Association between private health insurance and medical use by linking subjective health and chronic diseases

This empirical study identifies the negative aspects of private health insurance (PHI) by analyzing the association between subjective health conditions, 2 weeks of outpatient care, chronic diseases, and hospitalizations for 1 year. We used frequency analysis, χ² testing, an analysis of variance, and logistic and multiple logistic regression models to analyze the association between PHI and subjective health conditions, outpatient care, chronic disease status, and hospitalization. The PHI group had good subjective health but had more outpatient care for 2 weeks. There were few chronic diseases in the private insurance group, and there was no significant difference in hospitalizations for 1 year. Hospitalization may occur when essential medical care is required, regardless of health insurance type. This study confirmed that as the PHI lowers the burden of personal medical expenses, the PHI can lead to an increase in the medical resource expenditures on the outpatient medical service and higher public health costs. The government should work to redefine the role of private and national health insurance. Also, the effectiveness of PHI should be reevaluated so that it does not lead to indiscriminate use of medical services by minimizing the burden of private insurance.     

Scalarane sesterterpenes from the sponge Smenospongia sp

Ten new sesterterpene compounds (4-13) and seven known metabolites (1-3, 14-17) were isolated from the sponge Smenospongia sp. collected from Korean coastal waters. On the basis of combined spectroscopic analyses, the new compounds exhibited diverse functionalities on a common scalarane sesterterpene structure. The presence of a 23-aldehyde on compound 6 and a 20-carboxylic acid on 11 is unprecedented among sponge-derived scalarane sesterterpenes. Several of the new compounds showed significant cytotoxicity and antimicrobial activity, as well as moderate inhibitory activity against isocitrate lyase.     

Interleukin-1alpha polymorphism -889C/T related to obesity in Korean Taeumin women

Interleukin-1 (IL-1), a cytokine produced predominantly by cells from the macrophage lineage, can affect multiple neuroendocrine and metabolic functions. IL-1alpha production by cultured peripheral blood mononuclear cells from an obese group was significantly elevated in comparison to a control group. The aim of this study was to investigate whether the IL-1alpha polymorphism and Sasang constitution, a major branch in Korean traditional medicine, were related to obesity. Genotyping was done in 182 healthy females with a marked variation in body mass index (BMI) by a PCR-restriction fragment length polymorphism assay. The T allele was associated with decreased BMI (p = 0.020). In a subgroup with BMI values ranging from 27 approximately 29 kg/m(2), the frequency of the T allele was significantly decreased (p = 0.004, odds ratio, OR = 0.141 compared to a subgroup with a BMI values less than 25 Kg/m(2)). In addition, in Taeumin female subjects, the frequency of the IL-1alpha T allele was markedly decreased in a subgroup with BMI values in the range of 27 approximately 29 kg/m(2) compared to a lean group with BMI values less than 25 kg/m(2) (p = 0.004, OR = 0.139). In Korean women, an association was found between -889C/T polymorphism in the regulatory region of the IL-1alpha gene and BMI values. In addition, an association was found among IL-1alpha polymorphism, obesity, and the Sasang constitution.     

Management of high-risk hydatidiform mole and persistent gestational trophoblastic neoplasia: the Korean experience

OBJECTIVE: To test the efficacy of a new scoring system to differentiate high-risk hydatidiform mole (H-mole) and initiate early selective postmolar chemotherapy. STUDY DESIGN: According to Kim's scoring system, 262 patients were identified as high-risk H-mole patients. Fifty (19.1%) received early chemotherapy, and the rest constituted the control group. Salvage therapy with etoposide, methotrexate, actinomycin D/etoposide, cisplatin (EMA/EP) and taxol, cisplatin/taxol, etoposide (TP/TE) was applied in 21 cases of ultra-high-risk GTT. RESULTS: None of the 50 cases in the early chemotherapy group progressed to persistent GTT. However, 58.9% in the control group developed GTT with 8.0% drug resistance. Of those receiving salvage therapy in the 21 ultra-high-risk GTT cases resistant to EMA/CO, 10 of 14 (71%) receiving EMA/EP and 4 of 7 (57.1%) receiving TP/TE achieved remission. CONCLUSION: Early postmolar chemotherapy for high-risk H-mole is effective in preventing progression to persistent GTT and treatment failure. Ultra-high-risk GTT should be approached with multimodal treatment, including EMA/EP and TP/TE regimens.     

Reference charts and equations of Korean fetal biometry

OBJECTIVE: To construct new reference charts and equations for fetal biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur diaphysis length (FDL) from Korean fetuses at 12-40 weeks. METHOD: Prospective cross-sectional data obtained in one center for 5 years from a population of pregnant women undergoing ultrasound examination between the 12th and 40th week of gestation. Exclusion criteria comprised all maternal and fetal conditions possibly affecting fetal biometry. No fetuses were excluded on the basis of abnormal biometry. For each measurement, regression models were fitted to estimate both the mean and the standard deviation at each menstrual age. RESULTS: Biometric measurements were obtained for 10 455 fetuses. New charts and reference equations are reported for BPD, HC, AC and FDL. Reference equations are cubic models. CONCLUSION: We present new Korean reference charts and equations for fetal biometry. They can be easily used in obstetric ultrasound studies for the Korean population.     

Accuracy of MR imaging for the prediction of myometrial invasion of endometrial carcinoma

OBJECTIVES: To retrospectively evaluate the accuracy of magnetic resonance (MR) imaging for the prediction of depth of myometrial invasion in the preoperative assessment of women with endometrial carcinoma. METHODS: We retrospectively reviewed the medical records and MR imaging reports of 120 women with pathologically-proven endometrial carcinoma who underwent preoperative pelvic MR imaging between June 1997 and February 2006. Tumor signal intensity, the appearance of the junctional zone (JZ), the presence of large polypoid tumors and leiomyomas were analyzed. Univariate logistic-regression analysis was performed to identify associations between incorrect MR staging and the study variables. RESULTS: Data from 120 patients were registered for the current study and analyzed. The sensitivity, specificity and accuracy of the MR imaging in assessment of myometrial invasion among patients with endometrial carcinoma were: 50.6%, 89.2% and 62.5% respectively. MR differentiation of deep myometrial invasion from superficial disease had an 83.3% accuracy (100 of 120 cases). Isointense JZ to myometrium (P<0.001), and the presence of polypoid tumors (P=0.037) on MR imaging were significantly associated with an underestimation of myometrial invasion by endometrial carcinoma. CONCLUSIONS: Isointense JZ to myometrium and polypoid tumors are difficult to accurately evaluate for myometrial invasion of endometrial carcinoma by MR imaging.