• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.239-247
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• 2016

Background: The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. Materials and Methods: Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. Results: The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. Conclusions: An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3383-3389
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• 2014

Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.5 no.10
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• pp.1830-1840
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• 2011

CDISC (Clinical Data Interchanging Standards Consortium) standards are to support the acquisition, exchange, submission and archival of clinical trial and research data. SDTM (Study Data Tabulation Model) for Case Report Forms (CRFs) was recommended for U.S. Food and Drug Administration (FDA) regulatory submissions since 2004. Although the SDTM Implementation Guide gives a standardized and predefined collection of submission metadata 'domains' containing extensive variable collections, transforming CRFs to SDTM files for FDA submission is still a very hard and time-consuming task. For addressing this issue, we developed metadata based SDTM mapping rules. Using these mapping rules, we also developed a semi-automatic tool, named CDISC Transformer, for transforming clinical trial data to CDISC standard compliant data. The performance of CDISC Transformer with or without MDR support was evaluated using CDISC blank CRF as the 'gold standard'. Both MDR and user inquiry-supported transformation substantially improved the accuracy of our transformation rules. CDISC Transformer will greatly reduce the workloads and enhance standardized data entry and integration for clinical trial and research in various healthcare domains.

• Journal of Korean Medical Science
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• v.33 no.51
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• pp.328.1-328.12
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• 2018

Background: In cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program. Methods: Data from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention. Results: Of 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1-3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3-2.9 [1.6%]; 1.4-1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes. Conclusion: The nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.1
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• pp.25-32
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• 2015

Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.10003-10008
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• 2014

Background: Cervical cancer has been a leading female cancer in Thailand for decades, and has been second to breast cancer after 2007. The Ministry of Public Health (MoPH) has provided opportunistic screening with Pap smears for more than 30 years. In 2002, the MoPH and the National Health Security Office provided countrywide systematic screening of cervical cancer to all Thai women aged 35-60 years under universal health care coverage insurance scheme at 5-year intervals. Objectives: This study characterized the cervical cancer incidence trends in Songkhla in southern Thailand using joinpoint and age period cohort (APC) analysis to observe the effect of cervical cancer screening activities in the past decades, and to project cervical cancer rates in the province, to 2030. Materials and Methods: Invasive and in situ cervical cancer cases were extracted from the Songkhla Cancer Registry from 1990 through 2010. Age standardized incidence rates were estimated. Trends in incidences were evaluated by joinpoint and APC regression models. The Norpred package was modified for R and was used to project the future trends to 2030 using the power of 5 function and cut trend method. Results: Cervical cancer incidence in Songkhla peaked around 1998-2000 and then dropped by -4.7% per year. APC analysis demonstrated that in situ tumors caused an increase in incidence in early ages, younger cohorts, and in later years of diagnosis. Conclusions: Both joinpoint and APC analysis give the same conclusion in continuation of a declining trend of cervical cancer to 2030 but with different rates and the predicted goal of ASR below 10 or even 5 per 100,000 women by 2030 would be achieved. Thus, maintenance and improvement of the screening program should be continued. Other population based cancer registries in Thailand should analyze their data to confirm the success of cervical cancer screening policy of Thailand.

• Child Health Nursing Research
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• v.15 no.1
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• pp.81-87
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• 2009

In recent years, reductions in infant mortality have mainly been accomplished by improving the survival of premature and low birth weight infants, however premature infants still remain at great risk. The purpose of this study was to review the maternal child health service related to premature infants and to provide a future direction for improving maternal child health (MCH) in Korea. We reviewed two MCH services which are directly related to premature infants: 1) a registry and financial support program for families with a premature infant, and 2) financial support to build neonatal intensive care units in rural public hospitals. Suggestions are made for the development of a national vital signs record system to identify high risk infants and to monitor the trends in infant mortality due to prematurity. Prevention efforts and preconception care for childbearing women is also an important strategy to reduce the rate of preterm births. Finally, we need consider long-term follow-up plans for premature infants for a successful transit to the special education system. Developing MCH policy related to premature infants that decreases the occurrence of premature may decrease infant mortality, and also improve maternal and child health services.

• Asian-Australasian Journal of Animal Sciences
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• v.28 no.11
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• pp.1525-1531
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• 2015

Using next-generation sequencing, we conducted a genome-wide scan of selective sweeps associated with selection toward genetic improvement in Thoroughbreds. We investigated potential phenotypic consequence of putative candidate loci by candidate gene association mapping for the finishing time in 240 Thoroughbred horses. We found a significant association with the trait for Ral GApase alpha 2 (RALGAP2) that regulates a variety of cellular processes of signal trafficking. Neighboring genes around RALGAP2 included insulinoma-associated 1 (INSM1), pallid (PLDN), and Ras and Rab interactor 2 (RIN2) genes have similar roles in signal trafficking, suggesting that a co-evolving gene cluster located on the chromosome 22 is under strong artificial selection in racehorses.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8659-8663
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• 2016

In Nepal, while no population based cancer registry program exists to assess the incidence, prevalence, morbidity and mortality of cancer, at the national level a number of hospital based cancer registries are cooperating to provide relevant data. Seven major cancer diagnosis and treatment hospitals are involved, including the BP Koirala Memorial Cancer hospital, supported by WHO-Nepal since 2003. The present retrospective analysis of cancer patients of all age groups was conducted to assess the frequencies of different types of cancer presenting from January 1st to December 31st 2012. A total of 7,212 cancer cases were registered, the mean age of the patients being 51.9 years. The most prevalent age group in males was 60-64 yrs (13.6%), while in females it was 50-54 yrs (12.8%). The commonest forms of cancer in males were bronchus and lung (17.6%) followed by stomach (7.3%), larynx (5.2%) and non Hodgkins lymphoma (4.5%). In females, cervix uteri (19.1%) and breast (16.3%), were the top ranking cancer sites followed by bronchus and lung (10.2%), ovary (6.1%) and stomach (3.8%). The present data provide an update of the cancer burden in Nepal and highlight the relatively young age of breast and cervical cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.1-4
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• 2016

The aim of this research was to describe the incidence and histopathological subtypes of head and neck lymphoma in Guilan province, Iran. In this retrospective study, all cases of head and neck cancers registered in Iranian Cancer Registry Program in Guilan province of Iran from 2004 to 2009 were obtained and included in the analysis. Out of 1,510 cases, 169 (11.2%) were reported as lymphomas (87 cases of non-Hodgkin, 67 cases of Hodgkin, and 13 cases of unknown type). The mean ages of males and females diagnosed with Hodgkin's lymphoma were 30.4 and 28.7 years, respectively. For non-Hodgkin's lymphoma the respective figures were 50.5 and 49.3 years old. Among various histological subtypes of non-Hodgkin's lymphoma, the diffuse large B-cell type (74.2%) was the most frequent while immunoblastic lymphoma (1.1%) was the least frequent. Nodular sclerosis (58.2%) and mixed cellularity (18.0%) types were most frequent among Hodgkin's lymphomas.