• Journal of Preventive Medicine and Public Health
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• 제53권5호
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• pp.342-352
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• 2020

Objectives: The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease. Methods: This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient's age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors. Results: Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant. Conclusions: NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

• Journal of Chest Surgery
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• 제57권5호
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• pp.484-489
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• 2024

Background: Catamenial pneumothorax (CP) is a rare form of spontaneous pneumothorax that is linked to endometriosis; thus, it predominantly manifests in women of reproductive age. Considerable research has explored the potential benefits of postoperative hormone therapy following various surgical interventions. This study was performed to examine the clinical implications of postoperative hormone treatment in patients with CP. Methods: The study included patients who underwent surgical intervention for CP between November 2009 and February 2023. These procedures included wedge resection, diaphragm resection, and total pleural coverage. Recurrence-free survival was analyzed using the Kaplan-Meier log-rank test to assess the impact of hormone therapy. Additionally, Cox proportional hazards analysis was employed to identify risk factors associated with postoperative CP recurrence. Results: The study included 41 patients, with a median age of 38.4 years. Among them, 27 individuals received hormone therapy, 8 of whom experienced recurrence during a median follow-up period of 1 year. Patients who received hormone therapy exhibited a lower rate of recurrence than those who did not; however, the difference was not statistically significant, likely due to the small sample size. Side effects of hormone therapy included depression (6.8%), excessive sweating (3.4%), and headache (3.4%). In the analysis of risk factors for postoperative recurrence, diaphragm resection emerged as a protective factor (hazard ratio, 0.16; 95% confidence interval, 0.03-0.77; p=0.022). Conclusion: Hormone treatment combined with surgery did not significantly impact recurrence in patients with CP. The application of diaphragm resection was the sole factor that displayed significance in preventing CP recurrence.

• Journal of Korean Neurosurgical Society
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• 제64권3호
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• pp.427-436
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• 2021

Objective : The fate of partially thrombosed intracranial aneurysms (PTIAs) is not well known after endovascular treatment. The authors aimed to analyze the treatment outcomes of PTIAs. Methods : We retrospectively reviewed the medical records of 27 PTIAs treated with endovascular intervention between January 1999 and March 2018. Twenty-one aneurysms were treated with intraluminal embolization (ILE), and six were treated with parent artery occlusion (PAO) with or without bypass surgery. Radiological results, clinical outcomes and risk factors for major recurrence were assessed. Results : The initial clinical status was similar in both groups; however, the last status was better in the ILE group than in the PAO group (p=0.049). Neurological deterioration resulted from mass effect in one case and rupture in one after ILE, and mass effect in two and perforator infarction in one after PAO. Twenty cases (94.2%) in the ILE group initially achieved complete occlusion or residual neck status. However, 13 cases (61.9%) showed major recurrence, the major causes of which included coil migration or compaction. Seven cases (33.3%) ultimately achieved residual sac status after repeat treatment. In the PAO group, all initially showed complete occlusion or a residual neck, and just one case ultimately had a residual sac. Two cases showed major recurrence, the cause of which was incomplete PAO. Aneurysm wall calcification was the only significantly protective factor against major recurrence (odds ratio, 36.12; 95% confidence interval, 1.85 to 705.18; p=0.018). Conclusion : Complete PAO of PTIAs is the best option if treatment-related complications can be minimized. Simple fluoroscopy is a useful imaging modality because of the recurrence pattern.

• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.441-450
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• 2021

Objectives: Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area. Methods: We defined social relations as "meetings with neighbors" (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in. Results: MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas. Conclusions: The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.

• 정신신체의학
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• 제27권1호
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• pp.13-24
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• 2019

연구목적 코호트 연구의 목적은 국내 아동청소년 성폭력 피해자 코호트 시스템 구축과 피해자들의 정신건강에 작용하는 위험요인과 보호요인을 규명하기 위함이며, 이 연구는 코호트 참여자들의 참여 당시 초기 평가 결과를 분석한 예비 결과이다. 방 법 서울 해바라기아동센터를 통해 3년 7개월간 모집한 19세 이하의 65명 아동청소년 성폭력 피해자 및 그 가족들의 인구학적, 성폭력 관련 요인 및 정신심리학적 상태와 정신건강학적 진단을 평가하여 초기자료를 분석하였다. 결 과 초기 평가 자료의 예비 분석 결과는 다음과 같다. 여성 대상자 56명, 대상자 평균나이 12.4세(SD=4.4), 성폭력 추행 71.8%, 친족 및 지인 가해자 87.1% 였고, 피해자의 61.5%가 성폭력 피해와 관련된 정신의학적 진단을 받았으며 이중 외상 후 스트레스 장애가 29.2%, 우울장애가 23.1%로 나타났다. 피해 이후 발고까지 걸린 기간은 평균 1.5년이었다. IES-R-K, TSCYC 외상 후 스트레스장애-회피 항목과 CBCL의 총문제행동 항목이 임상적으로 유의하게 증가한 결과를 나타내었다. 결 론 아동청소년 성폭력 피해자는 정신건강학적 문제가 발생할 위험성이 높은 경향을 가지고 있다. 코호트 연구는 국내 성폭력 피해자들의 정신건강에 영향을 미치는 위험요인과 보호요인을 확인하고 예측모형을 설립할 수 있을 것이다.

