• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2369-2374
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• 2014

Background and Aim: Selumetinib is a promising and interesting targeted therapy agent as it may reverse radioiodine uptake in patients with radioiodine-refractory differentiated thyroid cancer. We conduct this metaanalysis to compare the efficacy and safety of selumetinib with current therapies in patients with advanced cancer. Methods: An electronic search was conducted using PubMed/ Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity of eligible studies. Results: Six eligible trials involved 601 patients were identified. Compared with current therapies, treatment schedules with selumetinib did not improve progression free survival (hazard ratio, 0.91; 95%CI 0.70-1.17, P= 0.448), but did identify better clinical benefits (odds ratio, 1.24; 95%CI 0.69-2.24, P = 0.472) and less disease progression (hazard ratio, 0.72; 95%CI 0.51-1.00, P = 0.052) though its impact was not statistically significant. Sub-group analysis resulted in significantly improved progression free survival (hazard ratio, 0.61; 95%CI 0.49-0.57, P = 0.00), clinical benefits (odds ratio, 3.04; 95%CI 1.60-5.77, P = 0.001) and reduced disease progression (hazard ratio, 0.35; 95%CI 0.18-0.67, P = 0.001) in patients administrated selumetinib. Dermatitis acneiform (risk ratio, 9.775; 95%CI 3.143-30.395, P = 0.00) and peripheral edema (risk ratio, 2.371; 95%CI 1.690-3.327, P = 0.00) are the most frequently observed adverse effects associated with selumetinib. Conclusions: Compared with current chemotherapy, selumetinib has modest clinical activity as monotherapy in patients with advanced cancer, but combinations of selumetinib with cytotoxic agents in patients with BRAF or KRAS mutations hold great promise for cancer treatment. Dermatitis acneiform and peripheral edema are the most frequently observed adverse effects in patients with selumetinib.

• 정신신체의학
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• 제20권2호
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• pp.91-97
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• 2012

목 적 : 암의 유병율 증가와 함께 암 생존자의 건강 행동에 대한 이해가 중요해지고 있다. 본 연구는 암 진단 후 신체 및 심리사회적 건강 행동의 변화와 관련된 여러 심리사회적 요인들을 분석하였다. 방 법 : 유방암 환자 95명을 대상으로 우울, 불안, 불면, 외상후 스트레스 증상, 사회적 제약, 자신의 암의 원인에 대한 생각 및 건강 행동에 대해 자가보고식 설문조사를 수행하였다. 결 과 : 신체적 행동 변화에 대한 다중 회귀분석에서 불면만이 유의한 연관성을 보여 정상수면군(Odds ratio=9.462, 95% CI 1.738-51.509)과 역치하 불면증군(Odds ratio=10.529, 95% CI 1.701-65.161)에서 불면증을 겪는 군보다 더 높은 증가를 보였다. 심리사회적 건강 행동 변화에서는 낮은 연령, 종교를 가진 경우, 호르몬 요인과 암과 관련이 있다고 믿을수록 증가하였다. 결 론 : 유방암 환자의 건강 행동 변화에 기여하는 요인들은 건강 행동 영역별로 차이를 보인다. 긍정적 변화를 유도하기 위해 영역별로 다른 접근이 필요함을 시사한다.

• 한국직업건강간호학회지
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• 제11권1호
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• pp.63-80
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• 2002

Objectives: The objective of this study is to evaluate the job characteristics of container terminal workers by applying the Job Strain model, and to assess the relationship among the general characteristics, job characteristics and psychosocial distress. Methods: A self-administrated questionnaire survey was performed to the container terminal workers in Pusan. Among the 200 male workers who answered the questionnaires, white-collar workers and blue-collar workers were 100, respectively. Karaseks Job Content Questionnaire was utilized to evaluate the job characteristics and Psychosocial well-being index (PWI) was applied to measure the extent of their psychosocial stress. Results: In white-collar workers, the skill discretion, created skill, decision-making authority, decision-making latitude, psychological job demand, and supervisor support of the job characteristics were significantly high, while in blue-collar workers physical exertion was significantly high. The result of Psychosocial well-being index (PWI) reveals that blue-collar workers were more stressed than white-collar workers, especially, the indices of depression (factor 2), sleeping disturbance and anxiety (factor 3), General well-being and vitality (factor 4) were significantly increased; whereas, in white-collar workers, only the index of social performance and self-confidence (factor 1) was significantly increased. And PWI scores were significantly increased in the lower social support and psychological job demand. By the multiple logistic regression analysis for PWI, blue-collar workers had increased odds ratio of 2.66(95% CI;1.11-6.41) compared with white-collar workers. The unmarried workers increased odds ratio of 3.54(95% CI;1.18-10.62) compared with married workers. And workers who have not own house increased odds ratio of 2.35(95% CI;1.15-4.79) compared with workers who have own house. Particularly, odds ratio of work-shift in blue-collar workers was 11.10(2.14-57.64). Conclusion: Skill discretion, created skill, decision-making authority, decision-making latitude, psychological job demand, and supervisor support were increased in white-collar workers. Decreased skill discretion and increased physical exertion were found in blue-collar workers, which is supported the Job Strain model. Job stress of blue-collar workers was comparatively higher than that of white-collar workers, especially, skill discretion, decision-making authority, decision-making latitude, job insecurity, physical exertion were noticeable factors. Especially, sleeping, smoking, and work shifting turned out to be a main cause that increases stress. Therefore, in order to decrease the job stress, a health promotion program to change the health behaviors should be activated and an organized job stress management program should be introduced. Especially, working condition for blue-collar such as physical exertion and work-shift should be improved.

