• Title/Summary/Keyword: Sensitivity analyses

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Economic Value of the Sirolimus Eluting Stent($CYPHER^{TM}$) in Treating Acute Coronary Heart Disease (관상동맥질환 치료를 위한 시롤리무스 방출 스텐트 ($CYPHER^{TM}$)의 경제성 분석)

  • Lee, Hoo-Yeon;Park, Eun-Cheol;Park, Ki-Dong;Park, Ji-Eun;Kim, Young;Lee, Sang-Soo;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.339-348
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    • 2003
  • Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

Evaluation of cellular energy allocation (CEA) in the Manila clam, Ruditapes philippinarum as a tool for assessment of contaminated sediments (오염 퇴적물 평가 기법으로서의 바지락 (Ruditapes philippinarum) 세포내 에너지 할당 (cellular energy allocation, CEA) 적용성 검토)

  • Sung, Chan-Gyoung;Kang, Sin-Kil;Chung, Jiwoong;Park, Dong-Ho;Lee, Jong-Hyeon;Lee, Chang-Hoon
    • The Korean Journal of Malacology
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    • v.32 no.1
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    • pp.45-54
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    • 2016
  • To evaluate the applicability of cellular energy allocation (CEA) in the bivalves as a biomarker for the assessment of environmental contamination, the energy contents and energy consumption in several tissues of the Manila clam, Ruditapes philippinarum were analyzed. The contents of lipid, glucose, protein and electron transport system (ETS) activity in the foot, siphons, gills, and body of R. philippinarum exposed to crude oil-spiked sediments were measured at 1, 2, 4, 7, 10 days after exposure. The reserved energy (energy available, EA) in the lipid, glucose and protein decreased as contamination level and exposure time increased. In contrast, the ETS activity (energy consumed, EC) showed the reverse tendency. The order of available energy contents were foot > siphons > gill > body. Significant differences in both EA and EC were found only at the highest contamination level (58.3 mg TPAHs/kg DW). EA decreased significantly in the foot and gill at 1 day, in the body at 2 and 7 days after exposure. EC increased significantly in the body at 4 days after exposure. CEA showed higher sensitivity to the contamination than EA or EC. Especially, CEA in the foot and body decreased significantly at lower ranges of contamination level (as low as 6.5 mg TPAHs/kg DW) during 1 to 7 days after exposure. The CEA is more useful than EA or EC alone for the assessment of sediment contamination at lower level that acute toxicity could not be detected. CEA analyses in the body of R. philippinarum after 4 days' exposure to contaminated sediments seem to be the most sensitive and reliable.

Numerical Simulation of the Formation of Oxygen Deficient Water-masses in Jinhae Bay (진해만의 빈산소 수괴 형성에 관한 수치실험)

  • CHOI Woo-Jeung;PARK Chung-Kill;LEE Suk-Mo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.27 no.4
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    • pp.413-433
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    • 1994
  • Jinhae Bay once was a productive area of fisheries. It is, however, now notorious for its red tides; and oxygen deficient water-masses extensively develop at present in summer. Therefore the shellfish production of the bay has been decreasing and mass mortality often occurs. Under these circumstances, the three-dimensional numerical hydrodynamic and the material cycle models, which were developed by the Institute for Resources and Environment of Japan, were applied to analyze the processes affecting the oxygen depletion and also to evaluate the environment capacity for the reception of pollutant loads without dissolved oxygen depletion. In field surveys, oxygen deficient water-masses were formed with concentrations of below 2.0mg/l at the bottom layer in Masan Bay and the western part of Jinhae Bay during the summer. Current directions, computed by the $M_2$ constituent, were mainly toward the western part of Jinhae Bay during flood flows and in opposite directions during ebb flows. Tidal currents velocities during the ebb tide were stronger than that of the flood tide. The comparision between the simulated and observed tidal ellipses showed fairly good agreement. The residual currents, which were obtained by averaging the simulated tidal currents over 1 tidal cycle, showed the presence of counterclockwise eddies in the central part of Jinhae Bay. Density driven currents were generated southward at surface and northward at the bottom in Masan Bay and Jindong Bay, where the fresh water of rivers entered. The material cycle model was calibrated with the data surveyed in the field of the study area from June to July, 1992. The calibrated results are in fairly good agreement with measured values within relative error of $28\%$. The simulated dissolved oxygen distributions of bottom layer were relatively high with the concentration of $6.0{\sim}8.0mg/l$ at the boundaries, but an oxygen deficient water-masses were formed within the concentration of 2.0mg/l at the inner part of Masan Bay and the western part of Jinhae Bay. The results of sensitivity analyses showed that sediment oxygen demand(SOD) was one of the most important influence on the formation of oxygen depletion. Therefore, to control the oxygen deficient water-masses and to conserve the coastal environment, it is an effective method to reduce the SOD by improving the polluted sediment. As the results of simulations, in Masan Bay, oxygen deficient water-masses recovered to 5.0mg/l when the $50\%$ reduction in input COD loads from Masan basin and $70\%$ reduction in SOD was conducted. In the western part of Jinhae Bay, oxygen deficient water-masses recovered to 5.0mg/l when the $95\%$ reduction in SOD and $90\%$ reduction in culturing ground fecal loads was conducted.

