• Title/Summary/Keyword: Hospital utilization

Search Result 741, Processing Time 0.028 seconds

Cordycepin inhibits lipopolysaccharide-induced cell migration and invasion in human colorectal carcinoma HCT-116 cells through down-regulation of prostaglandin E2 receptor EP4

  • Jeong, Jin-Woo;Park, Cheol;Cha, Hee-Jae;Hong, Su Hyun;Park, Shin-Hyung;Kim, Gi-Young;Kim, Woo Jean;Kim, Cheol Hong;Song, Kyoung Seob;Choi, Yung Hyun
    • BMB Reports
    • /
    • v.51 no.10
    • /
    • pp.532-537
    • /
    • 2018
  • Prostaglandin $E_2$ ($PGE_2$), a major product of cyclooxygenase-2 (COX-2), plays an important role in the carcinogenesis of many solid tumors, including colorectal cancer. Because $PGE_2$ functions by signaling through $PGE_2$ receptors (EPs), which regulate tumor cell growth, invasion, and migration, there has been a growing amount of interest in the therapeutic potential of targeting EPs. In the present study, we investigated the role of EP4 on the effectiveness of cordycepin in inhibiting the migration and invasion of HCT116 human colorectal carcinoma cells. Our data indicate that cordycepin suppressed lipopolysaccharide (LPS)-enhanced cell migration and invasion through the inactivation of matrix metalloproteinase (MMP)-9 as well as the down-regulation of COX-2 expression and $PGE_2$ production. These events were shown to be associated with the inactivation of EP4 and activation of AMP-activated protein kinase (AMPK). Moreover, the EP4 antagonist AH23848 prevented LPS-induced MMP-9 expression and cell invasion in HCT116 cells. However, the AMPK inhibitor, compound C, as well as AMPK knockdown via siRNA, attenuated the cordycepin-induced inhibition of EP4 expression. Cordycepin treatment also reduced the activation of CREB. These findings indicate that cordycepin suppresses the migration and invasion of HCT116 cells through modulating EP4 expression and the AMPK-CREB signaling pathway. Therefore, cordycepin has the potential to serve as a potent anti-cancer agent in therapeutic strategies against colorectal cancer metastasis.

Attitude towards Traditional Korean Medicine Use among Hemiplegic Patients after Cerebrovascular Accident (재활치료 중인 뇌졸중환자의 한의약의료에 대한 태도)

  • Han, Dong-Woon;An, Taek-Soo;Choi, Soo-Jeong;Kim, Ji-Woo
    • Journal of Society of Preventive Korean Medicine
    • /
    • v.15 no.3
    • /
    • pp.67-81
    • /
    • 2011
  • Background : Complementary and alternative medicine has bee used to cardiovascular diseases. In recent years, many hospitals have tried to integrate complementary and alternative medicine(CAM) with conventional medical approaches for patients with chronic diseases. Recently, the prevalence of the use of traditional Korean medicine(TKM) among patients with chronic diseases, expecially, hemiplegia patients after cerebrovascular accident is increasing in Korea. To date, however, there were only few studies addressing the patients' attitudes, and utilization of TKM, compared to the well-documented escalating use of TKM among consumers in Korea. Objectives : The objective of this study was to analyze the prevalence of TKM use among hemiplegia patients after cerebrovascular accident and to determine what factors affect to use CAM among the patients. The study also aims to provide information on TKM and assist therapy selection among various CAM therapies for hemiplegia patients after cerebrovascular accident within health care system in which both practitioners of TKM and practitioners of modern Western medicine coexisted. Methods : The design of the study was descriptive cross-sectional, and data were collected using a 32-items questionnaire. The subjects were one hundred fifty nine patients with chronic diseases who visited or admitted to health care facilities in a hospital in Seoul Metropolitan city, Korea. Data were analyzed using 'SPSS Statistics 18.0 Network Version(on release 18.0.1 of PASW Statistics)' program. Various statistical methods were used to obtain a profile for participants and the therapies most frequently used by hemiplegia patients of TKM. Logistic regression analysis was employed in order to determine the predicting variables of TKM use. Results : The prevalence of the use of TKM was 51.6%. The most common TKM therapies used by the patients included acupuncture(93.2%), herbal medicine(64.8%), and cupping(37.5%). Results of logistic regression analysis revealed that the variables significantly related with TKM use were gender, marital status, job, No. of visiting health care facilities/week. Conclusions : This study shows that the use of TKM among the hemiplegia patients is relatively high in Korea, this topic should be taken into account in the development of a holistic approach for patients with chronic diseases and an efficient chronic disease management system in Korea.

