Absorption Study of Genistein Using Solid Lipid Microparticles and Nanoparticles: Control of Oral Bioavailability by Particle Sizes

In this study, the effect of particle size of genistein-loaded solid lipid particulate systems on drug dissolution behavior and oral bioavailability was investigated. Genistein-loaded solid lipid microparticles and nanoparticles were prepared with glyceryl palmitostearate. Except for the particle size, other properties of genistein-loaded solid lipid microparticles and nanoparticles such as particle composition and drug loading efficiency and amount were similarly controlled to mainly evaluate the effect of different particle sizes of the solid lipid particulate systems on drug dissolution behavior and oral bioavailability. The results showed that genistein-loaded solid lipid microparticles and nanoparticles exhibited a considerably increased drug dissolution rate compared to that of genistein bulk powder and suspension. The microparticles gradually released genistein as a function of time while the nanoparticles exhibited a biphasic drug release pattern, showing an initial burst drug release, followed by a sustained release. The oral bioavailability of genistein loaded in solid lipid microparticles and nanoparticles in rats was also significantly enhanced compared to that in bulk powders and the suspension. However, the bioavailability from the microparticles increased more than that from the nanoparticles mainly because the rapid drug dissolution rate and rapid absorption of genistein because of the large surface area of the genistein-solid lipid nanoparticles cleared the drug to a greater extent than the genistein-solid lipid microparticles did. Therefore, the findings of this study suggest that controlling the particle size of solid-lipid particulate systems at a micro-scale would be a promising strategy to increase the oral bioavailability of genistein.

Effects of an Educational Program for the High Risk Group of Cardio-cerebrovascular Disease: Awareness of the Warning Signs and Symptoms of Acute Myocardial Infarction and Stroke in the Aged at Senior Centers / 農村醫學 地域保健

OBJECTIVES: This study was performed to investigate the effects of a health education program for the aged on knowledge about the warning signs and symptoms of acute myocardial infarction and stroke. METHODS: Data from 337 elderly people (159 participated and 178 non-participated) at senior centers in Jeju-si were collected by 1 to 1 interview from January to March 2012, one year after the education program provided. Two stages of study were performed: Cross-sectional, case-control study on the level of knowledge about the warning signs and symptoms; and multivariate logistic regression to fine out predictors of optimal awareness. RESULTS: No significant discrepancy of knowledge level between case and control group was found. The knowledge level as high as a surge was shown in both groups one year later. A surge of knowledge had been shown after the education provided in one month. The factors affecting the optimal level of knowledge were education (Odds ratio 3.01; Confidence Interval 1.72-5.26; P-value <0.001) and 7 days of watching TV news per week (2.97; 1.68-5.23; P<0.001). However, participation in the health education was not significant (1.60; 0.98-2.61; P=0.059). CONCLUSIONS: The effects of a targeted program in high-risk groups for cardio-cerebrovascular disease are only guaranteed in the enhancement by a population-based mass-media education campaign.

Predictors of Breast Self Examination Practice among North Korean Immigrant Women

BACKGROUND: Breast cancer is one of the most commonly diagnosed cancers in women worldwide. Immigrant women face cultural and social impediments, discrimination, and emotional and mental stressors; and they participate less in breast cancer prevention services. Breast self examination (BSE) may be effective in early detection. The purpose of this descriptive cross-sectional study was to identify the practice of BSE and to examine predictors related to the practice of BSE among North Korean female immigrants residing in South Korea. METHODS: Data were collected from a convenience sample of 131 North Korean female immigrants aged 20 years through 65 years who had attended community centers, local churches, and women's gatherings located in Incheon, Kyeongkido, Seoul, and Jeju. RESULTS: This study found that 17.6% of the women performed BSE and 8.4% were taught the methods of detecting breast cancer including BSE. Two significant predictors to performing BSE were found-good perceived health status (P=.003)and education about breast cancer screening and the breast self examination (P<.001). CONCLUSIONS: The results showed that North Korean female immigrants who were taught the detecting methods of breast cancer including BSE were more likely to practice BSE.

