Baeg-Ju Na

An imbalance in interleukin-17-producing T and Foxp3+ regulatory T cells in women with idiopathic recurrent pregnancy loss

BACKGROUND T cells which produce interleukin (IL)-17 are involved in chronic inflammatory processes and regulatory T (Treg) cells are possibly the most important immune regulators. We aimed to investigate peripheral blood IL-17(+) T and Foxp3(+) Treg cells in women with idiopathic recurrent pregnancy loss (RPL). METHODS The study design is a cross-sectional evaluation of Th1, Th2, IL-17(+) T and Treg cells in women with idiopathic RPL (n = 42) and age-matched parous controls (n = 24). Flow cytometric analysis was performed to measure IL-17(+) T and Foxp3(+) Treg cells, and ratios of Th1/Th2 cells using anti-IL-17A and anti-Foxp3 antibodies, and monoclonal antibodies to tumor necrosis factor (TNF)-α, interferon (IFN)-γ and IL-10. Students t-test and partial correlations were applied for statistical analysis. RESULTS TNF-α-/IL-10-producing CD3(+)CD4(+) T cell ratio was higher in women with RPL than controls (P = 0.048). Levels of IL-17(+) T cells (P = 0.021) and the IL-17(+) T/CD4(+)Foxp3(+) Treg cell ratio (P = 0.001) were increased, whereas Foxp3(+) (P = 0.035), Foxp3(low) (P = 0.032) and CD4(+)Foxp3(+) T cell (P = 0.037) levels were decreased in women with RPL, compared with controls. Levels of IL-17(+) T cells were correlated with TNF-α-producing CD3(+)CD4(+) T cells (r = 0.269, P = 0.033), and with ratios of TNF-α/IL-10 (r = 0.276, P = 0.027) and IFN-γ/IL-10 (r = 0.266, P = 0.035)-producing CD3(+)CD4(+) cells. Furthermore, the ratio of IL-17(+) T cells to CD4(+)Foxp3(+) Treg cells showed a positive correlation with TNF-α-producing CD3(+)CD4(+) T cells (P = 0.047) and IFN-γ-producing CD3(+)CD4(+) T cells (P = 0.048) as well as a ratio of IFN-γ/IL-10-producing CD3(+)CD4(+) T cells (P = 0.037). CONCLUSIONS Enhanced pro-inflammatory immune responses with suppressed immune regulation may be an important immune mechanism involved in RPL.

Fluctuation of Peripheral Blood T, B, and NK Cells during a Menstrual Cycle of Normal Healthy Women

Cyclical hormonal changes during an ovarian cycle may affect immune responses, which is crucial for the embryonic implantation. We aim to investigate whether the levels and activity of T, B, and NK cells change during a menstrual cycle. Twenty-two normally cycling women were enrolled and peripheral blood was drawn serially during a menstrual cycle. Intracellular cytokine expression of CD3+CD4+ and CD3+CD8+ cells, and Th1/Th2 cytokine-producing T cell ratios were determined using flow cytometric analysis. NK cell cytotoxicity was measured by flow cytometric analysis at E:T ratios of 50:1, 25:1, and 12.5:1 and also using LU at 20%. Proportions (percentage) of CD3+ (p = 0.046) and CD3+CD4+ (p = 0.002) T cells were increased in the follicular phase compared with the luteal phase. The levels of CD3−CD56+ (p = 0.010) and CD3−CD56dim (p = 0.012) NK cells and NK cytotoxicity at E:T ratio of 50:1, 25:1, and 12.5:1 and LU at 20% were significantly increased in the luteal phase compared with the follicular phase. Even though IL-10–producing CD3+CD4+ T cells were significantly lower in the midluteal phase as compared with the early follicular phase, proportions of CD19+ B cells, CD3+CD56+ NKT cells, Th1 cytokine-producing T cell subsets, and ratios of Th1/Th2 cytokine-producing T cells were not significantly changed during a menstrual cycle. We conclude that peripheral blood NK and T cell levels as well as NK cytotoxicity are changed during a menstrual cycle. Neuroendocrine regulation on immune responses is suggested during an ovarian cycle, which may be critical for embryonic implantation and pregnancy.

