• Korean Journal of Radiology
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• v.21 no.7
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• pp.880-890
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• 2020

Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (D_Thorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. D_Thorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between D_Thorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. D_Thorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. D_Thorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV₁) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DL_CO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower D_Thorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower D_Thorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV₁, and lower DL_CO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.483-486
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• 2012

Background: The hepatocellular carcinoma is very common in China. Our aim in this report was to investigate clinical and pathological factors based on the current decade data that could influence prognosis of HCC patients after hepatectomy. Methods: Between 2002 and 2009, all patients undergoing hepatectomy for HCC were followed up and reviewed retrospectively. Prognostic factors were studied by univariate and multivariate analysis, with Kaplan-Meier and Cox multivariate survival analyses. Results: Complete clinicopathologic and follow-up data were available for 114 patients. The estimated cumulative survival rates at 1, 3, and 5 yr were 84.6%, 60.2% and 51.8%, respectively. On univariate analysis, key prognostic factors were AFP level, GGT level, tumor size, number of tumors, portal vein invasion, liver cirrhosis status and TNM stage. In the multivariate analysis, tumor size, GGT level, liver cirrhosis status and portal vein invasion were significantly associated with patients' prognosis. Conclusion: Through follow-up of a relatively large cohort of Chinese patients, tumor size, GGT level, liver cirrhosis status, portal vein invasion were revealed as important factors for long-term survival after hepatectomy. Early diagnosis for tumor and the improvement of liver function before surgery are important ways to improve the prognosis.

• The korean journal of orthodontics
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• v.47 no.5
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• pp.298-305
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• 2017

Objective: This paper describes changes in the characteristics of patients seeking orthodontic treatment over the past decade and the treatment they received, to identify any seasonal variations or trends. Methods: This single-center retrospective cohort study included all patients who presented to Seoul National University Dental Hospital for orthodontic diagnosis and treatment between January 1, 2005 and December 31, 2015. The study analyzed a set of heterogeneous variables grouped into the following categories: demographic (age, gender, and address), clinical (Angle Classification, anomaly, mode of orthodontic treatment, removable appliances for Phase 1 treatment, fixed appliances for Phase 2 treatment, orthognathic surgery, extraction, mini-plate, mini-implant, and patient transfer) and time-related variables (date of first visit and orthodontic treatment time). Time series analysis was applied to each variable. Results: The sample included 14,510 patients with a median age of 19.5 years. The number of patients and their ages demonstrated a clear seasonal variation, which peaked in the summer and winter. Increasing trends were observed for the proportion of male patients, use of non-extraction treatment modality, use of ceramic brackets, patients from provinces outside the Seoul region at large, patients transferred from private practitioners, and patients who underwent orthognathic surgery performed by university surgeons. Decreasing trends included the use of metal brackets and orthodontic treatment time. Conclusions: Time series analysis revealed a seasonal variation in some characteristics, and several variables showed changing trends over the past decade.

• Survey Research
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• v.13 no.1
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• pp.1-31
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• 2012

Demographic Analysis(DA) as well as Post Enumeration Survey(PES) are typical methods for evaluating completeness of census and vital statistics. In spite of its popularity, DA has never been attempted in Korea, while other international journals of demography have pointed out the backwardness of death registration in Korea in terms of DA approach. This paper introduces various DA methods and modifies them to be adequate for Korea census and vital statistics. Our method are also applied to reconstruct year-age-sex specific population and estimate their omission rates for year and age. Empirical analysis of census and vital statistics of Korea from 1985 to 2010 demonstrates high completeness of death registration in Korea, contrary to existing literatures. We also investigates abnormal patterns in census by comparing with reconstruction data in view of cohort, sex ratio and age ratio.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.441-447
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• 2013

