• Title/Summary/Keyword: Mass screening

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Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea (성인 고지혈증 선별 검사의 비용-효과 분석)

  • Cha, Yeon-Soon;Khang, Young-Ho;Lee, Moo-Song;Kang, Wee-Chang;Jeon, Sung-Hoon;Kim, Kee-Lak;Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.99-106
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    • 2002
  • Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

Differences in Breast Cancer Screening Rates according to Obesity and Weight Perception among Korean Women (한국 여성의 비만과 체형인식왜곡에 따른 유방암 검진율 차이)

  • Kim, Sejeong;Kim, Hee-Seung;Kim, Hye-Jin
    • Journal of Korean Biological Nursing Science
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    • v.20 no.3
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    • pp.169-176
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    • 2018
  • Purpose: This study was performed to elucidate whether the obesity or body image is a barrier to breast screening compliance in Korean women. Methods: We included 54,017 women aged between 35 to 70 years from the Korea Community Health Survey (KCHS) 2014 dataset. To identify whether a mutual relationship exists between weight perceptions and breast cancer screening rates, the participants were divided into three groups according to the level of concordance between Body Mass Index (BMI) and a subjective body image. Descriptive analyses, a chi-square test, and multivariate logistic regression analyses were performed. Results: After covariate adjustment, the screening rate of the overweight group was 1.09 times higher than the normal weight group (odds ratio [OR], 1.09; confidence interval [CI], 0.00-0.16; p= .038) and the severe obesity group was 1.20 times lower (OR, 0.83; CI, -0.36-0.00; p= .047). Weight misperception also had a significant influence on breast cancer screening. Especially, The overweight distortion group was less likely to undergo breast cancer screening (OR, 0.93; CI, -0.15-0.00; p= .037). Conclusion: Obesity and weight misperceptions are associated with lower compliance with breast cancer screening guidelines.

Mass Screening Method for Rice Virus Resistance Using Screen House (망실을 이용한 벼 바이러스병 저항성 대량 검정체계)

  • Kwak, Do-Yeon;Yeo, Un-Sang;Lee, Jong-Hee;Oh, Byeong-Geun;Shin, Mun-Sik;Ku, Yeon-Chung
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.52 no.2
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    • pp.129-133
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    • 2007
  • To breed virus resistant rice variety, developing an efficient screening method is the most important. Two screening methods such as field screening and tray screening method have been used, but the efficiency of the field screening method is too low because of environment factors and the that of the tray screening method is good but screening capability is limited with only $200{\sim}300$ lines per year. To overcome those problems, mass screening method using screen house was developed. Barely as host plant of vector insect was grown in screen house in winter season. Then viruliferous insects are spread in the first spring of the initiation year and sustain them annually. Screening of virus resistance was tested two times in a year, the first screening was from April to June and the second from July to September. The virus infected rate of each susceptible varieties was increased to 92% for RSV and 100% for RDV from the second year. Also, this method can evaluate as many as $1,500{\sim}2,000$ pedigree lines in one time compared with the tray screening method. The result indicates that the mass screening method using screen house, which combines the advantages of the field and tray screening methods, is proven to be more efficient and reliable.

Screening Analysis of 10 Adrenal Steroids by Matrix-Assisted Laser Desorption Ionization-Tandem Mass Spectrometry

  • Kim, Sun-Ju;Jung, Hyun-Jin;Chung, Bong-Chul;Choi, Man-Ho
    • Mass Spectrometry Letters
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    • v.2 no.3
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    • pp.69-72
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    • 2011
  • Defective synthesis of the steroid hormones by the adrenal cortex has profound effects on human development and homeostasis. Due to the time-consuming chromatography procedure combined with mass spectrometry, the matrix-assisted laser desorption ionization method coupled to the linear ion-trap tandem mass spectrometry (MALDI-LTQ-MS/MS) was developed for quantitative analysis of 10 adrenal steroids in human serum. Although MALDI-MS can be introduced for its applicability as a high-throughput screening method, it has a limitation on reproducibility within and between samples, which renders poor reproducibility for quantification. For quantitative MALDI-MS/MS analysis, the stable-isotope labeled internal standards were used and the conditions of crystallization were tested. The precision and accuracy were 3.1~35.5% and 83.8~138.5%, respectively, when a mixture of 10 mg/mL ${\alpha}$-cyano-4-hydroxycinnamic acid in 0.2% TFA of 70% acetonitrile was used as the MALDI matrix. The limit of quantification ranged from 5 to 340 ng/mL, and the linearity as a correlation coefficient was higher than 0.988 for all analytes in the calibration range. Clinical applications include quantitative analyses of patients with congenital adrenal hyperplasia. The devised MALDI-MS/MS technique could be successfully applied to diagnosis of clinical samples.

