Complementarity among International Asset Holdings: Do Banks Have a Special Role?

This paper studies the pattern and structure of cross-border bilateral financial asset holdings. By utilizing an extended dataset and employing a variant of gravity models, we find strong evidence for the presence of complementarities among bank loans, shortand long-term debts, and portfolio equity holdings. The complementarities can be explained by common factors of standard gravity models such as economy size, state of development, and information cost proxies, as well as bilateral trade in goods and services. However, we also find the presence of a direct channel of complementarities among financial asset holdings that cannot be explained by these gravity factors. We proceed to investigate whether the complementarities can be characterized by the models that predict a special role of banks in alleviating information asymmetry. We find supporting evidence for this hypothesis in that international bank lending tends to increase the volume of portfolio asset holdings. This acceleration effect of bank lending is stronger for destination countries with higher degrees of ‘law and order,’ which suggests that cross-border bank lending may not lead to capital market integration, despite reduced information cost, if there is no appropriate infrastructure to facilitate portfolio investment. By investigating the structure of bilateral asset holdings, we also find positive evidence for the information role of banks. The share of bank lending decreases with increasing state of development of destination countries measured by per capita GDP and human capital accumulation, but increases with increasing distance, suggesting that information cost may play an important role in determining the structure of cross-border asset holdings.Cross-border asset holdings; Financial integration; Bank lending

Causes of the Korean Financial Crisis: Lessons for Policy

This paper uses an asymmetric information framework to understand the causes of the recent financial crisis in Korea. It shows that the Korean data is consistent with this explanation of the crisis. It then draws on this analysis to discuss several lessons that can help guide Korean policymakers in the future.

Complementarity among International Asset Holdings: Do Banks Have a Special Role?

This paper studies the pattern and structure of cross-border bilateral financial asset holdings. By utilizing an extended dataset and employing a variant of gravity models, we find strong evidence for the presence of complementarities among bank loans, shortand long-term debts, and portfolio equity holdings. The complementarities can be explained by common factors of standard gravity models such as economy size, state of development, and information cost proxies, as well as bilateral trade in goods and services. However, we also find the presence of a direct channel of complementarities among financial asset holdings that cannot be explained by these gravity factors. We proceed to investigate whether the complementarities can be characterized by the models that predict a special role of banks in alleviating information asymmetry. We find supporting evidence for this hypothesis in that international bank lending tends to increase the volume of portfolio asset holdings. This acceleration effect of bank lending is stronger for destination countries with higher degrees of ‘law and order,’ which suggests that cross-border bank lending may not lead to capital market integration, despite reduced information cost, if there is no appropriate infrastructure to facilitate portfolio investment. By investigating the structure of bilateral asset holdings, we also find positive evidence for the information role of banks. The share of bank lending decreases with increasing state of development of destination countries measured by per capita GDP and human capital accumulation, but increases with increasing distance, suggesting that information cost may play an important role in determining the structure of cross-border asset holdings

Telemedicine System Using a High-Speed Network: Past, Present, and Future

There is no doubt that telecommunication saves a great deal of time and expense when exchanging information, and recent technological advances have increased its popularity in business and educational applications. Telemedicine is a rapidly developing application of clinical medicine in which medical information is transferred via the Internet or another communication network for the purpose of consultations, and sometimes also for remote medical procedures or examinations. A telemedicine system can also be applied to medical education. Many doctors and medical students could benefit from telementoring and tele-education based on videoconferencing systems. However, telemedicine in general has not yet become popular in clinical practice or medical education. In our university, we have used a telemedicine system to educate doctors and medical students since 2003. Since our first telemedical conference with Kyushu University Hospital on February 12, 2003 when we have regularly performed telemedical conferences. Here we introduce a general methodology for telemedicine, our experiences of medical conferencing using telemedicine, and future possible directions

Incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer

Background: Subsyndromal delirium, a condition in which patients exhibit some, but not all, of the symptoms of delirium, can negatively affect the outcomes of patients with cancer. However, the incidence of subsyndromal delirium in patients with gastric cancer is unknown. Here, we investigated the incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer. Methods: We recruited consecutive patients with gastric cancer who were scheduled for curative resection at a tertiary hospital. Patients' subsyndromal delirium symptoms were serially assessed preoperatively and 1, 2, 3, and 7 days postoperatively using the Delirium Rating Scale-Revised-98 (DRS-R-98). A DRS-R-98 score of 8-14 at any postoperative assessment was considered to indicate subsyndromal delirium. Sociodemographic and pre-/intraoperative clinical data were also assessed. Logistic regression analyses were used to determine the associated risk factors. Results: Data were analysed from 163 out of 217 eligible patients. Postoperative delirium occurred in one patient (0.6%) and subsyndromal delirium occurred in 19 patients (11.7%). Age >= 70 years (odds ratio, [OR] 3.85; 95% confidence interval [0], 136-10.92; p = 0.011) and education level <= 9 years (OR, 3.98; 95% CI, 139-11.41; p= 0.010) were independent risk factors of subsyndromal delirium after adjusting for preoperative cognitive function. Other pre-/intra-operative variables including anxiety/depression, poor sleep quality, and anaesthesia duration were not associated with subsyndromal delirium. Conclusions: In contrast to the low incidence of delirium among patients undergoing curative resection of gastric cancer, a substantial proportion of such patients experienced subsyndromal delirium. Considering the prognostic implications, more careful detection and management of subsyndromal delirium may be warranted in patients with gastric cance

Low-dose steroid-induced tumor lysis syndrome in a hepatocellular carcinoma patient

Tumor lysis syndrome is rare in hepatocellular carcinoma (HCC), but it has been reported more frequently recently in response to treatments such as transcatheter arterial chemoembolization (TACE), radiofrequency thermal ablation (RFTA), and sorafenib. Tumor lysis syndrome induced by low-dose steroid appears to be very unusual in HCC. We report a patient with hepatitis-C-related liver cirrhosis and HCC in whom tumor lysis syndrome occurred due to low-dose steroid (10 mg of prednisolone). The patient was a 90-year-old male who presented at the emergency room of our hospital with general weakness and poor oral intake. He had started to take prednisolone to treat adrenal insufficiency 2 days previously. Laboratory results revealed hyperuricemia, hyperphosphatemia, and increased creatinine. These abnormalities fulfilled the criteria in the Cairo-Bishop definition of tumor lysis syndrome. Although the patient received adequate hydration, severe metabolic acidosis and acute kidney injury progressed unabated. He finally developed multiple organ failure, and died 3 days after admission. This was a case of tumor lysis syndrome caused by administration of low-dose steroid in a patient with HCC

Endoscopic Pancreatic Sphincterotomy: Indications and Complications

Background/Aims: Although a few recent studies have reported the effectiveness of endoscopic pancreatic sphincterotomy (EPST), none has compared physicians' skills and complications resulting from the procedure. Thus, we examined the indications, complications, and safety of EPST performed by a single physician at a single center. Methods: Among 2,313 patients who underwent endoscopic retrograde cholangiopancreatography between January 1996 and March 2008, 46 patients who underwent EPST were included in this retrospective study. We examined the indications, complications, safety, and effectiveness of EPST, as well as the need for a pancreatic drainage procedure and the concomitant application of EPST and endoscopic sphincterotomy (EST). Results: Diagnostic indications for EPST were chronic pancreatitis (26 cases), pancreatic divisum (4 cases), and pancreatic cancer (8 cases). Therapeutic indications for EPST were removal of a pancreaticolith (10 cases), stent insertion for pancreatic duct stenosis (9 cases), nasopancreatic drainage (7 cases), and treatment of sphincter of Oddi dysfunction (1 case). The success rate of EPST was 95.7% (44/46). Acute complications of EPST included five cases (10.9%) of pancreatitis and one of cholangitis (2.2%). EPST with EST did not reduce biliary complications. Endoscopic pancreatic drainage procedures following EPST did not reduce pancreatic complications. Conclusions: EPST showed a low incidence of complications and a high rate of treatment success; thus, EPST is a relatively safe procedure that can be used to treat pancreatic diseases. Pancreatic drainage procedures and additional EST following EPST did not reduce the incidence of procedure-related complications

Visceral Fat as a Useful Parameter in the Differential Diagnosis of Crohn's Disease and Intestinal Tuberculosis

Background/AimsBecause of the similarities in the clinical presentations of Crohn's disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB.MethodsWe conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT.ResultsThe ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively.ConclusionMeasurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB