• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.903-907
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• 2015

Background: Among human epidermal growth factor receptor 2 (HER2)-positive breast cancer, more than half are also hormone receptor (HR)-positive. Although HR is a predictive factor for the efficacy of hormone therapy, there are still some uncertainties in regard to the effects on patients with HR-positive and HER2-positive metastatic breast cancers due to the potential resistance to hormone therapy caused by co-expression of HR and HER2. There are no clinical trials directly comparing the efficacy of hormonal therapy with chemotherapy. Materials and Methods: To examine the real-world effect of hormone therapy on patients with HR-positive and HER2-positive metastatic breast cancers, a cross-sectional study of a representative sample of the Chinese population was conducted. The study included 113 patients who received first-line and second-line palliative treatment between 2005 and 2010 in the Cancer Institute and Hospital, Chinese Academy of Medical Science. The effect of hormone therapy on overall survival (OS) was studied. Results: The patients who received hormone therapy (n=51) had better overall survival in contrast to those who received chemotherapy with anti-HER2 therapy (n=62) in first- or second-line treatment. The difference was of borderline statistical significance (51.8m vs 31.9m, p=0.065). In addition, the effect of hormone therapy did not differ significantly with other prognostic factors, including age (${\leq}50$ years or >50 years), disease free survival (${\geq}2$ years or < 2 years) and site of metastasis (visceral or bone/soft tissue). On multivariate analysis, administration of hormone therapy was associated with a trend toward a favorable prognosis (p=0.148, HR=0.693, 95%CI 0.422-1.139). Age more than 50 years was the sole independent harmful prognostic factor (p<0.001, HR=2.797, 95%CI 1.676-4.668). Conclusions: Our data suggest that hormonel therapy may improve outcomes of the patients with ER-positive and HER2-positive metastatic breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3249-3253
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• 2016

Background: Pemetrexed monotherapy has come to be recognized as one of the standard second-line therapies for advanced non-squamous non-small cell lung cancer (NSCLC). However, there have been no reports of studies that have evaluated the efficacy of pemetrexed according to type of active EGFR mutation, i.e., an exon 19 deletion or an L858R point mutation. Materials and Methods: The records of non-squamous NSCLC patients harboring an EGFR mutation who received pemetrexed monotherapy as a second or later line of chemotherapy at Kitasato University Hospital between March 2010 and October 2015 were retrospectively reviewed, and the treatment outcomes were evaluated. Results: The overall response rate and progression-free survival time (PFS) of the 53 patients with non-squamous NSCLC were 15.1% and 2.3 months, respectively. There were significant differences between the disease control rate (37.5% vs. 76.2%) and PFS time (1.8 months vs. 3.3 months) of the exon 19 deletion group and the L858R point mutation group, and a multivariate analysis identified type of EGFR mutation as well as performance status (PS) as independent predictors of PFS. Conclusions: The clinical data obtained in this study provided a valuable rationale for considering type of EGFR mutation as well as non-squamous histology as predictors of the efficacy of pemetrexed monotherapy.

• Clinical and Experimental Pediatrics
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• v.59 no.5
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• pp.231-238
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• 2016

Purpose: Lipopolysaccharide-binding protein (LBP) is a 65-kDa acute phase protein, derived from the liver, which is present in high concentrations in plasma. Data regarding the association between circulating plasma LBP levels and obesity-related biomarkers in the pediatric population are scarce. We aimed to determine whether there was a difference in plasma LBP levels between overweight/obese and normal-weight adolescents and to assess the correlation of circulating LBP levels with anthropometric measures and obesity-related biomarkers, including insulin resistance, liver enzyme levels, and lipid profiles. Methods: The study included 87 adolescents aged 12-13 years; 44 were overweight/obese and 43 were of normal-weight. We assessed anthropometric and laboratory measures, including body mass index (BMI), blood pressure, insulin resistance, liver enzyme levels, and lipid profiles. Plasma LBP levels were measured using an enzyme-linked immunosorbent assay. Results: The mean age of the participants was $12.9{\pm}0.3$ years. Circulating plasma LBP levels were significantly increased in overweight/obese participants compared with those in normal-weight participants ($7.8{\pm}1.9{\mu}g/mL$ vs. $6.0{\pm}1.6{\mu}g/mL$, P<0.001). LBP levels were significantly and positively associated with BMI, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, low density lipoprotein-cholesterol, fasting glucose and insulin, and insulin resistance as indicated by the homeostatic model assessment of insulin resistance (HOMA-IR) (all P<0.05). In multivariate linear regression analysis, BMI and HOMA-IR were independently and positively associated with plasma LBP levels. Conclusion: LBP is an inflammatory biomarker associated with BMI and obesity-related insulin resistance in adolescents. The positive correlation between these parameters suggests a potentially relevant pathophysiological mechanism linking LBP to obesity-related insulin resistance in adolescents.

