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1.
Plant J ; 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31869481

RESUMO

Biological control agents including microbes and their products have been studied as sustainable crop protection strategies. Although aquatic microalgae have been recently introduced as a biological control agent, the underlying molecular mechanisms are largely unknown. The aim of the present study was to investigate the molecular mechanisms underlying biological control by microalga Chlorella fusca. Foliar application of C. fusca elicits induced resistance in Arabidopsis thaliana against Pseudomonas syringae pv. tomato DC3000 that activates plant immunity rather than direct antagonism. To understand the basis of C. fusca-triggered induced resistance at the transcriptional level, we conducted RNA sequencing (RNA-seq) analysis. RNA-seq data showed that, upon pathogen inoculation, C. fusca treatment primed the expression of cysteine-rich receptor-like kinases, WRKY transcription factor genes, and salicylic acid and jasmonic acid signalling-related genes. Intriguingly, the application of C. fusca primed pathogen-associated molecular pattern -triggered immunity, characterized by reactive oxygen species burst and callose deposition, upon flagellin 22 treatment. The attempts to find C. fusca determinants allowed us to identify d-lactic acid secreted in the supernatant of C. fusca as a defence priming agent. This is the first report of the mechanism of innate immune activation by aquatic microalga Chlorella in higher plants.

2.
Medicine (Baltimore) ; 98(45): e17869, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702652

RESUMO

Nontuberculous mycobacteria (NTM) are important pathogens in humans, and hospital-based studies have shown an increased incidence of NTM infection. However, little is known about the treatment pattern of NTM infection with respect to the number of cases per population in South Korea. This study evaluated the trends in the incidence of NTM infection, respiratory comorbidities, and treatment patterns in South Korea.National claims data from the Health Insurance Review and Assessment service database for the years 2009 to 2015 were reviewed, and codes related to NTM infection, respiratory comorbidities occurring from one year before NTM infection and associated treatments were identified.In total, 52,551 patients were included in the study and the average annual incidence per 100,000 person-years was 12.8. The annual incidence was found to have increased from 6.6 to 26.6 per 100,000 persons. Accompanied comorbidities were tuberculosis (33.7%), followed by bronchial asthma (33.2%), chronic obstructive pulmonary disease (25.6%), and lung cancer (5.8%). A total of 76.6% of patients did not receive any combination treatment within one year after the diagnosis of NTM infection. Macrolide-based treatment was administered to 18.8% of patients.A dramatic increase in the incidence of NTM infection was noted in the population of South Korea. Approximately three-fourth of the patients with NTM infection were clinically observed without treatment for at least 1 year after the identification of NTM infection and most patients who treated NTM infection received macrolide-based combination therapy.


Assuntos
Antibióticos Antituberculose/uso terapêutico , Infecções por Micobactéria não Tuberculosa , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Comorbidade , Bases de Dados Factuais , Quimioterapia Combinada , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Infecções por Micobactéria não Tuberculosa/epidemiologia , Infecções por Micobactéria não Tuberculosa/terapia , República da Coreia/epidemiologia , Adulto Jovem
3.
JAMA Intern Med ; 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31633736

