PURPOSE: Demand of specialized maternity ward is increasing as national income level rises. However, the National Health Insurance limits the number of hospital's non-standard room to less than 50% of total hospital beds. Therefore, this research was performed to investigate the utilization rate of non-standard room among the Korean women who recently delivered baby in medical facilities in order to examine the factors affecting their selection. METHODS: One hundred sixty six medical facilities which deliver a minimum of ten cases in 2011 were selected and categorized by type, region, and size. A cross-sectional survey was done in November 2012 by a professional research survey company. Eight hundred and two pregnant women answered the questionnaire through a face-to-face interview. RESULTS: Of the 802 expecting mothers, 690 (86%) occupied non-standard room and 684 (85.2%) preferred non-standard room to the standard room. Satisfaction levels were significantly higher in mothers occupying non-standard room [5.9+/-1.0 vs. 5.4+/-1.2 (0-7 scale), P<0.01] and high-income families used non-standard room more often. Reasons for using non-standard room included adequate convalescence (78%), separate place for breastfeeding (6.1%), and convenience on receiving visitors (5.4%). Preference for non-standard room on next visit was higher in case of delivery compared to other cause of hospitalization (81.8% vs. 44.9%, P<0.001). CONCLUSIONS: Preference and actual use of non-standard room after delivery were significant. In spite of concrete preference, there was certain barrier in use of non-standard room according to the income and types of hospitals. Therefore, changes of policy such as insurance support for room charge may be needed in case of delivery.
Breast Feeding ; Convalescence ; Cross-Sectional Studies ; Female ; Hospitalization ; Humans ; Insurance ; Maternal Health Services ; Mothers* ; National Health Programs ; Patients' Rooms ; Postpartum Period ; Pregnant Women ; Surveys and Questionnaires ; Maternal Health

Calbindin-D9k (CaBP-9k) is a cytosolic calcium-binding protein expressed in tissues in the intestine, uterus, placenta, kidney, pituitary gland and bone. Its exact function is unknown, but it is considered to regulate intracytoplasmic concentration and transport of free ions (Ca2+). CaBP-9k protein is involved in intestinal calcium absorption in the intestine and in the regulation of myometrial activity by intracellular calcium in the uterus. Renal CaBP-9k protein is expressed at the site of calcium re-absorption in the kidney and expressed in distal convoluted tubules, where it is thought to facilitate calcium re-absorption. Expression of the CaBP-9k gene has been explored in most mammalians except in a canine model. Presently, we elucidated the expression of CaBP-9k mRNA and protein in the duodenum, kidney and uterus in a canine model involving two adult (2.5-year-old) female beagles. To collect tissues, the dogs were euthanized and then the abdominal cavity was exposed by midline incision. The proximal duodenum, cortex of kidney and uterine horn were collected. Expression of CaBP-9k mRNA was confirmed by reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR. CaBP-9k protein expression and localization were ascertained by Western blot analysis and immunohistochemistry, respectively. CaBP-9k mRNA was detected in the duodenum, but not in the kidney and uterus. Its protein was expressed only in the enterocytes of the duodenum. Taken together, the results indicate that CaBP-9k mRNA and protein are highly expressed in the enterocytes of the duodenum of a canine model, consistent with findings in other mammalian species.
Animals ; Blotting, Western/veterinary ; Calcium-Binding Protein, Vitamin D-Dependent/*biosynthesis/genetics ; Dogs/*physiology ; Duodenum/*physiology ; Female ; Immunohistochemistry/veterinary ; Kidney/*physiology ; RNA, Messenger/biosynthesis/genetics ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Transcription, Genetic ; Uterus/*physiology

