• 여성건강간호학회지
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• 제29권4호
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• pp.317-327
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• 2023

Purpose: This study investigated the influence of cervical cancer knowledge, human papillomavirus (HPV) knowledge, self-efficacy, and uncertainty on the intention to engage in cervical cancer preventive behavior in HPV-infected women. Methods: This descriptive correlational study was conducted among 129 adult women aged 20 to 65 years who received positive HPV results at a general hospital in Changwon, Korea. The dataset was analyzed using descriptive statistics, the independent t-test, analysis of variance, the Pearson correlation coefficient, and multiple regression. Results: The mean score for the intention to engage in cervical cancer preventive behavior was high (4.43±0.65). This intention was significantly different according to age at first sexual intercourse (F=7.38, p=.001), HPV type (F=4.79, p=.010), vaccination (t=3.19, p=.002), and condom use (t=3.03, p=.003). The intention to engage in cervical cancer preventive behavior showed significant, weak-to-moderate positive correlations with HPV knowledge (r=.22, p=.012) and self-efficacy (r=.42, p<.001). Self-efficacy (β=.46, p<.001), first sexual intercourse at <20 years (β=.45, p<.001), first sexual intercourse at 20-24 years (β=.29, p=. 018), HPV high- and low-risk group infection (β=.26, p=.019), HPV high-risk group infection (β=.26, p=.026), and vaccination (β=.21, p=.007) significantly influenced the intention to engage in cervical cancer preventive behavior. These variables explained 34.6% of variance in intention. Conclusion: Study findings support the need to develop a program that effectively conveys accurate information about cervical cancer prevention to HPV-infected women and helps them enhance self-efficacy to boost the intention to engage in cervical cancer preventive behavior.

• Korean Journal of Radiology
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• 제1권1호
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• pp.38-42
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• 2000

Objective: The purpose of this study was to determine the utility of preoperative CT in predicting early recurrence of hepatocellular carcinoma after partial hepatic resection. Materials and Methods: Preoperative three-phase helical CT scans in 53 patients with hepatocellular carcinoma were retrospectively reviewed by two radiologists. In 27 patients (group I), HCC had recurred within six months, while 26 (group II) had remained disease free for at least two years. In each group, preoperative CT findings were evaluated in each group for the tumor size and number, the presence or absence of capsule, distinctness of tumor margin, perinodular extension, and the presence or absence of portal vein thrombosis. Results: In group I, a tumor capsule of tumor was seen in five of 27 patients (19%), and in group II, in 16 of 26 (62%) (p = .001). The tumor margin was distinct in eight patients (30%) in group I and in 20 (77%) in group II (p = .001). Multiple tumors, perinodular extension, and portal vein thrombosis were more frequently seen in group I but the differences were not statistically significant (p > .05). Tumor size was similar in each group (p > .05). Conclusion: Preoperative CT findings that may help predict the early recurrence of hepatocellular carcinoma after surgical resection are an absence of capsule of tumors and an indistinct margin. Reference to these findings during preoperative CT can guide clinicians in their choice of treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제13권2호
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• pp.154-163
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• 2010

목 적: 대장용종증은 소아에서는 드문 질환군으로 다수의 용종으로 인한 출혈, 복통, 장중첩증 등이 반복될 수 있고 용종의 악성화나 장외종양이 발생할 수 있으나 아직은 이에 관한 연구가 많지 않다. 본 연구에서는 소아 대장용종증의 임상 양상과 내시경적, 조직학적 특징을 살펴보고자 하였다. 방 법: 서울대병원 어린이병원에서 1987년부터 2009년까지 대장내시경을 시행 받은 2,956명의 소아 환자중에서 대장용종증으로 진단받은 37명의 환자를 대상으로 의무기록 분석을 시행하였다. 대장용종증 환자들의 진단 시 평균나이는 8세였다. 결 과: Peutz-Jeghers 증후군이 22예로 가장 많았으며 연소성 용종증 7예, 가족성 선종성 용종증 6예, 림프성용종증 2예이었다. 내원 시 가장 흔한 주소는 혈변이었다. 50% 이상의 환자에서 혈변과 복통이 동반되었고 일부에서 항문종괴, 설사, 변비가 동반되었다. 용종의 수와 크기는 다양하였고 위장과 소장에 용종이 동반된 환자는 각각 21명, 17명이었다. Peutz-Jeghers 증후군 환자에서는 주로 다엽성의 목이 있는 용종이 관찰되었다. 연소성 용종증 환자에서는 둥글고 목이 있는 용종이 대부분이었다. 가족성 선종성 용종증 환자에서는 작고 둥글며 목이 없는 용종이 관찰되었다. 림프성 용종증 환자에서는 목이 없는 용종이 관찰되었다. 모든 환자는 내시경적 용종절제술을 시행받았고 14명(38%)은 수술적 용종절제술을 시행받았다. 부분장절제술을 시행받은 환자는 13명(35%)이었고, 가족성 선종성 용종증 환자 4명은 전대장절제술을 시행받았다. Peutz-Jeghers 증후군 환자 중 일부에서 장외 종양이 발생하였으나 용종의 악성화는 없었다. 결 론: 소아의 대장용종증 환자는 출혈, 복통 등의 증상을 보이며 장중첩증 등의 합병증이 발생할 수 있어 조기 진단과 치료가 필요하며 정기적인 대장내시경 검사를 통해 합병증을 예방하고 용종의 악성화나 장외 종양 여부를 확인해야 한다.

