• Annals of Coloproctology
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• 제34권6호
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• pp.286-291
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• 2018

Purpose: Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer. Methods: From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary endpoint was the 5-year DFS. Results: The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1-134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19-1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29-2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08-2.15; P < 0.01) and a high (${\geq}0.4$) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63-5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC. Conclusion: Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.

• 한국심리학회지:여성
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• 제16권3호
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• pp.303-329
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• 2011

우리나라는 여성의 교육참여율이 과거 어느 때보다 높은데 비해 인력활용율은 OECD국가 중 최저 수준에 머물고 있다. 이렇게 고학력 여성인력의 활용률이 저조한 원인으로 진로상담영역에서 '진로선택'과 관련된 원인에 주목하였다. 전통적으로 직업을 여성중심 또는 남성 중심 직업으로 분류할 때 아직까지도 많은 여성들이 남성중심 직업을 회피하는 경향이 있으며, 이러한 편중현상을 해소해야만 다양한 인력활용이 가능할 것이다. 이를 위해 본 연구에서는 남성중심적 직업을 희망하는 여대생들에 대한 질적 연구를 통해 이들의 경험구조 및 직업결정 과정을 밝히고, 그 과정에서 부정적 또는 긍정적으로 작용하는 요인들을 밝혀 여성 진로지도에 활용하고자 하였다. 남성중심적 직업을 선택하며 취업준비중인 대학교 3학년 이상 여학생 8명을 심층면접한 녹음자료를 분석한 결과 총 61개의 개념과 27개의 하위범주, 12개의 범주가 도출되었다. 범주들을 토대로 핵심범주인 '특별한 삶을 위해 의지를 갖고 도전해 나가기'가 도출 되었다. 또한 패러다임 분석을 통해 인과적 조건, 중심현상, 맥락적 조건, 중재적 조건, 작용/상호작용 전략과 결과를 구분하였다. 과정 분석을 통해 기질과 포부 인식 단계, 내적결의 단계, 지지와 수용 단계, 도전과 극복의 순환 단계, 긍정과 확신의 단계로 총 5 단계의 직업결정 과정이 밝혀졌다. 논의에서는 연구의 의의와 제한점 및 후속연구에 대한 제안에 대해 언급하였다.

• 보건교육건강증진학회지
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• 제21권1호
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• pp.153-170
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• 2004

Objectives： This study was performed to develop a smoking prevention program for Korean high school students, and to evaluate the effects of the program. Methods： A smoking prevention program, composed of five-session curriculum, was developed by modifying several smoking prevention and cessation programs based on the Social Influence Model. The program was applied to the freshmen of a technical high school. We surveyed with a questionnaire one week before education, one week after education, and two months after education. The number of participants for data analysis were 282(181 males, 101 females). Among those, 162(97 males, 65 females) students were allocated to the education group, and the other 120(84 males, 36 females) students were allocated to the control group. The effect of education was analyzed by multiple logistic regression analysis adjusted by potential confounders. Results： Among smokers, those who had education were more likely to quit smoking (OR＝2.99, 95% confidence interval(CI) 0.84-10.64), and to decrease smoking frequency(OR＝2.29, 95% CI 0.95-5.53) in borderline significance one week after education. However, the effect of education disappeared two months after education. The effect of education was significant(OR＝9.11, 95% CI 3.22-25.76) for the increase of smoking cessation intention one week after education, and it persisted until two months after education(OR＝2.94, 95% CI 1.18-7.35). Education was also a significant predictor(OR＝1.97, 95% CI 0.89-4.37) for the increase of smoking cessation stage one week after education and it persisted(OR＝6.39, 95% CI 2.42-16.86) after two months. Among non-smokers, those who had education were more likely to decrease smoking intention one week after education(OR＝4.71, 95% CI 1.63-13.58). However, the statistical significance of education disappeared two months after education. Conclusions： The results showed that the smoking prevention program developed in this study changed smoking behaviors immdeiately after education even though the effect did not persist. However, this program was successful in increasing smoking cessation intention and stage of smoking cessation among smokers.

• Clinical and Experimental Pediatrics
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• 제56권3호
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• pp.112-115
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• 2013

Purpose: To investigate the association between necrotizing enterocolitis (NEC) and red blood cell transfusions in very low birth weight (VLBW) preterm infants. Methods: We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell's criteria) and a control group (less than stage II on the modified Bell's critieria). We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18) in the NEC group and the frequency of transfusion until 18 days after birth in the control group. Results: Of the 180 subjects, 18 (10%) belonged to the NEC group, and 14 (78%) of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received $3.1{\pm}2.9$ transfusions, and the control group received $1.0{\pm}1.1$ transfusions before the NEC diagnosis (P=0.005). In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P=0.007) with transfusion before the NEC diagnosis. Conclusion: The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.

