This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview survey performed by the korean Institute of Health & social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions; There were more elderly people over the age of 65; unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionally, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.
Aged ; Causality ; Education ; Health Resources ; Humans ; Inpatients ; Korea* ; Length of Stay ; Marital Status ; Models, Statistical ; Primary Health Care ; Public Health ; Sample Size

No abstract available.
Nitric Oxide*

NADPH oxidase produces a large amount of reactive oxygen species (ROS) in Helicobacter pylori (H. pylori)-induced gastric epithelial cells. Even though ROS mediate apoptotic cell death, direct involvement of NADPH oxidase on H. pylori-induced apoptosis remains unclear. Besides, H. pylori isolates show a high degree of genetic variability. The predominant genotype of H. pylori in Korea has been reported as cagA+, vacA s1b, m2, iceA genotype. Present study aims to investigate whether NADPH oxidase-generated ROS mediate apoptosis in human gastric epithelial AGS cells infected with H. pylori in a Korean isolate. AGS cells were pretreated with or without an NADPH oxidase inhibitor diphenyleneiodonium (DPI) and cultured in the presence of H. pylori at a bacterium/cell ratio of 300:1. Cell viability, hydrogen peroxide level, DNA fragmentation, and protein levels of p53, Bcl-2, and Bax were determined. Results showed that H. pylori inhibited cell viability with the density of H. pylori added to the cells. Inhibition of NADPH oxidase by DPI suppressed H. pylori-induced cell death, increased hydrogen peroxide, DNA fragmentation, and the ratio of Bax/Bcl-2, and p53 induction in AGS cells dose-dependently. The results suggest that targeting NADPH oxidase may prevent the development of gastric inflammation associated with H. pylori infection by suppressing abnormal apoptotic cell death of gastric epithelial cells.
Apoptosis ; Apoptosis Regulatory Proteins/metabolism ; Cell Survival ; Epithelial Cells/metabolism/microbiology ; Gastric Mucosa/metabolism ; Helicobacter Infections/*metabolism/microbiology ; Helicobacter pylori/drug effects/genetics/*isolation & purification ; Humans ; NADPH Oxidase/metabolism ; Onium Compounds/*antagonists & inhibitors/pharmacology ; Oxidative Stress/drug effects ; Reactive Oxygen Species/metabolism ; Republic of Korea ; Stomach/cytology/*metabolism/microbiology

OBJECTIVE Present study was aimed to verify the effect of granulocyte macrophage-colony stimulating factor (GM-CSF) in the preimplantation development of mouse embryos and the involvement of the mitogen activated protein kiase (MAPK) in the GM-CSF signaling. METHODS: Two-cell embryos were cultured for 96 h in the presence or absence of GM-CSF (0, 0.4, 2, 10 ng/ml) and PD98059, a MEK inhibitor (10 muM). Morphological development, cell number per blastocyst, and apoptotic nuclei, were eamined. MAPK activity of embryonic immunoprecipitate by MAPK (ERK1/2) antibody was measured by in vitro phosphorylation of myelin basic protein. RESULTS: At post hCG 122 h the embryonic development among the experimental groups was significantly different (p=0.018). The rate of blastocyst development and cell number per embryo were the highest in 2 ng/ml GM-CSF treatment group. The percent of apoptotic cells of the GM-CSF-treated embryos was the lowest among the group. in blastocysts, GM-CSF treatment transiently increased MAPK activity. PD098059 attenuated the effect of GM-CSF on the morphological development, increase in cell number per blastocyst, down regulation of apoptosis, and upregulation of MAPK activity, suggesting that activation of MAPK cascade possibly mediated the embryotropic effect of GM-CSF. CONCLUSION: This result suggested that GM-CSF potentiated the development of preimplantation mouse embryos by activation of MAPK.
Animals ; Apoptosis ; Blastocyst ; Cell Count ; Down-Regulation ; Embryonic Development ; Embryonic Structures* ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes* ; Mice* ; Myelin Basic Protein ; Phosphorylation ; Pregnancy ; Up-Regulation

