The objective of this study was to provide basic reference data for stabilization scheme of medical insurance benefits through forecasting of the medical care utilization rate, the medical expense per case, and the treatment days per case in medical insurance program for government employees and private school teachers and for industrial workers. For the achievement of above objective, this study was carried out by Bos-Jenkins time series analysis (ARIMA Model), using monthly statistical data from Jan. 1979 to Dec. 1989, of medical insurance program for government employees and private school teachers and for industrial workers. The results are as follows; ARIMA model of the medical care utilization rate in medical insurance program for government employees and private school teachers was ARIMA (1, 1, 1) and it for outpatient in medical insurance program for industrial workers was ARIMA (1, 1, 1), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the medical expense per case in medical insurance program for government employees and private school teachers and for outpatient in medical insurance program for industrial workers were ARIMA (1, 1, 0), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the treatment days per case of both medical insurance program for government employees and private school teachers and industrial workers were ARIMA (1, 1, 1). Forecasting value of the medical care utilization rate for inpatient in medical insurance program for government employees and private school teachers was 0.0061 at dec. 1989, 0.0066 at dec. 1994 and it for outpatient was 0.280 at dec. 1989, 0.294 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 0.0052 at dec. 1989, 0.0056 at dec. 1994 and it for outpatient was 0.203 at dec. 1989, 0.215 at 1994. Forecasting value of the medical expense per case for inpatient in medical insurance program for government employees and private school teachers was 332,751 at dec. 1989, 354,511 at dec. 1994 and it for outpatient was 11,925 at dec. 1989, 12,904 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 281,835 at dec. 1989, 293,973 at dec. 1994 and it for outpatient was 11,599 at dec. 1989, 11,585 at 1994. Forecasting value of the treatment days per case for inpatient in medical insurance program for government employees and private school teachers was 13.79 at dec. 1989, 13.85 at dec. 1994 and it for outpatient was 5.03 at dec. 1989, 5.00 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 12.23 at dec. 1989, 12.85 at dec. 1994 and it for outpatient was 4.61 at dec. 1989, 4.60 at 1994.
Forecasting ; Humans ; Inpatients ; Insurance Benefits ; Insurance* ; Moclobemide* ; Outpatients

Transforming growth factor (TGF)-beta1 is an important fibrogenic factor that is involved in the pathogenesis of diabetic nephropathy. We evaluated the effect of circular antisense TGF-beta1 oligodeoxynucleotides (ODNs) on the TGF-beta1 expression in the rat mesangial cell culture and in streptozotocin (STZ)-induced diabetic rats. Circular antisense TGF-beta1 ODNs were found to be stable in rat serum, significantly decreasing TGF-beta1 mRNA expression compared with linear antisense ODNs in the rat mesangial cell culture. Circular antisense TGF-beta1 ODNs were introduced into the tail vein of normal rats using hemagglutinating virus of Japan (HVJ)-liposome-mediated gene transfer method and were confirmed to be delivered effectively into the kidney, liver, lungs, and spleen. To inhibit the overexpression of TGF-beta1 in diabetic kidneys, we introduced circular antisense TGF-beta1 ODNs into the STZ-induced diabetic rats. On day 13 after circular antisense TGF-beta1 ODNs injection, TGF-beta1 mRNA and protein expression markedly decreased and urinary TGF-beta1 excretion rate also dropped in the circular antisense TGF-beta1 ODNs-treated diabetic rats. These results suggest that circular antisense TGF-beta1 ODNs may be a useful tool for developing new therapeutic application for progressive diabetic nephropathy.
Animals ; Blood Glucose/metabolism ; Cells, Cultured ; Diabetes Mellitus, Experimental/*therapy ; Enzyme-Linked Immunosorbent Assay ; Gene Transfer Techniques ; Immunohistochemistry ; Liposomes/chemistry ; Male ; Microscopy, Confocal ; Oligonucleotides, Antisense/metabolism/pharmacology/*therapeutic use ; RNA/metabolism ; RNA, Messenger/metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Streptozocin ; Support, Non-U.S. Gov't ; Time Factors ; Transfection ; Transforming Growth Factor beta/*genetics