The Relationship between Cognitive Decline and Psychopathology in Patients with Schizophrenia and Bipolar Disorder

OBJECTIVE: The primary goals of the present study were to assess intellectual function in participants with schizophrenia or bipolar disorder (BD) and to investigate the relationships between cognitive decline and the severity of each type of psychopathology. METHODS: The present study included 51 patients with schizophrenia and 42 with BD who were recruited from the psychiatry outpatient clinic of Jeju University Hospital between March 2011 and March 2014. The Korean Wechsler Adult Intelligence Scale (K-WAIS) was administered to each of the 93 participants, and they were categorized into two groups based on their current intelligence quotient (IQ) and their estimated premorbid IQ: severely impaired group (SIG) and mildly impaired group (MIG). The Minnesota Multiple Personality Inventory (MMPI) and the Brief Psychiatric Rating Scale (BPRS) were used to assess psychopathology. RESULTS: The SIG schizophrenia participants exhibited significantly higher scores on the frequent (F) and schizophrenia (Sc) subscales of the MMPI, but significantly lower scores on the correction (K) and psychopathic deviate (Pd) subscales compared with the MIG schizophrenia participants. Furthermore, the BPRS scores were significantly higher in the SIG schizophrenia participants relative to the MIG schizophrenia participants. The SIG BD participants had significantly higher F, masculinity-femininity (Mf), paranoia (Pa), and Sc but significantly lower Pd scores compared with the MIG BD participants. CONCLUSION: The present findings revealed a significant discrepancy between the estimated premorbid levels of cognitive function and current cognitive function in participants with schizophrenia or BD. Moreover, this discrepancy was correlated with severity of psychopathology in both groups.

Suicidal Ideation and Associated Factors among Korean Elementary School Students / 대한정신약물학회지

OBJECTIVE: This study evaluated the occurrence and associated factors with self-reported suicidal ideation within the last 12 months among Korean elementary school students. METHODS: In a school-based cross-sectional survey, a total of 657 students were recruited from elementary schools (age range: 11??2 years) in Jeju area. They filled out self-completing questionnaires on suicidality (suicidal ideation and suicidal attempt), depression (Kovacs' Children's Depression Inventory), and sociodemographic characteristics, including school and family factors. RESULTS: A total of 192 (29.2%) students reported suicidal ideation, and the rate of suicidal attempt was 6.1% (n=40). Logistic regression analysis identified factors associated with recent suicidal ideation. Female had higher rates of suicidal ideation than male [odds ratio (OR)=1.81, p=0.005], and students with depression (OR=3.23, p<0.001) and experience of abuse in the home (OR=6.77, p<0.001) were at high risk for suicidal ideation. CONCLUSION: These results suggest that suicidal ideation and actions are relatively common in Korean elementary school students, and have implications for prevention and intervention.

Factors Affecting Suicidal Ideation in Korean High School Students / 대한정신약물학회지

OBJECTIVE: The purpose of this study was to evaluate the occurrence of the suicidal ideation and associated factors with self-reported suicidal ideation within the last 12 months among Korean high school students. METHODS: A total of 697 adolescents were recruited from high schools (age range: 15-16 years) in Jeju area. According to existence of suicidal ideation, they were divided into two groups-suicidal ideation group and non-suicidal ideation group, and the differences between groups in terms of various sociodemographic and clinical characteristics, including depression (Beck Depression Inventory), and health related conditions. RESULTS: A total of 187 (26.8%) high school students reported suicidal ideation, and the rate of suicidal attempt was 4.9% (n=34). The associated factors of suicidal ideation were depression [odds ratio (OR)=2.42, p< or =0.001], short sleep duration (OR=1.84, p=0.009), current alcohol use (OR=4.94, p< or =0.001), self reported poor health (OR=2.10, p=0.004), and school bullying (OR=3.06, p=0.002). CONCLUSION: These results may have important implications for the strategies and specified intervention in preventing suicidal ideation in Korean high school students.

Panonychus citri Can Induce T-helper Type 2 Immune Responses via the Release of Thymic Stromal Lymphopoietin and IL-4

Panonychus citri damages the leaves of citrus trees, causing defoliation, and induces T-helper type 2 (TH2) immune responses (occupational asthma) via a hitherto unknown mechanism. This is a particular problem on Jeju Island, which is located to the south of the Korean peninsula. In this study, we show for the first time how P. citri induces TH2 immunity. Exposure to P. citri induces the production of thymic stromal lymphopoietin (TSLP) by either basophils or CD4+ T cells (it is not certain which), which results in the production of interleukin 4 (IL-4). IL-4 promotes the production of immunoglobulin E (IgE), which ultimately contributes to the process of allergic inflammation. Therefore, TSLP plays an important role in the P. citri-induced TH2 immune response.

