Purpose : Death due to cancer has been continuously increasing, therefore cancer is the first in the cause of death now. A national policy for the elevation of medical costs in cancer patients is necessary, therefore, we searched for the medical costs and its related factors in terminal cancer patients for the effective reduction of the medical costs. Methods : We reviewed the medical records of 259 hospitalized terminal cancer patients who had died during the period of July 1, 2000 to June 30, 2002. History of cancer included type of cancer, type of past treatment, existence of metastasis. Clinical manifestation was examined and medical costs on last admission was categorized based on the account of charges of the department of patient affair on the last hospitalization. For analysis of factors related with medical costs, ANOVA was used. Results : Of the 259 patients, the number of male was 135 cases (52.1%), and the female, 124 cases (47.9%). The most frequent type of cancer was stomach (21.9%) cancer. Of the clinical manifestation, anorexia (87.6%) was the most frequent manifestation. Total medical costs was 740,628,045won, the mean costs was $285,968{\pm}3,070,272won$. The frequent category of medical costs was injection (32.0%), medical accommodation (27.9%), examination (14.0%), in order. The only factor related with mean medical costs was pain (P<0.05). Conclusion : If unnecessary injection of opioid analgesics is reduced, hospice care at home is activated and excessive examination is reduced In terminal cancer inpatients, it will be possible to reduce the medical costs in terminal cancer patients more effectively.
Kim, Dong-Heui;Lee, Kyu-Jae;Qi, Xu-Feng;Lee, Young-Mi;Yoon, Yang-Suk;Kim, Jeong-Lye;Chang, Byung-Soo;Ryang, Yong-Suk
Applied Microscopy
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제38권3호
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pp.167-174
/
2008
Atopic dermatitis (AD) is a chronically relapsing inflammatory skin disease that often has asthma and allergic rhinitis. Magnesium salts, the important component of minerals in Dead Sea water, are known to exhibit beneficial effects in inflammatory disease. Favorable effects of magnesium ions and sea water treated to the skin of patients with contact dermatitis have been reported. But histological and immunological investigations are insufficient. This study was performed to examine the inhibitory effect of magnesium-rich sea mineral water on the development of AD-like skin lesions in hairless mice. AD-like skin lesions are induced by the repeated application of 2,4-dinitrochlorobenzene (DNCB). Local application of magnesium-rich sea mineral water on hairless mice skin applied with DNCB inhibited the development of AD-like skin lesions as exemplified by a significant increase in skin hydration (p<0.01), and a decrease in epidermal water loss (p<0.01). Serum IgE level was also significantly decreased (p<0.01). These results suggest that magnesium-rich sea mineral water inhibits the development of DNCB-induced AD-like skin lesions in hairless mice. These observations indicate that magnesium-rich sea mineral water may be alternative and assistant substances for the management of AD.
Purpose : One of the most important adverse effects of long-term cyclosporine therapy is nephrotoxicity, the morphologic changes of which include interstitial fibrosis and arteriolar hyalinization. Recently, several authors have shown that osteopontin plays an important role in the development of interstitial fibrosis by acting as a macrophage chemoattractant and stimulating the production of $TGF-{\beta}$ in experimental cyclosporine nephrotoxicity. However, the relationship between osteopontin and $TGF-{\beta}$ in humans has not been clearly documented so far. We studied the expression of osteopontin and $TGF-{\beta}$ in children with minimal change nephrotic syndrome treated with cyclosporine to demonstrate whether there is a relationship between cyclosporine toxicity and osteopontin expression as previously shown in animal models. Materials and methods : Nineteen children (15 males and 4 females) were the subject of this study. Renal biopsies had been performed before and after the cyclosporine therapy (mean duration: 15.9 months). In 5 patients, additional biopsies were performed after completing the cyclosporine treatment (mean; 26 months). The expressions of osteopontin and $TGF-{\beta}$ were evaluated by immunohistochemistry in the glomeruli and tubulointerstitium. Results : Osteopontin expression was significantly increased in the glomerular mesangium and tubules after cyclosporine treatment. But there was no statistically significant increase of $TGF-{\beta}$ in the interstitium. There was no significant increase in tubular osteopontin and interstitial $TGF-{\beta}$ expression in those cases developing interstitial fibrosis after cyclosporine treatment compared with cases those not developing interstitial fibrosis. No significant changes in osteopontin or $TGF-{\beta}$ expression were observed in subsequent 5 biopsy samples after discontinuation of cyclosporine compared with the first follow up biopsies. Conclusion : These results suggest that osteopontin is a nonspecific marker of renal injury rather than a mediator of interstitial fibrosis in cyclosporine nephrotoxicity of human.
