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The Relationship between Socioeconomic Status and Gastric Cancer Screening in the Population of a Metropolitan Area (일 광역단위에서의 사회경제적 수준과 위암 수검률과의 관련성)

  • Oh, Hyun-Suk;Kim, Sun A;Kweon, Sun-Seog;Rhee, Jung-Ae;Ryu, So-Yeon;Shin, Min-Ho
    • Journal of agricultural medicine and community health
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    • v.38 no.3
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    • pp.174-181
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    • 2013
  • Objectives: Socioeconomic status plays an important role in health care and disease prevention. This study aimed to examine the association between socioeconomic status, measured by education levels and household income, and gastric cancer screening. Methods: A total of 21,220 community-dwelling adults aged 40 to 69 years within a defined geographic area participated in a community health survey in 2009 and 2010. The survey was conducted using a structured questionnaire by trained investigators who visited the subjects' households directly. Logistic regression analysis was used to determine the relationship between self-reported participation in gastric cancer screening and socioeconomic variables (education and household income). Results: The gastric cancer screening rate was 52.1% for subjects in their forties, 63.7% for those in their fifties, and 67.3% for those in their sixties. In multivariate analysis, higher education and income levels were associated with higher rates of gastric cancer screening (high school vs. elementary school: odds ratio [OR] 1.41, 95 % confidence interval [CI] 1.26-1.58; highest income quartile vs. lowest income quartile: OR 1.62, 95% CI 1.44-1.84). The gradient between income and screening rate was more pronounced in the population aged 40 to 49 years than in the other age groups. Conclusions: This study demonstrates that lower socioeconomic status is associated with decreased participation in gastric cancer screening. Our findings suggest that the screening program should be focused on low-income and less-educated populations, especially among younger adults, to reduce health disparities.

Psychosocial Factors Predicting Delayed Diagnosis of Breast Cancer : The Role of Marital Relationship Functioning (지연된 유방암 진단을 예측하는 정신사회적 요인 : 부부관계기능의 역할)

  • Kim, Ji Young;Woo, Jungmin;Lee, Sang Shin;Kim, Hea Won;Khang, Dongwoo;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.13-22
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    • 2014
  • Objectives : Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. Methods : Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. Results : Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p<0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after diagnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. Conclusions : We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.

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Development of A Cognitive-Behavioral Anger Control Program and It's Effects on Elementary School Children Under the Anger-inducing Situation (초등학생의 분노유발상황에 초점을 둔 인지행동적 분노조절 프로그램의 효과)

  • Lee, Mi-Gyeong
    • The Korean Journal of Elementary Counseling
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    • v.6 no.1
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    • pp.141-169
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    • 2007
  • One of the most common feelings in everyday life is anger. Anger plays an important role in activating emotional energy and increasing intolerance when confronted with hardships, frustration and improper treatments. And it provides us with controlling interpersonal behavior, organizing internal, physiological, psychological process and various adaptive functions. If anger is not properly expressed, it brings about offensive attitude, leading to not only physical impairment but also anxiety in interpersonal relations and maladaptive to everyday life. For elementary school students, frequent quarrels, abusive words and defiant attitude toward adults are also caused by students' anger. Therefore, students' anger is one of the most difficult problems to be dealt with not only psychologically but also in elementary schools. In this respect, after investigating frequently experienced anger- inducing situations and inventing anger-inducing situation questionnaire, we postulated specific situations changing irrational belief into rational one. Based on these situations, we accounted for how to cope with anger inducing factors and change irrational belief into rational one, introducing several strategies needed to control anger, invented cognitive behavioral anger control program and tried to clarify the relationship between anger inducing experience and anger regulation ability. In order to derive usual anger-inducing situations, we made 180 students with fifth and sixth grade to record the reason why he/she got angry, mood, thought, behavior and result. Through this process, we could derive 47 situations bringing about anger and prepared anger-inducing situation questionnaire. It can be divided into 3 anger inducing situations by using factor analysis into 500 elementary students of fifth and sixth grade. Cognitive behavioral anger control program used in this study consists of 13 sessions. From first to fifth session, it is composed of 10 anger control methods to make students be aware of and control their anger. From sixth through thirteenth session, the relationship between irrational belief and anger inducing is introduced is focused on how irrational belief is changed into rational one. To examine the effects of the program, high anger students and the students lacking anger control are selected. Thirty students through pre-test using anger-inducing questionnaire and anger control ability questionnaire are taught the goals and procedures. Volunteer students and students with parents' consent allocated to experimental group (12 students) and the rest of the students are control group (12 students). Cognitive Behavioral Anger Control Program are applied every 50 minutes twice a week for 7 weeks and 4 weeks before and after this program, anger-inducing situation questionnaire and anger control ability questionnaire are practiced. Data collected in this study analyzed by SPSS and Kwakstat. In the middle of this program, quarterly reports and satisfaction measuratings were evaluated to examine whether there is verbal and non-verbal behavior change and students feel satisfied with the program. The results of this study are as follows: First, Cognitive-behavioral anger control program used in this study effectively reduced anger experience and lasted for 4 weeks. Second, cognitive behavioral anger control program increased students' ability to control anger inducing situations and also effective for 4 weeks. And its effect on verbal and non-verbal behaviour was very impressive Students come to realize that irrational belief is the cause of their anger and actively apply cognitive-behavioral anger control technique to themselves as well. Students became improved in their peer relations and felt confident in everyday life. The overall evaluation of this program can be listed as follows; "very satisfactory (91.67%)", "satisfactory (8.33%)", "very helpful (91.67%)", "helpful (8.33%). In this study we first investigated several anger-inducing situations and invented anger-inducing situation questionnaire and then applied cognitive behavioral anger control program in order to control their. anger and not to experience it. By creating workbooks and manuals this method can easily be used in school education settings.

