Impact of Interferon-Based Treatment on Quality of Life and Work Related Productivity from the Korean Cohort in the MOSAIC Study

( Sang Hoon Ahn ),( Won Hyeok Choe ),( Yoon Jun Kim ),( Jeong Heo ),( Dorota Latarska-smuga ),( Jiho Kang ),( Seung Woon Paik ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Chronic Hepatitis C Virus (HCV) infection increases the risk for progressive liver disease, hepatocellular carcinoma and negatively impacts the patient’s quality of life. HCV treatment is evolving with direct acting antivirals but IFN based therapy has been the standard of care for many years and remains available in some countries. The MOSAIC study aims to characterize patients with chronic HCV infection and assess the impact of IFN-containing treatment on health-related quality of life, work related productivity and health care utilization. Methods: MOSAIC is an international prospective multicenter observational study that has been conducted in 20 countries. Consecutive patients with chronic HCV infection were enrolled and those who initiated an IFN based regimen were prospectively followed for 48 weeks. We report results from the Korean cohort Results: 100 patients were enrolled: 86 were treatment naïve and 14 were treatment experienced. 33 patients initiated an IFN based regimen: 6 patients started IFN + RBV, 26 patients started Peg-IFN + RBV, none started Peg-IFN + RBV + DAA and 1 patient received other treatment. Among the treated cohort, demographic and disease characteristics were the following: the mean age was 54.5 years; 14 patients were male. 14 had minimal or no fibrosis, 2 portal fibrosis, 3 bridging fibrosis and 6 patients suffered from cirrhosis. HCV Genotype distribution was as follows: genotype 1: 11; genotype 2: 19 and genotype 3: 3. Table 1 describes the results at baseline and changes over 4, 12 and 48 weeks and end-of-treatment (EOT) for the quality of life and work productivity outcome measures (EQ-5D-5L, HCV-PRO and WPAI). Conclusions: Results from the Korean cohort of the MOSAIC study show a moderate trend for deterioration of health-related quality of life and work productivity associated with IFN based treatment for patients with chronic HCV infection during treatment period. Acknowledgements: The design, study conduct, analysis, and financial support of MOSAIC study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the content of the abstract. All authors had access to all relevant data and participated in writing, review, and approval of this abstract. Medical writing support was provided by Olivier Van de Steen of Medeor-consulting, funded by AbbVie. Disclosures: Sang Hoon Ahn: served as an advisor and lecturer for Bristol-Myers Squibb, Gilead Sciences, F.Hoffmann-La Roche, Merck, AbbVie, and has received unrestricted grants from Bristol-Myers Squibb, Gilead Sciences, and F. Hoffmann-La Roche for investigator- initiated trials Won Hyeok Choe: Nothing to disclosure Yoon Jun Kim: Nothing to disclosure Jeong Heo: received a grant from GSK; Research support from BMS, and Roche; Advisor for Abbvie, BMS, Gilead Sciences, Pharma Essentia, SillaJen, and Johnson & Johnson. Dorota Latarska-Smuga, Jiho Kang: are employees of AbbVie, Inc. and may hold stock or stock options. Seung Woon Paik: received grant and research support from AbbVie, BMS, Gilead, GSK, Merck, Novartis, and Roche

Investigation of the April 2000 forest fire damage in Kang-won Province, Korea, using RADARSAT data

Kang, Sung Chul,Seo, Jin Won,Lee, Tae Hee,Park, Sang Eun,Hong, Suk Young,Moon, Wooil M. 대한원격탐사학회 2000 International Symposium on Remote Sensing Vol.16 No.1

