• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.997-1001
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• 2013

Background: Lymphangiogenesis, assessed as lymphovascular density (LVD), is the initial step of generalized tumor lymphovascular invasion (LVI). It also involves VEGF-C as the most important protein family. Lymphangiogenesis among breast cancer cases correlations with several clinicopathological factors are important to determine prognosis and treatment strategies, but results have been controversial and require clarification. Aim: To define correlations between VEGF-C expression, LVD and LVI with several clinicopathological parameters from Indonesian breast cancer patients. Materials and Methods: Using a cross-sectional study, a total of 48 paraffin-embedded tissues of breast cancer from Dr. Sardjito General Hospital Indonesia were assessed for VEGF-C expression, LVD and LVI by immunohistochemistry. Correlations of these markers with clinicopathological parameters like patient age, tumor size, lymph node status, grade, ER/PR and Her-2 status, cell proliferation and p-53 expression were investigated by linear analysis. Correlations of VEGF-C expression and LVI with several clinicopathological parameters were analyzed with Coefficient Contingency Chi-Square test. Results: The mean of patients age was 53.0 year, pre and post-menopausal patients accounting for 56.3% and 43.8%, respectively. Some 10.4% were well, 41.7% moderate and 47.9% poorly differentiated. ER positivity was evident in 50% while PR and Her-2 positivity was found in 31.3% and 33.3%, respectively. Breast cancer cells with over-expression of p-53 was 64.6% and with high cell proliferation was 56.3%. Lymph node metastasis was noted in 63.5%, and LVI in 72.9%. Significant correlations were found between LVD and tumor size (p:0.037), grade (p:0.000), lymphnode status (p:0.036), LVI (p:0.003), as well as with p-53 and cell proliferation. There were also significant correlation of VEGF-C (p:0.011) and LVI (p:0.001) with tumor grade. Only ER status was found to have a correlation with tumor size (p:0.027). Conclusions: This study suggested that in Indonesian breast cancer patients, lymphangiogenesis is correlated with tumor size, grade, lymph node status and tumor lymphovascular invasion, the latter also being related with p-53 over expression and high cell proliferation.

• 정신신체의학
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• 제27권2호
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• pp.173-180
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• 2019

연구목적 외로움은 정신 및 신체 건강과 관련이 있다고 알려져 있다. 하지만 우리나라에서 독거노인의 외로움에 영향을 주는 위험 요인에 대해서는 연구된 바가 거의 없다. 본 연구는 독거노인에서 외로움의 위험 요인을 확인하고자 하였다. 방 법 본 연구는 천안시에 거주하는 독거노인 1,091명을 대상자로 시행되었다. 훈련된 간호사외 면담과 외로움 척도, 인구사회학적 정보, 신체 건강상태(Cumulative illness rating scale, CIRS), 인지기능, 단축형 노인우울척도(SGDS-K) 등의 자가설문지를 통해 조사하였다. 통계분석은 인구학적 변인과 외로움 척도 간의 관계를 탐색하기 위해 기술적 통계분석을 시행하였으며 외로움과 관련된 위험 인자를 확인하기 위해 단변량 및 다중회귀분석을 사용하였다. 결 과 전체 대상자의 평균 외로움 척도 점수는 3.8 (SD=1.7)이었다. 가족과의 만남(standardized β=0.115, p<0.001), 종교(standardized β=0.057, p=0.028), 친교 활동(standardized β=0.088, p=0.001), SGDS-K 점수(standardized β=0.502, p<0.001)가 독거노인의 외로움에 유의한 영향을 주었다. 결 론 독거노인에게 가족관계, 종교 및 친교 활동, 우울증은 외로움의 위험요인이 될 수 있다. 독거노인의 외로움을 줄이기 위한 개입은 가족관계와 사회활동을 개선, 유지하고 우울증을 조기발견 및 치료하는데 초점을 맞추어야 할 것이다.

