BACKGROUND: Stratum corneum lipids serve as a water retainer as well as permeability barrier by forming a multi-lamellae structure in the stratum corneum. The major constituent of these lipids, ceramides, have been shown to be predominantly associated with both functions. OBJECTIVE: Exposure of human epidermis to ultraviolet(UV) irradiation leads to changes in the physiologic and biochemical features of the skin. In order to investigate the effect of UVB irradiation on the skin barrier function in hairless mice, transepidermal water loss (TEWL) and lipid composition of stratum corneum were evaluated in hairless mice. METHODS: Hairless mice were irradiated 3 times weekly for 3 weeks with suberythemal dose (0.6MED, Group I) and minimal erythemal dose(MED), Group II) of UB. The mice of Group III received high dose of UVB(3MED) on the back in a single exposure. The control was Group IV. TEWL measured by evaporimeter and lipid composition of stratum corneum appraised by high performance thin layer chromatography(HPTLC) were evaluated weekly for 3 weeks. RESULTS: 1. Each time it was measured, the values of TEWL in group I were lower than group IV, but the difference was not significant. The peak value of TEWL in group II was 8.2+/-1.56 g/cm/h on the 7th day. The increase in TEWL was markedly significant at this point(P<0.001). Although the values of TEWL on the 14th and 21th day in group E increased compared with those of the control group, the significance of the values decreased (P<0.05). 2. The peak value of TEWL in group III was 9.88+/-1.13 g/cm/h on the 2nd day, showed a markedly significant increase compared with that of the control group(P<0.001). The values of TEWL decreased to the level of the control group on the 14th day. 3. The lipid(cholesterol sulfate, ceramide and neutral lipid) and total lipid mass in group 1 were insignificantly larger than that of the group IV measured each time. On the 7th and 14th day, the amount of each three lipid and total lipid mass significantly increased (P<0.05). On the 21th day, the amount of ceramide and neutral lipid showed a significant increase(P<0.05), furthermore the total lipid mass increased pronouncedly(P<0.01) in group II. 4. The amount of the 3 kinds of lipid and total lipid mass in group III significantly increased compared with those of the control group on the 2nd day(P<0.05). After the 7th day, no significant difference of the lipid mass except neutral lipid compared with that of the control group was seen. Comparing the 2nd and 14th day, there was a significant decrease in the amount of ceramide and total lipid mass(P<0.05) CONCLUSION: These results results suggest that considerable amount of UVB irradiation given in single or repeated exposure causes the disruption of skin barrier function, but a compensatory increase of skin lipid, especially ceramide, protests it from further damage and also improves skin barrier function.
Animals ; Ceramides ; Epidermis ; Humans ; Mice ; Mice, Hairless* ; Permeability ; Skin*

BACKGROUND: Influenza vaccine coverage among the elderly is important for informed vaccination policies and programs. There are few studies that define influenza coverage in the elderly in South Korea. The aim of this study is to examine influenza vaccination coverage among those 65 years old and older in South Korea over the 2004-2005 influenza season and to identify the socioeconomic and clinical factors associated with vaccination. METHODS: We analyzed data retrieved from The Third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005 conducted by the Korea Centers for Disease Control and Prevention. Subjects included in this study were older than 65 years. We used questionnaires to obtain information regarding demographics, chronic diseases, and individual health behavioral risk factors. Univariate analysis, logistic regression, and trend test were performed. RESULTS: There were 1,097 persons included in this study. Influenza vaccination among those 65 years old and older was 77.2 %. There was no difference of coverage by sex, education level, and income status. For elderly females, the moreunheal thy lifestyle (currently smoking, heavy alcohol use, and no exercise) that was practiced, the less likely they wereto be vaccinated (p for trend=0.007). CONCLUSION: The influenza vaccination coverage rate among the elderly in South Korea during the 2004-2005 flu season was relatively high compared to that of Europe (19.3-26.5 %) during the same season. Nevertheless, the coverage rate in elderly women with unhealthy lifestyle was not satisfactory causing them to be more vulnerable to related illnesses than those who practiced a healthy lifestyle. To prevent influenza related illnesses, clinicians should, in particular, encourage vaccination in those with an unhealthy lifestyle, as well as, lifestyle modification.
Aged ; Centers for Disease Control and Prevention (U.S.) ; Chronic Disease ; Cross-Sectional Studies ; Demography ; Europe ; Female ; Health Behavior ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Life Style ; Logistic Models ; Nutrition Surveys ; Surveys and Questionnaires ; Republic of Korea ; Risk Factors ; Seasons ; Smoke ; Smoking ; Vaccination

