PURPOSE: Systemic inflammatory reaction (SIR) is an important determinant of cardiovascular (CV) mortality in CRF patients. UA is an end-product of purine metabolism, and recent studies have demonstrated that an elevated serum UA level is associated with an increased level of inflammatory mediators. Since hyperuricemia is one of the most prevalent complications in CRF and is linked to CV disease, we hypothesized hyperuricemia in CRF may play an important role in the development of CV disease by inducing SIR. METHODS: PBMCs were isolated by density gradient centrifugation in 21 CRF patients and age and sex-matched 20 healthy adults. CRP expression was evaluated by real time PCR and ELISA in PBMC stimulated with UA (0.3-12 mg/dL). RESULTS: There was no difference in constitutional CRP expression in PBMC from control and CRF patients. UA induced CRP mRNA (RT-PCR) and protein (ELISA) expression in PBMC, which was blocked by the organic anion transport inhibitor, probenecid (1 mM), suggesting entry of uric acid into cells was responsible for CRP expression. PBMC from CRF patients showed a significantly higher CRP production by UA compared to healthy control. There was no correlation between serum UA level and % increase in CRP production by UA. CONCLUSION: The exaggerated CRP expression by UA can be another mechanism of SIR and increased CV morbidity in CRF patients. Prospective studies with uric acid-lowering therapy are necessary to confirm clinical significance of these interesting in-vitro findings.
Adult ; C-Reactive Protein* ; Cardiovascular Diseases ; Centrifugation, Density Gradient ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hyperuricemia ; Inflammation ; Metabolism ; Mortality ; Probenecid ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Uric Acid*

The objectives of this study were to: (a) examine the overall operating conditions of both government-dominant and non-governmental food bank programs, (b) understand the operational management attributes on the target based on IPA (importance performance analysis)(c) analyze the present status of donating management, and (d) suggest a direction based on the analysis of advantages and disadvantages of food banks in each part. The random samples of 120 food bank operators were selected by a proportionate stratified random sampling method. A total of 60 government-dominant food banks and 25 non-governmental food banks were analyzed. The main results of this study were as follows: According to the Importance-Performance Analysis of operational management, "assistance for operating funds" and "deployment of experience staff" were placed at "Focus Here". There was a great shortage of experienced staff with food bank-specific knowledge. The average number of the government-dominant and non-governmental food bank program employees was 0.29 and 0.30 respectively, while the ratios of employees with other jobs were 0.96 and 0.83 respectively. Shortages of refrigeration facilities were an area that needs to be addressed. While 51.6% of donated food required cold storage, only 45% of government-dominant and 60% of non-governmental food bank programs had refrigeration facilities. Most of food bank operators (96.3%) were required to visit the donators' locations to pick up the donated foods. And the foods were distributed to the people in need, especially to the livelihood protectee.
Refrigeration

The purpose of this study was to examine the donators' characteristics and donative foods of both government-dominant and non-governmental food bank program, to understand the problems and benefits of food bank program, and to find the solutions to activate food bank program. The questionnaires were distributed to 120 food bank operators and 3 donators were selected from each food bank for the survey from April 2002 to May 2002. 118 sheets (32.8%) from government-dominant food bank and 53 sheets (20.1%) from non-governmental food bank were collected. The main results of this study were as follows: The largest donators to either government-dominant or non-governmental food bank programs were bakery and confectionery companies 31.4% and 45.3% respectively. The majority of donated foods were "goods in stock" (55.6%) and frequency of donation were largely on a daily basis (27.1% for government-dominant and 22.6% for non-governmental). Some of the donators who had more donative food did not donate, and the reasons were closeness to expiration date of food (67.3%), lack of legal protection in the event of food poisoning (54.5%), and poor public image of food related accidents (52.3%).
Foodborne Diseases

BACKGROUND: The detection of antibody to hepatitis C virus (anti-HCV) is the most useful method to investigate past or current HCV infections. We performed a clinical evaluation of ADVIA Centaur HCV assay, a new third generation assay for the qualitative detection of IgG antibody. METHODS: Included in the study were a total of 323 samples (108 positive and 215 negative), for which HCV reverse transcription polymerase chain reaction (RT-PCR) was requested. ADVIA Centaur HCV assay (Bayer Healthcare LLC, Diagnostics Division, Tarrytown, NY, USA) was compared with a currently available and widely used AxSYM HCV version 3.0 assay (Abbott Laboratories, Abbott Park, IL, USA). Samples with discrepant results were retested with each assay, and further tested with a recombinant immunoblot assay (RIBA, LG HCD Confirm, LG Chemical Co., Seoul, Korea). Reproducibility of Centaur assay was evaluated in five groups (two samples in each group) with different index values. RESULTS: The overall concordance rate was 91.6% (296/323) between Centaur and AxSYM assays. It was 100% (108/108) in RT-PCR positive samples and 87.4% (188/215) in RT-PCR negative samples. Discrepant samples (8.4%, 27/323) were all RT-PCR negative, and all except two were Centaur negative and AxSYM positive. In discrepant samples, RIBA showed negative results except for two samples with indeterminate results. The sensitivity and specificity of Cenyaur assay were 98.1% and 65.6%, and the respective figures for AxSYM assay were 98.1% and 54.9%. Reproducibility of Centaur assay was satisfactory. CONCLUSIONS: The overall concordance between Centaur and AxSYM assays was satisfactory. Sensitivity and specificity of Centaur assay were equivalent to or better than those of AxSYM assay. ADVIA Centaur HCV assay seems to be a reliable and useful method for the detection of anti-HCV in clinical laboratories.
Delivery of Health Care ; Hepacivirus* ; Immunoglobulin G ; Polymerase Chain Reaction ; Reverse Transcription ; Sensitivity and Specificity ; Seoul

