Impact of a Primary Health Care Chronic Diseases Management Pilot Program / 대한내과학회지

Considerable efforts have been made to prevent and manage hypertension and diabetes, but the prevalence of these diseases has not changed significantly over the past 10 years. Hypertension and diabetes are chronic conditions requiring continuous treatment and management. Controlling blood pressure and blood sugar levels can prevent life-threatening complications and a deterioration in the quality of life. Community-centered primary health care is characterized by inclusiveness and continuous contact. Well-established primary health care services can reduce the number of unnecessary emergency room visits, hospitalizations, and medical tests, and therefore minimize unnecessary medical expenses. However, the number of patients treated for mild chronic diseases at large hospitals has increased, with a concomitant decrease in the proportion of outpatient clinic visits (41.6% in 2007 vs. 37.8% in 2016). Thus, there is a clear need to strengthen primary health care, including for the treatment of chronic diseases. To establish a chronic diseases management system based on local clinics, the Ministry of Health and Welfare of Korea launched a pilot chronic diseases management program aimed at increasing patient acceptance of local primary health care. The program was implemented in 2014, 2016, and 2019. This review examines the short-term impact of the pilot program with respect to the prevention and management of hypertension and diabetes.

Impact of a Primary Health Care Chronic Diseases Management Pilot Program / 대한내과학회지

Considerable efforts have been made to prevent and manage hypertension and diabetes, but the prevalence of these diseases has not changed significantly over the past 10 years. Hypertension and diabetes are chronic conditions requiring continuous treatment and management. Controlling blood pressure and blood sugar levels can prevent life-threatening complications and a deterioration in the quality of life. Community-centered primary health care is characterized by inclusiveness and continuous contact. Well-established primary health care services can reduce the number of unnecessary emergency room visits, hospitalizations, and medical tests, and therefore minimize unnecessary medical expenses. However, the number of patients treated for mild chronic diseases at large hospitals has increased, with a concomitant decrease in the proportion of outpatient clinic visits (41.6% in 2007 vs. 37.8% in 2016). Thus, there is a clear need to strengthen primary health care, including for the treatment of chronic diseases. To establish a chronic diseases management system based on local clinics, the Ministry of Health and Welfare of Korea launched a pilot chronic diseases management program aimed at increasing patient acceptance of local primary health care. The program was implemented in 2014, 2016, and 2019. This review examines the short-term impact of the pilot program with respect to the prevention and management of hypertension and diabetes.

Psychometric Properties of the Korean Version of the Tromsø Social Intelligence Scale / 정신간호학회지

PURPOSE: The purpose of this study was to translate Tromsø Social Intelligence Scale (TSIS) into Korean and verify the validity and reliability of the Korean version of the TSIS. METHODS: This study used a methodological research design. Exploratory factor analysis, content, construct, criterion-related validity, and internal consistency reliability of the TSIS were evaluated. Participants, 269 nursing students, were recruited from three universities in three provinces in South Korea from November 2016 to April 2017. RESULTS: The Korean version of TSIS contained 16 items. Exploratory factor analysis showed three factors that explained the construct validity with a three-factor solution; that explained 61.3% of the total variance. Concurrent validity was associated with the Global Interpersonal Communication Competence Scale (r=.68, p<.001). Cronbach's α for the 16 items was .80. CONCLUSION: Our study findings suggest that the Korean version of TSIS was a valid and reliable scale with a robust factorial structure and useful for measuring social intelligence of nursing students.

Survey of Oral Health Education Effects in Twenties / 대한소아치과학회지

The purpose of this study was to improve efficacy of oral health education in children and adolescents based on the experience and perception of oral health education in young adults who graduated from high school within 10 years.Questionnaires were given to 412 people, and among them, 388 completed survey forms were selected. The questionnaire included categories which examined one's experience and perception of oral health education, oral health knowledge, dental history, and oral health behavior.The results showed that the respondents perceived elementary school as the most effective period of oral health education. Oral examination with direct explanation was the most preferred method of oral health education, but web search was the main source of oral health information. And knowledge of fluoride and sealant about caries preventive effect was still lacking. Considering these results, oral examination with direct explanation and web search would be useful to improve efficacy of oral health education in children and adolescents.

Inhibitory effect of Gastrodia elata Blume extract on alpha-melanocyte stimulating hormone-induced melanogenesis in murine B16F10 melanoma

BACKGROUND/OBJECTIVES: Gastrodia elata Blume (GEB), a traditional herbal medicine, has been used to treat a wide range of neurological disorders (e.g., paralysis and stroke) and skin problems (e.g., atopic dermatitis and eczema) in oriental medicine. This study was designed to investigate whether GEB extract inhibits melanogenesis activity in murine B16F10 melanoma. MATERIALS/METHOD: Murine B16F10 cells were treated with 0-5 mg/mL of GEB extract or 400 µg/mL arbutin (a positive control) for 72 h after treatment with/without 200 nM alpha-melanocyte stimulating hormone (α-MSH) for 24 h. Melanin concentration, tyrosinase activity, mRNA levels, and protein expression of microphthalmia-associated transcription factor (MITF), tyrosinase, tyrosinase-related protein (Trp)1, and Trp2 were analyzed in α-MSH-untreated and α-MSH-treated B16F10 cells. RESULTS: Treatment with 200 nM α-MSH induced almost 2-fold melanin synthesis and tyrosinase activity along with increased mRNA levels and protein expression of MITF, tyrosinase, Trp1 and Trp2. Irrespective of α-MSH stimulation, GEB extract at doses of 0.5-5 mg/mL inhibited all these markers for skin whitening in a dose-dependent manner. While lower doses (0.5-1 mg/mL) of GEB extract generally had a tendency to decrease melanogenesis, tyrosinase activity, and mRNA levels and protein expression of MITF, tyrosinase, Trp1, and Trp2, higher doses (2-5 mg/mL) significantly inhibited all these markers in α-MSH-treated B16F10 cells in a dose-dependent manner. These inhibitory effects of the GEB extract at higher concentrations were similar to those of 400 µg/mL arbutin, a well-known depigmenting agent. CONCLUSIONS: These results suggest that GEB displays dose-dependent inhibition of melanin synthesis through the suppression of tyrosinase activity as well as molecular levels of MITF, tyrosinase, Trp1, and Trp2 in murine B16F10 melanoma. Therefore, GEB may be an effective and natural skin-whitening agent for application in the cosmetic industry.