• 한국임상약학회지
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• 제22권3호
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• pp.251-259
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• 2012

Ulcerative colitis (UC) is characterized by a life-long chronic course with remissions and exacerbations. Use of biological therapies may reduce or delay the surgical procedures in patients with UC. The aim of this study was to determine the impact of infliximab (IFX) use on the rate of remission, surgical interventions, and the effect on quality of life in patients with moderate to severe UC. Literature was searched for studies that investigated the efficacy of IFX on the rate of remission, colectomy and quality of life (QoL) between January 1990 and June 2012 at MEDLINE, January 1988 and June 2012 at EMbase and others. Eleven trials were included in the meta-analysis; divided into placebo controlled 8 trials and intravenous corticosteroid controlled group 3 trials. In comparison to placebo control groups, patients who received IFX had an odds ratio (OR) of 3.712 (95% CI: 2.714, 5.079) for the short-term clinical remission, and 3.053 (95% CI: 2.044, 4.559) for the rate of long-term remission. In colectomy rate and quality of life (QoL), odds ratio were 0.566(95% CI: 0.387, 0.827) and 0.658 (0.505, 0.811) respectively. Any adverse reactions including infections, infusion reaction, rash and arthralgia were equivalent in both groups. Compared with intravenous corticosteroid controlled group, patients who received IFX had lower remission rate with short-term odds ratio 0.227 (95% CI: 0.033, 1.556) and long-term odds ratio 1.054 (95% CI: 0.317, 3.502) respectively. However, statistical significance was not showed with both two analyses. The higher adverse drug reaction (ADR) rates were occurred in the corticosteroid controlled groups. 73.3% of patients treated corticosteroid reported Cushing-like syndrome with moon face. In conclusion, IFX does increase remission rate and decrease the rate of colectomy in patients with UC without elevating any adverse reactions significantly. IFX also improves QoL in moderate to severe UC patients. It would not exceed the efficacy of intravenous corticosteroid, whereas intravenous corticosteroid also reported high rate of adverse reactions.

• 동의생리병리학회지
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• 제23권5호
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• pp.1199-1205
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• 2009

The purpose of this case-control study was done to examine the relationship among the cerebral infarction, blood lipids and homocysteine. We compared the components of blood lipids and homocysteine between cerebral infarction patients group (n=127) and controls group (n=158). We performed Pearson's chi-square test and Student's t-test for univariate analysis, Binary logistic regression for multivariate analysis to evaluate risk factors of cerebral infarction and Pearson's correlation analysis to investigate correlation between blood lipids and homocysteine. The results were as follows. The blood levels of High density lipoprotein cholesterol(HDL-Chol) and Low density lipoprotein cholesterol (LDL-Chol) were significantly lower in patients group, while age, the blood levels of Triglyceride(TG) and homocysteine were significantly higher in patients group. Hypertension had a 4.62 odds ratio, $TG{\geq}150\;mg/d{\ell}$ had a 2.33 odds ratio, HDL-Chol ${\leq}40\;mg/d{\ell}$ had a 6.85 odds ratio, but sex, DM, T-Chol, LDL-Chol had no direct relationship with odds ratio(non significant). In addition, among T-Chol and TG , HDL-Chol, LDL-Chol, they had positive correlation each other. Between TG and HDL-Chol had negative correlation each other. Homocysteine was not correlated with blood lipids adjusted for age and sex. These results suggest that low HDL-Chol and high TG may be risk factor of cerebral infarction. The correlation between homocysteine and blood lipids was not proven.y urther reserch on the subject is needed.

