BACKGROUND/OBJECTIVES: This study was aimed at examining the association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome (MetS) in Korean women with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A cross-sectional analysis was performed among 502 female T2DM patients (non-MetS group; n = 129, MetS group; n = 373) who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) and the data was analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. The intake of flavanones was estimated on the basis of the flavonoid database. RESULTS: In the multiple linear regression analysis after adjustment for confounding factors, daily flavanones intake was negatively associated with CVD risk factors such as total cholesterol, LDL-cholesterol, and apoB and apoB/apoA1 ratio only in the MetS group but not in the non-MetS group. Multiple logistic regression analysis revealed that the odds ratio for a higher apoB/apoA1 ratio above the median (> or = 0.74) was significantly low in the 4th quartile compared to that in the 1st quartile of dietary flavanones intake [OR: 0.477, 95% CI: 0.255-0.894, P for trend = 0.0377] in the MetS group. CONCLUSIONS: Dietary flavanones intake was inversely associated with the apoB/apoA1 ratio, suggesting a potential protective effect of flavanones against CVD in T2DM women with MetS.
Apolipoproteins ; Apolipoproteins B ; Cholesterol ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2* ; Female ; Flavanones* ; Humans ; Korea ; Linear Models ; Logistic Models ; Odds Ratio ; Risk Factors ; Seoul

BACKGROUND: Laboratory diagnosis of new influenza A (H1N1) is crucial for managing patients and establishing control and prevention measures. We compared the diagnostic accuracies of the real time RT-PCR (rRT-PCR) test recommended for the confirmation of the new flu and the viral culture method used conventionally for viral disease with that of the rapid antigen test (RAT). METHODS: We performed RAT, R-mix culture, and real-time PCR by using 861 respiratory samples collected from December 2009 to January 2010 and evaluated the abilities of these methods to detect new influenza A. The relationship among the positive rates of RAT, grades of culture, and the cycle threshold (Ct) values of rRT-PCR was also evaluated. RESULTS: Of the 861 patients, 308 (35.8%) were diagnosed with new influenza A. The sensitivities, specificities, positive predictive values, and negative predictive values of the tests were respectively as follows: 59.7%, 99.5%, 98.4%, and 81.6% for RAT; 93.2%, 100%, 100%, and 96.3% for R-mix culture; and 95.8%, 100%, 100%, and 97.7% for rRT-PCR. Samples with weak positive grade in culture and those with Ct values of 30-37 in rRT-PCR showed positivities as low as 25.3% and 2.3% in RAT, respectively. The hospitalization rate and death rate of the confirmed patients were 3.2% and 0.3%, respectively, and gastrointestinal symptoms were observed in 7.2% of the patients. CONCLUSIONS: R-mix culture and rRT-PCR tests showed excellent reliability in the diagnosis of new influenza A and could be very useful, especially for samples with low viral load.
Animals ; Clinical Laboratory Techniques ; Hospitalization ; Humans ; Influenza, Human ; Korea ; Pandemics ; Rats ; Real-Time Polymerase Chain Reaction ; Viral Load ; Virus Diseases

BACKGROUND: To access the clinical usefulness of MicroScan(R) Synergies plus Combo Panels (Siemens, USA) for the identification and antimicrobial susceptibility test (AST) of Gram-negative bacteria (GNB) and Gram-positive cocci (GPC), we compared MicroScan(R) Synergies plus Combo Panels with MicroScan(R) conventional Combo Panels. METHODS: One-hundred four isolates of GNB were simultaneously tested with MicroScan(R) Synergies plus Neg Combo Type 2 Panel (SINC2) and MicroScan(R) Neg Combo Panel Type 44 (NC44). One-hundred isolates of GPC were simultaneously tested with MicroScan(R) Synergies plus Pos Combo 3 Panel (SIPC3) and MicroScan(R) Pos Combo 1A (PC1A). RESULTS: Of the GNB isolates, agreement rate of identification between SINC2 and NC44 were 92.3% to the species level and 93.3% to the genus level. Of the GPC isolates, agreement rate of identification between SIPC3 and PC1A were 85.0% to the species level and 100% to the genus level. Of the GNB isolates, agreement rate of AST according to antimicrobial agents between SINC2 and NC44 ranged from 86.5% to 100%. Among GPC isolates, agreement rate of AST according to antimicrobial agents between SIPC3 and PC1A were higher than 96.0% with the exception of gentamicin and quinupristin-dalfopristin. CONCLUSION: Compared with MicroScan(R) conventional Combo Panels (NC44, PC1A), MicroScan(R) Synergies plus Combo Panels (SINC2, SIPC3) showed high agreement rate of identification and AST, and had the advantage of more rapid reporting.
Anti-Infective Agents ; Gentamicins ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Gram-Positive Cocci ; Imidazoles ; Nitro Compounds ; Virginiamycin