Partial Purification and Properties of a Cysteine Protease from Citrus Red Mite Panonychus citri

Several studies have reported that the citrus red mites Panonychus citri were an important allergen of citrus-cultivating farmers in Jeju Island. The aim of the present study was to purify and assess properties of a cysteine protease from the mites acting as a potentially pathogenic factor to citrus-cultivating farmers. A cysteine protease was purified using column chromatography of Mono Q anion exchanger and Superdex 200 HR gel filtration. It was estimated to be 46 kDa by gel filtration column chromatography and consisted of 2 polypeptides, at least. Cysteine protease inhibitors, such as trans poxy-succinyl-L-leucyl-amido (4-guanidino) butane (E-64) and iodoacetic acid (IAA) totally inhibited the enzyme activities, whereas serine or metalloprotease inhibitors did not affect the activities. In addition, the purified enzyme degraded human IgG, collagen, and fibronectin, but not egg albumin. From these results, the cysteine protease of the mites might be involved in the pathogenesis such as tissue destruction and penetration instead of nutrient digestion.

Prevalence of Dementia and Its Correlates among Participants in the National Early Dementia Detection Program during 2006-2009

OBJECTIVE: To investigate the prevalence of dementia and its correlates among people with poor socioeconomic status, poor social support systems, and poor performance on the Korean version of the Mini-Mental Status Exam (MMSE-KC). METHODS: We used 2006-2009 data of the National Early Dementia Detection Program (NEDDP) conducted on Jeju Island. This program included all residents >65 years old who were receiving financial assistance. We examined those who performed poorly (standard deviation from the norm of <-1.5) on the MMSE-KC administered as part of the NEDDP, using age-, gender-, and education-adjusted norms for Korean elders. A total of 1708 people were included in this category. RESULTS: The prevalence of dementia in this group was 20.5%. Multivariate logistic regression analysis revealed that the following factors were statistically significantly associated with dementia: age of 80 or older, no education, nursing home residence, and depression. CONCLUSION: The prevalence of dementia is very high among those with lower MMSE-KC scores, and significant correlates include older age, no education, living in a nursing home, and depression. Enhancing lifetime education to improve individuals' cognitive reserves by providing intellectually challenging activities, encouraging living at home rather than in a nursing home, and preventing and treating depression in its early phase could reduce the prevalence of dementia in this population.

Comparison of air pollution and the prevalence of allergy-related diseases in Incheon and Jeju City / 소아과

PURPOSE: A high level of air pollutants can increase the number of patients with allergy-related diseases such as asthma and allergic rhinitis (AR). To analyze the association between air pollution and allergic disease, we investigated 2 areas in Korea: Incheon, an industrial area, and Jeju, a non-industrialized area. METHODS: Second grade students at elementary schools (11 schools in Incheon and 45 schools in Jeju) were examined in a cross-sectional study. A questionnaire was used and a skin prick test was performed. The levels of NO2, CO2, O3, particulate matter (PM) PM10/2.5, formaldehyde, tVOCs, and dust mites in the classrooms and grounds were determined. RESULTS: The levels of outdoor CO, PM10, and PM2.5 were significantly higher in Incheon (P<0.01). The levels of indoor CO, CO2, PM10, PM2.5 were significantly higher in Incheon (P<0.01). The prevalence rates of AR symptoms at any time, AR symptoms during the last 12 months, diagnosis of rhinitis at any time, and AR treatment during the last 12 months were significantly higher in Incheon (P<0.01). The prevalence rate of wheezing or whistling at any time, and wheezing during the last 12 months were significantly higher in Incheon (P<0.01). CONCLUSION: We found that the children living in Incheon, which was more polluted than Jeju, had a higher rate of AR and asthma symptoms compared to children in Jeju. To determine the effect of air pollution on the development of the AR and asthma, further studies are needed.