• Toxicological Research
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• 제30권2호
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• pp.91-97
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• 2014

This study aimed to identify changes in the level of neuropeptides among current smokers, former smokers, and individuals who had never smoked, and how smoking habits affect obesity and metabolic syndrome (MetS). Neuropeptide levels, anthropometric parameters, and metabolic syndrome diagnostic indices were determined among male workers; 117 of these had never smoked, whereas 58 and 198 were former and current smokers, respectively. The total sample comprised 373 male workers. The results obtained from anthropometric measurements showed that current smokers attained significantly lower body weight, body mass index, waist circumference, and abdominal fat thickness values than former smokers and those who had never smoked. Current smokers' eating habits proved worse than those of non-smokers and individuals who had never smoked. The level of brain-derived neurotrophic factor (BDNF) in the neuropeptides in the case of former smokers was $23.6{\pm}9.2pg/ml$, higher than that of current smokers ($20.4{\pm}6.1$) and individuals who had never smoked ($22.4{\pm}5.8$) (F = 6.520, p = 0.002). The level of adiponectin among former smokers was somewhat lower than that of current smokers, whereas leptin levels were higher among former smokers than current smokers; these results were not statistically significant. A relationship was found between adiponectin and triglyceride among non-smokers (odds ratio = 0.660, ${\beta}$ value=-0.416, p < 0.01) and smokers (odds ratio = 0.827, ${\beta}$ value=-0.190, p < 0.05). Further, waist circumference among non-smokers (odds ratio = 1.622, ${\beta}$ value=0.483, p < 0.001) and smokers (odds ratio = 1.895, ${\beta}$ value=0.639, p < 0.001) was associated with leptin. It was concluded that cigarette smoking leads to an imbalance of energy expenditure and appetite by changing the concentration of neuropeptides such as adiponectin, BDNF, leptin, and hsCRP, and influences food intake, body weight, the body mass index, blood pressure, and abdominal fat, which are risk factors for MetS and cardiovascular disease.

• Journal of Preventive Medicine and Public Health
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• 제42권5호
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• pp.298-304
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• 2009

Objectives : The aim of this study was to investigate the association of blood pressure levels with the common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. Methods : Data were obtained from 2,635 subjects, aged 50 years and over, who participated in the Community Health Survey (a population-based, cross-sectional study) in Dong-gu, Gwangju city between 2007 and 2008. Participants were categorized into three groups according to blood pressure levels; normotensives (<120/80 mmHg), prehypertensives (120-139/80-89 mmHg), and hypertensives ($\geq$140/90 mmHg). Prehypertensives were further categorized as low prehypertensives (120-129/80-84 mmHg) and high prehypertensives (130-139/85-89 mmHg). Carotid intima-media thickness and plaques were evaluated with a high-resolution B-mode ultrasound. Statistical analyses were performed using chi-square test, ANOVA, and multiple logistic regression. Results : Prehypertensives had significantly greater maximal CCA-IMT values than normotensives, with a multivariate adjusted odds ratio of 1.78 (95% CI=1.36-2.32) for abnormal CCA-IMT (maximal CCA-IMT$\geq$1.0 mm), and 1.45 (95% CI=1.19-1.77) for carotid plaques. The multivariate adjusted odds ratio of low prehypertensives was 1.64 (95% CI=1.21-2.21) for abnormal CCA-IMT, and 1.30 (95% CI=1.04-1.63) for carotid plaques compared with normotensives. Subject with hypertension had higher frequency of abnormal CCA-IMT (odds ratio, 2.18; 95% CI=1.49-3.18), and carotid plaques (odds ratio, 1.98; 95% CI=1.46-2.67) compared with normotensives after adjustment for other cardiovascular risk factors. Conclusions : Our results indicate that there is a significant increase in the prevalence of carotid atherosclerosis in subjects with prehypertension (even in low prehypertensives) compared with normotensive subjects. Further studies are required to confirm the benefits and role of carotid ultrasonography in persons with prehypertension.

• 보건행정학회지
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• 제9권4호
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• pp.41-64
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• 1999

