Treatment In Korea Research Articles

An Estimation of Marginal Willingness to Pay for the Coverage Expansion of the Lung Cancer Treatments in Korea: Analysis Using Preference Elicitation Method

An Estimation of Marginal Willingness to Pay for the Coverage Expansion of the Lung Cancer Treatments in Korea: Analysis Using Preference Elicitation Method

Strategies to improve treatment outcome in gastric cancer: a retrospective analysis of patients from two high-volume hospitals in Korea and China.

China has high incidence of gastric cancer (GC). However, the treatment outcomes of China were unsatisfactory compared to those of Korea. We performed this study to compare tumour characteristics, treatment parameters, and survival outcomes of GC patients between Korea and China based on the databases of two high-volume hospitals, with the aim of identifying indicators of GC prognosis. Data of patients undergoing gastrectomy for GC from 2006 to 2010 were analysed retrospectively. Subgroup survival analyses, stratified by clinicopathologic factors and multivariable analyses, were performed. The interactive roles of chemotherapy and D2 lymphadenectomy for overall survival were also investigated. Among 1365 Chinese and 4981 Korean patients, the proportion of early cancer detection in Chinese patients was much lower relative to that of Korean patients. There were no significant differences between countries in terms of surgical morbidity and mortality. The overall 5-year survival rates were 54.3% and 81.4%; when stratified by clinicopathologic factors, the survival were generally statistically higher in Korean patients. Gender, age, T stage, N stage, extent of lymphadenectomy, radicality of surgery, resection type, and chemotherapy were independently associated with survival in patients without metastasis. Survival rates for stage II and III GC differed significantly between the two countries, but this difference was eliminated among patients who underwent D2 lymphadenectomy or received chemotherapy. These treatments were given to patients with advanced-stage diagnoses (approximately 20% and 80% of patients, respectively). Treatment type was selected as independent prognostic factors in stage I–III and D2/D2+, with chemotherapy resulting in the best prognosis. Many differences in GC tumour characteristics exist between two countries. Early cancer detection and standardized treatment in Korea contribute to superior survival rates. Promotion of an early screening program, training and dissemination of standard D2 lymphadenectomy, and appropriate applications of chemotherapy would improve survival outcomes.

Heritage Language Education Without Inheriting Hegemonic Ideologies: Shifting Perspectives on “Korea” in a Weekend Japanese-Language School in the United States

ABSTRACTLearning a heritage language can be celebrated to enhance marginalized groups’ self-esteem, but a heritage can also encompass ideologies prevalent in the groups’ original homeland. Based on ethnographic fieldwork (2007–2011) at a weekend Japanese-language school in the United States, this article investigates how ideologies on race politics within a heritage language community’s homeland are reproduced or subverted through heritage language education. We analyze treatment of Korea–Japan power relations at school by focusing on the practice of guiding students (not) to shift their perspectives in three cases involving (a) discrimination against Resident Koreans in Japan, (b) gender-specific abortion in South Korea, and (c) South Korea and Japan’s dispute over possession of Tokdo/Takeshima. While social analyses of heritage language education tend to focus on a minority group’s place in mainstream society, this article suggests investigating the reproduction of ideologies from its homeland via heritage language education.

Trends and Patterns of Hepatocellular Carcinoma Treatment in Korea

Multiple therapeutic modalities are available for hepatocellular carcinoma (HCC) treatment. We aimed to evaluate the trends for HCC treatment in Korea. Recent trends and patterns in treatment modalities were assessed in HCC patients who first registered for the Health Insurance Review Assessment Service between 2008 and 2012. From 2009 to 2012, 57,690 patients were diagnosed with HCC. Transcatheter arterial chemoembolization (TACE) was the most common treatment modality for initial treatment. Curative treatment modalities like hepatic resection, liver transplantation, and local ablation therapy increased gradually. The 3 most common treatment modalities (hepatic resection, local ablation therapy, TACE) used after initial treatment in 2009 were studied. Following initial hepatic resection, 44.5% of patients required re-treatment. TACE was the most common modality (in 48.3% of cases), while 15.0% of patients received local ablation therapy. After local ablation therapy, 55.4% of patients were re-treated, wherein 45.0% of patients received TACE and 31.5% received local ablation therapy. Following initial TACE, 73.9% patients were re-treated, most commonly with TACE (57.7%) followed by local ablation therapy (12.8%). While there were no significant differences between the initial and re-treatment modalities, various multiple treatments followed the initial treatment. The treatment modalities were interchangeable.

Predictors of Default from Treatment for Tuberculosis: a Single Center Case-Control Study in Korea.

Default from tuberculosis (TB) treatment could exacerbate the disease and result in the emergence of drug resistance. This study identified the risk factors for default from TB treatment in Korea. This single-center case–control study analyzed 46 default cases and 100 controls. Default was defined as interrupting treatment for 2 or more consecutive months. The reasons for default were mainly incorrect perception or information about TB (41.3%) and experience of adverse events due to TB drugs (41.3%). In univariate analysis, low income (< 2,000 US dollars/month, 88.1% vs. 68.4%, P = 0.015), absence of TB stigma (4.3% vs. 61.3%, P < 0.001), treatment by a non-pulmonologist (74.1% vs. 25.9%, P < 0.001), history of previous treatment (37.0% vs. 19.0%, P = 0.019), former defaulter (15.2% vs. 2.0%, P = 0.005), and combined extrapulmonary TB (54.3% vs. 34.0%, P = 0.020) were significant risk factors for default. In multivariate analysis, the absence of TB stigma (adjusted odd ratio [aOR]: 46.299, 95% confidence interval [CI]: 8.078–265.365, P < 0.001), treatment by a non-pulmonologist (aOR: 14.567, 95% CI: 3.260–65.089, P < 0.001), former defaulters (aOR: 33.226, 95% CI: 2.658–415.309, P = 0.007), and low income (aOR: 5.246, 95% CI: 1.249–22.029, P = 0.024) were independent predictors of default from TB treatment. In conclusion, patients with absence of disease stigma, treated by a non-pulmonologist, who were former defaulters, and with low income should be carefully monitored during TB treatment in Korea to avoid treatment default.

Development and Validation of a Survey Form for Adverse Events Associated with Acupuncture and Moxibustion

Objectives : To develop and validate a survey form for adverse events(AEs) associated with acupuncture and moxibustion treatment. Methods : The 1st version of a survey form consisting of 9 categories was developed and modified based on the analysis of questionnaires from previous studies on AEs. To evaluate content validity of the 1st version, a Delphi survey where experts in acupuncture and moxibustion, and research methodology were invited, was conducted alongside a separate content validity questionnaire. The content validity indices for each item and total scale were calculated as the proportion of the number of experts judging each item or scale valid to the number of total experts. Results : After the Delphi round 1, the content validity of 2 items and total scale was rated as inadequate. The 1st version was modified accordingly, and the 2nd version of the survey form was developed. The content validity of the 2nd version was assessed in the Delphi round 2 and the final version was completed after incorporating the expert comments. The final version consists of 13 questions regarding practitioner/patient information, condition/disease, intervention, treated body parts, safety issue and AE occurrence related with practitioner's behavior or instruments, AEs associated with treatment and emergency actions taken if necessary, time to AE occurrence, outcomes, serious AEs or death, and time to AE disappearance. Conclusions : This newly developed and validated survey form will serve to collect AEs associated with acupuncture and moxibustion treatments in Korea and contribute to establishing the evidence on safety of Korean acupuncture treatment.

Urologic cancers in Korea.

The incidence and prevalence of prostate and kidney cancers have been increasing in Korea during the last decade, and a marked improvement in survival rates has been noted. With a substantial proportion of the cancers diagnosed at an earlier stage of the disease, the landscape of urologic cancer treatment in Korea has been characterized by an exponential increase in the number of patients receiving surgical treatment. Throughout the last decade, an increasing proportion of surgeries have been performed using minimally invasive methods, with a notable increase in robot-assisted surgery.The evaluation and management strategies of urologic cancer in Korea are primarily based on an existing evidence-based framework provided by international guidelines. The adoption and clinical application of novel surgical techniques and systemic agents targeted at advanced stage cancer are promptly adopted; accordingly, multidisciplinary treatment options are often available for various cancers at different stages. At the same time, treatment decisions are greatly influenced by the availability of healthcare resources, which may be limited due to the National Health Insurance reimbursement policy.A racial disparity in cancer features appears to exist for certain urologic cancers among Korean patients, and the optimal management strategy specific for the Korean population has yet to be confirmed. A national comprehensive cancer database is needed for better insight into risk factors, selection of sequential strategies, tumor biology and survival outcome of Korean urologic cancer patients.

