Snack Provision Practice in Long-Term Care Hospitals and Facilities in Korea.

The study aimed to investigate the basic data to derive plans for snack provision to improve the nutritional status of older adults living in long-term care facilities (LFs) or long-term care hospitals (LHs). The 252 respondents (118 from LHs and 134 from LFs) were included in the study. The questionnaire of nationwide cross-sectional survey was developed by the authors and registered dietitians. The written questionnaire was sent to the food service managers across 800 LFs or LHs. The online survey was introduced using the online platform and network site for dietitians. More than 70% of live-in and non-live-in LFs provided snacks, which were mainly provided one to two times a day. Most institutions provided fruits one to three times a week. The main considerations when providing fruit were in the order of residents' preference, cost, and ease of consumption. The reasons for not serving fruit included cost and differences in the residents' eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and the lack of awareness of the need to provide them. To improve the quality of life and the offer benefits of fruits and dairy products to older people, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.

SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through Multidomain interventions via facE-to-facE and video communication plaTforms in mild cognitive impairment (SUPERBRAIN-MEET): Protocol for a Multicenter Randomized Controlled Trial.

Background and Purpose: The SoUth Korea study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention (SUPERBRAIN) proved the feasibility of multidomain intervention for elderly people. One-quarter of the Korean population over 65 years of age has mild cognitive impairment (MCI). Digital health interventions may be cost-effective and have fewer spatial constraints. We aim to examine the efficacy of a multidomain intervention through both face-to-face interactions and video communication platforms using a tablet personal computer (PC) application in MCI. Methods: Three hundred participants aged 60-85 years, with MCI and at least one modifiable dementia risk factor, will be recruited from 17 centers and randomly assigned in a 1:1 ratio to the multidomain intervention and the waiting-list control groups. Participants will receive the 24-week intervention through the tablet PC SUPERBRAIN application, which encompasses the following five elements: managing metabolic and vascular risk factors, cognitive training, physical exercise, nutritional guidance, and boosting motivation. Participants will attend the interventions at a facility every 1-2 weeks. They will also engage in one or two self-administered cognitive training sessions utilizing the tablet PC application at home each week. They will participate in twice or thrice weekly online exercise sessions at home via the ZOOM platform. The primary outcome will be the change in the total scale index score of the Repeatable Battery for the Assessment of Neuropsychological Status from baseline to study end. Conclusions: This study will inform the effectiveness of a comprehensive multidomain intervention utilizing digital technologies in MCI. Trial Registration: ClinicalTrials.gov Identifier: NCT05023057.

Effects of the multidomain intervention with nutritional supplements on cognition and gut microbiome in early symptomatic Alzheimer's disease: a randomized controlled trial.

Background: The SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN) is a part of the World-Wide Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (WW-FINGERS) network. This study aimed to demonstrate the effects of the SUPERBRAIN-based multidomain intervention with nutritional supplements in amyloid positive emission tomography (PET) proven early symptomatic Alzheimer's disease patients. Methods: Forty-six participants who were diagnosed with mild cognitive impairment or mild dementia and were positive in the amyloid PET study randomized into three groups: group A, the multidomain intervention with nutritional supplements; group B, nutritional supplements only; and a control group. The primary outcome was a change in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total scale index score after an 8-week intervention. Secondary outcomes, including gut microbiome data, were also analyzed. Results: The RBANS total scale index score improved significantly in group A compared with group B (p < 0.032) and compared with the control group (p < 0.001). After intervention, beta diversity of the gut microbiome between group A and the control group increased, and patients in group A were more enriched with Bifidobacterium. Conclusion: SUPERBRAIN-based multidomain intervention with nutritional supplements improves cognition and gut microbiota in patients with early symptomatic Alzheimer's disease who were amyloid-positive by PET.

Nutritional Status and Frailty Improvement through Senior-Friendly Diet among Community-Dwelling Older Adults in South Korea.