Molecular Genetic Typing of Legionella pneumophila Strains Isolated in Jejudo, Korea

Twenty two strains of Legionella species isolated from Jejudo, Korea were identified by comparing the rpoB (300 bp), dotA (360 bp), and mip (396 bp) gene sequence analysis. Furthermore, their genotypes were determined by sequence analysis of rpoB/dotA subgroup typing, pulse-field gel electrophoresis (PFGE) and random amplified polymorphic DNA (RAPD) patterns. Of the 22 isolates, 21 strains were identified as L. pneumophila and 1 strain was close to L. erythra (>95% similarity of rpoB and mip). Most of the L. pneumophila strains (90%) belonged to P-I of rpoB/dotA subgroup typing, one strain of each P-III and P-IV. L. pneumophila isolates were further grouped into 4 and 6 different PFGE (P1 to P4) and RAPD (R1 to R6) patterns, respectively. On the basis of these genotypes, which may be useful for future epidemiological studies, existence of diverse L. pneumophilla population in Jejudo, Korea were observed.

Prevalence and Correlates of Depressive Symptoms among North Korean Defectors Living in South Korea for More than One Year

OBJECTIVE: This study examined the prevalence and correlates of depressive symptoms in North Korean defectors who have been living in South Korea for more than one year. METHODS: We used questionnaires developed by the authors to collect sociodemographic data in addition to the Center for Epidemiologic Studies Depression Scale (CES-D), the Psychosocial Well-being Index to measure stress, and a social support scale. A total of 367 subjects were included in this study. RESULTS: The results showed that 30.5% of the men and 34.7% of the women reported depressive symptoms, and 33.1% of the men and 36.1% of the women exhibited signs of severe distress. Correlates of depressive symptoms were lack of occupation [odds ratio (OR)=2.198, 95% confidence interval (CI), 1.247-3.873], having escaped without family (OR=1.725, 95% CI, 1.006-2.959), and a poor subjective sense of health status (OR=3.111, 95% CI, 1.591-6.085). CONCLUSION: Continuing vocational training and career management, psychological support programs, and intensive physical health services are needed to improve the mental health of this population.

The Effect of the Traditional Living Arrangement, Anpakkori, on Depressive Symptoms in Elderly People Residing on Jeju Island

OBJECTIVE: We examined the effect of anpakkori, a traditional living arrangement, on depression among elderly people on Jeju Island in Korea. METHODS: A total of 593 subjects were assessed using a sociodemographic questionnaire developed by the authors, the Korean version of Geriatric Depression Scale (KGDS), the Social Support Scale, and the Activities of Daily Living/Instrumental Activities of Daily Living scales (ADL/IADL). Subjects were classified into three groups: those residing with their adult children, those living individually, and those living in the traditional Jeju anpakkori living arrangement. RESULTS: The prevalence of depression in this study was 53.1%, and the traditional Jeju living arrangement, anpakkori, was significantly correlated with the presence of depressive symptoms (p=0.005)[odds ratio (OR)=1.88, 95% confidence interval (CI)=1.16-3.06]. CONCLUSION: Living in the traditional Jeju way may not be as good for establishing family solidarity as is living with adult children. Moreover, elderly individuals prone to depression tended to live in this anpakkori living arrangement. Careful psychological and social support systems that might prevent the development of depressive symptoms should be provided for those who live in anpakkori living arrangements.

The Prevalence of Depression and Related Factors among Adults

PURPOSE: This study was to investigate depression prevalence and related factors of depression in Jeju Province. METHODS: The study sample selected using randomized cluster sampling method, and the unit of cluster was 25 households. Data were collected from 1275 adults in 723 households through home visit interview. The response rate was 89.4%. The instrument used for measuring depression was CES-D, the cut-off score was 21. Data were analyzed using Chi-square test and logistic regression. RESULTS: The prevalence of depression in Jeju was 18.1%. The significant differences were found with depression prevalence rate by the group of gender, age, inhabited area, marital status, educational status, monthly household income, life satisfaction, socioeconomic status, perceived health status, morbidity during last 2 weeks, perceived stress, perceived fatigue, participation in social activities, and family life satisfaction. The most predictive factors among those variables were perceived fatigue with 17.93 of odds ratio, family life satisfaction with 9.86 odds ratio, and perceived stress with 9.66 of odds ratio. CONCLUSION: The prevention and management of depression program development was suggested and mental health promotion program for the prevention of depression was suggested.