BACKGROUND: The prevalence of neonatal group B streptococcal infection depends mainly on the colonization rate of pregnant women by group B streptococci (GBS). Although the colonization rate of Korean women by GBS is considered lower than in other countries, recent data on the maternal colonization rate of GBS are sparse. METHODS: From August 2008 to June 2009, swab specimens from the anorectus, vagina, and urethral orifice of a sample of 234 pregnant Korean women were placed in new Granada medium (NGM-H), tube medium (NGM-T), commercial NGM (NGM-B), and selective Todd-Hewitt broth (S-THB) for 18~24 hours in 5% CO2 at 35degrees C. Agar dilutional antimicrobial susceptibility tests, serotyping, and PCR were performed for GBS isolates. RESULTS: The colonization rate of GBS in pregnant women was 11.5% (27/234). Of the specimen cultures, 9.8% of anorectal cultures were positive, 8.1% of urethral orifice cultures were positive, and 7.3% of vagina cultures were positive. The detection rate of GBS in the different culture media was S-THB (96.3%), NGM-B (92.6%), NGM-H (88.9%), and NGM-T (85.2%). The distribution of GBS serotypes was as follows: III (29.6%), V and VI (22.2%), Ib and II (11.1%), and Ia (3.7%). 33.3% of GBS isolates were resistant to erythromycin and 44.4% to clindamycin. Among the nine erythromycin-resistant isolates, eight were serotype V and VI, which are erm(B) positive serotypes. CONCLUSION: The colonization of pregnant women by GBS, and the incidence of resistance of the GBS isolates to erythromycin and clindamycin were higher than those previously reported. Serotypes V and VI, GBS serotypes that carry the erm(B), are novel serotypes that have not previously been identified in pregnant Korean women.
Agar ; Clindamycin ; Colon ; Culture Media ; Erythromycin ; Female ; Humans ; Incidence ; Polymerase Chain Reaction ; Pregnant Women ; Prevalence ; Serotyping ; Streptococcal Infections ; Vagina

Standardization of medical terminology is essential in data transmission between health care institutes and in maximizing the benefits of information technology. The purpose of this study was to standardize medical terms for laboratory observations. During the second year of the study, a standard database of concept names for laboratory terms that covered those used in tertiary health care institutes and reference laboratories was developed. The laboratory terms in the Logical Observation Identifier Names and Codes (LOINC) database were adopted and matched with the electronic data interchange (EDI) codes in Korea. A public hearing and a workshop for clinical pathologists were held to collect the opinions of experts. The Korean standard laboratory terminology database containing six axial concept names, components, property, time aspect, system (specimen), scale type, and method type, was established for 29,340 test observations. Short names and mapping tables for EDI codes and UMLS were added. Synonym tables were prepared to help match concept names to common terms used in the fields. We herein described the Korean standard laboratory terminology database for test names, result description terms, and result units encompassing most of the laboratory tests in Korea.
Clinical Laboratory Information Systems/*standards ; Humans ; Laboratory Techniques and Procedures/*standards ; *Logical Observation Identifiers Names and Codes ; Terminology as Topic ; *Unified Medical Language System

