Objective: To analyze the trends of development and equity of health institutions in China during the period from 2002 to 2013 , and put forward references to optimize the decision-making on health resources alloca-tion. Methods:Statistical map, Gini coefficient and other methods were used to analyze the distribution and equity of health institutions in China for 12 years, during the period from 2002 to 2013. Results:(1) The overall development of health institutions is on the rise in China, and the distribution density of health resources with the population ad-justment is opposite to the adjustment of both population and geographic area at the same time. (2) In the past 12 years, the number of tertiary hospitals showed an increasing trend, and growth in the eastern region was the most sig-nificant. (3) From 2002 to 2013, the Gini coefficient of the number of health institutions and beds per 1,000 per-sons per square kilometer was maintained at 0. 40, and decreased from 0. 70 to 0. 60 in the eastern region of China, respectively. This same number was maintained at 0. 40 and 0. 20 in the central and western region. Conclusion: In China, the fairness trend of health resources allocation has improved during the period from 2002 to 2013, but the imbalance is more serious in the eastern region than in the central and western regions. It should be paid more atten-tion to optimizing the health resources allocation according to the local conditions of different regions, especially the influence of geographical distribution.

BACKGROUND: The serotonin type 3 receptors are diffusely distributed in both the central and the peripheral nervous system. Physiological and pathophysiological processes thought to be mediated by this receptor include nausea and vomiting, peripheral nociception and central antinociception, conditioned aversion response to drugs, anxiety, and cognition. Because of the structural similarity between the nicotinic acetylcholine receptor and the 5HT3 receptor, we investigated the effects of clinically used neuromuscular blockers on the 5HT3 receptor function related with PONV. METHODS: A cDNA clone encoding the full length murine 5HT3a receptor was subcloned into an oocyte expression vector and 50 ng of cRNA transcribed in vitro injected per oocyte. After 24 72 h incubation, oocytes were placed into a recording chamber continuously perfused with frog Ringer's solution and electrophysiological recordings were obtained by the two electrode voltage clamp technique. Serotonin with or without the various drugs were bath applied by a computer controlled solenoid valve. Peak currents induced by the drug applications were measured and dose responses were obtained. RESULTS: The 5HT3 receptor expression in Xenopus oocyte was identified by the pharmacologic tools. Serotonin induced rapid inward currents, and thus was showed dose-dependent: KD = 2.5 micrometer, Hill coefficiency = 2.09. Inhibition by the neuromuscular blockers showed dose-dependence and their inhibitory potency on 5HT3 receptor (IC50) was in order of d-tubocurarine (0.046 micrometer) > vecuronium (16.32 micrometer) > gallamine (1,169 micrometer). CONCLUSIONS: There was a different inhibitory effect of nicotinic cholinergic antagonists, clinically used neuromuscular blockers, on the 5HT3 receptor and a judicious selection of them might contribute to reducing the incidence of PONV clinically.
Anxiety ; Baths ; Cholinergic Antagonists ; Clone Cells ; Cognition ; DNA, Complementary ; Electrodes ; Gallamine Triethiodide ; Incidence ; Nausea ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Nociception ; Oocytes* ; Peripheral Nervous System ; Postoperative Nausea and Vomiting ; Receptors, Nicotinic ; RNA, Complementary ; Serotonin* ; Tubocurarine ; Vecuronium Bromide ; Vomiting ; Xenopus*

BACKGROUND: The serotonin type 3 receptors are diffusely distributed in both the central and the peripheral nervous system. Physiological and pathophysiological processes thought to be mediated by this receptor include nausea and vomiting, peripheral nociception and central antinociception, conditioned aversion response to drugs, anxiety, and cognition. Because of the structural similarity between the nicotinic acetylcholine receptor and the 5HT3 receptor, we investigated the effects of clinically used neuromuscular blockers on the 5HT3 receptor function related with PONV. METHODS: A cDNA clone encoding the full length murine 5HT3a receptor was subcloned into an oocyte expression vector and 50 ng of cRNA transcribed in vitro injected per oocyte. After 24 72 h incubation, oocytes were placed into a recording chamber continuously perfused with frog Ringer's solution and electrophysiological recordings were obtained by the two electrode voltage clamp technique. Serotonin with or without the various drugs were bath applied by a computer controlled solenoid valve. Peak currents induced by the drug applications were measured and dose responses were obtained. RESULTS: The 5HT3 receptor expression in Xenopus oocyte was identified by the pharmacologic tools. Serotonin induced rapid inward currents, and thus was showed dose-dependent: KD = 2.5 micrometer, Hill coefficiency = 2.09. Inhibition by the neuromuscular blockers showed dose-dependence and their inhibitory potency on 5HT3 receptor (IC50) was in order of d-tubocurarine (0.046 micrometer) > vecuronium (16.32 micrometer) > gallamine (1,169 micrometer). CONCLUSIONS: There was a different inhibitory effect of nicotinic cholinergic antagonists, clinically used neuromuscular blockers, on the 5HT3 receptor and a judicious selection of them might contribute to reducing the incidence of PONV clinically.
Anxiety ; Baths ; Cholinergic Antagonists ; Clone Cells ; Cognition ; DNA, Complementary ; Electrodes ; Gallamine Triethiodide ; Incidence ; Nausea ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Nociception ; Oocytes* ; Peripheral Nervous System ; Postoperative Nausea and Vomiting ; Receptors, Nicotinic ; RNA, Complementary ; Serotonin* ; Tubocurarine ; Vecuronium Bromide ; Vomiting ; Xenopus*

