Protective effect of chlorophyllremoved ethanol extract of Lycium barbarum leaves against nonalcoholic fatty liver disease / 한국영양학회지

Purpose@#This study was conducted to establish whether an ethanol extract of Lycium barbarum leaves (LLE) and an ethanol extract of Lycium barbarum leaves from which chlorophyll has been removed, denoted as LLE(Ch−), have a protective effect against hepatic fat accumulation. @*Methods@#The inhibitory effects of LLE and LLE(Ch−) on liver fat accumulation were examined in C57BL/6 mice with non-alcoholic fatty liver disease (NAFLD) induced by an methionine and choline deficient diet and in HepG2 cells with palmitic acid-induced fat accumulation. @*Results@#The plasma triglyceride, aspartate aminotransferase, and alanine aminotransferase levels were lower in the LLE(Ch−) group, whereas the plasma ALT activity decreased significantly in the LLE group. In both the LLE and the LLE(Ch−) groups, the triglyceride and cholesterol contents in the hepatic tissue were significantly reduced. A greater inhibitory effect on tissue fat accumulation was observed in the LLE(Ch−) group than in the LLE group. In HepG2 cells, LLE and LLE(Ch−) were non-toxic up to a concentration of 1,000 µg/mL. Compared to the control group, intracellular fat accumulation in the LLE and LLE(Ch−) groups were significantly reduced at concentrations of 200 µg/mL and 500 µg/mL, respectively. The expression of phosphorylated adenosine monophosphate-activated protein kinase and phosphorylated acetyl-CoA carboxylase in both LLE groups increased at the concentrations of 100 μg/mL and 500 μg/mL. The fatty acid synthase expression was suppressed in a concentration-dependent manner at 10 μg/mL. @*Conclusion@#The examined two ethanol extracts of LLE inhibit hepatic fat accumulation in NAFLD. This effect was more pronounced in the LLE(Ch−) group. Therefore, these 2 extracts have an anti-steatosis effect and can be used for NAFLD treatment.

The Relationship between the Health System and the COVID-19 Case Fatality Rate / 보건행정학회지

Background@#The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. @*Methods@#This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. @*Results@#A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternalewborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. @*Conclusion@#Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

A case report of brain activity during mastication / 대한구강보건학회지

Objectives@#The aim of this study was to evaluate brain activity in youth during chewing gum and wood stick using functional magnetic resonance imaging (fMRI). @*Methods@#Two participants chewed wax gums and wood stick on the rhythm of 1 Hz during MRI scanning. The task paradigm was a block design and each chewing-rest procedure was repeated five times for 30s. @*Results@#The brain regions activated during chewing gum and wood stick were the precentral gyrus, postcentral gyrus, supplementary motor area, thalamus cerebellum. The medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), hippocampus, and precuneus were additionally activated by mastication of the wood stick. Brain activation induced by chewing wood stick was higher than chewing gum. @*Conclusions@#Our results suggest that mastication contribute to cognitive improvement through brain activity, this effect is stronger during chewing wood than gum. Therefore, eating harder foods may improve cognitive function more effectively.

Anti-inflammatory effects of the ethanol fraction of Spiraea prunifolia var. simpliciflora in RAW 264.7 cells / 한국영양학회지

Purpose@#Natural medicinal plant extracts have recently attracted attention as health beneficial foods and potential therapeutic agents for prevention of various diseases. This study was undertaken to measure the anti-inflammatory effect of the ethanol-water fraction obtained from the above-ground portion of Spiraea prunifolia var. simpliciflora, a wild-growing plant in Korea. The final fraction used in this study was the H 2 O-EtOH (40:60) fraction (SP60), which had the highest antioxidant activity, as determined in previous studies. @*Methods@#The amounts of nitric oxide (NO), tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-1β production were measured in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells exposed to SP60. Western blot was performed to measure the expressions of inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2, and the activation of nuclear factor (NF)-κB. @*Results@#SP60 exerted no cytotoxicity up to concentrations of 125 μg/mL. The levels of inflammatory cytokines, such as NO, TNF-α, IL-6, and IL-1β, were significantly decreased in LPS-stimulated RAW264.7 cells exposed to SP60. In addition, the expression levels of iNOS, COX-2, and phosphorylated p65 showed a concentration-dependent decrease subsequent to SP60 treatment. These results indicate that SP60 inhibits the LPS-induced production of inflammatory cytokines, iNOS, and COX-2, by inhibiting the activation of NF-κB, which is responsible for the expression of inflammatory mediators. @*Conclusion@#The results presented in this study indicate that the H 2 O-EtOH (40:60) fraction (SP60) extracted from the above-ground portion of Spiraea prunifolia var. simpliciflora has

