Self-Reported Health Status Improved For Racial And Ethnic Minority Groups After Michigan Medicaid Expansion.

Addressing health inequities for racial and ethnic minority populations is challenging. After passage of the Affordable Care Act, Michigan launched its Healthy Michigan Plan, which expanded Medicaid eligibility in the state. Our evaluation of the expansion provided the opportunity to study its impact on racial and ethnic minority groups, including Arab American and Chaldean American enrollees, an understudied population. Using data from telephone surveys collected in 2016, 2017, and 2018, we conducted an analysis to study the plan's impact on access to a regular source of care and health status among racial and ethnic minority groups. More than 90 percent of respondents of all racial and ethnic groups reported having a regular source of care after plan enrollment compared with 74.4 percent before enrollment. Respondents who identified as non-Hispanic White, African American, and Hispanic reported improvements in health status after plan enrollment. Our study demonstrates the potential of health insurance access to narrow health inequities between racial and ethnic groups.

Moderating Effect of Inner Strength between Mood Status and Quality of Life in Female Patients with Lung Cancer

Purpose@#This study aimed to examine associations among inner strength, mood status, symptom experience, and quality of life in women with lung cancer and to investigate whether inner strength has a moderating effect on these relationships. @*Methods@#This study used a cross-sectional design to analyze 106 women with lung cancer in the National Cancer Center. A hierarchical regression analysis was conducted on the influence of quality of life. For the moderating effects, the Johnson–Neyman methods were applied using the SPSS PROCESS macro. @*Results@#The significant factors of quality of life were inner strength, symptom experiences, total mood disturbance, accounting for 70.7% of the variance. Inner strength had a moderating effect on the relationship between total mood disturbance and quality of life. This means that when women have higher inner strength, there is a significantly less negative effect of total mood disturbance on quality of life. @*Conclusion@#Female patients with lung cancer who experienced inner strength can improve the quality of life as well as reduce the negative impact of mood status on the quality of life. Therefore, these findings support the theory of inner strength and provide nurses with an opportunity to foster the development of this theory in female cancer survivors.

Moderating Effect of Inner Strength between Mood Status and Quality of Life in Female Patients with Lung Cancer

Purpose@#This study aimed to examine associations among inner strength, mood status, symptom experience, and quality of life in women with lung cancer and to investigate whether inner strength has a moderating effect on these relationships. @*Methods@#This study used a cross-sectional design to analyze 106 women with lung cancer in the National Cancer Center. A hierarchical regression analysis was conducted on the influence of quality of life. For the moderating effects, the Johnson–Neyman methods were applied using the SPSS PROCESS macro. @*Results@#The significant factors of quality of life were inner strength, symptom experiences, total mood disturbance, accounting for 70.7% of the variance. Inner strength had a moderating effect on the relationship between total mood disturbance and quality of life. This means that when women have higher inner strength, there is a significantly less negative effect of total mood disturbance on quality of life. @*Conclusion@#Female patients with lung cancer who experienced inner strength can improve the quality of life as well as reduce the negative impact of mood status on the quality of life. Therefore, these findings support the theory of inner strength and provide nurses with an opportunity to foster the development of this theory in female cancer survivors.

Fibreoptic intubation in airway management: a review article

Since the first use of the flexible fibreoptic bronchoscope, a plethora of new airway equipment has become available. It is essential for clinicians to understand the role and limitations of the available equipment to make appropriate choices. The recent 4th National Audit Project conducted in the United Kingdom found that poor judgement with inappropriate choice of equipment was a contributory factor in airway morbidity and mortality. Given the many modern airway adjuncts that are available, we aimed to define the role of flexible fibreoptic intubation in decision-making and management of anticipated and unanticipated difficult airways. We also reviewed the recent literature regarding the role of flexible fibreoptic intubation in specific patient groups who may present with difficult intubation, and concluded that the flexible fibrescope maintains its important role in difficult airway management.

