No abstract available.
Hepatocytes*

No abstract available.
Varicose Veins

No abstract available.
Animals ; Liver Regeneration* ; Liver Transplantation* ; Liver* ; Rats*

Background: This study analyzed the effect of applying the diagnosis-related group (DRG)-based payment system, which was implemented in July 2012 for hospitals and clinics nationwide, on the cesarean section rate. Methods: The subjects of the study were divided into new groups that participated in the payment system after July 2012 and maintenance groups that participated in the payment system before July 2012. As an analysis method, a difference-in-difference analysis, which is a quasi-experimental design, was used. The risk-adjusted cesarean section rate was used as a dependent variable. Results: Seven risk factors (malpresentation of fetus, eclampsia, multiple pregnancies, problems in the placenta, previous Cesarean section, cephalopelvic disproportion, problems in amniotic fluid) were included in the final risk-adjustment model, and found to have a statistically significant relationship with the cesarean section rate. Results showed that the risk-adjusted cesarean section rate increased significantly in new groups after the application of the DRG-based payment system. Conclusion Study results provided policy implications for the reorganization of the DRG-based system should that reflects the demands of obstetricians, such as organizing a consultative body with obstetricians and establishing a reasonable fee.

PURPOSE: We evaluated the clinical characteristics of respiratory viruses that were frequently found in children during spring/summer, namely, human bocavirus (hBoV), human metapneumovirus (hMPV), parainfluenza virus (PIV), and human rhinovirus (hRV). METHODS: This study enrolled patients with acute lower respiratory infection in whom respiratory virus reverse transcriptase polymerase chain reaction was performed between March 2013 and August of 2013. We retrospectively reviewed the medical records to collect the patients' data. RESULTS: A total of 96 patients were enrolled and divided into 5 categories: hBoV in 19 patients (19.8%), hMPV in 18 patients (18.8%), PIV in 16 patients (16.7%), hRV in 20 patients (20.8%), and negative result in 23 patients (24.0%). The mean age of the patients was 8.2+/-5.9 months (median, 7.5 months; range, 1-24 months), and the male-to-female ratio was 1.1:1. The most common diagnoses were acute bronchiolitis (62.5%) and pneumonia (30.2%). Compared to other patients, those with hBoV were older (12.3+/-4.9 months, P=0.001) and more frequently diagnosed with acute bronchiolitis (P=0.005). In addition, they showed higher incidences of tachypnea and rales (P=0.039 and P=0.035, respectively), and were more frequently treated with oxygen and systemic steroids (P=0.044 and P=0.001, respectively) than the other patients. CONCLUSION: We compared respiratory viruses in children during spring/summer and found that hBoV may have more severe clinical manifestations than other viruses.
Bronchiolitis ; Child* ; Diagnosis ; Human bocavirus* ; Humans ; Humans* ; Incidence ; Medical Records ; Metapneumovirus ; Oxygen ; Paramyxoviridae Infections ; Pneumonia ; Respiratory Sounds ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus ; Steroids ; Tachypnea

BACKGROUND: A shortage of kidney donors has produced a progressively increasing gap between the supply of cadaveric kidneys and the demand for cadaveric transplants. Thus, efforts to expand the donor pool have included the use of the living related and unrelated kidney donors in Korea. In certain countries like ours, cadaveric kidney sources are very limited for various reasons, therefore, the living kidney donors have been a major source for uremic patients in our hospital. We propose a new program for donation, in which is an exchange-donor program. It is a program in which the donation is not commercial, but voluntary, thus overcoming the shortage of cadaveric donors, and giving the opportunity for transplant to as many uremic patients as possible. METHODS: Between Jan. 1991 and Dec. 1997, 411 living-donor renal transplants were performed in our hospital. Of those, 61 patients received grafts from exchange donors. We compared the graft survival rate of the exchange-donor transplantations with that of the living related donor transplantations based on the recipient's age and sex, the donor's age and sex, human leukocyte antigens (HLA) mismatching, and the frequency of acute rejection. RESULTS: Fifty-nine (59) of 61 patients were still alive in Dec. 1997, with a median follow-up of 31 months (6-76 months), and the mean serum creatinine level was 1.64 mg/dL. The graft survival rates of the exchange-donor renal transplantations at 1 and 5 years were 92.12% and 80.27%, respectively, and there were no significant differences compared with those of the living related renal transplantations (p=0.1424). The graft survival rates at 1 and 5 years were 93.75% and 81.25%, respectively, for those with more than one HLA-haploidentical pair, and 91.89% and 78.76% for those with less than a one-haplotype match, respectively. The frequency of acute rejection was 37.7% in the exchange-donor group. The renal function of the exchange donors after the donation was not altered, and the postoperative complication rate was 1.6%. CONCLUSIONS: The results show that the graft survival rates of the exchange-donor program were similar to those of the living related renal transplantations, and that the good graft survival rates for the exchange-donor group could not be attributed to better HLA matching. We propose an exchange-donor program that will be able to expand the donor pool and overcome the shortage of cadaveric organ donors.
Cadaver ; Creatinine ; Follow-Up Studies ; Graft Survival ; HLA Antigens ; Humans ; Kidney ; Kidney Transplantation* ; Korea ; Postoperative Complications ; Tissue Donors ; Transplants

