• Journal of Preventive Medicine and Public Health
• /
• v.51 no.2
• /
• pp.83-91
• /
• 2018

Objectives: One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households' income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

• Research in Plant Disease
• /
• v.12 no.3
• /
• pp.240-248
• /
• 2006

Control of white rot which is one of the most serious apple diseases in Korea has mainly relied on periodical spray of protective fungicides. As the main inoculum source of the disease is pycnidiospores produced in the warts formed on affected stems of apple tree, it can be conceivable that inhibition of spore production might be an effective means for controlling the disease. Inhibitory efficacy of eight selected fungicides against sporulation of the fungus was assessed by counting the number of spores produced at detached warts treated with the fungicides of recommended dilution. They showed diverse effect on sporulation. Carbendazim and azoxystrobin suppressed sporulation almost completely, the former irreversively. Thiram and folpet promoted sporulation as producing much more number of spores than untreated control. Others showed almost no effect on sporulation. Effects of suppression and promotion in the sporulation shown by the fungicides on the control of white rot were examined by incidences of disease and infection at the plots adopted the spray programs of which the fungicide at late May was substituted by carbendazim, azoxystrobin, folpet and thiram, respectively. Disease incidence and infection frequency at the plots sprayed former two chemicals which suppressed sporulation were much lower than those of the plots adopted latter two chemicals and untreated plot at which the fungicide spray was skipped at that time. These facts were reconfirmed in the experiments conducted with carbendazim and thiram, in which 100 fruits were bagged just prior to each spray from late May to late July for elucidating the effect of the two fungicides on the action of subsequent ones. Disease incidence and infection frequency on the fruit bagged just prior to each spray were gradually increased as the seasons going on. The increase rate at the carbendazim plot was much lower than that of thiram. Especially, the fruit infected till late July at the carbendazim plot were almost completely cured by the three fungicides, iminoctadine-triacetate, tebuconazole and samzinwang, a combined formular of iminoctadine-triacetate and difenoconazole, sprayed at late July and hence. In thiram plot, infected fruit were also cured by the 3 fungicides but not remarkable. From these results, it can be concluded that control efficiency of white rot can be greatly enhanced by selecting the fungicide capable of suppress the sporulation of white rot fungus at the season when the mass dispersal of spores is not initiated.

• Research in Plant Disease
• /
• v.26 no.2
• /
• pp.72-78
• /
• 2020

Clover cyst nematode, Heterodera trifolii, is one of the most important plant-parasitic nematode on Kimchi-cabbage in highland in Korea. Recently, a demand of soil disinfection machine for fumigants is increasing. This study was conducted to assess the control effects of a newly developed prototype soil disinfection machine to the cyst nematode. Two fumigants, dimethyl disulfide (DMDS) and metam sodium (MNa), were treated using the machine in a field, which was infected with the cyst nematode. After 4 weeks, control effects of fumigants were assessed as eggs hatching rates inside of cysts extracted from the soil, and as a number of females reproduced in roots of Kimchi-cabbage. DMDS (39 l/10 a) suppressed over 99.0% of the eggs hatching rate and the number of females reproduced. On the other hand, MNa (29 l/10 a) controlled the egg hatching rates from minimum 78.3% to maximum 99.4%, and the number of females from 34.7% to 49.3%. The control effects of two fumigants to clover cyst nematode by treated depth were no significant differences statistically. These results showed that DMDS treatment using the soil disinfection machine was expected to have the control effects for the clover cyst nematode.

• Radiation Oncology Journal
• /
• v.30 no.3
• /
• pp.140-145
• /
• 2012

Purpose: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. Materials and Methods: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. Results: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. Conclusion: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.

• The Korean Journal of Applied Statistics
• /
• v.26 no.4
• /
• pp.581-594
• /
• 2013

A group sequential design can end a clinical trial early if a confirmed efficacy or a futility of study medication is found during clinical trials. Adaptation can adjust the design of clinical trials based on accumulated data. The key to this methodology is considered to control the overall type 1 error rate while maintaining the integrity of clinical trials. The estimation would be more complex and the sample size calculation will be more difficult if the clinical trials have repeated measurement data. Lee et al. (2002) suggested a repeated observation case by using the independent increments properties of the interim test statistics and investigated the properties of the proposed confidence interval based on the stage-wise ordering. This study extend Lee et al. (2002) to adaptive group sequential design. We suggest test statistics for the adaptation as redesigning the second stage of clinical trials and induce the stage-wise confidence interval of parameter of interests. The simulation will help to confirm the suggested method.

