BACKGROUND: The EuroQol-5 Dimension (EQ-5D) is the most frequently used questionnaire in cost-utility studies such as the quality-adjusted life year measure. Nevertheless, little attention has been paid to the relationship between an individual's visual analogue scale (VAS) score and EQ-5D dimensions. The objective of this study was to assess the relationship between the EQ-5D and VAS quality of life measures after adjusting for socio-demographic factors in the Korean general population. METHODS: The Fourth Korea National Health and Nutrition Examination Survey, which is a national representative sample, was used to analyze the impact of the EQ-5D dimensions on the VAS. The known-group construct validity of the VAS was assessed by factors that included age, income and comorbidities. The ordinary linear regression models were applied to test for the effect of the EQ-5D dimensions after adjusting for socio-demographic and clinical factors. RESULTS: We found that the VAS showed good construct validity. The VAS significantly declined as age increased, and as education and income levels decreased. VAS scores decreased for all EQ-5D dimensions as the response level rose. The explanatory power of the VAS increased from 23.0% in the first model, which included only the EQ-5D dimensions and levels, to 25.0% in the full model, which included socio-demographic and clinical factors. CONCLUSIONS: While the EQ-5D dimensions were significant factors in determining the VAS, they did not, however, explain a sufficient amount of variance in the VAS. Further research is required on adding more dimensions to the EQ-5D preference-based instrument.
Comorbidity ; Korea ; Linear Models ; Nutrition Surveys ; Quality of Life ; Quality-Adjusted Life Years

No abstract available.
Factor VIII* ; Hemophilia A* ; Humans

To obtain the caries experience and, plaque accumulation severity and pit and fissure morphology in first permanent molars in 7-8 children in Wuhan, as a reasonable prediction of caries risk and preventive attention in the future, a convenient sample of five primary schools in the vicinity of the Wuhan University School and Hospital of Stomatology was drawn. Two calibrated examiners orally examined all present grade 2 children in the classroom, using standard caries plaque and tooth morphology criteria. Dental caries was scored at enamel (D(2)) and dentine (D(3)) for tooth and surface level. Independent variables were age, gender and school. Data analysis used analysis of variance and t-test. The sample comprised 1 043 7- and 8-year-olds. The prevalence of dental caries in permanent dentition was 8.7% and in primary dentition, 68.7%. Mean Decayed, Missing, Filled Teeth/S (DMFT/S) scores were 0.11 and 0.14, respectively. Mean dmft/s scores were 2.8 and 5.0. The d-component constituted 75% of the d(3)mft index, while enamel carious lesions constituted 36% of the total number of carious lesions (d(2,3)-component). Prevalence of medium and deep pits and fissures was 84.6%. Prevalence of medium and severe plaque accumulation was 67.4%. Prevalence of dental caries in the deciduous and permanent dentitions of 7- to 8-year-old children was high. Deep pits and fissures in high caries risk children should be sealed.
Child ; China ; epidemiology ; DMF Index ; Dental Caries ; epidemiology ; prevention & control ; Dental Enamel ; pathology ; Dental Fissures ; pathology ; Dental Plaque Index ; Dentin ; pathology ; Dentition, Permanent ; Female ; Humans ; Male ; Molar ; pathology ; Prevalence ; Tooth, Deciduous

No abstract available.
Humans ; Infant, Newborn* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

No abstract available.
Female ; Humans ; Osteoporosis* ; Uterine Prolapse*

No abstract available
Dermatitis, Atopic* ; Eczema* ; Humans ; Nipples*

BACKGROUND: Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002. We checked the preoperative factors; sex, age, history of previous serum creatinine over 2.0 mg/dL, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors; IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/dL. RESULT: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/dL in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6.4%) in the patients whose creatinine level have not increased over 2.0 mg/dL. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/dL are diabetes, the history of previous serum creatinine over 2.0 mg/dL and left ventricular ejection fraction. CONCLUSION: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2.0 mg/dL and left ventricular ejection fraction. Postoperative ARF could be the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.
Acute Kidney Injury* ; Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Vessels* ; Creatinine ; Dialysis ; Fluid Therapy ; Humans ; Hypertension ; Medical Records ; Mortality ; Postoperative Complications ; Pulmonary Edema ; Risk Factors ; Stroke Volume ; Thoracic Surgery