A Comparative Analysis of Accreditation System for Health Information Management Education and Curriculum in the Republic of Korea and the United States of America / 보건행정학회지

Background@#With the development of the information technology industry and the increasing importance of health information, there is a need to analyze the current certification system for health information management education. This study compared and analyzed the health information management education accreditation system between the Republic of Korea and the United States. @*Methods@#Descriptive analysis and quantitative methodologies were used to compare the education accreditation system and understand the current status of health information management curriculum run by universities in the Republic of Korea and the United States. @*Results@#Regardless of the academic year, the Republic of Korea had one certification system based on subject-based criteria. However, the United States had a certification system for associate, baccalaureate, and master’s degree programs with competency-based criteria. The accreditation system was different in terms of the way the curriculum is certified and the options for the different levels of university degree programs. @*Conclusion@#Accordingly, it is necessary to consider improving the quality of health information management personnel at different levels by improving the current accreditation system and differentiating the curriculum according to the degree program levels in the Republic of Korea.

The Association between Medication Use for Dyslipidemia and Osteoporosis

Background@#Osteoporosis is a disease that affects the quality of life and imposes a high socioeconomic burden. Studies have reported that statins, a HMG CoA reductase inhibitor, have a positive or negative effect on osteoporosis. The purpose of this study was to analyze the correlation between statins and osteoporosis risk. @*Methods@#We used the total patient sample data of the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the prevalence of osteoporosis in adult patients of Korea who were diagnosed with dyslipidemia and were prescribed statins at the same time. The odds ratio (OR) according to the intensity and type of statin was used to confirming the prevalence. @*Results@#Among the 1,138,899 patients included in the study, 143,895 patients used statins and 27,524 patients (19.13%) were diagnosed with osteoporosis in the statin group. The OR value of statin group was 0.96 (95% CI 0.94-0.98), confirming that the prevalence of osteoporosis decreased, and a significant decrease was seen in all statin intensity. Some of the moderate-intensity statins rather increased the prevalence of osteoporosis, but atorvastatin and rosuvastatin obtained positive results at both medium- and high-intensity doses, and lovastatin, a low-intensity statin, showed the greatest reduction in the prevalence of osteoporosis. @*Conclusion@#We found that the prevalence of osteoporosis was reduced in the statin group, and there was a constant correlation regardless of gender or age. However, a large, prospective, double-blind and randomized study is needed for a long period of time to demonstrate the effectiveness of statins.

Platycodi radix beverage ameliorates postprandial lipemia response through lipid clearance of triglyceride-rich lipoprotein: A randomized controlled study in healthy subjects with a high-fat load

BACKGROUND/OBJECTIVES: Elevation of postprandial lipemia characterized by a rise in triglyceride (TG)-rich lipoproteins can increase the risk of atherogenesis. The objective of this study was to investigate postprandial lipemia response to a single dietary fat/sugar load test and monitor beneficial changes induced by the consumption of Platycodi radix (AP) beverage in healthy subjects. SUBJECTS/METHODS: A total of 52 subjects were randomly assigned to either placebo or AP beverage group with a high-fat shake in a randomized controlled crossover trial. Postprandial blood was collected at 0, 1, 2, 4, and 6 h and analyzed for TG and lipoprotein lipase mass. Inhibition of pancreatic lipase was determined in vitro. RESULTS: AP inhibited pancreatic lipase activity in vitro (IC₅₀ = 5 mg/mL). Compared to placebo beverage, AP beverage consumption with a high-fat shake induced significant increase of plasma lipoprotein lipase mass (P = 0.0111, β estimate = 4.2948) with significant reduction in very low-density lipoprotein (VLDL) TG concentration (P = 0.038, β estimate = −52.69) at 6 h. Based on significant correlation between high-fat dietary scores MEDFICTS and postprandial TG responses in VLDL (P = 0.0395, r = 0.2127), subgroup analysis revealed that 6 h-postprandial VLDL TG response was significantly decreased by AP consumption in subjects with MEDFICTS ≥ 40 (P = 0.0291, β estimate = −7214). CONCLUSIONS: AP beverage might have potential to alleviate postprandial lipemia through inhibiting pancreatic lipase activity and elevating lipoprotein lipase mass. Subgroup analysis revealed that subjects with high-fat dietary pattern could be classified as responders to AP beverage among all subjects.