RESUMO

Importance: Current guidelines recommend that women delay pregnancy for 6 to 12 months after the receipt of radioactive iodine treatment (RAIT) following thyroidectomy for differentiated thyroid carcinoma. Although concerns exist regarding the risks associated with pregnancy after RAIT, no large-scale study, to date, has investigated the association between RAIT and pregnancy outcomes. Objective: To investigate whether RAIT was associated with increases in adverse pregnancy outcomes among South Korean women who received RAIT after thyroidectomy for thyroid cancer and to evaluate the appropriate interval between RAIT and conception. Design, Setting, and Participants: This population-based cohort study used the Health Insurance Review and Assessment database of South Korea to identify a total of 111 459 women of childbearing age (20-49 years) who underwent thyroidectomy for the treatment of differentiated thyroid carcinoma between January 1, 2008, and December 31, 2015. Participants were allocated to 2 cohorts: those who underwent surgery alone (n = 59 483 [53.4%]) and those who underwent surgery followed by RAIT (n = 51 976 [46.6%]). The pregnancy outcomes data were collected from January 1, 2008, to December 31, 2017. Main Outcomes and Measures: The rates of abortion (both spontaneous and induced), preterm delivery, and congenital malformation were assessed. Multivariate logistic regression models were used to control for confounding variables. Results: Among the 111 459 women of childbearing age who underwent thyroidectomy with or without RAIT for the treatment of thyroid cancer, the mean (SD) age at surgery or RAIT was 39.8 (6.7) years. Of those, 10 842 women (9.7%) became pregnant, and the mean (SD) age at conception was 33.3 (4.4) years. The rates of abortion, preterm delivery, and congenital malformation among patients who underwent surgery alone compared with patients who underwent surgery followed by RAIT were 30.7% vs 32.1% for abortion, 12.8% vs 12.9% for preterm delivery, and 8.9% vs 9.0% for congenital malformation, respectively (P > .05). A subgroup analysis based on the interval between RAIT and conception indicated congenital malformation rates of 13.3% for the interval of 0 to 5 months, 7.9% for 6 to 11 months, 8.3% for 12 to 23 months, and 9.6% for 24 months or more. The adjusted odds ratio of congenital malformation was 1.74 (95% CI, 1.01-2.97; P = .04) in conceptions that occurred 0 to 5 months after RAIT compared with conceptions that occurred 12 to 23 months after RAIT. The abortion rates based on the interval between RAIT and conception were 60.6% for the interval of 0 to 5 months, 30.1% for 6 to 11 months, 27.4% for 12 to 23 months, and 31.9% for 24 months or more. Conclusions and Relevance: These large-scale real-world data indicate that receipt of RAIT before pregnancy does not appear to be associated with increases in adverse pregnancy outcomes when conception occurs 6 months or more after treatment.

4.
J Anim Sci Technol ; 61(5): 278-284, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31602306

RESUMO

This study was carried out to investigate the effects of seeding dates on the yield and feed value of whole-crop barley cultivated in paddy soil. The field experiment was conceived as a randomized block design performed in triplicate with seeding dates of Oct. 19 (T1 as treatment 1), Oct. 26 (T2 as treatment 2), Nov. 2 (T3 as treatment 3), Nov. 9 (T4 as treatment 4), and Nov. 16 (T5 as treatment 5) as treatments. The barley grown in all treatments was harvested on May 21 of the following year. Plant length, fresh yield, dry matter yield, and total digestible nutrient (TDN) yield were higher (p < 0.05) in barley with early seeding dates, whereas crude protein and ether extract were higher (p < 0.05) with late seeding dates. Crude fiber and neutral detergent fiber were highest in the T3 treatment and lowest in the T1 treatment. There was no significant difference between acid detergent fiber and TDN among the different seeding dates. Total mineral contents were higher in the order T1 > T2 > T3 > T4 > T5 (p < 0.05), whereas the total amino acid content increased significantly (p < 0.05) with a delay in seeding date. Free sugar contents (fructose, glucose, and sucrose) were higher with early seeding dates (p < 0.05). Collectively, the results obtained in this study indicate that it is favorable to seed soon after harvesting rice to increase dry matter and TDN yields and mineral and free sugar contents of whole-crop barley in the midlands of Korea.

5.
Genes Genomics ; 41(7): 811-829, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30900192

RESUMO

BACKGROUND: Leaf morphology influences plant growth and productivity and is controlled by genetic and environmental cues. The various morphotypes of Brassica rapa provide an excellent resource for genetic and molecular studies of morphological traits. OBJECTIVE: This study aimed to identify genes regulating leaf morphology using segregating B. rapa p F2 population. METHODS: Phenotyping and transcriptomic analyses were performed on an F2 population derived from a cross between Rapid cycling B. rapa (RCBr) and B. rapa ssp. penkinensis, inbred line Kenshin. Analyses focused on four target traits: lamina (leaf) length (LL), lamina width (LW), petiole length (PL), and leaf margin (LM). RESULTS: All four traits were controlled by multiple QTLs, and expression of 466 and 602 genes showed positive and negative correlation with leaf phenotypes, respectively. From this microarray analysis, large numbers of genes were putatively identified as leaf morphology-related genes. The Gene Ontology (GO) category containing the highest number of differentially expressed genes (DEGs) was "phytohormones". The sets of genes enriched in the four leaf phenotypes did not overlap, indicating that each phenotype was regulated by a different set of genes. The expression of BrAS2, BrAN3, BrCYCB1;2, BrCYCB2;1,4, BrCYCB3;1, CrCYCBD3;2, BrULT1, and BrANT seemed to be related to leaf size traits (LL and LW), whereas BrCUC1, BrCUC2, and BrCUC3 expression for LM trait. CONCLUSION: An analysis integrating the results of the current study with previously published data revealed that Kenshin alleles largely determined LL and LW but LM resulted from RCBr alleles. Genes identified in this study could be used to develop molecular markers for use in Brassica breeding projects and for the dissection of gene function.