Background: Prior studies examining the relation between diabetes mellitus (DM) and prostate cancer risk have reported controversial findings. We examined this association by conducting a detailed meta-analysis of the peer-reviewed literature. Methods: A comprehensive search for articles of MEDLINE and EMBASE databases and bibliographies of retrieved articles published up to November, 2012 was performed. Methodological quality assessment of the trials was based on the Newcastle-Ottawa Scaleq and the meta-analysis was performed using STATA 12.0. Dose-response regression was conducted with SPSS 19.0. Results: We included 29 studies in the meta-analysis (13 case-control studies, 16 cohort studies), and found an inverse association between DM and prostate cancer (relative risk (RR) 0.84, 95% confidence interval (CI), 0.78-0.91). An inverse association was also observed in non-Asian populations (RR 0.81, 95% CI 0.76-0.87) and population-based studies (RR 0.80, 95% CI 0.77-0.91). No statistical significance was found of the association between prostate cancer risk and the duration of DM (p=0.338), and risk seemed not related with the age of DM diagnosis. Conclusions: This study suggested an inverse relationship between DM and prostate cancer, but without links to duration of disease or age of diagnosis.

• The Journal of Advanced Prosthodontics
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• v.2 no.4
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• pp.122-127
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• 2010

PURPOSE. The aim of this study was to examine the relationship between tooth loss and sub-clinical atherosclerosis in Korean adults. MATERIALS AND METHODS. The subjects were part of a cohort study conducted in Ansan city by the Korea University medical school as part of the Korean Genome project. 749 subjects over than 40 years old were evaluated. After taking panoramic radiography, the amount of tooth loss was calculated. The intima-media thickness (IMT) was assessed by using ultrasonography at the common carotid artery. Traditional cardiovascular risk factors for atherosclerosis were also evaluated. The relationship between tooth loss and the IMT was evaluated using ANOVA with Scheffe's multiple comparison method in univariate analysis. Multiple regression analysis was also performed to determine the significance between the IMT and tooth loss. RESULTS. With age, tooth loss increased, but there was no significant increase in other traditional cardiovascular risk factors. Univariate analysis revealed the IMT to be positively related with the amount of tooth loss. Regression analysis of the IMT in the anterior and posterior tooth loss revealed that only the posterior tooth loss was significantly related with the IMT at all sites of the common carotid artery (right far wall, P = .015; left far wall, P = .008; right near wall, P < .001; left near wall, P = .001). CONCLUSION. This study verified the positive relationship between the increased tooth loss at the posterior area and the accumulation of atheroma in arteries.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.367-375
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• 2016

Objectives: The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than Western women have dense breasts, but the incidence of breast cancer is lower among Asian women. This meta-analysis investigated the association between breast density in mammography and breast cancer risk in Asian women. Methods: PubMed and Scopus were searched, and the final date of publication was set as December 31, 2015. The effect size in each article was calculated using the interval-collapse method. Summary effect sizes (sESs) and 95% confidence intervals (CIs) were calculated by conducting a meta-analysis applying a random effect model. To investigate the dose-response relationship, random effect dose-response meta-regression (RE-DRMR) was conducted. Results: Six analytical epidemiology studies in total were selected, including one cohort study and five case-control studies. A total of 17 datasets were constructed by type of breast density index and menopausal status. In analyzing the subgroups of premenopausal vs. postmenopausal women, the percent density (PD) index was confirmed to be associated with a significantly elevated risk for breast cancer (sES, 2.21; 95% CI, 1.52 to 3.21; $I^2=50.0%$). The RE-DRMR results showed that the risk of breast cancer increased 1.73 times for each 25% increase in PD in postmenopausal women (95% CI, 1.20 to 2.47). Conclusions: In Asian women, breast cancer risk increased with breast density measured using the PD index, regardless of menopausal status. We propose the further development of a breast cancer risk prediction model based on the application of PD in Asian women.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.337-346
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• 1993