• Journal of Gastric Cancer
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• 제16권3호
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• pp.161-166
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• 2016

Purpose: Lymph node (LN) metastasis is the best prognostic indicator in non-distant metastatic advanced gastric cancer. This study aimed to assess the prognostic value of various clinicopathologic factors in node-negative advanced gastric cancer. Materials and Methods: We retrospectively analyzed the clinical records of 254 patients with primary node-negative stage T2~4 gastric cancer. These patients were selected from a pool of 1,890 patients who underwent radical resection at Memorial Jin-Pok Kim Korea Gastric Cancer Center, Inje University Seoul Paik Hospital between 1998 and 2008. Results: Of the 254 patients, 128 patients (50.4%), 88 patients (34.6%), 37 patients (14.6%), and 1 patient (0.4%) had T2, T3, T4a, and T4b tumors, respectively. In a univariate analysis, operation type, T-stage, venous invasion, tumor size, and less than 15 LNs significantly correlated with tumor recurrence and cumulative overall survival. In a multivariate logistic regression analysis, tumor size, venous invasion, and less than 15 LNs significantly and independently correlated with recurrence. In a multivariate Cox proportional hazards analysis, tumor size (hazard ratio [HR]: 2.926; 95% confidence interval [CI]: 1.173~7.300; P=0.021), venous invasion (HR: 3.985; 95% CI: 1.401~11.338; P=0.010), and less than 15 LNs (HR: 0.092; 95% CI: 0.029~0.290; P<0.001) significantly correlated with overall survival. Conclusions: Node-negative gastric cancers recurred in 8.3% of the patients in our study. Tumor size, venous invasion, and less than 15 LNs reliably predicted recurrence as well as survival. Aggressive postoperative treatments and timely follow-ups should be considered in cases with these characteristics.

• 한국실내디자인학회논문집
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• 제16권5호
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• pp.71-80
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• 2007

Although the history of the contemporary museum architecture is relatively short, the concept of its existence has changed owing to its openness to the spectators at large. Within the short period of time, it has developed into a multi functional architecture with eduinfortainment function for the general publics in concert of the changes of its social activities in addition to its innate function as a museum to meet the intellectual desires of the spectators. Therefore, this study looks Into how to suffice the ever changing Intellectual desires of the spectators and the various spatial correspondences in accordance with the social and cultural roles of the museum with purpose to present the materials of the typological characteristics of the third generation museum architecture, which shows diversifying propensity, by means of an analytical study on the characteristics of the third generation museum architecture with confidence in mind that such materials are needed in the early planning stage. The chapter 2 divides the museum architecture into three generations for a comparative analytical study and presents the three classification standards thru the preceding studies related to the museum typological classifications. In accordance with the standards, 60 selective art museums have been classified by their typological patterns. The chapter 3 shows the result of the typological space classification of the 60 art museums through an analyzation on the typological characteristics and the interrelations of them. Such study is considered to furnish important measures for the realization of the substance of the museum architecture. At the same time, it Is also judged to play an instrumental role for the theoretical system of the communication function and classification required in the early designing stage as well as to play an educational role important as the designing guide line.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6387-6390
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• 2014

Background: The prognostic significance of the circulating absolute monocyte count (AMC) in patients with locally advanced hepatocellular carcinoma (HCC) is uncertain. This study was designed to assess the association of circulating AMC with survival outcomes in patients diagnosed with locally advanced or metastatic HCC receiving systemic chemotherapy. Materials and Methods: Between January 1, 2005 and December 30, 2012, locally advanced or metastatic HCC patients who had Child-Pugh stage A or B disease and received systemic chemotherapy were retrospectively enrolled. Patient features including gender, age, extrahepatic metastasis, Child-Pugh stage, serum alpha-fetoprotein(AFP) level and AMC were collected to investigate their prognostic impact on overall survival(OS). Results: A total of 216 patients were eligible for the study. The optimal cut-off value of AMC for OS analysis was $0.38{\times}10^9/L$. Median OS was 5.84 months in low-AMC group (95% confidence interval [CI], 5.23 to 6.45), and 5.21 months in high-AMC group (95% CI, 4.37 to 6.04; p=0.003). In COX multivariate analysis, elevated AMC remained as an independent prognostic factor for worse OS (HR, 1.578; 95% CI, 1.120 to 2.223, p=0.009). Conclusions: Our results indiicate that circulating AMC is confirmed to be an independent prognostic factor for OS in patients with locally advanced or metastatic HCC receiving systemic chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3331-3335
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• 2013

