OBJECTIVES: The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors. METHODS: The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables. RESULTS: Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to "financial burden" (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to "service not available when needed." There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to "financial burden" (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to "service not available when needed." CONCLUSIONS: Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.
Adult ; Delivery of Health Care* ; Employment ; Health Services Accessibility ; Health Surveys ; Humans ; Korea* ; Multilevel Analysis ; Population Groups ; Residence Characteristics

PURPOSE: We evaluated the effect of human parathyroid hormone (hPTH) on the engraftment and/or in vivo expansion of hematopoietic stem cells in an umbilical cord blood (UCB)-xenotransplantation model. In addition, we assessed its effect on the expression of cell adhesion molecules. MATERIALS AND METHODS: Female NOD/SCID mice received sublethal total body irradiation with a single dose of 250 cGy. Eighteen to 24 hours after irradiation, 1x107 human UCB-derived mononuclear cells (MNCs) and 5x106 human UCB-derived mesenchymal stem cells (MSCs) were infused via the tail vein. Mice were randomly divided into three groups: Group 1 mice received MNCs only, Group 2 received MNCs only and were then treated with hPTH, Group 3 mice received MNCs and MSCs, and were treated with hPTH. RESULTS: Engraftment was achieved in all the mice. Bone marrow cellularity was approximately 20% in Group 1, but 70-80% in the hPTH treated groups. Transplantation of MNCs together with MSCs had no additional effect on bone marrow cellularity. However, the proportion of human CD13 and CD33 myeloid progenitor cells was higher in Group 3, while the proportion of human CD34 did not differ significantly between the three groups. The proportion of CXCR4 cells in Group 3 was larger than in Groups 1 and 2 but without statistical significance. CONCLUSION: We have demonstrated a positive effect of hPTH on stem cell proliferation and a possible synergistic effect of MSCs and hPTH on the proportion of human hematopoietic progenitor cells, in a xenotransplantation model. Clinical trials of the use of hPTH after stem cell transplantation should be considered.
Animals ; Bone Marrow/metabolism ; Cell Proliferation ; Female ; Fetal Blood/*cytology ; Flow Cytometry ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells/*drug effects ; Humans ; Leukocytes, Mononuclear/*cytology ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells/*cytology ; Mice ; Mice, Inbred NOD ; Mice, SCID ; Parathyroid Hormone/*therapeutic use ; Stem Cells/cytology ; Transplantation, Heterologous

A previous animal study has shown the effects of erythropoietin (EPO) and its non-erythropoietic carbamylated derivative (CEPO) on neurogenesis in the dentate gyrus. In the present study, we sought to investigate the effect of EPO on adult hippocampal neurogenesis, and to compare the ability of EPO and CEPO promoting dendrite elongation in cultured hippocampal neural progenitor cells. Two-month-old male BALB/c mice were given daily injections of EPO (5 U/g) for seven days and were sacrificed 12 hours after the final injection. Proliferation assays demonstrated that EPO treatment increased the density of bromodeoxyuridine (BrdU)-labeled cells in the subgranular zone (SGZ) compared to that in vehicle-treated controls. Functional differentiation studies using dissociated hippocampal cultures revealed that EPO treatment also increased the number of double-labeled BrdU/microtubule-associated protein 2 (MAP2) neurons compared to those in vehicle-treated controls. Both EPO and CEPO treatment significantly increased the length of neurites and spine density in MAP2(+) cells. In summary, these results provide evidences that EPO and CEPO promote adult hippocampal neurogenesis and neuronal differentiation. These suggest that EPO and CEPO could be a good candidate for treating neuropsychiatric disorders such as depression and anxiety associated with neuronal atrophy and reduced hippocampal neurogenesis.
Adult ; Animals ; Anxiety ; Atrophy ; Bromodeoxyuridine ; Dendrites ; Dentate Gyrus ; Depression ; Erythropoietin ; Hippocampus ; Humans ; Male ; Mice ; Neurites ; Neurogenesis ; Neurons ; Spine ; Stem Cells

PURPOSE: The aim of this study was to examine the effects of long-term endurance exercise and natural fermented vinegar on body composition and cardiopulmonary function of 50-aged postmenopausal women. METHODS: Subjects were divided into four groups (sedentary group, aerobic exercise group, natural fermented vinegar group, and aerobic exercise plus natural fermented vinegar group) to perform natural fermented vinegar intake or aerobic exercise for 8 weeks. Body weight, body composition, cardio-pulmonary function test, and blood concentration of glucose, lipid profiles, aspartate aminotransferase, and alanine aminotransferase were measured. RESULTS: The results showed that natural fermented vinegar or aerobic exercise training for 8 weeks no significantly improved body weight control and body composition. However, natural fermented vinegar plus aerobic exercise training for 8 weeks significantly improved cardiopulmonary function. CONCLUSION: These results suggest that natural fermented vinegar plus aerobic exercise training has a significant effect on anti-fatigue.
Acetic Acid* ; Alanine Transaminase ; Aspartate Aminotransferases ; Body Composition* ; Body Weight ; Exercise* ; Fatigue ; Female ; Glucose ; Humans ; Middle Aged* ; Obesity