In the previous study, serial section analysis in the Adriamycin animal model of progressive glomerulosclerosis, diffuse, rather than focal glomerulosclerosis were reported. However, the study in patients with nephrotic syndrome and idiopathic focal segmental glomerulosclerosis by three-dimensional analysis demonstrated a focal pattern of sclerosis. The distribution of lesions, whether focal or diffuse, has important implications, not only for pathogenesis and potential therapeutic response, but also for relevance of animal studies to human disease. We therefore evaluated the distribution of segmental glomerulosclerosis in the rat remnant kidney model. We used male M nich-Wistar rats weighing 250 grams at the start of the experiments. Ten rats had 1-1/2 nephrectomy. At the 24th week after the surgical procedure, GFR and arterial BP were measured. Renal tissues were then perfused with 1% glutaraldehyde at physiologic pressures. Sixty serial sections(4 micrometer thick) per a rat were stained with PAS. An average of 19.2+2.4 glomeruli was examined. Sclerosis assessed on a single section involved 32.6+11.4%. After the serial section analysis, the percent of glomeruli involved by sclerosis increased to 57.6+15.0%. Our results show that single section examination of kidney tissue underestimates glomerulosclerosis in the renal ablation model. However, much more intact glomeruli were present in the renal ablation model compared to Adriamycin rat model after serial section analysis. This finding may reflect the different pathogenic mechanism between the two animal models.
Animals ; Doxorubicin ; Glomerulosclerosis, Focal Segmental ; Glutaral ; Humans ; Kidney* ; Male ; Models, Animal ; Nephrectomy ; Nephrotic Syndrome ; Rats* ; Sclerosis

No abstract available.
Gyeongsangbuk-do* ; Quality Control*

It is uncommon for Fabry's disease (FD) patient to present with an isolated ischemic stroke without other typical symptoms or signs of FD. A 48-year-old woman presented with recurrent limb weakness and her brain magnetic resonance imaging revealed multiple ischemic brain lesions. Ten years ago, the patient had been diagnosed with heterozygote FD by the genetic test, but she had not shown any typical symptoms or sign of FD so far. Isolated organ involvement could occur in heterozygote FD.
Brain ; Brain Ischemia ; Extremities ; Fabry Disease ; Female ; Heterozygote ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Stroke

BACKGROUND AND OBJECTIVES: Platelet activation and aggregation, with resultant arterial thrombus formation, play pivotal roles in the pathophysiology of acute coronary syndrome (ACS). The efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin, or low molecular heparin (LMWH), in the management of ACS were evaluated. SUBJECTS AND MEHTODS: One hundred seventeen patients (60.8+/-10.9 years, 76 male), with unstable angina or non-ST elevation myocardial infarction, who had ST-T changes and elevated troponin, were divided into 4 groups : Group I (n=30 : heparin alone), Group II (n=28 : LMWH, dalteparin alone), Group III (n=29 : tirofiban combined with heparin) and Group IV (n=30 : tirofiban with LMWH). The major adverse cardiac events (MACE) among the 4 groups, during 6-month clinical follow-ups, were compared. RESULTS: Percutaneous coronary intervention, or a coronary artery bypass graft, was performed in 23, 19, 19 and 22 patients from Groups I, II, III and IV, respectively (p=0.87). A minor bleeding complication developed in 2 (6.7%), 1 (3.6%), 1 (3.4%) and 2 patients (6.7%) in groups I, II, III and IV, respectively (p=0.79). During the six-month follow-up MACE occurred in 7 (30.4%), 6 (31.6%), 3 (15.8%) and 4 patients (18.2%) in groups I, II, III and IV, respectively (p=0.02 : Group I and II vs. Group III and IV). CONCLUSION: Tirofiban combined with LMWH is safe and may improve the long-term prognosis of patients with ACS.
Acute Coronary Syndrome* ; Angina, Unstable ; Angioplasty ; Blood Platelets* ; Coronary Artery Bypass ; Dalteparin ; Follow-Up Studies ; Glycoproteins* ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Platelet Activation ; Prognosis ; Thrombosis ; Transplants ; Troponin