An Appropriateness Evaluation of Cesarean Section, Cholecystectomy, and Admission in Pediatric Pneumonia (입원과 수술시행의 적정성 평가)

  • Kim, Chang-Yup;Ahn, Hyeong-Sik;Lee, Young-Seong;Kwon, Young-Dae;Kim, Yong-Ik;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
    • /
    • v.25 no.4 s.40
    • /
    • pp.413-428
    • /
    • 1992
  • The aim of this study was to evaluate the appropriateness of some kinds of surgery and admission, such as cesarean section (C/S), cholecystectomy, and pediatric pneumonia. For appropriateness evaluation, we ourselves developed some criteria, which were included in the category of explicit and linear criteria, with the assistance of specialists of relevant clinical field. The evaluation of appropriateness was performed by two family physicians. The major findings were as follows: 1. For cesarean section, 77.6% of deliveries were determined to be 'appropriate', but the level of appropriateness was not significantly different among hospitals and between hospital groups by size. The most freqeunt indication of C/S was repeated operation, followed by cephalopelvic disproportion (CPD). The labor trials for vaginal delivery among repeated C/S and CPD cases were performed in 24.5% of pertinent deliveries. 2. About 73.8% of cholecystectomy cases was appropriate to one of the surgical indications, without significant differences among hospitals. Of surgical indications, 'sufficiently frequent and intense symptom recurrence' was the most frequent, and 'confirmed acute cholecystitis' was the second. 3. Of children admitted due to pneumonia, only 57.4% of cases satisfied admission criteria, and the level of appropriateness of admission was different among hospitals. The common reasons fur admission were 'failure to initial treatment', 'suspected bacterial pneumonia', 'young infant', etc. We could find that there were differences of quality among hospitals in some procedures, especially in the pediatric pneumonia and labor trial before C/S, which suggested that the implementation of quality assurance activiteis would be necessary in this country. In this study, we used some simple and primitive research tools and the numbers of subjects and tracer procedures were limited. So advanced studios with plentiful subjects and more representative diseases or procedures should be tried.

  • PDF

Effects of a Home Respiratory Management Program on Unmet Healthcare need and Healthcare resource utilizations for Patients applying Home Mechanical Ventilator with Amyotrophic Lateral Sclerosis (가정형 인공호흡기 사용 중인 재가 근위축성 측삭증후군 환자의 가정간호기반 호흡관리 프로그램이 미충족의료와 의료자원이용에 미치는 효과)

  • Hwang, Moon Sook;Park, Jin-Hee
    • Journal of Industrial Convergence
    • /
    • v.17 no.4
    • /
    • pp.77-86
    • /
    • 2019
  • The purpose of this study was to identify the effect of Home Health Nursing based Respiratory Management Program (HHNbRMP) on unmet healthcare need and healthcare resource utilizations of patients applying the home mechanical ventilator in the home with amyotrophic lateral sclerosis. The subjects of this study were 40 patients placed in an experimental group(n=19) and a control group(n=21), respectively. This HHNbRMP based on Cox's interaction model was consisted of cognitive assent (education, specialized medical care, case management), internal motivation (airway clearance, thoracic and air accumulated exercise) and psychological response (meditation & active listening). The intervention was applied to experimental group during 12 weeks. As variables was measured at baseline, twelve, twenty-four weeks and healthcare unmet need, resource utilizations (admission, out patient department, emergency room) was measured at 24 weeks. The data were analyzed by t-test, ANOVA and Repeated Measures ANCOVA. This intervention was not effective the unmet healthcare need. But the admission in to the hospital among the healthcare resource utilizations variables showed a significant difference at twenty-four weeks(t=4.17, p=.049). This results suggest that applying this program tailored to patients condition, utility of medical resource would be decreased, specially admission.

Skeletal-Related Events among Breast and Prostate Cancer Patients: Towards New Treatment Initiation in Malaysia's Hospital Setting

  • Ezat, Sharifa Wan Puteh;Junid, Syed Mohamed Aljunid Syed;Khamis, Noraziani;Ahmed, Zafar;Sulong, Saperi;Nur, Amrizal Muhammad;Aizuddin, Azimatun Noor;Ismail, Fuad;Abdullah, Norlia;Zainuddin, Zulkifli Md;Kassim, Abdul Yazid Mohd;Haflah, Nor Hazla Mohamed
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.5
    • /
    • pp.3357-3362
    • /
    • 2013
  • The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient healthrelated quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.