Current Topics on Quality Assurance of X-ray Diagnosis in Japan

  • Katoh, Tuguhisa;Imamura, Keiko;Matumoto, Toru
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.13-16
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    • 2002
  • Recent topics on quality assurance (QA) of X-ray diagnosis in Japan were reported in this presentation. These were related to mass screening mammography (MMG), lung screening CT (LSCT), skin injury caused by interventional radiology (IVR) and traceable system of dosimeters for x-ray diagnosis. In these successful stories, the author would like to stress the cooperation of all the medical am: clinical staff including medical doctors, radiological technologists, medical physicists, manufacturers of medical devices and others.

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A Sensitive Determination of Plasma Free Fatty Acids Following Tert-butyldimethylsilyl Derivatization using Gas Chromatography-Mass Spectrometry for Screening of Fatty Acid Oxidation Disorders (지방산대사이상질환 스크리닝을 위한 TBDMS 유도체화 후 GC-MS를 이용한 혈장 중 유리지방산의 분석)

  • Yoon, Hye-Ran;Thapa, Maheshwor
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.2
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    • pp.39-47
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    • 2017
  • Purpose: A sensitive gas chromatography mass spectrometry (GC-MS) method was developed for screening of fatty acid oxidation disorders. Methods: The assay utilized a simple protein precipitation with sulfosalicylic acid followed by tert-butyl dimethylsilyl (TBDMS) derivatization of hydroxyl functional group by N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide (MTBSTFA). Results: Calibration curves of spiked pooled plasma showed a linear relationship in the range of 0.01 ng -2 mg with correlation coefficient value greater than 0.98. Limits of detection (LOD) and limits of quantification (LOQ) were found in the range of 0.9-8.8 ng and 9-88 ng, respectively. Conclusion: The new developed method might be useful for a rapid, sensitive screening of inherited fatty acid oxidation disorders. In addition, the method expected to be one of the alternative method for screening newborns of metabolic disorders in the laboratories where expensive MS/MS is unavailable.

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Isolated 3-Methylcrotonyl CoA Carboxylase Deficiency Detected by Newborn Screening Program Using Tandem Mass Spectrometry (탠덤매스 신생아 스크리닝 검사로 발견된 Isolated 3-Methylcrotonyl CoA Carboxylase 결핍증 1례)

  • Kwak, Ju Young;Park, Jun Young;Nam, Kyung A;Son, Sang Hi;Seo, Son Sang
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.561-564
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    • 2005
  • Isolated deficiency of 3-methylcrotonyl CoA carboxylase is a rare disorder of the catabolic pathway for leucine and many patients have mild symptoms or no symptom. However, the introduction of tandem mass spectrometry in newborn screening has revealed an unexpectedly high incidence of this disorder. We report an asymptomatic premature infant with isolated 3-methylcrotonyl CoA carboxylase deficiency detected by newborn screening program using tandem mass spectrometry. She was born at preterm, 36 weeks of gestation and her birth weight was 1,912 gm. She was delivered by Cesarian section due to maternal preeclampsia and oligohydramnios. An elevation of 3-hydroxyisovalerylcarnitine in a blood sample obtained at Seven days was detected by tandem mass screening. Massively elevated excretion of 3-hydroxyisovalerate and 3-methylcrotonylglycine was detected in the urine collected at 15 days. L-carnitine(100 mg/kg/day) was administrated orally to correct sencondary carnitine deficiency. Carnitine is conjugated with metabolites, to decrease the potential toxic effects. She is asymptomatic to date, and her growth and development are within normal limits.

