No abstract available.
Arthritis, Juvenile*

OBJECTIVETo detect serum erythropoietin (EPO) levels in patients with acute leukemia (AL) and iron deficient anemia (IDA) with moderate or severe anemia and explore the mechanism of anemia in these patients.

METHODSEnzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of EPO in 59 patients with AL, among whom 15 had complete remission without anemia and 44 had moderate or severe anemia (including 12 receiving the initial treatment, 13 with complete remission and concurrent anemia, and 19 with bone marrow suppression). Serum EPO was also detected in 15 IDA patients and 12 healthy individuals.

RESULTSThe IDA patients and healthy individuals had similar serum EPO levels (P>0.05), and by comparison, the EPO levels were significantly increased in AL patients upon the initial treatment, those with bone marrow suppression and those with complete remission and anemia, but comparable between the latter 3 groups (P>0.05). Among the patients with complete remission, the EPO levels were significantly higher in anemic patients than in those without anemia (P<0.05), and the latter patients had similar EPO levels with the healthy individuals (P>0.05). In both AL and IDA patients with moderate or severe anemia, the serum EPO level was inversely correlated to the level of hemoglobin (r=-0.697 and -0.970, respectively, P<0.05).

CONCLUSIONAL patients with anemia have significantly higher serum EPO levels than healthy individuals. In AL and IDA patients with moderate or severe anemia, EPO levels are inversely correlated to the level of hemoglobin, suggesting the integrity of the EPO synthesis mechanism in AL patients. Serum EPO level is also associated with bone marrow function in addition to hypoxia and hemoglobin levels, and hematopoiesis deficit in the early stage may be the main cause of anemia.

Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anemia ; blood ; etiology ; Erythropoietin ; blood ; Female ; Humans ; Leukemia ; blood ; complications ; Male ; Middle Aged ; Young Adult

Objective To evaluate the value of low-density lipoprotein-cholesterol (LDL-C) and non-high-density lipoprotein-cholesterol (non-HDL-C) in differential diagnosis of familial hypertriglyceridemia (FHTG) and familial combined hyperlipidemia (FCHL).Methods We recruited 9 FHTG pedigrees (94 subjects) and 24 FCHL pedigrees (94 subjects) and then divided them into affected groups and non-affected groups according to lipid abnormality.Another 10 normal control pedigrees (57 subjects) served as controls.We compared the routine lipid levels such as triglyceride (TAG),total cholesterol (TC),HDL-C and LDL-C and non-HDL-C between the groups.After stratification based on TAG level,we observed the relationship between LDL-C and non-HDL-C.Last we confirmed and analyzed the cut-off value of differential diagnosis between FHTG and FCHL with receiver operating characteristic (ROC) curve.Results The levels of TAG,TC,and non-HDL-C were significantly higher in the affected group of FHTG than in the non-affected group of FHTG and the normal group (P＜0.01 or P＜0.05).The levels of TAG,TC,HDL-C,LDL-C and non-tHDL-C wcrc significantly higher in the affected group of FCHL than in the non-affected group of FCHL and the normal group (P＜0.01 or P＜0.05).The levels of TAG were significantly higher (P＜0.01) while TC,HDL-C,LDL-C and non-HDL-C levels were significantly lower (P＜ 0.01 or P＜0.05) in the affected group of FHTG than in the affected group of FCHL.The association between LDL-C and non-HDL-C was positive both in FHTG and FCHL,but the relationship became weaker as TAG level increased.The cut-off value of LDL-C and non-HDL-C was 3.575 mmol/L and 4.525 mmol/L,respectively.Conclusion In addition to the routinely used lipid indexes,non-HDL-C may be a new index for differential diagnosis of FHTG and FCHL,and may be superior to LDL-C in this regard.

Clinical practice is a key step that seven-year clinic student take to become doctors.Take the First Affiliated Hospital of Xi'an Jiaotong University as an example,in the medical practice of seven-year clinic students,there still exist some problems such as students' being unable to transform from probationers to doctors,not good at treating with interpersonal relationship in the department and having no perseverant practice attitude.So training before practice should be perfected and supervision should be strengthened to make the seven-year clinic students better.

OBJECTIVES: This study was conducted to identify factors that affect medical service performance in rural health sub-centers and to develop a method to improve health sub-center performance that takes advantage of these insights. METHODS: This study included 1,242 South Korean health sub-centers that had been in operation at least since December 31, 2009 as units of analysis. After adjusting for population differences between areas, the performance of medical service among health sub-centers was analyzed according to medical services performed per person. We performed t-tests, ANOVA, Scheffe's tests and multiple regression analyses. RESULTS: The following were significant variables affecting the medical service performance of rural health sub-centers: number of hospitals and clinics, presence of community health practitioner posts, distance from health sub-centers to main public health centers, distance from health sub-centers to the nearest emergency medical facilities, and proportion of the local population aged 65 and over. In contrast, the proportion of the local population between ages 0-4 and the placement of public health doctors that had already completed their internship were not significant variables. CONCLUSIONS: The medical service performance of health sub-centers located in rural areas is significantly affected by local population and health care environment characteristics, and therefore, it is imperative to develop strategies to provide differentiated service based on these factors.
Aged ; Delivery of Health Care ; Emergencies ; Humans ; Imidazoles ; Internship and Residency ; Nitro Compounds ; Public Health ; Rural Health

