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Clinical Outcomes and Cost-Effectiveness of Osteoporosis Screening With Dual-Energy X-ray Absorptiometry

  • Chiao-Lin Hsu;Pin-Chieh Wu;Chun-Hao Yin;Chung-Hwan Chen;King-Teh Lee;Chih-Lung Lin;Hon-Yi Shi
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1249-1259
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    • 2023
  • Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

The Study on the Composting by Using Dam Suspended Particle Sawdust and Sewage Sludge (댐부유물 톱밥과 하수슬러지를 이용한 퇴비화 연구)

  • Ryu, Ji-Hune;Lee, Jong-Jin;Hong, Joo-Hwa;Chang, Ki-Woon;Lee, Gyu-Seung;Park, Gwan-Soo;Han, Ki-Pil
    • Journal of the Korea Organic Resources Recycling Association
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    • v.18 no.1
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    • pp.98-103
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    • 2010
  • This study was carried out on the composting of the most part of the plant waste materials inflowed-drifting into the dam during the localized heavy rain and the rainy season, due to the abnormal climate change, and for the sewage sludge banned to dispose legally into the ocean from the year of 2012. It was analysed the distinctive physicochemical qualities of the compost with treatment S-1(dam suspended particle sawdust : oak tree bark : sewage sludge : chicken manure = 30 : 20 : 40 : 10) and treatment S-2(dam suspended particle sawdust : oak tree bark : sewage sludge : chicken manure = 30 : 30 : 30 : 10). Both S-1 and S-2 maintained for 10 days at above $65^{\circ}C$ of the compost pile temperature, and the most of its pathogen were destroyed. In case of pH, until the 90th day into composting, S-1 with the pH value of 7.78 was slightly higher than S-2. The C/N value of S-1 was 15.3 and that of S-2 was 16.9. The quality of its final product was satisfied to the manufacture-standards. The GI value of S-1 was 91 higher than that of S-2, which was 84. In conclusion, it is highly recommendable to manufacture S-1 for its frequent usage of dam suspended particle sawdust and sewage sludge, and for its excellent quality and safety.

Radiosynthesis of $[^{11}C]6-OH-BTA-1$ in Different Media and Confirmation of Reaction By-products. ($[^{11}C]6-OH-BTA-1$ 조제 시 생성되는 부산물 규명과 반응용매에 따른 표지 효율 비교)

  • Lee, Hak-Jeong;Jeong, Jae-Min;Lee, Yun-Sang;Kim, Hyung-Woo;Lee, Eun-Kyoung;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.241-246
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    • 2007
  • Purpose: $[^{11}C]6-OH-BTA-1$ ([N-methyl-$^{11}C$]2-(4'-methylaminophenyl)-6-hydroxybenzothiazole, 1), a -amyloid imaging agent for the diagnosis of Alzheimer's disease in PET, can be labeled with higher yield by a simple loop method. During the synthesis of $[^{11}C]1$, we found the formation of by-products in various solvents, e.g., methylethylketone (MEK), cyclohexanone (CHO), diethylketone (DEK), and dimethylformamide (DMF). Materials and Methods: In Automated radiosynthesis module, 1 mg of 4-aminophenyl-6-hydroxybenzothiazole (4) in 100 l of each solvent was reacted with $[^{11}C]methyl$ triflate in HPLC loop at room temperature (RT). The reaction mixture was separated by semi-preparative HPLC. Aliquots eluted at 14.4, 16.3 and 17.6 min were collected and analyzed by analytical HPLC and LC/MS spectrometer. Results: The labeling efficiencies of $[^{11}C]1$ were $86.0{\pm}5.5%$, $59.7{\pm}2.4%$, $29.9{\pm}1.8%$, and $7.6{\pm}0.5%$ in MEK, CHO, DEK and DMF, respectively. The LC/MS spectra of three products eluted at 14.4, 16.3 and 17.6 mins showed m/z peaks at 257.3 (M+1), 257.3 (M+1) and 271.3 (M+1), respectively, indicating their structures as 1, 2-(4'-aminophenyl)-6-methoxybenzothiazole (2) and by-product (3), respectively. Ratios of labeling efficiencies for the three products $([^{11}C]1:[^{11}C]2:[^{11}C]3)$ were $86.0{\pm}5.5%:5.0{\pm}3.4%:1.5{\pm}1.3%$ in MEK, $59.7{\pm}2.4%:4.7{\pm}3.2%:1.3{\pm}0.5%$ in CHO, $9.9{\pm}1.8%:2.0{\pm}0.7%:0.3{\pm}0.1%$ in DEK and $7.6{\pm}0.5%:0.0%:0.0%$ in DMF, respectively. Conclusion: The labeling efficiency of $[^{11}C]1$ was the highest when MEK was used as a reaction solvent. As results of mass spectrometry, 1 and 2 were conformed. 3 was presumed.