The series of forest Fires in Kangwon Province in April, 2000, were one of the mast serious ones in the Kang-won Province in recent years. The fire damaged areas are extensive and this paper investigates the utility of the satellite image data, particularly the RADARSAT SAR data. One of the main objectives of this study included evaluation of potential usefulness of the C-band RADARSAT data in the detection of forest fires in mountainous areas. Among several fire damaged sites, the area near Samchuk (city) was selected as the main study area and mufti-temporal RADARSAT(raw) data were acquired and the processed results were comparatively investigated with the IRS-1c data acquired shortly after the fire. To identify the burnt area from the undamaged background in the optical imagery, supervised classification and NDVI processing were carried out and tested with the IRS-1C data. For this experiment, several sets of raw RADARSAT standard and Fine mode (S4, F3, ascending orbit) data were processed and the final image was formed. In addition to the final image, sigma nought (σ°) was catnputed and compared for the burnt area against the undamaged areas. Because of the steep slopes in the study area and subsequent deviation from the flat surface scattering models, the fire scars in the sigma nought (σ°) image were not apparent. However, fire scars are slightly detected in the difference and ratio images obtained from the signal intensity data acquired at different dates (bath before and after fire). Texture analysis of the image data including the burnt areas were carried out using the Multiplicative Markov Random-Field (MMRF) algorithm. The detection of the fire damaged area from both standard mode and fine mode RADARSAT was not as straightforward as in optical data. However, Previous studies with ERS-1 S_AR and RADARSAT data in Indonesia and in the North American Plains indicate that C-band SAR data provide us with an effective tool for studying the forest fire damages. However, the application of C-band SAR data to the analysis of the forest fire areas requires careful processing of the data with realistic scattering models.

c-형강 및 ebb & flow 방식에 따른 경제성 분석

강승원(Seung Won Kang),박천호(Chun Ho Pak),조용성(Yong Sung Cho) 한국원예학회 2007 원예과학기술지 Vol.25 No.3

관비재배와 저면관수인 ebb & flow, C-형강의 재배방식에 따른 고품질분화 생산을 위한 재배농가의 경제성을 분석하였다. 이를 위해 화훼농가의 비용구조를 분석하였고 자본 회수기간 및 내부수익률의 추정, 관수에 따른 인건비 절감 효과를 분석하여 재배방식에 따른 경제성을 비교하였다. 10a(991.7m²) 규모의 자동온실에 대해 관비재배방식을 선택한 시클라멘 재배농가의 총 비용은 9,993.8만원으로 추정되며, 이 중 시설비는 74%(7,410만원)를 점하고 연간 2,583.8만원의 경영비를 지출할 것으로 예상된다. 반면, C-형강방식을 선택한 재배농가는 초기 시설비용으로 약 8,520.0만원(총비용의 약 70%)을 지출하고, 매년 경영비로 3,597.0만원을 지출할 것으로 추정된다. 한편, 투자자금에 대한 자본회수 기간을 분석한 결과 10a 규모의 자동온실에서 시클라멘을 재배하는 농가에서 관비재배방식 혹은 C-형강방식을 선택할 경우에는 초기시설투자비 회수기간이 약 4 년 정도 소요될 것으로 예측되며, ebb & flow 방식을 선택할 경우에는 약 5년 정도의 시간이 소요될 것으로 예상된다. 또한, 내부 수익률을 추정한 결과 ebb & flow시설과 C-형강시설을 5년과 6년씩 사용한다고 가정할 경우, ebb & flow시설의 내부 수익률은 각각 9%와 14%로 나타났고, C-형강시설의 경우에는 각각 13%와 17%로 나타나 시중의 저축성예금 수신금리 4.82%와 비교하여 경제성이 높은 것으로 분석되었다. Economical efficiency for production of high quality-potted plants was analyzed by types of irrigation system such as conventional fertigation, ebb & flow, and C-channel as subirrigation systems. After cost structure was analyzed, payback period of capital, internal rate return (IRR), and effects of reduced labor cost were estimated. The gross cost of cyclamen-producing farmers using hydroponic systems in automated greenhouses (10a) was about 100 million won. Of the gross cost, installation and operation costs occupied 74% and 25%, respectively. In the C-channel subirrigation system, gross cost was 120 million won approximately. Installation and operation costs occupied 70% and 30%, respectively. Payback period of capital was 4 years for fertigated irrigation and C-channel subirrigation system, whereas it was 5 years for ebb & flow. IRR of ebb & flow and C-channel subirrigation systems was higher than the interest rates of 4.82%, indicating economic efficiency.