Prevalence of Severe Distress and Its Correlates Among Cheju Medical College Students / 한국의학교육

PURPOSE: To determine the prevalence of severe distress and its correlates among Cheju medical college students. METHODS: Data were gathered in December 2005, and all medical college students were included. Of a total of 170 medical college students, 52(30.6%), 41(24.1%), 37(21.8%), and 40(23.5%) were 1st, 2nd, 3rd, and 4th year students, respectively. The questionnaire for sociodemographic information included age, sex, year, hometown, accommodation, education level of parents, socioeconomic status of parents, GPA(grade point average), and standing. Subjective sense of health status, level of health concern, smoking habit, drinking habit(CAGE), sleep pattern, degree of obesity, and body image satisfaction were included to reveal health habits and health behaviors of the subjects. CES-D for depression, Psychosocial Well-being Index(PWI) for stress level, State-Trait Anxiety Inventory(STAI) for level of anxiety, and SCL-90-R(Symptom Checklist 90 revised) for level of general psychopathology were used RESULTS: 1st year students were 4.338 times(95% CI; 1.412-13.324) more likely than other years to experience severe distress. Students who felt that they had insufficient time for relaxation showed 5.027 times(95% CI; 1.489-16.969) higher prevalence of severe distress than those who felt they had sufficient time for relaxation. Those with poor self-esteem were 18.347 times(95% CI; 5.484-61.382) more likely to experience severe distress than those with 'good' self-esteem. CONCLUSION: Offering various programs for improving coping skills, advanced counseling program, or tutoring system and providing sufficient relaxation timeby various methods, such as modifying curriculum, are needed to ameliorate severe distress.

A Study on Regional Differentials in Death Caused by Suicide in South Korea / 간호학회지

PURPOSE: The purpose of this study was to compare suicide mortality by region in South Korea. METHOD: Suicide mortality differentials were calculated for several mortality indicators by geographical regions from raw data of the cause of death from KNSO. RESULTS: The results are as follows; the Crude suicide death rate was 22.63 per 100,000. The highest was in Kangwon showing 37.84% whereas, Chungnam, and Jeonbuk followed after. Suicide was 4.4% of all causes of death, but Inchon and Ulsan showed a higher proportion. The male suicide death rate was 31.12 per 100,000 and females 14.09. The ratio of gender suicide mortality was 2.21, per 100,000 and was the highest in Jeju. For age-specific suicide death rates, the rate increased as age advanced, showing 2.33 per 100,000 in 0-19years, 18.68 in 20-39, 30.48 in 40-59,63.33 in 60 years and over. In Ulsan, Kangwon, and Inchon, age-specific suicide death rates of the 60 and over age group were higher than other regions, Daegu, Busan, and Kangwon showed a higher age-specific suicide mortality of the 40-59 age group, and Kangwon, Jeonnam, and Chungnam had a higher age-specific suicide mortality of the 20-39 age group. CONCLUSIONS: Suicide mortality differed by region. These results can be used for a regional health care plan and planning for suicide prevention by regions.

Diseases and Health Service Utilization Patterns of Geriatric Inpatients

BACKGROUND: Recently elderly people have increased in Korea and increased demands of medical service. This study was carried out to identify diseases and health service utilization patterns of geriatric inpatients to provide better understanding and basis planning to meet the needs of expanding geriatric population. METHOD: We use data of `Patient Survey in Korea` in 1999 and analyzed characteristics of disease structure and utilization patterns of health care service of 54,013 cases of discharged patients aged 65 years or more. RESULT: The proportion of the elderly in total discharged patients is 14.7%. Male to female ratio is 1:1.3 and most common age group was between 65 and 69 years old. 84.2% of elderly patients were admitted at secondary or tertiary health care facilities. The most common disease in geriatric inpatients is malig- nancy in male and vascular disease in female. The average duration of hospitalization is 14.2 days. They stay longer than the nation wide average hospital length and stay longest when they are admitted by mental and behavioral disorders. CONCLUSION: Geriatric patients are admitted mostly with chronic degenerative diseases such as neoplasm and vascular disease. Elders prefer to be admitted to tertiary hospitals and oriental hospitals. They stay more in hospital.