Considering that Korea's aging population is rapidly increasing, health serves as an indicator of older adults' quality of life, and dietary life directly affects their health. For health maintenance and improvement, preventive healthcare measures including safe food selection and nutritional supply are needed. This study aimed to evaluate the effect of senior-friendly diet on nutrition and health status improvement in older adults receiving community care. A total of 180 older adults were analyzed, with 154 and 26 in the senior-friendly diet intervention group and the general diet group, respectively. Surveys, blood tests, and frailty evaluations were conducted before and after the study. After 5 months of intervention, the blood status, nutrient intake, and frailty level were evaluated. The participants' mean age was 82.7 years, and 89.4% of them were living alone. In both groups, energy, protein, vitamin A, vitamin D, vitamin C, calcium, and magnesium intake were insufficient initially but generally improved after the intervention. Especially in the intervention group, energy, protein, vitamin D, vitamin C, and folic acid intake significantly increased. The frailty level also slightly improved, and the malnutrition rate was reduced. Even after the passage of time, the improvement effect size significantly differed between the groups. Therefore, resolving and supporting meals corresponding to the physiological needs of the older adults has a great impact on improving their quality of life, and such special consideration is a reasonable way to respond to a super-aged society.

Mucociliary Epithelial Organoids from Xenopus Embryonic Cells: Generation, Culture and High-Resolution Live Imaging.

Mucociliary epithelium provides the first line of defense by removing foreign particles through the action of mucus production and cilia-mediated clearance. Many clinically relevant defects in the mucociliary epithelium are inferred as they occur deep within the body. Here, we introduce a tractable 3D model for mucociliary epithelium generated from multipotent progenitors that were microsurgically isolated from Xenopus laevis embryos. The mucociliary epithelial organoids are covered with newly generated epithelium from deep ectoderm cells and later decorated with distinct patterned multiciliated cells, secretory cells, and mucus-producing goblet cells that are indistinguishable from the native epidermis within 24 h. The full sequences of dynamic cell transitions from mesenchymal to epithelial that emerge on the apical surface of organoids can be tracked by high-resolution live imaging. These in vitro cultured, self-organizing mucociliary epithelial organoids offer distinct advantages in studying the biology of mucociliary epithelium with high-efficiency in generation, defined culture conditions, control over number and size, and direct access for live imaging during the regeneration of the differentiated epithelium.

Reducing Veterinary Drug Residues in Animal Products: A Review.

A survey we conducted suggests that the ingestion of veterinary drug residues in edible animal parts constitutes a potential health hazard for its consumers, including, specifically, the possibility of developing multidrug resistance, carcinogenicity, and disruption of intestinal normal microflora. The survey results indicated that antibiotics, parasitic drugs, anticoccidial, or nonsteroidal anti-inflammatory drugs (NSAIDs) are broadly used, and this use in livestock is associated with the appearance of residues in various animal products such as milk, meat, and eggs. We observed that different cooking procedures, heating temperatures, storage times, fermentation, and pH have the potential to decrease drug residues in animal products. Several studies have reported the use of thermal treatments and sterilization to decrease the quantity of antibiotics such as tetracycline, oxytetracycline, macrolides, and sulfonamides, in animal products. Fermentation treatments also decreased levels of penicillin and pesticides such as dimethoate, malathion, Dichlorodiphenyldichloroethylene, and lindane. pH, known to influence decreases in cloxacillin and oxacillin levels, reportedly enhanced the dissolution of antimicrobial drug residues. Pressure cooking also reduced aldrin, dieldrin, and endosulfan in animal products. Therefore, this review provides updated information on the control of drug residues in animal products, which is of significance to veterinarians, livestock producers, and consumer health.

Innate Color Preference of Zebrafish and Its Use in Behavioral Analyses.

Although innate color preference of motile organisms may provide clues to behavioral biases, it has remained a longstanding question. In this study, we investigated innate color preference of zebrafish larvae. A cross maze with different color sleeves around each arm was used for the color preference test (R; red, G; green, B; blue, Y; yellow). The findings showed that 5 dpf zebrafish larvae preferred blue over other colors (B > R > G > Y). To study innate color recognition further, tyrosinase mutants were generated using CRISPR/Cas9 system. As a model for oculocutaneous albinism (OCA) and color vision impairment, tyrosinase mutants demonstrated diminished color sensation, indicated mainly by hypopigmentation of the retinal pigment epithelium (RPE). Due to its relative simplicity and ease, color preference screening using zebrafish larvae is suitable for high-throughput screening applications. This system may potentially be applied to the analysis of drug effects on larval behavior or the detection of sensory deficits in neurological disorder models, such as autism-related disorders, using mutant larvae generated by the CRISPR/Cas9 technique.