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Correlation Between the Expression of Amino Acid Transporter LAT1 mRNA and the Amount of L - Leucine Transport in Human Cancer Cell Lines (사람 암세포주들에서 아미노산 수송체 LAT1 mRNA 발현과 아미노산 L - Leucine 수송의 상관관계)

  • Kim, Do-Kyung;Song, Soo-Keun;Kim, In-Jin;Kook, Joong-Ki
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.9
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    • pp.1451-1456
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    • 2004
  • Amino acid transporters play an important role in supplying nutrients to normal and cancer cells for cell proliferation. System L is a major transport system responsible for the $Na^+$ -independent, large neutral amino acids including several essential amino acids. L-type amino acid transporter 1 (LAT1), an isoform of system L amino acid transporter, is highly expressed presumably to support their continuous growth and proliferation in malignant tumors. In the present study, we have examined the correlation between the expressions of amino acid transporter LAT1 mRNA and its subunit 4F2hc mRNA and the amount of L-leucine transport in various human cancer cell lines. Northern blot analysis have revealed that the 26 human cancer cell lines expressed LAT1 mRNA and 4F2hc mRNA. There were the differences for the levels of LAT1 and 4F2hc mRNA expressions in the 26 human cancer cell lines. The 26 human cancer cell lines transported the L-[$^{14}C$]leucine into the cells via amino acid transporter. In the 26 human cancer cell lines, a linear relationship was observed between the expression of amino acid transporter LAT1 mRNA and the amount of L-leucine transport. Little relationship was observed between the expression of 4F2hc mRNA and the amount of L-leucine transport, but the statistical significance of difference was not detected. These results indicate that the 26 human cancer cell lines express LAT1 mRNA and 4F2hc mRNA and there is the correlation between the expression of amino acid transporter LAT1 mRNA and the amount of L-leucine transport. In addition, specific inhibition of LAT1 in cancer cells will be a new rationale for anti-cancer therapy.

Retrospect and Prospect of Medical Law 20th Anniversary (Medical Criminal Law) (의료법학 20주년 회고와 전망(의료형법 분야))