Purpose: Some of the properties of the prosodic phrasing and some acoustic and phonological effects of contrastive focus on the tonal pattern of Seoul Korean is explored based on a brief experiment of analyzing the fundamental frequency(=FO) contour of the speech of the author. Data Base and Analysis Procedures: The examples were chosen to contain mostly nasal and liquid consonants, since it is difficult to track down the formants in stops and fricatives during their corresponding consonantal intervals and stops may yield an effect of unwanted increase in the FO value due to their burst into the following vowel. All examples were recorded three times and the spectrum of the most stable repetition was generated, from which the FO contour of each sentence was obtained, the peaks with a value higher than 250Hz being interpreted as a high tone (=H). The result is then discussed within the prosodic hierarchy framework of Selkirk (1986) and compared with the tonal pattern of the Northern Kyungsang dialect of Korean reported in Kenstowicz & Sohn (1996). Prosodic Phrasing: In N.K. Korean, H never appears both on the object and on the verb in a neutral sentence, which indicates the object and the verb form a single Phonological Phrase ($={\phi}$), given that there is only one pitch peak for each $={\phi}$. However, Seoul Korean shows that both the object and the verb have H of their own, indicating that they are not contained in one $={\phi}$. This violates the Optimality constraint of Wrap-XP (=Enclose a lexical head and its arguments in one $={\phi}$), while N.K. Korean obeys the constraint by grouping a VP in a single $={\phi}$. This asymmetry can be resolved through a constraint that favors the separate grouping of each lexical category and is ranked higher than Wrap-XP in Seoul Korean but vice versa in N.K. Korean; $Align-x^{lex}$ (=Align the left edge of a lexical category with that of a $={\phi}$). (1) nuna-ka manll-ll mEk-nIn-ta ('sister-NOM garlic-ACC eat-PRES-DECL') a. (LLH) (LLH) (HLL) ----Seoul Korean b. (LLH) (LLL LHL) ----N.K. Korean Focus and Phrasing: Two major effects of contrastive focus on phonological phrasing are found in Seoul Korean: (a) the peak of an Intonatioanl Phrase (=IP) falls on the focused element; and (b) focus has the effect of deleting all the following prosodic structures. A focused element always attracts the peak of IP, showing an increase of approximately 30Hz compared with the peak of a non-focused IP. When a subject is focused, no H appears either on the object or on the verb and a focused object is never followed by a verb with H. The post-focus deletion of prosodic boundaries is forced through the interaction of StressFocus (=If F is a focus and DF is its semantic domain, the highest prominence in DF will be within F) and Rightmost-IP (=The peak of an IP projects from the rightmost $={\phi}$). First Stress-F requires the peak of IP to fall on the focused element. Then to avoid violating Rightmost-IP, all the boundaries after the focused element should delete, minimizing the number of $={\phi}$'s intervening from the right edge of IP. (2) (omitted) Conclusion: In general, there seems to be no direct alignment constraints between the syntactically focused element and the edge of $={\phi}$ determined in phonology; all the alignment effects come from a single requirement that the peak of IP projects from the rightmost $={\phi}$ as proposed in Truckenbrodt (1995).
