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Montelukast Reduces Serum Levels of Eosinophil-Derived Neurotoxin in Preschool Asthma

  • Kim, Chang-Keun;Callaway, Zak;Park, Jin-Sung;Nishimori, Hisashi;Ogino, Tikatoshi;Nagao, Mizuho;Fujisawa, Takao
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.686-697
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    • 2018
  • Purpose: Several markers for eosinophilic inflammation have been proposed to predict response to asthma treatment. However, definitive criteria for treatment decisions have not yet been established. We investigate a potentially useful relatively non-invasive biomarker, eosinophil-derived neurotoxin (EDN), to predict favorable responses to budesonide or montelukast, common treatment for children with asthma. Methods: Young children (1 to 6 years old) were enrolled in this randomized, parallel, 2-group, open-label trial. Criteria for eligibility included: 1) being symptomatic during the run-in period; and 2) having a serum EDN (sEDN) level ${\geq}53ng/mL$, with positive specific immunoglobulin E to house dust mite. Eligible patients were randomly placed into 2 groups: the BIS group received budesonide inhalation suspension (BIS) 0.5 mg once daily; the MONT group received montelukast 4 mg once daily. Ineligible patients were invited to receive montelukast 4 mg once daily (OBS group). Treatment period was 12 weeks. Results: Asthma control days increased significantly in the BIS and MONT groups (P < 0.000) over the 12-week study period. There was no significant change in sEDN in the BIS group but there was a significant decrease in the MONT group (P < 0.000). Patients in the OBS group with high EDN levels (> 53 ng/mL) showed a significant decrease due to MONT treatment (P = 0.023). Rescue medication usage significantly decreased in the BIS and MONT groups (P < 0.000). Conclusions: EDN is a useful relatively non-invasive biomarker for predicting responses to montelukast and budesonide treatment of preschool children with beta2-agonist responsive recurrent wheeze and multiple-trigger wheeze (Trial registry at UMIN Clinical Trials Registry, UMIN000008335).

Pre-pregnancy Diet to Maternal and Child Health Outcome: A Scoping Review of Current Evidence

  • Fadila Wirawan;Desak Gede Arie Yudhantari;Aghnaa Gayatri
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.2
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    • pp.111-127
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    • 2023
  • Objectives: Pre-pregnancy diet has an important role in preparing for healthy generation. However, evidence on this issue has been scarce. A scoping review synthesising current evidence will support the demand to map 'what has been researched' on pre-pregnancy diet and maternal and child health. Methods: Systematic search was performed using PICOS (Population, Intervention, Comparison, Outcomes, and Study design) framework in electronic databases. Articles were screened for eligibility, summarized, and the quality was assessed using the National Institute of Health assessment tool. The review structure complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guide. Results: Forty-two articles were included after full-text screening. Twenty-five studies were in high-income countries (HICs), six in each upper-middle income, five in lower-middle income countries (LMICs), and one in low-income countries (LIC). Based on the regions: North America (n=16), Europe (n=5), South America (n=4), Australia (n=4), Asia (n=5), Middle East (n=2), and sub-Saharan Africa (n=1). The two-most observed diet-related exposures were dietary pattern (n=17) and dietary quality (n=12). The most assessed outcome was gestational diabetes mellitus (n=28) and fetal and newborn anthropometry (n=7). The average quality score±standard deviation was 70±18%. Conclusions: Research related to pre-pregnancy diet is still concentrated in HICs. The context of diet may vary; therefore, future research is encouraged in LMICs and LICs context, and Mediterranean, South-East Asia, Pacific, and African regions. Some maternal and child nutrition-related morbidity, such as anemia and micronutrient deficiencies, have not been discussed. Research on these aspects will benefit to fill in the gaps related to pre-pregnancy diet and maternal and child health.