• Journal of Korean Society of Forest Science
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• v.95 no.4
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• pp.459-467
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• 2006

The purpose of this study was to identify the effects of expectancy-disconfirmation (ED) of attraction affecting visitor's satisfaction in natural recreation forest (NRF). After reviewing the literature about recreational resources (RRs), facilities, ED, and visitor's satisfaction in NRF, this study analogized 11 attractions of NRF and constructed the conceptual framework. This study had obtained data through a questionnaire, which surveyed 415 visitors at 3 NRFs in 204 summer season. This study found that 1) The expectancy-performance of visitor's interesting resources is the highest among RRs, 2) There was mean difference between expectancy and performance of attraction at one percent significant level, 3) Safety facility had the highest ED value and plant resources had the lowest ED value, 4) The higher ED value of attractions, the lower value of visitor's satisfaction, 5) in multivariate analysis, such variables as physical resource, social culture resource, lodging facility, foundation facility, safety facility, sanitary facility, and education facility have been turned out be statistically significant at one percent level, 6) The relative contribution of the ED of foundation facility, lodging facility, and education facility on visitor's satisfaction have ben determined to have respectively 2.50, 1.48, and 1.88 times more important than that of physical resources.

• Journal of Preventive Medicine and Public Health
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• v.26 no.1 s.41
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• pp.20-36
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• 1993

Work-related low back pain is one of the major factors that cause the loss of working power especially in actively working age, therefore controlling the work-related low back pain is one of the major issues in the field of industrial safety and health. This study was performed for detecting the risk factors and proposing the efficient control program of the work-related low back pain. The subjects were male workers employed at the manufacturing industry in Pusan with longer than 6 months' working duration. The data was collected by self-reported questionnaire and interview from May 1 to October 31,1992. The contents of questionnaire were as follows:. the experience of low back pain within the recent one month, general characteristics(age, marital status, education level, religion, regular exercise), physical characteristics(height, weight), employment status(working duration, daily working hours, rest during work, satis(action fur the job), type of work and working environments(posture, forward bending, lifting and movement, satisfaction for table and chair). The result was analyzed for 608 entire respondents by case-control comparative method. The number of cases was 152 with a history of work-related low back pain, so the relative frequency of self-reported work-related low back pain was 25.0%, and the number of controls was 344 without any history of low back pain. As a result, two characteristics of the employment status(working duration, satisfaction fur the job) and all characteristics of type of work and working environments showed a statistical significance between the case and control groups(p<0.01). The Oddb ratios of these variables for Work-related low back pain were calculated. They were 7.88 for the satisfaction fur chair, 7.86 for lifting and movement,3.31 for satisfaction for table, and 2.22 fur bending forward(p<0.01). And for the multivariate logistic regression analysis confirmed that unsatisfaction for table was independent risk factor for Work-related low back pain. In summary, though this study was based upon the self-reported questionnaire and the subjective complaints, the satisfaction for chair, lifting and movement, satisfaction for table, and bending forward concerned with the type of work and working environments were considered as the main factors causing the work-related low back pain, and the work-related low back pain may be preventable by the ergonomic control of these factors.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.779-790
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• 1997

The Association between myofascial pain syndrome and some tests was assessed in a cross-sectional study of 904 female telephone operators using video display terminals(VDTs). 105 cases were diagnosed as Myofascial pain syndrome with symptom questionnaire, laboratory examination and physician's physical examination and 550 controls were defined to show only musculoskeletal symptoms using NIOSH symptom criteria. Data on demographics, musculoskeletal symptom and visual analogue scale(VAS) were obtained by questionnaire. Anthropometric measurements, pressure pain threshold, Grip & Pinch strength and laboratory test were conducted. No significant difference between case and control at comparing of demographics, occupational history and body measurements were observed. But, Grip strength, pressure pain threshold and VAS showed the statistical difference between case and controt. Age, pressure pain threshold of Rt. Upper trapezius and VAS were associated with myofascial pain syndrome in multivariate logistic regression analysis. This results suggest that, to diagnose of myofascial pain syndrome, the consideration of the objective aspects among patients' subjective symptom complaints through the VAS and pressure pain threshold is required.