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The Optimal Configuration of Arch Structures Using Force Approximate Method (부재력(部材力) 근사해법(近似解法)을 이용(利用)한 아치구조물(構造物)의 형상최적화(形狀最適化)에 관한 연구(研究))

  • Lee, Gyu Won;Ro, Min Lae
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.13 no.2
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    • pp.95-109
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    • 1993
  • In this study, the optimal configuration of arch structure has been tested by a decomposition technique. The object of this study is to provide the method of optimizing the shapes of both two hinged and fixed arches. The problem of optimal configuration of arch structures includes the interaction formulas, the working stress, and the buckling stress constraints on the assumption that arch ribs can be approximated by a finite number of straight members. On the first level, buckling loads are calculated from the relation of the stiffness matrix and the geometric stiffness matrix by using Rayleigh-Ritz method, and the number of the structural analyses can be decreased by approximating member forces through sensitivity analysis using the design space approach. The objective function is formulated as the total weight of the structures, and the constraints are derived by including the working stress, the buckling stress, and the side limit. On the second level, the nodal point coordinates of the arch structures are used as design variables and the objective function has been taken as the weight function. By treating the nodal point coordinates as design variable, the problem of optimization can be reduced to unconstrained optimal design problem which is easy to solve. Numerical comparisons with results which are obtained from numerical tests for several arch structures with various shapes and constraints show that convergence rate is very fast regardless of constraint types and configuration of arch structures. And the optimal configuration or the arch structures obtained in this study is almost the identical one from other results. The total weight could be decreased by 17.7%-91.7% when an optimal configuration is accomplished.

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A Validation Study for the Practical Use of Screening Scale for Potential Drug-use Adolescents(SPDA) (청소년 약물사용 잠재군 선별척도(SPDA) 활용을 위한 타당화 연구)

  • Lee, Ki-Young;Kim, Young-Mi;Im, Hyuk;Park, Mi-Jin;Park, Sun-Hee
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.305-335
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    • 2005
  • This paper is a result from validation study for SPDA(A Screening Scale For Potential Drug-use Adolescents) created in 2003 and newly developed during 2004. SPDA aims to screen adolescents in their early stage of drug-use and to help practitioners make a preventive approach for the adolescents. 4307 junior and senior high school students were selected as primary research subjects by stratified and quota sampling methods. 305 adolescents on probation were also selected as a comparison group and asked to answer the same questionnaire. Reliability for SPDA recorded 0.914, which proved to be better than previous year's (0.898). Exploratory and confirmatory factor analyses to test construct validity proved that SPDA could be divided into 7 factors and that each factor structure of SPDA could be a proper measurement model with high level of fitness and factor loadings. Discriminant analysis to test predictive validity confirmed that SPDA could classify the adolescents excellently by the frequency of drug-use, with hit ratio of 86.6 percent(78.8% and 87.4% for junior and senior high school students respectively). For concurrent validity test, Hare Home Self-Esteem Scale, Hare School Self-Esteem, Zuckerman-Kuhlman Sensation-seeking Scale were employed to find correlation with SPDA and all the three scales had significant Pearson correlation coefficients with SPDA. Known-groups validity test indicated that SPDA had an adequate power to classify out adolescents on probation from those in schooling, with a hit ratio of 71.8 percent. Cut-off point to detect adolescents with high risk of substance use was 77, which indicated approximately T score, 55 (0.5 SD), satisfying sensitivity, specificity, and efficiency criteria.

