• Tuberculosis and Respiratory Diseases
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• 제82권2호
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• pp.91-93
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• 2019

Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer-related deaths worldwide. Globally, there were an estimated 1.8 million new cases and 1.59 million deaths in 2012. In Korea, the incidence of lung cancer is increasing and 24,267 (47.6/100,000) patients with lung cancer were registered at the Korea Central Cancer Registry in 2015. Previous nationwide surveys of lung cancer were performed in 1998 by the Korean Academy of Tuberculosis and Respiratory Diseases and in 2007 by the Korean Association for Lung Cancer (KALC), but the studies faced difficulties in maintaining lung cancer registry because of limitations regarding the Private Information Protection Act. To produce unbiased and reliable epidemiological data, the KALC and Korean Central Cancer Registry developed a detailed lung cancer registry (KALC-R) data structure. Following a pilot survey of 489 lung cancer cases in 2013, about 10% of the sampled lung cancer cases from the Korean Central Cancer Registry are surveyed each year. With the analysis of detailed data from the KALC-R, an important epidemiological background for scientific research or policy development is expected to be generated.

• 한국학교ㆍ지역보건교육학회지
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• 제20권3호
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• pp.53-65
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• 2019

Objectives: The purpose of this study is to examine the current status of cancer screening among subjects in the lung cancer screening cycle and to analyze the factors affecting the cancer screening of subjects in the lung cancer screening cycle. Methods: This study used the 'National Health and Nutrition Survey 7th Year (2017)' surveyed nationwide as the main data. The subjects are lung cancer screening projects, the dependent variable is early cancer screening, the independent variables are gender, age, marital status, household income level, education level, national health insurance type, private health insurance, The number of chronic diseases, general health examination, smoking status, drinking status, moderate intensity physical activity, stress perception rate, and weight control efforts were determined. Results: The results of this study showed that factors affecting early cancer screening of lung cancer screening subjects were gender, age, marital status, education level, national health insurance, smoking status, drinking status, moderate physical activity, and weight. Irrespective of the control effort, it was found that the private medical insurance, the number of chronic diseases, the medical examination, and the stress perception rate were affected. Conclusion: If the lung cancer screening subjects recognize the importance of early cancer screening themselves and create a social environment to increase their participation rate, lung cancer screening patients and their families will help them to live a healthy life.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6293-6298
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• 2015

Opportunistic screening for lung cancer is commonly conducted in Korea in accordance with physician recommendations and screenee's preferences. However, studies have yet to thoroughly examine the public's understanding of the risks posed by lung cancer screening. This study was conducted to assess changes in intentions to undergo lung cancer screening in response to being informed about exposure to radiation during low-dose computed tomography (LDCT) tests and to identify factors with the greatest influence thereon among Korean men. We conducted sub-group interviews among men chosen from the 2013 Korea National Cancer Screening Survey (KNCSS), a nationwide, population-based, cross-sectional survey of men aged 40 to 74 years and women aged 30 to 74 years. From 4100 participants in the KNCSS, 414 men who underwent any cancer screening test within the last 2 years were randomly selected for inclusion in this study. Via face-to-face interviews, their intentions to undergo lung cancer screening were assessed before and after being informed about exposure to radiation during LDCT testing. Of the 414 participants, 50% were current smokers. After receiving information on the benefits of the test, 95.1% stated an intention to undergo screening; this decreased to 81.6% after they received information on the harms of the test. The average decrease in intention rate was 35.3%. Smoking status, household income, and education level were not associated with lowered intentions to undergo lung cancer screening. Participants who were older than 60 years old (OR=0.56; 95% CI= 0.33-0.96) and those with less concern for radiation exposure (OR=0.56; 95% CI=0.36-0.89) were less likely to lower their screening intentions. The results of this study suggest that there is a need to educate both non-smokers and former smokers on the harms of lung cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3105-3108
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• 2013

