1.An Analysis of Economic Value of the Old-age Preparation Service
Health Policy and Management 2018;28(1):77-86
BACKGROUND: The purpose of this study is to emphasize the importance and necessity of the government's old-age preparation service by measuring the economic value of the old-age service and the policy direction and policy implications of the government's old-age preparation service project. METHODS: Contingent Valuation Method (CVM) was used as an analytical method. CV methodology was used to calculate the Willingness to pay (WTP) for old-age preparation service and its value was estimated and the economic benefit of the project was estimated. RESULTS: As a result of the analysis, the average monthly payment amount for the old service was calculated as 5,100 won, and the annual average payment amount was estimated to be 61,197.1 won. CONCLUSION: The present value of the benefit for 10 years with the discount rate of 5.5% is 484,651 won. Based on the value of peruser benefit, the total benefit value calculation result of the old-age preparation service considering the Willingness to pay for the next 10 years shows that the total benefit value of the old service, which occurs during the period from 2016 to 2025(10 years) was estimated at 415.1 billion won. As a result of calculating the benefit for each scenario, the present value of basic service is higher in all scenarios than the linked service.
Methods
2.Protracted Venous Infusion of 5-Fluorouracil as a Chemotherapy in Colorectal Cancer.
Hyun Sik JEONG ; Won Seog KIM ; Sook In JUNG ; Jong Tae LEE ; Ki Hyun KIM ; Sung Soo YOON ; Won Ki KANG ; Hong Ghi LEE ; Ken Chil PARK ; Poong Lyul RHEE ; Hae Jun KIM ; Ho Kyun CHUN ; Chan Hyung PARK
Journal of the Korean Cancer Association 1999;31(1):120-125
PURPOSE: The administration of 5-fluorouracil (5-FU) by protracted intravenous infusion is an alternative to the bolus administration of 5-FU in patients with advanced colorectal cancers. This study was performed to evaluate the response rate and toxicities of protracted infusion of 5-FU in patients with advanced or recurrent colorectal cancers who had been treated with 5-FU by bolus or shortterm continuous administration. MATERIALS AND METHODS: Between March 1995 and June 1997, twenty-eight patients with advanced colorectal cancer previously exposed to 5-FU based chemotherapy were enrolled in this triaL Patients received 5-FU (250 mg/m(2)/day days 1-28) or 5-FU plus leucovorin (5-FU; 200 mg/m/day days 1-28, leucovorin; 20 mg/m IV days 1, 8, 15, 21) by ambulatory infusion pump. Treatment course was repeated every 42 days until disease progression. RESULT: Twenty-eight patients entered. All 28 patients were assessable for response and toxicity. Five (19%) patients achieved a partial response, with the median response duration of 15 weeks (range; 7-22 weeks), and median survival time of entire patients was 54 weeks (range 7-151+ weeks). Gastrointestinal toxicity, specifically stomatitis was a major toxicity (grade 2, 12%; grade 3, 4%), but hand-foot syndrome was less frequent (5%) compared with other trials with protracted infusion of 5-FU reported in the literature. Hematologic toxicity was generally of low grade. CONCLUSION: Prolonged intravenous infusion of 5-FU can produce a response rate of 19% with low toxicity among patients refractory to bolus or short-term infusion of S-FU.
Colorectal Neoplasms*
;
Disease Progression
;
Drug Therapy*
;
Fluorouracil*
;
Hand-Foot Syndrome
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Humans
;
Infusion Pumps
;
Infusions, Intravenous
;
Leucovorin
;
Stomatitis
3.Comparison of Efficacy of Glimepiride, Alogliptin, and Alogliptin-Pioglitazone as the Initial Periods of Therapy in Patients with Poorly Controlled Type 2 Diabetes Mellitus: An Open-Label, Multicenter, Randomized, Controlled Study
Hae Jin KIM ; In Kyung JEONG ; Kyu Yeon HUR ; Soo-Kyung KIM ; Jung Hyun NOH ; Sung Wan CHUN ; Eun Seok KANG ; Eun-Jung RHEE ; Sung Hee CHOI
Diabetes & Metabolism Journal 2022;46(5):689-700
Background:
The choice of an optimal oral hypoglycemic agent in the initial treatment periods for type 2 diabetes mellitus (T2DM) patients remains difficult and deliberate. We compared the efficacy and safety of glimepiride (GLIM), alogliptin (ALO), and alogliptin-pioglitazone (ALO-PIO) in poorly controlled T2DM patients with drug-naïve or metformin failure.