Oligometastases confined one organ from colorectal cancer treated by SBRT.

To determine the feasibility and efficacy of stereotactic body radiotherapy (SBRT) for oligometastases from colorectal cancer (CRC). Total of 59 patients with 78 lesions confined to one organ and treated from 2001 to 2006 were involved in this retrospective review. These patients presented with 1-4 metastatic lesions of largest diameter of <7 cm, progressed after chemotherapy, and were amenable to local treatment. The median radiation dose administered was 42 Gy, which was delivered in 3 fractions. Lymph node lesions were most frequent, followed in order by the lung and liver. Five-year overall survival and local control rates were 29 and 19%, respectively. Cumulative gross tumor volume, site of metastasis, and SBRT dose were found to be significantly associated with overall survival. In terms of local control, a cumulative GTV below 23 ml was found to be a significantly favorable prognostic factor. Acute grade 1-2 toxicities occurred in 24 of the 59 patients, and a late grade 4 complication occurred in 2 (3%), and these were relieved by bypass surgery. CRC patients with oligometastases generally fare well after SBRT. In particular, the survival rates of patients with a pelvic LN or a small tumor are promising.

Six-week supplementation with Chlorella has favorable impact on antioxidant status in Korean male smokers.

OBJECTIVE: Chlorella vulgaris is a popular food supplement in Asia and is currently marketed as a nutritional supplement. However, available scientific studies do not support its effectiveness for preventing or treating any disease in humans. Because Chlorella contains numerous nutrients, including antioxidants, it is thought to exert antioxidative functions by scavenging free radicals created by various environmental factors such as smoking. The purpose of this study was to investigate whether 6 wk of Chlorella supplementation to smokers is protective against oxidative damage in a randomized, double-blinded, placebo-controlled trial. METHODS: Fifty-two smokers, aged 20-65 y, were given 6.3g of Chlorella or placebo every day for 6 wk. Blood samples were drawn at the beginning and after the supplementation. Plasma antioxidant vitamin levels and lipid peroxidation levels were measured. As a marker of oxidative stress, lymphocyte DNA damage was measured. RESULTS: Chlorella supplementation increased plasma vitamin C (44.4%), alpha-tocopherol (15.7%), and erythrocyte catalase and superoxide dismutase activities. Although 6 wk of Chlorella supplementation resulted in a significant decrease in lymphocyte DNA damage, as measured by comet assay, placebo supplementation also decreased the measured amount of lymphocyte DNA damage. CONCLUSION: Chlorella supplementation resulted in the conservation of plasma antioxidant nutrient status and improvement in erythrocyte antioxidant enzyme activities in subjects. Therefore, our results are supportive of an antioxidant role for Chlorella and indicate that Chlorella is an important whole-food supplement that should be included as a key component of a healthy diet.

Three-fraction stereotactic body radiation therapy for isolated liver recurrence from colorectal cancer.

AIMS: To determine the feasibility and efficacy of 3-fraction stereotactic body radiation therapy for isolated colorectal cancer liver metastases. MATERIALS AND METHODS: Ten patients with isolated inoperable liver metastasis from colorectal cancer with progression after salvage chemotherapy underwent stereotactic body radiation therapy. Follow-up was 7-49 months (median, 12). Six patients had a solitary lesion and 4 patients had 2 lesions. Internal target volumes of metastatic liver tumors ranged from 3.4 to 271 ml. Stereotactic body radiation therapy doses ranged from 36 to 51 Gy and were administered in three fractions. All patients demonstrated disease progression despite chemotherapy prior to stereotactic body radiation therapy. RESULTS: Three-year overall survival and local control rates were 40% and 60%, respectively. Tumors with an internal target volume < 100 ml showed better local control rate than larger tumors. No severe complication was attributed to the therapy. CONCLUSION: Our study suggests the potential feasibility of stereotactic body radiation therapy for selected patients with colorectal cancer liver metastasis and no treatment option. The study showed that excellent local control was achieved in patients with a total tumor volume of < 100 ml but failed to clarify the role of stereotactic body radiation therapy for larger tumors. Further large scale studies are needed to define the indications of such therapy.