PURPOSE: Analyses of risk factors associated with surgical site infections (SSIs) after laparoscopic appendectomy (LA) have been limited. Especially, the association of an underweight body mass index (BMI) with SSIs has not been clearly defined. This study aimed to identify the impact of underweight BMI in predicting SSIs after LA. MATERIALS AND METHODS: The records of a total of 101 consecutive patients aged > or =16 years who underwent LA by a single surgeon between March 2011 and December 2012 were retrieved from a prospectively collected database. The rate of SSIs was compared among the underweight, normal and overweight and obese groups. Also, univariate and multivariate analyses were performed to identify the factors associated with SSIs. RESULTS: The overall rate of SSIs was 12.8%. The superficial incisional SSI rate was highest in the underweight group (44.4% in the underweight group, 11.0% in the normal group, and 0% in the overweight and obese group, p=0.006). In univariate analysis, open conversion and being underweight were determined to be risk factors for SSIs. Underweight BMI was also found to be a significant predictor for SSIs in multivariate analysis (odds ratio, 10.0; 95% confidence interval, 2.0-49.5; p=0.005). CONCLUSION: This study demonstrated underweight BMI as being associated with SSIs after LA. Surgeons should be more cautious to prevent SSIs in patients that are underweight when performing LA.
Adult ; Aged ; Appendectomy/*adverse effects ; Appendicitis/*surgery ; *Body Mass Index ; Body Weight ; Female ; Humans ; *Laparoscopy ; Male ; Middle Aged ; Multivariate Analysis ; Obesity/complications ; Odds Ratio ; Prospective Studies ; Risk Factors ; Surgical Wound Infection/*etiology ; Thinness/*complications ; Treatment Outcome

Background: Few studies have investigated the association between religion and health behaviors in Korea, where various religions coexist. The present study aimed to investigate the association between religion and health behaviors among primary care patients in Korea. Methods: We analyzed data from the Family Cohort Study in Primary Care. Among the 1,040 participants in the cohort, 973 of those who had reported their religion were included in the analysis. Participants completed standardized questionnaires that included religious status and lifestyle factors, such as physical activity, smoking status, drinking status, and dietary habits. The association between religion and health behaviors was analyzed using multivariate logistic regression models. Results: Among the 973 participants, 345 (35.5%) were Christian, 153 (15.7%) were Roman Catholic, 308 (31.7%) were Buddhist, and 163 (16.8%) did not have any religion. Compared with those without a religion, the odds ratio (OR) for vigorous physical activity (OR, 1.52; 95% confidence interval [CI], 1.01–2.28) increased, and that for binge drinking (OR, 0.67; 95% CI, 0.46–0.78) and problematic drinking (OR, 0.59; 95% CI, 0.35–0.99) decreased among participants with a religion. Compared with those without a religion, Catholics were more likely to engage in vigorous physical activity (OR, 2.20; 95% CI, 1.31–3.67), whereas Christians were less likely to engage in heavy (OR, 0.50; 95% CI, 0.30–0.84), binge (OR, 0.35; 95% CI, 0.22–0.54), and problematic drinking (OR, 0.46; 95% CI, 0.25–0.86). Smoking, meal regularity, and breakfast consumption were not associated with religion. Conclusion The status of drinking and physical activities were different according to religion. As religion is one of the psychosocial characteristics of patients, knowing patients’ religion can be helpful for primary physicians.