• 한국지역사회생활과학회지
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• 제20권3호
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• pp.413-421
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• 2009

The purpose of this study was to analyze the patterns and the interrelationships for meeting guidelines of three health behaviors including physical activity(PA), sedentary behavior(SB), and dietary behavior(DB) for Korean adolescents using 2007 KYRBS(Korea Youth Risk Behavior Survey) data. A cross-sectional design was used to assess 73392 middle-high school students. PA(moderate physical activity${\geqq}$5times/week, or vigorous ${\geqq}$3times/week), SB(watching TV, computer, DVD, video, etc. < 3 hr/day), and DB(servings of fruits ${\geqq}$1 times/day, or vegetables ${\geqq}$ 3 times/day) were categorized into two levels (meeting guidelines or not). Chi-squared tests were conducted to compare the prevalence of students not meeting these three health behaviors between boys and girls, and logistic linear regression was used to determine the interrelationships of three health behaviors. Students meeting guidelines for PA, SB, and DB were 31.0%(boys 42.6%, girls 18.0%), 74.7%(boys 75.4%, girls 74.0%), and 38.5%(boys 38.6%, girls 38.4%), respectively. In addition, there were significant differences between both genders for PA and SB (PA; $x^2(1)$=35175.11, p<.0001, SB; $x^2(1)$=19.44, p<.0001). Only 10.9% of students met all three guidelines and 12.4% did not meet all three. Pattern that simultaneously did not meet PA and DB were high in both boys(27.1%) and girls(37.2%). Students who did not meet DB were at greater risk of not meeting PA(Boys; OR 1.49, 95% CI 1.43 to 1.55, Girls; OR 1.42, 95% CI 1.34 to 1.50), and not meeting SB(Boys; OR 1.41, 95% CI 1.34 to 1.48, Girls; OR 1.36, 95% CI 1.29 to 1.43) compared with students who met DB. The findings of this study supported further evidence for the need of a multiple behavior approach considering gender and interrelationships among three behaviors.

• 대한지역사회영양학회지
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• 제6권4호
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• pp.604-616
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• 2001

This study was to investigate weight-control experience disorder and nutrient intake of college student attending web class via the internet. The subject were 1200 college students(392 male, 808 female) attending web class concerned with nutrition and weight control. This cross-sectional survey was conducted by self-administered questionnaire and data were analyzed by Students t-test and $\chi$$^2$-test. Nutrient intake collected from 3 day-recalls were analyzed by the Computer Aided Nutritional Analysis Program. Mean height, weight and RBW(relative body weight) of the male college students were 174.7 cm, 68.0 kg and 101.2%, respectively. Mean height, weight and RBW of the female college students were 162.3% cm, 52.7% kg and 95.3% respectively. Among the male college students, low weight were 1.0%, underweight were 12.8%, overweight were 12.5%, obese were 6.9% by RBW standard. Among the female college students, low weight were 5.1%, underweight 30.2%, overweight were 5.2%, obese were 1.5% by RBW standard. Percentages of weight control experience were 21.7% and 67.0% in the male and female college students, respectively. According to RBW, 22.4% of the weight control experience group were low weight or underweight in the female college students but none of weight control experience group were low weight or underweight in the male college students. Percentage of eating disorder were 6.8%(2.8%, male, 8.7% female) in the college students. Among the female college students, most nutrient intakes were significantly lower in the weight-control experienced group compared to the weight-control nonexperienced group. Among the male college students, there was a tendency that the intake of nutrients, except carbohydrate, calcium and vitamin A was higher in the eating disorder group compared to the non-eating disorder group. However, among the female college students, there was a tendency that the intake of nutrients, except calcium and thiamin was lower in the eating disorder group compared to the non-eating disorder group. Therefore, nutrition education via the internet is required for college students to know proper weight loss methods, desirable eating habits and eating disorder problem well.

• 대한지역사회영양학회지
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• 제19권6호
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• pp.537-549
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• 2014

Objectives: This study was conducted to examine blood pressure and other characteristics of a high sodium intake group assessed with 24-hr urine analysis and the dietary factors related to the risk of high sodium intake among Korean adults. Methods: A cross-sectional study was conducted with adults aged 20-59 years. Subjects who completed 24-hr urine collection (N = 205) were divided into 3 groups (tertile) according to the sodium intake estimated with 24-hour urine analysis. We compared the blood pressure, BMI and dietary related factors of the 3 groups (low, medium, high sodium intake group) with General Linear Model (GLM) and Duncan's multiple range test (p < 0.05). The risk factors related to high sodium intake were assessed with odds ratio (p < 0.05). Results: The sodium intake (mg/day) of the 3 groups were $3359.8{\pm}627.9$, $4900.3{\pm}395.1$ and $6770.6{\pm}873.9$, respectively, corresponding to daily salt intake (g/day) 8.5, 12.4 and 17.2, respectively. High sodium group showed significantly elevated age, BMI and systolic/diastolic blood pressure. Being male gender was associated with significantly increased risk of sodium intake (OR = 1.972; 95%CI: 1.083-3.593). The other factors related to high sodium intake were higher BMI (${\leq}25$) (OR = 2.619; 95% CI: 1.368-5.015), current alcohol consumption (OR = 1.943; 95%CI: 1.060-3.564), and having salty soybean paste with salt percentage > 14% (OR = 3.99; 95% CI: 1.404-6.841). The dietary attitude related to increased risk of high sodium intake included 'enjoy dried fish and salted mackerel' (p < 0.001) and 'eat all broth of soup, stew or noodle' (p < 0.001). Conclusions: Because high sodium intake was associated with higher blood pressure, nutrition education should focus on alcohol consumption, emphasis on related dietary factors such as using low salt soybean paste, improvements in the habit of eating dried fish and salted mackerel or eating all broth of soup, stew or noodle.