Prepancreatic postduodenal portal vein (PPPV) is a rare anomaly in which the portal vein runs between the pancreatic head and the duodenum. Understanding of this portal vein anomaly is important to avoid devastating complications, including portal vein ligation, resection or intraoperative hemorrhage. A 28-year-old female patient presented with right upper quadrant pain that she had suffered with for 2 days. Before performing laparoscopic cholecystectomy, we detected an abnormal shaped portal vein that ran in front of the pancreatic head and posterior to the duodenum on the CT scan. We report here on a rare case of prepancreatic postduodenal portal vein that was incidentally discovered on the CT axial images and coronally reformated images, in addition to observing it on the conventional portography.
Adult ; Cholecystectomy, Laparoscopic ; Duodenum ; Female ; Head ; Hemorrhage ; Humans ; Ligation ; Portal Vein* ; Portography ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Previous studies examining the gender differences in patients undergoing percutaneous coronary intervention (PCI) have reported that women have a higher in-hospital mortality rate, and are at an increased risk for adverse outcomes compared to men. The aim of this study was to determine whether or not Korean women undergoing contemporary PCI have a higher risk than men. SUBJECTS AND METHODS:Seventy eight elderly patients with 105 lesions, including 33 women (47 lesions, 81.9+/-1.97 year-old) and 45 men (58 lesions, 81.6+/-1.74 year-old) who underwent PCI from Jan 1996 to Apr 2001 were enrolled in this study. The demographics, angiographic findings and the clinical outcomes of each gender were compared. RESULTS: Clinical diagnosis and risk factors for atherosclerosis for males and females were similar with the exception of their smoking status (36.7% vs. 14.8%, p=0.002) and stroke history (9.1% vs. 0%, p=0.038). There were no differences in the major in-hospital complications including cardiac death (12.1% vs 15.6%, p=0.75), acute myocardial infarction (AMI:3% vs. 0%, p=0.42), rescue PCI (3% vs. 0%, p=0.42) and emergent coronary artery bypass grafts (CABG:6.1% vs. 11.1%. p=0.44) between the two groups. A twelve-month clinical follow-up showed that the major adverse cardiac events including cardiac death (17.8% vs 28.9%, p=0.27), AMI (0% vs. 5.3%, p=0.5) and repeated revascularization (20.7% vs. 15.8%, p=0.6) in males and females were also similar. CONCLUSION: PCI in Korean female patients older than 80 years can be performed with a comparable procedural success rate and clinical outcomes to those of elderly male patients.
Aged ; Aged, 80 and over* ; Angioplasty ; Atherosclerosis ; Coronary Artery Bypass ; Coronary Disease ; Death ; Demography ; Diagnosis ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Male ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Prognosis ; Risk Factors ; Smoke ; Smoking ; Stroke ; Transplants

PURPOSE: Human embryonic stem (ES) cell is pluripotent cell derived from a group of cells called the inner cell mass and has the ability to reproduce itself for long periods and give rise to types of cells that develop from the three germ layers. Due to its pluripotency, ES cell holds the promise of being able to replace cells that are damaged or destroyed by many devastating diseases. However, the potential for the recipient of an ES cell transplant to reject this cell as foreign is very high. Thus, it is essential to determine whether human ES cells express MHC antigens. The purpose of this study is to characterize the stem cell properties of our cell line (SNUhES1) and the expression profile of MHC antigens on the surface of these cells and their differentiated derivatives, embryoid bodies (EBs). METHODS: The ES cells were grown on STO fibroblast in DMEM-F12. The EBs were grown in the same medium with exception that it lacked LIF and bFGF. The expression of self-renewal-associated genes and three germ layer cell-specific genes in ES cells and EBs were measured by RT-PCR at varying time point of incubation (1, 7, 14 and 28 day). The expression of MHC molecules were measured by RT-PCR and FACS analysis. RESULTS: The SNUhES1 cells expressed all self-renewal- associated genes (Fgf4, FoxD3, Oct4, Sox2 and TERT) we tested. During the differentiation three germ layer cell-specific genes in EBs were expressed as following order: ecto-, meso- and endodermal cell-specific genes. MHC class I proteins (HLA-ABC and beta2m) on the surfaces of ES cells and EBs were expressed in very low levels. MHC class II proteins (HLA-DP, -DQ and -DR) and HLA-G were not expressed on the surface of these cells. However, the expression of MHC class II proteins were detected in 1% more or less cells of 28-day-old EBs which were hardly detected in the population of 1-day-old EBs. CONCLUSION: These data imply that SNUhES1 cells and EBs have stem cell properties. Although they express very low MHC antigens, further investigation determining whether the MHC expression in the ES cells and EBs may alter under inflammatory condition which can be occurred in damaged tissue or through surgical process.
Cell Line ; Embryoid Bodies* ; Embryonic Stem Cells* ; Endoderm ; Fibroblasts ; Germ Layers ; HLA-G Antigens ; Humans* ; Stem Cells ; Transplants