Background: The incidence of prostate cancer, one of the most common cancers in elderly men, is increasing annually in Thailand. Matrix metalloproteinase 11 (MMP-11) is a member of the extracellular matrix metalloproteases which has been associated with human tumor progression and clinical outcome. Aim: To quantify MMP-11 expression in prostatic adenocarcinoma tissues and to determine whether its overexpression correlates with survival outcome, and to assess its potential as a new prognostic marker. Materials and Methods: Expression of MMP-11 was analyzed using immunohistochemistry in 103 Thai patients with prostatic adenocarcinoma. Overall survival was analyzed using Kaplan-Meier methods and Cox regression models. Results: Immunoreactivity of MMP-11 was seen in the stroma of prostatic adenocarcinoma tissue samples, high expression being significantly correlated with poor differentiation in Gleason grading, pathologic tumor stage 4 (pT4), and positive-bone metastasis (p<0.05), but not age and prostatic-specific antigen (PSA) level. Patients with high levels of MMP-11 expression demonstrated significantly shorter survival (p<0.001) when compared to those with low levels. Multivariate analysis showed that MMP-11 expression and pT stage were related with survival in prostatic adenocarcinoma [hazard ratio (HR)=0.448, 95% confidence interval (95%CI)=0.212-0.946, HR=0.333, 95%CI=0.15-0.74, respectively]. Conclusions: Expression of MMP-11 is significantly associated with survival in prostatic adenocarcinoma. High levels may potentially be used for prediction of a poor prognosis.

• Journal of Korean Neurosurgical Society
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• 제51권1호
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• pp.24-30
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• 2012

Objective : This study was conducted to assess the clinical significance of traumatic brain stem injury (TBSI) reflected on Glasgow Coma Score (GCS) and Glasgow Outcome Score (GOS) by various clinical variables. Methods : A total of 136 TBSI patients were selected out of 2695 head-injured patients. All initial computerized tomography and/or magnetic resonance imaging studies were retrospectively analyzed according to demographic- and injury variables which result in GCS and GOS. Results : In univariate analysis, mode of injury showed a significant effect on combined injury (p<0.001), as were the cases with skull fracture on radiologic finding (p<0.000). The GCS showed a various correlation with radiologic finding (p<0.000), mode of injury (p<0.002), but less favorably with impact site (p<0.052), age (p<0.054) and skull fracture (p<0.057), in order of statistical significances. However, only GOS showed a definite correlation to radiologic finding (p<0.000). In multivariate analysis, the individual variables to enhance an unfavorable effect on GCS were radiologic finding [odds ratio (OR) 7.327, 95% confidence interval (CI)], mode of injury (OR; 4.499, 95% CI) and age (OR; 3.141, 95% CI). Those which influence an unfavorable effect on GOS were radiologic finding (OR; 25.420, 95% CI) and age (OR; 2.674, 95% CI). Conclusion : In evaluation of TBSI on outcome, the variables such as radiological finding, mode of injury, and age were revealed as three important ones to have an unfavorable effect on early stage outcome expressed as GCS. However, mode of injury was shown not to have an unfavorable effect on late stage outcome as GOS. Among all unfavorable variables, radiological finding was confirmed as the only powerful prognostic variable both on GCS and GOS.

• Radiation Oncology Journal
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• 제37권3호
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• pp.185-192
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• 2019

Purpose: The effectiveness of thoracic radiation therapy (TRT) in extensive-stage small cell lung cancer (ES-SCLC) patients is increasingly reported, but there is no definite consensus on its application. The aim of this study was to identify factors associated with better outcomes of TRT among patients with ES-SCLC, focusing on whether a higher TRT dose could improve treatment outcome. Materials and Methods: The medical records of 85 patients with ES-SCLC who received TRT between January 2008 and June 2017 were retrospectively reviewed. Eligibility criteria were a biological effective dose with α/β = 10 (BED) higher than 30 Gy₁₀ and completion of planned radiotherapy. Results: During a median follow-up of 5.3 months, 68 patients (80.0%) experienced disease progression. In univariate analysis, a BED >50 Gy₁₀ was a significant prognostic factor for overall survival (OS; 40.8% vs. 12.5%, p = 0.006), progression-free survival (PFS; 15.9% vs. 9.6%, p = 0.004), and intrathoracic PFS (IT-PFS; 39.3% vs. 20.5%, p = 0.004) at 1 year. In multivariate analysis, a BED >50 Gy₁₀ remained a significant prognostic factor for OS (hazard ratio [HR] = 0.502; 95% confidence interval [CI], 0.287-0.876; p = 0.015), PFS (HR = 0.453; 95% CI, 0.265-0.773; p = 0.004), and IT-PFS (HR = 0.331; 95% CI, 0.171-0.641; p = 0.001). Response to the last chemotherapy was also associated with better OS in both univariate and multivariate analysis. Conclusion: A TRT dose of BED >50 Gy₁₀ may be beneficial for patients with ES-SCLC. Further studies are needed to select patients who will most benefit from high-dose TRT.