Assuntos
Brassica/genética , Folhas de Planta/anatomia & histologia , Locos de Características Quantitativas , Transcriptoma , Brassica/anatomia & histologia , Endogamia , Fenótipo , Folhas de Planta/genética , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo
6.
Korean J Intern Med ; 34(6): 1347-1362, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29347812

RESUMO

BACKGROUND/AIMS: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals, and has recently emerged in the community. The impact of methicillin-resistance on mortality and medical costs for patients with S. aureus bacteremia (SAB) requires reevaluation. METHODS: We searched studies with SAB or endocarditis using electronic databases including Ovid-Medline, Embase-Medline, and Cochrane Library, as well as five local databases for published studies during the period January 2000 to September 2011. RESULTS: A total of 2,841 studies were identified, 62 of which involved 17,563 adult subjects and were selected as eligible. A significant increase in overall mortality associated with MRSA, compared to that with methicillin-susceptible S. aureus (MSSA), was evidenced by an odds ratio (OR) of 1.95 (95% confidence interval [CI], 1.73 to 2.21; p < 0.01). In 13 endocarditis studies, MRSA increased the risk of mortality, with an OR of 2.65 (95% CI, 1.46 to 4.80). When three studies, which compared mortality rates between CA-MRSA and CA-MSSA, were combined, the risk of methicillin-resistance increased 3.23-fold compared to MSSA (95% CI, 1.25 to 8.34). The length of hospital stay in the MRSA group was 10 days longer than that in the MSSA group (95% CI, 3.36 to 16.70). Of six studies that reported medical costs, two were included in the analysis, which estimated medical costs to be $9,954.58 (95% CI, 8,951.99 to 10,957.17). CONCLUSION: MRSA is still associated with increased mortality, longer hospital stays and medical costs, compared with MSSA in SAB in studies published since the year 2000.

7.
New Phytol ; 220(3): 684-691, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29266296

RESUMO

Plants emit a plethora of volatile organic compounds in response to biotic and abiotic stresses. These compounds act as infochemicals for ecological communication in the phytobiome. This study reviews the role of microbe-induced plant volatiles (MIPVs) in plant-microbe interactions. MIPVs are affected by the taxonomic position of the microbe, the identity of the plant and the type of interaction. Plants also emit exclusive blends of volatiles in response to nonhost and host interactions, as well as to beneficial microbes and necrotrophic/biotrophic pathogens. These MIPVs directly inhibit pathogen growth and indirectly promote resistance/susceptibility to subsequent plant pathogen attack. Viruses and phloem-limiting bacteria modify plant volatiles to attract insect vectors. Susceptible plants can respond to MIPVs from resistant plants and become resistant. Recent advances in our understanding of the molecular mechanisms of MIPV synthesis in plants and how plant pathogen effectors manipulate their biosynthesis are discussed. This knowledge will help broaden our understanding of plant-microbe interactions and should facilitate the development of new emerging techniques for sustainable plant disease management.


Assuntos
Bactérias/metabolismo , Fungos/metabolismo , Plantas/metabolismo , Plantas/microbiologia , Compostos Orgânicos Voláteis/metabolismo , Transdução de Sinais , Compostos Orgânicos Voláteis/química
8.
Epilepsy Behav ; 74: 94-98, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28732261

RESUMO

PURPOSE: Epilepsy is a concealable stigmatizing condition. We investigated the factors predicting disclosure management behavior in Korean adults with newly diagnosed epilepsy. METHODS: This longitudinal multicenter study included Korean adults with newly diagnosed epilepsy. Using statistical analyses, we determined at the end of a 1-year follow-up whether Disclosure Management Scale (DMS) scores were predicted by demographic, clinical, and psychosocial variables, including felt stigma, stress coping style, personality traits, social support, and experienced discrimination from society. RESULTS: Of a total of 121 participants, 69% reported that they often or sometimes kept their diagnosis a secret from others and rarely or never talked to others about their epilepsy. The average DMS score was 5.8 (SD=2.9, range 0-11). In univariate analyses, DMS scores were significantly associated with an emotion-focused coping style (r=0.320, p<0.001), social support (r=-0.185, p<0.05), and experienced discrimination (p<0.05). Emotion-focused coping was the only independent predictor of a higher DMS score. Felt stigma, personality traits, and seizure freedom were not related to the DMS score. CONCLUSIONS: Two-thirds of Korean adults with newly diagnosed epilepsy often or sometimes keep their epilepsy a secret. Emotion-focused coping is the most important predictor of concealment of epilepsy diagnosis at the end of a 1-year follow-up, although social support and episodes of experienced discrimination are also associated with disclosure management strategies.