Background: This study used National Health and Nutrition Examination Survey III to study the relationship between blood lead concentration and all cause, all cancer and lung cancer mortality in adults. Patients and Methods: Public use National Health and Nutrition Examination Survey (NHANES III) data were used. NHANES III uses stratified, multistage probabilistic methods to sample nationally representative samples. Household adult, laboratory and mortality data were merged. Sample persons who were available to be examined in aMobile Examination Center (MEC) were included in this study. Specialized survey analysis software was used. Results: A total of 3,482 sample participants with complete information for all variables were included in this analysis. For all cause death, the odds ratios (S.E.) for statistically significant variables were body mass index, 1.03 (1.01-1.06); 1.01 (1.01-1.01); blood lead concentration, 1.05 (1.01-1.08); poverty income ratio, 0.823 (0.76-0.89); and drinking hard liquor, 1.01 (1.00-1.02). For all cancer mortality, the odds ratios (S.E.) of the statistically signigicant variables were: age, 1.01 (1.01-1.01); blood lead concentration, 1.07 (1.04-1.12), black race, using non-Hispanic white as reference, 1.69 (1.12-2.56); and smoking, 1.02 (1.01-1.04). For lung cancer mortality, the odds ratios (S.E.) of the statistically significant variables were: age, 1.01(1.01-1.01); blood lead concentration, 1.09 (1.05-1.13); Mexican Americans, using non-Hispanic white as refrence, 0.33 (0.129-0.850); other races, 1.80 (0.53-6.18); and smoking, 1.03 (1.02-1.05). Conclusion: Blood lead concentration correlated with all cause, all cancer, and lung cancer mortality in adults.

• 한국임상수의학회지
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• 제24권1호
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• pp.46-50
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• 2007

A 7-year-old female, Jindo dog was referred to the Veterinary Teaching Hospital with mild dyspnea and anorexia due to a gunshot trauma. The dog was wounded in the thoracic region 3 days ago. Plain radiographs showed the left 8th rib fracture, interstitial pattern in the left caudal lung field and pleural effusion. Abdominal radiographs showed the lead bullet. Computed tomographs(CT) showed the size of pulmonary contusion, laceration, lung parenchymal injuries, hemothorax and perforation of abdominal wall. The therapeutic plan was based on abnormalities seen on CT scans but not clearly seen in survey radiographs. Thoracic CT significantly provides even more informations compared with the corresponding radiographs in thoracic gunshot trauma. Although thoracic survey radiographs are useful as a screening tool, CT is highly sensitive in detecting thoracic injuries after thoracic trauma and is superior to routine thoracic survey radiographs in visualizing lung contusion, pneumothorax and hemothorax. Therefore, we recommend CT in the initial diagnostic work-up of patients with thoracic injuries and with suspected chest trauma because early and exact diagnosis of all thoracic injuries along with sufficient therapeutic consequences may reduce complications.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.105-114
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• 2021

Background: Complementary and alternative medicine (CAM) has been used frequently, and its use continues to increase in lung cancer patients, despite insufficient scientific of its efficacy. To investigate this situation, we analyzed the current awareness and use of CAM in Korean lung-cancer patients. Methods: This prospective survey-based study was performed at seven medical centers in South Korea between August and October 2019. The survey assessed general patient characteristics and the awareness and use of CAM. We analyzed differences in the clinical parameters of patients aware and not aware of CAM and of CAM non-users and users. Results: Of the 434 patients included in this study, 68.8% responded that they were aware of CAM and 30.9% said they had experienced it. In univariate analysis, the patients aware of CAM were younger with poor performance status, had advanced-stage lung cancer, received more systemic therapy, and received concurrent chemoradiation therapy (CCRT). By multiple logistic regression, younger age, poor performance status, advanced stage, and prior CCRT were identified as independent risk factors for CAM awareness. There were no significant differences in the general characteristics and cancer-associated clinical parameters of CAM non-users and users. Conclusion: Specific clinical parameters were associated with patients' awareness of CAM, although there were no significantly different characteristics between CAM users and non-users.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.309-314
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• 2015