• 한국콘텐츠학회논문지
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• 제18권8호
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• pp.594-606
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• 2018

본 연구의 목적은 대학생의 스마트폰 중독과 자기생활관리의 관계에서 보호요인인 긍정심리자본과 위험요인인 정신건강의 매개효과를 확인하는 것이다. 대학생 266명을 대상으로 스마트폰 중독, 긍정심리자본, 정신건강, 자기생활관리 척도를 실시하고 분석한 결과는 다음과 같다. 첫째, 관련 요인들의 상관관계를 분석한 결과 스마트폰 중독은 자기생활관리와 긍정심리자본에서 유의한 부적상관을 나타냈으며 정신건강간의 유의한 정적상관을 나타냈다. 둘째, 대학생의 스마트폰 중독과 자기생활관리의 경로분석결과 긍정심리자본이 매개 효과를 나타냈다. 셋째, 매개변인인 긍정심리자본과 정신건강 하위요인들과 자기생활관리 간 회귀분석을 실시한 결과 긍정심리자본에서는 낙관성과 탄력성이 자기생활관리에 유의한 영향을 미쳤으며, 정신건강에서는 우울과 충동성이 유의한 영향을 미치는 것으로 나타났다. 본 연구 결과를 토대로 대학생의 자기생활관리를 위한 교육적 시사점과 후속연구에 대한 제언을 논의하였다.

• 한국콘텐츠학회논문지
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• 제19권9호
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• pp.338-347
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• 2019

본 연구에서는 노인의 삶의 질 향상을 위한 정책과 실천적 제언을 제공하려는 목적으로 노인의 심리 정서적 변인과 노인의 삶의 질에 대한 메타분석을 실시하였다. 총 65편의 학술지 논문을 선정해 위험요인과 보호요인으로 구분하여 메타분석을 진행한 결과, 심리 정서적 변인의 위험요인은 우울, 고독, 외로움, 불안, 스트레스 순으로 중간효과크기가 나타났으며 자살생각과 죽음불안은 작은 효과크기를 보였다. 보호요인으로는 자아존중감이 가장 큰 효과크기를 보였고 자아효능감, 자아통제 순으로 효과크기가 나타났다. 본 연구를 통해서 우울이 노인의 삶의 질에 중요한 영향요인이 되고 있음을 확인할 수 있었으며 노인의 삶의 질 향상을 위해서 우울을 조기발견하고 개입할 수 있는 게이트키퍼의 활용과 찾아가는 상담서비스의 확대가 필요하며 자살생각이나 죽음불안을 경감시키기 위해 죽음준비교육을 일반화시키고 자아존중감을 높이기 위해 노인에게 적합한 일자리를 창출하고 재능기부 및 자원봉사활동 참여 기회의 확대를 제언하였다.

• 사회복지연구
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• 제40권3호
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• pp.377-406
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• 2009

