노인의 사회경제적 상태, 건강상태, 건강행태와 건강관련 삶의 질의 관계 : 성별 차이를 중심으로

문성미 한국디지털정책학회 2017 디지털융복합연구 Vol.15 No.6

유방암 환자의 건강관련 삶의 질과 림프부종, 어깨관절운동, 피로 및 사회적 지지와의 관계

문성미,이은현,송영숙,전미선 한국유방암학회 2010 Journal of breast cancer Vol.13 No.2

Purpose: The purpose of this study was to identify the variables that are associated with the health related quality of life (HRQOL) for patients with breast cancer. Methods: A total of 112 subjects were recruited from a cancer center at a university hospital by using convenience sampling. The subjects were asked to complete questionnaires about HRQOL, fatigue and social support (family and medical team support). A trained research assistant then measured the subjects’ shoulder range of motion (ROM) and the arm parameters for lymphedema. The data was analyzed using t-tests, Mann-Whitney tests, ANOVA, Pearson’s correlation coefficient and hierarchical multiple regression analysis. Results: The HRQOL was strongly correlated with fatigue (r=-0.80, p<0.01). It was also positively correlated with family support (r=0.57, p<0.01) and medical team support (r=0.33, p<0.01). The HRQOL was significantly lower for the patients who had limited shoulder rotation. Fatigue and family support together explained 65% of the variance in the HRQOL for the patients with breast cancer, after controlling for education and income. Of them, fatigue uniquely explained 32% of the variance in the HRQOL. Conclusion: Fatigue was the strong predictor of the HRQOL. This result suggests that fatigue might be primary managed for improving the HRQOL of patients with breast cancer.

F-117 Diagnostic performance of radial probe endobronchial ultrasound without guide sheath

문성미,이현,정병호,엄상원,서지영,정만표,김호중,권오정,이경종 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-

Radial probe endobronchial ultrasound (R-EBUS) is a one of new bronchoscopic modalities which have led to the improvement of tissue diagnosis of lung lesions. We evaluated diagnostic performance of R-EBUS without guide sheath and identify the factors associated with the accurate diagnosis of malignancy. A total of 211 patients undergoing R-EBUS without guide sheath between June 2016 and May 2017 were reviewed retrospectively. After exclusion of 27 patients which failed to reach to the target lesion, 184 were included. Multivariate logistic regression was used to identify factors associated with diagnosis of malignancy. Among 184 patients, R-EBUS diagnosed malignancy in 109 (59%) and non-malignant tissue was obtained in 75 (41%) patients and they underwent additional diagnostic workup. Based on final diagnosis, diagnostic accuracy of R-EBUS was 80% and sensitivity and specificity for malignancy were 76% and 100% respectively. In multivariate analysis, bronchus sign on ultrasound was the only factor associated with diagnosis for malignancy (adjusted odds ratio 2.544; 95% confidence interval 1.130, 5.730; p value 0.024). Molecular and genetic analysis conducted successfully except only one case with inadequate specimen. Complication rate was 5%. R-EBUS without guide sheath is a useful diagnostic tool and the procedure is valuable for the lesions of bronchus sign positive on ultrasound.

Diagnostic Performance of Radial Probe Endobronchial Ultrasound without a Guide-Sheath and the Feasibility of Molecular Analysis

문성미,최준수,정병호,엄상원,김호중,권오정,이경종 대한결핵및호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4

Background: Radial probe endobronchial ultrasound (R-EBUS), is effective for tissue diagnosis of lung lesions. We evaluated the diagnostic performance of R-EBUS both a guide-sheath and fluoroscopy and identified factors associated with accurate diagnosis. The feasibility of molecular and genetic testing, using specimens obtained by R-EBUS, was also investigated. Methods: The study retrospectively reviewed 211 patients undergoing R-EBUS without a guide-sheath and fluoroscopy, June 2016–May 2017. After excluding 27 patients of which the target lesion was not reached, 184 were finally included. Multivariate logistic regression was used, to identify factors associated with accurate diagnosis. Results: Among 184 patients, R-EBUS–guided biopsy diagnosed malignancy in 109 patients (59%). The remaining 75 patients (41%) with non-malignant results underwent additional work-ups, and 34 were diagnosed with malignancy. Based on final diagnosis, diagnostic accuracy was 80% (136/170), and sensitivity and specificity for malignancy were 76% (109/143) and 100% (27/27), respectively. In multivariate analysis, peripheral location (adjusted odds ratio [aOR], 3.925; 95% confidence interval [CI], 1.203–12.811; p=0.023), and central position of the probe (aOR, 2.435; 95% CI, 1.424–7.013; p=0.035), were associated with accurate diagnosis of malignancy. Molecular and genetic analyses were successful, in all but one case, with inadequate specimens. Conclusion: R-EBUS–guided biopsy without equipment, is effective for tissue diagnosis. Peripheral location and central position of the radial probe, were crucial for accurate diagnosis. Performance of molecular and genetic testing, using samples obtained by R-EBUS, was satisfactory.