PURPOSE: Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services. METHODS: We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015. Participants were African refugee women, aged over 18 years, who had given birth in Korea within the previous 5 years and had come to Korea over a year before recruitment. Interview questions examined participants' experiences in pregnancy and childbirth and concerns regarding their child's health status. Initial data analysis involved all researchers' immersion in the entire collection of transcripts. We then noted recurrent topics and themes and identified similar issues. RESULTS: At the time of giving birth, 5 participants were asylum seekers and one had undocumented status. The following barriers impeded their access to maternal child healthcare: socioeconomic factors (unstable social identity, low economic status, difficulty obtaining health insurance), language barriers (lack of linguistically appropriate health information, limited access to translation services), and cultural barriers (religious and cultural differences). Weak social support also hindered access to healthcare soon after migration; however, social links with the community emerged as a key coping strategy following settlement. CONCLUSION: We identified barriers to maternal and child healthcare and coping strategies among African refugee mothers in Korea. Future research should assess refugees' health status and improve health access and literacy among refugee mothers.
Child ; Communication Barriers ; Delivery of Health Care* ; Emigrants and Immigrants ; Female ; Health Services Accessibility ; Humans ; Immersion ; Infant ; Korea* ; Literacy ; Maternal-Child Health Services ; Mothers* ; Parturition ; Pregnancy ; Refugees* ; Social Identification ; Socioeconomic Factors ; Statistics as Topic

Background: The objective of this article is to assess the mental health issues of the mild condition coronavirus disease 2019 (COVID-19) patients admitted to a community treatment center (CTC) in Korea. Methods: A total of 107 patients admitted to a CTC were included as the study population, and their mental health problems including depression (patient health questionnaire-9), anxiety (generalized anxiety disorder scale-7), post-traumatic stress disorder (PTSD) (PTSD checklist-5) and somatic symptoms (by patient health questionnaire-15) were evaluated every week during their stay. The stigma related to COVID-19 infection was evaluated with an adjusted version of the Middle East respiratory syndrome (MERS) stigma scale. Results: During the first week of isolation, the prevalence of more-than-moderate depression was 24.3%, more-than-moderate anxiety was 14.9%, more-than-moderate somatic symptoms was 36.5% and possible PTSD was 5.6% of total population. For depression and anxiety, previous psychiatric history and stigma of COVID-19 infection were significant risk factors. For PTSD, previous psychiatric history and stigma of COVID-19 infection as well as total duration of isolation were found to be significant risk factors. Prevalence of depression, anxiety and possible PTSD remained similar across the four weeks of observations, though the prevalence of severe depression, increased after four weeks of stay. Somatic symptoms seemed to decrease during their stay. Conclusion The results suggest that social mitigation of COVID-19 related stigma, as well as care of patients with pre-existing mental health problems are important mental health measures during this crisis period. It is also important that clinical guidelines and public health policies be well balanced over the protection of the public and those quarantined to minimize the negative psychosocial consequences from isolation of the patients.

Background: This study compared chronic diseases and health-related quality of life (HRQoL) in between primary care underserved areas residents and the general population. Methods: Underserved areas were identified according to accessibility and the time relevance index for primary care. Overall, 279 participants aged ≥60 years from four counties enrolled voluntarily. A total of 1,873 individuals were assigned in the control group using the Korea National Health and Nutrition Examination Survey database. We assessed the differences in prevalence, awareness, and control of hypertension and diabetes and HRQoL using both subjective health status and the Korean version of the EuroQol-5D (EQ-5D) questionnaire using multivariate logistic regression analysis between the two groups. Results: For hypertension, prevalence did not differ significantly between the two groups, whereas awareness and control were lower in the underserved areas than that in the general population; the adjusted odds ratios (95% confidence interval) were 0.40 (0.25–0.64) and 0.27 (0.18–0.41), respectively. For diabetes, differences in prevalence, awareness, and control were statistically insignificant. The proportion reporting poor subjective health status and problems in four EQ-5D indexes (ability to exercise, daily activities, pain/discomfort, anxiety/depression) was higher in the underserved areas, which also had a lower EQ-5D index, than that in the general population. Conclusion Primary care underserved area residents were underdiagnosed and under-controlled for hypertension and reported poorer subjective health and HRQoL compared to the general population. Primary care is the attributable factor to awareness and control of chronic diseases and subjective health and QoL in communities.