Strange attractor can be constructed from time series data such as heart sound. In the areas of the recognition and diagnosis of abnormal heart sounds, signal presentation method is very useful because good features can be detected from good presentation. This paper examines efficiency in diagnosing abnormal heart sounds of the two different methods for constructing attractor. Nine different heart sounds from typical clinical conditions were used for this study. The first method was constructing attractors using original heart sounds, and the second was modifying the original sounds by autocorrelation and they were then applied to the orignal sounds as to cross correlation checks. Attractors could be constructed using signals generated by these methods, and values of fractal dimensions would then be calculated which has been a well known method to measure characteristics of attractors. The results showed that the second method appeared to provide more efficient way to correctly classify abnormal heart sounds.
Diagnosis ; Fractals* ; Heart Sounds* ; Heart*

Due to the diversification of the food industry and its heightened competition, the marketing strategy to be required the most would be to improve competitiveness by enhancing customer loyalty as a resulting variable of customer satisfaction. Thus, this study, taking a food service provider as a subject, is to find factors and the scope of the perceived quality ; and to analyze how far the perceived service quality factor as such could explain customer's overall satisfaction and customer loyalty ; finally to provide basic data for establishing a customer satisfaction marketing strategy as related to customer loyalty. The results of the study are as below. 1) 25 factors of service quality perceived by a food service provider have been categorized into 8 independent dimensions through factor analysis. Each of them are named 'Employee attitude', 'Cleanliness', 'Reputation', 'Reliability', 'Food', 'Price', 'Convenience', 'Variety', all of which explain 64.3% of the service again quality perception level. 2) After classifying customers into 3 groups according to two criteria -"will buy the service again" and "will suggest it to others" and making a pair of service providers with each customer, each customer loyalty group compared the service quality perception factor of the food service provider. The result was that the group having both the "will buy the service again" and "will suggest to others" criteria, that is, with higher loyalty, tend to have higher points than other group s in the dimension of 'Employee attitude' and 'Cleanliness'(p<0.05), which means these two dimensions are closely related to customer loyalty. 3) From a regression analysis for the service quality perception level of the food service provider and overall satisfaction, it has been found that : the regression models are different for each group, that 'Employee attitude' seems to be related more closely to the group with higher loyalty(p<0.05); that the 'Price' dimension is found to be a meaningful factor to the group categorized not having "will buy the service again" and "will suggest to others" criteria(p<0.05).
Food Industry ; Food Services ; Marketing ; Restaurants*

Service quality has become an important factor to meet customer satisfaction in the food service industry where competition is getting severe. Organizations are focused upon strengthening customer loyalty through customer satisfaction. Therefore, this study, taking customers as subjects, is intended to analyze factors affecting customer loyalty, on the basis of service quality satisfaction. In doing. so, the analysis has been done with 232 customers who are purchasing service from the food services industry, for general information, and service quality expectation, service quality satisfaction and overall satisfaction. The results of the study are as below. 1) From a factor analysis, the service quality expectation level of customer has been categorized into 4 factors, which are named General 'General management ', 'Food', 'Reliability' and 'Reputation'. 2) From the factor analysis, the service quality satisfaction level of customer has been categorized into 6 factors, which are named 'Employee attitude', 'Food', 'Reliability', 'Atmosphere', 'Reputation' and 'Price'. 3) After classifying customers into 3 groups according to two criteria-"will buy the service again" and "will suggest to others", a comparison has been done for the service quality expectation dimension of customers by each customer group. The result shows that the group having both the "will buy the service again" and "will buy the service again "and "will suggest to others" criteria, that is, with higher customer loyalty, tend to have higher point than other group in factors of 'Food', 'Reliability', 'Reputation'(p<.05). 4) As per the dimension of customer's service quality satisfaction level, factors like 'Employee attitude', 'Food', 'Reliability', 'Atmosphere', 'Reputation', and 'Price' have shown differences according to each loyalty group(P<.001). 5) Customers' overall satisfaction level according to each customer loyalty group has been found to be more important for the group having a higher loyalty level(p<.001) 6) From the discriminant analysis with employing judging variables, such as the customer's service quality expectation level, service quality satisfaction level and general satisfaction level, customer loyalty groups have been identified as accurately as 68.9% of the explanatory power.
Food Services ; Restaurants*

