• Title/Summary/Keyword: Patients with cancer

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Cost-Utility Analysis of the Cochlear Implant (인공와우 이식의 비용효용 분석)

  • Lee, Hoo-Yeon;Kim, Hee-Nam;Kim, Han-Joong;Choi, Jae-Young;Park, Eun-Cheol
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.4
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    • pp.353-358
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    • 2004
  • Objective : To determine the quality of life and cost consequences for deaf adults who received a cochlear implant. Methods : The data from 11 patients, post-lingual deaf adults who received cochlear implants from 1990 to 2002, underwent cost-utility analysis. The average age of the participants was 49.6 years. The main outcomes were direct cost per quality-adjusted life-year (QALY) using the visual analog scale (VAS), health utility index (HUI), EuroQol (EQ-5D), and quality well-being (QWB), with costs and utilities being discounted 3% annually. Results : Recipients had an average of 5.6 years of implant use. Mean VAS scores increased by 0.33, from 0.27 before implantation to 0.60 at survey. HUI scores increased by 0.36, from 0.29 to 0.65, EQ-5D scores increased by 0.26, from 0.52 to 0.78, and QWB scores increased by 0.16, from 0.45 to 0.61. Discounted direct costs were $22,320, yielding $19,223/QALY using VAS, $17,387/QALY using HUI, $24,604/QALY using EQ-5D, and $40,474/QALY using QWB. Cost-utility ratios using VAS, HUI, and EQ-5D were all below $25,000 per QALY, except using QWB. Conclusion : Cochlear implants in post-lingual deaf adult have a positive effect on quality of life at reasonable direct costs and appear to produce a net saving to society.

Increased Plasma $PGE_2$ Levels after Administration of Radionuclides Used in Nuclear Medicine (핵의학 이용 방사핵종의 투여후 혈중 $PGE_2$의 변동)

  • Ryu, Yong-Wun
    • Journal of Radiation Protection and Research
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    • v.14 no.1
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    • pp.8-15
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    • 1989
  • After administration of $^{99m}TC,\;^{67}Ga,\;^{131}I,\;^{32}P\;and\;^{238}U(UO_2(NO_2)_3{\cdot}6H_2O)$, in male rats, toxic effects were examined by determining the biological materials in blood. Dosages of radio-nuclides injected are based on the amounts routinely administered to patients, and concentrations of BUN, creatinine, SGOT, SGPT and $PGE_2$ in plasma are determinated as indices to the biochemical response. No increase of creatinine was observed after injection of $^{99m}TC$. Concentrations of BUN, SGOT and $PGE_2$ were not significantly increased in comparison with before-administration. Administration of $^{67}Ga,\;^{131}I\;and\;^{32}P$, did not significantly change BUN, SGPT and SGOT, but largely increased $PGE_2$ than control levels. Besides, $^{238}U$ Showed the most severe toxicity. From the above results, we suggest that the determination of $PGE_2$ in plasma can be used as an index in case of elvaluating the effects of radiation toxicity by nuclides used in nuclear medicine.

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Lactobacillus plantarum HY7712 Ameliorates Cyclophosphamide-Induced Immunosuppression in Mice

