• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2055-2060
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• 2016

Background: Colorectal cancer (CRC) is one of the most common causes of death worldwide and in Thailand. The X-ray repair cross-complementary protein 1 (XRCC1) is required for efficient DNA repair. The effects of this gene on survival in colorectal cancer remain controversial and have not been reported in Thailand. The aim of this study was to investigate the association of the XRCC1 gene with survival of colorectal cancer patients in a Thai population. Materials and Methods: Data and blood samples were collected from 255 newly diagnosed and pathologically confirmed CRC patients who were recruited during the period 2002 to 2006 and whose vital status was followed up until 31 October, 2014. Real-time PCR-HRM was used for genotype identification. The Kaplan-Meier method, the log-rank test, and Cox proportional hazard regression were used to estimate cumulative survival curves and compare various survival distributions and adjusted hazard ratios. Results: Most of the cases were males, and the median age was 55 years. The median survival time was 2.43 years. The cumulative 1-, 3-, 5-, 7-, and 10 year survival rates were 76.70%, 39.25%, 26.50%, 16.60% and 3.56%, respectively. After adjustment, female gender, ages 50-59 and ${\geq}60years$, tumour stage III+IV, a signet-ring cell carcinoma, and poor differentiation had significant associations with increased risk of CRC death. While the XRCC1 Arg/Arg homozygote appeared to be a risk factor for CRC death, the association was not significant. Conclusions: The genetic variant in the XRCC1 may not be associated with the survival of CRC patients in Thailand. Further studies are needed to verify our findings.

• 한국방재학회 논문집
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• 제5권4호
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• pp.59-69
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• 2005

가뭄을 미리 발견하고 감시하는 것은 어려우나, 가뭄지수를 이용하면 가뭄의 파악이 용이하다. PDSI는 통상적으로 가장 널리 이용되나 운영상 제한성을 가지고 있다. 최근 들어 가뭄을 인지하고 감시하는 능력이 향상된 SPI가 개발되었으며, 이는 기존의 지수들에 비해 모든 시간간격에 적용이 가능하고 간단하게 이용이 가능하다. KBDI는 상부토양층의 누적수분부족량을 산출함에 있어서 증발산과 강수량의 순영향을 나타내는 지수로 정의하였다. 본 연구에서는 PDSI, SPI, KBDI를 이용하여 산정된 가뭄지수의 상호비교 연구를 통하여 표준 가뭄지수를 제안하고자 한다. 이를 위하여 우리나라 8개 수계의 30년 이상의 기상자료를 보유한 기상청 강우관측소 자료를 이용하였다. 그 결과 PDSI는 누적되는 강우의 부족으로 가뭄심도를 나타내는 데 유리하고, SPI와 KBDI는 단기간 강우부족을 나타내는데 유리한 것으로 나타났다.

• Safety and Health at Work
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• 제9권3호
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• pp.290-295
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• 2018

Background: There is little information on the dose-response relationship between exposure to occupational carcinogenic agents and mesothelioma. This study aimed to investigate this association as well as the existence of agents other than asbestos that might cause mesothelioma. Methods: The Swedish component of the Nordic Occupational Cancer (NOCCA) study consists of 6.78 million individuals with detailed information on occupation. Mesothelioma diagnoses recorded in 1961-2009 were identified through linkage to the Swedish Cancer Registry. We determined cumulative exposure, time of first exposure, and maximum exposure intensity by linking data on occupation to the Swedish NOCCA job-exposure matrix, which includes 29 carcinogenic agents and corresponding exposure for 283 occupations. To assess the risk of mesothelioma, we used conditional logistic regression models to estimate hazard ratios and 95% confidence intervals. Results: 2,757 mesothelioma cases were identified in males, including 1,416 who were exposed to asbestos. Univariate analyses showed not only a significant excess risk for maximum exposure intensity, with a hazard ratio of 4.81 at exposure levels 1.25-2.0 fb/ml but also a clear dose-response effect for cumulative exposure with a 30-, 40-, and 50-year latency time. No convincing excess risk was revealed for any of the other carcinogenic agents included in the Swedish NOCCA job-exposure matrix. Conclusion: When considering asbestos exposure, past exposure, even for short periods, might be enough to cause mesothelioma of the pleura later in life.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.341-347
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• 2019