Quality Reporting of Systematic Review and Meta-Analysis According to PRISMA 2020 Guidelines: Results from Recently Published Papers in the Korean Journal of Radiology

  • Ho Young Park;Chong Hyun Suh;Sungmin Woo;Pyeong Hwa Kim;Kyung Won Kim
    • Korean Journal of Radiology
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    • v.23 no.3
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    • pp.355-369
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    • 2022
  • Objective: To evaluate the completeness of the reporting of systematic reviews and meta-analyses published in a general radiology journal using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Materials and Methods: Twenty-four articles (systematic review and meta-analysis, n = 18; systematic review only, n = 6) published between August 2009 and September 2021 in the Korean Journal of Radiology were analyzed. Completeness of the reporting of main texts and abstracts were evaluated using the PRISMA 2020 statement. For each item in the statement, the proportion of studies that met the guidelines' recommendation was calculated and items that were satisfied by fewer than 80% of the studies were identified. The review process was conducted by two independent reviewers. Results: Of the 42 items (including sub-items) in the PRISMA 2020 statement for main text, 24 were satisfied by fewer than 80% of the included articles. The 24 items were grouped into eight domains: 1) assessment of the eligibility of potential articles, 2) assessment of the risk of bias, 3) synthesis of results, 4) additional analysis of study heterogeneity, 5) assessment of non-reporting bias, 6) assessment of the certainty of evidence, 7) provision of limitations of the study, and 8) additional information, such as protocol registration. Of the 12 items in the abstract checklists, eight were incorporated in fewer than 80% of the included publications. Conclusion: Several items included in the PRISMA 2020 checklist were overlooked in systematic review and meta-analysis articles published in the Korean Journal of Radiology. Based on these results, we suggest a double-check list for improving the quality of systematic reviews and meta-analyses. Authors and reviewers should familiarize themselves with the PRISMA 2020 statement and check whether the recommended items are fully satisfied prior to publication.

Intraoperative Radiotherapy (IORT) for Locally Advanced Colorectal Cancer (대장-직장암의 수술중 방사선 치료)

  • Kim, Myung-Se;Kim, Sung-Kyu;Kim, Jae-Hwang;Kwan, Koing-Bo;Kim, Heung-Dae
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.265-270
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    • 1991
  • Colorectal cancer is the second most frequent malignant tumor in the United States and fourth most frequent tumor in Korea. Surgery has been used as a primary treatment modality but reported overall survivals after curative resection were from $20\%\;to\;50\%$. Local recurrence is the most common failure in the treatment of locally advanced colorectal cancer. Once recurrence has developed, surgery has rarely the role and the five year survival of locally advanced rectal cancer is less than $5\%$, in spite of massive combination therapy. Intraoperative radiotherapy (IORT) with or without external beam irradiation has been advocated for reducing local recurrence and improving survival. The recent report of local failure by this modality was only $5\%$, this indicated that significant improvement of local control could be achieved. We performed 6 cases of IORT for locally advanced colorectal cancer which is the first experience in Korea. Patient's eligibility, treatment applicator, electron energy, dose distribution on the surface and depth within the treatment field and detailed skills are discussed. We hope that our IORT protocol can reduce local failure and increase the long term survival significantly.

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A Study of the Price Determinants for Public Residential Land Investment - From the Perspective of Land and Market Factors - (택지지구 공동주택용지의 투자가격 결정요인에 관한 연구 - 토지특성 및 시장요인 관점에서 -)

  • Choi, Kiheon;Lee, Sangyoub
    • Korean Journal of Construction Engineering and Management
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    • v.17 no.3
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    • pp.108-115
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    • 2016
  • The price determinant for land investment depends on the internal information process and subjective decision making by management in general. Accordingly, the systematic frame to determine the feasibility of investment price to the public residential land for multi-housing development by private sector has not been proposed. The purpose of this study is to explore the frame to determine the investment price for public residential land from the perspectives of land attribute and apartment market factor. Multiple regression has been implemented to confirm the eligibility of proposed model. Research findings indicate that the land area, floor area ratio, coverage ratio, location have been identified as the total land cost determinant, and for the determinants for floor area land cost, the ratio of apartment, sale price, rent price, etc, have been identified. This research intends to provide the basis for land providers to predict the land value as a raw material in market and present the indicators for land buyers to review the price adequacy for the investment.