Changes of aeroallergen sensitization in children with asthma or allergic rhinitis from a tertiary referral hospital in Seoul over 10 years

PURPOSE: Allergic diseases have been increased in Korea. The aim of this study was to investigate the changes of sensitization rate to inhalant allergens over 10 years in children with allergic diseases from a tertiary referral hospital. METHODS: Skin prick tests were done in total 2,225 children in 2000, 2005, and 2010. Changes of skin reactivity to 12 major inhalant allergens, including Tree pollen mixture I (Alder, Elm, Hazel, Poplar, Willow), Tree pollen mixture II (Beech, Birch, Oak, Plane tree), Dermatophagoides pteronyssinus, Dermatophagoides farina, Alternaria, cat dander, and dog dander were investigated. RESULTS: The sensitization rates to Tree pollen mixture I and II were increased as 5.0%, 6.8% in 2000, 8.5%, 9.8% in 2005, and 14.8%, 17.3% in 2010, respectively (trend P<0.001, P<0.001, respectively). And the sensitization rates to D. pteronyssinus cat dander and dog dander were changed as 55%, 4.8%, 4.8% in 2000, 62.2%, 11.9%, 28% in 2005, and 63.1%, 12.7%, 16.7% in 2010, respectively. The distribution of sensitized pollens was oak (12.8%), beech (12.4%), pine (10.3%), birch (10%), hazel (9.6%), alder (8%), elder (6.9%), elm (5.4%) in the study of 2010. When allergen/histamine ratio was compared, rates of strong sensitization over 4+ to tree pollen were increased. CONCLUSION: The sensitization rates to inhalant allergens were increased in children with asthma or allergic rhinitis from a tertiary referral hospital in Seoul over last 10 years. Especially, an increase in the degree of skin reactivity was observed in cat dander, dog dander, and tree pollens. The studies to investigate the etiology of this increase and prevention will be needed.

Studies on development of serum-free conditioned media using Vero cells and DMEM with controlled concentration of glucose and pyruvate / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to examine in vitro development of early preimplantation mouse embryos in various kind of serum-free conditioned media (SF-VCM) manufactured from DMEM cultured with Vero Cells. METHODS: A total of 846 two-cell mouse embryos were cultured in different kind of SF-VCM. SF-VCMs were divided into SF-VCM-10, -30 and -50 by media volume using DMEM #1 media, and divided into SF-VCM #1, #2 and #3 by controlled concentration of glucose and pyruvate (manufactured by DMEM #1: mixed three volume of DMEM-G (DMEM with glutamine without glucose and pyruvate) and one volume of DMEM-GGP (DMEM with glutamine, glucose, pyruvate), #2: mixed same volume of DMEM-G and DMEM-GGP and #3: mixed one volume of DMEM-G and three volume of DMEM-GGP, respectively). Experimental groups were mainly added 10% SSS, and 20% hFF was added to only Control group co-cultured with Vero cells. Development of embryos was observed every 24 hours. Results between different groups were analyzed using Chi-square test, and considered statistically significant when P-value was less than 0.05. RESULTS: In vitro developmental rate by each cleavage stages of mouse embryos cultured in SF-VCMs with a various volumes were significantly (P<0.05) higher in SF-VCM-30 (morula< or =: 97.2%, Blastocyst (BL)< or =: 97.2%, Hatching BL< or =: 82.2%) than other groups. In the rate of development on in vitro co-culture vs. a various SF-VCMs manufactured by DMEM controlled concentration of glucose and pyruvate, Group I (SF-VCM #1) was higher than other groups in each cleavage stages (morula< or =: 98.1%, Blastocyst (BL)< or =: 97.1%, hatching BL< or =: 81.7%, respectively). Moreover, specially, in the developmental rate into the hatching blastocyst < or = after 96 hours in vitro culture, Group I (81.7%) was significantly higher than control group (67.6%, P<0.05). CONCLUSION: SF-VCM #1 manufactured by volume of 30 mL DMEM #1 media cultured in vitro for 48 hours in 250 mL flask was the most effective on in vitro developmental rate of mouse preimplantation embryos. Therefore, it is expected that SF-VCM #1 has application to human IVF-ET.

Gene Expression of Endothelin-1 and Endothelin Receptor A on Monocrotaline-Induced Pulmonary Hypertension in Rats After Bosentan Treatment

BACKGROUND AND OBJECTIVES: Endothelin (ET)-1, a potent endothelium-derived vasoconstrictor peptide, has a potential pathophysiologic role in pulmonary hypertension. Bosentan, a dual ET receptor (ET(A)/ET(B)) antagonist, is efficacious in treatment of pulmonary hypertension. The objectives of this study were to investigate the expression of ET-1 and ET receptor A (ERA) genes and to evaluate the effect of bosentan in monocrotaline (MCT)-induced pulmonary hypertension. MATERIALS AND METHODS: Four-week-old male Sprague-Dawley rats were treated as follows: control (n=36), subcutaneous (sc) injection of saline; MCT (n=36), sc injection of MCT (60 mg/kg); and bosentan (n=36), sc injection of MCT (60 mg/kg) plus 25 mg/kg/day bosentan orally. RESULTS: Serum ET-1 concentrations in the MCT group were higher than the control group on day 28 and 42. Quantitative analysis of peripheral pulmonary arteries revealed that the increase in medial wall thickness after MCT injection was significantly attenuated in the bosentan group on day 28 and 42. In addition, the increase in the number of intra-acinar muscular arteries after MCT injection was reduced by bosentan on day 14, 28 and 42. The levels of ET-1 and ERA gene expression were significantly increased in the MCT group compared with control group on day 5, and bosentan decreased the expression of ET-1 on day 5. CONCLUSION: ET-1 contributes to the progression of cardiopulmonary pathology in rats with MCT-induced pulmonary hypertension. Administration of bosentan reduced ET-1 gene expression in MCT-induced pulmonary hypertension in rats.

