• Journal of muscle and joint health
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• v.5 no.1
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• pp.83-109
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• 1998

This study was carried out to identify the Important modifiable risk factors for reduced bone mass and to construct prediction model which can classify women with either low or high bone mass. Through the literature review, individual characteristics such as age, body weight, height, education level, family history, age of menarche, postmenopausal period, gravity, parity, menopausal status, and breast feeding period were identified and factors of life style such as past milk consumption, past physical activity, present daily activity, present calcium intake, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of reduced bone mass in women. Four hundred and eighty women aged between 28 and 76 who had given measurement bone mineral density by dual energy x-ray absortiometry in lumbar vertebrae and femur from July to October, 1997 at 4 general hospitals in Seoul and Pusan were selected for this study. Women were excluded if they had a history of any chronic illness such as rheumatoid arthritis, diabetes mellitus, hyperthroidism, & gastrointestinal disorder and any medication such as calcium supplements, calcitonin, estrogen, thyroxine, antacids, & corticosteroids known affect bone. As a result of these exclusion criteria, four hundred and seventeen women were used for analysis. Multiple logistic regression model was developed for estimating the likelihood of the presence or absence of reduced bone mass. A SAS procedure was used to estimate risk factor coefficient. The results are as follows For lumbar spine, the variables significant were age, body weight, menopause status, daily activity, past milk consumption, and past physical activity(p<0.01), while for femoral Ward's triangle, age, body weight, level of education, past milk consumption, past physical activity(p<0.001). Past physical activity, present daily activity and past milk consumption are the most powerful modifiable predictors in vertebrae and femur among the predictors. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 74.1% of persons with reduced bone mass and 84.5% of persons with normal bone mass in the lumbar vertebrae and 82.9% of persons with reduced bone mass and 75.0% of persons with normal bone mass in the femoral Ward's triangle. On the basis of these results, a number of recommendations for the management of reduced bone mass may be made : First, those woman who are classified as high risk group of the reduced bone mass in the prediction model should examine the bone mineral density to further examine the usefulness of this model. Second, the optimal amount of milk consumption and a regular weight bearing exercise in childhood, adolescence, and early adult should be ensured.

• Journal of muscle and joint health
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• v.7 no.1
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• pp.89-101
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• 2000

This study was carried out to compare the bone mineral density and risk factors of osteoporosis between normal and rheumatoid arthritis in postmenopausal women. Sixty-eight postmenopausal patients with rheumatoid arthritis(RA) were compared with 124 postmenopausal normal women. Data were collected from october, 1998 to April, 1999 at Dong-a university hospital in Pusan. From all subjects, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption, exercise, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of osteoporosis by questionnaire. From RA patients, health assessment score, Ritchie articular index, erythrocyte sedimentation rate, C-reactive protein and steroid dosage were measured by rheumatologist on measuring bone mineral density. Bone mineral density was measured at the Lumbar spine, femoral neck, femur Ward's triangle, and femur trochanter using dual x-ray absorptiometry. The data was analyzed by using a frequency, t-test, Chi-square, ANCOVA with SPSS PC program. The results could be summarized as follows : 1) There was a significant difference in age and breast feeding period between RA patients and normal women. 2) RA patients took less calcium in the past and practiced less regular exercise in past and present than normal women. 3) There was no difference in lumbar bone mineral density between RA patients and normal women. 4) There was a significant difference in femur Ward's triangle and femur trochanter between RA patients and normal women after adjustment for age and breast feeding period. 5) The prevalence of osteoporosis of all subjects was the highest in femur Ward's triangle. In summary, our findings suggest that the bone mineral densities of femur Ward's triangle and trochanter in postmenopausal women with RA is significantly lower than normal women. Also the exercise participation rate of postmenopausal women with RA is lower than normal women. For the further study, we recommend to develop exercise program that improve the bone mineral density in femur Ward's triangle and trochanter and to test the effect of that exercise program.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5095-5099
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• 2013

Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was $34.6{\pm}5.0$ years among younger patients compared to $54.1{\pm}9.9$ for those ${\geq}40$ years. The mean age at menarche was also significantly lower ($13.5{\pm}1.5$ vs $14.2{\pm}1.5$ years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women ($5.0{\pm}2.5$ vs $4.5{\pm}2.4cm$, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, $p{\leq}0.05$). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7485-7489
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• 2015

Background: Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. Materials and Methods: We conducted a cross-sectional study among women aged 18 to 25 using a self-administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Results: Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. Conclusions: The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.

• Women's Health Nursing
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• v.3 no.2
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• pp.113-128
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• 1997

The purpose of this study was to investigate the relation between self concept and depression of middle-age women. Data were collected by a questionnaire from June 23 to July 3, 1997. The subject for this study were 138 women between 40-60 years of age living in Seoul and Incheon. The instruments used for this study were the self concept scale developed by Rosenberg and Choi, Jung-Hun and the depression scale developed by Rockliff and the investigator. The data were analyzed by descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, stepwise multiple regression using the SPSS program. The results of this study were as follows 1. Mean score of self concept was 3.58, in minimum score 2.86 to maximum score 3.99. 2. Mean score of depression scale was 1.95, in a minimum score 1.50 to maximum score 2.61. 3. The relationship between self concept and depression was statistically significant negative correlation(r=-0.5121, p<0.001). 4. General characteristics variables significantly related to the level of self concept were marital status(t=-3.22, p<0.01), experience of disease in a year(t=2.76, p<0.01), child problem(t=-2.59, p<0.05), marital satisfaction(F=6.80, p<0.05). 5. General characteristics variables significantly related to the level of depression were possession of house(t=-2.42, p<0.01), experience of disease in a year(t=-4.32, p<0.001), child problem(t=3.12, p<0.05), husband problem(t=5.29, p<0.001), marital satisfaction (F=8.36, p<0.001). 6. Obstetrical characteristics variables significantly related to the level of self concept was times of pregnancy(F=3.54, p<0.05). 7. Obstetrical characteristics variables significantly related to the level of depression were age of menarche(F=3.87, p<0.05), times of abortion(F=2.49, p<0.01) number of children(F=3.36, p<0.01). 8. In the stepwise multiple regression analysis, the main influencing variables on depression of middle aged women were self concept($R^2$=.26, p<0.001), husband problem ($R^2$=.37, p<0.001), experience of disease in a year($R^2$=.41, p<0.001) and possession of house($R^2$=.44, p<0.001).

• Journal of the Korean Dietetic Association
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• v.9 no.4
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• pp.307-315
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• 2003

This study was to investigate the relation of nutrients intake, health status, and bone mineral density in middle-aged women. Daily nutrients intake were analyzed by convenient method. The BMD of subjects were measured by Dual Energy X-ray Absorptiometry(DEXA). BMD was measured at the spine(vertebrae L2-L4) and femur(neck, Ward's triangle and trochanter). The nutrients intake of subjects were higher than recommended dietary allowances(RDA) except for calorie, iron, calcium, vitamin B1. Nutrients intake of vitamin A(p<0.05), iron(p<0.01), vitamin $B_2$(p<0.05), niacin(p<0.05), and vitamin C(p<0.05) between $\leq$49 yr group and $\geq$50 yr group. Mean daily intake of calcium was much less than the Korean RDA, 78.5% in $\leq$49 yr group and 77.3% in $\geq$50 yr group. 35.8% of the subjects under 50 years of age($\leq$49 yr group) and 77.4% of the subjects from 50 years up($\geq$50 yr group) were classified as osteopenia or osteoporosis. BMD of L2-L4 were positively correlated with height(p<0.05), weight(p<0.05) and BMI(p<0.05). BMD of femoral neck was positively correlated with BMI(p<0.05), BMD of Ward's triangle was positively correlated with weight(p<0.001). But BMD of L2-L4 and femoral neck were negatively correlated with age(p<0.05), menarche(p<0.05). BMD of Ward's triangle was negatively correlated with age(p<0.001). The BMD of L2-L4 were positively correlated with animal protein(p<0.05), calcium(p<0.05) and iron(p<0.05). The BMD of femoral neck was positively correlated with animal protein(p<0.05). The BMD of Ward's triangle was positively correlated with animal protein(p<0.001) and iron(p<0.001). The above results suggest that it should be difficult to prevent middle-aged women's bone destruction through nutrients intake. Further investigation is necessary to prove the mutual relations between BMD, exercise, and calcium intake. Therefore, middle-aged women will need proper exercise as well as Ca supplementation in order to prevent osteoporosis with aging.