BACKGROUND: This study aims to analyze the effects of insurance types on the medical service uses for heart failure inpatients using propensity score matching (PSM). METHODS: 2014 National inpatient sample based on health insurance claims data was used in the analysis. PSM was applied to control factors influencing the service uses except insurance types. Negative binomial regression was used after PSM to analyze factors that had influences on the service uses among inpatients. Subjects were divided by health insurance type, national health insurance (NHI) and medical aid (MA). Total charges and length of stay were used to represent the medical service uses. Covariance variables in PSM consist of sociodemographic characteristics (gender, age, Elixhauser comorbidity index) and hospital characteristics (hospital types, number of beds, location, number of doctors per 50 beds). These variables were also used as independent variables in negative binomial regression. RESULTS: After the PSM, length of stay showed statistically significant difference on medical uses between insurance types. Negative binomial regression provided that insurance types, Elixhauser comorbidity index, and number of doctors per 50 beds were significant on the length of stay. CONCLUSION: This study provided that the service uses, especially length of stay, were differed by insurance types. Health policy makers will be required to prepare interventions to narrow the gap of the service uses between NHI and MA.
Comorbidity ; Health Policy ; Heart Failure* ; Heart* ; Humans ; Inpatients* ; Insurance* ; Insurance, Health ; Length of Stay ; National Health Programs ; Propensity Score*

Background: Quantitative viral load tests are essential for diagnosing and monitoring the response to antiviral treatment for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus type 1 (HIV-1) infections. The Hologic Aptima Quant assay (Hologic Inc., USA) is a fully integrated and automated quantitative assay based on real-time transcription-mediated amplification technology using the Panthers system.In this study, we evaluated the performance of the Hologic Aptima Quant assay for measuring HBV, HCV, and HIV-1 viral load, and compared the results with those obtained with Abbott Alinity m system (Abbott Laboratories, USA). Methods: The reproducibility and linearity of the assay were evaluated in the present study. Additionally, the precision, analytical specificity, interference, and limit of detection (LOD) of each assay on the Panther system were evaluated. A comparative evaluation between the Hologic Aptima Quant assay and the Abbott Alinity m assay was conducted using clinical patient samples. Results: The results of the precision study demonstrated excellent total precision, with the coefficient of variation of precision being less than 5%. The linearity of the viral loads was excellent for all assays (correlation coefficient [R2 ] >0.99 for HBV, HCV, and HIV-1). Furthermore, the specificity of all assays was determined to be 100%. The LOD results were 10 IU/mL for HBV and HCV assays, and 20 copies/mL for HIV-1 assay, with 100% replicates being detected. Additionally, the viral load measured with the Hologic Aptima Quant assay was strongly correlated with that measured with Abbott Alinity m assay (R2 =0.94–0.97). Conclusions The Hologic Aptima Quant assay demonstrated excellent performance, with results being comparable to those obtained with the Abbott Alinity m assay for detecting HBV, HCV, and HIV-1 viral loads.