Methods:
In this three-arm, multicenter, open-label, randomized, controlled trial, poorly controlled T2DM patients were randomized to receive GLIM (n=35), ALO (n=31), or ALO-PIO (n=33) therapy for 24 weeks. The primary endpoint was change in the mean glycosylated hemoglobin (HbA1c) levels at week 24 from baseline. Secondary endpoints were changes in HbA1c level at week 12 from baseline, fasting plasma glucose (FPG) levels, lipid profiles at weeks 12 and 24, and parameters of glycemic variability, assessed by continuous glucose monitoring for 24 weeks.
Results:
At weeks 12 and 24, the ALO-PIO group showed significant reduction in HbA1c levels compared to the ALO group (–0.96%±0.17% vs. –0.37%±0.17% at week 12; –1.13%±0.19% vs. –0.18%±0.2% at week 24). The ALO-PIO therapy caused greater reduction in FPG levels and significant increase in high-density lipoprotein cholesterol levels at weeks 12 and 24 than the ALO therapy. Compared to low-dose GLIM therapy, ALO-PIO therapy showed greater improvement in glycemic variability. The adverse events were similar among the three arms.
Conclusion
ALO-PIO combination therapy during the early period exerts better glycemic control than ALO monotherapy and excellency in glycemic variability than low-dose sulfonylurea therapy in uncontrolled, drug-naïve or metformin failed T2DM patients.
4.Total Plasma Exchange in a Patient with HD-MTX-induced Acute Renal Failure: A Case Report.
Hyong Ju KANG ; Hae Won HAN ; Myoung Cheol KIM ; Jin No PARK ; Dong Chan JIN ; Young Seon HONG ; Seung Koo RHEE ; Chun Choo KIM ; Kyung Shick LEE
Korean Journal of Hematology 2001;36(3):265-268
A 16-year-old male patient was diagnosed as chondroid osteosarcoma of the left humeral shaft. He showed normal serum creatinine level and no complications following the first course of high-dose methotrexate (HD-MTX) chemotherapy with a total dose of 12g/m2. After the 2nd HD-MTX chemotherapy with the same dosage as in the 1st course, plasma MTX levels soared up to 72micromol/L and serum creatinine level increased to 1.39mg/dL. We failed to lower the plasma MTX levels and to recover the renal function by high-dose leucovorin rescue and plasmapheresis. Plasma MTX level was successfully lowered after three consecutive total plasma exchanges and the withdrawal of aceclofenac which was suspected as an aggravating agent. No rebound in plasma MTX level was observed. We report that total plasma exchanges were effective in a patient with renal failure and delayed MTX excretion which occurred after HD-MTX chemotherapy.
Acute Kidney Injury*
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Adolescent
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Creatinine
;
Drug Therapy
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Humans
;
Leucovorin
;
Male
;
Methotrexate
;
Osteosarcoma
;
Plasma Exchange*
;
Plasma*
;
Plasmapheresis
;
Renal Insufficiency
5.Factors Influencing Delay in Symptom-to-Door Time in Patients with Acute ST-Segment Elevation Myocardial Infarction.