Background: Information about the epidemiology of venous thromboembolism (VTE) recurrence in Korea is lacking. The purpose of this study was to investigate VTE cumulative recurrence rates and identify risk factors for VTE recurrence among Korean adults. Methods: A retrospective cohort study was conducted on adult patients (${\geq}18years$) admitted to a university teaching hospital for pulmonary embolism (PE) from 2005 to 2013. The main outcome of interest was a recurrence of VTE. We used Cox proportional hazard regression analyses to calculate the relative risk of VTE recurrence. Results: Five-year cumulative incidence of recurrent VTE events was 21.5% (95% confidence interval [CI], 17.7-25.4) in all cases of PE; 17% after provoked and 27% after unprovoked PE. Multivariate analysis showed that body mass index (BMI) of ${\geq}25$ (hazard ratio [HR], 2.02; 95% CI, 1.17-3.46; p=0.01) and longer anticoagulation therapy duration (HR, 0.90; 95% CI, 0.84-0.96; p<0.01) were independently associated with risk of VTE recurrence. Risk factors not found to be statistically significant at the <0.05 level included history of VTE (HR, 1.81; 95% CI, 0.84-3.88; p=0.12), unprovoked PE (HR, 1.70; 95% CI, 0.89-3.25; p=0.10), symptomatic deep vein thrombosis (HR, 1.62; 95% CI, 0.89-2.94; p=0.10), and female sex (HR, 1.42; 95% CI, 0.78-2.55; p=0.24). We found that age, history of cancer, and other co-morbidities did not significantly affect the risk of VTE recurrence. Conclusion: Recurrence of VTE after PE is high. Patients with BMI ${\geq}25$ or reduced anticoagulation therapy duration have a higher risk of recurrent VTE.

• Journal of Chest Surgery
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• 제54권1호
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• pp.36-44
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• 2021

Background: Extracorporeal membrane oxygenation (ECMO) has become increasingly accepted as a life-saving procedure for patients with severe acute respiratory distress syndrome (ARDS). This study investigated the relationship between cumulative fluid balance (CFB) and outcomes in adult ARDS patients treated with ECMO. Methods: We retrospectively analyzed the data of adult ARDS patients who received ECMO between December 2009 and December 2019 at Korea University Anam Hospital. CFB was calculated during the first 7 days after ECMO initiation. The primary endpoint was 28-day mortality. Results: The 74 patients were divided into survivor (n=33) and non-survivor (n=41) groups based on 28-day survival. Non-survivors showed a significantly higher CFB at 1-7 days (p<0.05). Cox multivariable proportional hazard regression revealed a relationship between CFB on day 3 and 28-day mortality (hazard ratio, 3.366; 95% confidence interval, 1.528-7.417; p=0.003). Conclusion: In adult ARDS patients treated with ECMO, a higher positive CFB on day 3 was associated with increased 28-day mortality. Based on our findings, we suggest a restrictive fluid strategy in ARDS patients treated with ECMO. CFB may be a useful predictor of survival in ARDS patients treated with ECMO.

• 한국사회복지학
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• 제59권1호
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• pp.301-327
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• 2007

본 연구의 목적은 미국에서 친권상실이 선고된 위탁아동의 입양률 추이를 살펴보고, 입양결정에 영향을 미치는 주된 요인을 규명하는 데 있다. 본 연구는 미국 위탁보호와 입양에 관한 패널데이터 FY1999-FY2002를 이용하여 1998년 10월부터 2002년 9월까지 32개 주를 추출하여 총 26,895명을 분석에 활용하였다. 사건사 분석의 Kaplan-Meier 분석과 비례적 위험회귀모형(Cox proportional hazards regression model)을 이용하여 친권상실선고 이후 소요되는 위탁기간에 따른 입양률 추이와 위험 입양배율(hazard ratios for adoption)를 산출하였다. 본 연구의 주요 결과로는 친권상실선고 이후 3개월-19개월까지 입양률이 급속히 증가하다가 20개월이 지나면서 오히려 감소추세를 보이고 있었다. 입양여부와 관련한 주요 요인으로서는 백인아동일 경우, 나이가 어릴수록, 선입양가족, 도시소재의 위탁보호일 경우, 양부모 위탁가족, 또는 인종적으로 동일한 위탁부모에 의해 위탁보호 될 경우 입양가능성이 상대적으로 높게 나타났다. 또한, 아동이 지체나 장애가 있을 경우, 신체학대나 성학대를 경험한 경우, 친부모의 양육능력부족으로 위탁보호 된 경우 상대적으로 낮은 입양가능성을 보이고 있다. 본 연구결과 친권상실 이전에 발생한 위탁보호 원인이 친권상실 이후에도 입양에 영향을 미치고 있으며, 입양촉진방안으로 친권상실선고 이후 제공된 위탁서비스 활용과 적극적 지원방안 모색의 필요성이 제기되었다. 끝으로 본 연구결과를 바탕으로 한국사회에서 요보호아동의 친권개입의 정책적 방향과 항구적 보호마련을 위한 함의와 제언을 개괄적으로 제시하였다.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.469-478
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• 2022