  • Jang, Se-Eun;Joh, Eun-Ha;Lee, Ho-Yong;Ahn, Young-Tae;Lee, Jung-Hee;Huh, Chul-Sung;Han, Myung Joo;Kim, Dong-Hyun
    • Journal of Microbiology and Biotechnology
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    • v.23 no.3
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    • pp.414-421
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    • 2013
  • Lactic acid bacteria (LAB) in fermented foods have attracted considerable attention recently as treatment options for immune diseases, the incidence of which has been increasing worldwide. The ability of 500 strains of LAB, isolated from kimchi, to induce TNF-${\alpha}$ production in peritoneal macrophages was investigated. Lactobacillus plantarum HY7712 most strongly induced TNF-${\alpha}$ production as well as NF-${\kappa}B$ activation. However, HY7712 inhibited NF-${\kappa}B$ activation in LPS-stimulated peritoneal macrophages. When HY7712 was orally treated in cyclophosphamide (CP)-immunosuppressed mice for 5 or 15 days, it reversed the body and spleen weights, blood RBC and WBC levels, and splenocyte and bone marrow cells that were reduced by CP. Orally administered HY7712 increased concanavalin A-induced T cell proliferation to 84.5% of the normal group on day 15, although treatment with CP alone markedly reduced it to 53.7% of the normal group. Furthermore, orally administered HY7712 significantly induced the expressions of IL-2 and IFN-${\gamma}$ in ConA-induced splenic cytotoxic T cells of CP-treated mice. Orally administered HY7712 restored the CP-impaired phagocytosis of macrophages in mice. Orally administered HY7712 also restored the cytotoxicity of NK and cytotoxic T cells derived from spleen and bone marrow against YAC-1 in CP-immunosuppressed mice. Based on these findings, orally administered HY7712 may accelerate the recovery of cyclophosphamide-caused immunosuppression, without evident side effects, by immunopotentiating NK and Tc cells, and may provide a mechanistic basis for using HY7712 as an alternative means in lessening chemotherapyinduced immunosuppression in cancer patients.

An Analysis of Health Promotion Programs Utilizing Forests based on Korea's Regional Healthcare Program Plans (지역보건의료계획에 근거한 보건소 숲 건강증진 프로그램 현황)

  • Lee, Insook;Kim, Sungjae;Bang, Kyung-Sook;Choi, Heeseung;Ko, Chinkang;Kim, Jieun;Kim, Sunyoung
    • Perspectives in Nursing Science
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    • v.11 no.1
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    • pp.10-17
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    • 2014
  • Purpose: The aim of this study was to analyze health promotion programs utilizing forests by reviewing regional healthcare program plans in Korea. Methods: We analyzed 227 regional healthcare program plans from 2011 to 2014; seven health promotion programs of the 16 major healthcare programs were prescribed by public health law. Results: Our analysis revealed that only 35 health promotion programs from 29 sites were utilizing forests. Furthermore, of 21 known categories of health promotion programs, only nine incorporated the use of forests. Atopy-asthma healthcare programs were the most common forest health promotion programs, which also included specialized disease management programs (e.g., for atopy prevention and healing, patients with metabolic syndrome or cancer) and specialized mental health management programs (e.g., for addiction or dementia prevention). Others included programs on the development of forest roads or industrial development using forest products. Conclusion: Health programs using forests in Korea are still very limited and primarily comprise atopy-asthma prevention/management, health behavioral change, and mental health programs. This study provided useful information for developing health policies and forest health promotion programs further in Korea.

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Evaluation of Significance of Diffusely Increased Bilateral Renal Uptake on Bone Scan (골스캔상 신장의 미만성 방사능집적 증가소견의 임상적 의의)

  • Sung, Mi-Sook;Yang, Woo-Jin;Byun, Jae-Young;Park, Jung-Mi;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.1
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    • pp.119-123
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    • 1990
  • Unexpected renal abnormality can be detected on bone scan using Tc-99m-MDP. The purpose of the study is to evaluate the diagnostic significance of diffusely increased bliateral renal uptake on bone scarf. 1,500 boor scan were reviewed and 43 scans which showed diffusely increased bliateral renal uptake were selected for analysis. Laboratory findings for renal and liver function tests including routine urinalysis were reviewed in 43 patients. 26 of 43 case showed abnormality in urinalysis and renal function stud 20 of 43 cases showed abnormal liver function study and 3 of these cases were diagnosed as hepatorenal syndrome later. 13 of those 20 cases had liver cirrhosis with or without hepatoma. 12 of 43 cases showed abnormality both in renal and liver function studies. 2 of 43 cases showed diffusely increased bilateral renal uptake after chemotherapy for cancer but not on previous scans before chemotherapy. 2 of 43 cases showed hypercalcemia and 8 of 43 cases had multifocal bone uptake due to metastasis or benign bone lesion. but the latter showed no hypercalcemia at all. There was no significant correlatrion between increased renal uptake and MDP uptake in soft tissue other than kidneys. This study raised the possibility that the impaired liver and/or renal function may result in diffuse increase of bliateral renal uptake of MDP of unknown mechaninsm. It seems to need further study on this correlation.

