• Title/Summary/Keyword: treatment strategy

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Economic Evaluation of Rosuvastatin and Atorvastatin for the Treatment of Dyslipidemia from a Korean Health System Perspective (이상지질혈증 환자에게 사용되는 Rosuvastain과 Atorvastatin의 경제성 평가)

  • Suh, Sunghwan;Jung, Chang Hee;Hong, Soon-Jun;Kim, Jung-Sun;Song, Byung Ju;Sohn, Hyun Soon;Choi, Sung Hee
    • Journal of Lipid and Atherosclerosis
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    • v.5 no.1
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    • pp.61-77
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    • 2016
  • Objective: This study aims to analyze cost-effectiveness of two most-commonly used statins from the perspective of the Korean national health system. Methods: The scope of the analysis included rosuvastatin (5 mg, 10 mg, and 20 mg) and atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Effectiveness was defined as percentage (%) and absolute (mg/dL) reductions of low-density lipoprotein cholesterol (LDL-C) from the baseline. They were derived from published randomized controlled studies for rosuvastatin and atorvastatin. Effectiveness was defined as reductions in LDL-C levels per mg dose of the drugs. The annual direct medical costs including drug acquisition costs and monitoring costs over the one-year time horizon were calculated for each alternative. The average cost-effectiveness ratios (ACERs) and incremental cost-effectiveness ratios (ICERs) for each statin dose were calculated. Results: The ACERs for all doses of rosuvastatin (5 mg, 10 mg, and 20 mg) were lower than those for all doses of atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Rosuvastatin 10 mg was the most cost-effective statin for LDL-C reduction. In cost-effectiveness analyses for corresponding doses of rosuvastatin and atorvastatin, rosuvastatin was the superior strategy which suggests both higher effectiveness and lower costs than atorvastatin. However, we have to consider this analysis is highly influenced by current price of statins in each market. Conclusion: For reduction of LDL-C levels in Korean patients with dyslipidemia, rosuvastatin 10mg is the most cost-effective statin in the current Korean market.

The context of concentration and polarization of Korean film industry (한국 영화산업의 집중성과 불균형의 맥락들)

  • KIM, Meehyun
    • Review of Culture and Economy
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    • v.21 no.1
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    • pp.3-20
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    • 2018
  • This study investigates a comprehensive context between the vertical integration and concentration of Korean film market. The concentration of distribution and screening markets are result of industrial strategy to defend demand uncertainty and to pursue economies of scale. Major distributors are increasingly inclined to defend industrial risk by concentrating resources on blockbusters and bargaining power of the multiplex is getting strengthened by distribution competition to secure as many screens as possible. Vertically integrated multiplexes operate discriminatory preferential treatment to their affiliates, however, there is a difference in degree of discrimination between vertically integrated groups. Furthermore, it is difficult to exclude each other from the distribution competition in which the largest screen number has to be secured. It is difficult for multiplex only to pursue the interests of affiliates and make negative choices in screening performance. As the number of screening screens increases, the seat occupancy also increases. As a result, the polarization of the distribution and screening markets, including the screen monopoly, is a phenomenon that occurs commercial films centered markets and the unfair behavior of the vertically affiliated multiplex has a limited effect on the movie market.

How perceived communication satisfaction can affect turnover intention through affective commitment (조직 내 커뮤니케이션의 효과성 -정서적 몰입 및 이직의도를 중심으로-)

  • Song, Min-Young;Lee, Joong-Hak;Park, Jae-Hyeong
    • Journal of Digital Convergence
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    • v.17 no.10
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    • pp.149-158
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    • 2019
  • Drawing on literatures from communication strategy and human resource management, this study examines how perceived communication satisfaction can affect turnover intention and also figure out mediating effect through affective commitment. We analyzed a data set from one of the largest government organizations in health and medical treatment including 267 employees's sample. Apart from previous studies, this study emphasizes perceived communication satisfaction is a critical factor rather than communication policies. Also, affective communication partially mediates the relationship between perceived communication satisfaction and turnover intention. Our theory and findings provide new insight into human resource management field in growing Korean organizations.

Sasang Constitutional Characteristic of Amyotrophic Lateral Sclerosis (근위축성측삭경화증 환자의 사상체질 특성)

  • Park, Soo-Jung;Jeong, Ho-Hyun;Jang, Eun-Su;Kim, Sang-Hyuk;Kim, Sung-Chul;Joo, Jong-Cheon
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.2
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    • pp.156-164
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    • 2014
  • Objectives The purpose of this study was to analyze the Sasang constitution and psychological traits of amyotrophic lateral sclerosis (ALS) patients and to utilize the results in treatment and management. Methods The differences of Sasang Constitution distribution, psychological characteristics, comorbid disorders between ALS group of 26 patients and general group of 1132 persons were investigated and analyzed. Results There was no significant different distribution of Sasang Constitution between ALS group and general group but there was Yang-like personality tendency in ALS group than general group. In overall constitution, ALS group had the high prevalence rate of musculoskeletal disorders and diabetes than general group. In Soyangin constitution, ALS group had a high prevalence rate of musculoskeletal disorders than genral group. In Taeeumin constitution, ALS group had a high prevalence rate of diabetes and hypertension than general group. Conclusion ALS patients have the Yang-like personality. It is due to the adaptation of personality on the environmental change or coping strategy on diseases rather than the characteristics of congenital Sasang Constitution.

