• Journal of Gastric Cancer
• /
• v.15 no.2
• /
• pp.87-104
• /
• 2015

Purpose: To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods: This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ${\geq}65$ years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemotherapy agent. Results: In total, 2,583 patients met the inclusion criteria. The mean age at index was $74.8{\pm}6.0years$. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) $70,808{\pm}56,620$. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions: The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.

• Annals of dermatology
• /
• v.30 no.6
• /
• pp.668-675
• /
• 2018

Background: Drug survival, defined as the time until discontinuation, is a parameter reflecting real-world therapeutic effectiveness. Few studies have examined the influence of economic factors on the drug survival of biologic agents for psoriasis, particularly in Asian countries. Objective: To determine the drug survival for ustekinumab in real-life settings and investigate the factors affecting drug survival for psoriasis patients in Korea. Methods: We evaluated 98 psoriasis patients who were treated with ustekinumab at a single center. We analyzed the efficacy and drug survival of ustekinumab. Cox proportional hazard analysis and competing risk regression analysis were performed to reveal the factors affecting the drug survival of ustekinumab. Results: The overall mean drug survival was 1,596 days (95% confidence interval [CI], 904~2,288). Among the 39 cessations of ustekinumab treatment, 9 (23.1%) patients discontinued treatment after experiencing satisfactory results. Multivariate Cox proportional hazard analysis revealed that paying on patients' own expense was the major predictor for the discontinuation of ustekinumab (hazard ratio [HR], 9.696; 95% CI, 4.088~22.998). Competing risk regression analysis modeling of discontinuation because of factors other than satisfaction of an event also revealed that ustekinumab treatment at the patient's expense (HR, 4.138; 95% CI, 1.684~10.168) was a predictor of discontinuation rather than satisfaction. Conclusion: The results of our study revealed that the cost of biologics treatment affects the drug survival of ustekinumab and suggested that economic factors affect the drug survival of ustekinumab treatment in Korea.

• Journal of Preventive Medicine and Public Health
• /
• v.46 no.6
• /
• pp.293-299
• /
• 2013

Objectives: The purposes of this study were to evaluate the prevalence of epilepsy and to estimate the cost of epilepsy in Korea, 2010. Methods: This study used a prevalence based approach to calculate the cost of epilepsy. Claims data from the Korean national health insurance and data from the Korea health panel, the Korea National Statistical Office's records of causes of death, and labor statistics were used to estimate the cost of epilepsy. Patients were defined as those who were hospitalized or visited an outpatient clinic during 2010 with a diagnosis of epilepsy (International Classification of Diseases 10th revision codes G40-G41). Total costs of epilepsy included direct medical costs, direct non-medical cost and indirect costs. Results: The annual prevalence of treated epilepsy was 228 per 100 000 population, and higher in men. The age-specific prevalence was highest for teenagers. The total economic burden of epilepsy was 536 billion Korean won (KW). Indirect cost (304 billion KW) was 1.3 times greater than direct cost (232 billion KW). By gender, the male (347 billion KW) were more burdened than the female (189 billion KW). The estimated cost in young age younger than 20 years old was 24.5% of the total burden of epilepsy. Conclusions: A significant portion of the economic burden of epilepsy is borne by people in young age. To reduce the economic burden of epilepsy, effective prevention and treatment strategies are needed.

• Journal of Microbiology and Biotechnology
• /
• v.25 no.1
• /
• pp.109-118
• /
• 2015

Open raceway ponds are cost-efficient for mass cultivation of microalgae compared with photobioreactors. Although low-cost options like wastewater as nutrient source is studied to overcome the commercialization threshold for biodiesel production from microalgae, a cost analysis on the use of wastewater and other incremental increases in productivity has not been elucidated. We determined the effect of using wastewater and wavelength filters on microalgal productivity. Experimental results were then fitted into a model, and cost analysis was performed in comparison with control raceways. Three different microalgal strains, Chlorella vulgaris AG10032, Chlorella sp. JK2, and Scenedesmus sp. JK10, were tested for nutrient removal under different light wavelengths (blue, green, red, and white) using filters in batch cultivation. Blue wavelength showed an average of 27% higher nutrient removal and at least 42% higher chemical oxygen demand removal compared with white light. Naturally, the specific growth rate of microalgae cultivated under blue wavelength was on average 10.8% higher than white wavelength. Similarly, lipid productivity was highest in blue wavelength, at least 46.8% higher than white wavelength, whereas FAME composition revealed a mild increase in oleic and palmitic acid levels. Cost analysis reveals that raceways treating wastewater and using monochromatic wavelength would decrease costs from 2.71 to 0.73 $/kg biomass. We prove that increasing both biomass and lipid productivity is possible through cost-effective approaches, thereby accelerating the commercialization of low-value products from microalgae, like biodiesel.

