The production of endothelial IL-8 and MCP-1 and their plasma levels in HSP.

<p>HMVEC-d were first cultured in complete medium which contains fetal calf serum till their growth became confluent, and then incubated in serum free medium. C3a or C5a of different concentrations (0, 25, 50, 100, and 200 ng/ml) was added to each well for further 24 hr, the supernatant of each well was collected to test the levels of IL-8 secreted by C3a-treated HMVEC-d (A), MCP-1 secreted by C3a-treated HMVEC-d (B), IL-8 secreted by C5a-treated HMVEC-d (C), and MCP-1 secreted by C5a-treated HMVEC-d (D). * denotes <i>p</i> < 0.05, compared with the value of nontreated. Using the same ELISA kits, plasma levels of IL-8 (E) and MCP-1 (F) were evaluated in 30 patients with acute HSP and 30 healthy controls. * denotes <i>p</i> < 0.05.</p

The serum levels of C3 and C4 in 30 HSP patients.

<p>Serum C3 (A) and C4 (B) levels were detected by nephelometry in HSP patients between acute and convalescent stages. * denotes <i>p</i> < 0.001.</p

The plasma levels of complement proteins in HSP patients.

<p>Plasma C3a (A), C4a (B), C5a (C), and Bb (D) levels were determined by ELISA between 30 patients with acute HSP and 30 healthy controls. * denotes <i>p</i> < 0.0001. Plasma C3a (E) and C5a (F) levels in HSP patients between acute and convalescent stages were compared. * denotes <i>p</i> < 0.0001, ** denotes <i>p</i> = 0.007.</p

The hypothetic model of complement activation in the pathogenesis of childhood HSP.

<p>* The expression of IL-8, MCP-1, E-selectin, and ICAM-1 by HMVEC-d was majorly enhanced by C5a.</p

The production of C3 and C5 by HMVEC-d.

<p>HMVEC-d were pre-incubated with plasma of patients with acute HSP (N = 30) or plasma of healthy controls (N = 30) for 48 hr, and then the cells were washed and re-cultured in serum free medium for another 48 hr. C3 (A) and C5 (B) levels in culture supernatants were analyzed by ELISA. * denotes <i>p</i> < 0.01.</p

The expression of E-selectin and ICAM-1 by HMVEC-d.

<p>HMVEC-d were stimulated by C3a, C5a of different concentrations (0, 50, 100, 200 ng/ml), or TNF-α (10 ng/ml). Six hr and 18 hr later, the cells were harvested and analyzed for the expression of E-selectin (A) and ICAM-1 (B) by flow cytometry. The expression levels were presented as mean fluorescence intensity (MFI). * denotes <i>p</i> < 0.05, compared with the value of nontreated.</p

The Utilization of Rehabilitation in Patients with Hemophilia A in Taiwan: A Nationwide Population-Based Study

<div><p>Introduction</p><p>Rehabilitation plays an important role in the physical health of patients with hemophilia. However, comprehensive information regarding the utilization of rehabilitation for such patients remains scarce.</p><p>Aim</p><p>This population-based study aimed to examine the characteristics, trends, and most important factors affecting rehabilitation usage in patients with hemophilia A using a nationwide database in Taiwan.</p><p>Methods</p><p>Data from 777 patients with hemophilia A who were registered in the National Health Insurance Research Database between 1998 and 2008 were analyzed using SAS 9.0.</p><p>Results</p><p>Musculoskeletal or nervous system-related surgical procedures and clotting factor VIII concentrate costs were identified as factors affecting rehabilitation usage; musculoskeletal or nervous system-related surgical procedures (odds ratio = 3.788; P < 0.001) were the most important predictor of whether a patient with hemophilia A would use rehabilitation services. Joint disorders, arthropathies, bone and cartilage disorders, intracranial hemorrhage, and brain trauma were common diagnoses during rehabilitation use. The costs of physical therapy (physiotherapy) comprised the majority (71.2%) of rehabilitation therapy categories. Increasingly, rehabilitation therapy was performed at physician clinics. The total rehabilitation costs were <0.1% of the total annual medical costs.</p><p>Conclusion</p><p>Musculoskeletal or nervous system-related surgical procedures and increased use of clotting factor VIII concentrate affect the rehabilitation utilization of patients with hemophilia A the most. The findings in this study could help clinicians comprehensively understand the rehabilitation utilization of patients with hemophilia A.</p></div

Distributions of total number of hemophilia A cases and number of rehabilitation users in terms of the number of rehabilitation therapy sessions received.

<p>Distributions of total number of hemophilia A cases and number of rehabilitation users in terms of the number of rehabilitation therapy sessions received.</p

Logistic regression analysis of factors that might affect rehabilitation usage in patients with hemophilia A.

<p>Logistic regression analysis of factors that might affect rehabilitation usage in patients with hemophilia A.</p

Patient selection flow chart.

<p>Patient selection flow chart.</p