Development of non-CO2 emission factors from MSW pyrolysis melting treatment in Korea

In Korea, few investigations from the waste incineration were conducted on greenhouse gas emitted. This research calculates and compares non-CO2 concentrations and emission factors for the facilities of an incinerator comprising a pyrolysis melting incineration type (incinerator A) and a stoker incineration type (incinerator B). An analysis was made of daily average concentrations of the samples collected over a 24-h period, and the results show that incinerator A had a CH4 concentration of about 1.9 ppm and a N2O concentration of about 1.2 ppm; incinerator B had a CH4 concentration of about 2.1 ppm and a N2O concentration of about 4.5 ppm. A pyrolysis melting incineration type showed a similar value to the emission factor derived from a gasification melting furnace suggested by NIR in Japan, and there is about a 5.1 times difference between the pyrolysis melting incineration type and the stoker incineration type used in this study. This implies that, when the same default emission factor is applied without giving consideration to the characteristics of each incinerator, greenhouse gas emissions may be excessively calculated.

수산부산물의 발생·처리 실태 및 산업화 방향

The study aims to identify the generation and treatment of fishery by-products in Korea and suggests future directions and strategies for their eco-friendly utilization and industrialization. First, the study focuses on the identification of the generation and their treatment in Korea since merely few study were conducted and they did not provide enough information regarding the overall generation and treatment at the national level. According to the estimation, Korea generates 800 thousand to 1,200 thousand tones of fishery by-product every year. The fishery by-products generated at large seafood markets and processing facilities are used or processed as fish meal and feed, but those generated from households and small seafood restaurants are currently treated as food waste. In addition, inadequately treated fishery by-products cause various problems such as spoiling urban landscape, creating odor and incubating pest. After identifying the generation and treatment of fishery by-products, the study suggests directions for the formulation of infrastructure for transition into resource circulation society, minimization of dumped waste and their eco-friendly recycling as resources, diversification of recycled goods and development into a high-value added industry. Finally, the study suggests detailed strategies for the directions such as establishment of legal and institutional foundation, separation of fishery by-products from wastes, development of technology tailored for commercialization, introduction of pilot projects for industrialization and cultivation of social enterprises.

Patent Analysis-Based Technology Level Evaluation of Dental Implant

The rapid advancement of technology has changed the business environment to a great extent. Recognizing technological leadership as the mainstay of competitive strength, most companies make an increasing investment in research and development activities. Along this line, this study outlines the evaluation of technology levels for different countries by analyzing an extensive amount of patent information in dental implant systems. Dividing technologies relevant to dental implant into three categories (i.e, fixture, abutment and surface treatment), extracted and analyzed are 2,873 patents registered in Patent Cooperation Treaty (PCT), the United States, EU, Japan and Korea for the last 20 years from 1994 to 2013. The patent trend analysis revealed that Korea came to the second place after the United States in terms of the number of patent applications. In particular, the ratio of patent applications by technology category indicated that a relatively large portion of research has been directed to the category of surface treatment in Korea. On the other hand, Korea is placed last in terms of overall technology level mainly due to the lack of cites per patent. The results of this study may provide valuable information for developing strategies for ensuring the sustained growth and market leadership in the future.

Sleep apnea Treatment in Korea

Sleep apnea Treatment in Korea

Preference elicitation approach for measuring the willingness to pay for liver cancer treatment in Korea.

