• Title/Summary/Keyword: Antibody test

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The Utility of Immunological Markers and Pulmonary Function Test in the Early Diagnosis of Pulmonary Involvement in the Patients with Rheumatoid Arthritis (류마티스 관절염환자에서 폐침범의 진단에 있어서 면역학적 지표와 폐기능 검사의 유용성)

  • Lee, Dong-Suk;Lee, Chang-Beam;Koh, Hee-Kwan;Moon, Doo-Seop;Lee, Jae-Young;Lee, Kyung-Sang;Yang, Suck-Chul;Yoon, Ho-Joo;Bae, Sang-Cheol;Shin, Dong-Ho;Kim, Seong-Yoon;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.878-887
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    • 1995
  • Background: It is reported that frequency of pulmonary involvement in the patients with rheumatoid arthritis reaches 10 to 50% and pulmonary involvement is a principal cause of death. As immunology and radiology has developed, interest for the early diagnosis of pulmonary involvement is increasing. Method: Among the patients at Hanyang University Hospital from March, 1990 to July, 1995, we compared the 29 patients having pulmonary involvement with the 18 patients controls in clinical and chest high resolution computed tomography(HRCT) findings by immunological markers and findings of pulmonary function test. We sought useful markers for early diagnosis of pulmonary involvement with noninvasive investigations. Results: The ratio of males to females was 14 : 15 in the group of pulmonary involvement, and all of the 18 patients were females in the control group. Smoking history was 31%(9/29) in the former group and none in the latter group. Rheumatoid factor(RF) was positive in 95.5%(28/29) of the pulmonary involvement group and in 100%(18/18) of the control group(p=0.12). Antiperinuclear factor(APF) showed a significant difference: 86.9%(20/23, average value: 2.0) was positive in the pulmonary involvement group and 50%(8/16, average value: 1.1) in the control group(p=0.04). Antinuclear antibody(ANA) was positive in 60.7%(17/28) of the pulmonary involvement group and in 72.2%(13/18) of the control group(p=0.33). Cryoglobulin also showed a significant difference: 72%(18/25) in the pulmonary involvement group was positive and 56.2%(9/16) in the control group was positive(p=0.02). Bony erosion was positive in 61.5%(16/26) of the pulmonary involvement group and in 77.7%(14/18) of the control group(p=0.8). On the pulmonary function test, the average value of alveolar volume corrected diffusion capacity and residual volume in the pulmonary involvement group and in the control group were 1.07mmol/rnin/KPa(predicted value: 64.2%), 1.32L(predicted value: 70%) and 1.44mmol/min/KPa, 3.75L(predicted value: 86.6%), respectively(p=0.003, p=0.004), showing a significant difference. Conclusion: APF or cryoglobulin on the serological test, the measurement of residual volume and alveolar volume corrected diffusion capacity may be used as effective markers in the diagnosis of pulmonary involvement of the patients with rheumatoid arthritis.

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Comparison of Resistance to Fowl Typhoid among Crossbreed (산란계 합성종의 가금티푸스 저항성 비교 연구)

