Objectives: To conduct a comparative study of children’s health in South Korea versus North Korea focusing on air pollution. Methods: We used annual mortality rate, prevalence, and environmental indicators data from the World Bank and World Health Organizations (WHO). Trend analysis of the two Koreas was conducted to evaluate changes in health status over time. Spearman’s correlation analysis was used to find out the correlation between environmental indicators and children’s health status. Results: We found a distinct gap in children’s health status between the two Koreas. While North Korea reported a higher death rate of children than South Korea, both showed a decreasing trend with the gap narrowing from 2000 to 2017. The prevalence of overweight and obesity increased and that of thinness decreased in both Koreas. Except PM2.5 exposure, South Korea reported higher figures in most indicators of air pollutant emissions (South Korea, mean (SD)=28.3 (2.0); North Korea, mean (SD)=36.5 (2.8), P-value=0.002). Conclusion This study empirically discovered the gaps and patterns of children’s health between South Korea and North Korea. North Korean children experienced more severe health outcomes than children in South Korea. These findings imply that epigenetic modification caused by environmental stressors affect children’s health in the two Koreas despite similar genetic characteristics. Considering the gaps in children’s health between the two Koreas, more attention and resources need to be directed towards North Korea because the necessary commodities and services to improve children’s health are lacking in North Korea.

Purpose: South Korea ranked 18th out of the 162 participating countries in the 2019 report on sustainable development goals (SDGs). Among the 17 specified goals, it has the most difficulty in achieving gender equality (SDG 5). This shortcoming is manifested in the lack of studies on gender-sensitive indicators. The study aims to establish the significance of the development of a comprehensive health matrix to concretize the concept of gender-sensitivity which is often considered as abstract. Methods: An integrated analysis of health determinants was conducted through a convergence study involving medical, social and natural sciences. This analysis was based on both literature reviews and focusgroup discussions. The 6 following focal points were chosen based on the SDGs: gender equality, medicine, education, economy, nutrition, and environment. Objective quantitative indicators were then designated to each of the 6 areas and comparatively analyzed for South Korea, North Korea, and the other SDGs countries. Four areas on sexual and reproductive health were also selected. Results: The results indicated that South Korea scored much lower than North Korea and the other SDGs countries in terms of gender equality. It was also behind North Korea in education, although North Korea had a comparatively lower ranking in the rest of the areas. On the other hand, it fared better than the aforementioned countries with respect to environment, nutrition, medicine, and economy. Conclusion A comprehensive gender-sensitive health matrix was developed to refine the abstract concept of gender-sensitivity through objective quantitative indicators that assess the health status of a country by means of a scoring system. Gender equality was also confirmed as a common and significant component in the disciplines of sexual and reproductive health and comprehensive health.

Purpose: South Korea ranked 18th out of the 162 participating countries in the 2019 report on sustainable development goals (SDGs). Among the 17 specified goals, it has the most difficulty in achieving gender equality (SDG 5). This shortcoming is manifested in the lack of studies on gender-sensitive indicators. The study aims to establish the significance of the development of a comprehensive health matrix to concretize the concept of gender-sensitivity which is often considered as abstract. Methods: An integrated analysis of health determinants was conducted through a convergence study involving medical, social and natural sciences. This analysis was based on both literature reviews and focusgroup discussions. The 6 following focal points were chosen based on the SDGs: gender equality, medicine, education, economy, nutrition, and environment. Objective quantitative indicators were then designated to each of the 6 areas and comparatively analyzed for South Korea, North Korea, and the other SDGs countries. Four areas on sexual and reproductive health were also selected. Results: The results indicated that South Korea scored much lower than North Korea and the other SDGs countries in terms of gender equality. It was also behind North Korea in education, although North Korea had a comparatively lower ranking in the rest of the areas. On the other hand, it fared better than the aforementioned countries with respect to environment, nutrition, medicine, and economy. Conclusion A comprehensive gender-sensitive health matrix was developed to refine the abstract concept of gender-sensitivity through objective quantitative indicators that assess the health status of a country by means of a scoring system. Gender equality was also confirmed as a common and significant component in the disciplines of sexual and reproductive health and comprehensive health.

