BACKGROUND: Health Insurance reimbursement does not accurately reflect the cost of test items performed in a hospital, and it is particularly more difficult to introduce laboratory tests applying new technology. Ensuring the safety of blood bank tests is encumbered since the reimbursement rates for the blood bank items that are high risk are not properly set. In this study, we analyzed the validity of reimbursement through a cost analysis of testing performed in Severance Hospital blood bank. METHODS: Original cost and net income were calculated for the tests performed in Severance Hospital blood bank from 1 January, 2009 to 31 December 2009. RESULTS: The original cost and deficit of ABO & Rh(D) blood tests using an automated blood test analyzer was 4,588 won and 1,572 won (52% compared to reimbursement), respectively. Irregular antibody screening test was 3,416 won in original cost and 3,422 won profit. Lewis antigen test was 10,816 won in original cost, creating a 4,745 won deficit. Irregular antibody identification was 32,568 won in original cost and 17,189 won in deficit. CONCLUSION: Unless the original cost of blood bank tests is reflected in the reimbursement rates, hospital blood banks will run into a budget deficit and blood bank automation, which is used worldwide for patient safety, will not be used in domestic health care.
Automation ; Blood Banks ; Budgets ; Costs and Cost Analysis ; Delivery of Health Care ; Hematologic Tests ; Insurance, Health, Reimbursement ; Mass Screening ; Patient Safety

Recent studies described the epsilon 4 allele of apoE confers a two-to fourfold increased risk for late-onset Alzheimer's disease (LOAD), but LOAD pathology does not all fit neatly around apo E. Therefore, the goal of this study was to find the association between Alzheimer and apo E4 genotype in the 107 elderly between 50 to 64 years old who visited to FHWC of Sungshin Women's University. We conducted the questionnaire survey (general & 24 hr dietary recall), anthropometerics (BP, waist & BMI) and blood biochemistry (FBS & lipid profiles). LDL-c and HOMA-IR were calculated by Friedwald's and Matthew's formulas. The apo E genotyping was performed by PCR-RFLP method and subjects were divided into three allele groups (epsilon 3; wild, epsilon 2 & epsilon 4; mutants). The apo E allele frequencies were 7.0% for the epsilon 2, 83.6% for the epsilon 3 and 9.3% for the epsilon 4. In comparison with biochemistry characteristics by apo E genotype, FBS was significantly higher in epsilon 4 (129.2 +/- 6.8) than that in the others (epsilon 2: 117 +/- 7.4, epsilon 3: 107.3 +/- 2.2)(p < 0.01). More than forty percents of epsilon 4 group shown the dyslipidemia [high TG (> 150 mg/dl) & low HDL (< 40 mg/dl: male symbol or < 50 mg/dl: female symbol )]. The cytokines levels such as IL-1beta, IL-6 and TNF-alpha were not different among three apoE alleles. After the adjusting sex, age & dietary fiber, LDL-c level was significantly higher in epsilon 4 (108.3 +/- 7.7) than that in epsilon 2 (100.4 +/- 8.4)(p < 0.05). According to food intake and the recipe on the basis of 24 hr dietary recall, the elderly with epsilon 4 allele took higher intake frequency of the light -colored vegetable (radish, onion & cabbage) and pan-fried foods (sauteed beef and vegetables, stir-fried vienna with vegetables) than the others. We knew that the elderly with epsilon 4 allele had been restricted the calories intakes with high dietary fiber (33.6 + 2.5 g/d) to maintain the normal level of FBS and LDL-c. On next study, the prevalence of Alzheimer's disease in this population who has epsilon 4 allele on the condition of calories restriction will be continually follow-up.
Aged ; Alleles ; Alzheimer Disease ; Apolipoprotein E4* ; Apolipoproteins E ; Biochemistry ; Cytokines ; Dietary Fiber ; Dyslipidemias ; Eating ; Female ; Gene Frequency ; Genotype* ; Humans ; Interleukin-6 ; Male ; Middle Aged* ; Onions ; Pathology ; Prevalence ; Surveys and Questionnaires ; Tumor Necrosis Factor-alpha ; Vegetables

Pilocarpine-induced rat epilepsy model is an established animal model that mimics medial temporal lobe epilepsy in humans. The purpose of this study was to investigate neuroimaging abnormalities in various stages of epileptogenesis and to correlate them with seizure severity in pilocarpine-induced rat epilepsy model. Fifty male Sprague-Dawley rats were subject to continuous video and electroencephalographic monitoring after inducing status epilepticus (SE) and seizure severity was estimated by frequency and total durations of class 3 to 5 spontaneous recurrent seizures (SRS) by modified Racine's classification. The 7.0 Tesla magnetic resonance imaging (MRI) with high resolution flurodeoxyglucose positron emission tomography (FDG-PET) was performed at 3 hours, 1, 3, 7 days and 4 weeks after the initial insult. The initial SRS was observed 9.7±1.3 days after the pilocarpine injection. MRI revealed an abnormal T2 signal change with swelling in both hippocampi and amygdala in acute (day 1 after injection) and latent phases (days 3 and 7), in association with PET hypometabolism in these areas. Interestingly, the mean frequency of class 3 to 5 SRS was positively correlated with abnormal T2 signals in hippocampal area at 3 days. SRS duration became longer with more decreased glucose metabolism in both hippocampi and amygdala at 7 days after pilocarpine injection. This study indicates that development and severity of SRS at chronic phase could be closely related with structural and functional changes in hippocampus during the latent period, a pre-epileptic stage.
Amygdala ; Animals ; Classification ; Epilepsy* ; Epilepsy, Temporal Lobe ; Glucose ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Male ; Metabolism ; Models, Animal ; Neuroimaging ; Pilocarpine ; Positron-Emission Tomography ; Rats ; Rats, Sprague-Dawley ; Seizures ; Status Epilepticus