We report a case of retroperitoneal hemorrhage and abdominal wall hemorrhage due to spontaneous lumbar artery and inferior epigastric artery rupture, in a patient with chronic renal failure treated with hemodialysis. There was no history of specific trauma. The bleeding was confirmed by CT and angiography, and controlled successfully by selective angiographic embolization. We suggest that a possibility of spontaneous retroperitoneal bleeding should be considered in a case of abdominal pain or mass in a hemodialysis patient.
Abdominal Pain ; Abdominal Wall ; Angiography ; Arteries* ; Epigastric Arteries* ; Hemorrhage ; Humans ; Kidney Failure, Chronic ; Renal Dialysis* ; Rupture ; Rupture, Spontaneous*

Twenty-four factories registered at the Ministry of Labor as factories using or producing cadmium in 1991 were investigated to know the present state of occupational exposure to cadmium in 1992. Nine factories among 24 stopped using or changed to other substances and 1 factory didn't produce any more, but delivered it to other factories through imports. Therefore, only 14 factories were producing or using cadmium. But, alloying materials were uspplied to about 20 and more factories, however, they couldn't be investigated because of limited information. Three factories had less than 50 workers were 3, 6 had 50-300 and 5 had more than 300. About 167 workers were exposed to cadmium. According to the classification by process, there were 4 alloy processes, 2 refinary, 2 elctroplating, 2 dry cell making, 1 industrial battery and 1 copper refinary. 8 factories used metal cadmium, 3 cadmium oxide, 2 cadmium sulfide, and 1 cadmium hyroxide. One factory was importing cadmium stearates only and supplying them to the PVC making factories. The amount of metal cadmium producing in 2 refinary factories was about 50-65 ton per month. The other cadmium compounds were imported. According to exposure level of cadmium in air of the 10 factories examined, each factory could be divided into high, moderate and low exposure groups. 1 battery recycling factory and 3 alloy factories were in the high exposure group and their mean air concentrations were 0.06679, 0.05481, 0.02492, and 0.003mg/m3, respectively. Refinary and industrial battery making factories were in the middle exposure group and their mean air concentrations were 0.00773 and 0.00613 mg/m3, respectively. Finally, low exposure group were copper smelting, dry cell case making, duplicator drum making and electroplating factory and their mean air concentrations were 0.00096, 0.00071, 0.00057 and 0.00054 mg/m3 respectively.
Alloys ; Cadmium Compounds ; Cadmium* ; Classification ; Copper ; Electroplating ; Korea* ; Occupational Exposure* ; Osmeriformes ; Recycling ; Stearates

PURPOSE: To evaluate the association between degree of retinal abnormalities and uncorrected visual acuity (UCVA) in idiopathic epiretinal membrane (ERM) patients with a small amount of refractive error. METHODS: We retrospectively reviewed 49 eyes (37 patients) of idiopathic ERM patients. We investigated the association between visual acuity and macular status (central macular thickness [CMT], outer retinal integrity score, and inner retinal irregularity index) that was assessed by optical coherence tomography using multiple linear regression analysis. We defined visual acuity difference (VAD) as the difference between UCVA and best-corrected visual acuity (BCVA). We divided patients into two groups according to VAD size and compared clinical characteristics between the two groups. We also investigated factors associated with VAD using multiple linear regression analysis. RESULTS: BCVA showed significant association with CMT and outer retinal integrity score, while UCVA showed significant association with CMT and inner retinal irregularity index. Patients with a large VAD showed a similar level of BCVA compared to the small VAD group (logarithm of the minimum angle of resolution [logMAR], large VAD group 0.11 ± 0.11 vs. small VAD group 0.13 ± 0.12, p = 0.585). However, UCVA was worse (logMAR, large VAD group 0.44 ± 0.14 vs. small VAD group 0.18 ± 0.14, p < 0.001) and inner retinal irregularity was higher (large VAD group 1.06 ± 0.04 vs. small VAD group 1.04 ± 0.03, p < 0.001) in patients with a large VAD. On multiple linear regression analysis, the absolute value of spherical equivalent (standardized coefficient β 0.521, p < 0.001) and inner retinal irregularity index (standardized coefficient β 0.448, p < 0.001) were significantly associated with VAD. CONCLUSIONS: UCVA was associated with inner retinal irregularity in idiopathic ERM patients with a mild degree of refractive error. Inner retinal irregularity was also associated with degree of VAD, suggesting that the effect of refractive error correction is greater in patients with more distorted retina.
Epiretinal Membrane* ; Humans ; Linear Models ; Refractive Errors ; Retina ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity*