A Case of Successful Resuscitation of 10,150 J Shocks and Therapeutic Hypothermia on Aconitine-induced Cardiovascular Collapse (10,150 J의 심장조율동과 치료적 저체온법으로 소생한 중증 초오 중독 환자 1례)

  • Moon, Hyung Jun;Lee, Jung Won;Kim, Ki Hwan;Jeong, Dong Kil;Kim, Jong Ho;Kim, Young Ki;Lee, Hyun Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.97-101
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    • 2014
  • Aconitine, found in the Aconitum species, is highly extremely toxic, and has been known to cause fatal cardiac arrhythmias and cardiovascular collapse. Although several reports have described treatment of aconitine intoxication, management strategy for the patient in a hemodynamically compromised state who experienced cardiopulmonary collapse is unknown. We report here on a case of a successful cardiopulmonary resuscitation and therapeutic hypothermia in an aconitine-induced cardiovascular collapsed patient. A 73-year-old male who presented with nausea, vomiting, chest discomfort, and drowsy mental state after eating an herbal decoction made from aconite roots was admitted to the emergency department. He showed hemodynamic compromise with monomorphic ventricular tachycardia resistant to amiodarone and lidocaine. After 3 minutes on admission, he collapsed, and cardiopulmonary resuscitation was initiated. We treated him with repeated cardioversion/defibrillation of 51 times, 10,150 joules and cardiopulmonary resuscitation of 12 times, 69 minutes for 14 hours and therapeutic hypothermia for 36 hours. He recovered fully in 7 days.

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Non-Operative Management with Angioembolization of Grade IV and V Renal Injuries in a Hybrid Emergency Room System

  • Ahn, So Ra;Seo, Sang Hyun;Lee, Joo Hyun;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.191-197
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    • 2021
  • Renal injuries occur in more than 10% of patients who sustain blunt abdominal injuries. Non-operative management (NOM) is the established treatment strategy for lowgrade (I-III) renal injuries. However, despite some evidence that NOM can be successfully applied to high-grade (IV, V) renal injuries, it remains unclear whether NOM is appropriate in such cases. The authors report two cases of high-grade renal injuries that underwent NOM after embolization in a hybrid emergency room (ER) system with a 24/7 in-house interventional radiology (IR) team. A 29-year-old male visited Wonkwang University Hospital Regional Trauma Center complaining of right abdominal pain after being hit by a rope. Computed tomography (CT) was performed 16 minutes after arrival, and the CT scan indicated a grade V right renal injury. Arterial embolization was initiated within 31 minutes of presentation. A 56-year-old male was transferred to Wonkwang University Hospital Regional Trauma Center with a complaint of right flank pain. He had initially presented to a nearby hospital after falling from a 3-m height. Thanks to the key CT images sent from the previous hospital prior to the patient's arrival, angiography was performed within 8 minutes of the patient's arrival and arterial embolization was completed within 25 minutes. Both patients were treated successfully through NOM with angioembolization and preserved kidneys. Hematoma in the first patient and urinoma in the second patient resolved with percutaneous catheter drainage. The authors believe that the hybrid ER system with an in-house IR team could contribute to NOM and kidney preservation even in high-grade renal injuries.

Therapeutic strategies to manage chronic wounds by using biofilm dispersal mechanisms (생물막 분산기작을 이용한 만성창상의 치료전략)

  • Kim, Jaisoo;Kim, Min-Ho
    • Korean Journal of Microbiology
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    • v.55 no.2
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    • pp.87-102
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    • 2019
  • Most chronic wounds persist in the inflammatory phase during wound healing due to the biofilm. Biofilms are resistant to antibiotics, weakening penetration, resistance to biocides and weakening local immune responses. The biofilm is firmly attached to the surrounding tissues and is very difficult to remove. Therefore, strategies to remove hard biofilms without damaging surrounding tissue are very important. One of possible strategies is dispersal. So many studies have been done to develop new strategies using dispersal mechanisms. In this review paper, especially chemotaxis, phage therapy, polysaccharides, various enzymes (glycosidases, proteases, and deoxyribonucleases), surfactants, dispersion signals, autoinducers, inhibitors were introduced. Combination therapies with other therapies such as antibiotic therapy were also introduced. It is expected that the possibility of treatment of chronic wound infection using the knowledge of the biofilm dispersal mechanisms presented in this paper will be higher.