Patients with diabetes mellitus (DM) often suffer from diverse skin disorders, which might be attributable to skin barrier dysfunction. To explore the role of lipid alterations in the epidermis in DM skin disorders, we quantitated 49 lipids (34 ceramides, 14 free fatty acids (FFAs), and cholesterol) in the skin epidermis, liver, and kidneys of db/db mice, a Type 2 DM model, using UPLC-MS/MS. The expression of genes involved in lipid synthesis was also evaluated. With the full establishment of hyperglycemia at the age of 20 weeks, remarkable lipid enrichment was noted in the skin of the db/db mice, especially at the epidermis and subcutaneous fat bed. Prominent increases in the ceramides and FFAs (>3 fold) with short or medium chains ( Animals ; Ceramides ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Epidermis ; Fatty Acids, Nonesterified ; Humans ; Hyperglycemia ; Kidney ; Liver ; Mice ; Receptors, Cytoplasmic and Nuclear ; Skin ; Stearoyl-CoA Desaturase ; Subcutaneous Fat

Acute subdural hematoma (SDH) is a neurological trauma that can lead to death or life-long disability of the patient. It is usually diagnosed by examination of the patient's brain computed tomography (CT) images. While macroscopic change in the posttraumatic brain can be identified using this mode of diagnosis, visualization of abnormal change in cerebral blood flow and the resulting brain damage following a head injury is often difficult. The two patients studied in this case report were similar in terms of thickness and volume of subdural hematoma and severity of midline shift. However, their perfusion parameters were markedly different and so were their outcomes. According to findings of our study, with its perfusion parameters, CT brain perfusion imaging is a practical tool for use in initial evaluation of patients with traumatic brain injury and for prediction of the clinical prognosis. Subsequently, we may use the information for help in planning of treatment and in preparation for post-operative complication based on the severity of brain damage.
Brain ; Brain Injuries ; Craniocerebral Trauma ; Emergencies ; Head ; Hematoma, Subdural ; Hematoma, Subdural, Acute ; Humans ; Perfusion ; Perfusion Imaging ; Prognosis

BACKGROUND: Lithospermic acid B (LAB), an active component isolated from Salvia miltiorrhizae, has been reported to have renoprotective effects in type 1 and type 2 diabetic animal models. We examined the effects of LAB on the prevention of diabetic nephropathy compared with amlodipine, a calcium channel blocker, and losartan, an angiotensin receptor blocker, in Otsuka Long-Evans-Tokushima Fatty (OLETF) rats, an animal model of type 2 diabetes. METHODS: LAB (20 mg/kg), amlodipine (10 mg/kg), or losartan (10 mg/kg) was given orally once daily to 10-week-old male OLETF rats for 28 weeks. RESULTS: None of LAB, losartan, and amlodipine exhibited effects on blood glucose levels. Treatment with amlodipine or losartan resulted in similar reductions in blood pressure; however, LAB was less effective in lowering blood pressure. Albuminuria was markedly suppressed by losartan and LAB, but not by amlodipine. LAB treatment decreased levels of renal lipid peroxidation, monocyte chemoattractant protein-1 (MCP-1), and transforming growth factor-beta1 (TGF-beta1). CONCLUSION: These results suggest that LAB has beneficial effects on the diabetic nephropathy in OLETF rats by decreasing oxidative stress and inflammation as potent as losartan.
Albuminuria ; Amlodipine ; Angiotensins ; Animals ; Benzofurans ; Blood Glucose ; Blood Pressure ; Calcium Channels ; Chemokine CCL2 ; Depsides ; Diabetic Nephropathies ; Humans ; Inflammation ; Lipid Peroxidation ; Losartan ; Male ; Models, Animal ; Oxidative Stress ; Pyridines ; Rats ; Rats, Inbred OLETF ; Salvia miltiorrhiza ; Thiazoles