Dual Component Analysis for In Vivo T₂* Decay of Hyperpolarized ¹³C Metabolites

PURPOSE: To investigate the exchange and redistribution of hyperpolarized ¹³C metabolites between different pools by temporally analyzing the relative fraction of dual T₂* components of hyperpolarized ¹³C metabolites. MATERIALS AND METHODS: A dual exponential decay analysis of T₂* is performed for [1-¹³C] pyruvate and [1-¹³C] lactate using nonspatially resolved dynamic ¹³C MR spectroscopy from mice brains with tumors (n = 3) and without (n = 4) tumors. The values of shorter and longer T₂* components are explored when fitted from averaged spectrum and temporal variations of their fractions. RESULTS: The T₂* values were not significantly different between the tumor and control groups, but the fraction of longer T₂* [1-¹³C] lactate components was more than 10% in the tumor group over that of the controls (P < 0.1). The fraction of shorter T₂* components of [1-¹³C] pyruvate showed an increasing tendency while that of the [1-¹³C] lactate was decreasing over time. The slopes of the changing fraction were steeper for the tumor group than the controls, especially for lactate (P < 0.01). In both pyruvate and lactate, the fraction of the shorter T₂* component was always greater than the longer T₂* component over time. CONCLUSIONS: The exchange and redistribution of pyruvate and lactate between different pools was investigated by dual component analysis of the free induction decay signal from hyperpolarized ¹³C experiments. Tumor and control groups showed differences in their fractions rather than the values of longer and shorter T₂* components. Fraction changing dynamics may provide an aspect for extravasation and membrane transport of pyruvate and lactate, and will be useful to determine the appropriate time window for acquisition of hyperpolarized ¹³C images.

Development of a Novel Subunit Vaccine Targeting Fusobacterium nucleatum FomA Porin Based on In Silico Analysis

Selecting an appropriate antigen with optimal immunogenicity and physicochemical properties is a pivotal factor to develop a protein based subunit vaccine. Despite rapid progress in modern molecular cloning and recombinant protein technology, there remains a huge challenge for purifying and using protein antigens rich in hydrophobic domains, such as membrane associated proteins. To overcome current limitations using hydrophobic proteins as vaccine antigens, we adopted in silico analyses which included bioinformatic prediction and sequence-based protein 3D structure modeling, to develop a novel periodontitis subunit vaccine against the outer membrane protein FomA of Fusobacterium nucleatum. To generate an optimal antigen candidate, we predicted hydrophilicity and B cell epitope parameter by querying to web-based databases, and designed a truncated FomA (tFomA) candidate with better solubility and preserved B cell epitopes. The truncated recombinant protein was engineered to expose epitopes on the surface through simulating amino acid sequence-based 3D folding in aqueous environment. The recombinant tFomA was further expressed and purified, and its immunological properties were evaluated. In the mice intranasal vaccination study, tFomA significantly induced antigen-specific IgG and sIgA responses in both systemic and oral-mucosal compartments, respectively. Our results testify that intelligent in silico designing of antigens provide amenable vaccine epitopes from hard-to-manufacture hydrophobic domain rich microbial antigens.

Alternating Acquisition Technique for Quantification of in vitro Hyperpolarized 1-13C Pyruvate Metabolism

PURPOSE: To develop a technique for quantifying the 13C-metabolites by performing frequency-selective hyperpolarized 13C magnetic resonance spectroscopy (MRS) in vitro which combines simple spectrally-selective excitation with spectrally interleaved acquisition. METHODS: Numerical simulations were performed with varying noise level and K(p) values to compare the quantification accuracies of the proposed and the conventional methods. For in vitro experiments, a spectrally-selective excitation scheme was enabled by narrow-band radiofrequency (RF) excitation pulse implemented into a free-induction decay chemical shift imaging (FIDCSI) sequence. Experiments with LDH / NADH enzyme mixture were performed to validate the effectiveness of the proposed acquisition method. Also, a modified two-site exchange model was formulated for metabolism kinetics quantification with the proposed method. RESULTS: From the simulation results, significant increase of the lactate peak signal to noise ratio (PSNR) was observed. Also, the quantified K(p) value from the dynamic curves were more accurate in the case of the proposed acquisition method compared to the conventional non-selective excitation scheme. In vitro experiment results were in good agreement with the simulation results, also displaying increased PSNR for lactate. Fitting results using the modified two-site exchange model also showed expected results in agreement with the simulations. CONCLUSION: A method for accurate quantification of hyperpolarized pyruvate and the downstream product focused on in vitro experiment was described. By using a narrow-band RF excitation pulse with alternating acquisition, different resonances were selectively excited with a different flip angle for increased PSNR while the hyperpolarized magnetization of the substrate can be minimally perturbed with a low flip angle. Baseline signals from neighboring resonances can be effectively suppressed to accurately quantify the metabolism kinetics.