Clinical utility of combined ctDNA and CTC assays in the diagnosis of primary lung cancer

문성미,이경종,정병호,김경희,김홍관,김진국,이혜선,정윤규,문정미,김성민,송미연,배진식,권혁중,김지호,이민섭,이성훈,엄상원 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-

Objectives: Liquid biopsy is a promising non-invasive test for the detection of malignancy. The purpose of this prospective study was to evaluate diagnostic performance of each and combined assays of circulating tumor DNA (ctDNA) and circulating tumor cell (CTC) compared with traditional tumor markers including CEA, cyfra 21-1 and NSE. Methods: From March 15, 2018 through July 9, 2018, a total of 44 subjects who had suspicious lesions for primary lung cancer were enrolled. After excluding 8 subjects diagnosed with other tumors or inconclusive results, 32 subjects with primary lung cancer and 4 subjects with benign pulmonary disease were analyzed. For ctDNA analysis, single nucleotide variants and copy number alterations were evaluated in the platform of next-generation sequencing. For the detection of CTC, EpCAM and cytokeratin were used for the markers. Results: The diagnostic sensitivity and specificity of ctDNA and CTC were 75% and 50% vs. 78% and 75%, respectively. The combination of ctDNA and CTC showed the diagnostic sensitivity and specificity of 100% and 50%, respectively. The positive predictive value, negative predictive value and overall accuracy of the combined two assays were 94%, 100% and 94%, respectively. Combined diagnostic sensitivity and specificity of tumor markers (CEA, cyfra 21-1 and NSE) were 53% and 75%, respectively. Conclusion: The combination of ctDNA and CTC assays can enhance the diagnostic sensitivity for the diagnosis of the primary lung cancer (ClinicalTrials.gov number, NCT03479099).

Clinical Significance of Mycobacterium kansasii Isolates From Respiratory Specimens

문성미,박혜윤,전경만,정병호,김수영,정명진,허희재,기창석,이남용,신성재,고원중 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.0

Background: The clinical significance of Mycobacterium kansasii respiratory isolates is uncertain. The aims of this study were to determine the clinical relevance of M. kansasii isolates and to identify the clinical features and outcomes of M. kansasii disease. Methods: We reviewed the medical records of 104 patients from whom at least one respiratory M. kansasii isolate was obtained from 2003 to 2014 at Samsung Medical Center. Results: Of these 104 patients, 54 (52%) met the diagnostic criteria for nontuberculous mycobacterial lung disease; among them, 41 (76%) patients received treatment for a median time of 15.0 months (interquartile range [IQR] 7.0-18.0). The remaining 13 (24%) without overt progression were observed for a median period of 24.0 months (IQR 5.0-34.5). Patients with M. kansasii disease exhibited various radiographic findings, including the fibrocavitary form (n=24, 44%) and the nodular bronchiectatic form (n=17, 32%). The fibrocavitary form was common in patients under treatment (n=23, 56%), while the nodular bronchiectatic form was common in patients without treatment (n=9, 70%). None of the patients with a single isolate (n=18) developed M. kansasii disease. Conclusions: In total, 52% of all patients exhibited clinically significant disease. Moreover, patients with M. kansasii disease displayed diverse radiographic findings. Some patients showed an indolent course without treatment. Thus, since the clinical significance of a single M. kansasii isolate is not definite, strict adherence to recommended diagnostic criteria is advised.