We examined the ultrastructural features of the lung parenchyma and the expression of apoptosis of the respiratory cells by TUNEL technique. Male Sprague-Dawley rats (n=30) were intra-tracheally injected with cadmium (2.5 mg/kg) into both lungs. The light and electron microscopic features of the lung tissues were examined on Days 1, 3, 7 and 10 after the injection of cadmium. Specimen preparations for the light and electron microscopic TUNEL stains were performed. Ultrastructurally, on Days 1 and 3, the alveolar spaces were filled with edematous fluid, and desquamated type I epithelial cells. On Days 7 and 10, the alveolar spaces and interstitium were patchy infiltrated with young fibroblasts and some collagen deposition. The light microscopic TUNEL stain showed that apoptosis of the alveolar cells was most prominent on Day 1, and then the number of apoptosis was markedly decreased on Days 3, 7 and 10. The electron microscopic TUNEL stain showed the electron dense homogenous nuclear expression, and the formation of intra-nuclear blebs which protrude to the outside of nuclei. On Days 7 and 10, there are frequent apoptotic nuclear bodies in the alveolar macrophages. We could examine the identification of the equivocal apoptotic cells and various morphologic expression of apoptotic nuclei on the electron microscopic TUNEL stain.
Acetone/pharmacology ; Animals ; Apoptosis ; Cadmium/metabolism/*pharmacology ; Cell Nucleus/metabolism ; *In Situ Nick-End Labeling ; Lung/*cytology/*injuries/pathology/*ultrastructure ; Male ; Microscopy, Electron ; Microscopy, Electron, Scanning ; Pulmonary Alveoli/metabolism ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't ; Time Factors

For the repairing of bone defect, autogenous or allogenic bone grafting remains the standard. However, these methods have numerous disadvantages including limited amount, donor site morbidity and spread of diseases. Tissue engineering technique by culturing stem cells may allow for a smart solution for this problem. Adipose tissue contains mesenchymal stem cells that can be differentiate into bone, cartilage, fat or muscle by exposing them to specific growth conditions. In this study, the authors procured the stem cell from buccal fat pad and differentiate them into osteoblast and are to examine the bone induction capacity. Buccal fat-derived cells (BFDC) were obtained from human buccal fat pad and cultured. BFDC were analyzed for presence of stem cell by immunofluorescent staining against CD-34, CD-105 and STRO-1. After BFDC were differentiated in osteogenic medium for three passages, their ability to differentiate into osteogenic pathway were checked by alkaline phosphatase (ALP) staining, Alizarin red staining and RT-PCR for osteocalcin (OC) gene expression. Immunofluorescent and biochemical assays demonstrated that BFDC might be a distinguished stem cells and mineralization was accompanied by increased activity or expression of ALP and OC. And calcium phosphate deposition was also detected in their extracelluar matrix. The current study supports the presence of stem cells within the buccal fat pad and the potential implications for human bone tissue engineering for maxillofacial reconstruction.
Adipose Tissue* ; Adult Stem Cells* ; Adult* ; Alkaline Phosphatase ; Bone and Bones ; Bone Transplantation ; Calcium ; Cartilage ; Gene Expression ; Humans ; Mesenchymal Stromal Cells ; Osteoblasts* ; Osteocalcin ; Stem Cells ; Tissue Donors ; Tissue Engineering