In recent years, advancements in information and communication technologies, including artificial intelligence, big data, virtual reality, and augmented reality, have driven substantial growth in the field of digital medical diagnosis and treatment, thereby enhancing quality of life. Beginning in the mid-2010s with the advent of digital healthcare applications, and further accelerated by the impact of coronavirus disease 2019, digital therapeutic products have profoundly influenced society. Nevertheless, the expansion of digital therapeutics has encountered challenges associated with regulatory hurdles, differentiation from general digital healthcare, and the necessity for trustworthiness, which have contributed to a slower rate of progress. This study proposes a 3P content model–encompassing pre-education, prediction/diagnosis/treatment, and postmanagement–to increase the trustworthiness of digital therapeutics. The design of the 3P content model includes a fundamental structure that establishes networks with healthcare institutions, aiming to increase the reliability of data utilization and to facilitate integration with medical decision support systems. For case development, the study introduces a prototype of a mobile application that utilizes chronic disease urinary dysfunction data, demonstrating the cyclical structure inherent in the 3P content model.

PURPOSE: Magnesium sulfate (MgSO4) is a commonly used drug for eclampsia prophylaxis and the first choice tocolytic agent for preterm labor. Recently it has been reported to have a fetal neuroprotective effect. This study was aimed to evaluate the influence of antenatal magnesium sulfate exposure on perinatal outcomes in very low birth weight infants (VLBWIs) with maternal preeclampsia. METHODS: We conducted a retrospective study of VLBWIs (n=81) with maternal preeclampsia (June 2005 through June 2012), who had been admitted to the NICU at Ewha Womans University Mok Dong Hospital. Clinical characteristics and neonatal complications were analyzed according to the antenatal exposure to MgSO4. Antenatal MgSO4 exposure was the only medication that had been administered up to the period of delivery. RESULTS: Among 81 neonates, 20 neonates were exposed to antenatal MgSO4. Mean gestational age was low in MgSO4 exposed group [29.5+/-2.8 vs. 31.6+/-2.3 weeks (P=0.02)]. The incidence of significant patent ductus arteriosus (S-PDA) was higher in MgSO4 exposed group after adjustment by gestational age (P=0.02). There were no differences between the two groups with regard to rates of respiratory distress syndrome, use of ventilator, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia and mortality. CONCLUSION: Antenatal MgSO4 exposure was associated with a higher risk of significant PDA in VLBWIs with maternal preeclampsia.
Ductus Arteriosus, Patent ; Eclampsia ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Leukomalacia, Periventricular ; Magnesium ; Magnesium Sulfate ; Neuroprotective Agents ; Obstetric Labor, Premature ; Pre-Eclampsia ; Pregnancy ; Retinopathy of Prematurity ; Retrospective Studies ; Ventilators, Mechanical

No abstract available.
Gingiva* ; Periodontitis ; Protein Isoforms* ; Superoxide Dismutase* ; Superoxides*

PURPOSE: Test equating studies in medical education have been conducted only for high-stake exams or to compare two tests given in a single course. Based on item response theory, we equated computer-based test (CBT) results from the basic medical education curriculum at the College of Medicine, the Catholic University of Korea and evaluated the validity of using fixed passing scores. METHODS: We collected 232 CBTs (28,636 items) for 40 courses administered over a study period of 9 years. The final data used for test equating included 12 pairs of tests. After test equating, Wilcoxon rank-sum tests were utilized to identify changes in item difficulty between previous tests and subsequent tests. Then, we identified gaps between equated passing scores and actual passing scores in subsequent tests through an observed-score equating method. RESULTS: The results of Wilcoxon rank-sum tests indicated that there were no significant differences in item difficulty distribution by year for seven pairs. In the other five pairs, however, the items were significantly more difficult in subsequent years than in previous years. Concerning the gaps between equated passing scores and actual passing scores, equated passing scores in 10 pairs were found to be lower than actual passing scores. In the other two pairs, equated passing scores were higher than actual passing scores. CONCLUSION: Our results suggest that the item difficulty distributions of tests taught in the same course during successive terms can differ significantly. It may therefore be problematic to use fixed passing scores without considering this possibility.
Curriculum ; Education, Medical ; Educational Measurement ; Korea ; Methods

PURPOSE: Test equating studies in medical education have been conducted only for high-stake exams or to compare two tests given in a single course. Based on item response theory, we equated computer-based test (CBT) results from the basic medical education curriculum at the College of Medicine, the Catholic University of Korea and evaluated the validity of using fixed passing scores. METHODS: We collected 232 CBTs (28,636 items) for 40 courses administered over a study period of 9 years. The final data used for test equating included 12 pairs of tests. After test equating, Wilcoxon rank-sum tests were utilized to identify changes in item difficulty between previous tests and subsequent tests. Then, we identified gaps between equated passing scores and actual passing scores in subsequent tests through an observed-score equating method. RESULTS: The results of Wilcoxon rank-sum tests indicated that there were no significant differences in item difficulty distribution by year for seven pairs. In the other five pairs, however, the items were significantly more difficult in subsequent years than in previous years. Concerning the gaps between equated passing scores and actual passing scores, equated passing scores in 10 pairs were found to be lower than actual passing scores. In the other two pairs, equated passing scores were higher than actual passing scores. CONCLUSION Our results suggest that the item difficulty distributions of tests taught in the same course during successive terms can differ significantly. It may therefore be problematic to use fixed passing scores without considering this possibility.