• 한국치위생학회지
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• 제16권6호
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• pp.969-978
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• 2016

Objectives: The purpose of the study was to examine the expected role and competency of future public health dental hygienist. Methods: This study was cross-sectional design. One dental hygienist per 16 cities and provinces was selected from the list of Korea Society of public dental hygienists. After signing in the informed consent, the interview was carried out. Transcripts were made after each interview. Six researchers recorded meaningful contents in the transcripts. They classified and integrated the information that they had recorded commonly or not. Their opinions were converged by conference. Two supervisors verified results whether they were derived from actual recordings for the reliability of the results. The records were confirmed once again and corrected into common message. Results: The main difficult subjects in public health official examination were public health, English, and medical legislation to pass the examine. The preliminary certificates included public health related certificate, computer certificate, and driver's license. In the personality aspect, creativity, activeness, cooperation and good responsibility were very important trait to public health official. Among 16 interviews, 9 were positive and 5 were negative about the future prospects of a public dental hygienist. Conclusions: The future of public health dental hygienist will be positive. Throughout effort to prepare for the public health official, the public health dental hygienist will be expanded and in many ways the dental hygienists will take the charge of the important parts of the public health administration in the near future.

• Journal of Preventive Medicine and Public Health
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• 제30권4호
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• pp.729-740
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• 1997

고혈압과 영양소 섭취와의 관계를 분석하기 위하여 춘천시 남면과 사북면의 10개리에 거주하는 30세 이상 성인을 대상으로 1995년 7월$\sim$8월, 1996년 6월에 혈압측정 및 24시간 회상법을 이용한 식이조사를 시행하여 남자 250명, 여자 297명을 대상으로 분석하였다. 혈압과 영양소 섭취와의 관련성을 분석한 결과를 요약하면 아래와 같다. 1. 평균 수축기 혈압과 영양소 섭취와의 상관관계 분석에서 유의한 상관관계를 보인 영양소는 남성에서 단백질 에너지(%)였다$(\gamma=0.16)$. 여성에서는 유의한 상관 관계를 보여주지 않았다. 2. 평균 이완기 혈압과의 상관관계 분석시 남성에서 단백질 밀도와 단백질 에너지(%)가 강한 양의 상관관계를(p<0.01)보여주었으며, 칼슘 밀도(calcium density)와 에너지 보정 단백질도 유의한 양의 상관관계를 보여주었다. 여성에서는 유의한 상관관계를 보인 영양소는 없었다. 3. 탄수화물과 나트륨을 제외한 영양소 섭취량은 전체적으로 고혈압군에서 높았으나 유의한 차이는 보이지 않았다. 4. 다중선형회귀분석(multiple linear regression analysis)에서 남성의 경우 영양소 밀도를 이용한 모델에서는 평균 이완기 혈압만이 단백질 밀도와 유의한 양의 연관성을 보여주었다. 에너지 보정 영양소를 이용한 모델에서는 평균 이완기 혈압과 에너지 보정 단백질만이 유의한 양의 연관성을, 총 열량은 음의 연관성을 보여주었다. 여성의 경우는 평균 수축기 및 이완기 혈압과 유의한 연관성을 보여주는 영양소는 없었다. 5. 고혈압과 영양소와의 관계를 성, 연령, 체질량 지수, 가족력을 보정하고 선형중회귀로짓분석을 이용하여 분석시 영양소 밀도를 이용한 모델에서는 단백질 밀도가 강한 양의 연관성을(Odds ratio=3.18), 지방밀도는 유의한 양의 연관성을(Odds ratio=1.94)을, 나트륨 밀도는 유의한 음의 연관성을 보여주었다(Odds ratio=0.73). 에너지 보정 영양소를 이용한 모델에서는 에너지 보정 단백질이 유의한 양의 연관성을 보여주었다(Odds ratio=1.01). 본 연구는 단면조사를 통하여 혈압과 영양소와의 상관관계 분석과 고혈압군과 정상혈압군의 영양소 섭취의 차이를 분석하여 영양소섭취와 고혈압과의 연관성을 보고자 하였는데 적대적인 영양소 섭취량보다는, 같은 에너지 섭취수준에서 단백질과 지방 섭취가 상대적으로 많은 경우가 양의 연관성을 보였고, 나트륨 섭취가 상대적으로 적은 경우가 음의 연관성을 보였다.