BACKGROUND: Standardization of medical terminology is essential for data transmission between health-care institutions or clinical laboratories and for maximizing the benefits of information technology. Purpose of our study was to standardize the medical terms used in the clinical laboratory, such as test names, units, terms used in result descriptions, etc. During the first year of the study, we developed a standard database of concept names for laboratory terms, which covered the terms used in government health care centers, their branch offices, and primary health care units. METHODS: Laboratory terms were collected from the electronic data interchange (EDI) codes from National Health Insurance Corporation (NHIC), Logical Observation Identifier Names and Codes (LOINC) database, community health centers and their branch offices, and clinical laboratories of representative university medical centers. For standard expression, we referred to the English-Korean/ Korean-English medical dictionary of Korean Medical Association and the rules for foreign language translation. Programs for mapping between LOINC DB and EDI code and for translating English to Korean were developed. RESULTS: A Korean standard laboratory terminology database containing six axial concept names such as components, property, time aspect, system (specimen), scale type, and method type was established for 7,508 test observations. Short names and a mapping table for EDI codes and Unified Medical Language System (UMLS) were added. Synonym tables for concept names, words used in the database, and six axial terms were prepared to make it easier to find the standard terminology with common terms used in the field of laboratory medicine. CONCLUSIONS: Here we report for the first time a Korean standard laboratory terminology database for test names, result description terms, result units covering most laboratory tests in primary healthcare centers.
Clinical Laboratory Techniques/*classification/standards ; Databases, Factual ; Korea ; Language ; *Logical Observation Identifiers Names and Codes ; Terminology as Topic ; *Unified Medical Language System

BACKGROUND: A questionnaire survey was performed to perceive the problem of the current medical insurance reimbursement system for laboratory tests referred to independent medical laboratories; then, we intended to find a way to improve the reimbursement system. METHODS: Questionnaires were distributed to 220 independent medical laboratories and 700 laboratory physicians from July through October 2005. Frequency analysis was used to analyse the replies from 109 respondents to 25 questionnaire items regarding the current medical insurance reimbursement system for referral tests, problems with the system, and suggestions for the improvement of the system. RESULTS: Among the 109 respondents to this survey, 49 (45.8%) considered the current reimbursement system to be unsatisfactory, while only 16 (15.0%) answered satisfactory. The problem was that the referral clinics-not the laboratories that performed the tests--would first receive their reimbursement for the laboratory tests from Health Insurance Review Agency (HIRA) and then give a portion of the laboratory test fees to the independent medical laboratories after the deduction of administrative fees. They (62.5% of the respondents) would prefer a separated reimbursement system by which the referral clinic-as well as the independent medical laboratory-would receive their reimbursement directly from HIRA through an Electronic Data Interchange (EDI) system. In this new system, 34% of the respondents expected the quality of the laboratory tests to be improved; however, 41.6% answered that the income of the referral clinic is expected to decrease. CONCLUSIONS: For the improvement of the medical insurance reimbursement system, the administrative fee for the referral clinic and the test fee for the independent medical laboratory should be reimbursed directly to the respective organizations. These changes could be made possible with the proper analysis of medical costs and the development of an effective EDI reimbursement system.
Clinical Laboratory Techniques/*economics ; Female ; Humans ; *Insurance, Health, Reimbursement ; Korea ; Laboratories, Hospital/economics ; Male ; Questionnaires

In a preliminary study, we found that benzyloxycarbonyl-Val-Ala-Asp(OMe)-fluoromethylketone (zVAD- fmk), unlike Boc-aspartyl(OMe)-fluoromethylketone (BocD-fmk), at usual dosage could not prevent genistein-induced apoptosis of p815 mastocytoma cells. This study was undertaken to reveal the mechanism underlying the incapability of zVAD-fmk in preventing this type of apoptosis. We observed that 14-3-3 protein level was reduced in genistein-treated cells and that BocD-fmk but not zVAD-fmk prevented the reduction of 14-3-3 protein level and the release of Bad from 14-3-3. We also demonstrated that truncated Bad to Bcl-xL interaction in genistein- treated cells was prevented by BocD-fmk but not by zVAD-fmk treatment. Our data indicate that BocD- fmk, compared to zVAD-fmk, has a certain preference for inhibiting 14-3-3/Bad signalling pathway. We also elucidated that this differential efficacy of BocD-fmk and zVAD-fmk resulted from the different effect in inhibiting caspase-6 and that co-treatment of zVAD-fmk and caspase-6 specific inhibitor substantially prevented genistein-induced apoptosis. Our data shows that caspase-6 plays a role on Bad/14-3-3 pathway in genistein-induced apoptosis of p815 cells, and that the usual dose of zVAD-fmk, in contrast to BocD-fmk, did not prevent caspase-6 acting on 14-3-3/Bad-mediated event.
bcl-Associated Death Protein/*metabolism ; *Signal Transduction/drug effects ; Mitochondria/drug effects ; Mice ; Mastocytoma ; Hydrocarbons, Fluorinated/*pharmacology ; Genistein/pharmacology ; Enzyme Inhibitors/*pharmacology ; Cell Line, Tumor ; Caspase 6/antagonists & inhibitors/*metabolism ; Benzyl Compounds/*pharmacology ; Apoptosis/*drug effects ; Animals ; Amino Acid Chloromethyl Ketones/pharmacology ; 14-3-3 Proteins/*metabolism

