Lee J.-Y.,Yonsei University |
Kim Y.,Institute of Health and Environment |
Lee T.-J.,Seoul National University |
Jeon Y.W.,Korean Health Promotion Foundation |
And 2 more authors.
Journal of Gynecologic Oncology | Year: 2015
Objective: To evaluate the cost-effectiveness of nodal staging surgery before chemoradiotherapy (CRT) for locally advanced cervical cancer in the era of positron emission tomography/computed tomography (PET/CT). Methods: A modified Markov model was constructed to evaluate the cost-effectiveness of para-aortic staging surgery before definite CRT when no uptake is recorded in the para-aortic lymph nodes (PALN) on PET/CT. Survival and complication rates were estimated based on the published literature. Cost data were obtained from the Korean Health Insurance Review and Assessment Service. Strategies were compared using an incremental cost-effectiveness ratio (ICER). Sensitivity analyses were performed, including estimates for the performance of PET/CT, postoperative complication rate, and varying survival rates according to the radiation field. Results: We compared two strategies: strategy 1, pelvic CRT for all patients; and strategy 2, nodal staging surgery followed by extended-field CRT when PALN metastasis was found and pelvic CRT otherwise. The ICER for strategy 2 compared to strategy 1 was $19,505 per quality-adjusted life year (QALY). Under deterministic sensitivity analyses, the model was relatively sensitive to survival reduction in patients who undergo pelvic CRT alone despite having occult PALN metastasis. A probabilistic sensitivity analysis demonstrated the robustness of the case results, with a 91% probability of cost-effectiveness at the willingness-to-pay thresholds of $60,000/QALY. Conclusion: Nodal staging surgery before definite CRT may be cost-effective when PET/CT imaging shows no evidence of PALN metastasis. Prospective trials are warranted to transfer these results to guidelines. Keywords: Chemoradiotherapy; Cost-Benefit Analysis; Postoperative Complications; Quality-Adjusted Life Years; Uterine Cervical Neoplasms. © 2015. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.
Kim H.-S.,Institute of Health and Environment |
Kim D.-S.,Seoul Development Institute |
Kim H.,Institute of Health and Environment |
Yi S.-M.,Institute of Health and Environment
International Journal of Environmental Health Research | Year: 2012
This study examined the association between all-cause/cardiovascular mortality and PM2.5 as related to Asian dust (AD), smog-AD, smog, and nonevent days and evaluated the differential risks according to specific events for mortality. The daily records of all-cause/cardiovascular mortality and PM2.5 from March to May 2003-2006 in Seoul, Korea, were used as independent and dependent variables. Differences in the event effects were assessed using a time-series analysis. Both all-cause and cardiovascular mortalities were significantly associated with PM2.5 during smog-AD and AD days only. Differences in chemical composition emerging during long-range transport to Korea may explain these observations, especially as regards secondary aerosol, metal-sulfate/or nitrate, and metallic components. These results suggest that exposure to PM2.5 during specific events isdifferentially associated with human mortality and that changes in the chemicalcomposition of PM2.5, occurring during long-range transport, represent important factors in such differential effects on health. © 2012 Copyright Taylor and Francis Group, LLC.
Kim T.,Texas A&M University |
Kim T.,Institute of Health and Environment |
Cho S.-I.,Texas A&M University |
Cho S.-I.,Institute of Health and Environment |
And 2 more authors.