• Tuberculosis and Respiratory Diseases
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• 제56권6호
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• pp.664-669
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• 2004

저자들은 기관지내 종괴로 발현된 일차성 폐 형질세포종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.9009-9013
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• 2014

Background: The aim of this study was to explore the efficacy and adverse reactions of CT-guided radioactive 125I-seed implantation treatment combined with chemotherapy for platinum-resistant recurrent ovarian carcinoma. Materials and Methods: From September 2010 to December 2012, 23 patients with platinum-resistant recurrent ovarian carcinoma were enrolled. All the patients refused, could not bear, or were not suitable for surgery. They all had no more than 3 lesions, which were detected and could also be measured by CT. All were clarified as single-lesion or multiple-lesion groups. A total of 41 lesions underwent implantation of from 8 to 106 125I seeds (median=43). Multi-plane implanting was adopted and 125I-seeds of (0.4-0.7)mCi were placed at intervals of (0.5-1.0) cm. After implantation treatment, all patients underwent 4 cycles of chemotherapy with gemcitabine $800mg/m^2$ (days 1, 8 and 15). Results: The outcome was evaluated with CT 3 weeks and every 3 months after implantation treatment. After 6 months, the volume of 32 out of 41 lesions (78.0%) was reduced at least 30%, within which 9 lesions completely disappeared(22.0%). Complete response was observed in 7 cases (30.4%), with a partial response in 4 cases (17.4%), 4 cases stable(17.4%)and 8 cases showing progression (34.8%). The total clinical remission rate was 47.8% (11/23). The clinical remission rate was 77.8% (7/9) in the single-lesion group and 28.6% (4/14) in the multiple-lesion group with a significant difference between the two(P=0.036). The common side effects observed were mild gastrointestinal reactions. Conclusions: 125I-seed implantation combined with chemotherapy applies an effective way in the treatment of platinum-resistant recurrent ovarian epithelial carcinoma with the advantages of high local control rates, good short-term effects, little trauma and less side effects.

• Journal of Preventive Medicine and Public Health
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• 제42권2호
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• pp.117-122
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• 2009

Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

• 대한영상의학회지
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• 제82권5호
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• pp.1207-1217
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• 2021

목적 췌장 및 췌장 주위의 주요 혈관에 인접한 병변에 대하여 초음파 유도하 경피적 중심 바늘 생검(ultrasound-guided percutaneous core needle biopsy; 이하 USPCB)의 안전성과 효능을 평가하였다. 대상과 방법 10년 동안 췌장(n = 98), 간문맥 근처 췌장 주위(n = 34), 또는 췌장 갈고리돌기 부위와 십이지장 제3부분과 인접한 대동맥주위(n = 30) 병변에 대하여 USPCB를 시행받은 162명의 환자의 검사 결과를 수집하였다. 초음파 유도하18게이지 바늘을 가진 자동 생검 총을 사용하였고, USPCB 결과는 수술 결과 또는 추적 관찰 영상과 비교하였다. USPCB의 진단 정확도 및 주요 합병증 비율을 계산했으며, 성공적인 생검의 예측을 위한 요인이 무엇인지 단변량 및 다변량 분석을 사용하여 평가하였다. 결과 USPCB에서 조직 병리학 진단은 149명(92%) 환자에서 일치했다. 주요 합병증은 장간막 혈종 4건과 십이지장 벽내혈종 1건이 발생했다(3%). 성공적인 생검을 위한 요인으로는 위 또는 장관을 통과하는 경로보다는 경장간막 경로를 이용할수록, 초음파상 표적 및 생검 경로가 잘 보일수록 등이 포함되었다. 또한 결과적으로 생검에 성공한 경우 생검 횟수가 더 적었다. 결론 USPCB는 주요 혈관에 인접한 췌장 및 간문맥 근처 췌장 주위 병변 또는 췌장 갈고리돌기 부위나 십이지장 제3부분과 인접한 대동맥 주위 병변의 조직학적 진단을 위한 높은 정확도 및 낮은 합병증 비율을 나타냈다.