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Effect of Korean Red Ginseng extract on colorectal lung metastasis through inhibiting the epithelial-mesenchymal transition via transforming growth factor-β1/Smad-signaling-mediated Snail/E-cadherin expression

  • Kee, Ji-Ye;Han, Yo-Han;Mun, Jeong-Geon;Park, Seong-Hwan;Jeon, Hee Dong;Hong, Seung-Heon
    • Journal of Ginseng Research
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    • v.43 no.1
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    • pp.68-76
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    • 2019
  • Background: In colorectal cancer (CRC), 40-60% of patients develop metastasis. The epithelial-mesenchymal transition (EMT) is a pivotal and intricate process that increases the metastatic potential of CRC. The aim of this study was to investigate the effect of Korean Red Ginseng extract (RGE) on colorectal metastasis through inhibition of EMT and the metastatic abilities of CRC cells. Methods: To investigate the effect of RGE on the metastatic phenotypes of CRC cells, CT26 and HT29 cells were evaluated by using an adhesion assay, a wound-healing assay, an invasion assay, zymography, and real-time reverse transcription-polymerase chain reaction. Western-blot analysis was conducted to elucidate the molecular mechanisms of RGE, which showed an inhibitory effect on the transforming growth factor-${\beta}1$ ($TGF-{\beta}1$)-induced EMT in HT29 cells. Additionally, the antimetastatic effect of RGE was evaluated in a mouse model of lung metastasis injected with CT26 cells. Results: RGE decreased the adhesion and migration ability of the CT26 cells and TGF-${\beta}1$-treated HT29 cells. The invasion ability was also reduced by RGE treatment through the inhibition of matrix metalloproteinase-9 expression and activity. Moreover, RGE suppressed the TGF-${\beta}1$-induced EMT via TGF-${\beta}1$/Smad-signaling-mediated Snail/E-cadherin expression in HT29 cells and lung tissue in CT26 tumor-bearing mice. Conclusion: Our results demonstrated that RGE inhibited colorectal lung metastasis through a reduction in metastatic phenotypes, such as migration, invasion, and the EMT of CRC cells.

Measuring Trends in the Socioeconomic Burden of Disease in Korea, 2007-2015

  • Kim, Tae Eung;Lee, Ru-Gyeom;Park, So-Youn;Oh, In-Hwan
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.1
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    • pp.19-27
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    • 2022
  • This study estimated the direct and indirect socioeconomic costs of 238 diseases and 22 injuries from a social perspective in Korea from 2007 to 2015. The socioeconomic cost of each disease group was calculated based on the Korean Standard Disease Classification System. Direct costs were estimated using health insurance claims data provided by the National Health Insurance Service. The numbers of outpatients and inpatients with the main diagnostic codes for each disease were selected as a proxy indicator for estimating patients' medical use behavior by disease. The economic burden of disease from 2007 to 2015 showed an approximately 20% increase in total costs. From 2007 to 2015, communicable diseases (including infectious, maternal, pediatric, and nutritional diseases) accounted for 8.9-12.2% of the socioeconomic burden, while non-infectious diseases accounted for 65.7-70.7% and injuries accounted for 19.1-22.8%. The top 5 diseases in terms of the socioeconomic burden were self-harm (which took the top spot for 8 years), followed by cirrhosis of the liver, liver cancer, ischemic heart disease, and upper respiratory infections in 2007. Since 2010, the economic burden of conditions such as low back pain, falls, and acute bronchitis has been included in this ranking. This study expanded the scope of calculating the burden of disease at the national level by calculating the burden of disease in Koreans by gender and disease. These findings can be used as indicators of health equality and as useful data for establishing community-centered (or customized) health promotion policies, projects, and national health policy goals.

Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

  • Escandon, Joseph M.;Mohammad, Arbab;Mathews, Saumya;Bustos, Valeria P.;Santamaria, Eric;Ciudad, Pedro;Chen, Hung-Chi;Langstein, Howard N.;Manrique, Oscar J.
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.617-632
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    • 2022
  • Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

Identification of Hub Genes in the Pathogenesis of Ischemic Stroke Based on Bioinformatics Analysis

  • Yang, Xitong;Yan, Shanquan;Wang, Pengyu;Wang, Guangming
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.697-709
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    • 2022
  • Objective : The present study aimed to identify the function of ischemic stroke (IS) patients' peripheral blood and its role in IS, explore the pathogenesis, and provide direction for clinical research progress by comprehensive bioinformatics analysis. Methods : Two datasets, including GSE58294 and GSE22255, were downloaded from Gene Expression Omnibus database. GEO2R was utilized to obtain differentially expressed genes (DEGs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of DEGs were performed using the database annotation, visualization and integrated discovery database. The protein-protein interaction (PPI) network of DEGs was constructed by search tool of searching interactive gene and visualized by Cytoscape software, and then the Hub gene was identified by degree analysis. The microRNA (miRNA) and miRNA target genes closely related to the onset of stroke were obtained through the miRNA gene regulatory network. Results : In total, 36 DEGs, containing 27 up-regulated and nine down-regulated DEGs, were identified. GO functional analysis showed that these DEGs were involved in regulation of apoptotic process, cytoplasm, protein binding and other biological processes. KEGG enrichment analysis showed that these DEGs mediated signaling pathways, including human T-cell lymphotropic virus (HTLV)-I infection and microRNAs in cancer. The results of PPI network and cytohubba showed that there was a relationship between DEGs, and five hub genes related to stroke were obtained : SOCS3, KRAS, PTGS2, EGR1, and DUSP1. Combined with the visualization of DEG-miRNAs, hsa-mir-16-5p, hsa-mir-181a-5p and hsa-mir-124-3p were predicted to be the key miRNAs in stroke, and three miRNAs were related to hub gene. Conclusion : Thirty-six DEGs, five Hub genes, and three miRNA were obtained from bioinformatics analysis of IS microarray data, which might provide potential targets for diagnosis and treatment of IS.

Radioprotective role of amifostine on osteointegration of titanium implants in the tibia of rats

  • Nevra Aydemir Celep;Hulya Kara ;Elif Erbas;Elif Dogan
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.35.1-35.10
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    • 2023
  • Background: Titanium is the most widely used metal for bone integration, especially for cancer patients receiving ionizing radiation. This study aimed to investigate the amifostine administration that would reduce the effects of radiation on bone healing and osseointegration in rat models. Objectives: It is aimed that the application of amifostine in rats receiving radiotherapy treatment will reduce the negative effects of ionizing radiation on the bone. Methods: Thirty-five adult male Wistar rats were randomly divided into one healthy and four experimental groups. In three consecutive days, two experimental groups of rats (AMF-RT-IMP and RT-IMP) were exposed to radiation (15 Gy/3 fractions of 5 Gy each). Then the titanium implants were inserted into the left tibia. Before the radiotherapy process, a 200 mg/kg dose of amifostine (AMF) was administered to the rats in the AMF-IMP and AMF-RT-IMP groups. Twenty-eight days after the screw implant, all rats were sacrificed, and their blood samples and tibia bones were collected for analysis. Results: The results indicated an accelerated bone formation and a more rapid healing process in the screw implants in the AMF-IMP, AMF-RT-IMP, and AMF-RT groups than in the RT-IMP group. Also, bone-implant contact area measurement and inflammation decreased with amifostine treatment in the implants subjected to irradiation (p < 0.05). Conclusions: The results obtained in the present study suggested that amifostine prevents the losses of bone minerals, bone integrity, and implant position from ionizing-radiation when given before exposure.