Urodynamic assessment of bladder and urethral function among men with lower urinary tract symptoms after radical prostatectomy: A comparison between men with and without urinary incontinence

PURPOSE: We compared bladder and urethral functions following radical prostatectomy (RP) between men with and without urinary incontinence (UI), using a large-scale database from SNU-experts-of-urodynamics-leading (SEOUL) Study Group. MATERIALS AND METHODS: Since July 2004, we have prospectively collected data on urodynamics from 303 patients with lower urinary tract symptoms (LUTS) following RP at three affiliated hospitals of SEOUL Study Group. After excluding 35 patients with neurogenic abnormality, pelvic irradiation after surgery, or a history of surgery on the lower urinary tract, 268 men were evaluated. We compared the urodynamic findings between men who had LUTS with UI (postprostatectomy incontinence [PPI] group) and those who had LUTS without UI (non-PPI group). RESULTS: The mean age at an urodynamic study was 68.2 years. Overall, a reduced bladder compliance (< or =20 mL/cmH2O) was shown in 27.2% of patients; and 31.3% patients had idiopathic detrusor overactivity. The patients in the PPI group were older (p=0.001) at an urodynamic study and had a lower maximum urethral closure pressure (MUCP) (p<0.001), as compared with those in the non-PPI group. Bladder capacity and detrusor pressure during voiding were also significantly lower in the PPI group. In the logistic regression, only MUCP and maximum cystometric capacity were identified as the related factor with the presence of PPI. CONCLUSIONS: In our study, significant number of patients with LUTS following RP showed a reduced bladder compliance and detrusor overactivity. PPI is associated with both impairment of the urethral closuring mechanism and bladder storage dysfunction.

Determination of Optimal Scan Time for the Measurement of Downstream Metabolites in Hyperpolarized 13C MRSI

PURPOSE: For a single time-point hyperpolarized 13C magnetic resonance spectroscopy imaging (MRSI) of animal models, scan-time window after injecting substrates is critical in terms of signal-to-noise ratio (SNR) of downstream metabolites. Prescans of time-resolved magnetic resonance spectroscopy (MRS) can be performed to determine the scan-time window. In this study, based on two-site exchange model, protocol-specific simulation approaches were developed for 13C MRSI and the optimal scan-time window was determined to maximize the SNR of downstream metabolites. MATERIALS AND METHODS: The arterial input function and conversion rate constant from injected substrates (pyruvate) to downstream metabolite (lactate) were precalibrated, based on pre-scans of time-resolved MRS. MRSI was simulated using twosite exchange model with considerations of scan parameters of MRSI. Optimal scantime window for mapping lactate was chosen from simulated lactate intensity maps. The performance was validated by multiple in vivo experiments of BALB/C nude mice with MDA-MB-231 breast tumor cells. As a comparison, MRSI were performed with other scan-time windows simply chosen from the lactate signal intensities of prescan time-resolved MRS. RESULTS: The optimal scan timing for our animal models was determined by simulation, and was found to be 15 s after injection of the pyruvate. Compared to the simple approach, we observed that the lactate peak signal to noise ratio (PSNR) was increased by 230%. CONCLUSIONS: Optimal scan timing to measure downstream metabolites using hyperpolarized 13C MRSI can be determined by the proposed protocol-specific simulation approaches.