Objective : Cranial base chordomas are rare, but their treatment is challenging. Tumor recurrence is still common despite improvements in microsurgical techniques and postoperative radiotherapy. We retrospectively analyzed the course of treatment, overall survival, and recurrence/progression of chordomas over the past 10 years. Methods : We retrospectively reviewed 50 patients who underwent surgery at Tianjin Huanhu Hospital between 2010 and 2020 and were pathologically diagnosed with chordomas. Tumor resection was performed within the maximum safe range in all patients; the extent of resection was evaluated by imaging; and the incidence of complications, recurrence or progression, and overall survival were assessed. Results : Fifty patients were divided into the low-risk group (LRG) and high-risk group (HRG) based on the cranial chordoma grading system (CCGS). The Karnofsky Performance Scale scores and gross total resection rate of the LRG were significantly higher than those of the HRG (p<0.05). The incidence of complications and mortality in the LRG were lower than those of HRG. The analysis of cumulative survival and cumulative recurrence free survival/progression free survival (RFS/PFS) showed no statistical differences in the extent of resection for survival, recurrence, or progression. Univariate and multivariate analyses showed that Ki-67 was significantly associated with tumor recurrence and was an independent hazard factor (p=0.02). Conclusion : The CCGS can help neurosurgeons anticipate surgical outcomes. Pathological results are important in evaluating the possibility of tumor recurrence, and postoperative radiotherapy improves overall survival and RFS/PFS.

• 응용통계연구
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• 제29권7호
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• pp.1231-1246
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• 2016

경쟁위험에 대한 연구 중 주로 쓰이는 방법은 Cause-specific 위험 모형과 subdistribution을 이용한 비례 위험 모형 방법이다. 그 이후에도 많은 모형이 제시되었지만, 추정 방법 면에서 설명력이 부족하거나 알고리즘으로 구현하기 어려운 단점을 가지고 있어서 잘 활용되고 있지 않다. 이 논문에서는 Cause-specific 위험 모형, subdistribution을 이용한 비례 위험 모형과 비교적 최근에 제시된 이항 회귀 모형(direct binomial model), 절대 위험 회귀 모형(absolute risk regression model), Eriksson 등 (2015)의 비례 오즈 모형(proportional odds model)을 소개하고 추정 방법을 간단히 설명하고자 한다. 각 모형에 대하여 SAS와 R을 이용한 활용 방법을 제시하고, 두 가지 경쟁위험이 존재하는 데이터를 R을 이용하여 분석하였다.

• 중환자간호학회지
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• 제3권2호
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• pp.1-11
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• 2010

Purpose: This study was designed to identify the factors affecting healing of Stage 2 pressure ulcer in an acute care facility in Korea. Methods: 286 Stage 2 pressure ulcers of 145 patients were examined. Data were collected in the period between October $1^{st}$, 2006 and September $30^{th}$, 2007. Data were analyzed with Kaplan-Meier survival analysis for cumulative recovery rate of Stage 2 pressure ulcers. Cox proportional hazard model was used to examine effects of multiple variables simultaneously. Results: Out of 286 initial Stage 2 pressure ulcers, 204 (71.3%) pressure ulcers healed completely. The median time to heal was 15 days according to Kaplan-Meier survival analysis. Cox proportional hazard model showed that the Stage 2 pressure ulcers healed more quickly when pressure redistribution surfaces were used (p<.001, HR=2.184), patients were administered with vitamins (p= .038, HR=1.451), and the size of the pressure ulcers were small (${\leq}3.0cm^2$, p= .006, HR=1.765). Conclusion: The factors contributing to the healing of Stage 2 pressure ulcer in an acute care setting were the application of pressure redistribution surface, small ulcer size (${\leq}3.0cm^2$), and the administration of vitamins.

• Environmental Engineering Research
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• 제24권1호
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• pp.150-158
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• 2019

Soil contaminated with heavy metals from artisanal gold mining in Anka Local Government Area in Northwestern Nigeria was investigated to evaluate the human health risk as a result of heavy metals. Measured concentration of heavy metals and exposure parameters were used to estimate human carcinogenic and non-carcinogenic risk. GIS-based Kriging method was utilized to create a prediction maps of human health risks and probability maps of heavy metals concentrations exceeding their threshold limits. Hazard index calculation showed that 21 out of 23 locations are posing non-cancer risk for children. Adults and children are at high cancer risk in all locations as the total cancer risk exceeded $1{\times}10^{-6}$ (the lower limit CTR value). Kriging model showed that only a very small area in Anka has a hazard index of less than unity and cumulative target risk of less than $1{\times}10^{-4}$, indicating a significant carcinogenic and non-carcinogenic risks for children. The probability of heavy metals to exceed their threshold concentrations around the study area was also found to be high.