• Journal of Preventive Medicine and Public Health
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• 제46권6호
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• pp.346-352
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• 2013

Objectives: To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study. Methods: The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer. Results: Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer. Conclusions: Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.764-768
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• 2006

Purpose: Parotid neoplasia are relatively frequent, representing approximately 3% of all tumors in the head and neck regions. But incomplete resection and misdiagnosis of parotid gland is followed by multiple tumor invasion, tumor recurrence, and other iatrogenic tumor formation. In patients undergoing parotidectomy for confirmed or suspected malignancy, the traditional or modified rhytidectomy incision may prove suboptimal because it does not easily lend itself to a continuous neck dissection. Similarly, patients with tumors of the anterior accessory lobe or patients with large anterior tumors may also require the modified Blair incision for adequate surgical exposure. This report serves to revisit the topic of accessory and parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of recurrence are avoided. Methods: This is a retrospective review of our experience with two cases of parotid tumors; one accessory parotid gland neoplasm and one parotid gland neoplasm. We report the case of parotid tumor and epidermal cyst in a 54-year old male patient and the case of case of recurrent parotid tumor with local invasion in 30-year old male patient. Results: All were removed through a modified Blair incision. Pathologic report notified that One was found pleomorphic adenoma and epidermal cyst, and the other one pleomorphic adenoma with subcutenous invasion. The patients recovered well without any complication such as infection, hematoma, facial nerve palsy, and necrosis of skin flap. Patients were discharge POD#7. Patients were followed up to for 1 year and they have no sign of recurrence. Conclusions: A high index of suspicion, prudent diagnostic skills(including fine-needle aspiration biopsy, CT, US), and meticulous surgical approach are the keys to a successful management of these lesions. We experienced two cases of parotid neoplasia, in the treatment of tumor reccurence & iatrogenic tumor arising from the parotid gland and are presented with the review of literatures.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6811-6817
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• 2014

Background: Breast cancer risk prediction models are widely used in clinical practice. They should be useful in identifying high risk women for screening in limited-resource countries. However, previous models showed poor performance in derived and validated settings. Therefore, we aimed to develop and validate a breast cancer risk prediction model for Thai women. Materials and Methods: This cross-sectional study consisted of derived and validation phases. Data collected at Ramathibodi and other two hospitals were used for deriving and externally validating models, respectively. Multiple logistic regression was applied to construct the model. Calibration and discrimination performances were assessed using the observed/expected ratio and concordance statistic (C-statistic), respectively. A bootstrap with 200 repetitions was applied for internal validation. Results: Age, menopausal status, body mass index, and use of oral contraceptives were significantly associated with breast cancer and were included in the model. Observed/expected ratio and C-statistic were 1.00 (95% CI: 0.82, 1.21) and 0.651 (95% CI: 0.595, 0.707), respectively. Internal validation showed good performance with a bias of 0.010 (95% CI: 0.002, 0.018) and C-statistic of 0.646(95% CI: 0.642, 0.650). The observed/expected ratio and C-statistic from external validation were 0.97 (95% CI: 0.68, 1.35) and 0.609 (95% CI: 0.511, 0.706), respectively. Risk scores were created and was stratified as low (0-0.86), low-intermediate (0.87-1.14), intermediate-high (1.15-1.52), and high-risk (1.53-3.40) groups. Conclusions: A Thai breast cancer risk prediction model was created with good calibration and fair discrimination performance. Risk stratification should aid to prioritize high risk women to receive an organized breast cancer screening program in Thailand and other limited-resource countries.