청소년의 비행예방을 위한 사회복지실천전략 개발을 목적으로 종단자료를 통한 청소년 비행행동의 잠재집단유형을 확인하고자 하였다. 비행행동의 차별적 발달궤적을 갖는 잠재집단유형의 확인은 이들 집단의 특성을 고려한 맞춤형 실천전략의 수립을 가능케 한다. 이를 위해 본 연구에서는 청소년패널조사의 1-4차년도 종단자료를 이용하여 비행행동의 수준과 변화율이 상이한 잠재집단이 존재할 것으로 가정하는 잠재계층 성장분석을 수행하였다. 그 결과 비행행동의 수준과 변화율이 상이한 4개의 잠재집단을 확인할 수 있었다. 비행행동의 경험수준이 적고 변화율이 거의 없는 규범집단, 측정기간 내내 높은 비행행동수준을 유지하고 있는 비행지속집단, 측정초기에는 높은 비행행동수준을 보이다 점차 감소하는 경향을 보이는 비행감소집단, 낮은 비행행동 수준에서 점차 비행경험이 증가하는 비행증가집단 등 4개의 잠재계층집단을 발견하였다. 잠재계층집단에 대해 청소년 비행행동의 보호 및 위험요인이 미치는 영향력을 확인하기 위해 다항로지스틱분석을 실시한 결과, 부모의 지도감독, 자기통제력, 비행친구와의 교류, 부정적 낙인 등이 잠재계층집단의 분류와 밀접한 관련성이 있는 것으로 나타났다. 최초측정시점인 중학교 2학년시기에서 부모의 지도감독을 많이 받고, 자기통제력이 높으며, 비행친구와의 교류가 적고, 부정적 낙인이 적을수록 비행행동을 경험하지 않는 규범집단에 속할 가능성이 높았다. 가족구조결손, 빈곤가족, 남자청소년의 인구학적 특성과 비행친구와의 교류증가는 비행증가집단과 비행지속집단에 속할 가능성을 높이는 것으로 나타났다. 종단자료를 통해 청소년기 비행행동의 이질적인 성장궤적을 갖는 잠재계층집단을 확인한 연구결과에 기반하여 청소년의 비행행동 예방 및 개입을 위한 사회복지 실천전략을 제시하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7127-7131
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• 2013

The primary aim of this study was to evaluate the relationship of single nucleotide polymorphisms (SNPs) in ribosomal protein SA (RPSA) gene with colorectal cancer (CRC). A case-control study including 388 controls and 387 patients with CRC was conducted in a Chinese population. Information about socio-demography and living behavior factors was collected by a structured questionnaire. Three SNPs (rs2133579, rs2269349, rs7641291) in RPSA gene were genotyped by Illumina SnapShot method. Multiple logistic regression models were used for assessing the joint effects between tea consumption and SNPs on CRC. The subjects with rs2269349 CC genotype had a decreased risk for CRC (OR=0.60; 95%CI = 0.37-0.99), compared with TT/CT genotype after adjustment for covariates. A similar association of rs2269349 with rectal cancer was observed (OR=0.49; 95%CI=0.24-1.00). Further analyses indicated that this SNP could modify the protective effect of tea drinking on CRC. Among the subjects with rs2269349 TT/CT or rs2133579 AA/GA, there was a marginal significantly lower risk of CRC (OR and 95%CI: 0.63 and 0.39-1.01 for rs2269349; 0.64 and 0.40-1.02 for rs2133579) in tea-drinking subjects in comparison to non-tea-drinking subjects. Mutants in the RPSA gene might be associated with genetic susceptibility to CRC and influence the protective effect of tea consumption in the Chinese population.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5709-5714
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• 2014

Background: An association between alcohol/tobacco use and risk of metastasis in breast cancer has been clearly shown. Materials and Methods: The present study explored, in 48 samples of tissue from mammary ductal carcinoma (taken from Mexican women with an average age of $58.2{\pm}10.9$ years), the association of risk of metastasis with the status of hormonal receptors and the c-erbB2 protein (by immunohistochemistry) as well as clinical, histopathological and sociodemographic factors. Results: Of 48 patients, 41.6% (20/48) presented with metastasis, 43.8% were positive for the estrogen receptor (RE+), 31.3% for the progesterone receptor (RP+) and 47.7% for c-erbB2 (c-erbB2+). The following combinations were found: RE+/RP+/c-erbB2+ 8.3%, RE+/RP+ 22.9%, RE+/RP- 20.8%, RE-/RP+ 8.3%, RE-/RP-/c-erbB2- 22.9% and RE-/RP- 47.8%. There were 12 patients who used alcohol/tobacco, of which 91.6% did not present metastasis and 81.9% were RE-/RP-. Compared to the RE-/RP-/c-erbB2+, the RE+/RP+/c-erbB2+ group had a 15-fold greater risk for metastasis (95%CI, 0.9-228.8, p=0.05). The carriers of the double negative hormonal receptors had a 4.7 fold greater probability of being (or having been) smokers or drinkers (95%CI, 1.0-20.4, p = 0.03). Conclusions: There was a clear protective effect of using alcohol and/or tobacco, in the cases included in the present study of mammary ductal carcinoma, associated with double negative hormonal receptors. However, this association could be due to a protective factor not measured (Neyman bias) or to a bias inherent in the rate of hospitalization (Berkson fallacy). This question should be explored in a broad prospective longitudinal study.