• Quality Improvement in Health Care
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• v.12 no.2
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• pp.93-112
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• 2006

This study reviewed published studies on interventions used by hospitals, health insurance programs, or governments to improve use of medicines in foreign countries. Interventions to improve use of medicines are classified into two categories: 1) information strategies-dissemination of educational materials, group education, one-to-one educational outreach, drug utilization review, and feedback; 2) managerial strategies- formularies, prior authorization, and financial incentives. Dissemination of educational materials, which is a common intervention, was unsuccessful in changing physicians' prescribing behaviors. Problem-based small group education was more likely to change behaviors than didactic large group education. One-to-one educational outreach(academic detailing) was among the most effective strategies used to change prescribing behaviors. Prospective drug utilization review (DUR) program was more successful in improving use of medicines than retrospective DUR program. Feedback intervention has been reported to be ineffective to change behaviors. Formularies are frequently used to control medication use by most health insurance programs. Financial incentives provide physicians economic incentives according to appropriateness of prescribing. However, few published studies have assessed the efficacy of formularies or financial incentives. Prior authorization requires physicians to get authorization from health insurers before prescribing a certain group of drugs which is usually of high costs or risk. There is no magic bullet for quality use of medicines. Multifaceted interventions that help to predispose, enable, and reinforce desired behaviors are more likely to be successful.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.497-509
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• 2006

Until recently, the tuberculin skin test (TST) has been the only tool available for diagnosing a latent TB infection. However, the development of new diagnostic tools, using the Mycobacterium tuberculosis (MTB)-specific early secreted antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) antigens, should improve the control of tuberculosis (TB) by allowing a more accurate identification of a latent TB infection (LTBI). Antigen-specific interferon-gamma ($IFN-{\gamma}$) assays have greater specificity in BCG-vaccinated individuals, and as less biased by nontuberculous mycobacterial infections. Many comparative studies have suggested that those assays have a higher specificity than the TST, and the sensitivity of these assays are expected to remarkably improved if more MTB-specific antigens can become available. Nevertheless, the major obstacle to the widespread use of these tests is the limited financial resources. Similar to other diagnostic tests, the predictive value of $IFN-{\gamma}$ assays depends on the prevalence of a MTB infection in the population being tested. Therefore, prospective studies will be meeded to establish the applicability of these new assays at multiple geographic locations among patients of different ethnicities, and to determine if the $IFN-{\gamma}$ responses can indicate those with a high risk of progressing to active TB.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.209-217
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• 2018

Although the incidence of gastroesophageal junction (GEJ) adenocarcinoma has been increasing worldwide, no standardized surgical strategy for its treatment has been established. This study aimed to provide an update on the surgical treatment of GEJ adenocarcinoma by reviewing previous reports and propose recommended surgical approaches. The Siewert classification is widely used for determining which surgical procedure is used, because previous studies have shown that the pattern of lymph node (LN) metastasis depends on tumor location. In terms of surgical approaches for GEJ adenocarcinoma, a consensus was reached based on two randomized controlled trials. Siewert types I and III are treated as esophageal cancer and gastric cancer, respectively. Although no consensus has been reached regarding the treatment of Siewert type II, several retrospective studies suggested that the optimal treatment strategy includes paraaortic LN dissection. Against this background, a Japanese nationwide prospective trial is being conducted to determine the proportion of LN metastasis in GEJ cancers and to identify the optimal extent of LN dissection in each type.

• The Journal of Society for e-Business Studies
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• v.1 no.1
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• pp.5-26
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• 1996

This paper aims to present a prospective trend to establish a proper CALS conception and an efficient CALS environment in Korea.. It is crucial at this point for Korea to develop a comprehensive CALS conception which considers our present economic and social situation, national security, and our national emotion. Korean CALS has been developed and led mainly by the government and private industry. It is now necessary to improve CALS conception in Korea by making CALS standard more interchangeable among international as well as domestic business fields through EDI and the automation of the industries along with the government. In this regard, this paper proposes three potential methods to accomplish this goal and discuss each of them in detail. First, we suggest to establish a proper CALS introduction policy on the government level. We propose an introduction policy with three phases such as introduction, spreading and target which will cover through the year 1996 to 2007. Second. we suggest to establish a proper CALS standardization policy by improving the acquisition of digital data and process, and modernizing infrastructure. Third, we suggest that the government should amend and enforce the necessary laws and acts for more efficient CALS implementation in Korea. Government should arrange for these acts to be applied not optionally but obligatorily to Korean enterprises so that they survive the harsh and competitive world market in the upcoming 21th century.