Assuntos
Adaptação Psicológica/fisiologia , Epilepsia/psicologia , Estigma Social , Apoio Social , Revelação da Verdade , Adulto , Emoções/fisiologia , Epilepsia/diagnóstico , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Personalidade , República da Coreia , Estresse Psicológico/psicologia , Adulto Jovem
9.
Trends Plant Sci ; 22(5): 357-360, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28366543

RESUMO

Circular RNAs (circ-RNAs), a novel class of noncoding RNAs, are a popular topic in animal research because they have potential as post-transcriptional regulators and diagnostic markers. Research in plants is only now emerging, but indicates that circ-RNAs could also be a crucial class of noncoding regulators.


Assuntos
Processamento de RNA/genética , RNA de Plantas/genética , RNA/genética , Regulação da Expressão Gênica , MicroRNAs/genética , RNA não Traduzido/genética
10.
J Anim Sci Technol ; 58: 32, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27551433

RESUMO

BACKGROUND: The objectives of this study were to investigate the effects of persimmon peel (PPM) supplementation on carcass performance, pork quality, eating quality, fatty acid composition, and cholesterol concentration of the porcine longissimus dorsi muscle. RESULTS: No adverse effects of PPM supplementation were observed on carcass and meat quality characteristics among the treatment groups (P > 0.05), whereas pork loins from pigs fed a diet supplemented with 0.9 % persimmon peel (T3) showed more tender meat than did pork loins from pigs fed a control diet (P < 0.01), even though no significant difference was observed between the control and T1 group. The T3 group had higher ratio of polyunsaturated fatty acids relative to saturated fatty acids (0.33 vs. 0.28, P < 0.05) and lower total cholesterol concentration (94.4 vs. 99.1 mg/g, P < 0.05) compared to the control group. Persimmon peel appeared to have beneficial effects on fatty acid composition and cholesterol concentration, probably leading to a hypocholesterolemic effect. CONCLUSIONS: Animal diets fortified with persimmon peel represents an efficient and useful method for improving the nutritional quality of pork without impairing growth performance and eating quality properties.

11.
Epilepsy Behav ; 54: 1-6, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26610094

RESUMO

PURPOSE: We evaluated the course of perceived stigma and the factors associated with perceived stigma over the first year in newly diagnosed people with epilepsy (PWE). METHODS: We recruited newly diagnosed PWE from 12 tertiary hospitals in Korea. The perceived stigma of epilepsy was assessed using the Stigma Scale at baseline and one year later. At the time of diagnosis, demographic, clinical seizure-related, and psychological data were collected. The predictive factors for perceived stigma over one year were analyzed using logistic regression analyses. RESULTS: Two hundred eighteen newly diagnosed PWE were included at baseline, and 153 completed the study. The percentage of participants who felt stigmatized decreased from 30.7% at the time of diagnosis to 17.6% at the end of follow-up. Introverted personality and a high level of anxiety were independent factors contributing to stigma at the time of epilepsy diagnosis. At the one-year follow-up, introverted personality and lower economic status were predictive of the development of perceived stigma. CONCLUSION: Introverted personality was an important factor contributing to the development of perceived stigma at the time of diagnosis and at one year after diagnosis. In addition, a high level of anxiety and a low economic status were independently related to feelings of stigma at baseline and at one year after diagnosis, respectively. There may be a decrease in the perception of stigma over one year in newly diagnosed PWE.