Background/AimsThe Korean government has expanded the coverage of the national insurance scheme for four major diseases: cancers, cardiovascular diseases, cerebrovascular diseases, and rare diseases. This policy may have a detrimental effect on the budget of the national health insurance agency. Like taxes, national insurance premiums are levied on the basis of the income or wealth of the insured.MethodsUsing a preference elicitation method, we attempted to estimate how much people are willing to pay for insurance premiums that would expand their coverage for liver cancer treatment.ResultsWe calculated the marginal willingness to pay (MWTP) through the marginal rate of substitution between the two attributes of the insurance premium and the total annual treatment cost by adopting conditional logit and mixed logit models.ConclusionsThe effects of various other terms that could interact with socioeconomic status were also estimated, such as gender, income level, educational attainment, age, employment status, and marital status. The estimated MWTP values of the monthly insurance premium for liver cancer treatment range from 4,130 KRW to 9,090 KRW.

Medication Related Osteonecrosis of the Jaw: 2015 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons.

Bisphosphonates are the most widely prescribed drugs for the treatment of osteoporosis, and are also used in malignant bone metastases, multiple myeloma, and Paget's disease, and provide therapeutic efficacy on those diseases. However, it was reported that occurrence of osteonecrosis of the jaw (ONJ) could be related with bisphosphonate exposures, and there have been many cases regarding this issue. Therefore, a clearer definition and treatment guidelines were needed for this disease. The American Society for Bone and Mineral Research (ASBMR) and American Association of Oral and Maxillofacial Surgeons (AAOMS) reported statements on bisphosphonate-related ONJ (BRONJ), and a revised version was recently presented. In the revised edition, the diagnosis BRONJ was changed to medication-related ONJ (MRONJ), which reflects a consideration of the fact that ONJ also occurs for denosumab, a bone resorption inhibitor of the receptor activator of nuclear factor-kappa B ligand (RANKL) antibody family, and bevacizumab, an anti-angiogenesis inhibitor. In 2009, a statement on ONJ was also reported locally by a relevant organization, which has served as basis for clinical treatment in Korea. In addition to the new official stance of the AAOMS and ASBMR, with an increasing pool of ONJ clinical experience, a revised version of the 2009 local statement is needed. As such, the Korean Society for Bone and Mineral Research (KSBMR) and the Korean Association of Oral and Maxillofacial Surgeons (KAOMS) have collectively formed a committee for the preparation of an official statement on MRONJ, and have reviewed recent local and international data to propose guidelines customized for the local Korean situation.

Personality construct of Sasang Personality Questionnaire in an adolescent sample

BackgroundSasang typology is a widely used personalized traditional medicine in clinical diagnosis and treatment in Korea. The aim of this study was to examine the personality construct of the Sasang Personality Questionnaire (SPQ) to replicate the previous findings in the adolescent sample. MethodsA total of 543 high school students completed the SPQ and the Korean version of the Junior Temperament and Character Inventory (JTCI). The relationships between the subscales of JTCI and SPQ were examined using Pearson's correlation. The profile analysis and analysis of variance were used to investigate the difference among high, middle, and low SPQ total score groups. ResultsThe SPQ and its subscales were significantly correlated with the JTCI subscales. SPQ total score was positively correlated with Novelty Seeking (r=0.424) and negatively correlated with Harm Avoidance (r=–0.291). The high, middle, and low SPQ total score groups showed significantly different JTCI profile (flatness with Greenhouse–Geisser correction, df=3.424, F=443.812, p<0.001; parallelism with Greenhouse–Geisser correction, df=6.848, F=18.610, p<0.001). ConclusionThe validity of the SPQ construct was confirmed with adolescents. Further investigation on its personality construct would extend the clinical application of SPQ to young age groups including children.

소독제 농도, pH, 온도, 암모니아 농도, 부유물질이 강우 월류수 염소 소독에 미치는 영향

The treatment of combined sewer overflow (CSO) is one of potential concerns in domestic wastewater treatment in Korea due to the pre-announce of CSO regulations. This work investigated the effects of disinfectant (NaOCl) concentration (0.11 to 4.0 mg Cl2/L), pH (6.5 to 8.0), temperature (15 to 25°C), ammonia (10 to 41 mg N/L), and suspended solids (91 to 271 mg SS/L) on the chlorine disinfection of CSO. The effect of NaOCl concentration on the pseudo-1 order reaction rate for total coliform inactivation was described well with a saturation-type model with the half-velocity constant of 1.212 mg/L. The total coliform inactivation reaction rate decreased with SS and pH, and increased with temperature. Ammonia in the examined range did not affect the disinfection kinetics. A chlorine contact tank with the injection chlorine level of 1 mg Cl2/L and the hydraulic retention time of 1.25 min is estimated to reduce total coliform from 1 × 10 MPN/mL to 1,000 MPN/mL at 271 mg SS/L, 15°C, and pH 8.0. Chlorine would be a proper option for the disinfection of CSO.