가족과 함께하는 창의성 경진대회 평가연구

  • 송규운;황동주;윤정진
    • Journal of Gifted/Talented Education
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    • v.11 no.2
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    • pp.127-150
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    • 2001
  • The upcoming century is a knowledge based society which did not exist before which requires creative ability to solve problems. Therefore, it is necessary to Provide a creative program of problem solution in order to match this global trend The creativity of problem solution means the ability to solve a problem using previous ideas in an advanced way or develop new ideas. Creative education is especially important for infants. Because the young mind is where fresh ideas preside and can frame-work the early stage of life like a blank sheet of paper. The Infant-Early Child Creative Development Institute. as an adhesive institute at Yeungjin College, develops various programs that integrate methods which match current trend in this era and also start the Creative Promotion Test with 2,000 Families for the expansion of creative education from the baseline as an alternative method. The infants tested in the creative test will find ways of problem solution through animation beam projects for their given situation and also discuss the problems with their family members. Through these processes the infant and family members will complete the creative structures to solve the problems using limited materials given by the institute, and the final product will be evaluated as objective results. The final evaluation of the test will also be considered the teamwork of family cooperation and the attitudes of participants as well as the product of problem solution. The criterion of the evaluation is to be considered both a creative way of thinking and creative attitudes. Because the score counts were conducted manually it delayed the selection of awarded students who took the test. Also, we found that some parents have difficulty in accessing information to find the score through homepage from the computer. this Problem might be corrected in the future plan. Like Freud's saying, if human character and exploring attitudes during the early stage of a child, a person's creativity is composed their infant period as their basic foundation. Therefore, the family wh first environment the infant encounters will be treated as a prima when making basic structure. From this viewpoint, this creative test work as a festival of creativity fare with 2,000 families.

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Evaluation of Patient Radiation Doses Using DAP Meter in Interventional Radiology Procedures (인터벤션 시술 시 면적선량계를 이용한 환자 방사선 선량 평가)

  • Kang, Byung-Sam;Yoon, Yong-Su
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.27-34
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    • 2017
  • The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipments in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effectives of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were $237.7Gy{\cdot}cm^2$ in TACE, $17.3Gy{\cdot}cm^2$ in AVF, $114.1Gy{\cdot}cm^2$ in LE PTA & STENT, $188.5Gy{\cdot}cm^2$ in TFCA, $383.5Gy{\cdot}cm^2$ in Aneurysm Coil, $64.6Gy{\cdot}cm^2$ in PTBD, $64.6Gy{\cdot}cm^2$ in Biliary Stent, $22.4Gy{\cdot}cm^2$ in PCN, $4.3Gy{\cdot}cm^2$ in Hickman, $2.8Gy{\cdot}cm^2$ in Chemo-port, $4.4Gy{\cdot}cm^2$ in Perm-Cather, $17.1Gy{\cdot}cm^2$ in PCD, and $357.9Gy{\cdot}cm^2$ in Vis, EMB. Dose referenece level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipments and procedures in the interventional radiology procedures, further studies and monitorings are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

Spectrophotometric Analysis of Crown Discoloration Induced by Various MTA Based Materials (분광분석법을 이용한 수종 MTA의 치관변색 평가)

  • Lim, Yuran;Choi, Namki;Kim, Jaehwan;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.1
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    • pp.28-37
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    • 2017
  • Mineral trioxide aggregate have been used for many years as a pulp therapy material. The most widely used product, Proroot white $MTA^{(R)}$ has a major drawback that it causes tooth discoloration. This study assessed discoloration of crown when various MTA-based materials were placed in the coronal aspect of the root canal. Seventy-five single-rooted, unrestored premolar teeth were selected. The teeth were randomly assigned to four experimental groups, each of $Biodentine^{(R)}$, Proroot $wMTA^{(R)}$, $Endocem^{(R)}$, $RetroMTA^{(R)}$ and one negative control groups. Color measurements were utilized by the Commission International de I'Eclairage's L*a*b* system with spectrophotometer. The color was assessed eight times : initial, 1 day, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after the placement. Statistical analysis was performed using the 2-way repeated analysis of variance and Bonferroni's method with p < 0.05. Proroot $wMTA^{(R)}$ induced significant decreases in $L^*$ values during experiment period. Tooth samples from the $Endocem^{(R)}$ group presented indistinct grayish color changes. The $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ showed color stability. Consequently, while Proroot $wMTA^{(R)}$ and $Endocem^{(R)}$ that contain bismuth oxide as a radiopacifier showed tooth discoloration, displayed no sign of discoloration $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ that contain zirconium oxide as a radiopacifier.