Optometry and Vision Science | Year: 2013
PURPOSE: To investigate the association between the degree of obesity and cataract. METHODS: We examined 3248 subjects (1421 men and 1827 women) aged 50 years and older who did not have a previous cataract operation. Data were derived from the fourth Korea National Health and Nutrition Examination Survey (2009). Cataract was evaluated by using Lens Opacities Classification System III. Body mass index was categorized into four groups (underweight, <18.5 kg/m; normal weight, 18.5 to 22.9 kg/m; overweight, 23.0 to 24.9 kg/m; and obese, ≥25.0 kg/m). Association between the degree of obesity and cataract was evaluated using logistic regression analyses with adjustments of age, the total pack-years of cigarettes smoked, the amount of pure alcohol (g) consumed per day, daily time spent in vigorous physical activity, diabetes mellitus, sunlight exposure, education level, and income. RESULTS: Compared with the normal-weight group, the overweight group had significantly lower risk of any type of cataract (odds ratio, 0.70; 95% confidence interval, 0.50 to 0.97) in men and (odds ratio, 0.70; 95% confidence interval, 0.51 to 0.97) in women in the multiple logistic regression analyses. We could not find any unusual lifestyles or metabolic risks for explaining this low cataract prevalence in the overweight groups. However, nutrient intakes (e.g., vitamin B2, niacin, vitamin C, and vitamin A) were highest in the overweight group. CONCLUSIONS: The overweight group had significantly lower risk of cataract formation than the normal-weight group in Korean population. © 2013 American Academy of Optometry.
Lee K.-C.,Institute of Health and Environment |
Beak H.-J.,Institute of Health and Environment |
Choo K.-H.,Kyungpook National University
Water Research | Year: 2015
A membrane photoreactor (MPR) system was investigated for the purification of textile wastewater effluent containing 1,4-dioxane for potential reuse. The effects of TiO2 dosage, alkalinity, particulate matter, and sunlight radiation on the removal of 1,4-dioxane from the effluent were evaluated. The photocatalytic 1,4-dioxane degradation followed pseudo-first order reaction kinetics. A considerably large dose of TiO2 catalyst (5g/L) was required for maximal 1,4-dioxane degradation by MPR. The high alkalinity (~550mg/L) of the textile wastewater effluent negatively affected the 1,4-dioxane degradation rate, whereas 1,4-dioxane degradation was not impacted by the presence of particulate matter. Solar photocatalysis of 1,4-dioxane was as effective as that achieved with UV lamps in the MPR, which could lead to energy savings. Continuous flow MPR was effective for continuous degradation of 1,4-dioxane; the unsteady- and steady-state performances were well-predicted at various hydraulic residence times (HRTs). The quality of the MPR product obtained at an HRT of 8.57h satisfied the drinking water guidelines. The transmembrane pressure (TMP) buildup, which is indicative of fouling, was dependent on the TiO2 dose and permeate flux. The TMP buildup was marginal at low flux, but increased dramatically beyond a flux level of >60L/m2-h. However, the fouling layer could be sufficiently removed by periodic backwashing, even at an extremely high flux of 100L/m2-h. The membrane permeability was sustained without any sign of irreversible fouling during MPR treatment of textile wastewater effluents. © 2015 Elsevier Ltd.
Jang S.I.,U.S. Department of Agriculture |
Jang S.I.,Institute of Health and Environment |
Kim D.K.,U.S. Department of Agriculture |
Lillehoj H.S.,U.S. Department of Agriculture |
And 7 more authors.
PLoS ONE | Year: 2013
Chickens were immunized subcutaneously with an Eimeria recombinant profilin protein plus Montanide™ ISA 70 VG (ISA 70) or Montanide™ ISA 71 VG (ISA 71) water-in-oil adjuvants, or with profilin alone, and comparative RNA microarray hybridizations were performed to ascertain global transcriptome changes induced by profilin/ISA 70 vs. profilin alone and by profilin/ISA 71 vs. profilin alone. While immunization with profilin/ISA 70 vs. profilin alone altered the levels of more total transcripts compared with profilin/ISA 71 vs. profilin alone (509 vs. 296), the latter was associated with a greater number of unique biological functions, and a larger number of genes within these functions, compared with the former. Further, canonical pathway analysis identified 10 pathways that were associated with genes encoding the altered transcripts in animals immunized with profilin/ISA 71 vs. profilin alone, compared with only 2 pathways in profilin/ISA 70 vs. profilin alone. Therefore, ISA 71 was selected as a candidate adjuvant in conjunction with profilin vaccination for in vivo disease protection studies. Vaccination with profilin/ISA 71 was associated with greater body weight gain following E. acervulina infection, and decreased parasite fecal shedding after E. maxima infection, compared with profilin alone. Anti-profilin antibody levels were higher in sera of E. maxima- and E. tenella-infected chickens vaccinated with profilin/ISA 71 compared with profilin alone. Finally, the levels of transcripts encoding interferon-γ, interleukin (IL)-2, IL-10, and IL-17A were increased in intestinal lymphocytes from E. acervulina-, E. maxima-, and/or E. tenella-infected chickens vaccinated with profilin/ISA 71 compared with profilin alone. None of these effects were seen in chickens injected with ISA 71 alone indicating that the adjuvant was not conferring non-specific immune stimulation. These results suggest that profilin plus ISA 71 augments protective immunity against selective Eimeria species in chickens.