A Case of Anuric Acute Renal Failure, Acute Hepatitis and Rhabdomyolysis occurred after Carp Bile Ingestion / 대한신장학회지

Gall bladder of a common carp is taken in some areas of Asia as a traditional medicine for improvement of their general health problems like hypertension, poor visual acuity, and impotence. Many cases have been reported on acute hepatitis, acute renal failure, gastrointestinal problems and neurological symptoms following ingestion of raw carp bile juice. We experienced a case of anuric ARF, acute hepatitis, and rhabdomyolysis that developed after indigestion of raw carp bile juice, not yet seen in previous studies. In this case, anuric state of patient was resolved after 4 days with continuous renal replacement therapy. Thus we report this case with review of literature.

The Accuracy of the Accelerometers (Actical and Actigraph) among Korean People

BACKGROUND: Nowadays, decreased physical activity is considered to be a contributor to increase the prevalence of many diseases such as obesity, coronary heart disease and so on. Many researches demonstrated that regular physical activity reduce all cause mortality. To increase the physical activities of the population, accurate estimation of the activities is needed. Actical and actigraph are confirmed as accurate tools to measure physical activities. But the target populations of the validity studies were not Asian people. Therefore, the accuracy of the accelerometers should be confirmed in Asian people. The accuracy of the tools could be different. Therefore head to head comparison study between the tools would be needed. METHODS: Thirty volunteers from the community, ages over 20 yrs, were recruited. The participants put on the two accelerometers (Actical, Actigraph) on the waists, secured with elastic belts, and performed a session of rest and three structured activities (two walking speeds, 4 km/hr and 6 km/hr, and one jogging speed, 8 km/hr). During each activity, expired respiratory gases were collected, and oxygen consumption (VO2) was measured by indirect calorimetry (Model Quark beta2(R)). The calories measured by gas analyzer and two accelerometers were compared by correlation analysis using SPSS program. RESULTS: Pearson correlation coefficient between gas analyzer and two accelerometers was calculated at three structured activities. The r in Actical was 0.747, 0.785, and 0.677, at speed of 4, 6, 8 km/hr, respectively (P<0.05), and the same measures in Actigraph was 0.617, 0.737, and 0.530 (P<0.05), respectively. Pearson correlation coefficient was also calculated between the two accelerometers, and the r was 0.881, 0.927, and 0.824, at each speed. CONCLUSION: The Actical and Actigraph are valid tools for measuring physical activities in Korean people.

Murine Model of Buckwheat Allergy by Intragastric Sensitization with Fresh Buckwheat Flour Extract

Food allergies affect about 4% of the Korean population, and buckwheat allergy is one of the most severe food allergies in Korea. The purpose of the present study was to develop a murine model of IgE-mediated buckwheat hypersensitivity induced by intragastric sensitization. Young female C3H/HeJ mice were sensitized and challenged intragastricly with fresh buckwheat flour (1, 5, 25 mg/dose of proteins) mixed in cholera toxin, followed by intragastric challenge. Anaphylactic reactions, antigen-specific antibodies, splenocytes proliferation assays and cytokine productions were evaluated. Oral buckwheat challenges of sensitized mice provoked anaphylactic reactions such as severe scratch, perioral/periorbital swellings, or decreased activity. Reactions were associated with elevated levels of buckwheatspecific IgE antibodies. Splenocytes from buckwheat allergic mice exhibited significantly greater proliferative responses to buckwheat than non-allergic mice. Buckwheat-stimulated IL-4, IL-5, and INF-gamma productions were associated with elevated levels of buckwheat-specific IgE in sensitized mice. In this model, 1 mg and 5 mg dose of sensitization produced almost the same degree of Th2-directed immune response, however, a 25 mg dose showed blunted antibody responses. In conclusion, we developed IgE-mediated buckwheat allergy by intragastric sensitization and challenge, and this model could provide a good tool for future studies.