  • Ha, Tae Hoon
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.47-79
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    • 2019
  • The Korean Society of Law and Medicine has faithfully played the role of professional academic organizations last 20 years in terms of academic activities, accumulated achievements, diversity, professionalism, and influence on academic circles. The Korean Society of Law and Medicine and the Journal of Medical Law serve as a platform for academic information and exchange of opinions on medical law. Medical law began in the midst of increasing conflicts and disputes caused by medical malpractice and the enactment and legal coercion of medical care as pressure on medical workers. It tried to find a way to coexist with each other through the encounter and convergence of medicine and law. Medical criminal law extends from traditional crimes in the realm of life and body protection to bioethics violations caused by the development of biomedical technology, corruption and economic crime in the medical field. Medical law has evolved into a comprehensive legal area dealing with legal issues raised in medical treatment, healthcare, bioethics, and life sciences technology. On the legal side, medical law is not independent legal areas. It is overlapping with traditional law areas such as civil law, administrative law, criminal law, social law, civil and criminal procedure law. However, it is now established as a convergence study in medicine, bioethics, life science, as well as in various fields of law. It has become an area where collaboration is needed with the field of law, medicine, ethics, sociology and economics. Medical criminal law has undergone a dynamic development over the last two decades. The development of medicine and medical technology provides new and innovative methods of diagnosis and treatment. The achievements and risks of revolutionary developments in biotechnology, genetic engineering and medicine coexist. While there is a dazzling achievement that mankind has hoped for: combating disease and improving health, it also creates unwanted side effects and risks to humans. There is a need to reconsider ethical and legal principles. The discovery and development of patient identity and autonomy has changed the medical doctor-patient relationship. Furthermore, it was complicated by the triangle relationship of patients, medical doctors and insurance. Legal matters are also complicated. This is why the necessity of legislation is emerging. Criminal punishment provisions are also required. The Medical Law and Biomedical Law are systematically and coherently deformed as mosaic-based legislation that takes place whenever there are social issues, citizens' needs, and medical organizations' interests, rather than sufficient enactment and revision procedures. It needs a complete overhaul, and this is possible through interdisciplinary collaboration which is the strength of The Korean Society of Law and Medicine.

EGFR, p53, Cox-2 and Bcl-2 Expression in Nasopharyngeal Carcinoma and Their Potential Clinical Implication (비인강암에서 예후인자로서의 EGFR, p53, Cox-2, Bcl-2 단백발현)

  • Chae, Soo-Min;Lee, Youn-Soo;Roh, Kwang-Won;Chung, Su-Mi;Yoon, Sei-Chul;Jang, Hong-Seok;Kim, Yeon-Sil
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.43-53
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    • 2007
  • [ $\underline{Purpose}$ ]: To evaluate the relationship between the expression of EGFR, p53, Cox-2, Bcl-2 and the clinical parameters of NPC (nasopharyngeal carcinoma) patients treated with radiotherapy with/without chemotherapy, and to determine if these could be used as a biologic marker. $\underline{Materials\;and\;Methods}$: This study retrospectively examined 75 NPC patients who were pathologically diagnosed at St. Mary's Hospital and Kangnam St Mary's Hospital from March 1988 to August 2002 and treated with radiotherapy with/without chemotherapy. The levels of EGFR, p53, Cox-2, and Bcl-2 expression were determined immunohistochemically. The relationship between the levels of EGFR, p53, Cox-2 and Bcl-2 expression and the H- E staining findings including the WHO classification, TNM stage, tumor response to chemotherapy and radiotherapy, disease free survival (DFS), and overall survival (OS) was analyzed. $\underline{Results}$: At a median follow up of 50.8 months (range: $5.5{\sim}201$ months), the 3 years OS rate and PFS rate were 68.7% and 68.2%, respectively. The five year OS rate and PFS rate were 53.5% and 51.1%, respectively. The median OS duration and PFS duration were 85.5 months and 61.1 months, respectively. The WHO classification correlated with the complete response rate, lymph node metastasis and distant metastasis. The expression of p53 was associated with increased mitosis and poor overall survival. The expression of Bcl-2 correlated with the DFS and WHO classification. The expression of Cox-2 correlated with a poor overall survival and response rate in the lymph node. However, EGFR was not correlated with any factors. $\underline{Conclusion}$: These results suggest that the expression of p53, Cox-2, Bcl-2 plays role in predicting prognostic factors for NPC treated with radiotherapy with/without chemotherapy. However, further study on a larger number of patients will be needed to identify more useful biomarkers of NPC.