  • 김기석;이영주;강민수;한성욱;오봉국
    • Korean Journal of Poultry Science
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    • v.29 no.1
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    • pp.59-75
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    • 2002
  • The present study was conducted to compare the disease resistance to fowl typhoid among White Leghorn (WL) known as possessing greater genetic resistance to Salmonella, Rhode Island Red (RIR) susceptible to the disease and their mating crossbreed, WL ${\times}$RIR. Also, it was carried out to compare fowl typhoid-resistance among Hyline white${\times}$Hyline brown(HwHb), Hw${\times}$lsa brown(Hwlb), Isa white${\times}$lb(Iwlb), Iw${\times}$ Hb(IwHb) and Ib ${\times}$ Iw(IbIw) in order to select crossbreed chickens which have disease resistance to fowl typhoid and simultaneously produce the brown eggs which our domestic consummers prefer There was no death of WL chickens challenged with Sal. gallinarum at each 2, 5 and 8 wk of age, while average 86.2 to 64.1% of RIR chickens tested died at the same challenge age during the test period of 2 weeks. Their maiting crossbreed, WL ${\times}$ RIR were intermediate between the two breeds. weight gains of tested chickens were significantly higher in WL and WL ${\times}$RIR without difference between them than RIR. In recovery rate of tested strain of Sal. gallinarum from braun, heart, fiver, spleen and cecum of chickens challenged, WL ${\times}$RIR fell between the other two breeds, with somewhat higher rate then WL but much lower then RIR. In the disease resistance determination test using HwHb, Hwlb, Iwlb, IwHb and IbIw$.$ crossbreed chickens experimentally infected with Sal. gallinarum, it was recognized that all of crossbreeds tested developed marked resistance to fowl typhoid, based on the results judged by the measurement parameters of mortality, weight gain, recovery rate of challenged strain of bacteria, and positive rate of agglutination antibody, and HwHb had a tittle higher disease resistance then ethers.

Studies on Bovine Serum Protein Fractions (I, II) (혈청단백질분획(血淸蛋白質分劃)에 대한 연구(硏究) (I, II))

  • Rim, Bong Ho
    • Korean Journal of Veterinary Research
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    • v.5 no.1
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    • pp.1-16
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    • 1965
  • I. A Comparison of Sodium Sulfate Precipitation and Zone(Paper, Agar) Electrophoresis; Many kinds of techniques have been used for fractionating serum proteins. In the present study, using bovine serum, the fractions obtained with sodium sulfate were compared with those determined by zone electrophoresis. 1. Fibrinogen was precipitated with 4 to 10 percent of sodium sulfate. 2. ${\gamma}$-globulin required 10 to 16 percent of the salt for precipitation. 3. ${\beta}$-globulin began to precipitate at 12 percent sodium sulfate, and completed precipitation at approximately 26 percent in paper electrophoresis, while at 22 percent in agar electrophoresis. 4. ${\alpha}$-globulin completed precipitation at 13 to 28 percent sodium sulfate in paper electrophoresis and at 22 percent in agar electrophoresis. 5. Albumin began to precipitate at 14 percent of the salt, and was free from the mixture of globulins approximately at 28 percent in paper electrophoresis, while at 22 percent in agar electrophoresis. The results of comparing fractions by the two methods were as follows: 1. Euglobulin (15%) was equal to the sum of the most ${\gamma}$-globulin and a small quantity of the ${\alpha}$-, and ${\beta}$-globulins. 2. Pseudoglobulin I (15-17.5%) corresponded to the most ${\alpha}$-, ${\beta}$-globulins and a small quantity of albumin. 3. Pseudoglobulin II(18-22%) was a mixture of the ${\alpha}$-, ${\beta}$-globulins and albumin fraction. 4. Albumin (above 22%) contained the most albumin fraction separated by zone electrophoresis and a small quantity of the ${\alpha}$-, and ${\beta}$-globulins. As mentioned above the fractions obtained with sodium sulfate were a mixture of the various proportion of the fractions determined by zone electrophoresis. The solubility of serum fractions to sodium sulfate coincided with the mobility of those by zone electrophoresis. (By percent of sodium sulfate we mean gram of sodium sulfate contained in $100m{\ell}$ of solution). II. Immunological Studies on Serum Protein Fractions with Sodium Sulfate; In the previous report the fractions of bovine serum protein with sodium sulfate compared with those obtained by zone electrophoresis, and the findings were that the former contained various proportion components of the latter. In this study the author studied whether or not the fractions with sodium sulfate are simple component antigenically by immunoelectrophoresis and micro double diffusion test (Immuno-precipitation), using rabbit antiserum to bovine serum. In immunoelectrophoresis, normal bovine serum developed with rabbit antibovine serum showed about ten distinct precipitin arcs. The distribution of these arcs was as follows: 1 albumin, 2 ${\alpha}_1$-, 3 ${\alpha}_2$-, 2 ${\beta}_1$-, ${\beta}_2$-, and 1 ${\gamma}$-globulin (Fig. 7, 9). In micro double diffusion test, five to six precipitation bands could be seen between antigens and antibody, the order of the precipitation bands location is albumin, ${\alpha}$-, ${\beta}$-, and ${\gamma}$-globulin from the side of antiserum well (Fig.19). Frequently the ${\alpha}$-, and ${\beta}$-precipitation bands were separated into two or three precipitation bands, which indicated that these globuline are not a pure component antigenically as shown in immuno-electrophoresis. In both Immunological methods, the two ${\alpha}$-, ${\beta}$-precipitin arcs and bands appeared clear and strong, indicating that the two globulins reacted as strong antigens. The precipitate reaction of ${\gamma}$-globulin was shown at 12 to 16 percent sodium sulfate; ${\beta}$-globulin at 12 to 20 percent; ${\alpha}$-globulin at 12 to 22 percent (immuno-electrophoresis), at 12 to 26 percent (Diffusion); and albumin at above 22 percent. Antigenically euglobulin contained ${\gamma}$-, ${\beta}$-, and ${\alpha}$-globulins, Pseudoglobulin I and Pseudoglobulin II were composed of ${\alpha}$-, and ${\beta}$-globulins, and albumin was a mixture of ${\alpha}$-globulin and albumin determined by zone electrophoresis. The results indicated that the fractions of serum protein obtained by either method were constituents of various proteins antigenically except ${\gamma}$-globulin and albumin by Zone electrophoresis.