Assuntos
Epilepsia/psicologia , Personalidade , Convulsões/psicologia , Estigma Social , Estereotipagem , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Testes de Personalidade , República da Coreia , Adulto Jovem
12.
J Anim Sci Technol ; 57: 3, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26290723

RESUMO

This study investigated the effects of feeding by-product feed (BF)-based silage on the behavior of growing Hanwoo heifers. Twelve Hanwoo heifers (13.2 months-old, 315 kg body weight; four heifers per pen) were assigned to three diets: a rice straw (RS) diet (concentrate mix and free access to RS), a RS and BF-based silage (RSBFS) diet (concentrate mix and free access to RS and BF-based silage), and a BF-based silage (BFS) diet (concentrate mix and free access to BF-based silage). Behavior was recorded for 5 days using camcorders. Compared to the RS group, the BFS group showed 21.7% higher dry matter intake, shorter feeding, rumination, and chewing times, as well as longer resting time (p < 0.05). Although all groups exhibited similar drinking, urination, and defecation frequencies, the BFS group exhibited higher feeding rates, rumination efficiency, and chewing efficiency than the RS group (p < 0.05). Compared to the BFS group, the RSBFS group showed higher peNDF8.0 intake (15.2% vs. 25.0% dry matter intake), longer feeding and sitting times, lower defecation frequency (p < 0.05), and similar rumination efficiency. In conclusion, complete replacement of conventional RS with BF-based silage reduced rumination and chewing activity in growing Hanwoo heifers, and BF-based silage feeding with large-particle straw is an effective approach in improving heifer behavior.

13.
Asian Pac J Cancer Prev ; 15(8): 3383-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24870726

RESUMO

BACKGROUND: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. MATERIALS AND METHODS: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. RESULTS: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. CONCLUSIONS: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.


Assuntos
Análise Custo-Benefício , Detecção Precoce de Câncer/economia , Neoplasias da Próstata/diagnóstico , Adulto , Idoso , Custos de Cuidados de Saúde , Humanos , Calicreínas/sangue , Masculino , Programas de Rastreamento/economia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/economia , Neoplasias da Próstata/terapia , Anos de Vida Ajustados por Qualidade de Vida , República da Coreia
14.
Infect Chemother ; 45(2): 202-10, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24265968

RESUMO

BACKGROUND: Staphylococcus aureus bacteremia (SAB) is the Staphylococcal infections in blood, one of the most common and fatal bacterial infectious diseases worldwide in adults as well as children or neonates. Recently, some studies have yielded inconsistent findings about the association between methicillin-resistance and mortality in patients with SAB. We performed a meta-analysis to assess the impact of methicillin-resistance on mortality in children or neonates with S. aureus bacteremia. MATERIALS AND METHODS: We searched using electronic databases such as Ovid-Medline, EMBASE-Medline, and Cochrane Library, as well as five local databases for published studies during the period of 1 January 2000 to 15 September 2011. Two reviewers independently selected articles in accordance with predetermined criteria and extracted prespecified data based on standardized forms. All cohort studies, which compared in-hospital mortality or SAB-related mortality in children and neonates with methicillin-resistant S. aureus (MRSA) infection to those with methicillin-susceptible S. aureus (MSSA), were included. We conducted meta-analysis using the fixed-effect model to obtain pooled estimates of effect. RESULTS: Of 2,841 screened studies, seven cohort studies were finally selected for analysis. In children or neonates, MRSA bacteremia was associated with a higher mortality compared with MSSA bacteremia (pooled odds ratio [OR] 2.33, P = 0.0008, 95% confidence interval [CI] 1.42 to 3.82, I(2) = 0%). Four studies reported SAB-related mortality, the pooled OR of these studies was 2.03 (P = 0.29, 95% CI 0.55 to 7.53, I(2) = 0%). A significant increase in mortality associated with methicillin resistance was found in the subgroup analyses of the studies with only neonates (OR: 2.66, 95% CI: 1.46 to 4.85, P = 0.001), prospectively design ones (OR: 3.20, 95% CI: 1.66 to 6.15, P = 0.0005,), the larger studies (OR: 2.89, 95% CI: 1.62 to 5.16, P = 0.0003) and the higher quality studies (OR: 2.76, 95% CI: 1.50 to 5.06, P = 0.001). CONCLUSIONS: MRSA bacteremia is associated with increased mortality compared with MSSA bacteremia in children or neonates. Due to limited studies for mortality in children or neonates with SAB, further research is needed to evaluate the impact of methicillin resistance on mortality in those populations.

15.
J Prev Med Public Health ; 46(4): 201-9, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23946878

RESUMO

OBJECTIVES: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. METHODS: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. RESULTS: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. CONCLUSIONS: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.