OBJECTIVES: In this study the relationship between neighborhood deprivation and the unmet health care needs of elderly individuals (≥ 65 years) was examined. Some previous studies suggested that neighborhood characteristics affect access to health care, yet research on the unmet needs of older individuals is limited. METHODS: Multilevel logistic regression analysis was used to assess the relationship of neighborhood-level factors with unmet health care needs due to costs, adjusting for individual-level factors, in individuals ≥ 65 years in the 2017 Korean Community Health Survey (n = 63,388). RESULTS: There were 2.6% of elderly individuals who experienced unmet health care needs due to costs. Following adjustment for individual and neighborhood characteristics, the neighborhood deprivation in urban areas was found to have an inverse association with unmet needs (odds ratio = 0.50; 95% confidence interval = 0.24–1.06) for the most deprived quartile versus the least deprived quartile). However, in rural areas neighborhood deprivation was not a significant variable. Among the individual-level variables, household income was one of the strongest correlates with unmet needs in both urban and rural areas. CONCLUSION: The present findings suggest that targeted policy interventions reflecting both neighborhood and individual characteristics, should be implemented to reduce the unmet health care needs of elderly individuals.
Aged ; Delivery of Health Care ; Family Characteristics ; Health Services Accessibility ; Health Surveys ; Humans ; Korea ; Logistic Models ; Multilevel Analysis ; Residence Characteristics

Human infection by Rhodococcus species is rare and mostly limited to immunocompromised hosts such as patients infected with the human immunodeficiency virus (HIV) or organ transplant recipients. The most common strain is R. equi, and the most common clinical presentation is pulmonary infection, reported in 80% of Rhodococcus spp. infections. The central nervous system is an uncommon infection site. We report a case of a patient with pneumonia, brain abscess, and recurrent meningitis caused by Rhodococcus spp. He initially presented with pneumonia with necrosis, which progressed to brain abscess and recurrent meningitis. Rhodococcus spp. was identified from the cerobrospinal fluid (CSF) collected during his fourth hospital admission. Despite prolonged treatment with appropriate antibiotics, meningitis recurred three times. Finally, in order to administer antibiotics directly into the CSF and bypass the blood-brain barrier, an Ommaya reservoir was inserted for administration of 90 days of intrathecal vancomycin and amikacin in conjunction with intravenous and oral antibiotics; the patient was finally cured with this treatment regimen.
Amikacin ; Anti-Bacterial Agents ; Blood-Brain Barrier ; Brain Abscess ; Central Nervous System ; HIV ; Humans ; Immunocompromised Host ; Injections, Spinal* ; Meningitis* ; Necrosis ; Pneumonia ; Rhodococcus* ; Transplants ; Vancomycin*

Objective: The Public Health Disaster Response Team (PHDRT) has been organized by the Community Health Center since 2016 under the National Disaster Response Frame. They are mobilized when a Mass-Casualty-Incident is expected to occur. This study sheds light on the disaster medical system by analyzing the awareness of the PHDRT on the disaster medical management capacity. Methods: To develop the questionnaire, a literature review was conducted. The questionnaire was distributed and obtained after inspecting the survey questionnaire filled out by the PHDRT. There were 254 samples. The data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression. Results: Research has proven that the awareness of the disaster medical management capacity was 3.11 (rating 1-5). In detail, organizational capacity received the highest agreement score (3.54±0.84), while the budget and organization management was below the midpoint (2.73±0.83). Significant positive correlations were found between the capacity components, particularly the organizational capacity and cooperation system (r=0.71, P<0.01). The awareness was significantly different according to sex, age, job (type), total career, and task weight. The factors influencing the awareness of disaster medical management capacity included age, total career, and task weight. Conclusion The findings from awareness analysis suggest that national and systemic supports, as well as personal efforts, are necessary to strengthen the disaster medical management capacity.

Delftia acidovorans is a gram-negative motile rod found ubiquitously in soil and in water. Confirmed isolation from clinical infections is rare, and has been documented mostly in immunocompromised patients or those with indwelling catheters. A 53-year-old man was referred for the evaluation of a huge mass-like lesion found incidentally by chest X-ray. The lesion occupied more than half of the right lung and was diagnosed as a large loculated pleural effusion by CT scan. Bloody pus was drained through a percutaneous catheter, and D. acidovorans, identified by the Vitek GN card and confirmed by amplification of 16S ribosomal RNA and sequencing analysis, was isolated repeatedly from the drained pus. The patient was treated with imipenem/cilastatin to which the organism was sensitive. This is a rare report of chronic empyema associated with D. acidovorans in the respiratory system of an immunocompetent patient.
Catheters ; Catheters, Indwelling ; Delftia ; Delftia acidovorans ; Drainage ; Empyema ; Empyema, Pleural ; Humans ; Immunocompetence ; Immunocompromised Host ; Lung ; Middle Aged ; Pleural Effusion ; Respiratory System ; RNA, Ribosomal, 16S ; Soil ; Suppuration ; Thorax