PURPOSE: The objectives of this study are to compare the hospital employees' and patients' recognition and attitudes toward the opening of the medical services market, to analyze the differences between hospital employees and patients on the factors in selecting a foreign hospital. MATERIALS AND METHODS: This study collected and analyzed data using systematic questionnaires that were self-administered by employees and outpatients to compare their recognition of the opening of the medical services market and the factors involved in selecting a foreign hospital. RESUTLS: Employees exhibited a higher level of recognition than the patients. Reasons for agreement were to ensure the right of selection for both the employees and patients. Reasons for disagreement, however, were split between the two groups: degraded public characteristics of medical services, for employees; and expensive medical fees, for patients. The most urgent task to prepare for the opening of the medical services market is the improvement of the diagnosis and treatment technologies for employees, and improvement of the services provided by hospital staff for patients. CONCLUSION: Korean hospitals shall need to improve their diagnosis and treatment technologies and provide medical services of high quality in order to compete with foreign hospitals.

Purpose: Long-term culture- initiating cells(LTC-IC) are stem cells that have the capacities of long-term engraftment and helping to establish hematopoietic microenvironment. For evaluation of the LTC-IC, we measured the counts and function with multidimentional flowcytometry in long-term culture media. METHODS: Samples were obtained from umbilical cord blood, leukapheresis products and bone marrow(BM). LTC-IC were counted with flowcytometric analysis using anti- CD34, anti-CD38, and anti-HLA-DR antibodies at 0, 5, and 8 weeks. Cell adhesion molecule related with stem cell were evaluated with flowcytometric analysis also using anti-VCAM-1(CD106) and anti-VLA-4(CD49d) at 0 and 8 weeks. RESULTS: The proportion of CD34+/CD38- cell from fractionated mononuclear cells at 0 week were 0.46%, 0.044%, and 0.038% for BM, leukapheresis products, and umbilical cord blood respectively and then rapidly decreased at 5 weeks, but still persisted at 8 weeks in all three groups. The proportion of CD34+/HLA-DR- cells was the same tendency to CD34+/CD38-. VCAM+ expression rate from fractionated CD34+ cells at 0 and 8 weeks were 67.3% and 40.2% for BM and 64.1% 44.2% for umbilical cord blood but it was very low 31.2% and 5.1% for leukapheresis products. VLA-4+ expression rate for fractionated CD34+ cells at 0 and 8 weeks were similar tendency to VCAM+ cells. CONCLUSION: This study suggest that the count of LTC-IC decreased with time but still persisted until 8 weeks. Umbilical cord blood including BM help to establish the hematopoietic microenvironments.
Antibodies ; Cell Adhesion ; Culture Media ; Fetal Blood ; Leukapheresis ; Stem Cells

Cyclin D1, a cell cycle regulator essential for G1 phase progression, is a candidate proto-oncogene implicated in pathogenesis of several human carcinomas including breast carcinoma. We studied the cyclin D1 expression in 101 cases of primary breast carcinoma tissues. The overexpression of cyclin D1 was immunohistochemically demonstrated in 34 (37.8%) of 90 cases of invasive breast carcinoma. Positive cyclin D1 staining was seen in 32 of 79 invasive ductal carcinomas, and 2 of 3 mucinous carcinomas. All 5 medullary carcinomas, 2 invasive lobular carcinomas, and 1 metaplastic carcinoma were negative. Cyclin D1 overexpression was observed in 9 of 11 ductal carcinoma in situ (DCIS). Normal epithelial components, either ductal or lobular, were not immunoreactive for cyclin D1. No significant correlations were observed between cyclin D1 immunoreactivity and other parameters including tumor size, clinical stage, nuclear or histologic grades, lymphatic or angioinvasion, lymph node metastasis, and immunohistochemical status of progesterone receptor, p53 and c-erbB-2. The overexpression of cyclin D1 was positively correlated with estrogen receptor status (p=0.025). Based on our results, the cyclin D1 protein aberration may play a role in tumorigenesis of breast carcinoma, but does not seem to have prognostic value in invasive breast carcinoma without hormonal treatment.
Adenocarcinoma, Mucinous ; Breast Neoplasms* ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Carcinoma, Medullary ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Estrogens ; G1 Phase ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proto-Oncogenes ; Receptors, Progesterone