The major concern for this research is to discuss and to offer some solutions to bring the effectiveness of existing notifiable diseases reporting system over the physicians' attitudes of reporting, the actual condition of performance and the reasons of inertia in notifiable diseases reporting through examining the physicians of medical institutions in nationwide such as pediatrics, internal medicine and family medicine. The actual conditions of notifiable communicable diseases(NCD) reporting was surveyed by mail objectifying an internal medicine, pediatrics and family medicine in nationwide on the basis of stratified random sampling method divided into the classification of medical institutions and areas. As a result of survey. the rate of respondents showed 145 persons from physicians, 105 persons from hospitals. 120 persons from general hospitals, and 51 persons from tertiary hospitals. The total number of respondents were 421 and was rated 59.0 %. The analysis of collected survey went through a descriptive analysis primarily to grasp physicians' attitudes on the notifiable communicable diseases reporting, and then upon the dependent variables. Following are major findings obtained form the data analysis. 1. The results of a descriptive analysis on physicians' attitudes towards reporting NCD were as follows: First, the respondents who didn't know that yellow fever is reporting NCD were 11.0% of clinic, 10.5% of hospital. 5.0% of general hospital. 11.8% of tertiary hospital. and in case of hepatitis B, were 26.9% of clinic, 35.2% of hospital. 35.0% of general hospital. 23.5% of tertiary hospital. Second, The rate of physicians' knowledge on penalties of not reporting the NCD by their medical institution were 35.2% of clinic, 45.7% of hospital. 36.7% of general hospital. 62.7% of tertiary hospital. Third, among the no-reporting physicians in whole, the major reason of not reporting NCD were uncertainty of diagnosis(78.9%), no need to report(46.4%), no adequate actions from PHC(29.1%), no knowledge of the cases being notifiable ones in the order of their frequencies(30.4%), meddling from PHC(29.1%), concerning of patient's privacy(26.3%). 2. To analyze the characteristics related to the physicians' behaviors to report NCD, univariate and multiple logistic regression analyses were applied to the variables related to physician, 4 medical facility, PHC, and reporting system. The result were as follows: First, the result of the univariate analysis on physicians' attitude to report NCD and characteristics related to reporting in odds ratio was in the case of hospital. 3.4 times higher positive responses on physicians' attitude to report NCD came up as compared to the clinic. Second, the result of the univariate analysis on physicians' action of reporting NCD and characteristics related to reporting by the classification of medical institutions showed that the odds ratio of hospital was 2.3 times, the odds ratio of general hospital was 2.0 times, the odds ratio of tertiary was 6.8 times significantly higher than clinic. And the medical institution with significantly higher positive attitudes rate by multiple logistic regression analysis was hospital that rated 2.5 times significantly higher than clinic. Also in the PHC related characteristics of reporting, the rate of action in reporting NCD was significantly higher in medical institution that were endowed with the good condition of reporting. In multiple logistic regression analysis, the medical institution that has a good conditions of reporting showed a significantly higher positive rate on the action of reporting than the others.

• 한국안광학회지
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• 제16권3호
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• pp.319-325
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• 2011

목적: 본 연구는 저시력과 가구 소득, 교육 수준 및 직업과 같은 사회경제적 요인과의 관련성을 평가하고자 하였다. 방법: 국민건강영양조사(2009년) 데이터를 이용하여 교정시력 검사를 받은 2,514명을 대상으로 가구소득, 교육수준, 직업에 따른 저시력의 유병률을 t-검정 및 $\chi^2$ 검정하였고, 대응위험도(odds ratio)를 측정하기 위하여 이분형 로지스틱 회귀분석을 이용하였다. 결과: 가구 소득, 교육수준, 직능 수준이 낮을수록 저시력 발생이 높은 것으로 나타났으며, 가구소득이 '하'인 경우 대응위험도는 2.77(95% CI, 1.72-4.47)이었고, 교육수준이 '초졸 이하'인 경우는 4.02(95% CI, 1.75-9.23)이었으며, 직업이 '무직'인 경우는 3.65(95% CI, 1.14-11.68)이었다. 결론: 사회적으로 저시력에 대한 관심이 필요하며, 정책적으로 저시력 환자들의 눈 건강형평성을 해소하기 위한 안 보건 교육, 안질환 조기발견을 위한 검진 사업, 저시력 보조기구 사용교육 등 폭넓고 세심한 지원 그리고 이를 위해 가능한 보건 정책이 개발되어야 할 것으로 생각된다.

• 치위생과학회지
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• 제8권3호
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• pp.169-173
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• 2008

본 연구는 2007년 3월10일부터 2007년 6월3일까지 충남 당진에 위치한 S대학 치위생과 3학년들의 치면세마 실습환자 248명을 대상으로 치간칫솔 사용에 따른 치면세균막 제거효과를 비례오즈모형(proportional odds models)을 사용하여 분석한 결과 다음과 같은 결론을 얻었다. 1. 비례오즈모형의 적합도는 자유도가 3인 1.2552이고 p값이 .7398로 비례오즈모형이 적절함을 의미하고 치면세균막 제거효과와 치간칫솔 사용의 독립성문제는 $H_0:{\beta}=0$에 대한 검정으로 검정통계량은 자유도가 1인 15.5496이고 p 값은 <.0001 이다. 이는 치면세균막 제거 효과와 치간칫솔의 사용은 매우 연관성이 높음을 의미한다. 2. 모형의$\beta$에 대한 ML추정치는 $\hat{\beta}=1.2493$(ASE = 0.3207)임을 알 수 있고 반응이 매우 불량이다 보다는 매우 양호하다 에 속할(이를 라 표현할 수 있다) 경향은 치간칫솔을 사용하지 않는다. 라는 반응에 비해 치간칫솔을 사 용한다. 라는 경향이 추정오즈비 exp(1.2493) = 3.49배 높다. 3. 비례오즈모형의 추정반응은 치간칫솔을 사용한다. 라는 반응이 매우양호와 양호한 치면세균막 제거효과에 속할 추정(누적)확률은 0.38(0.50)이다.