleven patients had a resection of the proximal tibia and 2 had an extracapsular total knee resection with distal femur. Reconstruction of the defect was done in 8 cases with a custom-made Link Endo-Model Total Rotation Knee Joint Prosthesis, and in 5 with How Medica Modular Resection System (HMRS). We used two methods to reconstruct the ligamentum patellae. Fixation of the patellar tendon to the prosthesis only with suturing and/or stapling(group SS) was done in 7. Transposition of gastrocnemius muscle to enhance fixation and to cover the prosthesis(group TG) was done in 6. Regardless of fixation methods, total patellectomy was done in 5 either to lengthen the patellar tendon or to make primary skin closure easier or for both. In 8 cases, patella was left intact or resurfaced with polyethylene prosthesis. Active extension was measured while the patient was in a sitting position. There is no statistically meaningful difference in terms of extension deficit (Wilcoxon rank test, p=0.8800) between patellectomy group and intact patella group, and between group of fixation only with suturing and that of gastrocnemius transposition. Two cases of extension deficit over 30 degree were seen in group SS and in the group of intact patella. Conclusively, total patellectomy could be an option without increasing the risk of extension deficit when primary skin closure is difficult or patellar tendon is a little bit short to be fixed. There is no rating in the Enneking system of functional evaluation that this finding into consideration.

• Journal of Korean Public Health Nursing
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• v.4 no.2
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• pp.79-99
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• 1990

This study was conducted to identify the family problems of the in-patients and to analize factors Influencing to the family problems. The subjects for this study were 277 family members those who were giving care for the adult patients during hospitalized in general wards at Seoul National University Hospital in Seoul. Data were collected through interviews with the questionnaire from September second to September twentieth in 1989. The instrument used for this study was the family problems scale which was developed by the researcher. Analysis of data was done by frequency, percent, mean, t-test, ANOVA, Pearson-Correlation Coefficients, and Stepwise Multiple Regression Analysis. The results of this study are summarized as follows: 1. General characteristics of the care-giver in family. The average age of care-givers was 37.9 years, and the $26.4\%$ of monthly Income of family was 310,000-500,000 won group. The $93.5\%$ of family had taken the responsibility of caring for the patients instead of hiring the care-givers, and the $12.3\%$of the care-givers complained weakning of health status during care giving for the patients. The spouse took the largest part of responsibility of the care-giving services to the patient among the family members. 2. General characteristics of the patients. The average age of patient was 47 years, and the $80.9\%$ of patient was married status. The $39\%$ of patient was father in the position of family, and the $41.5\%$ had the responsibility to support their family before hospitalization. The average hospitalization period of patient was 24.3 day and the $50.9\%$ had admission experience. 3. The factors of family problems which were faced by the family were classified into six problems. The factors of family problems were ranked as follows; the first rank problem was related to care-giving for the patients. the second problem was resulted from the patients diseases, the theirds problem was related with adaptation to the hospital enviroments, the fourth problem was related to the arisen conflicts with medical team. the fifth problem was related to the change of family function. and the sixth problem was the financial problem. 4. The relationship between the family problems and the general charateristics of the care-givers showed that the nuclear type family was higher the family problems, that the admission period of patients became longer, and that the family who had the worse condition of health status of the care givers during care giving for the patients. From the above results, it was confirmed that the family care giving for patients was faced with some problems resulted from patient's illness, relation to the medical team, adaptation to the hospital enviroment, financial problem. change of family function, and care-giving for patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.11
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• pp.693-700
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• 2020

This study compared the accuracy and reliability of definitive casts fabricated from a digital impression and conventional impression technique. A master model with the prepared upper full-arch tooth was used. Samples of ten plaster models and ten polyurethane models were duplicated using a selected standard master model. Six linear measurements were recorded between the landmarks, directly on each of the stone models and the polyurethane models on two occasions by a double examiner. The Wilcoxon signed-rank test, interclass correlation coefficient (ICC), measurement error (MSE), and limit of agreement (LoA) were used for statistical analysis. The ICC ranged from 0.76 to 0.99 when comparing the stone models and polyurethane models. The mean difference between the stone models and polyurethane models ranged from 0.09mm to 0.20mm, suggesting that stone models might be slightly larger than polyurethane models. Based on this study, the accuracy of the polyurethane models in evaluating the performance of an oral scanner and subtractive technology was acceptable. Further studies will be needed on patient subjects under clinical conditions that may involve missing or malpositioned teeth and fixed dental prostheses because this study was limited to use a standard master model and duplicated sample models in a laboratory setting.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.786-800
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• 1998

This study has attempted to show general characteristics of health centre directors who have served the post of directorship during the last 40 years. Of 3,000 such health centre directors, information on about 2,500 directors was collected. While average length of service for health center directors has increased, that of vacancy period has decreased. Rural areas have a shorter average length of service than the urban area. Rural areas have twice longer length of vacancy period per health center. Kangwon-do has the longest average length of vacancy period since 1980(2.79 months/year), and Daejeon has the shortest length of vacancy period(0.21 months/year). Chung-buk has no physician directors. The civil servant's rank for the directorship has promoted from the fifth level to the fourth level since 1990. A comparison between the physician director & non-physician director was made as follows : first, the proportion of physician directors had maintained rather high before 1980 s; 62.5% in 1963, 78.3% in 1970, 70.4% in 1980. It decreased to 44.1% in 1990 and 47.6% in 1997. Instead, non-physician directors has abruptly increased since 1980s (12.4% in 1980, 55.4% in 1990 and 50.8% in 1997). Second, physician directors mainly locate in the urban area(58.0% in 1997), but non-physician directors mainly in the rural area(67.2% in 1997). Third, since 1980, the average length of service for physician directors and for non-physician directors has become similar. Fourth, the mean age of physician directors is 45.1 years, and that of non-physician directors 55.7 years. The latter is 10 years older than the former.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2531-2535
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• 2015

Background: Breast cancer diagnosed in young women may be more aggressive, with higher rates of local and distant recurrence compared to the disease in older women. Epidemiologic evidence suggests that Korean women have a lower incidence of breast cancer than women in the United States, but that they present at a younger age than their American counterparts. We sought to compare risk factors and management of young women with breast cancer in Boston, Massachusetts (US) with those in Seoul, South Korea (KR). Materials and Methods: A retrospective review was performed of consecutive patients less than 35 years old with a diagnosis of breast cancer at academic cancer centers in the US and KR from 2000-2005. Patient data were obtained by chart review. Demographic, tumor and treatment characteristics were compared utilizing Pearson's chisquare or Wilcoxon rank-sum tests where appropriate. All differences were assessed as significant at the 0.05 level. Results: 205 patients from the US and 309 from KR were analyzed. Patients in US were more likely to have hormone receptor positive breast cancer, while patients in KR had a higher rate of triple negative lesions. Patients in US had a higher mean body mass index and more often reported use of birth control pills, while those in the KR were less likely to have a sentinel node procedure performed or to receive post mastectomy radiation. Conclusions: Patients under 35 diagnosed with breast cancer in the US and KR differ with respect to demographics, tumor characteristics and management. Although rates of breast conservation and mastectomy were similar, US patients were more likely to receive post mastectomy radiation. The lower use of sentinel node biopsy is explained by the later adoption of the technique in KR. Further evaluation is necessary to evaluate recurrence rates and survival in the setting of differing disease subtypes in these patients.