BACKGROUND AND OBJECTIVES: Plasma adiponectin, which decreases the progression of atherosclerosis and insulin resistance, as well as suppressing lipid accumulation in macrophages, is decreased in patients with acute myocardial infarction and unstable angina pectoris; however, the correlation between plasma adiponectin and vasospastic angina pectoris (VAP) remains to be verified. We compared the plasma adiponectin concentration between patients with VAP and other coronary artery diseases; moreover, we investigated the association between the plasma adiponectin concentration and VAP. SUBJECTS AND METHODS: Following coronary angiography for the evaluation of chest pain, 395 subjects (180 women and 215 men) were divided into 4 groups: acute coronary syndrome (ACS)(n=117), VAP (n=94), stable angina pectoris (SAP)(n=108) and angiographically normal coronary artery (n=76). The acetylcholine provocation test was used to confirm VAP, and plasma adiponectin concentrations were measured in all participants. RESULTS: The plasma adiponectin concentrations in patients with VAP and ACS were significantly lower than that of the normal coronary artery group (6.6+/-5.4 vs. 5.2+/-4.0 vs. 9.0+/-6.2 microgram/mL, p<0.001, respectively). A multivariate analysis indicated that plasma adiponectin [odd ratio (OR) 0.744, 95% confidence interval (CI) 0.645 to 0.858, p=0.001], smoking (OR 2.054, 95% CI 1.027 to 4.106, p=0.042) and age (OR 0.966, 95% CI 0.935 to 0.997, p=0.031) were independently correlated in patients diagnosed with VAP. CONCLUSION: Our results suggest that a decreased plasma adiponectin concentration may be associated with VAP.
Acetylcholine ; Acute Coronary Syndrome ; Adiponectin* ; Angina Pectoris ; Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vasospasm ; Coronary Vessels ; Female ; Humans ; Insulin Resistance ; Macrophages ; Multivariate Analysis ; Myocardial Infarction ; Plasma* ; Smoke ; Smoking

BACKGROUND: As an endemic area of viral hepatitis B, many studies on hepatitis B and C have been reported in Korea, but no on all five viral types, A, B, C, D, and E. We surveyed ten serologic markers for the five different viral hepatitis and reviewed the seropositivity of each viral hepatitis and concurrent infection. METHODS: Ten serologic markers of five viral hepatitis (anti-HAV IgM, anti-HAV IgG, HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe, anti-HCV, anti-HDV, and anti-HEV IgM) were tested for 260,488 samples requested for viral marker studies at three hospitals of Korea University Medical Centers from January through December, 2003. Anti-HAV IgM, anti-HAV IgG, anti-HDV, and anti-HEV IgM were tested by RIA and HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe, and anti-HCV were analysed by ELISA or RIA method. RESULTS: Anti-HAV IgM and IgG seropositivity was 1.2% and 88.0%, respectively. Anti-HAV IgM seropositivity was high in a patient group 20 to 29 years of age. The overall seropositivity of HBsAg was 10.4% and for anti-HBs 60.4%. The seropositivity was 1.3% for anti-HCV, 1.1% for anti-HDV, and 22.2% for anti-HEV IgM. The concurrent positivity of HBsAg and anti-HBs was 4.0%. HBsAg was positive in 7 (0.1%) of anti-HCV positive patients; anti-HEV IgM was positive in 2 (25%) of anti-HAV IgM positive patients. CONCLUSIONS: Hepatitis A infection was rare in children but increased in patient group 20 to 29 years of age. The concurrent infection rate of hepatitis A with hepatitis E was high, suggesting that hepatitis E should be considered in hepatitis A patients. In view of the finding that the concurrent infection of hepatis B and C was detected, though at a relatively low rate, patients with viral hepatitis need to be assessed for the possibility of concurrent infection with other types of hepatitis.
Academic Medical Centers* ; Biomarkers ; Child ; Coinfection ; Enzyme-Linked Immunosorbent Assay ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis E ; Hepatitis* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Korea