The renin-angiotensin system plays an important role in renal growth and development. Exposure of the fetus or neonate to angiotensin converting enzyme (ACE) inhibitors increases mortality, growth retardation, and results in renal anomalies. This study was designed to investigate the effects of ACE inhibition in the neonatal rat on the expression of genes known to modulate renal cellular proliferation, cell interactions, and extracellular matrix. Newborn rat pups were treated with enalapril (30mg/ kg/day) or vehicle for 14 days, and kidneys were removed for determination of mRNA for transforming growth factor-beta 1 (TGF- B1) and prepro epidermal growth factor (EGF). Enalapril treatment resulted in 40Yo mortality by day 14 as well as reduced body and kidney weight (P<0.05 vs vehicle group). Also enalapril decreased renal TGF-Bl and EGF mRNA expression (P<0.05). These results indicate that ACE inhibition in the developing kidney reduces the renal expression of critical growth factors, which may account for renal growth impairment.
Angiotensins* ; Animals ; Cell Communication ; Cell Proliferation ; Enalapril ; Epidermal Growth Factor ; Extracellular Matrix ; Fetus ; Growth and Development ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Kidney* ; Mortality ; Peptidyl-Dipeptidase A* ; Rats* ; Renin-Angiotensin System ; RNA, Messenger ; Transforming Growth Factor beta1

The Illness Intrusiveness Rating Scale (IIRS) measures illness-induced disruptions to 13 domains of lifestyles, activities, and interests. A stable three-factor structure has been well documented; however, the cross-cultural validity of this scale needs to be tested. This study investigated the factor structure of the Korean version of IIRS in 712 outpatients at a university medical center. A predominant diagnosis of the patients was rheumatoid arthritis (47%). The Center for Epidemiological Studies-Depression Scale (CES-D), and Health Assessment Questionnaire (HAQ) were also administered. Exploratory Principal Component Analysis identified a two-factor structure, "Relationships and Personal Development (RPD)" and "Instrumen-tal", accounting for 57% of the variance. Confirmatory analyses extracted an identical factor structure. However, a goodness-of-the fit test failed to support two-factor solution (X2 =138.2, df=43, p<.001). Two factors had high internal consistency (RPD, alpha=.89; Instrumental, alpha=.75) and significantly correlated with scores of HAQ (RPD, r=.53, p<.001; Instrumental, .r=44, p<.001) and CES-D (RPD, .r=55, p<.001; Instrumental, .r=43, p<.001). These findings supported construct validity of the Korean version of IIRS, but did not support cross-cultural equivalence of the factor structure.
Adult ; Aged ; Asian Continental Ancestry Group ; *Cross-Cultural Comparison ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; *Sickness Impact Profile

We investigated the major trends in health aid financing in the Democratic People's Republic of Korea (DPRK) by identifying the primary donor organizations and examining several data sources to track overall health aid trends. We collected gross disbursements from bilateral donor countries and international organizations toward the DPRK according to specific health sectors by using the Organization for Economic Cooperation and Development creditor reporting system database and the United Nations Office for the Coordination of Humanitarian Affairs financial tracking service database. We analyzed sources of health aid to the DPRK from the Republic of Korea (ROK) using the official records from the ROK's Ministry of Unification. We identified the ROK, United Nations Children's Fund (UNICEF), World Health Organization (WHO), United Nations Population Fund (UNFPA), and The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) as the major donor entities not only according to their level of health aid expenditures but also their growing roles within the health sector of the DPRK. We found that health aid from the ROK is comprised of funding from the Inter-Korean Cooperation Fund, private organizations, local governments, and South Korean branches of international organizations such as WHO and UNICEF. We also distinguished medical equipment aid from developmental aid to show that the majority of health aid from the ROK was developmental aid. This study highlights the valuable role of the ROK in the flow of health aid to the DPRK, especially in light of the DPRK's precarious international status. Although global health aid from many international organizations has decreased, organizations such as GFATM and UNFPA continue to maintain their focus on reproductive health and infectious diseases.
Databases, Factual ; Democratic People's Republic of Korea ; Electrical Equipment and Supplies/economics/statistics & numerical data ; Financial Management/*economics/trends ; Health Expenditures/statistics & numerical data ; Humans ; United Nations ; World Health Organization

