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PURPOSE: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. METHODS: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. RESULTS: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6+/-2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18+/-2.10 vs 4.79+/-1.49 days, P=.17) and total fever duration (5.32+/-2.07 vs 6.41+/-3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. CONCLUSION: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
Bacterial Infections ; Bronchiolitis ; Bronchitis ; Child* ; Croup ; Fever ; Hospitalization ; Hospitals, University* ; Humans ; Influenza B virus* ; Influenza, Human ; Inpatients ; Medical Records ; Oseltamivir* ; Outpatients ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Thorax

OBJECTIVES: The widespread adoption of health information technology (IT) will help contain health care costs by decreasing inefficiencies in healthcare delivery. Theoretically, health IT could lower hospitals' malpractice insurance premiums (MIPs) and improve the quality of care by reducing the number and size of malpractice. This study examines the relationship between health IT investment and MIP using California hospital data from 2006 to 2007. METHODS: To examine the effect of hospital IT on malpractice insurance expense, a generalized estimating equation (GEE) was employed. RESULTS: It was found that health IT investment was not negatively associated with MIP. Health IT was reported to reduce medical error and improve efficiency. Thus, it may reduce malpractice claims from patients, which will reduce malpractice insurance expenses for hospitals. However, health IT adoption could lead to increases in MIPs. For example, we expect increases in MIPs of about 1.2% and 1.5%, respectively, when health IT and labor increase by 10%. CONCLUSIONS: This study examined the effect of health IT investment on MIPs controlling other hospital and market, and volume characteristics. Against our expectation, we found that health IT investment was not negatively associated with MIP. There may be some possible reasons that the real effect of health IT on MIPs was not observed; barriers including communication problems among health ITs, shorter sample period, lower IT investment, and lack of a quality of care measure as a moderating variable.
California ; Delivery of Health Care ; Electronic Health Records ; Health Care Costs ; Health Information Systems ; Humans ; Insurance* ; Investments ; Malpractice* ; Medical Errors ; Medical Informatics*

OBJECTIVE: The purpose of this study was to determine the frequency and distribution of cytogenetically abnormal miscarriages in couples with spontaneous abortions (SA) or recurrent miscarriages (RM). METHODS: Karyotyping of specimens from 164 abortuses with SA and 86 abortuses with RM was successfully performed according to the standard cytogenetic methods using G-banding technique. RESULTS: Among the total 164 cases of SA group, 81 (49.4%) were euploid and the rest (83, 50.6%) showed chromosomal abnormalities. In RM(> or =2) and RM(> or =3) group, 31 (36.0%)/27 (34.6%) cases were euploid and 55 (64.0%)/51(65.4%) cases were abnormal, respectively. A statistically significant difference was found in the rate of cytogenetic abnormality between SA and RM groups (P<0.05). In all groups, women with advanced maternal age (> or =35 years) had a higher rate of chromosome anomalies compared with women younger than age 35 (normal:abnormal = 32.4%:67.6% for > or =35 years and 53.8%:46.2% for <35 years in SA; 19.2%:80.8%/21.7%:78.3% for > or =35 years and 43.3%:56.7%/40.0%:60.0% for <35 years in RM(> or =2) and RM(> or =3), respectively; P<0.05). In SA group, an increase of normal karyotypes was noted with increased gestational age (<10 week, 38.0%; 10-15 week, 53.5%; 16-20 week, 65.7%). In RM group, most of cases were in <10 week and the frequency of trisomies with chromosomes 1 to 10 were increased compared with that of SA. CONCLUSION: There was a statistically significant difference in the frequency and distribution of chromosomal abnormalities between SA and RM groups. Our results will provide useful information for diagnosis and genetic counseling of patients with SA or RM.
Abortion, Habitual* ; Abortion, Spontaneous* ; Chromosome Aberrations ; Cytogenetic Analysis ; Cytogenetics* ; Diagnosis* ; Family Characteristics ; Female ; Genetic Counseling ; Gestational Age ; Humans ; Karyotype ; Karyotyping ; Maternal Age ; Pregnancy ; Trisomy

Hepatitis C virus (HCV) is a major cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. HCV core protein has been shown to modulate various cellular signaling pathways including the nuclear factor κB (NF-κB) pathway which is associated with inflammation, cell proliferation and apoptosis. However, there have been conflicting reports about the effect of HCV core protein on NF-κB pathway, and the mechanism by which the core protein affects NF-κB activity remains nuclear. In this study, the functional interaction of HCV core protein and IκB kinase γ (IKKγ) was investigated using the expression plasmids of core and the components of IKK complex. The data revealed that HCV core protein activates NF-κB. Also, HCV core protein up-regulated the phosphorylation and degradation of IκBα. The activating effect of HCV core protein on NF-κB was synergistically elevated by IKKγ. It was noticed that the N-terminal IKKβ binding site, C-terminal leucine zipper, and zinc finger domains of IKKγ are not necessary for its synergistic effect. HCV core protein and IKKγ appeared to activate NF-κB by up-regulating the IKKβ activity resulting in the degradation of IκBα. As expected, HCV core protein induced the expression of NF-κB-targeted pro-inflammatory genes such as iNOS, IL-1β and IL-6 in the transcription level. These results suggest that HCV core protein induces NF-κB through the interaction with IKKγ and may play a critical role in the development of inflammation and related liver diseases.
Apoptosis ; Binding Sites ; Carcinoma, Hepatocellular ; Cell Proliferation ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Inflammation ; Interleukin-6 ; Leucine Zippers ; Liver Cirrhosis ; Liver Diseases ; Phosphorylation ; Phosphotransferases ; Plasmids ; Zinc Fingers