Background: Few studies have been conducted in Korea on concordance regarding chronic diseases and lifestyle factors among couples. We, therefore, evaluated spousal concordance regarding lifestyle factors and chronic diseases among Korean couples. Methods: A total 1,040 participants (520 couples) who visited family physicians were recruited from 22 hospitals. All participants were aged ≥40 years. Participants completed questionnaires on smoking, drinking, physical activity, and irregular eating habits, including skipping breakfast. We estimated the spousal concordance regarding lifestyle factors and chronic diseases using McNemar tests and logistic regression analysis. Results: The concordance rate was high among couples who shared unhealthy behaviors, such as low physical activity, irregular diet, and skipping breakfast (P<0.05). When cardiovascular risk factors such as overweight (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.14–2.63), hypertension (OR, 1.88; 95% CI, 1.23–2.86), or hyperlipidemia (OR, 2.41; 95% CI, 1.60–3.64) were prevalent among husbands, the odds that their wives also had the same risk factors at the same time was significantly high. The odds of being depressed when the spouse was depressed were also significantly high in both men (OR, 5.54; 95% CI, 2.19–13.96) and women (OR, 4.52; 95% CI, 1.77–11.53). Conclusion There was a high level of concordance regarding lifestyle factors among couples, which could lead to an increase in the prevalence of chronic diseases among couples. In addition, if a spouse has depression, the odds of their partner also having depression was high.

The objectives of this study were to (a) examine the users' characteristics of both government-dominant and non-governmental food bank programs, (b) understand the supporting quality of the food bank program, and (c) analyse the effectiveness of the programs from the users' perspectives. The random samples of 120 food bank operators were selected by proportionate stratified random sampling method and from each food bank, 3 users were selected for the survey. A total of 205 users were participated in this survey. The main results of this study were as follows; Average profile of food bank users were 58 year old, female, livelihood protectee (56.6%). Food assistance frequency were mostly once a week (34.1%), and everyday (22.4%). The survey also showed that non-governmental food banks delivered the food directly to the 42.7% of users, otherwise the users of government-dominant ones went to the food bank to receive the foods. Most of the donated foods were cooked food (50.0%), and the users also wanted to receive that kinds of food. Saving food expenses (55.6%) and overcoming hunger (16.6%) were found as the effectiveness to the users.
Female ; Food Assistance ; Humans ; Hunger ; Middle Aged

BACKGROUND: Peritoneal fibrosis is one of the major causes of technical failure in patients on peritoneal dialysis. Epithelial-to-mesenchymal transition (EMT) of the peritoneum is an early and reversible mechanism of peritoneal fibrosis. Human peritoneal mesothelial cells (HPMCs) have their own renin-angiotensin-aldosterone system (RAAS), however, it has not been investigated whether aldosterone, an end-product of the RAAS, induces EMT in HPMCs, and which mechanisms are responsible for aldosterone-induced EMT. METHODS: EMT of HPMCs was evaluated by comparing the expression of epithelial cell marker, E-cadherin, and mesenchymal cell marker, alpha-smooth muscle actin after stimulation with aldosterone (1-100nM) or spironolactone. Activation of extracellular signal-regulated kinase (ERK)1/2 and p38 mitogen-activated protein kinase (MAPK) and generation of reactive oxygen species (ROS) were assessed by western blotting and 2',7'-dichlorofluororescein diacetate staining, respectively. The effects of MAPK inhibitors or antioxidants (N-acetyl cysteine, apocynin, and rotenone) on aldosterone-induced EMT were evaluated. RESULTS: Aldosterone induced EMT in cultured HPMCs, and spironolactone blocked aldosterone-induced EMT. Aldosterone induced activation of both ERK1/2 and p38 MAPK from 1 hour. Either PD98059, an inhibitor of ERK1/2, or SB20358, an inhibitor of p38 MAPK, attenuated aldosterone-induced EMT. Aldosterone induced ROS in HPMCs from 5 minutes, and antioxidant treatment ameliorated aldosterone-induced EMT. N-acetyl cysteine and apocynin alleviated activation of ERK and p38 MAPK. CONCLUSION: Aldosterone induced EMT in HPMCs by acting through the mineralocorticoid receptor. Aldosterone-induced generation of ROS followed by activation of ERK, and p38 MAPK served as one of the mechanisms of aldosterone-induced EMT of HPMCs.
Actins ; Aldosterone* ; Antioxidants ; Blotting, Western ; Cadherins ; Cysteine ; Epithelial Cells ; Humans ; p38 Mitogen-Activated Protein Kinases ; Peritoneal Dialysis ; Peritoneal Fibrosis ; Peritoneum ; Phosphotransferases ; Protein Kinases ; Reactive Oxygen Species ; Receptors, Mineralocorticoid ; Renin-Angiotensin System ; Spironolactone

Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a nulligravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect. The other case was a primigravida with a history of prior cesarean delivery, whose sonography revealed myomectomy scar dehiscence at 31 weeks of gestation. Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect. In both cases, babies were born by emergency cesarean section. Conservative management can be one of treatment options for myomectomy scar dehiscence in preterm pregnancy. However, clinicians should always be aware of the possibility of obstetric emergencies.
Abdominal Pain ; Cesarean Section ; Cicatrix* ; Emergencies ; Female ; Fertilization ; Humans ; Leg ; Pregnancy* ; Premature Birth ; Uterine Myomectomy ; Uterine Rupture