Background: This study analyzed common gynecologic problems among Korean patients younger than ten years. Methods: We performed a retrospective analysis of medical records of patients younger than ten years who visited the Pediatric and Adolescent Gynecology Clinic at Samsung Medical Center between 1995 and 2020. Results: Among the 6,605 patients who visited the Pediatric and Adolescent Gynecology Clinic, data from 642 patients younger than ten years were analyzed in this study. The most common chief complaint was genital anomalies, followed by increased vaginal discharge and abnormal findings on clinical examinations. The most common disease entity was agglutination of the labia minora, which was commonly discovered incidentally during routine screenings. Vulvovaginitis, the second most common disease, was identified by symptoms of vaginal discharge, pruritus, and vaginal spotting. Neoplasm, issues with vaginal bleeding, and “other causes” were additional categories of gynecologic problems.245 patients (38.2%) were referred from primary care sources, 175 patients (27.4%) sought care directly at the clinic, 169 patients (26.3%) were referrals from the institution’s pediatric department, and the remainder were referrals from other departments. Conclusion This study provides information about the gynecologic problems most frequently encountered in pediatric patients. The study provides helpful insight for primary care physicians into the proper management and timing of referrals for these gynecologic problems of pediatric patients.

PURPOSE: The renin-angiotensin system plays an important role in renal growth and development. Exposuring the neonate to angiotensin converting enzyme(ACE) inhibitor increases mortality and results in growth retardation and abnormal renal development. ACE inhibition in the developing kidney reduces the renal expression of TGF-beta1 and EGF, which may account for renal growth impairment. This study was designed to investigate the relationship between this growth impairment, and apoptosis, cell proliferation, bcl-2 and clusterin expression. METHODS: Newborn rat pups were treated with enalapril(30mg/kg/d) or vehicle for 7 days and kidneys were removed for RT-PCR and Western blotting of bcl-2 and clusterin. Distribution of apoptosis was determined by modified TUNEL technique and PCNA for cell proliferation was stained by immunohistochemistry. RESULTS: Enalapril treatment resulted in 24% mortality by day 7 and reduced body weight(P< 0.05 versus vehicle group). Enalapril increased renal apoptosis and decreased PCNA positive proliferating cells especially in cortical tubular epithelial cells(P<0.05). Renal bcl-2 and clusterin mRNA expression was increased(P<0.05), but bcl-2 and clusterin protein expression was decreased by enalapril treatment. CONCLUSION: These results indicate that ACE inhibition in the developing kidney increases apoptosis and decreases cell proliferation, which may account for renal growth impairment. Bcl-2 and clusterin mRNA expression may increase as a secondary response to increased apoptosis and decreased their protein expression.
Angiotensins* ; Animals ; Apoptosis* ; Blotting, Western ; Cell Proliferation ; Clusterin ; Enalapril ; Epidermal Growth Factor ; Growth and Development ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Infant, Newborn ; Kidney* ; Mortality ; Peptidyl-Dipeptidase A* ; Proliferating Cell Nuclear Antigen ; Rats* ; Renin-Angiotensin System ; RNA, Messenger ; Transforming Growth Factor beta1