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.
*Attitude of Health Personnel ; Humans ; Program Development ; Quality Improvement/*economics ; Quality of Health Care/economics ; Reimbursement, Incentive/*organization & administration ; Republic of Korea

In full-thickness defects of the nasal alar rim, to achieve projection and maintain airway patency, cartilage graft is frequently needed. However, cartilage graft presents a challenge in considerations such as appropriate donor site, skeletal shape and size, and healing of the donor area. To avoid these demerits, we tried primary closure of alar rim defects by also making the contralateral normal ala smaller. We treated two patients who had a full-thickness nasal alar defect after tumor excision. Cartilage graft was considered for the reconstruction. However, their alar rims were overly curved and their nostril openings were large. To utilize their nasal shape, we did primary closure of the defect rather than cartilage graft, and then downsized the contralateral nasal ala by means of wedge resection to make the alae symmetric. Both patients were satisfied with their aesthetic results, which showed a smaller nostril and nearly straight alar rims. Moreover, functionally, there was no discomfort during breathing in both patients. We propose our idea as one of the reconstruction options for nasal alar defects. It is a simple and easy-to-perform procedure, in addition to enhancing the nasal contour. This method would be useful for patients with a large nostril and an overly curved alar rim.
Cartilage ; Humans ; Nose Deformities, Acquired ; Reconstructive Surgical Procedures ; Respiration ; Tissue Donors ; Transplants

BACKGROUND: Among the various mechanisms of Myocardial reperfusion injuries, neutrophil is thought to be one of them. Endogenous coronary vasodilator adenosine is known to have myocardial protective effect through variable pharmacologic action, influencing the function of several cell types involved in the pathogenesis of myocardial reperfusion injury. This study was designed to determine the beneficial effect of adenosine on the left ventricular function during reperfusion and whether this effect is due to the adenosine on the role of neutrophil. METHODS: 27 open-chest cats were randomly divided into 3 groups. 6 cats received ischemic injury without reperfusion(group 1). 21 cats were subjected to 60 minutes of proximal left anterior descending coronary artery occlusion followed by a 60-minute reperfusion. 11 of 21 cats received intravenous adenosine(0.15mg/Kg/min) infusion starting 5 minutes before reperfusion throughout the entire period(group 3). 10 cats received equal volume of saline instead of adenosine(group 2). RESULTS: 1) During the experimental period, significant decrease of heart rate, blood pressure, RPI, negative dP/dT and increase of LVEDP were noted in group 2 and 3 with no difference between the two groups. The reduction of positve dP/dT was more significant in group 2 at 30 and 60 minute of reperfusion than the preocclusion value(1404+/-111, 1631+/-161 vs 1832+/-169mmHg/sec at baseline, p<0.05). In contrast, positive dP/dT in group 3 at 30 and 60 minute of reperfusion were similar to baseline values(1890+/-92, 2052+/-112 vs 2025+/-227mmHg/sec at baseline, p=NS). These were significantly higher(p<0.05) than untreated group 2. 2) Infarct size was significantly reduced in adenosine-treated group 3, when expressed as a percentage of the area at risk(28.4+/-3.3% vs 44.5+/-3.2% of group 2, p<0.05). The significant increase in myeloperoxidase activity observed after reperfusion was not detected in adenosine treated group 3.(0.18+/-0.05 vs 0.46+/-0.09 unit/100mg wet tissue weight, p<0.05). A significant correlation was present between infarct size (% of left ventricle) and myeloperoxidase activity(r=0.72, p<0.01). 3) Light microscopic examination demonstrated the decreased acute interstitial and intra vascular inflammatory infiltration and capillary plugging together with decreased tendency of incidence of contraction band necrosis in adenosine treated group 3. CONCLUSION: These findings suggest that intravenous administration of adenosine during the early reperfusion period significantly reduces infarct size, improving the early recovery of global ventricular function. The probable cause is the effect of adenosine on neutrophil as one of the various protective mechanisms of adenosine in feline heart model subjected to coronary occlusion and reperfusion, 60 minutes each.
Adenosine* ; Administration, Intravenous ; Animals ; Blood Pressure ; Capillaries ; Cats ; Coronary Occlusion ; Coronary Vessels ; Heart Rate ; Heart* ; Incidence ; Myocardial Reperfusion Injury* ; Myocardial Reperfusion* ; Necrosis ; Neutrophils ; Peroxidase ; Reperfusion ; Reperfusion Injury ; Ventricular Function ; Ventricular Function, Left