Mediating Effect of Maladaptive Cognitive Emotion Regulation Strategies and Negative Affect on the Relationship between Perceived Stress and Smartphone Addiction (지각된 스트레스와 스마트폰 중독의 관계에서 부적응적 인지적 정서조절전략과 부적 정서의 매개효과)

  • Lim, Jeeyoung
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.185-196
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    • 2018
  • Current study was conducted to examine the mediating effect of maladaptive cognitive emotion regulation strategies and negative affect on the relationship between perceived stress and smartphone addiction of adults and to explore suggestions for counseling adults with smartphone addiction symptoms. Three hundred adults(146 males, 154 females) were administered perceived stress scale, maladaptive cognitive emotion regulation strategy scale, negative affect scale, and smartphone addiction scale. The main results are summarized as follows: First, perceived stress had positive influence on smartphone addiction. Second, negative affect showed mediating effect on the relationship between perceived stress and smartphone addiction. Third, maladaptive cognitive emotion regulation strategies did not show mediating effect on the relationship between perceived stress and smartphone addiction. Forth, maladaptive cognitive emotion regulation strategies and negative affect showed double mediating effect on the relationship between perceived stress and smartphone addiction. Based on the above results, it was suggested to include stress management and relief of negative affect through modification of maladaptive cognitive emotion regulation strategies in the treatment program for adults at high risk of smartphone addiction.

Proposal of a Selective Prophylaxis Strategy Based on Risk Factors to Prevent Early and Late Pneumocystis jirovecii Pneumonia after Renal Transplantation

  • Lee, Ho;Han, Ahram;Choi, Chanjoong;Ahn, Sanghyun;Min, Sang-il;Min, Seung-Kee;Lee, Hajeong;Kim, Yon Su;Yang, Jaeseok;Ha, Jongwon
    • Korean Journal of Transplantation
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    • v.32 no.4
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    • pp.92-103
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    • 2018
  • Background: Currently, trimethoprim-sulfamethoxazole is used for Pneumocystis jirovecii pneumonia (PJP) prophylaxis, but it is associated with frequent adverse effects. This study evaluated the efficacy and safety of the current protocol and proposes an individualized risk-based prophylaxis protocol. Methods: The PJP incidence and risk factors during the first 6 months (early PJP) and afterwards (late PJP) was assessed in renal transplant recipients with (prophylaxis group) and without (no-prophylaxis group) 6-month PJP prophylaxis. Results: In 578 patients, there were 39 cases of PJP during a median follow-up of 51 months. Renal adverse events were encountered frequently during trimethoprim-sulfamethoxazole prophylaxis, leading to premature discontinuation. Patients without the prophylaxis had a significantly higher incidence of early PJP (n=27, 6.6%) compared to patients with the prophylaxis (n=0). The incidence of late PJP was 2.2%, without between-group differences. The factors associated with early PJP were preoperative desensitization and acute rejection within 1 month, whereas late PJP was associated with age, deceased donor transplant, and acute rejection requiring antithymocyte globulin treatment. Conclusions: Based on the simulation results of several risk-based scenarios, the authors recommend universal prophylaxis up to 6 months post-transplant and extended selective prophylaxis in patients aged ${\geq}57$ years and those with a transplant from deceased donors.

Clinical significance of lymph node size in locally advanced cervical cancer treated with concurrent chemoradiotherapy

  • Oh, Jinju;Seol, Ki Ho;Choi, Youn Seok;Lee, Jeong Won;Bae, Jin Young
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.115-123
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    • 2019
  • Background: This study aimed to assess the in-field lymph node (LN) failure rate according to LN size and to investigate effect of LN size on the survival outcome of patients with locally advanced cervical carcinoma treated with concurrent chemoradiotherapy (CCRT). Methods: A total of 310 patients with locally advanced cervical carcinoma treated with CCRT were enrolled in retrospective study. LN status was evaluated by magnetic resonance imaging. All patients received conventional external beam irradiation and high-dose rate brachytherapy, and concurrent cisplatin-based chemotherapy. In-field LN failure rate according to LN size was analyzed. Results: The median follow-up period was 83 months (range, 3-201 months). In-field LN failure rate in patients with pelvic LN size more than 10 mm was significantly higher than that in patients with pelvic LN size less than 10 mm (p<0.001). A similar finding was observed in the infield para-aortic LN (PALN) failure rate (p=0.024). The pelvic and PALN size (${\geq}10mm$) was a significant prognostic factor of overall-survival (OS) and disease-free survival rate in univariate and multivariate analyses. The OS rate was significantly different between groups according to LN size (<10 mm vs. ${\geq}10mm$). Conclusion: A LN of less than 10 mm in size in an imaging study is controlled by CCRT. On the other hand, in LN of more than 10 mm in size, the in-field LN failure rate increase and the prognosis deteriorate. Therefore, a more aggressive treatment strategy is needed.