BACKGROUND: Respiratory viruses (RV) are important pathogen in both children and immunocompromised hosts. Rapid diagnosis of RV is important to manage patients and to implement infection control measures. To investigate the testing situation in Korea, we performed surveillance for the 95 medical institutions. Due to the paucity of long-term, multi-center data on RV epidemiology in Korea, we analyzed data from 5 university hospitals. METHODS: Surveillance questionnaires were sent to 95 members of the Korean Society for Clinical Microbiology. The RV data from 5 university hospitals, 2001 through 2005, were collected retrospectively and analyzed for the isolation rate of each virus. RESULTS: Among the 63 institutions, who replied, 49% performed RV testing and 84% of the testing institutes were university hospitals. A hundred percent institutes tested for respiratory syncytial virus (RSV), whereas 81% tested for influenza virus (Flu), 74% for parainfluenza virus (PIV) and adenovirus each, 32% for rhinovirus, 23% for coronavirus, and 36% for metapneumovirus. PCR and/or culture were employed in 42% of the institutes, immunochromatography 29%, immunofluorescent assay 23%, and enzyme immunoassay 7%. Among the total 11,131 specimens received, virus was detected in 22%, ranging from 12% to 28% by hospital. The most frequently detected virus was RSV (54%) and followed by PIV (18%), Flu (15%), and adenovirus (13%). But species distributions of these viruses were quite different by hospital or by year. CONCLUSION: It is necessary for more active implementation of the RV testing because only 55% of university hospitals and 17% of general hospitals performed this test.
Academies and Institutes ; Adenoviridae ; Child ; Coronavirus ; Diagnosis ; Epidemiology* ; Hospitals, General ; Hospitals, University* ; Humans ; Immunochromatography ; Immunocompromised Host ; Immunoenzyme Techniques ; Infection Control ; Korea* ; Metapneumovirus ; Orthomyxoviridae ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Republic of Korea ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Surveys and Questionnaires

PURPOSE: In recent years, the authors experienced a distinctive clinical entity of multiple intestinal ulcerations and perforations in infants. The purpose of this study was to describe the clinical characteristics of this entity, examine th possible pathogenesis and the effective treatment. METHODS: Seven infants underwent abdominal exploration under suspicion of surgical abdomen and were noted to have multiple intestinal ulcerations and perforations without evidence of necrotizing enterocolitis by the members of the Korean Association of Pediatric Surgeons. The clinical courses, operative findings, bacterial cultures, pathologic findings, treatment and prognosis of these seven cases were evaluated retrospectively. RESULTS: The characteristics of this entity are as follows : The initial presenting symptoms were all different. Despite conservative treatment with a broad spectrum of antibiotics, diarrhea and abdominal distention developed and progressively grew worse. At laparotomy, all patients exhibited numerous typical transverse linear ulcerative lesions with pin-point perforations scattered mainly in the small bowel. Histologic evaluations of the resected specimens revealed mucosal ulcerations with neutrophil infiltration, submucosal microabscesses and colonies of gram-positive cocci. Methicillin-resistant Staphylococcus aureus(MRSA) was the predominant organism cultured from the body fluid. Only two cases, the completely-resected one and the one immediately treated with vancomycin after operation, survived. CONCLUSION: We think this distinct clinical entity exhibiting multiple intestinal ulcerations and perforations is caused by MRSA occurring in infants. It has a high mortality because it is verydifficult to diagnosis in young infants before laparotomy. Vancomycin is highly effective in treating MRSA, so we think the early diagnosis of this entity can make the treatment successful.
Abdomen ; Anti-Bacterial Agents ; Body Fluids ; Diagnosis ; Diarrhea ; Early Diagnosis ; Enterocolitis, Necrotizing ; Gram-Positive Cocci ; Humans ; Infant* ; Intestinal Perforation ; Laparotomy ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mortality ; Neutrophil Infiltration ; Prognosis ; Retrospective Studies ; Staphylococcus ; Ulcer* ; Vancomycin