• Sleep Medicine and Psychophysiology
• /
• v.7 no.1
• /
• pp.5-9
• /
• 2000

Several nonpharmacological treatment methods of insomnia and their effects were reviewed. A long-term use of most hypnotics may produce tolerance, dependence, cognitive and psychomotor impairments at daytime, shallow sleep, and rebound insomnia on drug withdrawal. To reduce hypnotic abuse, nonpharmacological strategies have been developed to correct disordered behavioral and cognitive factors. These treatments aim at modifying maladaptive sleep habits, lowering physiological and cognitive arousal levels, and correcting dysfuctional beliefs and attitudes about sleep. These non-pharmacological or cognitive behavior treatments include stimulus control, sleep restriction, relaxation training, sleep hygiene education, cognitive therapy, and light therapy. Among them the stimulus control therapy has been demonstrated most effective as a single treatment or in combination with other treatments. Through nonpharmacological treatments, sleep latency was most significantly reduced and wake time after sleep onset was also reduced. About 50% of insomniacs reported clinical improvements in terms of nearly normalized sleep latency, awakening time, sleep efficiency, and reduction of hypnotic use. Compared to the hypnotic therapy, nonpharmacological treatments are more cost-effective and more readily accepted by patients, and their effects last longer.

• Membrane and Water Treatment
• /
• v.5 no.4
• /
• pp.251-263
• /
• 2014

The study contributes in the treatment of waste generated by the textile complex cotton of Draa Ben Khedda, Algeria. The azo dye "Direct Red Solophenyle 4GE" represents the base particle of the discharges and electrocoagulation with nanofiltration are used as a means of treatment. The solar photovoltaic is suitable for electrochemical process to reduce the energy cost. Several study parameters are considered in this work. The electrocoagulation batch gives the best reduction 37% for a dye concentration of 7.21 mg/L ($[NaCl]_{added}$=1g/L; $j=25.2mA/cm^2$). Coupling methods (electrocoagulation-nonofiltration) gives a complete discoloration rejecting concentration 52.4 mg/L (pHi = 7.6, $[NaCl]_{added}$=3g/L, $j=2.13mA/cm^2$). The result shows the coupling efficiency with a reduced amount of resulting slurry at the end of treatment.

• Proceedings of the IEEK Conference
• /
• 2001.10a
• /
• pp.711-714
• /
• 2001

A new technology to make fluoride gas such as NF$_3$contained in the exhaust gas from semiconductor manufacturing plants convert directly into a harmless substance have been established and new concept on the disposal treatment of global warming gases were presented. Experimental results verify that the chemical reactions can be take place at substantially lower temperature of 80-40$0^{\circ}C$ as compared with the combustion treatment method. Reaction product is mainly metal fluoride which is a harmless and a valuable chemical material as one of new resources. The other favorable characteristics are that the continuous treatment is possible at a low temperature under atmospheric pressure. Furthermore this process is compact, easily controllable and safely operable at low running cost. This paper concerns with a new harmless disposal treatment of toxic global warming gas.

• Transactions of Materials Processing
• /
• v.11 no.5
• /
• pp.388-393
• /
• 2002

Heat-treatment-free steels have been replacing for conventional quenched-and-tempered structural steels since the microalloyed forging steel was developed in early 1970s in Germany. Substantial cost reduction provides the driving force for this change. As a result of intensive R & D efforts and application trials, various kinds of grades, for example heat-treatment-free steels for hot forging, machining and cold heading, have been developed and moreover these steels are in tonnage production throughout the world. The developments in alloy steels, processing conditions and structure-property characteristics of the heat-treatment-free steels, are described and also recent trend and future prospect are summarized in this report.

• Advances in environmental research
• /
• v.5 no.3
• /
• pp.169-178
• /
• 2016

This study aimed at determining the treatability of high-strength wastewater (chemical oxygen demand, COD>4000 mg/L) using combined anaerobic-aerobic granular sludge in lagoon systems. The lagoon systems were simulated in laboratory-scale aerated and non-aerated batch processes inoculated with dried granular microorganisms at a dose of 0.4 g/L. In the anaerobic batch, a removal efficiency of 25% was not attained until the 12th day. It took 14 days of aerobic operation to achieve sCOD removal efficiency of 94% at COD:N:P of 100:4:1. The best removal efficiency of sCOD (96%) was achieved in the sequential anaerobic-aerobic batch of 12 days and 2 days, respectively at COD:N:P ratio of 200:4:1. Sequential anaerobic-aerobic treatment can achieve efficient and cost effective treatment for high-strength wastewater in lagoon systems.

• Journal of Korean Foot and Ankle Society
• /
• v.23 no.1
• /
• pp.6-11
• /
• 2019

As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.