Assuntos
Stents Farmacológicos/economia , Infarto do Miocárdio/terapia , Stents/economia , Serviço Hospitalar de Emergência/economia , Feminino , Humanos , Masculino , Metais , Pessoa de Meia-Idade , Infarto do Miocárdio/economia , República da Coreia , Estudos Retrospectivos
16.
Int J Technol Assess Health Care ; 29(3): 331-5, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23863190

RESUMO

OBJECTIVES: The aim of this study was to explore factors that influenced decision making in the assessment of new health technology in Korea. METHODS: We analyzed the decision-making results of the Committee for New Health Technology Assessment (CnHTA) on fifty-three new nondrug health technologies in Korea from July 2007 to December 2010. The scope of the committee was mainly limited to safety and efficacy/effectiveness, and every decision was based on a systematic review of the literature. The committee was composed of healthcare professionals, policy makers, lawyers, and representatives from nongovernmental organizations. Decisions made on therapeutic interventions were included, while those on diagnostic procedures were excluded. RESULTS: Factors that positively influenced decisions were lower complication rate than existing technology, similar or greater effectiveness compared with existing technology, ability to save critical organs, absence of alternative intervention, decreased invasiveness, expansion of patient's set of choices, and similarity to the mechanism of existing technology. Factors that negatively influenced decisions were higher complication rates than existing technology, lower effectiveness than comparable technology, low levels of evidence, unknown mechanisms of intervention, inconsistency, lack of long-term outcomes, lack of comparative data, nonstandardized technology, heterogeneity between control and treatment, excessively diverse indications, and nongeneralizability. CONCLUSIONS: This qualitative analysis of past decision-making results provided us with clues on the values that decision makers on the Korean CnHTA considered in terms of safety and effectiveness. These findings will help us develop appraisal guidelines and enhance the objectivity of decision-making processes in Korea.


Assuntos
Tomada de Decisões , Avaliação da Tecnologia Biomédica , Comitês Consultivos , Medicina Baseada em Evidências , Humanos , Segurança do Paciente , República da Coreia , Resultado do Tratamento
17.
Ann Lab Med ; 33(4): 233-41, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23826558

RESUMO

BACKGROUND: The effectiveness of prostate-specific antigen (PSA) for population screening has presented controversial results in large trials and prior reviews. We investigated the effectiveness of PSA population screening in a systematic review. METHODS: The study was conducted using existing systematic reviews. We searched Ovid MEDLINE, Embase, Cochrane library, and the major Korean databases. The quality of the systematic reviews was assessed by two reviewers independently using AMSTAR. Randomized controlled trials were assessed using the risk of bias tool in the Cochrane group. Meta-analyses were conducted using Review Manager. The level of evidence of each outcome was assessed using GRADE. RESULTS: Prostate-cancer-specific mortality was not reduced based on similar prior reviews (relative risk [RR] 0.93; 95% confidence interval [CI], 0.81-1.07, P=0.31). The detection rate of stage 1 prostate cancer was not greater, with a RR of 1.67 (95% CI, 0.95-2.94) and high heterogeneity. The detection rate of all cancer stages in the screening group was high, with a RR of 1.45 (95% CI, 1.13-1.85). No difference in all-cause mortality was observed between the screening and control groups (RR, 0.99; 95% CI, 0.98-1.01, P=0.50). Prostate-cancer-specific mortality, all-cause mortality, and diagnosis of prostate cancer at stages 3-4 showed moderate levels of evidence. CONCLUSIONS: Differently from prior studies, our review included updated Norrköping data and assessed the sole effect of PSA testing for prostate cancer screening. PSA screening alone did not increase early stage prostate cancer detection and did not lower mortality.


Assuntos
Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Ensaios Clínicos como Assunto , Bases de Dados Factuais , Humanos , Masculino , Programas de Rastreamento , Estadiamento de Neoplasias , Neoplasias da Próstata/mortalidade
18.
Int J Technol Assess Health Care ; 29(3): 244-53, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23769210