• Korean Journal of Community Nutrition
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• v.2 no.4
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• pp.496-504
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• 1997

The purpose of this study was to investigate the dietary intake, obesity index and psychosocial factors influencing obesity among 200 high school girls in Seoul. The Social Cognitive Theory provided the Conceptual basis for this study. A cross-sectional survey was conducted to examine factors related to obesity, including self-efficacy for controlling overeating, social support for eating behavior, perception of body image and weight control, nutrition knowledge, and attitudes toward obesity. The data were analyzed using t-test and multiple logistic regression. The results of this study are as follows : 1) The mean age of the girls was 16.4 years, and the rate of overweight and obesity(measured by obesity index) was 27.0$\%$. 2) The mean energy intake of subjects was 1832.3$\pm$384.0kcal. The energy derived from carbohydrates, proteins and fats was 62.7$\%$, 13.8$\%$, and 23.5$\%$, respectively. There was no significant difference between the obese and the comparison group in energy intake. 3) The result of multivariate analysis indicated that obesity had a significant relation to the perception of ideal body image, social support for eating behavior, and self-efficacy for controlling overeating(p〈0.01). As subjects preferred thinner body images(OR=0.39) and received less social support(OR=0.93), the odds of being classified as obese increased. The odds of being obese were also associated with self-efficacy, however, the relation was not strong(OR=1.04). 4) Specific social support was related to obesity among adolescent girls. As subjects received more support from family member, the odds of being obese decreased. The emotional support as well as family member's positive nutrition behavior plays a significant role. In addition, instrumental support from friends was associated with obesity. With repect to self-efficacy, the odds of being obese were increased as subjects felt less confident in controlling overeating when tempting food was placed in front of them or after an argument. In contrast, the obese group felt more confident in controlling overeating for the rest of the specific situations examined. These findings suggest that educational interventions for weight control should incorporate strategies to help participants realize their degree of obesity, to reduce the discrepancy between current and ideal body image, to elicit and maintain social support from friends and family, and to increase the self-efficacy for changing eating behaviors. (Korean J Community Nutrition 2(4) : 496-504, 1997)

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2259-2266
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• 2012

This study was analyzed the 119 rescuers' image of citizens to provide a fundamental material to improve 119 rescuers' image effectively. This research design was a descriptive study. Data were collected from November 9, 2011 to December 9, 2011, and analyzed by SPSS PASW statistics 18.0 program. Among the 4 subcategories of the image, occupational image was found the highest value($3.17{\pm}0.36$), and the social image($2.81{\pm}0.48$) was found the lowest. There were statistical different between age($p$ <.001), occupation($p$ <.001), whether or not the emergency first response education is completed($p$ <.05), and whether or not 119 emergency service is received($p$ <.05). In the result of multivariate regression analysis, adjusted $R^2$ value was 0.120. The model fit 12.0%. Occupation (students, housewives and office workers) and those who completed emergency first response education were showed a positive image of 119 rescuers. There is a need to compare and analyze the image of 119 rescuers in accordance with whether or not 119 emergency service is received and the satisfaction with the emergency service under the control of the general characteristics(sex, age, occupation, economic level, etc.) of subjects.

• The Journal of the Korea Contents Association
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• v.15 no.2
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• pp.363-369
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• 2015

Chronic pain is one of the leading causes of hospital visits. It not only affects the patients themselves but also has a major negative impact on their families and society. In this study, we investigated epidemiology of musculoskeletal disorders induced chronic pain among general population based on Korea National Health and Nutrition Examination Survey database and also analysed how it influenced on the use of medical services. This study was done by using the data of 5th Korea National Health and Nutrition Examination Survey (KNHANES V), taking aged 20 years and over adults as research subjects. The EuroQoL-5 Dimension Index(EQ-5D) was used as a survey instrument. T-test, chi-square test and multivariate logistic regression were used for statistical analysis. Subjects with chronic pain had a higher likelihood than control group to use medical services(odds ratio : 5.858, confidence interval 3.636-9.438). Controlling for existence of chronic pain, more women were likely to use medical services than men(1.156, 0.707-1.889). Age, gender and household income level did not affect the use of medical services. Proper control of chronic pain is very helpful in improving patient's quality of life and it also accounts for a large proportion in suppressing excessive consumption of medical services. Anesthesia and pain medicine specialists have superior knowledge about analgesics and anticonvulsants than other physicians do and also have specialized skills to perform procedures like nerve blocks in treating chronic pain. Therefore Anesthesia and pain medicine specialists need to play a leading role in managing chronic pain.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.609-626
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• 1994

This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows: 1 Extremal Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and Coefficient of Variation (CV) were 0.14, both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is Chansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than f years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of the private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.