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Recent Spatial and Temporal Changes in Means and Extreme Events of Temperature and Precipitation across the Republic of Korea (최근 우리나라 기온 및 강수 평균과 극한 사상의 시.공간적 변화)

  • Choi, Gwang-Yong;Kwon, Won-Tae;Boo, Kyung-On;Cha, Yu-Mi
    • Journal of the Korean Geographical Society
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    • v.43 no.5
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    • pp.681-700
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    • 2008
  • In this study, the spatial and temporal patterns of changes in means and extreme events of temperature and precipitation across the Republic of Korea over the last 35 years (1973-2007) are examined. Over the study period, meteorological winter (December-February) mean minimum (maximum) temperature has increased by $+0.54^{\circ}C$/decade ($+0.6^{\circ}C$/decade), while there have been no significant changes in meteorological summer (June-August) mean temperatures. According to analyses of upper or lower $10^{th}$ percentile-based extreme temperature indices, the annual frequency of cool nights (days) has decreased by -9.2 days/decade (-3.3 days/decade), while the annual frequency of warm nights (days) has increased by +4.9 days/decade (+6.8 days/decade). In contrast, the increase rates of summer warm nights (+8.0 days/$^{\circ}C$) and days (+6.6 days/$^{\circ}C$) relative to changes in summer means minimum and maximum temperatures means are greater than the decreasing rates of winter nights (-5.2 days/$^{\circ}C$) and days (-4.3 days/$^{\circ}C$) relative to changes in winter temperatures. These results demonstrate that seasonal and diurnal asymmetric changes in extreme temperature events have occurred. Moreover, annual total precipitation has increased by 85.5 mm/decade particularly in July and August, which led to the shift of a bimodal behavior of summer precipitation into a multi-modal structure. These changes have resulted from the intensification of heavy rainfall events above 40mm in recent decades, and spatially the statistically-significant increases in these heavy rainfall events are observed around the Taebaek mountain region.

Diagnosis of Pigs Producing PSE Meat using DNA Analysis (DNA검사기법을 이용한 PSE 돈육 생산 돼지 진단)

  • Chung Eui-Ryong;Chung Ku-Young
    • Food Science of Animal Resources
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    • v.24 no.4
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    • pp.349-354
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    • 2004
  • Stress-susceptible pigs have been known as the porcine stress syndrome (PSS), swine PSS, also known as malignant hyperthermia (MH), is characterized as sudden death and production of poor meat quality such as PSE (pale, soft and exudative) meat after slaughtering. PSS and PSE meat cause major economic losses in the pig industry. A point mutation in the gene coding for the ryanodine receptor (RYR1) in porcine skeletal muscle, also known calcium (Ca$^{2+}$) release channel, has been associated with swine PSS and halothane sensitivity. We used the PCR-RFLP(restriction fragment length polymorphism) and PCR-SSCP (single strand conformation polymorphism) methods to detect the PSS gene mutation (C1843T) in the RYR1 gene and to estimate genotype frequencies of PSS gene in Korean pig breed populations. In PCR-RFLP and SSCP analyses, three genotypes of homozygous normal (N/M), heterozygous carrier (N/n) and homozygous recessive mutant (n/n) were detected using agarose or polyacrylamide gel electrophoresis, respectively. The proportions of normal, carrier and PSS pigs were 57.1, 35.7 and 7.1% for Landrace, 82.5, 15.8 and 1.7% far L. Yorkshire, 95.2, 4.8 and 0.0% for Duroc and 72.0, 22.7 and 5.3% for Crossbreed. Consequently, DNA-based diagnosis for the identification of stress-susceptible pigs of PSS and pigs producing PSE meat is a powerful technique. Especially, PCR-SSCP method may be useful as a rapid, sensitive and inexpensive test for the large-scale screening of PSS genotypes and pigs with PSE meat in the pork industry.y.