A Randomized Phase III Study of Docetaxel Plus Cisplatin Versus Pemetrexed Plus Cisplatin in First Line Non-Squamous Non-Small Cell Lung Cancer (Nsq-Nsclc)

ABSTRACT Aim: For patients with NSq-NSCLC, pemetrexed(A) plus cisplatin(P) was superior to gemcitabine(G) plus cisplatin(P) in terms of efficacy and toxicity. However, there have been no prospective phase III trial directly comparing the efficacy of AP with docetaxel + cisplatin (DP) in NSq-NSCLC. The objective of this study is to prove the non-inferiority of progression free survival (PFS) of DP compared to AP. Methods: We undertook an open-label phase III trial with recruitment between August 2011, and December 2013, at 14 centers in Korea. Patients with chemotherapy-naive NSq-NSCLC were randomized into 3 weekly cisplatin 70 mg/m2 with either docetaxel 60mg/m2 (DP) or pemetrexed 500mg/m2 (AP) for up to 4 cycles with stratification strata of performance status and sex. The primary objective was to assess PFS and the secondary endpoints were response rate, overall survival (OS) and safety. Treatment response was evaluated according to RECIST version 1.1. Results: After 149 patients were randomized into AP (n = 77) and DP (n = 72) arm, study team finished enrollment because of approval and popular use of maintenance pemetrexed treatment in Korea. Clinical characteristics including sex, age, and performance status were well balanced between the arms. Number of cycles and relative dose intensity were not significantly different between the arms. Partial remission was observed in 24 (31.2%) and 24 (33.3%) cases of AP and DP group, respectively. Median PFS was 4.7 months (95% confidence interval, CI 4.4 ∼ 5.1) in AP arm and 4.6 months (3.7 ∼ 5.6) in DP arm. Rate of grade 3 or 4 neutropenia and febrile neutropenia, number of serious adverse events were significantly higher in DP compared to AP arm (Table 1). Conclusions: Although both regimens showed similar PFS and response rate, more frequent adverse events and higher toxicities were observed in DP arm. (ClinicalTrials.gov Identifier: NCT01282151) Disclosure: Y. Kim: This study was funded by Sanofi Aventis Korea. All other authors have declared no conflicts of interest. Comparison of treatment, response, and adverse events. Pemetrexed/Cisplatin (n = 77) Docetaxel/Cisplatin (n = 72) Age, mean(SD) 63.0 ± 8.9 63.8 ± 9.8 Sex 53/24 50/22 ECOG PS (0/1/2) 14/55/8 17/48/7 Histology ADC/LCC/NSCLC 75/0/2 69/1/2 Stage (IIIB/IV) 5/72 3/69 Cycles (1/2/3/4/6) 7/16/2/49/3 11/14/1/45/1 Cycles mean(range) 3.4 (1-6) 3.2 (1-6) Total number of Cycles 259 228 Cycles delayed 17 (6.7%) 18 (7.9%) Doses reduced 16 (6.3%) 21 (9.3%) Relative dose-intensity (%) 97.6 ± 5.7 96.2 ± 6.9 Response (PR/SD/PD/NE) 24/33/10/10 24/25/15/8 PFS (m) 4.7 (4.4-5.1) 4.6 (3.7-5.6) Overall survival (m) 19.7 (10.8-28.6) 28.0 (7.5-48.5) Neutropenia grade 3/4 1 (1.3%) 10 (13.9%) ** Febrile Neutropenia 1 (1.3%) 8 (11.1%) * Total number of SAE 42 (16.2%) 70 (30.7%) *** SAE cases 17 (22.1%) 29 (40.3%) * * p

Biopsychological traits of Sasang typology based on Sasang personality questionnaire and body mass index.