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Clinical implication of Dendritic Cell Infiltration in Cervical Tuberculous Lymphadenitis (결핵성 경부 림프절염에서 수지상돌기세포의 침윤과 임상양상의 연관성)

  • Jung, Jae Woo;Lee, Young Woo;Choi, Jae Cheol;Yoo, Seung Min;Lee, Hwa Yeon;Lim, Seoung Young;Shin, Jong Wook;Kim, Jae Yoel;Park, In Whn;Kim, Mi Kyung;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.523-531
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    • 2006
  • Background : Cervical tuberculous lymphadenopathy is a very common disease with a similar incidence to pulmonary tuberculosis. Dendritic cells play a role of initial antigen presentation of this illness. Nevertheless, the precise role of these antigen-presenting cells according to the clinical features in unclear. The aim of this study was to determine the clinical implication of dendritic cell infiltration in the cervical lymph nodes. Methods : A review of the clinical characteristics was carried out retrospectively based on the clinical records and radiography. Immunohistochemical staining was performed on the available histology specimens of 72 cases using the S-100b polyclonal antibody for dendritic cells. The number of dendritic cells with tuberculous granuloma were determined. A $X^2$ test, unpaired T test and multiple logistic regression analysis were performed. Results : Thirty percent of subjects had previous or concurrent pulmonary TB. Twenty one percent of cases showed a positive reaction on the AFB stain. Within a granuloma, the number of infiltrated dendritic cells was $113.0{\pm}7.0$. The incidence of fever and cough decreased with increasing infiltration of dendritic cells Multivariate regression analysis showed that the infiltration of dendritic cells could significantly contribute to fever. Conclusion : Overall, dendritic cells can control a Mycobacterium tuberculosis infection and modulate the immune response, as well as resolve the clinical manifestations of TB lymphadenopathy.

Infliximab: The Benefit for Refractory Crohn Disease and Top-down Induction Therapy in Severe Crohn Disease (Infliximab: 불응성 크론병 치료법으로서의 유용성과 Top-down 관해 유도 요법으로서의 가능성)

  • Lee, Jee-Hyun;Lee, Hae-Jeong;Park, Sung-Eun;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.28-35
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    • 2008
  • Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.