This is a retrospective cohort analysis of 58 patients who treated with postoperative radiation therapy following radical hysterectomy and bilateral pelvic adenectomy for early stage carcinoma of uterine cervix between January 1988 and December 1990 at department of radiation oncology, Keimyoung University Hospital. Sixteen percent of patients (9/58) had chemotherapy. Most patients were FIGO I b (47 patients), and FIGO I a and II a were one and ten patients, respectively. The median follow-up periods were 48.5 months. The indications for radiation therapy included pelvic lymph node metastasis, large tumor size, deep stromal invasion, lymphovascular invasion, positive surgical margin, endometrial invasion and parametrial invasion. Eighty five percent of the patients had more than one risk factor. The actuarial overall five year survival rate (5 YSR) and five year disease free survival rate (5 YDFSR) were $89.5\%,\;and\;87.8\%,$ respectively. Their overall recurrence rate was $12.1\%,$(758). Distant metastasis was the most common cause of treatment failure $(71.4\%:5/7).$ The univariate analysis of prognostic factors affecting to five year survival rate disclosed pelvic lymph node status (negative: $95.5\%,\;positive:69.2\%,$ p=0.006) and hemoglobin level $(\le11 :75\%,>11g/dl:93.3\%,p=0.05)$ as significant factor. The age status was marginally significant $(\le40:96.0\%,\;>\;40:84.3\%p=0.15).$ Multivariate analysis clarified three independent prognostic factors: pelvic lymph node metastasis (p=p.006), hemoglobin level (p=0.015) and age (p=0.035). Multivariate analysis of prognostic factor affecting to five year disease free survival rate disclosed pelvic lymph node status (p=0.0078) and status of surgical margin (p=0.008). Complications relating to radiotherapy were $10.3\%,(6/58).$ There were no severe major complication requiring surgical intervention or a long hospital stay. It is our opinion that the benefit of postoperative pelvic radiotherapy may be gained in such a high risk patient population with acceptible morbidity.

• Journal of Korean Biological Nursing Science
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• v.14 no.3
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• pp.221-230
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• 2012

Purpose: Quality of nursing research should be evaluated before it is applied as an evidence for evidence-based nursing practice. This study attempted to analyze and to compare tools for the quality assessment and reporting standards of nursing research using CONSORT and STROBE checklist by types of research design. Methods: We searched the tools for quality assessment in nursing research based on the National Evidence-based Healthcare Collaborating Agency (NECA) publication. Then, we analysed and compared the tools for quality evaluation by types of research design. Results: According to the analysis using CONSORT checklist, ROB shows coherence in 17 items, Jadad shows coherence in 3 items, SIGN (for RCT) shows coherence in 26 items, and Downs & Black shows coherence in 24 items. According to the analysis using STROBE checklist, MINORS shows coherence in 25 items, NOS shows coherence in 21 items, SIGN (for Cohort studies & Case-control studies) shows coherence in 29 items, and RoBANS shows coherence in 21 items. Conclusion: Based on our analysis, we recommend that nursing researchers should report according to the reporting standards of tools for quality evaluation. We hope that our analysis can be helpful to develop evidence-based nursing.

• Brain Tumor Research and Treatment
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• v.6 no.2
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• pp.54-59
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• 2018

Background Leptomeningeal metastasis (LM) is an uncommon, but devastating complication of advanced cancer and has no standard treatment. Herein, we analyzed the clinical characteristics and outcomes of patients with solid tumors who were diagnosed with LM. Methods Between January 2007 and December 2017, we retrospectively analyzed the medical records of patients with solid tumors who were diagnosed with LM. Results A total of 58 patients were enrolled in this study. The median age of patients was 51 years (range, 27-72 years), and 62.1% had a poor Eastern Cooperative Oncology Group (ECOG) performance status (PS) (>2). The common types of primary tumor were breast cancer (39.7%), gastric cancer (25.9%), and non-small cell lung cancer (20.7%). Forty-two patients (72.4%) were diagnosed with LM by MRI of the brain and/or spine and cerebrospinal fluid (CSF) analysis, 14 were diagnosed by CSF analysis alone, and 2 were diagnosed by MRI alone. Treatments for LM were performed in 53 patients (91.4%), and best supportive care was provided for 5 patients (8.6%). Intrathecal chemotherapy, radiotherapy, and systemic chemotherapy were administered in 43 (74.1%), 17 (29.3%), and 24 (41.4%) patients, respectively. The median overall survival of the entire cohort was 2.4 months (95% confidence interval, 1.0-3.7). In the analysis of prognostic factors for survival, a good ECOG PS (${\leq}2$), administration of systemic chemotherapy after LM diagnosis, and a prior history of brain radiation were associated with prolonged survival. Conclusion Although the prognosis of LM in patients with solid tumors is poor, systemic chemotherapy might improve survival in selected patients with a good PS.