BACKGROUND: Toll like receptor (TLR), an element of innate immunity, is upregulated by Ischemia/reperfusion (IR) injury and may be involved in adaptive immune response. Immunosuppressive agents may increase or attenuate IR injury and TLR expression. To explore the involvement of TLRs in hypoxic tubular injury and modification by mycophenolic acid (MPA) rapamycin (RAP), this study examined TLR expression in hypoxia-induced human renal proximal tubular epithelial cells (HK-2). METHODS: HK-2 cells were cultured in keratinocyte-SFM media supplemented with epidermal growth factor and bovine pituitary extract. The Induction of hypoxia was achieved using GasPak pouch system. TLR 2, 3, and 4 mRNA expression was analyzed by real time RT-PCR using SYBR green and TLR 4 protein expression was evaluated by Western blot analysis. MPA at concentration of 100 nM and 1uM and RAP at concentration of 20, 50, and 100 nM were added to culture medium. RESULTS: TLR4 but noTLR2 or TLR3 mRNA expressions increased in hypoxic HK-2 cells at 24 and 48 hrs. TLR4 protein expression also increased in hypoxic HK-2 cells at 24 and 48 hrs. MPA (100 nM and 1uM) and RAP (20, 50, and 100 nM) decreased hypoxia-induced TLR4 mRNA expression in HK-2 cells compared to normoxia at 24 hrs. However, TLR4 protein expression was decreased only by RAP at 20 and 50 nM. CONCLUSIONS: The results suggest that RAP may modify hypoxic renal tubular damage by decreasing TLR4-mediated inflammatory and immune reactions.
Adaptive Immunity ; Anoxia ; Blotting, Western ; Epidermal Growth Factor ; Epithelial Cells ; Humans ; Immunity, Innate ; Immunosuppressive Agents ; Mycophenolic Acid ; RNA, Messenger ; Sirolimus ; Toll-Like Receptors

Purpose: Interpersonal competence, a key competence for patient-centered care by nurses, should be understood. Therefore, factors influencing the interpersonal competence of nursing students should be identified to explore and enhance their interpersonal relationships during the undergraduate educational curriculum for nursing educators. In this study factors influencing interpersonal competence, especially on self-assertiveness and empathy in nursing students were identified and analysed. Methods: A cross-sectional study design was used for the study in two Korean nursing colleges with similar baccalaureate nursing curricula. A total of 251 nursing students from freshman to senior year completed a questionnaire to measure related factors that were assumed to influence nursing students’ interpersonal competence. Data were collected from October 11~31, 2016. Study variables included self-assertiveness, empathy, interpersonal competence, and socio-demographic status. Multiple regression analysis was used for data analysis. Results: Nursing students’ interpersonal competence was explained by personality (β=.22), self-assertiveness (β=.16) and empathy (β=.38). The explanatory power of these predictors was 26.8% (p<.001). Conclusions Nursing students’ interpersonal competence during the undergraduate nursing years can be enhanced by educational strategies that improve their interpersonal relationship as patient-centered care providers. Simultaneously, the attitude of the nurse educator is also important for nursing students who are to be treated as valuable learners and to improve students' empathy and self-assertiveness ability.

BACKGROUND: Helicobacter pylori infection is a major risk factor in the development of gastric cancer. H. pylori infection of gastric epithelial cells increases the levels of reactive oxygen species (ROS), activates oncogenes, and leads to β-catenin-mediated hyper-proliferation. β-Carotene reduces ROS levels, inhibits oxidant-mediated activation of inflammatory signaling and exhibits anticancer properties. The present study was carried out to determine if β-carotene inhibits H. pylori-induced cell proliferation and the expression of oncogenes c-myc and cyclin E by reducing the levels of β-catenin and phosphorylated glycogen synthase kinase 3β (p-GSK3β). METHODS: Gastric epithelial AGS cells were pre-treated with β-carotene (5 and 10 μM) for 2 hours prior to H. pylori infection and cultured for 6 hours (for determination of the levels of p-GSK3β, GSK3β, and β-catenin) and 24 hours (for determination of cell viability and protein levels of c-myc and cyclin E). Cell viability was determined by the MTT assay and protein levels were determined via western blot-based analysis. RESULTS: β-Carotene inhibited H. pylori-induced increases in the percentage of viable cells, phosphorylated GSK3β (p-GSK3β), and the levels of β-catenin, c-myc and cyclin E. CONCLUSIONS: β-Carotene inhibits H. pylori-induced hyper-proliferation of gastric epithelial cells by suppressing β-catenin signaling and oncogene expression.
beta Carotene ; beta Catenin ; Cell Proliferation ; Cell Survival ; Cyclin E ; Cyclins ; Epithelial Cells ; Glycogen Synthase Kinases ; Helicobacter pylori ; Helicobacter ; Oncogenes ; Reactive Oxygen Species ; Risk Factors ; Stomach Neoplasms