BackgroundThe purpose of present study was to examine biological and psychological characteristics of people according to the Sasang typology, which is popular in Korea. We evaluated the Sasang Personality Questionnaire (SPQ) as a measure of temperament, and Body Mass Index (BMI) as a measure of the somatic properties of each Sasang type.MethodsSubjects were 2506 (877 males, 1629 females) outpatients between the ages of 20 through 70 who requested traditional medical assessment and treatment in Korea. The structural validity of the SPQ was examined and its correlation with BMI was analyzed. The SPQ and BMI measures of each Sasang type across age and gender were presented and their differences were analyzed with Analysis of Variance.ResultsConfirmatory factor analysis and path analysis identified an acceptable three-factor structure of the SPQ measuring differences in individual’s behavior, emotion, and cognition. SPQ scores (29.71 ± 1.00, 28.29 ± 0.19 and 26.14 ± 0.22) and BMI scores (22.92 ± 0.09, 25.56 ± 0.10 and 21.44 ± 0.10) were significantly (p < 0.001) different among So-Yang, Tae-Eum and So-Eum Sasang types, respectively.ConclusionsThe results showed that the SPQ and BMI is a reliable measure for quantifying the biopsychological characteristics of each types, and useful for guiding personalized and type-specific treatment with medical herbs and acupuncture.

Analyzing the geographic distribution of major medical equipment with smart geographic system

This study examined geographic variations in major medical equipment used for patient diagnosis and treatment in Korea and analyzed their distributions in terms of sociodemographic variables. The study areas were all the city, gun (similar to a county), and gu (similar to a metropolitan ward office) administrative areas in Korea. The major medical equipment variable was measured by summing the numbers of major medical equipment in the study areas. The sociodemographic variables and the numbers of doctors and beds of each study area were collected from the Korean Statistical Information Services in 2010. Map data and study variables were imported into a geographic information system and used for the ordinary least squares regression and geographically weighted regression analysis. The results indicated that most of the sociodemographic variables were not statistically related to the distribution of medical equipment in Korea, but the numbers of doctors and beds were significant in explaining the variation in medical equipment.

AB1066 Korean Biologics Registry of Patients with Systemic Rheumatic Disease (KOBIO): A Nationwide Registry to Assess Adverse Events Associated with Biologic Treatment in Korea

BackgroundBiologic disease modifying anti-rheumatic drugs (DMARDs) have also become an important arsenal in treating inflammatory arthritides in Korea; nearly ten agents are currently used nationwide in daily clinical practice. Despite...

EFFECT OF SRI WATER MANAGEMENT ON WATER QUALITY AND GREENHOUSE GAS EMISSIONS IN KOREA

ABSTRACTA feasibility study on the system of rice intensification (SRI) methods with respect to irrigation requirements, non‐point source (NPS) pollution discharge, greenhouse gas (GHG) emissions and rice yields was conducted for either 2 or 3 years depending on the treatment in Korea. Large‐size runoff plots were prepared, and the necessary measuring systems installed. The SRI methods were carried out with a Japonica variety of rice, Odaebyeo (Oryza sativa L.), and the results were compared with those for control plots. The data indicated the high potentiality of adoption of the SRI methods for paddy farming in Korea. The SRI methods (i.e. SRI and conventional practice with SRI water management (CS)) reduced the irrigation requirement by 50.2 and 46.0%, respectively. For the SRI and CS plots, averaged concentration reductions of typical NPS pollutants, relative to conventional practice (CT) plots, ranged between 15.3 and 42.6%. The GHG emissions from the conventional practice with two forced drainages (CD) and the CS plots, in terms of their CO2 equivalents, were reduced by 65.5 and 72.8%, respectively, compared with those from the CT plots. The rice yields from the SRI and the CS plots were not greater than those from the CT plots. Application of SRI water management methods could help to improve Korea's water resources and water quality management, and could thus contribute to mitigation of the negative effects of global warming. Copyright © 2014 John Wiley &amp; Sons, Ltd.