• Journal of Dairy Science and Biotechnology
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• v.28 no.1
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• pp.17-28
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• 2010

A substantial body of evidence has emerged over the last decade in support of the novel concept that dietary calcium and dairy foods play an important role in regulating energy metabolism and thereby promote healthy weight management and reduce obesity risk. This concept has been demonstrated in experimental animals studies, cross-sectional and prospective population studies and a number of randomized clinical trials. Notably, the effects of dairy foods in weight management are more consistent than the effects of supplemental calcium across clinical trials, and calcium per se is responsible for approximately 40-50% of the effects of dairy. The calcium component is only effective in individuals with chronically low calcium intake, as it serves to prevent the endocrine response to low calcium diets which otherwise favors adipocyte energy storage; calcium also serves to promote energy loss via formation of calcium soaps in the gastrointestinal tract and thereby reduce fat absorption. The calcium-independent anti-obesity bioactivity of dairy resides primarily in whey. The key components identified to date are leucine and bioactive peptides resulting from whey protein digestion. The high concentration of leucine in whey stimulates a repartitioning of dietary energy from adipose tissue to skeletal muscle where it provides the energy required for leucine-stimulated protein synthesis, resulting in increased loss of adipose tissue and preservation of skeletal muscle mass during weight loss. Finally, dairy rich diets suppress the oxidative and inflammatory responses to obesity and thereby attenuate the diabetes and cardiovascular disease risk associated with obesity.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.397-405
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• 2014

Obesity has been considered as an important risk factor for the development of colorectal cancer (CRC), but the association has not been fully elucidated. Obesity is linked significantly to adipose tissue dysfunction and to alteration of adipokines in blood; in particular, obesity-induced inflammation is thought to be an important link between obesity and colorectal cancer. Based on epidemiological studies, we undertook a systematic review to understand the association of circulating levels of selected adipokines, including adiponectin, leptin, resistin, IL-6 and TNF-${\alpha}$, with the level of CRC risk. Most prospective studies suggested protective effects of adiponectin, but these were attenuated by body mass index (BMI) and waist circumference (WC) data in our meta-analysis. On the other hand, meta-analyses for leptin and CRC did not demonstrate any association, similar to the results of systematic review. Although it proved difficult to determine whether other selected adipokines (resistin, IL-6 and TNF-${\alpha}$) were related to CRC risk due to small number of reports, the present systematic review suggested a positive association with elevated resistin levels but null associations with IL-6 and TNF-${\alpha}$.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.853-857
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• 2015

Background: Gastric cancer is the most common cancer in the Iranian population. The aim of this study was to determine the effect of clinicopathological factors on prognosis by meta-analysis. Materials and Methods: A literature search was conducted using MEDLINE, EMBASE and Cochrane library and extensive literature search using the Persian databases until February 2011. Prospective follow up studies with multivariate analysis of overall survival of the patients with gastric cancer were included in this review. The data were analyzed by CMA.2. Publication bias are checked by funnel plot and data are shown as Forest plots. Results: From a total of 63 articles, 14 retrospective studies which examined 5 prognostic factors and involving 10,500 patients were included. Tumor size (>35mm) was the main significant factor predicting an unfavorable prognosis for the patients with gastric cancer (RR=1.829, p<0.001) followed by presence of distant metastases (RR=1.607, p<0.001), poor differentiation (RR=1.408, p<0.001) and male sex (RR=1.194, p<0.001). Lymph node metastases (RR=1.058, p=0.698) and moderate differentiation (RR=0.836, p=0.043) were not statistically significant as prognostic factors. Conclusions: This meta-analysis suggests that tumor size>35mm, poor differentiation, presence of distant metastasis and male gender are strongly associated with a poor prognosis in Iranian patients with gastric cancer.