Background: In tuberculosis (TB) patients, health-related quality of life (HRQoL) is significant in self-management, which in turn can be effective in therapeutic acceptance and prevention of treatment failure due to multi-drug resistant TB. This study was conducted to evaluate HRQoL and associated factors in TB patients referred to the National Research Institute of Tuberculosis and Lung Disease (NRITLD). Methods: In this study, patients were selected from TB clinics of the NRITLD in Tehran. In addition to an Iranian version of the Short-Form Health Survey (SF-36), demographic and disease characteristic questionnaires were used for data collection. The data were then analyzed using SPSS software. Results: Two hundred five TB patients, with the average age of $42.33{\pm}17.64$ years, participated in this study. The HRQoL scores in different domains ranged from $14.68{\pm}11.60$ for role limitations due to emotional problems to $46.99{\pm}13.25$ for general health perceptions. The variables of sex, marital status, education, job status, place of residence, and cigarette smoking, influenced the HRQoL scores in different dimensions. Conclusion: According to the study findings are the important variables that influenced the HRQoL of TB patients. The consideration of its can improve the HRQoL of TB patients.

• Journal of Yeungnam Medical Science
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• 제37권3호
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• pp.194-201
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• 2020

Background: Dietary polyunsaturated fatty acids (PUFA) are thought to modify systemic inflammation. The present study aimed to evaluate the relationship between PUFA intake, lung function, and health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). Methods: In this study, we used the dataset of 6th Korea National Health and Nutrition Examination Survey, in which, a total of 22,948 individuals including 573 participants with a high probability of developing COPD were enrolled. Participants with missing data for the investigated variables were excluded. Linear regression analyses were used to evaluate the association between PUFA intake (omega-3 [N3], omega-6 [N6], and total) with lung function, and HRQoL. HRQoL was determined according to the European Quality of Life-5 Dimensions (EQ-5D). Subgroup analysis of older patients was performed. Age, sex, body mass index, smoking, alcohol, education, residence, total calorie intake, and predicted FEV₁% were adjusted in all analyses. Results: Although lung function was not associated with PUFA intake, EQ-5D index was remarkably associated with N3, N6, and total PUFA intake in a dose-dependent manner. This association was more pronounced in elderly COPD patients. Mean levels of N3, N6, and total PUFA intake were significantly higher in patients having better HRQoL with respect to mobility, self-care, and usual activities. Conclusion: Our results suggest that N3, N6, and total PUFA intake are associated with HRQoL in COPD patients. This association may be attributed to mobility, self-care, and usual activities. Further longitudinal study is required to clarify this relationship.

• Tuberculosis and Respiratory Diseases
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• 제45권1호
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• pp.5-19
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• 1998