Investigation on Natural Radioactivity of Environmental Samples Near the Phosphate Rock Processing Facility (인광석 사용업체 주변 환경시료의 자연방사능 조사)

  • Lee, Gill-Jae;Koh, Sang-Mo;Chang, Byung-Uck;Kim, Tong-Kwon;Kim, Young-Ug
    • Economic and Environmental Geology
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    • v.44 no.1
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    • pp.37-48
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    • 2011
  • Some industrial minerals used in domestic industries such as monazite, apatite, bauxite, and ilmenite belong to NORM (Naturally Occurring Radioactive Materials) because they show a high radioactivity. Products, semi-products, wastes, and by-products which show higher radioactivity than NORM belong to TENORM (Technologically Enhanced Naturally Occurring Radioactive Materials). Apatite used for manufacturing phosphate fertilizer in Namhae Chemical company belongs to NORM, and its by-product, phospo-gypsum, belongs to TENORM. A geological investigation is needed for the future environmental impact assessment of the Namhae Chemical company's site. According to survey results of the Namhae Chemical company's site, soil mineral composition indicated the mixture of minerals derived from the country rock (quartz, feldspar, mica, $l4{\AA}$ mineral, kaolin and amphibole) and minerals from the gypsum open-air storage yard (gypsum and apatite). Soil samples showed average content of U 4.6 ppm and Th 10 ppm, which are similar to average crustal abundances. They also show average contents of $^{40}K$ 191-1,166 Bq/kg, $^{226}Ra$ 15.6-710 Bq/kg, and $^{232}Th$ 17.4-72.7 Bq/kg, which indicate moderate levels of radio nuclide. But $^{226}Ra$ anomaly in the gypsum open storage yard is clearly confirmed and $^{232}Th$ anomaly is also confirmed in the east road side of the factory and nearby mountain areas. Soil external hazard indices ranged 0.24-2.01 with the average 0.54. Although most external hazard indices were lower than 1, which means radiation hazard index to be negligible, 5 samples out of total 40 samples showed higher values than 1, and further detailed investigation is needed.

Synthesis of Visible-working Pt-C-TiO2 Photocatalyst for the Degradation of Dye Wastewater (염료폐수 분해를 위한 가시광 감응형 Pt-C-TiO2 광촉매의 합성)

  • Hahn, Mi Sun;Yun, Chang Yeon;Yi, Jongheop
    • Clean Technology
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    • v.11 no.3
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    • pp.123-128
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    • 2005
  • Among various metal oxides semiconductors, $TiO_2$ is the most studied semiconductor for environmental clean-up applications due to its unique ability in photocatalyzing various organic contaminants, its chemical inertness, and nontoxicity. $TiO_2$, however, has a few drawbacks to be solved such as reactivity mainly working under ultraviolet irradiation (${\lambda}$ < 387 nm) and electron - hole recombination on $TiO_2$. In this study, to extend the absorption range of $TiO_2$ into the visible range and enhance electron - hole separation, we synthesized platinum (Pt) deposited $C-TiO_2$. The presence of Pt as an electron sink has been known to snhance the separation of photogenerated electron-hole pairs and induce the thermal decomposition. The characterization of as-synthesized $Pt-C-TiO_2$ was performed by Transmission Electron Microscopic (TEM), the Brunuer-Emmett-Teller (BET) method, X-ray Diffractometer (XRD), UV-vis spectrometer (UV-DRS), and X-ray Photoelectron Spectroscopy (XPS). In order to estimate the photocatalytic activity of the synthesized materials, the photoelectron Spectroscopy (XPS). In order to estimate the photocatalytic activity of the synthesized materials, the photodegradation experiment of an azo dye (Acid Red 44; $C_{10}H_7N=NC_{10}H_3(SO_3Na)_2OH$)was carried out by using an Xe arc lamp (300 W, Oriel). A 420 nm cut-off filter was used for visible light irradiation. From the results, Pt-deposited $C-TiO_2$ showed a far superior phothdegradation activity to Degussa P25, the commercial product under the irradiation of visible light and enhanced photocatalytic activity of visible-working $C-TiO_2$. This is a useful result into the application for the purification system of dye wastewater using visible energy of sun light.