The Level of Emotional Labor among Workers in One University Hospital

Purpose : The purpose of this study was to investigate the level of emotional labor and to identify affecting factors on emotional labor among one university hospital employees. Material and Method : This study was based on cross-sectional, self-administered, and Internet-based survey. The survey was conducted from Mar. 2 to Mar. 28. 2011. Total subjects were 812 employees working in one university hospital. Total response rate was 61.5%. Modified evaluation tool was used, which was originally developed by Morris and Feldman, to measure the level of emotional labor among hospital personnel. In order to identify the affecting factors on high level of emotional labor, we conducted logistic regression. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were 2-sided and a p-value

The Effect of Re-building of Public Health Facilities on the Hypertension Control in the Rural Area

Objectives: The purpose of this study was to determine the effect of public health facilities rebuilding on the hypertension control in the rural area. Method: 6 health centers and 59 health subcenters in some Chung-chung province was surveyed. And 29,503 patients were finally selected who had records of prescription about hypertension at list once in those health facilities from July 1th, 2005 to June 30th, 2006. Demographic variable of patients and whether medical doctor was a medical specialist or not, and whether the facilities were recently rebuilded or not was measured. Results: The Overall control rate was 53.9%. Women had higher hypertension control rate than men. And 60s and 70s years old are had higher hypertension control rate than 40s and 80s years old. Patients who had been treated from medical specialist had higher hypertension control rate than general doctor. And patient who treated in rebuilded public health facilities had higher hypertension control rate. Conclusions: Rebuilding of public health facilities were related to increasing control rate of hypertensive patients.

Characteristics of non-emergent patients at emergency departments

The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient`s general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. and logistic regression analysis was performed to identify the nonurgent patients` characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government`s rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have `Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket`. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development` of triage scale and reexamination of the government`s rule on emergency visits are required for future policy in this area.

Age-related differences in diabetes care outcomes in Korea: a retrospective cohort study

BackgroundAge-related differences in diabetes outcomes are important both for clinical and policy considerations. To clarify the basis of such differences, we investigated patterns of associations for age in relation to hospitalization and glycemic control and examined the role of other factors.Methods4471 patients with diabetes aged 40–79 years were drawn from a retrospectively retrieved National Health Insurance Cohort. Using logistic regression, risk factors measured over the two years (2007–2008) were examined for their associations with hospitalization and poor glycemic control during the last year (2009) of follow-up.ResultsCompared to the middle-aged patients, older patients were more likely to have been hospitalized (Adjusted odds ratio (ORadjusted) = 1.97(95% CI = 1.28, 3.04) for the oldest group (ages 70–79) vs youngest group (ages 40–49)) but less likely to have poor glycemic control (ORadjusted = 0.45 (95% CI = 0.37, 0.56) for the oldest group vs youngest group). Older patients were also less likely to be obese but had more complications, longer duration of diabetes, lower continuity of care, and higher blood pressure and total cholesterol level. The pattern of associations for hospitalization and glycemic control was not uniform across the risk factors, sharing only a few common factors such as the duration of diabetes and blood pressure. In general, poor glycemic control was affected predominantly by metabolic management, while hospitalization was strongly related to functional status (i.e., number of complications) and care quality measures (i.e., continuity of care).ConclusionHospitalization was higher among the older diabetic patients, despite better glycemic control. Factors were differently associated with the two diabetes-related outcomes, providing more comprehensive risk profiles for hospitalization. The co-existence of improved glycemic control and increased hospitalization among older diabetic patients suggests an extension of a geriatric evaluation to wider functional and comorbidity status.

Factors Related to Fundus Examination in Diabetes Mellitus Patients

Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.