Stereotactic body radiotherapy for isolated para-aortic lymph node recurrence after curative resection in gastric cancer.

The aim of this study was to investigate whether stereotactic body radiotherapy (SBRT) can salvage gastric cancer patients with para-aortic lymph node (PALN) recurrence. From January 2003 to December 2006, 7 patients were treated for isolated PALN recurrence from gastric cancer after curative resection. Follow up durations ranged from 19 to 33 months (median; 26 months), and SBRT doses from 45 Gy to 51 Gy (median 48 Gy) in 3 fractions. Disease progression-free and overall survivals and toxicities were recorded. Response to treatment was assessed by computed tomography. Final patient outcomes were as follows: 2 were alive without evidence of disease, 3 remained alive with disease, and 2 patients died of disease. Five of 7 patients showed complete response and 2 patients partial response between 3 and 11 months after SBRT. Three-year overall and disease progression-free survival rates post-SBRT were 43% and 29%, respectively. No severe complication was detected during follow-up. Selected patients with isolated PALN recurrence can be salvaged by SBRT without severe complications.

A novel derivative of the natural agent deguelin for cancer chemoprevention and therapy.

The natural compound deguelin has promising preventive and therapeutic activity against diverse cancers by directly binding to heat shock protein-90 and thus suppressing its function. Potential side effects of deguelin over a certain dose, however, could be a substantial obstacle to its clinical use. To develop a derivative(s) of deguelin with reduced potential side effects, we synthesized five deguelin analogues (SH-02, SH-03, SH-09, SH-14, and SH-15) and compared them with the parent compound and each other for structural and biochemical features; solubility; and antiproliferative effects on normal, premalignant, and malignant human bronchial epithelial (HBE) and non-small-cell lung cancer (NSCLC) cell lines. Four derivatives destabilized hypoxia-inducible factor-1alpha as potently as did deguelin. Reverse-phase protein array (RPPA) analysis in H460 NSCLC cells revealed that deguelin and the derivatives suppressed expression of a number of proteins including heat shock protein-90 clients and proteins involved in the phosphoinositide 3-kinase/Akt pathway. One derivative, SH-14, showed several features of potential superiority for clinical use: the highest apoptotic activity; no detectable influence on Src/signal transducer and activator of transcription signaling, which can promote cancer progression and is closely related to pathogenesis of Parkinson's disease (deguelin, SH-02 and SH-03 strongly activated this signaling); better aqueous solubility; and less cytotoxicity to immortalized HBE cells (versus deguelin) at a dose (1 micromol/L) that induced apoptotic activity in most premalignant and malignant HBE and NSCLC cell lines. These collective results suggest that the novel derivative SH-14 has strong potential for cancer chemoprevention and therapy, with equivalent efficacy and lesser toxicity (versus deguelin).

Phase II study of gemcitabine, UFT and leucovorin in patients with advanced pancreatic cancer.

The combination of gemcitabine with protracted 5-fluorouracil (5-FU) in the treatment of metastatic pancreatic cancer has shown activity with tolerable toxicity. The administration of UFT may simulate the effects of a protracted infusion of 5-FU. Patients with previously untreated metastatic or unresectable measurable pancreatic adenocarcinoma received gemcitabine (800 mg/m2 i.v., administered as an 80-min infusion on days 1, 8 and 15), UFT (200 mg/m2/day, on days 1 to 21), and oral leucovorin (90 mg/day, on days 1 to 21). Thirty patients were enrolled in this study. Five patients had partial responses, with an overall response rate of 17% (5/30), using the intent-to-treat principle (95% confidence interval (CI), 3-30%). Nine out of 25 (36%) patients experienced clinical benefit responses (95% CI; 17-55%). The median time to progression was 3.0 months, and the median overall survival was 7.2 months. The principal adverse event was neutropenia. The combination of gemcitabine, UFT, plus oral leucovorin shows significant antitumor activity and a beneficial clinical effect with an acceptable level of toxicity.