CM전문회사의 현장관리조직 운영실태 분석

신원상(Shin, Won-Sang),이강민(Lee, Kang-Min),손창백(Son, Chang-Baek) 대한건축학회 2014 大韓建築學會論文集 : 構造系 Vol.30 No.8

This study is aimed at offering basic data for enhancing the organizational structure and productivity of on-site construction management (CM) employees. To accomplish the objective, the organizational operation system and employee evaluation of domestic CM companies were analyzed by site scale to promote efficient operation. The findings are as follows. First, in terms of CM workforce, the employees handling architecture, electricity, and machines represented the highest proportion. As for qualification, top engineers were dispatched to both large-scale and small-scale CM sites more than any other employee. Second, the results on CM organizational productivity are as follows. The per capita sales increased as the service payment increased. In terms of scale, the site worth less than a billion won had per capita sales of 76 million won, about 5 times less than the site worth 5 billion won or more whose per capita sales were 371 million won. The monthly per capita sales also increased as the service payment increased. However, the difference was minimal, about a half of the difference in per capita sales. These findings would be useful for companies that have no systematic criteria for CM organization selection and evaluation.

우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계

강혜영,강대룡,장영화,박성은,최원정,문성환,양규현,Kang, Hye-Young,Kang, Dae-Ryong,Jang, Young-Hwa,Park, Sung-Eun,Choi, Won-Jung,Moon, Seong-Hwan,Yang, Kyu-Hyun 대한예방의학회 2008 예방의학회지 Vol.41 No.5

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

필리핀 여행 후 발생한 쯔쯔가무시병 1예

김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up, Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

급냉 제강슬래그를 잔골재로 사용한 차폐콘크리트의 공학적 특성에 관한 실험적 연구

강기웅,조성현,정원섭,권기주,김진만,김무한 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

The steel slag, a by~product which is produced during the manufacture of steel by refining pig iron, is mainly used as road materials after aging it. It is necessary to age steel slag for long time in air because the reaction with water and free-CaO in steel slag could make the expansion of volume. This problem prevents steel slag from being used as aggregate for concrete. However, steel slag used in this study was controled by a air-jet method which rapidly cools substance melted at a high temperature. The rapid-chilling method prevents from generation of free-CaO in steel slag. The rapid-chilled steel slag is similar to be spherical shape and has the heavier specific gravity than natural aggregate. Therefore, it could be used to manufacture radiation shielding concrete as fine aggregate. This paper investigated the engineering properties of radiation shielding concrete when using rapid-chilled steel slag as fine aggregate. As results of this study, the increase of use of rapid-chilled steel slag decreased the desirable water content of concrete but developed the rate of radiation shielding of concrete. The strength of concrete using it is similar to that of concrete using river sand.

광범위 베타 락탐계 항생제 분해 효소를 생성하는 폐렴간균에 의한 균혈증이 발생한 환자에서 감영의 위험 인자 및 치료 결과

강철인,김성한,방지환,김홍빈,박상원,최영주,오명돈,김의종,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.2