A Case of Idiopathic Collapsing Glomerulopathy Showing Aggravation on a Chronic Progressive Course / 영남의대학술지

Collapsing glomerulopathy (CG) has become an important cause of end-stage renal disease (ESRD). First delineated from other proteinuric glomerular lesions in the 1980s, CG is now recognized as a common, distinct pattern of proliferative parenchymal injury that portends a rapid loss of renal function and poor responses to empirical therapy. The first cases in the literature trace back to human-immunodeficiency-virus (HIV)-negative patients who underwent biopsy in 1979. A 45-year-old male patient complained of hematuria and proteinuria eight years ago. He showed an abrupt serum creatinine increase from 1.75 to 2.65mg/dL in the last preceding months. Afterwards, his serum creatinine progressively increased up to 6.82mg/dL. Moreover, his 24 h urine protein level was determined to have reached 6,171 mg/day, as opposed to 670 mg/day a year earlier. Consequently, renal biopsy was performed, and its result showed collapsing glomerulopathy, compatible with the diagnosis. He has undergone continuous ambulatory peritoneal dialysis as renal replacement therapy. Thus, it is reported herein that a patient clinically diagnosed with chronic kidney disease eight years ago showed a sudden renal-function decrease and was clinicopathologically diagnosed with collapsing glomerulopathy based on the results of his renal biopsy.

14-3-3epsilon protein increases matrix metalloproteinase-2 gene expression via p38 MAPK signaling in NIH3T3 fibroblast cells

One of the 14-3-3 protein isoforms, 14-3-3epsilon, was previously shown to be increased during skin aging. We suggest here a possible role for the 14-3-3epsilon protein in skin aging by providing evidence that 14-3-3epsilon increases the expression of the matrix-metalloproteinase (MMP)-2 gene in NIH3T3 fibroblast cells. Expression of the 14-3-3epsilon gene in NIH3T3 cells primarily up-regulated the expression of the MMP-2 gene at the transcriptional level by inducing specific DNA binding proteins bound to an upstream region of the MMP-2 promoter from -1,629 to -1,612. Inhibition of endogenous 14-3-3epsilon gene expression by RNA interference also decreased endogenous MMP-2 gene expression. Furthermore, up-regulation of the MMP-2 gene by 14-3-3epsilon was suppressed by expression of a dominant-negative mutant of p38 MAP kinase. These findings strongly suggest that increased expression of 14-3-3epsilon contributes to remodeling of extracellular matrix in skin through increasing MMP-2 gene expression via p38 MAP kinase signaling.

The Roles of S1P on Placental Development / 체질인류학회지

Sphingosine-1-phosphate (S1P), a bioactive sphingolipid metabolite, has various functions to affect many signalling pathways leading to cellular proliferation and differentiation and to regulate of cell migration, invasion, and angiogenesis. However, there are little reports about the relation between trophoblast stem cells and S1P. Thus, the physiologic effects of S1P on trophoblast stem (TS) cells were investigated in this study. S1P was involved in early stage development of trophoblast via upregulation of Eomesodermine mRNA expression and suppressed differentiation of TS cells through activation of extracellular-signal regulated kinase (ERK) activation. Other actions of S1P were the activation of p38 and the induction of Dlx-3 mRNA expression for angiogenesis in TS cells. Interestingly, TS cells cultured with S1P for 4 days in thrombin-fibrinogen gel culture system, specific culture system for endothelial cells, showed good healthy appearance, but TS cells cultured without S1P got severe damages. Taken together, we suggest that S1P has very important roles on placenta such as development of early stage trophoblast, suppression of differentiation, and angiogenesis on placenta.

The Protective Effects of FGF-4 on Hypoxia-mediated Apoptosis of Trophoblast Stem Cells / 체질인류학회지

Preeclampsia and fetal growth restriction are conditions associated with placental hypoperfusion and villous hypoxia. The villous response to this environment includes elevated apoptosis. Recently, trophoblast stem (TS) cells had been successfully derived. FGF-4 locates in the inner cell mass (ICM) of blastocyst and TS cells have fibroblast growth factor receptor-2 (FGFR-2). To identify whether FGF-4 protects hypoxia-induced apoptosis in TS cells, this study was carried out. TS cells were cultured up to 48 h in standard (PO2 = 20%) or hypoxic (PO2 = 3%) conditions. TS cells were very vulnerable against exposure to hypoxia for 48 h but embryonic stem (ES) cells were very resistant to hypoxiamediated apoptosis. Death of TS cells bears the typical hallmarks of apoptosis as determined by DNA laddering. FGF- 4 and epidermal growth factor (EGF) protected the hypoxia-mediated cell death of trophoblast but granulocyte-macrophage colony stimulating factor (GMSF) and transforming growth factor-beta (TGF-beta) did not protect. In conclusion, we speculate that the effects of FGF-4 on apoptosis in trophoblasts may play an important role in protecting the placenta from hypoxic injury in pregnancy related with placental hypoperfusion.