The current status of the combination therapy of frequently used herbal extracts and anti-platelet drug, anti-coagulant drug in ischemic stroke patients hospitalized in oriental medical hospital (한방병원 입원 허혈성 뇌경색 환자에서 한방 의료보험용 엑스산제와 항혈소판제 및 항응고제의 병용투여 현황)

  • Han, Su-Ryun;Park, Sung-Hwan;Ahn, Young-Min;Ahn, Se-Young;Lee, Byung-Cheol
    • The Journal of Korean Medicine
    • /
    • v.32 no.2
    • /
    • pp.14-22
    • /
    • 2011
  • Objective: Nowadays the combined use of herbal extracts and western medicines has been prevalent, but concern about its risk is also increasing. Even though the importance of clinical trials is well recognized, there have been only a few studies on the combined use of herbal extracts and western medicines. This study was aimed to examine which herbal extracts and antiplatelets or anticoagulants are most commonly prescribed together to inpatient ischemicstroke patients and investigate the combined prescription rate. Methods: We investigated the most frequently prescribed herbal extracts from two different sources. First, we chose herbal medicine extracts from 2008 Traditional Korean Medicine Utilization Status. Then, among patients who were admitted to Kyung-Hee Oriental Medical Center diagnosed with ischemic stroke, we found patients who were administered with these herbal medicine extracts and among these patients, we investigated how many were concomitantly administered with antiplatelets or anticoagulants. Second, we chose other herbal medicine extracts that were most often prescribed within Kyung-Hee Oriental Medical Center and found patients who were administered with these herbal medicine extracts, then investigated how many of them were concomitantly administered with specific antiplatelets or anticoagulants. Results: The most commonly prescribed herbal medicine extracts among ischemic stroke patients were Ojeok-san, Bojungikgi-tang, Sochungryong-tang and Samsoeum. About 46 to 69 percent were concomitantly administered with either specific antiplatelets or anticoagulants. Conclusions: The most often prescribed herbal medicine extracts in inpatient ischemic stroke patients are Ojeok-san, Bojungikgi-tang, Sochungryong-tang, and Samsoeum. Among patients who were prescribed with Ojeok-san, Bojungikgi-tang, Sochungryong-tang, Samsoeum, patients who were concomitantly administered with either antiplatelets or anticoagulants were about 46% to 69%.

Correlates of Self-rated Fatigue in Korean Employees (우리나라 직장인 피로의 역학적 특성)

  • Chang, Sei-Jin;Kang, Myung-Gun;Hyun, Sook-Jung;Cha, Bong-Suk;Park, Jong-Ku;Park, Jun-Ho;Kim, Seong-Ah;Kang, Dong-Mug;Chang, Seong-Sil;Lee, Kyung-Jae;Ha, Eun-Hee;Ha, Mi-Na;Koh, Sang-Baek
    • Journal of Preventive Medicine and Public Health
    • /
    • v.38 no.1
    • /
    • pp.71-81
    • /
    • 2005
  • Objective : To elucidate the correlates of self-rated fatigue in Korean employees. Methods : The data for 10,176 (men, 7,984; women, 2,192; mean age, 34.2; SD: 8.8) employees recruited from a nationwide sample were examined. A structured questionnaire was used to measure the participants' fatigue, sociodemographics (sex, age, education, and marital status), job-related characteristics (work duration, grade at work, work hours, shiftwork, employment type, and magnitude of workplace), and health-related habits (smoking, drinking, coffee intake, and exercise). Two types of measurement for fatigue were used to evaluate the magnitude of fatigue: self-rated question and a standardized measurement tool (Multidimensional Fatigue Scale: MFS). Results : According to the self-rated fatigue, 32% of employees reported that they felt fatigue for the past two weeks, and 9.6% of males and 8.7% of females had experienced excessive fatigue (6 months or more). Hierarchical multiple regression analysis showed that fatigue measured by MFS was more common in women, younger, college or more graduated, single, and employees who do not regularly exercise. Fatigue was also associated with long work hours, and the size of the workplace (<1,000 employees). Conclusions : These results suggest that fatigue has been considered as a common complaint, and that it is affected by job-related factors like work hours and the workplace size as well as sociodemographics or health-related behaviors. Further research is needed to clarify the effects of fatigue on adverse health outcomes, work performance, work disability, sick absence and medical utilization, and to examine the relationship of job characteristics (e.g.: work demand, decision latitude) to fatigue.