PURPOSE: In recent years, the authors experienced a distinctive clinical entity of multiple intestinal ulcerations and perforations in infants. The purpose of this study was to describe the clinical characteristics of this entity, examine th possible pathogenesis and the effective treatment. METHODS: Seven infants underwent abdominal exploration under suspicion of surgical abdomen and were noted to have multiple intestinal ulcerations and perforations without evidence of necrotizing enterocolitis by the members of the Korean Association of Pediatric Surgeons. The clinical courses, operative findings, bacterial cultures, pathologic findings, treatment and prognosis of these seven cases were evaluated retrospectively. RESULTS: The characteristics of this entity are as follows : The initial presenting symptoms were all different. Despite conservative treatment with a broad spectrum of antibiotics, diarrhea and abdominal distention developed and progressively grew worse. At laparotomy, all patients exhibited numerous typical transverse linear ulcerative lesions with pin-point perforations scattered mainly in the small bowel. Histologic evaluations of the resected specimens revealed mucosal ulcerations with neutrophil infiltration, submucosal microabscesses and colonies of gram-positive cocci. Methicillin-resistant Staphylococcus aureus(MRSA) was the predominant organism cultured from the body fluid. Only two cases, the completely-resected one and the one immediately treated with vancomycin after operation, survived. CONCLUSION: We think this distinct clinical entity exhibiting multiple intestinal ulcerations and perforations is caused by MRSA occurring in infants. It has a high mortality because it is verydifficult to diagnosis in young infants before laparotomy. Vancomycin is highly effective in treating MRSA, so we think the early diagnosis of this entity can make the treatment successful.
Abdomen ; Anti-Bacterial Agents ; Body Fluids ; Diagnosis ; Diarrhea ; Early Diagnosis ; Enterocolitis, Necrotizing ; Gram-Positive Cocci ; Humans ; Infant* ; Intestinal Perforation ; Laparotomy ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mortality ; Neutrophil Infiltration ; Prognosis ; Retrospective Studies ; Staphylococcus ; Ulcer* ; Vancomycin

PURPOSE: Enteroviruses (EVs) are commonly known to cause infection, especially in infants and children. This report presents an overview of enterovirus epidemiology in central Korea. METHODS: From the spring of 2005 to the autumn of 2006, we collected the cerebrospinal fluid (CSF) and stool samples from the pediatric patients with a febrile illness or suspected meningitis who were admitted to hospitals in central Korea. In order to test for EVs, cell lines were derived from pretreated susceptible specimen, and the cytopathic effects were observed. Seminested real time-polymerase chain reaction (RT-PCR) and direct sequencing were performed for genotypic and phylogenetic analyses. RESULTS: Of the 305 patients examined, 51 (16.7%) tested positive for EV. Of these 51 patients, 44 showed the following serotypes: Echovirus (ECV) 18 (18 cases, 35.2%), Coxsackievirus B (CVB) 5 (13 cases, 25.4%), ECV25 (5 cases, 9.8%), ECV9 (4 cases, 7.8%), ECV5 (3 cases, 5.8%), and EV74 (1 case, 1.9%). In 2005, between June and August, ECV18 and CVB5 were mostly responsible for the enteroviral infections among the patients in central Korea. In 2006, between July and August, ECV25 was mostly the cause of enteroviral infection. Conclusions: There is a need for continuous surveillance of enteroviral infection and its clinical manifestations, particularly for EV74, which was first identified in Korea.
Cell Line ; Child ; Enterovirus ; Enterovirus B, Human ; Humans ; Infant ; Korea ; Meningitis

PURPOSE: Enteroviruses (EVs) are commonly known to cause infection, especially in infants and children. This report presents an overview of enterovirus epidemiology in central Korea. METHODS: From the spring of 2005 to the autumn of 2006, we collected the cerebrospinal fluid (CSF) and stool samples from the pediatric patients with a febrile illness or suspected meningitis who were admitted to hospitals in central Korea. In order to test for EVs, cell lines were derived from pretreated susceptible specimen, and the cytopathic effects were observed. Seminested real time-polymerase chain reaction (RT-PCR) and direct sequencing were performed for genotypic and phylogenetic analyses. RESULTS: Of the 305 patients examined, 51 (16.7%) tested positive for EV. Of these 51 patients, 44 showed the following serotypes: Echovirus (ECV) 18 (18 cases, 35.2%), Coxsackievirus B (CVB) 5 (13 cases, 25.4%), ECV25 (5 cases, 9.8%), ECV9 (4 cases, 7.8%), ECV5 (3 cases, 5.8%), and EV74 (1 case, 1.9%). In 2005, between June and August, ECV18 and CVB5 were mostly responsible for the enteroviral infections among the patients in central Korea. In 2006, between July and August, ECV25 was mostly the cause of enteroviral infection. Conclusions: There is a need for continuous surveillance of enteroviral infection and its clinical manifestations, particularly for EV74, which was first identified in Korea.
Cell Line ; Child ; Enterovirus ; Enterovirus B, Human ; Humans ; Infant ; Korea ; Meningitis