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Data Mining and Construction of Database Concerning Effects of Vitis Genus (산머루 관련 정보수집 및 데이터베이스의 구축)

  • Kim, Min-A;Jo, Yun-Ju;Shin, Jee-Young;Shin, Min-Kyu;Bae, Hyun-Su;Hong, Moo-Chang;Kim, Yang-Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.4
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    • pp.551-556
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    • 2012
  • The database for the oriental medicine had been existed in documentation in past times and it has been developed to the database type for random accesses in the information society. However, the aspects of the database are not so diversified and the database for the bio herbal material exists in widened type dictionary style. It is a situation that the database which handles the in-depth raw herbal medicines is not sufficient in its quantity and quality. Korean wild grape is a deciduous plant categorized into the Vitaceae and it was found experimentally that it has various medical effects. It is one of the medical materials with higher potentiality of academic study and commercialization recently because it has a bigger possibility to be applied into diverse industrial fields including the medical product for health, food and beauty. We constituted the cooperative system among the Muju cluster business group for Korean mountain wild grapes, Physiology Laboratory in Kyung Hee University Oriental Medicine and Medical Classics Laboratory in Kyung Hee University Oriental Medicine with a view to focusing on such potentiality and a database for Korean wild grapes was made a touchstone for establishing the in-depth database for the single bio medical materials. First of all, the literatures based on the North East Asia in ancient times had been categorized into the classical literature (Korean literature published by government organization, Korean classical literature, Chinese classical literature and classical literature fro Korean and Chinese oriental medicine) and modern literature (Modern literature for oriental medicine, modern literature for domestic and foreign herbal medicine) to cover the eastern and western research records and writings related to Korean wild grapes and the text-mining work has been performed through the cooperation system with the Medical Classics Laboratory in Kyung Hee University Oriental Medicine. First of all, the data for the experiment and theory for Korean wild grape were collected for the Medline database controlled by the Parliament Library of USA to arrange the domestic and foreign theses with topic for Korean wild grapes and the network hyperlink function and down load function were mounted for self-thesis searching function and active view based on the collected data. The thesis searching function provides various auxiliary functions and the searching is available according to the diverse searching/queries such as the name of sub species of Korean wild grape, the logical intersection index for the active ingredients, efficacy and elements. It was constituted for the researchers who design the Korean wild grape study to design of easier experiment. In addition, the data related to the patents for Korean wild grape which were collected from European Patent Office in response to the commercialization possibility and the system available for searching and view was established in the same viewpoint. Perl was used for the query programming and MS-SQL for database establishment and management in the designing of this database. Currently, the data is available for free use and the address is as follows. http://163.180.41.43:8011/index.html

A Study on the Resource Recovery of Fe-Clinker generated in the Recycling Process of Electric Arc Furnace Dust (전기로 제강분진의 재활용과정에서 발생되는 Fe-Clinker의 자원화에 관한 연구)

  • Jae-hong Yoon;Chi-hyun Yoon;Hirofumi Sugimoto;Akio Honjo
    • Resources Recycling
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    • v.32 no.1
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    • pp.50-59
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    • 2023
  • The amount of dust generated during the dissolution of scrap in an electric arc furnace is approximately 1.5% of the scrap metal input, and it is primarily collected in a bag filter. Electric arc furnace dust primarily consists of zinc and ion. The processing of zinc starts with its conversion into pellet form by the addition of a carbon-based reducing agent(coke, anthracite) and limestone (C/S control). These pellets then undergo reduction, volatilization, and re-oxidation in rotary kiln or RHF reactor to recover crude zinc oxide (60%w/w). Next, iron is discharged from the electric arc furnace dust as a solid called Fe clinker (secondary by-product of the Fe-base). Several methods are then used to treat the Fe clinker, which vary depending on the country, including landfilling and recycling (e.g., subbase course material, aggregate for concrete, Fe-source for cement manufacturing). However, landfilling has several drawbacks, including environmental pollution due to leaching, high landfill costs, and wastage of iron resources. To improve Fe recovery in the clinker, we pulverized it into optimal -sized particles and employed specific gravity and magnetic force selection methods to isolate this metal. A carbon-based reducing agent and a binding material were added to the separated coarse powder (>10㎛) to prepare briquette clinker. A small amount (1-3%w/w) of the briquette clinker was charged with the scrap in an electric arc furnace to evaluate its feasibility as an additives (carbonaceous material, heat-generating material, and Fe source).