OBJECTIVES: The stress response involves the activation of the hypothalamic-pituitary-adrenal(HPA) axis and the sympathetic nervous system. Corticosteroids have been clearly demonstrated to cause anti-inflammatory and/or immnosuppressive effects in man including granulocytosis in part by decreasing migration into tissue, especially damaged tissues(myocardium), and circulating relative lymphocytopenia. To test whether automated measurements of the the increased serum cortisol-induced hematologic changes in the leukocyte differential significance or not in the initial differential diagnosis of acute myocardial infarction in acute chest pain syndromes. METHODS: 101 consecutive patients with myocardial infarction or myocardial ischemia presenting to the emergency room of Seoul Adventist Hospital with acute chest pain from January 1993 to August 1995(Retrospective group) and from December 1995 to March patients compatible with exclusion criteria in myocardial infarction were excluded. We measured automated leukocyte differential and serial CK-MB level in both groups, and the intial serum cortisol levels in prospective infarction group. RESULTS: 1) Total leukocyte and granulocyte counts were increased in acute myocardial infarction(p<0.01). 2) In acute myocardial infarction group, lymphocyte counts were slightly increased(p<0.05), but relative lymphocytes percentage more significantly decreased(p<0.01). 3) Serum cortisol levels are significantly raised early in the course of the acute myocardial infarction and prior to the elevation of the specific cardiac enzymes on the basis of analytic results of prospective infarction group. 4) Cortisol-induced changes in leukocyte differential were noted with time passes into reverse approximately 4 days later in our study. 5) The leukocyte differential does not shows significant changes in the retrospective myocardial ischemia group, so we arrive in careful conclusion that serum cortisol level seems does not increase. 6) No sexual differences were noted in leukocyte differential. CONCLUSIONS: The serum cortisol level and cortisol-induced leukocyte differential are helpful for initial differential diagnosis of acute myocardial infarction in acute chest pain sysdrome.
Adrenal Cortex Hormones ; Axis, Cervical Vertebra ; Chest Pain* ; Diagnosis, Differential* ; Emergency Service, Hospital ; Granulocytes ; Humans ; Hydrocortisone* ; Infarction ; Leukocytes* ; Lymphocyte Count ; Lymphocytes ; Lymphopenia ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Retrospective Studies ; Seoul ; Sympathetic Nervous System ; Thorax*

The extracellular calcium sensing receptor (CaSR) belongs to the type III family of G-protein-coupled receptors, a family that comprises the metabotropic glutamate receptor and the putative vomeronasal organ receptors. The CaSR plays an important role for calcium homeostasis in parathyroid cells, kidney cells and other cells to directly 'sense' changes in the extracellular calcium ion concentration ((Ca2+)o). The mesangial cells are known to be involved in many pathologic sequences through the mediation of altered glomerular hemodynamics, cell proliferation, and matrix production. In this study, we examined the expression of the CaSR in the mouse mesangial cell lines (MMC, ATCC number CRL-1927). Reverse transcription- polymerase chain reaction (RT-PCR) was perform with CaSR-specific primers, and this was followed by nucleotide sequencing of the amplified product; this process identified the CaSR transcript in the MMCs. Moreover, CaSR protein was present in the MMCs as assessed by Western blot and immunocytochemical analysis using a polyclonal antibody specific for the CaSR. Functionally, (Ca2+)o induced the increment of the intracellular calcium concentration ((Ca2+)i) in a dose-dependent manner. This (Ca2+)i increment by (Ca2+)o was attenuated by the pretreatment with a phospholipase C inhibitor (U73122) and also by a pretreatment with a CaSR antagonist (NPS 2390). The similar results were also obtained in IP3 accumulation by (Ca2+)o. To investigate the physiological effect of the CaSR, the effect of the (Ca2+)o on cell proliferation was studied. The increased (Ca2+)o (up to 10 mM) produced a significant increase in the cell numbers. This mitogenic effect of (Ca2+)o was inhibited by the co-treatment with a CaSR antagonist. From these results, the (Ca2+)o-induced (Ca2+)i elevation in the MMC is coupled with the extracellular calcium sensing receptor. Furthermore, (Ca2+)o produces a mitogenic effect in MMCs.
Animals ; Calcium/metabolism ; Cell Line ; Cell Proliferation ; Inositol 1,4,5-Trisphosphate/metabolism ; Mesangial Cells/*cytology/*metabolism ; Mice ; RNA, Messenger/genetics/metabolism ; Receptors, Calcium-Sensing/genetics/*metabolism ; Research Support, Non-U.S. Gov't