Jae Hoon LEE ; Myung Ho JEONG ; Jung Ae RHEE ; Jin Su CHOI ; In Hyae PARK ; Leem Soon CHAI ; Soo Yong JANG ; Jae Young CHO ; Hae Chang JEONG ; Ki Hong LEE ; Keun Ho PARK ; Doo Sun SIM ; Kye Hun KIM ; Young Joon HONG ; Hyung Wook PARK ; Ju Han KIM ; Young Keun AHN ; Jeong Gwan CHO ; Jong Chun PARK
Korean Journal of Medicine 2014;87(4):429-438
BACKGROUND/AIMS: Delay in symptom-to-door time (SDT) in patients with acute ST-segment elevation myocardial infarction (STEMI) is the most important factor in the prediction of short and long-term mortality. The purpose of this study was to investigate the social and clinical factors affecting SDT in patients with STEMI. METHODS: We analyzed 784 patients (61.0 +/- 13.2 years, 603 male) diagnosed with STEMI from November 2005 to February 2012. The patients were divided into four groups according to SDT: Group I (n = 163, < or = 1 h), Group II (n = 183, 1-2 h), Group III (n = 142, 2-3 h) and Group IV (n = 296, > 3 h). RESULTS: Delay in SDT increased with age (Group I, 58.4 +/- 12.0; Group II, 59.4 +/- 13.3; Group III, 62.0 +/- 12.8; Group IV, 63.0 +/- 13.8 years, p = 0.001). In 119 patients, transportation was less frequently used as the delay in SDT (41.7% vs. 29.0% vs. 26.1% vs. 9.8%, p < 0.001). By multiple logistic regression analysis, family history [OR, 0.488; CI, 0.248-0.959; p = 0.037], previous ischemic heart disease [OR, 0.572; CI, 0.331-0.989; p = 0.045], no occupation [OR, 1.600; CI, 1.076-2.380; p = 0.020] and method of transportation [OR, 0.353; CI, 0.239-0.520; p < 0.001] were independent predictors of delay in SDT. CONCLUSIONS: Our study shows that general education about cardiovascular symptoms and a prompt emergency call could be important to reduce SDT in STEMI.
Education
;
Emergencies
;
Humans
;
Logistic Models
;
Mortality
;
Myocardial Infarction*
;
Myocardial Ischemia
;
Occupations
;
Transportation
6.Comparison of Clinical Outcomes after Implantation of First- and Second-Generation Overlapping Drug-Eluting Stents to Treat Diffuse Long Coronary Lesions.
Kyung Soo OH ; Myung Ho JEONG ; Jung Ae RHEE ; Jin Su CHOI ; Doo Hwan LEE ; Jeong Hun KIM ; Soo Hwan PARK ; In Soo KIM ; Dae Yong HYUN ; Yun Ah JEONG ; Hae Chang JEONG ; Keun Ho PARK ; Doo Sun SIM ; Hyun Ju YOON ; Kye Hun KIM ; Hyung Uk PARK ; Young Joon HONG ; Youngkeun AHN ; Jeong Gwan CHO ; Jong Chun PARK
Korean Journal of Medicine 2015;89(2):192-200
BACKGROUND/AIMS: Despite improved revascularization techniques, the clinical outcomes of patients with diffuse coronary artery lesions after percutaneous coronary intervention are unsatisfactory. However, few studies have compared the efficacy of first- and second-generation drug-eluting stents (DES) in patients with diffuse long coronary artery lesions. METHODS: Between January 2006 and July 2012, 364 patients who were treated with DES for long coronary artery stenosis (> 30 mm) were enrolled in this study and assigned to either Group I (first-generation DES, 62.3 +/- 10.4 years, 136 males, n = 183) or Group II (second-generation DES, 64.3 +/- 10.7 years, 134 males, n = 181). The incidence of major adverse cardiac events (MACE) was compared between the two groups over 2 years of follow-up, and predictive factors associated with MACE were evaluated through a multivariate analysis. RESULTS: Although several coronary angiographic characteristics were different between the two groups, most demographic and baseline clinical variables were the same. The cumulative incidence of MACE was significantly higher in Group I than in Group II (25.7 vs. 6.6%; p < 0.001), mainly due to reduced target lesion revascularization (21.9 vs. 2.2%; p < 0.001). According to the results of the multivariate analysis, the use of a paclitaxel-eluting stent (PES) (hazard ratio [HR], 5.168; 95% confidence interval [CI], 2.515-10.617; p < 0.001), decreased left ventricular function (< or = 45%; HR, 3.586; 95% CI, 1.839-6.990; p < 0.001), and diabetes mellitus (HR, 2.984; 95% CI, 1.605-5.548; p < 0.001) were independent contributors to MACE. CONCLUSIONS: For patients with diffuse long coronary artery stenosis, the use of second-generation DES improved the clinical outcome compared with first-generation DES. In addition, the use of a PES, left ventricular dysfunction, and diabetes were predictors of MACE after overlapping stenting.