To determine the adequate models for studying the functions of pancreatic acinar cells, secretory responses to CCK and to CCK receptor antagonist, L-364, 718 were examined in freshly isolated cells and confluent monolayer cells. The results showed that as CCK concentration increased, releases of amylase and lipase increased dose-dependently reaching a maximum at 10(-9) M in acinar cells cultured in serum-containing media as well as in serum-free media. Acinar response to CCK was partially inhibited by L-364, 718, L-364, 718 itself had no effect on the releases of both amylase and lipase. Confluent monolayer of acinar cells released relatively low levels of enzymes and exhibited less response to CCK. In conclusion, short-term culture of acinar cells would be suitable to study the regulation of pancreatic enzyme secretion, and serum factors do not influence acina response to the secretagogues. However, confluency of the acinar cells resulted in the loss of their secretory potential in the aspect of amylase and lipase release.
Amylases/secretion ; Animal ; Benzodiazepinones/pharmacology ; Cells, Cultured ; Cholecystokinin/*pharmacology ; Devazepide ; Dose-Response Relationship, Drug ; Hormone Antagonists/pharmacology ; Lipase/secretion ; Male ; Pancreas/cytology/*drug effects/*secretion ; Rats ; Rats, Sprague-Dawley ; Receptors, Cholecystokinin/antagonists & inhibitors ; Support, Non-U.S. Gov't

OBJECTIVES: The purpose of this study was to design a prediction model that explains the characteristics of elderly adults at risk of malnutrition. METHODS: Data were obtained from a large data set, 2008 Korean Elderly Survey, in which the data of 15,146 subjects were entered. With nutritional status a target variable, the input variables included the demographic and socioeconomic status of participants. The data were analyzed by using the SPSS Clementine 12.0 program's feature selection node to select meaningful variables. RESULTS: Among the C5.0, C&R Tree, QUEST, and CHAID models, the highest predictability was reported by C&R Tree with the accuracy rate of 77.1%. The presence of more than two comorbidities, living alone status, having severe difficulty in daily activities, and lower perceived economic status were identified as risk factors of malnutrition in elderly. CONCLUSIONS: A reliable decision support model was designed to provide accurate information regarding the characteristics of elderly individuals with malnutrition. The findings demonstrated the good feasibility of data mining when used for a large community data set and its value in assisting health professionals and local decision makers to come up with effective strategies for achieving public health goals.
Adult ; Aged* ; Comorbidity ; Data Mining ; Dataset* ; Decision Support Techniques ; Decision Trees ; Health Occupations ; Humans ; Malnutrition* ; Nutritional Status ; Public Health ; Risk Factors ; Social Class

MicroRNAs (miRNAs) are a class of small RNAs of 19-23 nucleotides that regulate gene expression through target mRNA degradation or translational gene silencing. The miRNAs are reported to be involved in many biological processes, and the discovery of miRNAs has been provided great impacts on computational biology as well as traditional biology. Most miRNA-associated computational methods comprise the prediction of miRNA genes and their targets, and increasing numbers of computational algorithms and web-based resources are being developed to fulfill the need of scientists performing miRNA research. Here we summarize the rules to predict miRNA targets and introduce some computational algorithms that have been developed for miRNA target prediction and the application of the methods. In addition, the issue of target gene validation in an experimental way will be discussed.