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Development of Immunochromatography for Detection of Escherichia coli O157:H7 Contaminated in Meats and Sprouts (육류 및 새싹채소에 오염된 Escherichia coli O157:H7의 신속검출을 위한 면역크로마토그래피법의 개발)

  • Lee, Won-Gyeong;Ryu, Hee-Jeong;Song, Jeong-Un;Kim, Kyeong-Yeol;Chung, Do-Yeong;Kim, Jeong-Sook;Shim, Won-Bo;Chung, Duck-Hwa
    • Korean Journal of Food Science and Technology
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    • v.43 no.5
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    • pp.618-623
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    • 2011
  • Escherichia coli O157:H7 has been considered as a significant food-borne pathogen since its role in causing hemorrhagic colitis and hemolytic uremic syndrome in humans was recognized. In this study, we developed an immunochromatography (ICG) assay for the detection of E. coli O157:H7. E. coli O157:H7 monoclonal antibody (EC MAb) and colloidal gold were conjugated and its specificity was determined by the ICG treated with EC MAb and antimouse IgG at test and control lines, respectively. The detection limit of the ICG was $1{\times}10^5$ CFU/mL, and no crossreactivity was observed to other E. coli strains and major food-borne pathogens. To determine the minimum enrichment time for the ICG, meats and sprouts were inoculated with $1{\times}10$ CFU/100 ${\mu}L$ of E. coli O157:H7. After enrichment time of 10 and 2 h for meats and sprouts, respectively, up to $1{\times}10$ CFU/100 ${\mu}L$ of E. coli O157:H7 could be detected by ICG.

Photoprotection and Anti-inflammatory Effects of Chinese Medical Plants (약용식물추출물의 광보호 효과와 항염증 효과 연구)

  • Jin-Hwa, Kim;Sung-Min, Park;Gwan-Sub, Sim;Bum-Chun , Lee;Hyeong-Bae, Pyo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.2
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    • pp.227-233
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    • 2004
  • Chronic exposure to solar radiation, particularly ultraviolet (UV) light, causes a variety of adverse reactions on human skin, such as sunburn, photoaging and photocarcinogenesis. Free radicals and reactive oxygen species (ROS) caused by UV exposure or other environmental facts play critical roles in cellular damage. And, repeated-UV irradiation activated the expression of the matrix metalloproteinase (MMP) and induced skin irritation. Therefore, the development of effective and safe photoprotectants that can reduce and improve the skin damage has been required. The purpose of this study was to investigate the photo-protective effect of several chinese medical plants (Juniperus chinensis) on the UV -induced skin cell damages. We tested free radical and superoxide scavenging effect in vitro. Fluorometric assays of the proteolytic activities of MMP-1 (collagenase) were performed using fluorescent collagen substrates. UVA induced MMP-1 synthesis and activity were analyzed by enzyme-linked immunosorbent assay (ELISA) and gelatin-based zymography in skin fibroblasts. We also examined anti-inflammatory effects by the determination test of proinflammatory cytokine, interleukin 6 in HaCaT keratinocytes. Expression of prostaglandin E$_2$ (PGE$_2$) after UVB irradiation was measured by competitive enzyme immunoassay(EIA) using PGE$_2$ monoclonal antibody. In the human skin we tested anti-irritation effect on the SLS-induced damage skin after appling the extract containing emulsion. We found that Juniperus chinensis extract had potent radical scavenging effect by 98% at 100$\mu\textrm{g}$/mL. The extract of Juniperus chinensis showed strong inhibitory effect on MMP-1 activities by 97% at 100 $\mu\textrm{g}$/mL and suppressed the UVA induced expression of MMP-1 by 79% at 25$\mu\textrm{g}$/mL. This extract also showed strong inhibition on MMP-2 activity in UVA irradiated fibroblast by zymography. In the test of proinflammatory cytokines of human keratinocytes Juniperus chinensis extract decreased expression of interleukin 6 about 30%. The amount of PGE$_2$ by HaCaT keratinocytes was significantly increased at the doses of above 10 mJ/$\textrm{cm}^2$ of UVB (p < 0.05). At the concentrations of 3.2-25$\mu\textrm{g}$/mL of this extract, the production of PGE$_2$ by HaCaT keratinocytes (24 h after 10mJ/$\textrm{cm}^2$ UVB irradiation) was significantly inhibited in culture supernatants (p < 0.05). In SLS-induced skin irritation model in vivo, we found to reduce skin erythema and improve barrier recovery after appling Juniperus chinensis extract containing emulsion when compared to irritated non-treated and placebo-treated skin. Our results suggest that Juniperus chinensis extract can be effectively used for the prevention of UV and SLS-induced adverse skin reactions and applied as anti-aging and anti-irritation cosmetics.