Purpose: Three phase bone scan was considered sensitive in Patients with Reflex Symphathetic Dystrophy Syndrome (RSDS). Generally, three phase bone scan in the RSDS patients shows increased uptake of one side extremity joint. But three phase bone scan has been performed with flow, blood pool and delayed scan. We performed blood pool half body scan in order to investigate its usefulness. Materials and Methods: From October 2007 to September 2009, three phase bone scan (flow, blood pool, half body blood pool, delayed) was performed after injection of 750 MBq of $^{99m}Tc$-DPD in diagnosed patients with RSDS (M:F=8:7, R:L=9:6). For quantitative analysis, we obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in the three phase images and compared with the count ratios of shoulders in half body blood pool and delayed images. Results: In flow images, right/left ratios were $1.09{\pm}0.53$. In blood pool images, right/left ratios were $1.13{\pm}0.47$ (hand), $1.08{\pm}0.26$ (shoulder). In delayed images, right/left ratios were $1.24{\pm}0.75$ (hand), $1.11{\pm}0.31$ (shoulder). As a result, Log of right/left counts of the others and that of shoulder blood pool image were correlated well with statistical significance (Spearman's R, p<0.005 SPSS for windows ver.12.0). Conclusion: Half body blood pool scan may be helpful in the diagnosis of patients with RSDS. Moreover, Half body blood pool scan reduced false negative and false positive rates. In order to improve agreement on interpretation of RSDS, Blood pool half body scan should be established as common criteria.
Insamjungchuntang has been used in Korea for many centuries as a treatment for respiratory disease. The effect of Insamjungchuntang on tracheal smooth muscle is not known. The purpose of the present study is to determine the effect of Insamjungchuntang on histamine and acetylcholine induced tracheal smooth muscle contraction in rats and guinea pigs. Guinea pig (500 g, male) and Sprague Dawley rats (200 g, male) were killed by $CO_2$ exposure and a segment (8-10 mm) of the thoracic trachea from each rat and guinea pig was cut into equal segments and mounted 'in pairs' in a tissue bath. Contractile force was measured with force displacement transducers under 0.5 g loading tension. The dose of histamine (His) and acetylcholine (Ach) which evoked 50% of maximal response $(ED_{50})$ was obtained from cumulative dose response curves for histamine and acetylcholine$(10^{-7}{\sim}10^{-4}\;M)$. Contractions evoked by His ($ED_{50}$) and Ach $(ED_{50})$ were inhibited significantly by Insamjungchuntang. In guinea pig tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was $38.58\(p<0.05)\;after\;10{\mu}l/ml$ Insamjungchuntang, $90.75\(p<0.01)\;after\;30{\mu}l/ml$. Insamjungchuntang and $133.17\(p<0.01)\;after\;100{\mu}l/ml$ Insamjungchuntang. In rat tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was $10.0\(p<0.05)\;after\;10{\mu}l/ml$ Insamjungchuntang, $80.71\(p<0.01)\;after\;30{\mu}/ml$ Insamjungchuntang and $118.29\(p<0.01)\;after\;100{\mu}l/ml$ Insamjungchuntang. Also, in guinea pig tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was $45.5\(p<0.01)\;after\;10{\mu}l/ml$ lnsamjungchuntang, and $93.17\(p<0.01)\;after\;30{\mu}l/ml$. lnsamjungchuntang $134.50\(p<0.01)\;after\;100{\mu}l/ml$ Insamjungchuntang. In rat tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was $37.83\(p<0.01)\;after\;10{\mu}l/ml$ lnsamjungchuntang, $90.5\(p<0.01)\;after\;30{\mu}l/ml$ Insamjungchuntang and $135.17\(p<0.01)\;after\;100{\mu}l/ml$ Insamjungchuntang. Propranolol $(10^{-7}\;M)$ slightly but significantly attenuated the inhibitory effects of Insamjungchuntang. Following treatment with propranolol, the mean percent inhibition caused by $100{\mu}l/ml$. Insamjungchuntang fell to 46.42% in guinea pig induced by acetylcholine contraction and by $100{\mu}l/ml$ Insamjungchuntang fell to 5.43% (p<0.05) in rat induced by acetylcholine contraction and the mean percent inhibition caused by $100{\mu}l/ml$ Insamjungchuntang fell to 49.0% in guinea pig induced by histamine contraction and by $100{\mu}l/ml$ Insamjungchuntang fell to 48.6% (p<0.05) in rat induced by histamine contraction. Indomethacin and methylene blue $(10^{-7}\;M)$ did not significantly alter the inhibitory effect of lnsamjungchuntang. Also, I could find the effects of lnsamjungchuntang and Insamjungchuntanggamorphine on the tracheal smooth muscle in guinea pig and rat did not change significantly. These results indicate that Insamjungchuntang can relax histamine and acetylcholine-induced contraction of guinea pig and rat tracheal smooth muscle, and that this inhibition involves sympathetic effects.