Prevalence of Depression and Correlates of Depressive Symptoms among Residents in Rural Areas of Jeju Island

BACKGROUND: Recently, various effective and rapid acting treatment modality for depression have been massively developed. Thus, early detection and treatment of depression is vitally important to improve community mental health. Using BDI, primary practitioner can easily find depressive symptoms that can complicate other physical diseases. Finding and treating depression early can improve general prognosis of physical diseases. The purpose of this study was to find out the prevalence of depression and depressive symptoms and their correlates among residents in Jeju and to provide baseline data. METHODS: The study subjects were 1,086 residents consisting of 531 males and 555 females of 10-Li in rural Jeju island and the data was gathered from trained interviewer using BDI and questionnaire about sociodemographic factors and health behavior. Depression was defined as BDI total score over 23 in males and over 24 in females. Depressive symptom was defined as BDI STEN score over 7. RESULTS: The prevalence of depression in rural Jeju island was 5.8% in total, 4.9% among males, 6.5% among females. The prevalence of depressive symptoms was 16.7% in total, 14.9% among males, 18.4% among females. The risk factors of depressive symptoms were self-assessed living standard, education years, perceived health status, self-assessed level of stress, perceived social support, body image, breakfast intake, and sleep. Sex, marital status and drinking habit were not statistically significant risk factors. CONCLUSION: The prevalence of depression and depressive symptoms in rural Jeju island was very low, especially among females. With intensive mental health service for those who are in low socioeconomic class and low education level and those who have poor health behavior, early detection of depressive symptoms from community will be important to improve general health status.

The Prevalence and Related Factors of Depressive Symptoms among the Elderly in Rural Areas of Jeju Island

OBJECTIVE: Depressive disorder is one of the most frequent and serious neuropsychiatric disorders in the elderly. This study is aimed to investigate the prevalence and related factors of depressive symptoms among the elderly in rural areas of Jeju island. METHODS: The Short form of Geriatric Depression Scale (SGDS) and structured questionnaire about factors related with depression were administered to 590 rural-dwelling elderly in Jeju island. RESULTS: The overall prevalence of depressive symptoms over score 10 in SGDS is 16.6% (Male 14.2%, Female 17.8%). But there was no sex difference. And statistically significant factors related with depression by multiple logistic regression analysis were economic status, chronic physical illness, and self-perceived health status. Factor of physical limitations would be a possible associated one. CONCLUSIONS: The prevalence of depressive symptoms of Jeju island was nearly same as that of other areas. And several risk factors for depression were identified but further evaluation will be needed because of those complex and controversial findings.

Pigmented Villonodular Synovitis of the Temporomandibular Joint: a case report / 대한이비인후과학회지

Pigmented villonodular synovitis is a benign proliferative disorder affecting the synovium. In 1941, Jaffe assembled under the common term of pigmented villonodular synovitis dissimilar lesions described by different names, that issuch as giant cell tumors of synovial tendon sheaths, actual pigmented villonodular synovitis, and villonodular bursitis. (Giant cell tumors of tendon sheaths, which may be localized, most often occurring in fingers, flexor tendons or interphalangeal joints, or diffuse, usually arising in the vicinity of large joints.) Involvement of the temporomandibular joint is very rare. (We report a rare case of pigmented villonodular synovitis of the temporomandibular joint that invaded the mandibular condyle. A 34-year-old man had a large left preauricular (parotid) mass for two years that he had focal facial nerve paralysis, temporal and zygomatic branches. The clinical appearance suggested a parotid tumor. At surgical exploration, a tumor was found to be severely adhered sion to the facial nerve and involving the temporomandibular joint. Histologically, Tthe resected specimen histologically was a proliferative lesion composed of epithelioid histiocytes, spindle cells, and multinucleated giant cells.) The appearance was typical of the family of lesions that includes pigmented villonodular synovitis, bursitis, and tenosynovitis . rewritten as follows: (Giant cell tumors of tendon sheaths, which may be localized, most often occurring in fingers, flexor tendons or interphalangeal joints, and spread to other parts after arising in the vicinity of large joints.) rewritten as follows: (A 34-year-old man had a large left preauricular (parotid) mass for two years and showed focal facial nerve paralysis in the temporal and zygomatic branches. The clinical appearance suggested a parotid tumor. Surgical exploration revealed a tumor that was severely connected to the facial nerve involving the temporomandibular joint. Histologically, the resected specimen was a proliferative lesion composed of epithelioid histiocytes, spindle cells, and multinucleated giant cells.)