The Palliative Care and Hospice for the People Living with HIV (HIV 감염인을 위한 완화의료와 호스피스)

  • Choi, Jae-Phil
    • Journal of Hospice and Palliative Care
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    • v.20 no.3
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    • pp.159-166
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    • 2017
  • According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

Legal Aspects on the Procedures and Settlement of the Disputes arising from the WTO Preshipment Inspection (WTO 선적전검사제도에 따른 실태와 분쟁조정의 해결에 관한 고찰)

  • Seo, Jeong-Il
    • Journal of Arbitration Studies
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    • v.8 no.1
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    • pp.293-322
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    • 1998
  • General Administrative Procedures of the Preshipment Inspection 1. Initial notification Preshipment Inspection is initiated by Agency when it receives notice either from the importing country, or the seller, that an export needs to be imspected 1.1 Notice from the importing country 1.2 Notice from the seller 2. Preliminary price verification After receipt of initial notification, Agency undertakes, Where possible, a preliminary price verification, based upon the Inspection Order and other contractual documents received. 3. Customs classification When required by the Government of the importing country. Agency forms an opinion of the Customs Classification Code based upon the Customs Tariff Book and Rules of Classification of the country of importation. The Customs Classification Code determines the tariff rate on the basis of which the importer will be required to pay import duties. 4. Import eligibility 5. Arrangements for physical inspection 5.1 Inspection request from seller 5.2 Place of inspection 5.3 Date of inspection 5.4 Physical inspection procedures 6. Physical inspection results When the physical inspection is completed, the inspector submits his report to the Agency office and the result of inspection will be communicated to the seller and, where applicable, the place of inspection. The result will state: satisfactory or conditional of unsatisfactory. The seller is welcome to present his views in writting to Agency in the event there is any query regarding the issuance of a conditional of unsatisfactory inspection result. 6.1 Satisfactory 6.2 Conditional 6.3 Unsatisfactory 7. Shipment of the goods The seller is advised to check with Agency prior to shipment if the physical inspection result has not been received or there are any doubts concerning whether a Clean Report of Findings will be issued. 8. Final price verification and classification Based on the results of physical inspection and appropriate final documents, Agency finalises the price verification and the Agency opinion of Customs classification code. When the preliminary price verification has not resulted in any unresolved questions and the inspection result and other documents received are consistent with the preliminary documentation, Agency will not normally require any additional information. The main exception would be if the terms of sale require reference to prices at the date of shipment. 9. The Report of Findings 9.1 Types of Reports of Findings - Clean Reports of Findings(CRF) The Agency will issue a Clean Reports of Findings(CRF), or equivalent document, normally within two working days after receipt of the necessary correct final documents and a satisfactory result in all aspects of the inspection. - Discrepancy Report.

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Chinese Patients with Gastric Cancer Need Targeted Adjuvant Chemotherapy Schemes

  • Shi, Wen-Tao;Wei, Lei;Xiang, Jin;Su, Ke;Ding, Qiong;Tang, Meng-Jie;Li, Ji-Qiang;Guo, Yi;Wang, Pu;Zhang, Jing-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5263-5272
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    • 2012
  • Background: Gastric cancer (GC) is one of the most common cancers in China. Adjuvant chemotherapy (AC) is a routine auxiliary treatment for GC recommended by the guidelines issued in 2011 by the Ministry of Health of the People's Republic of China, but the relevant credible consequences in China have been insufficient because of China's late start and ethical concerns. Methods: A series of databases, including Cochrane Library, MEDLINE, EMBASE, the Chinese database of the National Knowledge Infrastructure and the VIP database, were searched by 2 reviewers independently for studies investigating AC for GC through March 2012. The retrieved literature was screened according to the eligibility criteria. Results: A total of 35 randomized control trials (RCTs) were subjected to the final analysis, including 4,043 patients in treatment group and 3,884 in the control group, as well as 4 clinical-control trials (CCTs), which accessed the final analysis with 238 and 252 patients, respectively. AC reduced the risk of death as a protective treatment with statistical significance (HR=0.91, 95%CI: [0.85, 0.97], P=0.002), and it seemed more effective for Asian than non-Asian patients. The effects of AC were not influenced by the starting time (P>0.05). D2 lymphadenectomy-based chemotherapy was effective (HR=0.89, 95%CI: [0.80, 0.99], P=0.04). Oral S-1 40 mg/m2 after D2 lymphadenectomy might be a better choice for Asians with advanced GC and might result in a greater reduction of adverse events than in non-Asian patients. GRADE quality assessment determined that the strength of the evidence from foreign studies from Europe, the United States and Asian countries other than China was high, while it was moderate for Chinese studies. Conclusion: AC was effective or even curative in Chinese patients in general, although it is still necessary to optimize a targeted AC scheme for Chinese patients with GC.