Sung, Ji Yeon;Ki, Joo Hwa;Yang, Mi Ae;Kim, So Hee;Eun, Byung Wook;Kim, Nam Hee;Park, Kyoung Un;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
Pediatric Infection and Vaccine
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제15권1호
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pp.52-58
/
2008
Purpose : Whole blood interferon-$\gamma$ assay was developed and many studies showed its usefulness in diagnosing tuberculosis (TB) including latent tuberculosis infection (LTBI). However, assessment in children has been limited. This study was undertaken to evaluate the usefulness of QuantiFERON-TB Gold for the diagnosis of LTBI in children exposed to pulmonary TB. Methods : Children who visited Seoul National University Bundang Hospital with a history of TB exposure were enrolled from January 2006 to December 2007. They were evaluated with chest x-rays, tuberculin skin test (TST) and QuantiFERON-TB Gold test. TST was retested 3 months later for those with initial negative reactivity. Definition of LTBI was made on the basis of the TST reactivity. Results : Among the 103 children with a history of TB exposure, 49 children were tested with chest x-ray, TST, and QuantiFERON-TB Gold. Twenty-two were males. Median age was 7.5 years (range; 3 months to 14.7 years). According to TST reactivity, LTBI was in 8 (19%), no infection was in 21 (50%), possible LTBI was in 13 (31%). QuantiFERON-TB Gold test was positive in 5 of the 49 subjects (10%); 3 of the 13 subjects (23.1%) in unknown status, 1 of the 8 subjects (13%) in LTBI, and 1 of the 21 subjects (5%) without infection. The agreement between the QuantiFERON-TB Gold and the TST was poor (${\kappa}=0.101$). Conclusion : QuantiFERON-TB Gold showed poor sensitivity for the diagnosis of LTBI in children with exposure to TB. QuantiFERON-TB Gold alone does not seem to be useful in the diagnosis of LTBI in children.
Kim, Joong-Sun;Lee, Seung-Sook;Jang, Won-Suk;Lee, Sun-Joo;Park, Sun-Hoo;Cho, Soo-Youn;Moon, Chang-Jong;Kim, Sung-Ho;Kim, Mi-Sook
Radiation Oncology Journal
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제28권3호
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pp.141-146
/
2010
Purpose: We examined the radioprotective effects of 5-androstendiol (5-AED), a natural hormone produced in the reticularis of the adrenal cortex, as a result of intestinal damage in gamma-irradiated C3H/HeN mice. Materials and Methods: Thirty mice (C3H/HeN) were divided into three groups; 1) non-irradiated control group, 2) irradiated group, and 3) 5-AED-treated group prior to irradiation. Next, 5-AED (50 mg/kg per body weight) was subcutaneously injected 24 hours before irradiation. The mice were whole-body irradiated with 10 Gy for the histological examination of jejunal crypt survival and the determination of the villus morphology including crypt depth, crypt size, number of villi, villus height, and length of basal lamina, as well as 5 Gy for the detection of apoptosis. Results: The 5-AED pre-treated group significantly increased the survival of the jejunal crypt, compared to irradiation controls (p<0.05 vs. irradiation controls at 3.5 days after 10 Gy). The evaluation of morphological changes revealed that the administration of 5-AED reduced the radiation-induced intestinal damages such as villus shortening and increased length of the basal lamina of enterocytes (p<0.05 vs irradiation controls on 3.5 day after 10 Gy, respectively). The administration of 5-AED decreased the radiation-induced apoptosis in the intestinal crypt, with no significant difference between the vehicle and 5-AED at 12 hours after 5 Gy. Conclusion: The results of this study suggest that the administration of 5-AED has a protective effect on intestinal damage induced by $\gamma$-irradiation. In turn, these results suggest that 5-AED could be a useful candidate for radioprotection against intestinal mucosal injury following irradiation.