PURPOSE: Vascular smooth muscle cell (VSMC) proliferation plays an important role in the development and progression of chronic allograft vasculopathy. Mycophenolic acid (MPA) inhibits various mesenchymal cell proliferation, and reactive oxygen species (ROS) are involved in the anti-pro-liferative effect of MPA. In this study, we investigated the effects of MPA on oleic acid (OA)-induced VSMC proliferation and also the role of ROS in these processes. METHODS: Primary cultured rat VSMCs from Sprague-Dawley were stimulated with OA 100micrometer. MPA 0.1~10micrometer and N-acetylcystein (NAC) 5 mM were administered 1 hour before adding the OA. Cell proliferation was measured by Methylthiazoletetrazolium (MTT) assay, proliferating cell nuclear antigen (PCNA) expression by Western blot analysis, and dichlorofluorescein (DCF)-sensitive cellular ROS by flow cytometry. RESULTS: OA at 100micrometer significantly increased MTT level by 1.6-fold as well as PCNA expression at 48 hours in rat VSMCs. OA also induced DCF-sensitive cellular ROS by 1.6-fold at 5 minutes and the increment of cellular ROS remained for up to 1 hour. MPA at above 1micrometer inhibited OA- induced VSMC proliferation and cellular ROS in a dose-ependent manner. NAC 5 mM also inhibited OA-induced rat VSMC activation. CONCLUSION: These results suggest that MPA inhibits OA-induced VSMC proliferation partially through the inhibition of cellular ROS.
Allografts ; Animals ; Blotting, Western ; Cell Proliferation* ; Flow Cytometry ; Muscle, Smooth, Vascular* ; Mycophenolic Acid* ; Oleic Acid ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Reactive Oxygen Species

PURPOSE: Bone morphogenic protein (BMP)-7, a member of TGF-beta1 superfamily, is an endogenous antifibrotic protein highly expressed in normal kidney. It is not known, however, whether human peritoneal mesothelial cells (HPMC) express BMP-7 or if BMP-7 protects against peritoneal fibrosis and by what mechanism. We examined the effect of BMP-7 overexpression in TGF-beta1-induced epithelial-mesenchymal transition (EMT) of HPMC and in TGF-beta1 signaling in HPMC to elucidate the mechanisms of antifibrotic effect of BMP-7. METHODS: Growth arrested and synchronized HPMC were stimulated with 2 ng/mL of TGF-beta1 to induce EMT. HPMC were transiently transfected with adenovirus-mediated human BMP-7 (AdBMP-7) or with GFP (AdGFP). EMT was defined as downregulation of E-cadherin and upregulation of alpha-smooth muscle actin (SMA). RESULTS: HPMC constitutively expressed BMP-7 mRNA and protein. BMP-7 mRNA and protein expression were significantly inhibited by 50 mM D-glucose, 2x diluted commercial peritoneal dialysis solution, and 2 ng/ml of TGF-beta1. Transfection of AdBMP-7 resulted in 2.5-fold increase in BMP-7 mRNA expression in HPMC. TGF-beta1 significantly decreased E-cadherin and increased alpha-SMA expression in GFP transfected cells. BMP-7 overexpression effectively reversed TGF-beta1-induced E-cadherin and alpha-SMA expression and significantly suppressed TGF-beta1-induced phosphorylation of Smad2/3, ERK1/2, JNK, and p38 MAPK in HPMC as compared to GFP transfected cells. CONCLUSION: BMP-7 is an endogenous antifibrotic protein and downregulation of BMP-7 in HPMC by high glucose, PD solution, and TGF-beta1 may permit the development of peritoneal fibrosis during long-term PD. Our data demonstrate that BMP-7 overexpression reverses TGF-beta1-induced EMT of HPMC and consequent peritoneal fibrosis possibly through inhibition of Smad2/3 and MAPK phosphorylation.
Actins ; Bone Morphogenetic Protein 7* ; Cadherins ; Down-Regulation ; Epithelial-Mesenchymal Transition ; Glucose ; Humans ; Kidney ; p38 Mitogen-Activated Protein Kinases ; Peritoneal Dialysis ; Peritoneal Fibrosis ; Peritoneum* ; Phosphorylation ; RNA, Messenger ; Transfection ; Transforming Growth Factor beta1 ; Up-Regulation