Mouse model system based on apoptosis induction to crypt cells after exposure to ionizing radiation (방사선에 전신 조사된 마우스 음와 세포의 아포토시스 유도를 이용한 생물학적 선량 측정 모델 개발 연구)

  • Kim, Tae-Hwan
    • Korean Journal of Veterinary Research
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    • v.41 no.4
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    • pp.571-578
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    • 2001
  • To evaluate if the apoptotic fragment assay could be used to estimate the dose prediction after radiation exposure, we examined apoptotic mouse crypt cells per 1,000 cells after whole body $^{60}Co$ $\gamma$-rays and 50MeV ($p{\rightarrow}Be^+$) cyclotron fast neutron irradiation in the range of 0.25 to 1 Gy, respectively. The incidence of apoptotic cell death rose steeply at very low doses up to 1 Gy, and radiation at all doses tigger rapid changes in crypt cells in stem cell region. These data suggest that apoptosis may play an important role in homeostasis of damaged radiosensitive target organ by removing damaged cells. The curve of dose-effect relationship for the data of apoptotic fragments was obtained by the linear-quadratic model $y=0.18+(9.728{\pm}0.887)D+(-4.727{\pm}1.033)D^2$ ($r^2=0.984$) after $\gamma$-rays irradiation, while $y=0.18+(5.125{\pm}0.601)D+(-2.652{\pm}0.7000)D^2$ ($r^2=0.970$) after neutrons in mice. The dose-response curves were linear-quadratic, and a significant dose-response relationship was found between the frequency of apoptotic cell and dose. These data show a trend towards increase of the numbers of apoptotic crypt cells with increasing dose. Both the time course and the radiation dose-response curve for high and low linear energy transfer (LET) radiation modalities were similar. The relative biological effectiveness (RBE) value for crypt cells was 2.072. In addition, there were significant peaks on apoptosis induction at 4 and 6h after irradiation, and the morpholoigcal findings of the irradiated groups were typical apoptotic fragments in crypt cells that were hardly observed in the control group. Thus, apoptosis in crypt cells could be a useful in vivo model for studying radio-protective drug sensitivity or screening test, microdosimetric indicator and radiation-induced target organ injury. Since the apoptotic fragment assay is simple, rapid and reproducible in the range of 0.25 to 1 Gy, it will also be a good tool for evaluating the dose response of radiation-induced organ damage in vivo and provide a potentially valuable biodosimetry for the early dose prediction after accidental exposure.

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Serum and Cerebrospinal Fluid(CSF) Nitric Oxide, Macrophage Inflammatory Protein-1 α and Lactoferrin Levels in Aseptic Meningitis (무균성 뇌수막염 환자의 뇌척수액과 혈청에서 Nitric Oxide, Macrophage Inflammatory Protein(MIP)-1α, Lactoferrin 값의 비교)

  • Seo, Young;Sim, Jung Yeon;Shim, Jae Won;Kim, Deok Su;Jung, Hye Lim;Park, Moon Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.48-54
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    • 2005
  • Purpose : The pathologic mechanisms of central nervous system(CNS) injuries in human meningitis are not yet completely understood. Recent studies indicate that the host inflammatory responses are as important in brain damage as the infecting organisms and toxins. There have been some reports on the relationship of nitric oxide(NO), macrophage inflammatory protein-$1{\alpha}$(MIP-$1{\alpha}$), and lactoferrin in bacterial meningitis, but few reports in aseptic meningitis. Thus, we investigated the concentrations of NO, MIP-$1{\alpha}$ and lactoferrin in cerebrospinal fluid(CSF) and serum of patients with aseptic meningitis and control subjects and evaluated their relationship with other parameters of meningitis. Methods : CSF and blood were obtained from 25 subjects with aseptic meningitis and 15 control subjects. After centrifugation, supernatants were stored at $-70^{\circ}C$ and we assayed the concentrations of NO, MIP-$1{\alpha}$ and lactoferrin with the ELISA method. There were no patients with neurologic sequelae after being recovered from aseptic meningitis. Results : Concentrations of CSF and serum NO, MIP-$1{\alpha}$ were not increased in aseptic meningitis subjects compared to control subjects. Concentration of CSF lactoferrin was significantly elevated in patients with aseptic meningitis and concentration of serum lactoferrin was significantly decreased in patients with aseptic meningitis compared with those in control subjects(P<0.05). CSF lactoferrin level was positively correlated with CSF WBC counts($r_s=0.449$, P=0.007), especially with neutrophil counts($r_s=0.574$, P<0.001) and CSF protein level($r_s=0.508$, P=0.002). Conclusion : Lactoferrin plays an important role in aseptic meningitis and may be released from neutrophils recruited from blood to the CSF through breakdown of blood-brain barrier. NO and MIP-$1{\alpha}$ may not be important factors in the pathogenesis of aseptic meningitis without neurologic sequelae.