• Journal of Hospice and Palliative Care
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• 제19권4호
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• pp.322-330
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• 2016

목적: 본 연구는 요양병원 간호사의 통증관리 지식, 태도, 수행정도를 파악하여 추후 요양병원 통증관리 교육을 설계하는데 기초자료로 활용하고자 실시되었다. 방법: 본 연구는 4개 요양병원에서 근무하는 간호사 120명을 대상으로 한 횡단적 조사연구이다. 통증관리 지식과 통증관리 태도는 원래 연구도구는 Watt-Watson이 개발한 도구를 사용하였고, 통증관리 수행정도는 요양병원에서의 통증관리 가이드라인들을 근거로 연구자가 개발하여 사용하였다. 결과: 본 연구의 결과 통증관리 지식은 40점 만점 평균 26.2점이었다. 가장 많이 틀린 문항은 통증의 주관성에 대한 항목으로 '통증에 따르는 환자의 생리적, 행동적 반응을 보고 통증의 유무와 강도를 파악할 수 있다(89.2%)'였고, 56.7%는 내성의 증가는 마약성 진통제 중독을 의미한다고 생각하였다. 통증관리 태도와 실무에 관해서는, 80.2%가 통증을 자주 호소하는 환자에게 위약을 사용한다고 하였고, 위약사용은 간호사가 두 번째로 자주 사용하는 통증관리 방법이었다. 결론: 본 연구는 요양병원 간호사의 통증관리 지식이 낮고 태도가 부적절한 것으로 나타났고, 이는 통증관리 실무에 부정적 영향을 미칠 수 있다. 요양병원 간호사들에게 통증관리 교육, 특히 통증의 속성과 위약남용에 대한 교육이 시급하다.

• 대한임상검사과학회지
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• 제49권4호
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• pp.374-381
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• 2017

LAP 지수는 공복시 중성지방 농도와 허리둘레의 조합으로 과도한 지방축적을 평가하는 지표이다. 이 연구는 LAP 지수와 ALT간의 관련성과 LAP 지수가 ALT에 미치는 영향에 대해 알아 보고자 간질환의 병력이 없는 건강한 성인남성을 대상으로 횡단면 연구를 실시하였다. 2015년 1월부터 2017년 6월까지 경기지역 종합병원에서 건강검진을 시행한 20세 이상 70세 이하의 성인 남성 13,854명을 연구 대상자로 하였다. LAP 지수는 남성의 경우 [허리둘레(cm)-65]${\times}$[중성지방(mmol/L)]으로 산출하였으며, 혈청 ALT 농도의 이상치는 남성 40 IU/L 이상인 경우를 기준으로 설정하였다. 모든 대상자들은 인체측정학적 지표와 생리학적 검사를 실시하였다. LAP 분위수가 증가할수록 ALT는 통계적으로 유의한 증가를 보였다(p<0.001). LAP 지수는 ALT와 상관관계를 보였으며(r=0.238, p<0.001), 특히 인슐린(r=0.449, p<0.001) 및 HDL-콜레스테롤(r=-0.369, p<0.001)과 상관성이 높게 나타났다. 또한 LAP 지수는 ALT에 영향을 미치는 요인이었으며(p<0.001), LAP 지수가 높을수록 ALT가 상승할 위험이 높게 나타났다(p<0.001). 결론적으로 LAP 지수는 한국 성인남성에서 ALT 상승을 예측하는 지표로 나타났다.

• Journal of Trauma and Injury
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• 제26권2호
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• pp.39-46
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• 2013

Purpose: Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients. Methods: The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless. Results: There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg. Conclusion: Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.