Yu, Ri;Kwon, Young Sam;Oh, Tae-Ho;Kim, Tae-Hwan;Park, Sang-Joon
Journal of Veterinary Clinics
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제30권5호
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pp.339-345
/
2013
Mitogen-activated protein kinases (MAPKs) are a family of central signaling molecules that respond to numerous stimuli and are known to participate in processes of cell survival and death. However, it is not clear on data for cell-type specific activation of MAPKs in the progression of gastric ulcer. In the present study, we assessed how MAPKs localized at various cell types during the progression of gastric ulcer induced by ibuprofen. Gastric ulcer was induced by the repeated treatment of 200 mg/kg ibuprofen with 8 hrs interval in a day. Animals were sacrificed at 24 hrs, 48 hrs, and 72 hrs after oral treatment of ibuprofen and gastric tissues were subjected to immunohistochemical and immunoblotting evaluation. Immunoreactivity of phospho-extracellular signal-regulated kinase (p-ERK) was mainly expressed at the proliferating zone of gastric mucosa in control rats. But, these signals for p-ERK were highly shifted from cells of proliferating zone to parietal cells of the basal regions 24 hrs after treatment of ibuprofen. p-ERK signal was strongly expressed in epithelial cells adjacent to ulcer margin and new capillary and infiltrated inflammatory cells within granulation tissue of the ulcer base above 48 hrs after treatment of ibuprofen. While, phospho-c-Jun $NH_2$ terminal kinase (p-JNK) was mainly localized to the nuclei of the surface epithelial cells and the glandular epithelial cells in early gastric injury. Also, p-JNK was often observed as a scattered pattern in different regions of gastric mucosa with early gastric injury. Gradually, signal of p-JNK was strongly stained in infiltrated inflammatory cells and fibroblasts within severe ulcer base. Phospho-p38 (p-p38) MAPK was observed as scattered pattern within connective tissues of gastric mucosa. Especially, p-p38 MAPK showed strong signal in infiltrated macrophages within ulcer base. These results show that each MAPK has a specific role in various cell types during the progression of gastric ulcer.
LEE, Eun Ji;SEO, Young Il;PARK, Hee Won;KANG, Hee Joong;ZHANG, Chang Ik
Journal of the Korean Society of Fisheries and Ocean Technology
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제51권4호
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pp.535-544
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2015
Yield per recruit model is the most popular method for fisheries stock assessment. However, stock assessment using yield per recruit model can lead to recruitment overfishing as this model only considers the maximum yield per recruit without spawning biomass for reproduction. For this reason, spawning biomass per recruit model which reveals variations of spawning stock biomass per fishing mortality (F) and age at first capture ($t_c$) is considered as more proper method for stock assessment. There are mainly two methods for spawning biomass per recruit model known as age specific selectivity method and knife-edged selectivity method. In the knife-edged selectivity method, the spawning biomass per recruit has been often calculated using biomass per recruit value by multiplying the maturity ratio of the recruited age. But the maturity ratio in the previous method was not considered properly in previous studies. Therefore, a new method of the knife-edged selectivity model was suggested in this study using a weighted average of the maturity ratio for ages from the first capture to the lifespan. The optimum fishing mortality in terms of $F_{35%}$ which was obtained from the new method was compared to the old method for small yellow croaker stock in Korea. The value of $F_{35%}$ using the new knife-edged selectivity model was 0.302/year and the value using the old model was 0.349/year. However, the value of $F_{35%}$ using the age specific selectivity model was estimated as 0.320/year which was closer to the value from the new knife-edged selectivity model.
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