Evaluation of the Automated Immunohematology Analyzer DAYMATE M (혈액은행 자동화 검사장비 DAYMATE M의 수행능 평가)

  • Yoo, Jaeeun;Yu, Hain;Choi, Hyunyu;Lee, Gyoo Whung;Song, Young-Sun;Lee, Seungok;Jekarl, Dong Wook;Kim, Yonggoo
    • Laboratory Medicine Online
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    • v.7 no.4
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    • pp.163-169
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    • 2017
  • Background: An automated immunohematology analyzer, DAYMATE M (DAY Medical, Switzerland), has been recently developed. The potential of this analyzer to improve test results has been evaluated. Methods: A total of 300 blood samples from Seoul St. Mary's hospital and Incheon St. Mary's hospital were tested for ABO and RhD typing. In addition, 336 antibody screening test (AST) samples and 82 patients treated with hematopoietic stem cell transplantation (HSCT) were included. AST results by DAYMATE M were compared with those obtained by a manual method using DS-Screening II (Bio-Rad Laboratories, Switzerland) and red blood cells from Selectogen (Ortho-Clinical diagnostics Inc., USA). Results: Of the 300 patients enrolled, 87, 73, 79, and 61 had type A, B, O, and AB blood, respectively. The concordance rate was 99.9% for cell typing and 97.0% for serum typing. One discordant case was classified as type B instead of AB, and six discordant serum-typing cases were type A, but classified as type AB. Among the 336 AST samples, the concordance rate was 93.2%. From 136 positive cases, six were discordant. Within the 82 HSCT-treated patients, the concordance rate for ABO blood typing was 92.2%. Among the six discordant cases, DAYMATE M typed four cases as donor type where the standard method typed them as the recipient blood type. Conclusions: The DAYMATE M automated immunohematology analyzer performs reliably for ABO and RhD typing, as well as for ASTs and on samples from patients treated with HSCT.

Development and Assessment Individual Maximum Permissible Dose Method of I-131 Therapy in High Risk Patients with Differentiated Papillary Thyroid Cancer (물리학 선량법을 이용한 갑상선암의 개인별 최대안전용량 I-131 치료법 개발과 유용성 평가)

  • Kim, Jeong-Chul;Yoon, Jung-Han;Bom, Hee-Seung;JaeGal, Young-Jong;Song, Ho-Chun;Min, Jung-Joon;Jeong, Heong;Kim, Seong-Min;Heo, Young-Jun;Li, Ming-Hao;Park, Young-Kyu;Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.110-119
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    • 2003
  • Purpose: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age $50{\pm}11$ years) of papillary thyroid cancer. Among them 43 patients were treated with ${\Leq}7.4GBq$, while 15 patients with ${\geq}9.25GBq$. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were $13.3{\pm}1.9\;and\;13.8{\pm}2.1GBq$, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were $1.54{\pm}0.03\;and\;1.78{\pm}0.03Gy$ (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.

Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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