Congenital hypertrophic pyloric stenosis is characterized by projectile vomiting and pyloric thickening, and must be differentiated with gastroesophageal reflux. Gastroesophageal reflux may defined as relaxation of lower esophageal sphincter causing return of stomach content into eophagus, and frequently associated with hiatal hernia. The authors presented a case, having congenital hypertrophic pyloric stencsis and gastroesophageal reflux simultaneously which must be differentiated each other, in 28 days old newborn male with chief problem of severe projectile vomiting. A brief review of literatures was made on this subject.
Constriction, Pathologic* ; Esophageal Sphincter, Lower ; Gastroesophageal Reflux* ; Gastrointestinal Contents ; Hernia, Hiatal ; Humans ; Infant, Newborn ; Male ; Pyloric Stenosis, Hypertrophic ; Relaxation ; Vomiting

PURPOSE: To analyse the expression of the p53 tumour suppressor gene in the synovial tissue from rheumatoid patients. Material and Methods : Synovial membranes were obtained from 13 patients diagnosed as having RA, and 9 osteoarthritis (OA) patients. We studied p53 expression by immunohistochemical analysis and p53 DNA sequence using direct DNA preparation method. RESULT: In immunohistological studies, the Do-1 monoclonal antibody stained at 6 specimens out of the 13 rheumatoid arthritis tissue biopsies analysed. There was no p53 mutation in osteoarthritis samples, but there were 4 p53 mutations from the 13 rheumatoid arthritis samples. p53 mutations were found at the codon 177 (CTG to CTA, GA), 277 (TGT to TGC, TC), and, two patients at the codon 237 (CAT to TAT, CT). CONCLUSION: The predicted amino acid substitutions in p53 were similar to those commonly observed in a variety of tumors and might influence growth and survival of rheumatoid synoviocytes.
Amino Acid Substitution ; Arthritis, Rheumatoid* ; Base Sequence ; Biopsy ; Codon ; DNA ; Genes, Suppressor ; Genes, Tumor Suppressor* ; Humans ; Immunohistochemistry ; Membranes ; Osteoarthritis ; Synovial Membrane*

PURPOSE: To introduce the CMV promoter driven luciferase and -galactosidase marker gene into previously permeabilized human chondrial cells. MATERIALS AND METHODS: The cultured chondrocyte cells were transfected with a liposome/DNA mixture (pCMV-Luc or pSV40-lacZ). Cultured cells not transfected by liposome/DNA were used as a control. After forty-eight hours of incubation, the cells were used for reporter gene assays and the polymerase chain reaction (PCR). RESULTS: Fifteen percent of the chondrocyte cells treated with liposome/ pSV40-lacZ DNA were positive for -gal staining. Chondrocyte cells transfected with pCMV-Luc yielded a 70-fold increase in luciferase activity over that of the control cells. A PCR product corresponding to the luciferase gene appeared only in the transfected chondrocyte cells. These results indicate that the human chondrocyte cells can be transfected with pCMV-Luc and pSV40-lacZ. CONCLUSION: This system is particularly suitable for gene therapy, as well as for the use of genetically modified cartilage cells for resurfacing full thickness articular cartilage defects.
Cartilage ; Cartilage, Articular ; Cells, Cultured ; Chondrocytes* ; DNA ; Genes, Reporter ; Genetic Therapy ; Humans* ; Liposomes* ; Luciferases ; Polymerase Chain Reaction ; Transfection*