The Significance of Ku70 Expression in Patients with Nasopharyngeal Carcinoma (비인강암에서 방사선치료의 예측인자로써 Ku70 발현의 의의)

  • Song Si Yeol;Lee Sang-wook;Yu Eunsil;Cho Kyung-Ja;Park Jin-hong;Kim Sang Yoon;Nam Soon Yuhl;Lee Bong-Jae;Kim Sung Bae;Choi Seung-Ho;Ahn Seung Do;Shin Seong Soo;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.1-8
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    • 2005
  • Purpose : The objective of this study was to determine whether the expressions of the two components of DNA-dependent protein kinase, Ku70 and DNA-PKcs, influence the response to radiotherapy (RT) and outcome of treatment of non-disseminated nasopharyngeal carcinoma (NPC) in patients who received definitive RT. Materials and Methods : Sixty-six patients with NPC who were treated with radiotherapy alone or with concurrent chemotherapy between June 1995 and December 2001 were divided into groups based on the levels of immunoreactivity for Ku70 and DNA-PKcs in pretreatment biopsy specimens. The over-expression of Ku70 or DNA-PKcs groups Included patients whose biopsy specimens showed at least 50% immunopositive tumor cells; patients in which less than 50% of the tumor cells in the biopsy tissues were immunopositive were placed in the low Ku70 and DNA-PKcs groups. The immunoreactivities for Ku70 and DNA-PKcs were retrospectively compared with the sensitivity of the tumor to radiation and the patterns of therapy failure. Univariate analyses were peformed to determine the prognostic factors that influenced locoregional control of NPC. Results : The five-year locoregional control rate was significantly higher in the low Ku70 group (Ku(-)) (85%) than in the high Ku70 group (Ku(+)) (42%) (p=0.0042). However, there were no differences in the metastases-free survival rates between the two groups (Ku70 (+), 82%; Ku70 (-), 78%; p=0.8672). Univariate analysis indicated that the over-expression of Ku70 surpassed other well-known predictive clinocopathologic parameters as an Independent prognostic factor for locoregionai control. Eighteen of 22 patients who had locoregional recurrences of the tumor displayed an over-expression of Ku70. No significant association was found between the level of DNA-PKcs expression and the clinical outcome. Conclusion : Our data suggest that the level of Ku70 expression can be used as a molecular marker to predict the response to RT and the locoregional control after RT and concurrent chemotherapy in patients with non-disseminated NPC.

Etherification of n-Butanol to Di-n-Butyl Ether over H3+xPW12-xNbxO40 (x=0, 1, 2, 3) Keggin and H6+xP2W18-xNbxO62 (x=0, 1, 2, 3) Wells-Dawson Heteropolyacid Catalysts (Keggin형 H3+xPW12-xNbxO40 (x=0, 1, 2, 3) 및 Wells-Dawson형 H6+xP2W18-xNbxO62 (x=0, 1, 2, 3) 헤테로폴리산 촉매를 이용한 n-Butanol로부터 Di-n-Butyl Ether의 제조)

  • Kim, Jeong Kwon;Choi, Jung Ho;Yi, Jongheop;Song, In Kyu
    • Korean Chemical Engineering Research
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    • v.50 no.2
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    • pp.251-256
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    • 2012
  • Etherification of n-butanol to di-n-Butyl Ether was carried out over Keggin $H_{3+x}PW_{12-x}Nb_xO_{40}$ (x=0, 1, 2, 3) and $H_{6+x}P_2W_{18-x}Nb_xO_{62}$ (x=0, 1, 2, 3) Wells-Dawson heteropolyacid catalysts. Niobium-substituted Keggin and Wells-Dawson heteropolyacid catalysts with different niobium content were prepared. Successful preparation of the catalysts was confirmed by FT-IR, ICP-AES, and $^{31}P$ NMR analyses. Their acid properties were determined by $NH_3$-TPD (Temperature-Programmed Desorption) measurements. Heteropolyacid catalysts showed different acid properties depending on niobium content in both series. The correlation between acid properties of heteropolyacid catalysts and catalytic activity was then established. Acidity of Keggin and Wells-Dawson heteropolyacid catalysts decreased with increasing niobium content, and conversion of n-butanol and yield for di-n-butyl ether increased with increasing acidity of the catalysts, regardless of the identity of heteropolyacid catalysts (without heteropolyacid structural sensitivity). Thus, acidity of heteropolyacid catalysts served as an important factor determining the catalytic performance in the etherification of n-butanol to di-n-Butyl Ether.

Validation of the Korean version of Center for Epidemiologic Studies Depression Scale-Revised(K-CESD-R) (한국판 역학연구 우울척도 개정판(K-CESD-R)의 표준화 연구)

  • Lee, San;Oh, Seung-Taek;Ryu, So Yeon;Jun, Jin Yong;Lee, Kounseok;Lee, Eun;Park, Jin Young;Yi, Sang-Wook;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.83-93
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    • 2016
  • Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.