Angiotensin II(ANG II) plays an important role in the regulation of systemic and renal hemodynamics, and functions as a growth factor in various tissues. ANG II is also known to be associated with healing after tissue injuries as profibrotic molecule. To determine effects of ANG II itself on kidney and to know its mechanism of action, 36 adult male Sprague-Dawley rats were infused with ANG II at a dose of 50ng/min(low ANG group), 100ng/min(high ANG group), or vehicle(control group) for 1 week using osmotic minipump(Model 2001D, Alza Co, USA) inserted into the interscapular area of the back. Tissue fibrosis was quantitated morphometrically using point detection method after Masson-Trichrome stain. Expression of ED-1 was determined by immunohistochemical staining. Immunohistochemical stain, RT- PCR, and Western blot assay were done for TGFbeta1 mRNA and protien. Results were as follows:1) There were no differences in body weight or kidney weight/body weight among 3 groups. 2) Interstitial volume was increased significantly in the low and high ANG groups compared with the control group(P<0.05) 3) ED-1 positive cells were increased significantly in the the low and high ANG groups compared with the control group(P<0.05). 4) TGFbeta1 mRNA and protein expression were increased significantly in the low and high ANG groups compared with the control group(P<0.05). Therefore, regardless of systemic hypertension, ANG II infusion induced renal fibrosis and increased expression of TGFbeta1 mRNA and protein in the kidney of the Sprague-Dawley rat.
Adult ; Angiotensin II* ; Angiotensins* ; Animals ; Blotting, Western ; Body Weight ; Fibrosis ; Hemodynamics ; Humans ; Hypertension ; Kidney ; Macrophages ; Male ; Polymerase Chain Reaction ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger

OBJECTIVES: The direct causal relationship between the experience of sexual assault and development of psychiatric disorder remains uncertain. However, studies consistently show that those with history of this horrendous event report a wide range of symptoms, higher level of distress, and various social and psychological problems. This study investigated the prevalence and associated risk factors in a cohort sample of 340 Korean psychiatric patients. METHODS: Data from consecutive 340 new patients were gathered at a psychiatric department of a university affiliated hospital. Participants completed Life Events Scale, Symptom Checklist-90-R, State-Trait Anxiety Inventory, Beck Depression Inventory, and Dissociative Experiences Scale. RESULTS: History of sexual assault was reported by 11.5% of respondents (women 18.6%;men 2.1%). Bivariate analysis revealed that women (p<.001), divorced or widowed and never been married (p<.05), unemployed and students or housewives (p<.05), monthly income more than 2 million Won (p<.05) were associated significantly with experience of sexual assault. All the scores from the scales but Beck Depression Inventory were significantly higher for the sexually assaulted. Multiple logistic regression analysis revealed that women were 12 times more likely to be sexually assaulted (Odds ratio=12.24, 95% CI=3.51-42.64). Other risk factors included younger age and interaction of post-traumatic stress disorder (PTSD) and Global Severity Index. CONCLUSION: This study supported the risk factors of sexual assaults identified in western literature. Clinicians can be alert for any history of sexual assault when younger women with PTSD present higher level of symptomatology.
Anxiety ; Cohort Studies ; Surveys and Questionnaires ; Depression ; Divorce ; Female ; Humans ; Logistic Models ; Prevalence* ; Rape ; Risk Factors ; Stress Disorders, Post-Traumatic ; Weights and Measures ; Widowhood

From 1985 to 1995, 13 children with neurogenic bladder underwent augmentation cystoplasty. Diagnosis in these 13 children included Meningomyelocele in 11 and unknown origin in 2. Indications for augmentation cystoplasty were persists incontinence in 6 patients and progressive upper urinary tract deterioration in Bowel segments were used for augmentation included sigmoid colon in 1 patient, ileocecal segments incontinence in 6 patients stomach in 3. Dilated ureter also was used in 1 patient. Postoperatively, all the patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 12 require clean intermittent catheterization to empty bladder and 10 are completely continent. After operation, bladder capacity increased from 155 ml to 305 ml and there were significant increases in bladder compliance. Hypereflexia was present in 5 patients before operation and in 3 patients after operation. There has been no surgical mortality. Postoperative complications occurred in 4 patients included mild ileus in 2 patients, mucus obstruction in 1, mild hematuria in 1, metabolic alkalosis in 1 and superficial wound infection in All complications were transient and managed medically. the kind of bowel segments did not seem to influence results. We think that augmentation cystoplasty is a therapeutic modality that should be considered as a viable treatment option in selected patients with neurogenic bladder dysfunction.
Alkalosis ; Child ; Colon, Sigmoid ; Compliance ; Diagnosis ; Hematuria ; Humans ; Ileus ; Intermittent Urethral Catheterization ; Meningomyelocele ; Mortality ; Mucus ; Postoperative Complications ; Stomach ; Ureter ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Tract ; Wound Infection