NIC에 근거한 척수손상환자의 가정간호 중재 프로토콜 개발

문성미,김선희,Moon, Seong-Mi,Kim, Sun-Hee 한국가정간호학회 2001 가정간호학회지 Vol.8 No.1

Spinal cord injury patients need rehabilitation after the acute stage. They should be cared for at home to decrease hospitalization. Home care nurses play an important role in making spinal cord injury patients who have physical. and psychosocial problems do their best. For effective care, home care nurses need standardized nursing intervention protocols for spinal cord injury patients, but they are rarely developed. Therefore, this study was conducted to develop home care nursing protocols, based on NIC, that are applicable to spinal cord injury patients at home. Forty home care nursing charts of spinal cord injury patients registered in a home care nursing agency from July 1st, 1994 to August 31st, 1999 in S city were analyzed. Fifteen home care nurses participated in this study as a user validity validation group, The results of this study are as follows. 1. Fifteen nursing diagnoses were classified through the frequency analysis of home care nursing charts and previous literature for 40 spinal cord injury patients: altered urinary elimination, constipation, high risk for impaired skin integrity, chronic pain, impaired skin integrity, impaired social interaction, knowledge deficit, bowel incontinence, high risk for injury, altered role performance, care giver role strain, impaired physical mobility, sexual dysfunction, dysreflexia, and ineffective breathing pattern. 2. Based on validation by experts and user validities, 93 nursing interventions which were above ICV(Index of Content Validity) .80 were chosen. 3. Nursing intervention protocols which showed above ICV .80 were developed.

간질환자의 사회심리적 적응과 자기효능·사회적 지지와의 관계 연구

문성미 한국간호과학회 2000 Journal of Korean Academy of Nursing Vol.30 No.3

F-31 Clinical Characteristics, Treatment Outcomes, and Resistance Mutations Associated with Macrolide-Resistant Mycobacterium avium Complex Lung Disease

문성미,박혜윤,김수영,전병우,이현,전경만,김대훈,허희재,기창석,이남용,김홍관,최용수,김진국,이승헌,김창기,신성재,( Charles L. Daley ),고원중 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.-

Macrolides are key components of the multidrug treatment regimen for Mycobacterium avium complex lung disease (MAC-LD). Despite the emergence of macrolide resistance, limited data are available on macrolide-resistant MAC-LD. This study evaluated the clinical features and treatment outcomes of patients with macrolide-resistant MAC-LD and the molecular characteristics of the macrolide-resistant isolates. A retrospective review of the medical records of 34 patients with macrolide-resistant MAC-LD, who were diagnosed between January 2002 and December 2014, was performed along with genetic analysis of 28 clinical isolates. Nineteen (56%) patients had the fibrocavitary form and 15 (44%) had the nodular bronchiectatic form. M. intracellulare was the etiologic organism in 21 (62%) patients. Two-thirds (22/34, 65%) of the patients had been treated with currently recommended multidrug regimens prior to the emergence of macrolide resistance. The median duration of treatment after the detection of macrolide resistance was 23.0 months (interquartile range, 16.8-45.3 months). Treatment outcomes were poor after the development of macrolide resistance, with favorable treatment outcomes achieved in only five (15%) patients, including two patients who underwent surgical resection. One-, three-, and five-year mortality rates were 9, 24, and 47%, respectively. Molecular analysis of 28 clinical isolates revealed that 96% (27/28) had point mutations of the 23S rRNA gene. Our analyses indicate that more effective therapy is needed to treat macrolide-resistant MAC-LD and prevent its development.

우리나라 성인 흡연자의 금연의도와 관련 요인: 2014년 국민건강영양조사 자료를 이용하여

문성미,Moon, Seongmi 한국기초간호학회 2017 Journal of korean biological nursing science Vol.19 No.3

Purpose: The present study was designed to examine the impact of socioeconomic, health-related, and health behavioral factors on Korean people's intention to quit smoking. Methods: The subjects were 851 men and 145 women, aged 19 or more who had participated in the 2014 Korea National Health and Nutrition Examination Survey. The intention to quit smoking was categorized as "within 6 months," "after 6 months," or "no intention". The associations of the intention to quit smoking with sociodemographic, health related, and health behavioral factors were examined in a logistic regression. Results: In male smokers, the number of diseases, perceived somatotype, vigorous intensity leisure activity, aerobic physical activity, and smoking intensity had a significant influence on the intention to quit smoking. In female somkers, the economic status, number of diseases, walking activity, and moderate intensity leisure activity were significantly influential on the intention to quit smoking. Conclusion: To increase male smokers' intention to quit smoking, it should be emphasized that smoking is harmful to. Moreover, special attention should be paid to low-educated female smokers to increase their intention to quit smoking.