No abstract available.
Hepatolenticular Degeneration*

PURPOSE: The aim of this study was to investigate the alterations of growth and bone metabolism in SDR induced by dexa administration and to evaluate the effects of GH treatment in dexamethasone(dexa) induced growth and bone metabolism in SDR. METHODS: Forty-five female Sprague-Dawley rats(weight 150-170gm) were divided in 3 groups: Group 1(n=15) received normal saline as control, Group 2(n=15) received dexa(1mg/kg/day), Group 3(n=15) received dexa and rhGH(LG Chem, 1IU/kg/day) simultaneously. Group 2 and 3 were injected rhGH daily, 6 days per week. Each group was divided in three subgroups(n=5) and sacrificed at 4, 6, 8 weeks, respectively. RESULTS: In Group 2, the length of tibia and femur and tibia epiphyseal plate thickness decreased significantly at 4, 6, 8 weeks compared to Group 1, respectively. In Group 2, serum IGF-I and PICP level also decreased at 6, 8 weeks and serum ICTP level increased at 4, 6 weeks compared to Group 1 significantly. In Group 3, the length of tibia and femur increased at 4, 6, 8 weeks compared to Group 2 but there was no statistical significance. In Group 3, tibia epiphyseal plate thickness increased significantly at 6, 8 weeks compared to Group 1. In Group 3, serum IGF-I and PICP level increased significantly at 4, 6, 8 weeks respectively compared to Group 2. But serum ICTP level showed no changes between two groups. Serum PTH level increased in Group 2 compared to Group 1, and decreased in Group 3 compared to Group 2 but no statistical significance was noted, respectively. CONCLUSION: Our data suggest that dexa inhibits longitudinal bone growth and interferes with bone metabolism, both inhibiting bone formation and stimulating bone resorption in SDR. Simultaneous GH administration may abolish alterations of growth and bone metabolism induced by dexa in SDR.
Animals ; Bone Density ; Bone Development ; Bone Resorption ; Dexamethasone* ; Female ; Femur ; Growth Hormone* ; Growth Plate ; Humans ; Insulin-Like Growth Factor I ; Metabolism* ; Osteogenesis ; Rats* ; Rats, Sprague-Dawley ; Tibia

Squamous cell carcinoma of the pancreas is a rare variant of pancreatic ductal cell carcinoma. Its biologic behavior and clinical features are known to be similar to the much more common ductal adenocarcinoma of pancreas. A 70-year old man with postprandial vomiting symptom was admitted to our hospital. Initial endoscopy and abdominal CT showed that 6cm sized submucosal tumor on pylous or duodenum invaded the pancreas. Subtotal gastrectomy with partial pancreatic resection was done. The resection specimen revealed of metastatic squamous carcinoma of stomach and duodenum. Follow up CT was revealed that multiple liver metastasis and a large mass in peripancreatic space. The mass was confirmed invasive squamous cell carcinoma of pancreas by aspiration biopsy. The patient died of cancer cachexia 50 days after operation. We report an unusual case of squamous cell carcinoma of the pancreas which was invaded to duodenum and pylorus with a review of literature.
Adenocarcinoma ; Aged ; Biopsy, Needle ; Cachexia ; Carcinoma, Squamous Cell* ; Duodenum* ; Endoscopy ; Follow-Up Studies ; Gastrectomy ; Humans ; Liver ; Neoplasm Metastasis ; Pancreas* ; Pancreatic Ducts ; Pylorus* ; Stomach ; Tomography, X-Ray Computed ; Vomiting

Purpose: The aim of this study was to examine the nutritional intake status of the lung cancer patients who underwent pulmonary resection and to analyze the relationship between the status of the nutritional intake and the occurrence of postoperative pulmonary complications. Methods: This study was a secondary analysis to determine whether the changes in the nutritional intake after surgery were related to pulmonary complications. Data of a total of 89 patients were included in the analysis and the nutritional intake status was confirmed using a 24-hour dietary recall method. The data were analyzed by descriptive statistics, chi-square or Fisher’s exact test, and ANOVA using the SPSS WIN 26.0 program and word clouds were generated using the R software program. Results: Overall, a decrease in the postoperative nutritional intake was observed in the patients who underwent pulmonary resection, except for the intake of fat. The pulmonary complications were identified to be associated with BMI and the presence of comorbidity. Twenty-three out of 74 patients with vitamin E levels below the Estimated Average Requirements developed pulmonary complications after surgery. Conclusion Lung cancer patients who underwent pulmonary resection generally have difficulty in acquiring appropriate nutritional intake and need balanced nutritional management. Future investigations on the impact of increased vitamin E intake on postoperative pulmonary complications may provide better insight into the relationship between vitamin E intake and pulmonary complication among patients who underwent pulmonary resection.

With the exception of choriocarcinoma, the central nervous system (CNS) is rarely associated with metastases from gynecological malignancy. Cerebral involvement in ovarian carcinoma is generally regarded as occurring in 1% of cases. Overall incidence of cerebellar metestases is 27% of CNS metastases. However higher rates have been reported following initial platinum-based chemotherapy. We experienced a cerebellar metastatic cancer patient treated with craniectomy and radiation therapy. So we report the case with a brief review of literature.
Central Nervous System ; Choriocarcinoma ; Drug Therapy ; Female ; Humans ; Incidence ; Neoplasm Metastasis* ; Pregnancy