Influence of Sociocultural Services on Brand Image and Loyalty of Cafe (카페의 브랜드 이미지와 충성도에 대한 사회문화성서비스 영향)

  • Kim, Yeon Jong;Seol, Byung Moon;Mun, Hee Jung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.12 no.5
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    • pp.163-175
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    • 2017
  • The purpose of this study is to find out how to improve the brand image and loyalty of cafe by recognizing that social culture of middle school cafe, which is an important service quality in cafe establishment, emerges as a main characteristic of new coffee business. First, reliability, confidentness, professionalism, accessibility, and socio - culturality of the service quality of coffee specialty shops improve brand image. Confidence and professionalism play an important role in enhancing brand loyalty, and brand image has a significant effect on brand loyalty. Respectively, Among the service quality, social culture has a strong influence on brand image but it is not a direct influence on brand loyalty. Second, in the relationship between brand loyalty of coffee service quality, brand image shows full mediation effect on reliability, partial mediation effect on confidence, professionalism, accessibility, socialcultural property, and mediation effect on response and empathy. Third, as a result of analyzing the moderating effects of coffee shop types on the relationship between service quality and brand image of coffee specialty shops, reliability, confidentiality, and accessibility are positive factors in the nationwide franchise. On the other hand, in the private $caf{\acute{e}}$, professionalism and socio-culturality are the main factors for improving the brand image. In the case of the local franchise, similar to the franchise in the country, the improvement of service quality for responsiveness and professionalism is a positive factor Respectively. As a result, nationwide franchise $caf{\acute{e}}s$ have priority in enhancing brand image and brand loyalty through accessibility and assurance of service quality. On the other hand, in case of local franchise $caf{\acute{e}}$, it can be seen that the service quality is enhanced and the brand image and brand loyalty can be further improved through service professionalism and accessibility. On the other hand, regional cafes are more important than national franchises or local franchise cafes, and a strategy to enhance customer loyalty is needed through service strategies emphasizing socio - cultural aspects.

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Factors Affecting Participation Intention of the 4th Industrial Technology Education: Applying MGB Model (4차 산업혁명 기술교육의 참여의도에 영향을 미치는 요인 연구: 목표지향행동모델(MGB)을 중심으로)

  • Lee, Jihyun;Dong, Haklim
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.4
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    • pp.231-244
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    • 2020
  • With the rapid progress of the 4th industrial revolution, technical human capitals are considered to be the core competing factors of the enterprise. Technical manpower training of the 4th industrial revolution through technical education has become an essential task of venture start-ups. The opening of technical training courses and the education support system of companies are increasing, but the shortage of technical manpower is getting worse. This study was conducted to analyze the factors affecting participation intention of the 4th industrial revolution technology education. The research model was established based on the model of goal-directed behavior. For the analysis, 250 valid questionnaire data were used to test with a structural equation model. The results of the study are as follows. First, attitude had a positive effect on the intention to participate in education. Second, subjective norms had a positive effect on the intention to participate in education. Third, the perceived behavioral control has not been tested for a significant influence on educational participation intention. Fourth, positive and negative anticipated emotions had a significant effect on educational intention. The impact of significant variables were found in the order of positive anticipated emotions, attitudes, negative anticipated emotions, subjective norms. On the other hand, as a result of testing the mediating effect of desires, it was found that desires plays a mediating role between attitude, subjective norm, perceived behavioral control, positive anticipated emotions, negative anticipated emotions, and participation intention. In particular, the causal relationship between perceived behavioral control and intention to participate in education was not significant, but perceived behavioral control had a significant effect(full mediation) on participation intention through desires. Based on the results of this study, the following implication were suggested. First, the model of goal-directed behavior(MGB) was applied to the technical education field. Second, the direct relationship between antecedent variables and behavioral intentions was simultaneously tested. Third, unlike the existing education-related research, the factors affecting participation in education were analyzed. Fourth, the importance of desires for education were suggested.