• Asian Pacific Journal of Cancer Prevention
• /
• 제17권4호
• /
• pp.2205-2209
• /
• 2016

Cholangiocarcinoma (CCA) is a serious problem in Thailand, particularly in the northeastern region. Active surveillance in rural communities with an appropriat low-cost screening tool is required to facilitate early detection. Therefore, this study aimed to investigate the population at risk of CCA in Bua Yai district, Nakhon Ratchasima province, Northeastern Thailand using the Korat-CCA verbal screening test (KCVST) during June to October 2015. Reliability of KCVST demonstrated a Cronbach alpha coefficient=0.75 Stepwise-multiple regression showed that alcohol consumption was important for CCA screened, followed by agriculture and pesticide use, under-cooked cyprinoid fish consumption, praziquantel use, naïve northeastern people, opisthorchiasis, family relatives with CCA, and cholangitis or cholecystitis or gallstones, respectively. Population at risk for CCA was classified to low risk (63.4%), moderate risk (33.7%), and high risk (1.32%) for CCA. When CCA was screened using ultrasonography, 4 of 32 high risk participants had an abnormal biliary tract with dilated bile ducts. This study indicates that KCVST is a potential useful too which decrease the cost of large scale CCA screening.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권2호
• /
• pp.671-676
• /
• 2014

Objective: The objective of this study was to establish a program model for use in wide-spread cervical cancer screening. :Methods: Cervical cancer screening was conducted in Zhongshan city in Guangdong province, China through a coordinated network of multiple institutes and hospitals. A total of 43,567 women, 35 to 59 years of age, were screened during regular gynecological examinations using the liquid-based ThinPrep cytology test (TCT). Patients who tested positive were recalled for further treatment. Results: The TCT-positive rate was 3.17%, and 63.4% of these patients returned for follow-up. Pathology results were positive for 30.5% of the recalled women. Women who were younger than 50 years of age, urban dwelling, low-income, had a history of cervical disease, began having sex before 20 years of age, or had sex during menstruation, were at elevated risk for a positive TCT test. The recall rate was lower in women older than 50 years of age, urban dwelling, poorly educated, and who began having sex early. Ahigher recall rate was found in women 35 years of age and younger, urban dwelling, women who first had sex after 24 years of age, and women who had sex during menstruation. The positive pathology rate was higher in urban women 50 years of age and younger and women who tested positive for human papillomavirus. Conclusion: An effective model for large-scale cervical cancer screening was successfully established. These results suggest that improvements are needed in basic education regarding cervical cancer screening for young and poorly educated women. Improved outreach for follow-up is also necessary to effectively control cervical cancer.

• 과학기술학연구
• /
• 제13권1호
• /
• pp.77-109
• /
• 2013

현재 의료체계의 주된 변화로 근거중심의학(Evidence-based Medicine: EBM)의 전지구적확산을 꼽을 수 있다. 최근 STS 연구들은 EBM이 실제 의학 실행 속에서 어떻게 사용되고 작동하는지에 대한 검토를 수행했는데, 이 글은 이러한 맥락 속에서 전립선암 특이항원(Prostate-specific Antigen: PSA) 의 조기진단 검사 도구 사용 여부를 둘러싸고 미국에서 벌어진 논쟁을 추적한다. 본 연구는 EBM이 PSA 검사 조기진단의 지지자와 반대자 양측에서 논쟁의 자원으로 이용되었으며, 그 과정에서 '확고한 과학적 기준'을 제시할 것으로 기대되던 EBM의 과학적 증거 위계가 행위자들의 의도에 따라 사실상'유연하게' 해석되고 동원되었음을 보일 것이다. 나아가, 이 글은 현재 EBM이 PSA 검사 반대자를 지지하는 것처럼 보이는 일은 삶의 질이라는 가치가 EBM의 체계 내에 주요한 변수로 부상하는 역사적 맥락에 의해 만들어진 결과임을 드러낼 것이다. 본 사례 연구는 EBM 시대에 의료기술에 관한 논쟁을 검토하는 연구자들이 EBM이라는 대상을 주어진 것으로 간주하기 보다는 논쟁 속에서 맥락화하여 논쟁과 함께 분석해야 함을 시사한다.