연구배경: 개흉폐생검은 미만성 침윤성 폐질환의 감별진단, 면역억제 환자에서의 폐침윤의 원인 등 다양한 폐질환에서 확진에 이르기 위한 고전적인 진단술로서 충분한 크기의 검체를 제공할 뿐 아니라 폐생검시 생검사가 직접 병변부위를 관찰하고 생검장소를 결정할 수 있는 장점이 있는 반면 최근에는 흉강경하폐생검(video-assisted thoracoscopy, VATS)이 개발되어 늑막 및 폐질환의 진단에 이용되고 있다. 본 학회의 학술위원회에서는 폐질환에서 개흉 혹은 흉강경하 폐생검의 실시여부, 폐생검 실시 전에 시행할 진단절차, 실시시기 등을 결정하는데 필요한 기초자료를 수집하여 향후 임상연구 및 진료에 활용하고자 현재 한국에서의 개흉폐생검의 적응질환, 시행빈도, 진단성적, 치료에 미치는 영향, 합병증 등을 조사하였다. 방 법: 전국의 대학병원 및 400병상 이상의 종합병원에서 1994년 1월 1일부터 1996 년 12월 31일까지 3년간 개흉 및 흉강경하폐생검을 시행한 환자들에 대한 설문조사를 의뢰하였다. 본 실태조사에 응답한 37 개 병원의 511예를 대상으로 분석하여 다음의 결과를 얻었다. 통계 분석은 SAS 통계 프로그램을 이용하여 폐생검 전후의 비교는 paired t-test를 이용하였고 각 인자들에 따른 차이비교는 $x^2$-검정 혹은 t-검정법을 이용하였으며 P값은 0.05 이하인 경우를 유의하다고 판정하였다. 결 과: 1) 실태조사에 응답한 511 예 대상환자들의 평균연령은 50.2세(${\pm}15.1$세)이었으며, 남자 54.2%. 여자 45.9% 이었다. 2) 511 예 중에서 개흉폐생검은 313예(62%). 흉강경하폐생검은 192예(38%)에서 시행되었고, 미만성 폐질환자가 305명(59.7%), 국한성 폐질환자가 206명(40.3%)이었다. 3) 흉부 X-선 검사에서 이상소견이 발견되어 폐생검을 하기까지의 기간은 평균 82.4일 이었으며, 개흉폐생검은 평균 72.8일, 흉강경하폐생검은 평균 99.4일이 소요되었고, 폐생검 이전에 기관지내시경검사는 272예(53.2%), 기관지폐포세척술은 123예(24.1%), 경피적세침흡인술은 72예(14.1%)에서 시행되었다. 4) 대상질환은 간질성 폐질환이 230예(45.0%), 흉곽종양이 133예(26.0%), 결핵을 포함한 감염성 폐질환이 118예(23.1%), 선천성질환을 포함한 가타 폐질환이 30예(5.9%)이었다. 생검 방법에 따른 진단율이나 병변특성의 유의한 차이는 없었다. 5) 폐생검 이전의 임상적 진단과 폐생검 후의 최종 진단이 일치한 경우는 302예(59.2%) 이었고, 질환별로는 간질성 폐질환 66.5%, 흉곽종양 58.7%. 폐감염질환 32.7%, 결핵 55.1%. 선천성 폐질환을 포함한 기타 질환 62.5%에서 임상진단과 최종진단이 일치하였다. 6) 폐생검 전 및 1일 후에 시행한 동맥혈가스분석 검사상 $PaCO_2$는 $38.92{\pm}5.8mmHg$에서 $40.2{\pm}7.1mmHg$로 유의하게 증가하였고(P<0.05), $PaO_2/FiO_2$는 $380.3{\pm}109.3mmHg$에서 $339.2{\pm}138.2mmHg$로 유의하게 감소하였다(P=0.01). 7) 합병증은 10.1%에서 발생하였으며 개흉폐생검시 12.4%, 흉강경하폐생검시 5.8%로 흉강경하폐생 검시 유의하게 합병증이 적었다 (p<0.05). 합병증은 기흉 23예(4.6%), 혈흉 7예(1.4%), 사망 6예(1.2%), 기타 부정맥이나 타장기손상 15예(2.9%) 등이었다. 8) 폐생검으로 인한 사망은 개흉폐생겸후 5예, 기록이 불분명한 경우가 1예 등 모두 6예 이었으며 흉강경하폐생검 후 사망한 경우는 없었다. 사망한 사랑의 기저질환은 악성종양 3예(기관지폐포세포암 2예, 악성 중피종 1예), 전이성 악성종양 2예, 간질성폐질환 1예 이었다. 폐생검 후 사망까지의 기간은 평균 $15.5\pm9.9$일 이었다. 9) 개흉 또는 흉강경하폐생검으로도 진단할 수 없었던 경우는 19예(3.7%)이었다. 진단이 안된 원인은 병소 이외에서 조작검사를 시행한 5예, 조직의 크기가 너무 작은 3예 등 폐조직검사를 부적절하게 시행한 경우가 8예 이었고, 조직검사는 잘 되었으나 병리학적으로 진단이 불가능하였던 경우가 11예 이었다. 10) 개흉 또는 흉강경하폐생검이 진단에 결정적으로 기여한 경우가 334예(66.5%), 다소 기여한 경우가 140예(27.9%), 도움이 되지 않았거나 판단이 불가능한 경우가 28예(5.6%)이었다. 따라서 폐생검을 한 경우의 94.4%에서 확진에 도움을 주었다. 결 론: 개흉 및 흉강경하폐생검은, 기관지내시경 등 다른 술기로 진단이 안되는 폐질환의 확진에 도움이 되는 방법이며 환자상태가 위중한 경우에는 보다 안전하고 대등한 진단성적을 얻을 수 있는 흉강경하폐생검이 추천된다.