Kim D.K.,U.S. Department of Agriculture |
Kim D.K.,Hankyong National University |
Lillehoj H.S.,U.S. Department of Agriculture |
Jang S.I.,U.S. Department of Agriculture |
And 5 more authors.
PLoS ONE | Year: 2014
Necrotic enteritis (NE) is an important intestinal infectious disease of commercial poultry flocks caused by Clostridium perfringens. Using an experimental model of NE involving co-infection with C. perfringens and Eimeria maxima, transcriptome profiling and functional genomics approaches were applied to identify the genetic mechanisms that might regulate the host response to this disease. Microarray hybridization identified 1,049 transcripts whose levels were altered (601 increased, 448 decreased) in intestinal lymphocytes from C. perfringens/E. maxima coinfected Ross chickens compared with uninfected controls. Five biological functions, all related to host immunity and inflammation, and 11 pathways were identified from this dataset. To further elucidate the role of host genetics in NE susceptibility, two inbred chicken lines, ADOL line 6 and line 7 which share an identical B2 major histocompatibility complex haplotype but differ in their susceptibility to virus infection, were compared for clinical symptoms and the expression levels of a panel of immune-related genes during experimental NE. Line 6 chickens were more susceptible to development of experimental NE compared with line 7, as revealed by decreased body weight gain and increased E. maxima oocyst shedding. Of 21 immune-related genes examined, 15 were increased in C. perfringens/E. maxima co-infected line 6 vs. line 7 chickens. These results suggest that immune pathways are activated in response to experimental NE infection and that genetic determinants outside of the chicken B complex influence resistance to this disease. © 2014, Public Library of Science. All rights reserved.
Yoo E.-C.,Institute of Health and Environment |
Park O.-H.,Pusan National University
Korean Journal of Chemical Engineering | Year: 2010
The characteristics of concentration variations for dust, O3, and its precursors in Busan, South Korea were analyzed on the basis of pollution data from 19 stations during 2005. The objectives of these analyses were (i) to observe the ozone precursor concentrations under various conditions, (ii) to examine the mechanism of high [O3] episode development, (iii) to examine the formation of photochemical aerosols, (iv) to observe the spatial distribution of high [O3] occurrence over time, and (v) to observe the spatial distributions of temperature and wind speed over the whole area of Busan on high [O3] episode days. The ratio of initial [NO2] to initial [NO], O3 dosage, and O3 formation/hazard potential were established as relevant parameters on which to base allocation of monitoring stations according to each regional type, and criteria based on these parameters were determined for reallocating stations over the Busan area according to various regional types based on monitoring purposes. It was found that the current allocations of stations for investigating photochemical pollution do not reflect the areas where high O3 occurs and areas where it is desirable to measure O3 and its precursors flowing out of the target area. Therefore, based on these criteria, reallocated monitoring stations according to each regional type were suggested. © 2010 Korean Institute of Chemical Engineers, Seoul, Korea.