• Clinical and Experimental Pediatrics
• /
• 제49권10호
• /
• pp.1056-1060
• /
• 2006

목 적 : 청각 장애는 정상 신생아 출생 1,000명 당 2-7명의 높은 발병률을 보이는 것으로 알려져 있으나, 임상적으로 조기발견이 어려워 평균 2-2.5세에 발견된다. 청각은 언어 및 인지발달에 중요한 영향을 미치므로 청각 장애의 조기 발견을 위한 신생아 청력 선별검사의 중요성이 강조되고 있다. 이에 연구자들은 정상 신생아를 대상으로 시행한 선별검사의 결과를 분석하여 신생아에서의 청각 장애의 빈도를 파악하고, 선별검사의 효용성을 알아보고자 하였다. 방 법 : 2004년 7월부터 2005년 6월까지 성균관대학교 의과대학 삼성제일병원 신생아실에서 출생한 신생아 8,664명중 보호자의 신청에 의해 신생아 청력 선별검사를 시행한 정상 신생아 7,171명과 위험인자를 가진 47명 등 총 7,218명을 대상으로 하였다. 신생아 청력 선별검사는 $ALGO^{(3)}$ Newborn hearing screener를 이용하여 35 dB의 청각 자극에 대한 AABR을 시행하였다. 출생 2일째 1차 검사를 시행하였고, 1차 검사에서 통과하지 못한 경우 신생아실 퇴원 전 2차 검사를 시행하였으며 2차 검사에서 통과하지 못한 경우 생후 1개월에 삼성서울병원 이비인후과에서 추적검사를 시행하며 이후 추적관찰을 시행하였다. 결 과 : 선별검사를 받은 총 7,218명 중 7,163명이 정상 판정을 받았으며, 55명이 선별검사에서 재검 판정을 받아 재검율 0.8%이었다. 재검 판정자 중 생후 1개월에 추적 검사를 받지 않은 6명을 제외한 49명 중 정상으로 판정된 경우는 35명(71.4%)이었고, 청각 장애로 진단된 경우는 14명(28.6%)이었다. 추적검사에서 소실된 6명을 고려할 때 청각장애의 발생 빈도는 7,218명 중 14-20명이므로 1,000명 출생 당 1.9-2.8명으로 추정된다. 청각장애 14명 중 남:여 비율은 3.6:1이었으며 좌측이 장애인 경우가 64.3%로 우측(21.4%) 및 양측(14.3%)보다 높게 나타났다. 미숙아 등 위험 요인이 있는 47명 중 청각 장애인 경우는 8명(17.0%)으로 정상 신생아 7,171명에서의 발생 빈도(6명, 0.1%)보다 높았다. 청각 장애 14명 중 3명은 보청기로 치료를 시작하였으며, 나머지는 추적관찰 중에 있다. 결 론 : 신생아에서의 청각 장애의 비율은 신생아 1,000명당 1.9-2.8명으로 다른 연구자들의 연구와 비슷한 빈도를 나타내었다. 신생아에 대한 AABR은 신생아실에서 신속하게 시행할 수 있는 비침습적인 선별 검사이며, 보청기 등 조기치료를 가능하게 하는 유용한 검사로 판단된다.

• Journal of Genetic Medicine
• /
• 제9권2호
• /
• pp.73-77
• /
• 2012

Purpose: Fragile X carrier detection before or at early pregnancy through a wide screening program may not only confer a risk of having offspring with Fragile X syndrome (FXS), but may also confer a risk for Fragile X-associated primary ovarian insufficiency and Fragile X-associated tremor/ataxia syndrome. However, prior to the implementation of such a program, the carrier prevalence in a population and the availability of effective screening test should be evaluated. The aim of our study was to determine the prevalence of premutation carriers and to evaluate the feasibility of screening test. Materials and Methods: The blood samples were obtained from 8,641 pregnant women with no family history of mental retardation. We performed a three-primer CGG repeat primed (RP) PCR using the AmplideX$^{TM}$ FMR1 PCR kit (Asuragen, Inc. Austin, TX, USA). Samples showing full mutation alleles were reflexed to Southern blot analysis for methylation status and sizing. Results: Among the 8,641 women, we found 8 premutation carriers (1:1,090, 0.09%) and 46 women with an intermediate allele (1:190, 0.53%). No woman was found to carry the fully mutated allele. All the detected alleles were within the CGG repeat range of 8-117. Among the 8,641 samples, 29 and 30 CGG repeats represent 66.6% of all cases. The CGG RP PCR method provides robust detection of expanded alleles and resolves allele zygosity, thus minimizing the number of samples that require Southern blot analysis. Conclusion: This is the first study that has focused on the prevalence of FXS premutation carriers and FMR1 allele distribution in normal pregnant women. These data have important implications for population-based fragile X carrier screening in Korea.

• 한국학교보건학회지
• /
• 제31권1호
• /
• pp.1-9
• /
• 2018

Purpose: This study was conducted to explore the relationship between aggression, self-esteem, and social withdrawal. Methods: This research is a cross-sectional survey. This study used the 5th-year data of the Korean Children & Youth Panel Survey (KCYPS) including 218 middle school students having delinquent behavior. The collected data was analyzed through $x^2$ test, t-test, ANOVA, Pearson's correlation, and hierarchical multiple regression, using SPSS/Win (ver. 23.0). Results: Significant positive correlations were found between aggression and social withdrawal and between aggression and self-esteem. Higher aggression was associated with higher social withdrawal and lower self-esteem. The results of the 2-step regression are as follows. Aggression was negatively correlated with self-esteem, whereas self-esteem was positively correlated with social withdrawals. The hierarchical multiple regression showed that 21% of the variance of aggression was significantly accounted for by self-esteem and social withdrawal. The most significant factor influencing aggression was social withdrawal. Conclusion: These results suggest that earlier screening and intervention programs to increase self-esteem and decrease social withdrawal for early adolescents should be developed to prevent aggression.

• BMB Reports
• /
• 제41권10호
• /
• pp.685-692
• /
• 2008

Colorectal cancer (CRC) is the third most common malignancy in the world. Because CRC develops slowly from removable precancerous lesions, detection of the disease at an early stage during regular health examinations can reduce both the incidence and mortality of the disease. Although sigmoidoscopy offers significant improvements in the detection rate of CRC, its diagnostic value is limited by its high costs and inconvenience. Therefore, there is a compelling need for the identification of noninvasive biomarkers that can enable earlier detection of CRC. Accordingly, many validation studies have been conducted to evaluate genetic, epigenetic or protein markers that can be detected in the stool or in serum. Currently, the fecal-occult blood test is the most widely used method of screening for CRC. However, advances in genomics and proteomics combined with developments in other relevant fields will lead to the discovery of novel non invasive biomarkers whose usefulness will be tested in larger validation studies. Here, non-invasive molecular biomarkers that are currently used in clinical settings and have the potential for use as CRC biomarkers are discussed.

• Journal of Preventive Medicine and Public Health
• /
• 제40권6호
• /
• pp.505-511
• /
• 2007

Objectives : While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. Methods : Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. Results : Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. Conclusions : Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.

• 대한간호학회지
• /
• 제34권7호
• /
• pp.1215-1223
• /
• 2004

Purpose: This study was performed to test the clinical usefulness of the glucose test strip method for early detection of pulmonary aspiration in tube fed patients. Method: The subjects for the study were 36 patients who were receiving enteral feedings and 39 patients who were not given enteral feedings. For the analysis, the tube fed patients were divided into two groups (clinically significant aspiration and no aspiration) according to criteria. Result: The mean glucose concentration of tracheal secretions from non enteral fed patients was 26.35mg/dl and were lower than those concentrations found in tube fed patients (32.75mg/dl). The mean glucose concentration of the aspiration group was 45.60mg/dl and the glucose concentration of the non aspiration group was 19.93mg/dl. The difference was statistically significant (t=2.163, p=.038). More subjects in the no aspiration group ($73\%$) than the aspiration group ($56\%$) had glucose concentrations below 20mg/dl. After deleting the cases that had samples containing blood, glucose concentrations of tracheal aspirates were lower in both groups. Conclusion: The glucose level of the aspiration group was significantly lower than the no aspiration group and more subjects in the aspiration group had a glucose level higher than 101mg/dl. Therefore, the glucose test of tracheal secretions in tube fed patients could be a desirable test for screening for tracheal aspiration. Especially the patient who is showing repeatedly high glucose levels should not be given feedings until reassessment is completed.

• Clinical and Experimental Pediatrics
• /
• 제63권2호
• /
• pp.34-43
• /
• 2020

Phenylketonuria is a disease caused by congenital defects in phenylalanine metabolism that leads to irreversible nerve cell damage. However, its detection in the early days of life can reduce its severity. Thus, many countries have started disease screening programs for neonates. The present study aimed to determine the worldwide prevalence of classic phenylketonuria using the data of neonatal screening studies.The PubMed, Web of Sciences, Sciences Direct, ProQuest, and Scopus databases were searched for related articles. Article quality was evaluated using the Joanna Briggs Institute Critical Appraisal Evaluation Checklist. A random effect was used to calculate the pooled prevalence, and a phenylketonuria prevalence per 100,000 neonates was reported. A total of 53 studies with 119,152,905 participants conducted in 1964-2017 were included in this systematic review. The highest prevalence (38.13) was reported in Turkey, while the lowest (0.3) in Thailand. A total of 46 studies were entered into the meta-analysis for pooled prevalence estimation. The overall worldwide prevalence of the disease is 6.002 per 100,000 neonates (95% confidence interval, 5.07-6.93). The meta-regression test showed high heterogeneity in the worldwide disease prevalence (I²=99%). Heterogeneity in the worldwide prevalence of phenylketonuria is high, possibly due to differences in factors affecting the disease, such as consanguineous marriages and genetic reserves in different countries, study performance, diagnostic tests, cutoff points, and sample size.