The Mass Production Weapon System Environmental Stress-Screening Test Design Method based on Cost-effective-Optimization (비용 효과도 최적화 기반 양산 무기체계 환경 부하 선별 시험 설계 방법)

  • Kim, Jangeun
    • Journal of Applied Reliability
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    • v.18 no.3
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    • pp.229-239
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    • 2018
  • Purpose: There is a difficulty in Environmental Stress Screening (ESS) test design for weapon system's electrical/electronic components/products in small and medium-sized enterprises. To overcome this difficulty, I propose an easy ESS test design approach algorithm that is optimized with only one environment tolerance design information parameter (${\Delta}T$). Methods: To propose the mass production weapon system ESS test design for cost-effective optimization, I define an optimum cost-effective mathematical model ESS test algorithm model based on modified MIL-HDBK-344, MIL-HDBK-2164 and DTIC Technical Report 2477. Results: I clearly confirmed and obtained the quantitative data of ESS effectiveness and cost optimization along our ESS test design algorithm through the practical case. I will expect that proposed ESS test method is used for ESS process improvement activity and cost cutting of mass production weapon system manufacturing cost in small and medium-sized enterprises. Conclusion: In order to compare the effectiveness of the proposed algorithm, I compared the effectiveness of the existing ESS test and the proposed algorithm ESS test based on the existing weapon system circuit card assembly for signal processing. As a result of the comparison, it was confirmed that the test time was reduced from 573.0 minutes to 517.2minutes (9.74% less than existing test time).

Current Status of Gastric Cancer Screening (위암 선별검사 현황)

  • Sung Eun Kim
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.107-112
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    • 2016
  • Gastric cancer is the fifth most common malignancy in the world and still remains the third and fifth leading cause of cancer death in male and female, respectively. In terms of the cancer survival, the survival of gastric cancer is low in the West with showed 5-year survival rates of 10-30%, whereas the survival rates in Asia is more than 50%. The reason of the higher survival rate from gastric cancer in Asia partially related with the availability of gastric cancer screening programs, however, the population-based screening for gastric cancer has been conducted just in Korea and Japan. Therefore, more effective method for detecting the gastric cancer is needed for countries without a population-based gastric cancer screening. Endoscopy is the most effective method for diagnosis of gastric cancer however, it requires a large infrastructure including a large number of endoscopic equipment and well-trained endoscopists. To overcome these problems, several noninvasive methods (such as serologic markers, biomarkers, cancer autoantibodies, and exhaled breath analysis) for diagnosis of gastric cancer screening are suggested. This review addresses the conventional methods and the emerging methods for gastric cancer screening.

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Seven-year experience with inherited metabolic disorders screening by tandem mass spectrometry (Tandem Mass Spectrometry를 이용한 선천성 대사이상질환 선별검사 7년간의 경험)

  • Song, Sean-Mi;Yoon, Hye-Ran;Lee, An-Na;Lee, Kyoung-Ryul
    • Journal of Genetic Medicine
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    • v.5 no.1
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    • pp.21-25
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    • 2008
  • Purpose : In recent years, many countries have adopted newborn screening programs that use tandem mass spectrometry (MS/MS) to screen and the number of diseases screened has also increased. We began screening for inherited metabolic disorders using MS/MS in April, 2001. Our goal was to determine the overall prevalence of metabolic disorders and to assess the effectiveness of newborn screening by MS/MS in Korea. Methods : From April, 2001 to December, 2007, we screened newborns and high risk groups using MS/MS. Acylcarnitines and amino acids were extracted and butylated and were introduced into the inlet of MS/MS. Confirmatory testing including a repeat newborn screening, and urine organic acid and plasma amino acid analysis were performed on a case-by-case basis. Results : The total number of screened subjects 284,933 which comprised 251,799 neonates and 33,134 high risk subjects. The recall rate was 0.4% (1158 tests) and true positive cases were 117 (0.04%). Confirmed metabolic disorders (newborn/high risk group) were as follows; 78 (25/53) amino acid disorders, 27 (16/11) organic acid disorders, and 12 (5/7) fatty acid oxidation disorders. The estimated prevalence of inherited metabolic diseases in newborns was 1:5,000 and that in the total group was 1:2,000. Conclusion : Newborn screening by MS/MS improved the detection of many inherited metabolic disorders. We therefore propose that all newborns be screened by a MS/MS national program and followed-up using a systemic organization strategy.

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