The relationship between the new-building of rural public health centers and outpatient medical utilization - review of confounding effect by IMF economic recession

Objectives : The purpose of this study was to evaluate the relationship between new-building of rural public health centers and the outpatient medical utilization. Methods : The study subjects were 141 public health centers in rural area. The data were collected from 1995 to 2001, medical utilization and local population, healthcare resources, and economic characteristics were included. In order to evaluate new-building effects, we performed paired t-tests and multivariate regression analyses. Results : The following variables are significant affecting the medical utilization of rural public health centers: urban side location of public health centers(p

Difference of the Effect of Related Factors on Healthy Life_Styles by the Income level

Abstract This research have aimed for analyzing the effect of relative factors on healthy life styles by the income level in a medium-sized city. Especially, the research tried to figure out whether the public health centers health-promotion-activity had different effects on healthy life styles by the income level. The random sampled data of 809 citizens aged between 19 and 69 were analyzed through phone survey by the Korea Gallop inc(surveyed from 2006.10.11 to 10.13). In the low socioeconomic status, the relation between peoples positive conception about public health centers health-promoting-program and healthy behavior tendency is low. But in the high socioeconomic status, the relation is high. This result suggest that the effect of public health centers health promotion programs on healthy life styles is different by income level.Key World : Health promotion, Healthy life_styles, Income level 1. 서론 사회경제적 수준이 낮은 집단은 건강위험 요인에 더 많이 폭로되고, 실제 건강수준도 나쁘다는 것은 이미 많은 국내외 연구들을 통해 밝혀진 사실이다. 국내의 사회계층간 건강격차 현황을 체계적으로 분석한 연구[1]에 따르면, 상위 소득계층에 비해 하위 소득계층의 사망위험이 2.3배 더 높은 것으로 나타났다. 건강행위는 사회경제적 변수와 독립하여 존재할 수 없고, 물질적인 조건이나 사회구조적인 요인을 규정하는 사회경제적 계층에 따라 건강증진 행위 또는 건강위해 행위가 집단적으로 차별화된다[2].국내에서도 사회경제적 수준이 낮은 집단의 흡연율이 더 높은 경향이 보고되고 있다. 1998년과 2001년 국민건강영양조사를 분석한 결과, 소득수준에 따른 흡연율의 차이가 있을 뿐 아니라 이 같은 차이가 시간 경과에 따라 증가하는 것으로 나타났다[3].소득수준이 낮은 사회계층에서의 건강 행태 수준을 향상시키기 위해서는 소득수준이 높은 사회계층에 대한 접근법과는 차별성을 두어야 하는데, 실제로 소득수준이 낮

Relationship between the Expression of VEGF, HIF-1α, E-cadherin, p53 and Stage in Papillary Thyroid Carcinoma

Abstract The purpose of our study was to evaluate the correlation between expression of VEGF, HIF-1α, E-cadherin, and p53 and pathologic stage. We retrospectively reviewed the medical records of the 101 patients who underwent surgery of thyroid nodules from 2000 to 2007. Expression of VEGF, HIF-1α, E-cadherin, and p53 were examinated immunohistochemically. Papillary thyroid carcinoma in this study included 54 cases of more than 45 years old. Each expression of VEGF, HIF-1α, E-cadherin, and p53 was analysed. Only expression loss of E-cadherin was associated with the stage. High HIF-1 expression was significantly associated with VEGF immunoreactivity (p＜0.05). Expression loss of E-cadherin was independent unfavorable factors. It is suggested that high HIF-1α expression may be associated with intratumoral neovascularization possibly through HIF-VEGF pathway. Key Words : Papillary Thyroid Carcinoma, VEGF, HIF-1α, E-Cadherin, p53 * 교신저자 : 나백주(skqw@konyang.ac.kr)접수일 09년 07월 16일 수정일 (1차 09년 12월 09일, 2차 10년 01월 07일) 게재확정일 10년 03월 18일