RESUMO

OBJECTIVES: The aim of this study was to systematically assess the long-term (≥ 6 months) benefits of epidural steroid injection therapies for patients with low back pain. METHODS: We identified randomized controlled trials by database searches up to October 2011 and by additional hand searches without language restrictions. Randomized controlled trials on the effects of epidurals for low back pain with follow-up for at least 6 months were included. Outcomes considered were pain relief, functional improvement in 6 to 12 months after epidural steroid injection treatment and the number of patients who underwent subsequent surgery. Meta-analysis was performed using a random-effects model. RESULTS: Twenty-nine articles were selected. The meta-analysis suggested that a significant treatment effect on pain was noted at 6 months of follow-up (weighted mean difference [WMD], -0.41; 95 percent confidence interval [CI], -0.66 to -0.16), but was no longer statistically significant after adjusting for the baseline pain score (WMD, -0.19; 95 percent CI, -0.61 to 0.24). Epidural steroid injection did not improve back-specific disability more than a placebo or other procedure. Epidural steroid injection did not significantly decrease the number of patients who underwent subsequent surgery compared with a placebo or other treatments (relative risk, 1.02; 95 percent CI, 0.83 to 1.24). CONCLUSIONS: A long-term benefit of epidural steroid injections for low back pain was not suggested at 6 months or longer. Introduction of selection bias in the majority of injection studies seems apparent. Baseline adjustment is essential when we evaluate pain as a main outcome of injection therapy.


Assuntos
Anestesia Epidural , Anti-Inflamatórios/administração & dosagem , Glucocorticoides/administração & dosagem , Humanos , Dor Lombar/tratamento farmacológico , Radiculopatia
19.
J Health Organ Manag ; 26(3): 343-50, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22852456

RESUMO

PURPOSE: The purpose of this paper is to present the role of social values in setting healthcare priorities in Korea. DESIGN/METHODOLOGY/APPROACH: Using Clark and Weale's draft framework, Korean healthcare priority setting was analysed. The process values used were transparency, accountability, and participation, and the content values used were clinical effectiveness, cost effectiveness, justice/equity, solidarity and autonomy. FINDINGS: In the Korean health priority setting, it was found that multiple factors influence the decision-making process. Effectiveness and safety are the two most important values mentioned in the process. Cost-effectiveness is also considered in reimbursement decisions for new drugs since 2007. Recently, health technology assessment (HTA) has begun to change the social value system traditionally used in the Korean healthcare priority setting. ORIGINALITY/VALUE: The paper extends understanding of health priority setting in Korea, and how the interpretation and use of social values has changed over recent years.


Assuntos
Prioridades em Saúde , Valores Sociais , Tomada de Decisões , Entrevistas como Assunto , República da Coreia
20.
Asian-Australas J Anim Sci ; 25(11): 1553-8, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25049516

RESUMO

This study was conducted to investigate the effects of stocking density or group size on feed intake, daily gain, and carcass characteristics of Hanwoo (Korean indigenous breed) steers reared from 7 months to 31 months of age. Thirty Hanwoo steers were divided into four groups with three replicates each (a total of 12 pens). In each group, one (G1), two (G2), three (G3), and four steers (G4) per pen were allocated as treatments. Pen size was 32.0 m(2), and therefore Hanwoo steers in G1, G2, G3, and G4 were reared under different space allowances, i.e. 32.0, 16.0, 10.6, and 8.0 m(2)/steer, respectively. Steers were reared following a conventional beef cattle management method in Korea, and were offered a fixed amount of commercial concentrate with ad libitum forages. Results were subjected to analysis of variance with stocking density as the main effect, and significance was declared at p<0.05. Although total feed intake was not significantly altered, it numerically increased in animals of low stocking density (G1) compared to those subjected to high stocking density treatment (i.e. G4). Feed conversion ratio was higher (p<0.05) in G3 compared to G1 and G2. Animals in G1 (low stocking density) grew faster (p<0.05) than those of high stocking density (G3 and G4). Back fat thickness, meat yield index, and meat yield grade were similar among all levels of stocking density. However, longissimus muscle area was larger in G1 and G2 (p<0.01) compared to G3 and G4, and animals in G3 produced smaller carcasses (p<0.05). Carcass quality traits, including marbling score, meat color, fat color, texture, maturity and meat quality grade, as determined by a group of experts, were not significantly different among the treatments. In conclusion, lower stocking density resulted in increased feed efficiency, daily gain, and carcass weight in Hanwoo steers. However it remains unclear whether such differences are the results of stocking density or group size, or a combination of both. Nonetheless, these results confirm previous studies reporting a negative effect of increased stocking density on animal productivity. Further, animal welfare under an intensive farming system in relation to economical return is discussed.

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