A Study on the Mediation and Arbitration of Lease Dispute (임대차 분쟁의 조정과 중재에 관한 연구)

  • Nam, Seon-Mo
    • Journal of Arbitration Studies
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    • v.25 no.4
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    • pp.119-136
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    • 2015
  • The contracting parties must be provided a litigation scheme in order to resolve a dispute. This means taking advantage of effective measures for mediation or arbitration. A lease transaction is likely to occur mainly after a dispute. It is necessary to take the appropriate measures in advance. In general, when a variety of contracts are created, conflicts arise and disputes have to be resolved through mediation and arbitration documents, and adjustment or intervention is called for. Arbitration system is a system that is established based on the trust of the arbitral tribunal. For such system, quality education for enhancing professionalism required of the arbitrator is important. A party responding to an arbitration agreement presents a problem. The current system must ensure that there are no disadvantaged parties. However, a party must depend on an arbitration agreement that is part of the law rescue system. A litigation support by the local Bar Association must be carried out. It should be notified of the contents of the contract to select a strategy that will best resolve the conflict. In the case of lease transactions, there is a need to create a scheme to make a standard agreement that inserts an arbitration clause. Lease sale and purchase agreement or lease agreement is a form of contract that has been frequently used. Here, the arbitration agreement clause for a lawyer that will serve as arbitrator should be inserted. It is a scheme that can be activated for individuals in poor areas. In addition, it is possible to see it taking a scheme to take advantage of the lawyer system for the future of the town. The Attorney System of a town is a system that the Korean Bar Association, Legal Department has put in place since 2013. If a real estate trade dispute occurs, the role of the intermediary attorney should be to carry out his duties efficiently. In the case of real estate transaction conflicts, the lawyer of the village should be registered as the arbitrator. It is important to establish a basis of regulations through this type of real estate transaction accident analysis. Before proceeding with various adjustment systems, it is desirable to expand the arbitration region. Now we need a realtor amendment. It is the part where fragmentation of intermediary qualification is required, along with the eligibility of a subdivision.

Simulation of Pension Finance and Its Economic Effects (연금재정(年金財政) 시뮬레이션과 경제적(經濟的) 파급효과(波及效果))

  • Min, Jae-sung;Kim, Yong-ha
    • KDI Journal of Economic Policy
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    • v.13 no.1
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    • pp.115-134
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    • 1991
  • The role of pension plans in the macroeconomy has been a subject of much interest for some years. It has come to be recognized that pension plans may alter basic macroeconomic behavior patterns. The net effects on both savings and labor supply are thus matters for speculation. The aim of the present paper is to provide quantitative results which may be helpful in attaching orders of magnitude to some of the possible effects. We are not concerned with the providing empirical evidence relating to actual behavior, but rather with deriving the macroeconomic implications for a alternative possibilities. The pension plan interacts with the economy and the population in a number of ways. Demographic variables may thus affect both the economic burden of a national pension plan and the ability of the economy to sustain the burden. The tax transfer process associated with the pension plan may have implications for national patterns of saving and consumption. The existence of a pension plan may have implications also for the size of the labor force, inasmuch as labor force participation rates may be affected. Changes in technology and the associated changes in average productivity levels bear directly on the size of the national income, and hence on the pension contribution base. The vehicle for the analysis is a hypothetical but broadly realistic simulation model of an economic- demographic system into which is inserted a national pension plan. All income, expenditure, and related aggregates are in real terms. The economy is basically neoclassical; full employment is assumed, output is generated by a Cobb-Douglas production process, and factors receive their marginal products. The model was designed for use in computer simulation experiments. The simulation results suggest a number of general conclusions. These may be summarized as follows; - The introduction of a national pension plan (funded system) tends to increase the rate of economic growth until cost exceeds revenue. - A scheme with full wage indexing is more expensive than one in which pensions are merely price indexed. - The rate of technical progress is not a critical element in determining the economic burden of the pension scheme. - Raising the rate of benefits affects its economic burden, and raising the age of eligibility may decrease the burden substantially. - The level of fertility is an element in determining the long-run burden. A sustained low fertility rate increases the proportion of the aged in total population and increases the burden of the pension plan. High fertility has inverse effects.

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