PURPOSE: To evaluate the clinical result of congenital muscular torticollis treatment in patients older than 8 years. MATERIALS AND METHODS: Thirty two patients over 8 years who had not received any prior medical treatment or who recurred after the initial operation were included in this study. The patients were divided into two groups (Group 1; still in growth and Group 2; reached full growth). The average follow-up period was 9 months. Clinical results were assessed by using motion deficits, craniofacial asymmetry, scarrng, band, head tilt, and by subjective assessment. RESULTS: Clinical results were less successful in Group 2 than in Group 1. However, most members of Group 2 showed a marked improvement of neck motion and head tilt with satisfactory functional and cosmetic results. CONCLUSIONS: In patients older than school age, even in those who have reached full growth, satisfactory results can be expected by complete releasing the sternocleidomastoid muscle and intensive postoperative care.
Follow-Up Studies ; Head ; Humans ; Neck ; Postoperative Care ; Torticollis*

PURPOSE: To investigate the morphological features of choroidal vasculature in patients with erectile dysfunction (ED) by analyzing choroidal thickness using optical coherence tomography. MATERIALS AND METHODS: We enrolled 39 patients with ED and 19 controls. ED was defined as an erectile function domain score < 26 on the International Index of Erectile Function (IIEF) questionnaire. Small-choroidal-vessel-layer (SCVL) thickness was calculated by subtracting large-choroidal-vessel-layer (which corresponded to Haller's layer) thickness from total choroidal thickness. Choroidal thickness was compared between the ED and control groups. RESULTS: SCVL thickness was lesser in the ED group than in the control group (control, 69.8±24.3 µm vs. ED, 55.1±19.9 µm; p=0.017). Among patients without diabetes, the ED group showed significantly lesser SCVL thickness than did the control group (control, 77.1±22.7 µm vs. ED, 56.5±20.9 µm; p=0.021). However, among patients with diabetes, choroidal thickness showed no significant intergroup difference. Multiple linear regression analysis revealed that spherical equivalent (standardized coefficient β=0.294; p=0.019) and the IIEF erectile function score (standardized coefficient β=0.315; p=0.012) were significantly associated with SCVL thickness. CONCLUSIONS: SCVL thickness, including the choriocapillaris layer and medium-sized choroidal vascular layer, decreased in proportion to ED severity, suggesting that microvascular changes in choroidal vessels may occur before specific ocular diseases in patients with ED.
Choroid* ; Erectile Dysfunction* ; Humans ; Linear Models ; Male ; Tomography, Optical Coherence

OBJECTIVES: The purpose of this study is to analyze sleep habit and investigate the association between insomnia and demographic, health and psycho-behavioral symptomatology in Korean urban elderly. METHOD: A total of 723 community residents aged 65 years or older were surveyed by two stage, random cluster sampling method. The response rate was 76.2%. Interviewers performed door to door visits and administered a questionnaire about sleep, past medical history, and several scales as the Psychogeriatric Assessment Scale (PAS), the short form Quality of Life Scale (SF-36) and etc. RESULTS: The mean scores are as follows: retiring time was ten-sixteen p.m., wake-up time was five twenty two a.m., duration of sleep was seven hours and six minutes. Among the elderly, 11.6% and 14.8% of the subjects reported chronic and intermittent difficulty in sleeping, respectively. The patients with back pain and history of stroke complained of more insomnia symptoms in univariate analysis. In ANCOVA analysis, insomnia symptoms were associated with an old age, depressive symptoms in male. Bodily pain and history of dermatologic disease were additional risk factors in female. CONCLUSIONS: The data suggest insomnia is one of most common health problems among elderly Koreans living in the community. Strong positive relationship between depressive symptoms and insomnia were found. Further research is needed to explore the causal relationship between insomnia and risk factors.
Aged* ; Back Pain ; Depression ; Epidemiology ; Female ; Humans ; Male ; Quality of Life ; Surveys and Questionnaires ; Risk Factors ; Sleep Initiation and Maintenance Disorders ; Stroke ; Weights and Measures