• Tuberculosis and Respiratory Diseases
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• 제46권4호
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• pp.455-465
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• 1999

연구배경: 최근 급증하는 폐암에 대해 국내에서는 단위 병원의 폐암 환자의 특성, 조직학적 분류에 따른 분포, 진단 방법, 치료방법에 대한 수년간의 통계들이 있을 뿐 전국적인 조사는 없어 전국적인 폐암환자의 기초자료의 필요성이 대두되었다. 방 법: 대한 결핵 및 호흡기 학회에서는 전국을 대상으로 1997년 1년 동안 조직학적으로 증명된 원발성 폐암환자를 대상으로 환자의 특성, 폐암의 조직학적 분류, 병기, 치료법 등 폐암의 특성을 조사하였다. 결 과: 총 3,794명을 분석하여 다음의 결과를 얻었다. 1) 남자 환자가 79.3%였으며 평균 연령은 62.0세(남자 62.2세, 여자는 61.6세)였으며 76.8%가 흡연자로 남자환자의 89.8%, 그리고 여자환자의 25.4%가 흡연자이었다. 2) 병리학적으로는 편평상피세포암이 44.7%, 선암 27.9%, 기관지폐포세포암 2.2%, 대세포폐암 1.5%, 소세포폐암 16.8%로 관찰되었다. 흡연력은 편평상피세포암의 87.5%, 선암의 56.2%, 기판지폐포세포암의 35.5%, 대세포폐암의 94.1% 및 소세포폐암의 84.3%가 흡연자였으며 편평상피세포폐암 및 소세포폐암 환자에 비해 선암 환자의 흡연자 비율이 유의하게 낮았다(p<0.001). 3) 조직학적 진단방법은 객담세포진 검사가 15.5%, 기관지내시경을 통한 조직검사가 44.4%, 경피적 폐침생검법이 19.7%으로 중심형 암인 편평상피세포암 및 소세포암 환자에서는 기관지내시경 조직검사로 가장 많이 진단이 이루어진 반면 선암 및 대세포폐암 환자에서는 경피적 폐침생검법으로 진단이 많이 이루어졌다(p<0.001). 4) 환자의 진단시 증상은 기침 57.2%, 객담 40.8%, 호흡곤란 35.4%에서 보고되었으며 증상이 없었던 경우도 7.2%이었다. 5) 비소세포폐암환자 임상적 병기는 제I기 13.7%, 제II기 4.5%, 제IIIA기 16.6%, 제IIIB기 28.8% 및 제IV기 36.5%로 진행되어 발견되는 경우가 많았다. 소세포폐암환자 609명 중 제한병기가 45.2%, 확대병기가 54.8%이었다. 결 론: 폐암은 남자 및 흡연자에서 주로 발생하였으며 편평상피세포암이 가장 많았다. 따라서 이러한 국내의 자료는 폐암환자에서 여성의 비율이 상대적으로 높고 선암이 가장 흔한 폐암으로 알려진 구미의 자료와는 차이가 있었다. 진행된 상태에서 발견되는 경우가 많아 조기발견 프로그램의 개발 필요성이 제시되었다.