Bioconverted Jeju Hallabong tangor (Citrus kiyomi × ponkan) peel extracts by cytolase enhance antioxidant and anti-inflammatory capacity in RAW 264.7 cells

BACKGROUND/OBJECTIVES: Citrus and its peels have been used in Asian folk medicine due to abundant flavonoids and usage of citrus peels, which are byproducts from juice and/or jam processing, may be a good strategy. Therefore, the aim of this study was to examine antioxidant and anti-inflammatory effects of bioconversion of Jeju Hallabong tangor (Citrus kiyomi × ponkan; CKP) peels with cytolase (CKP-C) in RAW 264.7 cells. MATERIALS/METHODS: Glycosides of CKP were converted into aglycosides with cytolase treatment. RAW 264.7 cells were pre-treated with 0, 100, or 200 µg/ml of citrus peel extracts for 4 h, followed by stimulation with 1 µg/ml lipopolysaccharide (LPS) for 8 h. Cell viability, DPPH radical scavenging activity, nitric oxide (NO), and prostagladin E2 (PGE2) production were examined. Real time-PCR and western immunoblotting assay were performed for detection of mRNA and/or protein expression of pro-inflammatory mediators and cytokines, respectively. RESULTS: HPLC analysis showed that treatment of CKP with cytolase resulted in decreased flavanone rutinoside forms (narirutin and hesperidin) and increased flavanone aglycoside forms (naringenin and hesperetin). DPPH scavenging activities were observed in a dose-dependent manner for all of the citrus peel extracts and CKP-C was more potent than intact CKP. All of the citrus peel extracts decreased NO production by inducible nitric oxide synthase (iNOS) activity and PGE2 production by COX-2. Higher dose of CKP and all CKP-C groups significantly decreased mRNA and protein expression of LPS-stimulated iNOS. Only 200 µg/ml of CKP-C markedly decreased mRNA and protein expression of cyclooxygenase-2 in LPS-stimulated RAW 264.7 cells. Both 100 and 200 µg/ml of CKP-C notably inhibited mRNA levels of interleukin-1β (IL-1β) and IL-6, whereas 200 µg/ml CKP-C significantly inhibited mRNA levels of TNF-α. CONCLUSIONS: This result suggests that bioconversion of citrus peels with cytolase may enrich aglycoside flavanones of citrus peels and provide more potent functional food materials for prevention of chronic diseases attributable to oxidation and inflammation by increasing radical scavenging activity and suppressing pro-inflammatory mediators and cytokines.

Bioconversion of Citrus unshiu peel extracts with cytolase suppresses adipogenic activity in 3T3-L1 cells

BACKGROUND/OBJECTIVES: Citrus flavonoids have a variety of physiological properties such as anti-oxidant, anti-inflammation, anti-cancer, and anti-obesity. We investigated whether bioconversion of Citrus unshiu with cytolase (CU-C) ameliorates the anti-adipogenic effects by modulation of adipocyte differentiation and lipid metabolism in 3T3-L1 cells. MATERIALS/METHODS: Glycoside forms of Citrus unshiu (CU) were converted into aglycoside forms with cytolase treatment. Cell viability of CU and CU-C was measured at various concentrations in 3T3L-1 cells. The anti-adipogenic and lipolytic effects were examined using Oil red O staining and free glycerol assay, respectively. We performed real time-polymerase chain reaction and western immunoblotting assay to detect mRNA and protein expression of adipogenic transcription factors, respectively. RESULTS: Treatment with cytolase decreased flavanone rutinoside forms (narirutin and hesperidin) and instead, increased flavanone aglycoside forms (naringenin and hesperetin). During adipocyte differentiation, 3T3-L1 cells were treated with CU or CU-C at a dose of 0.5 mg/ml. Adipocyte differentiation was inhibited in CU-C group, but not in CU group. CU-C markedly suppressed the insulin-induced protein expression of CCAAT/enhancer-binding protein alpha (C/EBPalpha) and peroxisome proliferator-activated receptor gamma (PPARgamma) as well as the mRNA levels of CEBPalpha, PPARgamma, and sterol regulatory element binding protein 1c (SREBP1c). Both CU and CU-C groups significantly increased the adipolytic activity with the higher release of free glycerol than those of control group in differentiated 3T3-L1 adipocytes. CU-C is particularly superior in suppression of adipogenesis, whereas CU-C has similar effect to CU on stimulation of lipolysis. CONCLUSIONS: These results suggest that bioconversion of Citrus unshiu peel extracts with cytolase enhances aglycoside flavonoids and improves the anti-adipogenic metabolism via both inhibition of key adipogenic transcription factors and induction of adipolytic activity.