Moon S.-S.,Hanyang University |
Park S.-M.,Institute of Health and Environment |
Cho S.-I.,Institute of Health and Environment
Journal of Biosocial Science | Year: 2010
This study investigated gender difference in the effects of social support, including emotional support and instrumental support (such as help when sick and financial assistance), and social activities on perceived health of middle-aged and older adults in South Korea. Data were acquired from 3771 men and 4954 women aged 40 years and older who participated in the 2005 cross-sectional survey of the Seoul Citizens Health and Social Indicators Survey. Using multiple regression analysis, both age- and gender-specific differences related to social support and engagement in social activities and self-rated poor health were examined. Poor emotional support from close friends, relatives or someone with whom one could talk about worries was strongly associated with poor self-rated health in men, with the greatest effect in older men. Lack of engagement in social activities was associated with self-rated poor health in older adults, especially in older men. Poor instrumental support was associated with perceived poor health only in middle-aged women. As a health improvement strategy for men aged 65 years and older especially, emotional support should be considered. Measures should be considered for encouraging social activities by older adults, particularly older men. © 2010 Cambridge University Press.
Seo K.,Institute of Health and Environment |
Lee J.E.,Institute of Health and Environment |
Lim M.Y.,Institute of Health and Environment |
Ko G.,Institute of Health and Environment
Journal of Food Protection | Year: 2012
We investigated the resistance of murine norovirus (MNV) and coliphage MS2, a culturable human norovirus surrogate, to temperature, salt, and pH. Virus inactivation was measured by plaque, real-time TaqMan reverse transcription (RT) PCR, and long-template RT-PCR assays. Both MNV and MS2 were rapidly inactivated at temperatures above 60°C. Similarly, MNV tolerated low salt concentrations (0.3% NaCl) to a greater degree than high salt concentrations (3.3 to 6.3% NaCl). MNV was relatively resistant to strong acidic conditions (pH 2) and was more tolerant of slightly acidic (pH 4) or neutral (pH 7) conditions. In contrast, MS2 was resistant to high salinity. Overall, temperature had a greater effect on infectivity than salt or low pH. Additionally, temperature and low pH had a synergistic effect on MNV infectivity. Both real-time and long-template RT-PCR assays significantly underestimated the inactivation by temperature, salt, and pH. The inactivation kinetics of both MNV and MS2 under various environmental conditions gave a good fit by the Weibull model (R 2 > 0.9). This study suggests both the capacity of infectious human norovirus to persist in the face of various environmental conditions and its sensitivity to high temperatures, which may provide a mechanism of protection against this virus. Copyright © International Association for Food Protection.
Work M.E.,Columbia University |
John E.M.,Cancer Prevention Institute of California |
John E.M.,Stanford Cancer Institute |
Andrulis I.L.,Samuel Lunenfeld Research Institute |
And 13 more authors.
British Journal of Cancer | Year: 2014
Background:Oestrogen receptor (ER)- and progesterone receptor (PR)-negative (ER-PR-) breast cancer is associated with poorer prognosis compared with other breast cancer subtypes. High parity has been associated with an increased risk of ER-PR- cancer, but emerging evidence suggests that breastfeeding may reduce this risk. Whether this potential breastfeeding benefit extends to women at high risk of breast cancer remains critical to understand for prevention.Methods: Using population-based ascertained cases (n=4011) and controls (2997) from the Breast Cancer Family Registry, we examined reproductive risk factors in relation to ER and PR status.Results:High parity (≥3 live births) without breastfeeding was positively associated only with ER-PR- tumours (odds ratio (OR)=1.57, 95% confidence interval (CI), 1.10-2.24); there was no association with parity in women who breastfed (OR=0.93, 95% CI 0.71-1.22). Across all race/ethnicities, associations for ER-PR- cancer were higher among women who did not breastfeed than among women who did. Oral contraceptive (OC) use before 1975 was associated with an increased risk of ER-PR- cancer only (OR=1.32, 95% CI 1.04-1.67). For women who began OC use in 1975 or later there was no increased risk.Conclusions:Our findings support that there are modifiable factors for ER-PR- breast cancer and that breastfeeding in particular may mitigate the increased risk of ER-PR- cancers seen from multiparity. © 2014 Cancer Research UK.