Pancreaticopleural fistula (PPF) a fistulous connection between the pancreas and pleural space due to prolonged chronic pancreatitis (CP). PPF is a very rare complication which presents in 0.4% of chronic pancreatitis cases, especially among children. We report a case involving a 3-year-old boy who presented with pleural effusion caused by a PPF, a complication of hereditary pancreatitis, which was, for the first time in Korea, successfully managed with endoscopic treatment. Chest radiography and computed tomography showed massive pleural effusion. Percutaneous catheter drainage was performed. High amylase levels were observed in the pleural fluid and serum, suggesting PPF. The patient was managed with bowel rest and octreotide infusion. Endoscopic retrograde cholangiopancreatography revealed CP, and pleural effusion was successfully managed with stent placement. PRSS1 genetic screening revealed R122H mutation.
Amylases ; Catheters ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Fistula ; Genetic Testing ; Humans ; Korea ; Male ; Octreotide ; Pancreas ; Pancreatic Fistula ; Pancreatitis ; Pancreatitis, Chronic ; Pleural Effusion ; Radiography ; Stents ; Thorax

Purpose: This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management. Methods: A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns. Results: The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly. Conclusion Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.

Purpose: This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management. Methods: A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns. Results: The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly. Conclusion Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.

Purpose: This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management. Methods: A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns. Results: The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly. Conclusion Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.

Pelvic actinomycosis is an uncommon infectious disease. It induces a chronic, suppurative illness characterized by an infiltrative and granulomatous response and, thus, the clinical and radiologic findings may mimic other inflammatory and neoplastic conditions. A 56-year-old female with a long-standing intrauterine device was diagnosed with pelvic actinomycosis manifesting as a large uterine mass with locally infiltrative spread into surrounding tissue that mimicked uterine malignancy. Actinomyces israelii infection was confirmed with a surgical specimen, and the patient was treated with antibiotic medication. Pelvic actinomycosis must be included in the differential diagnoses of patients with an infiltrative pelvic mass extending across tissue planes or in patients with findings of multiple microabscesses, particularly in a patient with an intrauterine device, even the lesion primarily involves the uterus.
Actinomyces ; Actinomycosis ; Communicable Diseases ; Diagnosis, Differential ; Female ; Humans ; Intrauterine Devices ; Middle Aged ; Pelvic Inflammatory Disease ; Uterus

The national licensing examination is used to evaluate the medical competency at the time of graduation, however no study has been performed on the validity of traditional Korean medicine license examination yet. The purpose of this study was to develop learning analytics using item response theory (IRT) to examine the validity and academic competency of the mock test of the national licensing exam. Classical test theory and IRT were used to evaluate the validity of test items, and IRT was used for test validity and competency analysis. The correlation between competency score of 12 subjects was analyzed using Pearson’s correlation. The distribution of students’ latent competencies was examined by gender and administrative group using a Kernel density map, Latent Profile Analysis, and χ2. The guessing parameter of 340 items was relatively high, and the information level of 12 subjects were relatively low. Significant correlations (r = 0.49–0.83, p < 0.05) were observed between the competency scores of total and 12 subjects. Two (high and low) latent academic competency groups were identified based on the competency score of 12 subjects. The low academic competency group requiring intensive management has a significantly higher frequency of male students with the experience of academic fail in the seven-year course. This study presented the quantitative learning analytics for the national licensing exam of traditional Korean medicine. The multifaceted item and test validities of the mock license test were provided, and an evidence-based approach to competency-based student management and national licensing exam of traditional Korean medicine was suggested.

Background: The increased prevalence of obesity has led to increases in the prevalence of chronic diseases worldwide. There is interest whether probiotics have an effect on obesity, but the effectiveness and safety of only a few probiotics for the treatment of obesity have been reported. The purpose of this study was to investigate whether ingestion of Lactobacillus sakei (CJLS03) derived from kimchi causes weight loss in people with obesity. Methods: This randomized, double-blind, placebo-controlled, clinical trial involved 114 adults with a body mass index (BMI) ≥25 kg/m2 who were assigned randomly to a CJLS03 or placebo group. The groups received two allocations of either 5×109 colony-forming units of CJLS03/allocation or the equivalent vehicle for 12 weeks. Demographic and biochemical parameters, and body composition including fat and muscle mass were measured at baseline and after 12 weeks. Changes in body fat, weight, and waist circumference were compared between the two treatment groups. Adverse events were monitored during study period. Results: Body fat mass decreased by 0.2 kg in the CJLS03 group and increased by 0.6 kg in the placebo group (0.8 kg difference, P=0.018). After the 12 weeks, waist circumference was 0.8 cm smaller in the CJLS03 group than in the placebo group (P=0.013). BMI and body weight did not change after the 12 weeks. Adverse events were mild and did not differ between the two groups. Conclusion These data suggest that L. sakei (CJLS03) might help people with obesity reduce body fat mass without serious side effects (ClinicalTrials.gov: NCT03248414).