목적 : 본 연구는 ESBL을 생성하는 K. pneumoniae에 의한 균혈증 환자에서 감염의 위험 인자 및 치료 결과를 알아보고자 시행하였다. 방법 : 1998년 1월부터 2002년 4월까지 혈액 배양 검사에서 동정된 K. pneumoniae를 대상으로 NCCLS guidelines과 이중 디스크 확산법(double-disk diffusion test)을 이용하여 ESBL 생성 여부를 확인하였다. ESBL 생성 균주에 의한 균혈증 환자 60명(환자군)에 대해 ESBL을 생성하지 않는 균주에 의한 균혈증 환자들(대조군)을 연령, 성별, 균혈증 발생 시점을 고려하여 1:2 또는 1:3으로 배정하였다. 총 159명의 대조군을 선정하였고 후향적인 환자-대조군 연구를 시행하였다. 결과 : 환자군과 대조군 사이에 연령, 성별, APACHE Ⅱ score, 주된 감염 부위의 유의한 차이는 없었다. ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 발생할 독립적인 위험 인자에는 요관 삽입, 균혈증 발생 이전 72시간 동안 침습적인 시술을 받은 경우, 균혈증 발생 이전 30일 동안 투여받은 항생제 개수가 있었다. 초기 항생제 치료 72시간 후의 반응을 평가하였을 때, 완전 반응(complete response)은 대조군에서 더 많았고(13.3% vs. 40.3%, P<0.001), 치료 실패(treatment failure)는 환자군에서 더 많았다(33.3% vs. 11.9%, P<0.001). 7일 사망률은 환자군에서 20% (12/60), 대조군에서 15.6% (25/159)이었고(P=0.451), 30일 사망률은 환자군에서 30% (18/60), 대조군에서 24.5% (39/159)이었다(P=0.410). ESBL 생성 균주에 의한 균혈증이 있는 환자들에서 최종 항생제 치료가 부적절했던 환자들을 제외하고 30일 사망률을 분석하였을 때 효과적인 항생제 치료의 지연은 사망률을 높이지 않았다(11.1% vs. 9.1%, P=1.000). 결론 : ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 있는 환자에서 초기 항균제 치료 72시간 후의 치료 반응률은 낮지만 사망률은 유의하게 증가하지 않았다. 원인균이 동정된 후 최종 치료 항생제의 선정이 적절하다면 초기에 효과적인 항생제 투여의 지연은 사망률을 유의하게 증가시키지는 않았다. Background : This study was conducted to evaluate risk factors for infection and treatment outcome of bloodstream infection due to extended spectrum β-lactamases(ESBL)-producing K. pneumoniae. Methods: ESBL production was evaluated by NCCLS guidelines and/or double-disk synergy test in K. pneumoniae blood isolates stored from January, 1998 to April, 2002. Sixty patients with bloodstream infection due to ESBL-producing K. pneumoniae (case patients) were compared with 159 matched control patients with bloodstream infection of non-ESBL-producing K. pneumoniae. Retrospective case-control study was performed. Results : There were no significant differences in age, sex, APACHE Ⅱ score, and the primary site of infection between the case and control groups. In multivariate analysis, significant independent risk factors associated with bloodstream infection due to ESBL-producing K. pneumoniae were urinary catheterization, invasive procedure within previous 72 hours, and the number of antibiotics administered within previous 30 days. In clinical response at 72 hours after initial antibiotic treatment, complete response rate was higher in the controls (13.3% vs. 40.3%, respectively, P<0.001), however, treatment failure rate was higher in the cases (33.3% vs. 11.9%, respectively, P<0.001). Overall 7-day mortality rates in the cases and the controls were was 20% (12/60) and 15.7% (25/159) (P=0.451), respectively, and overall 30-day mortality rates were 30% (18/60) and 24.5% (39/159), respectively (P=0.410). When the patients with bloodstream infection of ESBL-producing organism were evaluated and the patients who received inadequate definitive antibiotic treatment were excluded, delayed effective antibiotic treatment was found to be not associated with higher mortality. Conclusion : In patients infected with ESBL-producing K. pneumoniae bacteremia, clinical response rate at 72 hours after antimicrobial therapy was lower, but the increase of mortality rate was not significant. Delayed effective antibiotic treatment was not associated with higher mortality, when definitive appropriate antibiotic treatment was prescribed.

의료관계 해부 감정예의 분석적 연구(I) : 1990년 국립과학수사연구소 감정예

姜信夢,李垣兌,李漢榮,尹順雄,全基悳,金相鉉,徐在冠,尹重鎭 大韓法醫學會 1991 대한법의학회지 Vol.15 No.2

A study of 118 autopsy cases associated with medical care in 1990 was present according to the medical department, the mode of treatment and the cause of death. The Pediatrics showed the highest rate (25.4%), followed by the Obstetrics & Gynecology (22.9%), and Internal medicine (20.2%). According to the mode of treatment, medical accidents during operation and anesthesia were 29 cases (24.6%) with highest rate in Obstetrics & Gynecology (13 cases), 38 cases (32.2%) were during medication and/or injection with highest rate in Internal Medicine (18 cases), and 51 cases (43.2%) were during general medical practice with highest rate in pediatrics (19 cases). The most prevalent cause of death was the disease of respiratory system (34.9%, 30 cases) and the diseases of cardiovascular and urogenital system accounted for 31.4% and 11.6% respectively. The main cause of death in Internal medicine was the disease of cardiovascular system (11/24 cases), the respiratory system in pediatrics (15/30 cases) and the disease of urogenital system in Obstetrics & Gynecology (9/27 cases. ) Asphyxial deaths were 7 cases and the death due to adverse drug reaction accounted for 10 cases.