Coronary Stenosis
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Coronary Vessels
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Diabetes Mellitus
;
Drug-Eluting Stents*
;
Follow-Up Studies
;
Humans
;
Incidence
;
Male
;
Multivariate Analysis
;
Percutaneous Coronary Intervention
;
Stents
;
Ventricular Dysfunction, Left
;
Ventricular Function, Left
7.Clinical Outcome Comparison of Everolimus- and Biolimus-eluting Stents in Patients with Acute Myocardial Infarction.
In Cheol PARK ; Myung Ho JEONG ; In Soo KIM ; Jung Ae RHEE ; Jin Su CHOI ; In Hyae PARK ; Leem Soon CHAI ; Yun Ah JEONG ; Dae Yong HYUN ; Hae Chang JEONG ; Ki Hong LEE ; Keun Ho PARK ; Doo Sun SIM ; Kye Hun KIM ; Young Joon HONG ; Hyung Uk PARK ; Ju Han KIM ; Young Keun AHN ; Jeong Gwan CHO ; Jong Chun PARK
Korean Journal of Medicine 2015;89(4):418-427
BACKGROUND/AIMS: We compared the efficacy and safety of the second-generation everolimus-eluting stent (EES) and the third generation biolimus-eluting stent (BES) in patients with acute myocardial infarction (AMI). METHODS: We analyzed 629 consecutive patients (mean age 65.1 +/- 11.2 years, 426 males) with AMI undergoing percutaneous coronary intervention from February 2008 to April 2012. They were divided into two groups according to stent type (EES group, n = 426; BES group, n = 203). The primary end-point was 2-year major adverse cardiac events (MACEs), defined as the composite of all-cause death, myocardial infarction, target vessel revascularization, non-target vessel revascularization and target lesion revascularization. The secondary end-point was 2-year target lesion failure (TLF). RESULTS: There were no significant differences in baseline characteristics, except that the patients with EES had a significantly higher prevalence of diabetes mellitus (34.7 vs. 22.7%, p = 0.002) and were older (67.1 +/- 11.3 vs. 64 +/- 12.9 years, p = 0.039) compared with the patients with BES. After propensity score matching, 2-year clinical outcomes showed no differences in composite MACEs or TLF between the two groups. Multivariate Cox regression analysis showed that stent type was not a predictor of 2-year mortality or MACEs. However, older age (hazard ratio [HR] 1.037, 95% confidence interval [CI] 1.014-1.060, p = 0.001), diabetes mellitus (HR 2.247, 95% CI 1.426-3.539, p = 0.001) and a left ventricular ejection fraction < or = 45% (HR 3.007, 95% CI 1.978-4.573, p = 0.001) were independent predictors for 2-year MACEs in patients undergoing EES or BES. CONCLUSIONS: Patients with BES had similar clinical 2-year outcomes compared with EES patients with AMI.
Diabetes Mellitus
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Humans
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Mortality
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Myocardial Infarction*
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Percutaneous Coronary Intervention
;
Prevalence
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Prognosis
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Propensity Score
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Stents*
;
Stroke Volume
8.The Association of Socioeconomic Status with Three-Year Clinical Outcomes in Patients with Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention.
