Health Impact Assessment of Free Immunization Program in Jinju City, Korea / 예방의학회지

OBJECTIVES: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. METHODS: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. RESULTS: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. CONCLUSIONS: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.

Vasorelaxing Activity of Ulmus davidiana Ethanol Extracts in Rats: Activation of Endothelial Nitric Oxide Synthase

Ulmus davidiana var. japonica Rehder (Urticales: Ulmaceae) (UD) is a tree widespread in northeast Asia. It is traditionally used for anticancer and anti-inflammatory therapy. The present study investigated the effect of an ethanol extract of UD on vascular tension and its underlying mechanism in rats. The dried root bark of UD was ground and extracted with 80% ethanol. The prepared UD extract was used in further analysis. The effect of UD on the cell viability, vasoreactivity and hemodynamics were investigated using propidium iodide staining in cultured cells, isometric tension recording and blood pressure analysis, respectively. Low dose of UD (10~100microg/ml) did not affect endothelial cell viability, but high dose of UD reduced cell viability. UD induced vasorelaxation in the range of 0.1~10microg/ml with an ED50 value of 2microg/ml. UD-induced vasorelaxation was completely abolished by removal of the endothelium or by pre-treatment with L-NAME, an inhibitor of nitric oxide synthase. UD inhibited calcium influx induced by phenylephrine and high K+ and also completely abolished the effect of L-NAME. Intravenous injection of UD extracts (10~100 mg/kg) decreased arterial and ventricular pressure in a dose-dependent manner. Moreover, UD extracts reduced the ventricular contractility (+dP/dt) in anesthetized rats. However, UD-induced hypotensive actions were minimized in L-NAME-treated rats. Taken together, out results showed that UD induced vasorelaxation and has antihypertensive properties, which may be due the activation of nitric oxide synthase in endothelium.

Overexpression of Ref-1 Inhibits Lead-induced Endothelial Cell Death via the Upregulation of Catalase

The role of apurinic/apyrimidinic endonuclease1/redox factor-1 (Ref-1) on the lead (Pb)-induced cellular response was investigated in the cultured endothelial cells. Pb caused progressive cellular death in endothelial cells, which occurred in a concentration- and time-dependent manner. However, Ref-1 overexpression with AdRef-1 significantly inhibited Pb-induced cell death in the endothelial cells. Also the overexpression of Ref-1 significantly suppressed Pb-induced superoxide and hydrogen peroxide elevation in the endothelial cells. Pb exposure induced the downregulation of catalase, it was inhibited by the Ref-1 overexpression in the endothelial cells. Taken together, our data suggests that the overexpression of Ref-1 inhibited Pb-induced cell death via the upregulation of catalase in the cultured endothelial cells.

p66shc Adaptor Protein Suppresses the Activation of Endothelial Nitric Oxide Synthase in Mouse Embryonic Fibroblasts

Among the Shc proteins, p66shc is known to be related to oxidative stress responses and regulation of the production of reactive oxygen species (ROS). The present study was undertaken to investigate the role of p66shc on endothelial nitric oxide synthase (eNOS) activity in the mouse embryonic fibroblasts (MEFs). When wild type (WT) or p66shc (-/-) MEFs were transfected with full length of eNOS cDNA, the expression and activity of eNOS protein were higher in the p66shc (-/-) MEFs. These phenomena were reversed by reconstitution of p66shc cDNA transfection in the p66shc (-/-) MEFs. The basal superoxide production in the p66shc (-/-) MEFs was not significantly different from that of WT of MEFs. However, superoxide production induced by NADPH in the p66shc (-/-) MEF was lesser than that in WT MEFs. When compared with WT MEFs, cell lysate of p66shc (-/-) MEFs showed significantly increased H-ras activity without change of endogenous H-ras expression. Our findings suggest the pivotal role of p66shc adaptor protein played in inhibition of endothelial nitric oxide production via modulation of the expression and/or activity of eNOS protein.

Self - Expanding EsophaCoilTM Esophageal Prosthesis for Malignant Esophageal Stenosis / 대한소화기내시경학회지

Endoscopic endoprosthesis is well established as a cheap, fast and durable procedure for palliation of malignant dysphagia. But the placement of conventional endoprosthesis is difficult and is associated with significant complications such as hemorrhage, perforation and dysfunction of the prosthesis. Recently, self -expand- able metal prosthesis have also been utilized for malignant esophageal stenosis, and palliation of this modality seems to be more effective than other modalities. However the main problems with these metal stents are tumor ingrowth leading to reobstruction, migration, and eophageal trauma by the distal, hard skirt of the stent. EsophaCoil stent is a simple coil with close loops made from a single flat wire of nickel titanium alloy. The radial force of this material is much stronger than stainless steel, expansion time is faster and the stent is able to dilate even extremely resistant strictures. This new metalic stent seems to have several advantages over the current commnerically available ones. We report our experiences with this EsophaCoil stent and review of literature.

A case of Unilateral blindness after Paraffin injection on the forehead

A 50 year old woman has lost her vision on the right eye abruptly, after subcutaneous Paraffin injection on-the forehead, for cosmetic correction of skin folds. The cause of blindness seems to be due to central retinal artery occlusion and probably to the thrombosis of ophthalmic vein too. It is likely that occlusion of the artery has develoded by compression of tile vessels from outward, but spastic occlusion of the arteries in hypersensitive reaction could not be ruled out.

Tne effets of anti-inflammatory ageets on bloed-aqueous-barrier in experimental uveitis

The purpose of this paper is to study the effects of anti-inflammatory agents on the blood-aqueous-berrier in experimentally induced uveitis. 10% solution of sodium fluorescein was injection intravenously in the ear vein of rabbits (0.25 ml/kg) and fluorescein curve was drawn after the method of Amsler and Huber. Experimental uveitis was induced by the injection of 0.2 ml of human serwn into the vitreous body. After uveitis had been induced. three kinds of anti-inflammatory agents-Prednisolone, Benzyron and Methotrexate-were Biven oralIy. In control animals in which no uveitis was induced, no changes in fluorescein curve were demonstrated before and after the administrations of drugs. In animals with uveitis, maked increases of the blood-aqueous barrier were noted. When Benoyron and Prednisolone were given to these animals, normaliration of the fluorescein curves were demonstrated. Methotrexate had no effects on the fluorescein curves in uveitis animals, showing no improvements in the permeability of uveal vessela. This ineffectiveness seemed to be due to the resistance of rabbits to methotrexate.

Orbitonometry in Graves' Disease

In discussing the ocular changes in exophthalmos, the resistance of orbital tissue to the backward displacement of the globe is one of the most interesting things. With the introduction of Copper's orbitonometer, many authors utilized it in case of exophthalmos-producing disease such as Graves' disease, inflammatory conditions of orbit, pseudotumor and neoplasms. The resistance to retrodisplacement of the globe in normal and Graves' disease was measured and the data was analysed in this paper. The orbitonometry with 50 gr., 100 gr. and 200 gr. weight was performed in 40 normal subjects and in 54 cases of thyroid dysfunction. The degree of the displacement of the eyeball were tabulated in table 2. This result shows that severe degree of exophthalmos and ocular findings are always associated with higher orbital tensions.