• Journal of Korean Academy of Nursing
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• v.7 no.1
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• pp.30-38
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• 1977

Breast cancer is one of the most feared health problems in women ; Recent studies revealed that it had come up to be the second most in this country and high prevalent disease in the western countries among breast disease in women. However, early detection of the cancer mass is known to be easier than in many other malignancies. This study was performed to investigate the various characteristics of patients of breast cancer ; by the structural variables, menstrual, marital, and child bearing, and also their understandings and attitude towards the disease. A hundred any in- and out- patients of 51. Mary's Hospital and National Atomic Institute, Seoul were sampled. Data were gathered through direct interview by the researcher from February 1976 to January 1977 and the clinical records were used as references. Results are as follows ; 1. Breast cancer revealed to be most prevalent in the forties ; average age of 45.2 years. 2. The average age of menarche revealed to be 15.4 years ; the largest group were the 16-20 years (N=75, 68.2%). In 55 cases (50%) menstruation were normal, 38 (34.5%) postmenopausal and only in 17 (15.5%), menstruation revealed irregularity. 3. The average marital age revealed to be 22.3 years ; the largest group were 21-25 group (N=43, 39.1%). The average duration of marital life revealed to be 24.7 years ; 11-20 years group were the largest (M=34, 30.9%). 4. Most of the patients revealed to have pregnancy experiences(N=100, 90.9%) ; the average rate of experience were 5, 3 times the largest group were 3.4 times group(N= 32, 29.1%). 54 patients (49.1%) revealed to have had abortion experience ; the average were 3.4 times. 5. The largest group(N=77, 70%) had been breast feeding : followed by mixed feeding (N=12, 10.9%) and artificial feeding(N=10, 9.1%). 6. Personal health history revealed that in 20 patients (18.2%) revealed to have the past history of Purulent mastitis, 5 patients(4.5%) of breast cancer and 3 patients(2.7%) of uttering cancer family history. 7. In the one half (N=56, 50.9%, they had some information about breast cancer :27 (24.5%) by mass media, 12 (10.9%) through personal contacts and 17 (15.5%) were not able to classify the source of information. 8. In 55 cases (50%) the canoe, mass were discovered incidentally, in 39 cases (35.5%) by manual detection by self, in 10 cases (9%) by others and in 6 cases(5.5%) by observing subjective symptoms. 9. The average duration lapsed between the discovery of cancer mass and the visit to the hospital revealed to be 9.4 month. Chief reason for the delay revealed to be the non-chaplaincy due to the absence of pain(N=50, 45.5 %) followed by the administration of herb and commercial medication (N=19, 17.3%). 10. The left side breast was more affected than the right side breast, represent by 60 cases in the left and 39 cases in the right. The most frequent site of the breast cancer was the upper- outer quadrant in 53 cases (47.7%), and followed by the center in 20 cases(18 %), and the upper inner quadrant, in 19 cases (17.1%). There was / cases of bilateral carcinoma. The most prominent symptom was painless mass.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.1
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• pp.43-51
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• 2006

Purpose: This study was performed to identity the relationship between PMS and menstrual attitudes. Method: Data were collected from 417 female college students in Seoul and Gyeonggi-do area during the period from the 6th of September to the 15th of October in 2004. Collected data were analysed using the SPSS WIN 11.0. Result: The results of this study were as follows: 1) Perceived subjective symptoms were clustered endogenous depressive feature($2.76{\pm}.97$), anxiety($2.76{\pm}1.09$), and impulsivity($2.72{\pm}1.02$). 2) PMS was significantly different according to the general characteristics of grade(F=3.414, p=.018), major(F=2.755, P=.004), menarche age(F=5.910, p=.003), pain(F=7.886, p=.000), family history(F=5.366, p=.005). 3) Menstrual attitudes was significantly different according to the general characteristics of grade(F=3.315, p=.020), major(F=3.813, P=.000), religion(F=6.313, p=.000), interval of menstruation(F=2.834, p=.016), pain(F=3.059, p=.048), family history(F=3.062, p=.048). 4) Menstrual attitudes and PMS were in a positive correlation with each other (r=.112, p=.002). Conclusion: This results showed that there is a significant correlation between PMS and menstrual attitudes. For further research, it is recommended to identity major factors affecting PMS and the relationships between them and various subjects.

• Journal of environmental and Sanitary engineering
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• v.19 no.3 s.53
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• pp.71-80
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• 2004

The purpose of this study was to find the relationship between osteoporosis and various factors such as general personal background, physical activity, menstruation, daily life and dietary habit. The following are the results of this study: 1. In the relationship of osteoporosis status with general personal background, the risk of osteoporosis increased with age. Active women with higher education, high income and jobs tended to have less risk of osteoporosis. Women with earlier menarche had a tendency of having thicker bone mineral density. 2. As for disease related to bone mineral density, stomach disease, thyroid, bone damage, and bad teeth conditions were significant factors affecting bone mineral density. Women with those diseases and family history of osteoporosis were more likely to have osteoporosis. 3. In relation to food intake regular diet of dairy products, anchovy, or meat showed significantly less risk of osteoporosis. 4. In relation between dietary habits and bone mineral density, unbalanced diet had statistically less probability of osteoporosis. It is important for genetically disposed women to prevent osteoporosis in advance by considering acquired factors like life-style and medication.