PURPOSE: Proliferation and extracellular matrix (ECM) accumulation in the vascular smooth muscle cell (VSMC) and glomerular mesangial cell (MC) play key roles in the development and the progression of transplant glomerulosclerosis and chronic allograft nephropathy. Tautomycetin (TMC), a newly developed immunosuppressive agent, induces T-lymphocyte apoptosis through the inhibition of tyrosine kinase and protein phosphatase 1. We examined the effects of TMC on platelet-derived growth factor (PDGF)-induced proliferation and ECM synthesis in cultured VSMCs and MCs of Sprague- Dawley rats, and investigated the molecular mechanisms that are involved. METHODS: Different concentrations of TMC were administered 1 hour before the addition of PDGF 10 ng/mL into the growth-arrested and synchronized cells. Cell proliferation was assessed by methylthiazoletetrazolium (MTT) assay. Caspase-3 cleavage, fibronectin secretion, and the activation of Akt, ERK, and p38 MAPK were assessed by Western blot analysis, respectively. RESULTS: PDGF 10 ng/ mL increased cell proliferation, fibronectin secretion, and the activation of Akt, ERK, and p38 MAPK in both VSMCs and MCs. In both cultured cells, TMC at above 1 microgram/mL significantly reduced basal MTT and increased cleavage caspase-3 in a dose-dependent manner. TMC at 100 ng/mL decreased the PDGF-induced VSMC and MC proliferation without cytotoxicity. However, fibronectin secretion and the activation of Akt, ERK, and p38 MAPK were not affected at this low concentration of TMC, respectively. CONCLUSION: The present data demonstrated that low-dose TMC reduced PDGF-induced VSMC and MC proliferation without affecting the fibronectin secretion and cellular kinase activation.
Allografts ; Animals ; Apoptosis ; Blotting, Western ; Caspase 3 ; Cell Proliferation ; Cells, Cultured ; Extracellular Matrix ; Fibronectins* ; Mesangial Cells* ; Muscle, Smooth, Vascular* ; p38 Mitogen-Activated Protein Kinases ; Phosphotransferases ; Platelet-Derived Growth Factor ; Protein Phosphatase 1 ; Protein-Tyrosine Kinases ; Rats ; T-Lymphocytes

PURPOSE: Increased oxidative stress and chronic inflammatory process have been substantially linked with the development and progression of chronic renal failure. However, the roles of oxidative stress and inflammation in chronic renal allograft dysfunction are not yet clear. The present study examined the plasma levels of lipid peroxides (LPO), C-reactive protein (CRP), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), transforming growth factor-beta1 (TGF-beta1), and heat shock protein 70 (Hsp 70) as the representative markers of oxidative stress, the inflammatory process and fibrosis among healthy control subjects (kidney donors, n=24), end-stage renal disease (ESRD) patients (n=28), transplant recipients with a serum creatinine (Scr) less than 1.5 mg% (n=30), and transplant recipients with Scr between 1.5 and 5.0 mg% (n=32) during the time at least one year after renal transplantation. METHODS: The plasma LPO concentration was measured by a thiobarbituric acid (TBA) reaction, CRP was measured by latex-enhanced immunonephelometric assay, and TGF-beta1, IL-6, sIL-6R, and HSP 70 were measured by enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS: The Plasma concentrations of LPO, TGF-beta1, Hsp 70, and IL-6 were significantly higher in both the ESRD and renal transplant recipients with Scr levels between 1.5 and 5.0 mg% than in both the healthy controls and transplant patients with Scr levels below 1.5 mg%. Plasma sIL-6R was significantly increased only in the ESRD patients. Among the other 3 groups, the concentrations of sIL-6R were not different between the groups. The plasma CRP concentrations were not different among the 4 study groups. Upon regression analysis, the plasma concentrations of LPO, TGF-beta1, Hsp 70, IL-6 and sIL-6R were positively correlated with the Scr level, respectively. CONCLUSION: Our results demonstrate that the markers of oxidative stress, inflammation and fibrosis were correlated with the Scr level which represents the graft (and native) renal function.
Allografts ; C-Reactive Protein ; Creatinine* ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; HSP70 Heat-Shock Proteins ; Humans ; Inflammation ; Interleukin-6 ; Kidney Failure, Chronic ; Kidney Transplantation* ; Lipid Peroxides ; Living Donors* ; Oxidative Stress* ; Plasma* ; Receptors, Interleukin-6 ; Tissue Donors ; Transforming Growth Factor beta1 ; Transplantation ; Transplants