Jeong Hun KIM ; Myung Ho JEONG ; In Hyae PARK ; Jin Soo CHOI ; Jung Ae RHEE ; Doo Hwan LEE ; Soo Hwan PARK ; In Soo KIM ; Hae Chang JEONG ; Jae Yeong CHO ; Soo Young JANG ; Ki hong LEE ; Keun Ho PARK ; Doo Sun SIM ; Kye Hun KIM ; Young Joon HONG ; Hyung Wook PARK ; Ju Han KIM ; Youngkeun AHN ; Jeong Gwan CHO ; Jong Chun PARK
Journal of Korean Medical Science 2014;29(4):536-543
The aim of this study was to evaluate whether the clinical outcomes were associated with socioeconomic status (SES) in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI). The author analyzed 2,358 patients (64.9 +/- 12.3 yr old, 71.5% male) hospitalized with AMI between November 2005 and June 2010. SES was measured by the self-reported education (years of schooling), the residential address (social deprivation index), and the national health insurance status (medical aid beneficiaries). Sequential multivariable modeling assessed the relationship of SES factors with 3-yr major adverse cardiovascular events (MACEs) and mortality after the adjustment for demographic and clinical factors. During the 3-yr follow-up, 630 (26.7%) MACEs and 322 (13.7%) all-cause deaths occurred in 2,358 patients. In multivariate Cox proportional hazards regression modeling, the only lower education of SES variables was associated with MACEs (hazard ratio [HR], 1.41; 95% confidence interval [CI], 1.04-1.91) and mortality (HR, 1.93; 95% CI, 1.16-3.20) in the patients with AMI who underwent PCI. The study results indicate that the lower education is a significant associated factor to increased poor clinical outcomes in patients with AMI who underwent PCI.
Acute Disease
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Age Factors
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Aged
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*Angioplasty, Balloon, Coronary
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Cohort Studies
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Demography
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Female
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Follow-Up Studies
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Humans
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Male
;
Middle Aged
;
Myocardial Infarction/economics/mortality/*therapy
;
*Percutaneous Coronary Intervention
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Proportional Hazards Models
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Retrospective Studies
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Risk Factors
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Sex Factors
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Social Class
;
Socioeconomic Factors
;
Treatment Outcome
9.A Comparison of Tiotropium 18microgram, Once Daily and Ipratropium 40microgram, 4 Times Daily in a Double-Blind, Double-Dummy, Efficacy and Safety Study in Adults with Chronic Obstructive Pulmonary Disease.
Seung Joon KIM ; Myung Sook KIM ; Sang Haak LEE ; Young Kyoon KIM ; Hwa Sik MOON ; Sung Hak PARK ; Sang Yeub LEE ; Kwang Ho IN ; Chang Youl LEE ; Young Sam KIM ; Hyung Jung KIM ; Chul Min AHN ; Sung Kyu KIM ; Kyung Rok KIM ; Seung Ick CHA ; Tae Hoon JUNG ; Mi Ok KIM ; Sung Soo PARK ; Cheon Woong CHOI ; Jee Hong YOO ; Hong Mo KANG ; Won Jung KOH ; Hyoung Suk HAM ; Eun Hae KANG ; O Jung KWON ; Yang Deok LEE ; Heung Bum LEE ; Yong Chul LEE ; Yang Keun RHEE ; Won Hyuk SHIN ; Sung Yeon KWON ; Woo Jin KIM ; Chul Gyu YOO ; Young Whan KIM ; Young Soo SHIM ; Sung Koo HAN ; Hye Kyung PARK ; Yun Seong KIM ; Min Ki LEE ; Soon Kew PARK ; Mi Hye KIM ; Won Yeon LEE ; Suk Joong YONG ; Kye Chul SHIN ; Byoung Whui CHOI ; Yeon Mok OH ; Chae Man LIM ; Sang Do LEE ; Woo Sung KIM ; Dong Soon KIM ; Sung Soo JUNG ; Ju Ock KIM ; Young Chun KO ; Young Chul KIM ; Nam Soo YOO
Tuberculosis and Respiratory Diseases 2005;58(5):498-506
BACKGROUND: This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules (18microgram once daily) with a ipratropium metered dose inhaler (2 puffs of 20microgram q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). METHOD: After the initial screening assessment and a two-week run-in period, patients received either tiotropium 18microgram once daily or ipratropium 40microgram four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. RESULT: In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted FEV1 of 42 (12)% were analyzed. The trough FEV1 response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. CONCLUSION: This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.
Adult*
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Albuterol
;
Bronchodilator Agents
;
Capsules
;
Forced Expiratory Volume
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Humans
;
Inhalation
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Ipratropium*
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Lung
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Mass Screening
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Metered Dose Inhalers
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Outcome Assessment (Health Care)
;
Peak Expiratory Flow Rate
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Pulmonary Disease, Chronic Obstructive*
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Surveys and Questionnaires
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Vital Capacity
;
Tiotropium Bromide