• Nutrition Research and Practice
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• v.10 no.3
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• pp.336-341
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• 2016

BACKGROUND/OBJECTIVES: The incidence of thyroid cancer has increased in many countries, including Korea. International differences in the incidence of thyroid cancer may indicate a role of diet, but findings from previous studies are inconclusive. Therefore, we aimed to investigate the roles of nutrients in thyroid cancer risk in Korean women. SUBJECTS/METHODS: We conducted a case-control study comprising 113 cases and 226 age-matched controls. Nutrient intake was assessed using a validated food frequency questionnaire, and the association between nutrient intake and thyroid cancer risk was estimated using a logistic regression model. RESULTS: We found that high calcium intake was associated with a reduced risk of thyroid cancer (OR [95% CI] = 0.55 [0.35-0.89]). Significant associations were observed among subjects who were older than 50 years, had low BMI, and had low calorie intake. However, other nutrients included in this study did not show any significant associations with thyroid cancer risk. CONCLUSION: This study suggested a possible protective effect of calcium on thyroid cancer risk. Well-designed prospective studies are required to confirm these findings.

• Clinical and Experimental Pediatrics
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• v.54 no.3
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• pp.95-105
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• 2011

Since the successful introduction of all-trans-retinoic acid (ATRA) and its combination with anthracycline-containing chemotherapy, the prognosis for acute promyelocytic leukemia (APL) has markedly improved. With ATRA and anthracycline-based-chemotherapy, the complete remission rate is greater than 90%, and the long-term survival rate is 70-89%. Moreover, arsenic trioxide (ATO), which was introduced for APL treatment in 1994, resulted in excellent remission rates in relapsed patients with APL, and more recently, several clinical studies have been designed to explore its role in initial therapy either alone or in combination with ATRA. APL is a rare disease in children and is frequently associated with hyperleukocytosis, which is a marker for higher risk of relapse and an increased incidence of microgranular morphology. The frequency of occurrence of the promyelocytic leu-kemia/retinoic acid receptor-alpha (PML/$RAR{\alpha}$) isoforms bcr 2 and bcr 3 is higher in children than in adults. Although recent clinical studies have reported comparable long-term survival rates in patients with APL, therapy for APL in children is challenging because of the risk of early death and the potential long-term cardiac toxicity resulting from the need to use high doses of anthracyclines. Additional prospective, randomized, large clinical trials are needed to address several issues in pediatric APL and to possibly minimize or eliminate the need for chemotherapy by combining ATRA and ATO. In this review article, we discuss the molecular pathogenesis, diagnostic progress, and most recent therapeutic advances in the treatment of children with APL.

• Journal of Arbitration Studies
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• v.23 no.2
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• pp.55-79
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• 2013

As arbitration becomes an increasingly popular mode of resolving disputes, neighboring industries begin to take notice. This interest is reflected in the increasing utilization of third party funding in international arbitration claims. In this regard, the third party funding industry appears particularly interested in investor-state arbitration claims because they typically involve considerable claim amounts and substantial legal fees. To examine this trend more closely, this paper, firstly, examines the investor-state arbitration more precisely in Chapter II. In Chapter III, this study continues to examine some legal issues which can arise as a result of a conflict of interest between the parties to the funding agreement including, inter alia, 1) a dispute in which the funder terminates the agreement during the arbitration proceedings, 2) a dispute in relation to a funder's intervention in arbitration proceedings, and 3) a dispute on the responsibility for adverse costs orders, if any. This paper further identifies major legal issues which can arise in relation to 1) disclosure of existence of the funding agreement, 2) attorney-client privilege. Lastly, in Chapter IV, this paper provides some lessons from an in-depth case study on third party funding agreements and solutions to avoid and to solve prospective disputes in the future.