This study compared the effects of programs according to management type by preparing a manual for oral muscle exercises that integrates oral movement and oral massage. The program was performed on 14 elderly patients in a seniors' college self-practice program group and 28 elderly patients in a social welfare center expert intervention group. In the self-practice group, an expert demonstrated oral muscle exercises and subsequently encouraged self-practice by selecting an oral muscle exercise leader. In the expert intervention group, an expert demonstrated oral exercises on a one-on-one basis and subsequently gave oral muscle massages. In the self-practice group, there was no difference in saliva secretion (p=0.213) or oral dryness (p=0.206), after the intervention, the expert intervention group showed improvements in saliva secretion (p=0.009) and oral dryness (p=0.007). There was no difference in program satisfaction between groups (p=0.143), and both groups reported high satisfaction. As seniors may have difficulty in maintaining oral health behaviors, a certain amount of expert intervention may be needed. The results suggest that both a self-practice oral exercise program and an expert intervention program can be effective elderly patients.
Aged* ; Exercise ; Gangwon-do* ; Humans ; Massage ; Oral Health ; Saliva ; Social Welfare ; Xerostomia

OBJECTIVE: Comprehensive neuropsychological tests are important in the diagnosis and follow-up of patients with MCI; however, most were developed without consideration of illiteracy. We developed the Literacy Independent Cognitive Assessment (LICA) as a comprehensive neuropsychological assessment battery applicable to older adults who are either literate or illiterate. This study aimed to assess the reliability and validity of the LICA for diagnosis of MCI. METHODS: Normal controls (n=634) and patients with MCI (n=128) were recruited from 13 centers were included in this study. Participants were divided into illiterate or literate groups, based on their performance on a brief reading and writing test. The LICA, Korean Mini-Mental State Examination (K-MMSE), and Seoul Neuropsychological Screening Battery (SNSB) were administered. RESULTS: Total LICA scores distinguished MCI patients from controls (p<0.001). They were closely and positively correlated to the K-MMSE scores (r=0.632, p<0.001) but negatively correlated to clinical dementia rating (CDR) (r=-0.358, p<0.001) and CDR sum of boxes (r=-0.339, p<0.001). Area under the receiver operating characteristic curve for patients with MCI by total LICA score was 0.827 (0.783-0.870), superior to that presented by the K-MMSE. For the classification of MCI subtypes, inter-method reliability of LICA with the SNSB was good (kappa 0.773; 0.679-0.867, p<0.001). CONCLUSION: The results of this study show that the LICA may be reliably used to distinguish MCI patients from cognitively intact adults, to identify MCI subtypes and monitor progression toward dementia, regardless of illiteracy.
Adult* ; Classification ; Dementia ; Diagnosis ; Literacy ; Follow-Up Studies ; Humans ; Mass Screening ; Mild Cognitive Impairment* ; Neuropsychological Tests ; Reproducibility of Results ; ROC Curve ; Sensitivity and Specificity ; Seoul ; Writing

BACKGROUND/AIMS: Rapid urease tests are used commonly for the detection of H. pylori. These tests are inexpensive and can be done easily and rapidly in the endoscopy room. A new rapid urease test, Hp Kit test, was developed for the first time in Korea. The test kit has two wells for two biopsies taken from each gastric antrum and corpus. We performed this study to estimate the diagnostic usefulness of Hp Kit test for the detection of H. pylori. METHODS: In one hundred patients undergoing gastroscopy, biopsy specimens were taken for Hp Kit test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). The 13C-urea breath test was also performed. The results of Hp Kit test were read after 2 hours. RESULTS: The sensitivity, specificity, positive and negative predictive value of Hp Kit test to diagnose H. pylori infection were 90.0%, 97.5%, 98.2%, and 86.7%, respectively. The positive reactions in only one well were observed in 12.9% of true positives with Hp Kit test. The reaction times of the Hp Kit test were 35.2+/-21.4, 26.6+/-15.3, and 17.8+/-15.8 minutes (mean+/-S.D.) at grade 1, 2, and 3, respectively (r=-0.3, p<0.05), therefore the results were usually observed within 1 hour. CONCLUSIONS: Hp Kit test has a high sensitivity and specificity, and may be used as an alternative rapid urease test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Endoscopy ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Polymerase Chain Reaction ; Pyloric Antrum ; Reaction Time ; Sensitivity and Specificity ; Urease