A Study on Policy Improvement for Ensuring the Effectiveness of Suicide Prevention Law (「자살예방 및 생명존중 문화 조성을 위한 법률」의 실효성 확보를 위한 정책적 개선 방안 - 「개인정보보호법」과의 충돌문제 해결을 중심으로 -)

  • Kwon, Do-Hyun;Park, Jong-Ik;Ah, Yong-Min
    • The Korean Society of Law and Medicine
    • /
    • v.20 no.2
    • /
    • pp.261-285
    • /
    • 2019
  • The essential policy of suicide prevention is to continuously manage and treat suicide attempted people through data base related to suicide retry rate and follow-up study report. In Korea, only few people are allowed to follow-up by the Personal Information Protection Act. As a result, the research participation rate and the service participation rate are rather low, so that the research participants is limited to a part of the suicide attempted people. Therefore, the policy proposals to be improved in the Ministry of Health and Welfare Act were examined comparatively in order to increase the practical utilization of the suicide prevention about Article 14 and Article 20 of the Suicide Prevention Act. As a criterion for policy improvement, measures for non-discrimination of information to be considered in terms of technical and ethical dimensions and non-profit research and medical information for medical purposes were suggested. In addition to the severity of the suicide, the suicide risk was assessed and the criteria for the objective assessment of the follow-up observation were considered in consideration of the severity of the suicide.

A Study on the Concept of Meaningful Activity for the Elderly and the Evaluation of Participation: Research Trends and Prospect for Utilization (노인의 의미 있는 활동의 개념과 참여 평가에 관한 고찰: 연구경향과 활용 전망)

  • Park, Da Sol;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
    • /
    • v.9 no.4
    • /
    • pp.83-93
    • /
    • 2020
  • Objective : This study was designed to analyze the concepts of current use and meaningful activity in the elderly and provide basic data on establishing concept of participation in meaningful activity and clinical applications. Methods : Using RISS, Google Scholar, Published and DBpia databases, the literature published in the journal was collected from January 2010 to July 2019. The main search term used was "meaningful activity" and 10 of the 182 papers were finally selected for analysis. Based on the qualitative level assessment study by Arbesman, Scheer and Lieberman (2008), the selected paper were classified as Level I to Level V. Results : Five out of 10 studies were published within the last 5 years, indicating that meaningful activity-related studies have been conducted recently. Through prior studies, the concept of meaningful activities was summarized as those that enable individuals to realize their values, achieve their goals and experience positive emotions in their daily lives. Conclusion : The concepts and direction of assessment tools derived from this study will be the basis for the study of 'meaningful activity participation' as a solution to the aging society's elderly problems in the future.

Treatment of Pulmonary Sequestration with Thoracoscopic Approach (폐분리증의 치료와 흉강경적 절제술의 경험)

  • Cho, Min-Jeng;Kim, Tae-Hoon;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
    • /
    • v.16 no.2
    • /
    • pp.154-161
    • /
    • 2010
  • Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The anomaly is characterized by absence of communication with the tracheobronchial tree and isolated blood supply from an anomalous systemic vessels. With the utilization of antenatal ultrasound, the diagnosis of asymptomatic neonatal PS has increased. Treatment options include observation, arterial embolization and surgical resection. The aim of the present study is to review the clinical course of PS and to share our experience with thoracoscopic resection. A total of 96 patients with PS were treated at Asan Children's Hospital between 1999 and 2010. The diagnosis of PS was established by CT in the cases managed by observation or embolization, and by tissue pathology in the surgical cases. Medical records and radiographic images were retrospectively reviewed. Thirty-nine patients were managed by embolization and 30 patients by surgery. The remaining 27 patients have been under observation without any procedures. Among 27 observation patients, 1 patient regressed completely and 10 patients were lost to follow up. Of the 39 embolizations patients, 2 had their lesion regress and sepsis was suspected after embolization. In 1 patient, the microcoil migrated to the iliac artery during the embolization procedure, and another patient developed renal abscess caused by renal artery embolization. Among 30 surgical cases, resection by thoracotomy was performed in 27 at the Department of Thoracic Surgery, and thoracoscopic resection in 3 at the Division of Pediatric Sugery. Only one wound complication ocurred. We conclud that surgical excision should be recommended for pulmonary sequestration, whether the sequestration is symptomatic or not because of the risk of infection, the low rate of natural regress, poor compliance, severe complications after embolization, and to exclude other pathology. In summary, thoracoscopic resection of the pulmonary sequestration is feasible, efficacious, safe and cosmetically superior even in neonatal period.

  • PDF