• Journal of Chest Surgery
• /
• v.53 no.3
• /
• pp.104-113
• /
• 2020

Background: Accurate intraoperative assessment of mediastinal lymph nodes is a critical aspect of lung cancer surgery. The efficacy and potential for upstaging implicit in these dissections must therefore be revisited in the current era of uniportal video-assisted thoracoscopic surgery (VATS). Methods: A retrospective study was conducted in which 544 patients with stage I (T1abc-T2a, N0, M0) primary lung cancer were analyzed. To assess risk factors for nodal upstaging and to limit any imbalance imposed by surgical choices, we constructed an inverse probability of treatment-weighted (IPTW) logistic regression model (in addition to non-weighted logistic models). We also evaluated risk factors for early locoregional recurrence using IPTW logistic regression analysis. Results: In the comparison of uniportal and multiportal VATS, the resected lymph node count (14.03±8.02 vs. 14.41±7.41, respectively; p=0.48) and rate of nodal upstaging (6.5% vs. 8.7%, respectively; p=0.51) appeared similar. Predictors of nodal upstaging included tumor size (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.12-2.70), carcinoembryonic antigen level (OR, 1.11; 95% CI, 1.04-1.18), and histologically confirmed pleural invasion (OR, 3.97; 95% CI, 1.89-8.34). The risk factors for locoregional recurrence within 1 year were found to be number of resected N2 nodes, age, and nodal upstaging. Conclusion: Uniportal and multiportal VATS appear similar with regard to accuracy and thoroughness, showing no significant difference in the extent of nodal dissection.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.8 no.2
• /
• pp.132-146
• /
• 2001

Purpose: This study was to analyze the trends and content of all the research (171 research papers) published in the Journal of Fundamentals of Nursing from 1994, when it began to 2000 using an objective tool developed by the researches, and to identify the direction for the future research in Fundamentals of Nursing. Method: Research published in the Journal of Fundamentals of Nursing from 1994 were reviewed. Result: Most of research (94.2%) was non-degree based and funded research was very limited. The average number of researchers per research study was 2.2 and collaborative research has been gradually increasing. The total number of key words was 331 and the average was 2.6 per research. The major key words were not different from other nursing departments and included home care nursing (10 times), health promotion (8 times), self-care (7 times). self-efficacy (7 times), and homo-dialysis (6 times). Eighty seven percent of the research was quantitative research. and there were very few qualitative studies. Considering theory level, it was found that 40% were factor related research For study design, non-experimental studies were most frequent (66%), and the rate, especially of surveys, has remarkably decreased. Selection of subjects by convenience sampling, was most frequent and there were very few studies that provided the rationale for the calculation of sample size. The major subjects of study were patients (44.8%) with various diagnoses. The subjects usually gave oral consent to take part in that study. Giving information (46.9%) and exercise (26.5%) were common nursing interventions, and physiological indices (16.5%). vital signs (10.3%), physical functioning (8.2%), level of knowledge/skill (7.2%) and level of activity (6.2%) were frequently measured as outcome. Variables questionnaires were the major approach used to collect data, and 57.8% of the research provided the Cronbach alpha to guarantee internal consistency of study instruments. Data were analyzed with computerized statistical packages using, ANOVA (42.0%), T test(39.5%), and chi-square test. For the last seven years, nursing research in Fundamentals of Nursing has gradually improved in both quantify and quality. Conclusion: It was difficult to find any uniqueness or difference compared to other departments of nursing. In fact, because the history of the Journal of Fundamentals of Nursing is rather short, we can expect that there will be further improvement in qualify and content in the future.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.20
• /
• pp.8661-8666
• /
• 2014