BACKGROUND/AIMS: Pronto Dry test, a new rapid urease test, is consisted of a dry filter paper containing urea and has been reported to have a more rapid reaction time than others. We performed this study to compare the accuracy of Pronto Dry test with the other conventional tests for detection of H. pylori. METHODS: One hundred patients underwent gastroscopy in our hospital for gastrointestinal symptoms. Biopsy specimens were taken for Pronto Dry test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). 13C-urea breath test was also performed. The results of Pronto Dry test were read after 1 hour. RESULTS: The sensitivity, specificity, positive and negative predictive value of Pronto Dry test to diagnose H. pylori infection were 90.0%, 100%, 100%, and 90.9%, respectively. The kappa statistic between H. pylori status and Pronto Dry test was 0.90, demonstrating an acceptable level of reliability. CONCLUSIONS: Pronto Dry test has a high sensitivity and specificity, and can be used as a rapid test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Diagnosis* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Reaction Time ; Sensitivity and Specificity ; Urea ; Urease

BACKGROUND/AIMS: Pronto Dry test, a new rapid urease test, is consisted of a dry filter paper containing urea and has been reported to have a more rapid reaction time than others. We performed this study to compare the accuracy of Pronto Dry test with the other conventional tests for detection of H. pylori. METHODS: One hundred patients underwent gastroscopy in our hospital for gastrointestinal symptoms. Biopsy specimens were taken for Pronto Dry test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). 13C-urea breath test was also performed. The results of Pronto Dry test were read after 1 hour. RESULTS: The sensitivity, specificity, positive and negative predictive value of Pronto Dry test to diagnose H. pylori infection were 90.0%, 100%, 100%, and 90.9%, respectively. The kappa statistic between H. pylori status and Pronto Dry test was 0.90, demonstrating an acceptable level of reliability. CONCLUSIONS: Pronto Dry test has a high sensitivity and specificity, and can be used as a rapid test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Diagnosis* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Reaction Time ; Sensitivity and Specificity ; Urea ; Urease

OBJECTIVE: Hyaluronidase (HAse), a degrading enzyme of hyaluronic acid (HA), is highly expressed in patients with malignant glioma. The purpose of this study was to verify whether HAse is related to the invasion of glioma cells. We also investigated if glioma cells with higher mobility in 2-dimensioal (2-D) method have also higher mobility at 3-dimensional (3-D) environment. METHODS: Malignant glioma cell lines (U87MG, U251MG, U343MG-A, and U373MG) were used, and their HAse expressions were evaluated by HA zymography. The migration ability was evaluated by simple scratch technique. The invasiveness of each cell lines was evaluated by Matrigel invasion assay and HA hydrogel invasion assay. In HA hydrogel invasion assay, colonies larger than 150 micrometer were regarded as positive ones and counted. Statistical analysis of migration ability and invasion properties of each cell lines was performed using t-test. RESULTS: In scratch test to examine migration ability of each cell lines, U87MG cells were most motile than others, and U343MG-A least motile. The HAse was expressed in U251MG and U343MG-A cell lines. However, U87MG and U373MG cell lines did not express HAse activity. In Matrigel invasion assay, the cell lines expressing HAse (U251MG and U343MG-A) were more invasive in the presence of HA than HAse deficient cell lines (U87MG and U373MG). In HA hydrogel invasion assay, the HAse-expressing cell lines formed colonies more invasively than HAse-deficient ones. CONCLUSION: Malignant Glioma cells expressing HAse were more invasive than HAse-deficient ones in 3-dimensional environment. Therefore, it might be suggested that invasion of malignant gliomas is suppressed by inhibition of HAse expression or HA secretion. Additionally, the ability of 2-D migration and 3-D invasion might not be always coincident to each other in malignant glioma cells.
Cell Line ; Collagen ; Drug Combinations ; Glioma ; Humans ; Hyaluronic Acid ; Hyaluronoglucosaminidase ; Hydrogel ; Laminin ; Proteoglycans

Among 80 types of yeast isolated from wild flowers in Daejeon, Korea, two species that have not yet been identified by phylogenetic analysis of the internal transcribed spacer-2 (ITS2) genes and 26S rDNA sequences were identified as Candida sp. 44-C-1 and Cryptococcus sp. 9-D-1. Neither of the newly identified species formed ascospores, while Candida sp. 44-C-1 formed pseudomycelium and Cryptococcus sp. 9-D-1 did not.
Candida ; Cryptococcus ; DNA, Ribosomal ; Flowers ; Korea ; Yeasts