Background: Docetaxel and cisplatin in combination with fluorouracil (DCF) regimen is accepted to be one of the standard regimens in the treatment of advanced gastric cancer. However, substantial toxicity has limited its use in daily clinical practice. Therefore, modification of DCF regimens, including introduction of capecitabine has been investigated to improve the safety profiles. In the present study, the efficacy and toxicity of a regimen with a modified dose of docetaxel and cisplatin in combination with oral capecitabine (DCX) was evaluated in untreated patients with HER2-negative advanced gastric cancer. Materials and Methods: Fifty-four patients with HER2-negative locally advanced or metastatic gastric cancer were included in this cohort. Patients received docetaxel $60mg/m^2$ plus cisplatin $60mg/m^2$ (day 1) combined with capecitabine $1650mg/m^2$ (days 1-14) every 3 weeks. Treatment response, survival, and toxicity were retrospectively analyzed. Results: The median age was 54 years (range: 24-76). The majority of patients (70%) had metastatic disease, while 11 patients (21%) had recurrent disease and underwent curative gastrectomy, and 5 patients (9%) had locally advanced disease (LAD). The median number of DCX cycles was 4. There were 28 partial responses and 11 complete responses, with an overall response rate of 72%. Curative surgery could be performed in four patients among five with LAD. At the median follow-up of 10 months, the median progression-free survival (PFS) and overall survival (OS) of the entire cohort of patients were 7.4 and 12.1 months, respectively. Dose modification was done in 12 patients due to toxicity in 8 and noncompliance in 4 patients. The most common hematological toxicity was neutropenia, which occurred at grade 3-4 intensity in 10 of 54 patients (27.7%). Febrile neutropenia was diagnosed only in two cases. Conclusions: DCX regimen offers prominent anti-tumor activity and considered to be effective first-line treatment with manageable toxicity for patients with HER2-negative advanced gastric cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.13
• /
• pp.5155-5160
• /
• 2014

Aim: To investigate the efficacy and safety of lobaplatin-transcatheter arterial chemoembolization (TACE) combined with radioactive $^{125}I$ seed implantation in treatment of primary hepatocellular carcinoma (HCC). Methods: 75 patients with primary HCC were enrolled in the study, among them 43 receiving lobaplatin-TACE (TACE group) and 32 lobaplatin-TACE combined with $^{125}I$ seed implantation (TACE+$^{125}I$ group). After treatment, the local remission rates and postoperative complications of two groups were compared using the Pearson Chi-square test. Overall survival in the two groups was calculated using Kaplan-Meier survival curves and the differences were tested using Log-rank test. Results: There were 7 cases of complete response (CR), 13 of partial response (PR), 6 of stable disease (SD) and 17 of progressive disease (PD) in the TACE group, with 13 cases of CR, 9 of PR, 5 of SD and 5 of PD in the TACE+$^{125}I$ group. The disease control rates of TACE and TACE+$^{125}I$ group were 60.5% (26/43) and 84.4% (27/32), respectively, with a significant difference between them (P < 0.05). The survival rates at 6, 12 and 18 months in the TACE group were 100.0%, 81.8% and 50.0%, respectively, and those in TACE+$^{125}I$ group were 100.0%, 93.8% and 65.6%. The mean survival times in the TACE and TACE+$^{125}I$ groups were 19.5 and 22.9 months, respectively. There was a significant difference in the overall survival rate between two groups (P < 0.05). No serious complications were encountered in either group. Conclusion: Lobaplatin-TACE combined with $^{125}I$ seed implantation is favorable and safe for treatment of primary HCC.

• Biomedical Science Letters
• /
• v.6 no.2
• /
• pp.119-129
• /
• 2000

The skin is an organ that has many important roles, including protection against infection, regulation of temperature and fluid loss, and sensory function. Injury to the skin, wound repair normally involves: (1) balanced activity of inflammation, (2) the re-epithelial phase and (3) the matrix formation of remodeling phase. Thus, skin wound healing is a finely controlled biological process involving a series of complex cellular interactions. Laser therapy is being implemented with increasing frequency in medicine. Low intensity laser is one that is capable of producing an energy density so low that any biologic alterations are the result of direct irradiation effect, not thermal events. This study was designed to evaluate the efficacy of low intensity laser therapy on skin wound healing in rabbits. A total of 10 male rabbits (New Zealand White Rabbit), age 8 weeks were used. Skin wound were surgically created dorso-lateral on the flank of 10 rabbits (2$\times$2 cm/damage areas). The experimental animals were treated with 5Hz (830 nm wave length) low-intensity laser (MILTA-01 Model) daily for 10 min (1.6 J/$cm^2$) for 12 days. Control animals were sham treated with the laser head. Laser irradiation animals showed a complete remodeling of the epithelial layer, a positive repair of connective tissues, and enhanced the wound closure rate over time as compared to the control animals. Especially, laser irradiation groups improved fibroblast activity, cellular content, granulation tissue formation, and collagen deposition which is resulted in improving the tensile strength of the wound. These findings suggest that laser photostimulation could accelerate healing of open wound in rabbits, and may be benefit in the treatment of open wound, including decubitis ulcers.