PURPOSE: Interprofessional communication skills are an essential competency for medical students training to be physicians. Nevertheless, interprofessional education (IPE) is relatively rare in Korean medical schools compared with those overseas. We attempted to evaluate the effectiveness of the first IPE program in our school. METHODS: In the first semester of the school year 2018, third-grade medical students (N=149) at the Seoul National University College of Medicine participated in ‘communication between healthcare professionals in the clinical field’ training, which consisted of small group discussions and role-play. To evaluate the effectiveness of this training, we conducted pre- and post-training questionnaire surveys. Comparing paired t-tests, we evaluated the students' competency in interpersonal communication and their attitude towards the importance of IPE before and after the training. The Global Interpersonal Communication Competence Scale (GICC-15) was used to evaluate competency in interpersonal communication. RESULTS: Out of 149 students, 144 completed the pre- and post-training questionnaires. The total GICC-15 scores before and after training were 55.60±6.94 (mean±standard deviation) and 58.89±7.34, respectively (p=0.000). All subcategory scores of GICC-15 after training were higher after training and were statistically significant (p<0.05), except for two subcategories. The importance of IPE score also improved after training but was not significant (p=0.159). The appropriateness of content and training method scores were 3.99±0.92 and 3.94±1.00, respectively. CONCLUSION: From the results, our school's IPE program demonstrated a positive overall educational effect. Deployment of systematic and varied IPE courses is expected in the future, with more longitudinal evaluation of educational effect.
Delivery of Health Care ; Education ; Humans ; Interprofessional Relations ; Mental Competency ; Methods ; Role Playing ; Schools, Medical ; Seoul ; Students, Medical

PURPOSE: Interprofessional communication skills are an essential competency for medical students training to be physicians. Nevertheless, interprofessional education (IPE) is relatively rare in Korean medical schools compared with those overseas. We attempted to evaluate the effectiveness of the first IPE program in our school. METHODS: In the first semester of the school year 2018, third-grade medical students (N=149) at the Seoul National University College of Medicine participated in ‘communication between healthcare professionals in the clinical field’ training, which consisted of small group discussions and role-play. To evaluate the effectiveness of this training, we conducted pre- and post-training questionnaire surveys. Comparing paired t-tests, we evaluated the students' competency in interpersonal communication and their attitude towards the importance of IPE before and after the training. The Global Interpersonal Communication Competence Scale (GICC-15) was used to evaluate competency in interpersonal communication. RESULTS: Out of 149 students, 144 completed the pre- and post-training questionnaires. The total GICC-15 scores before and after training were 55.60±6.94 (mean±standard deviation) and 58.89±7.34, respectively (p=0.000). All subcategory scores of GICC-15 after training were higher after training and were statistically significant (p<0.05), except for two subcategories. The importance of IPE score also improved after training but was not significant (p=0.159). The appropriateness of content and training method scores were 3.99±0.92 and 3.94±1.00, respectively. CONCLUSION From the results, our school's IPE program demonstrated a positive overall educational effect. Deployment of systematic and varied IPE courses is expected in the future, with more longitudinal evaluation of educational effect.

Background: and Purpose Despite the growing demands and challenges faced by patients with amyotrophic lateral sclerosis (ALS) in accessing healthcare services, our understanding of this access remains poor. This study aimed to investigate the healthcare utilization patterns and timing of nutritional and respiration support in patients with ALS in South Korea. Methods: A retrospective cohort study was conducted on patients diagnosed with ALS at a single tertiary hospital between 2016 and 2019 and followed up for 2 years. We evaluated patient characteristics, healthcare utilization (hospital admissions, outpatient visits, and emergency department [ED] visits), and the timing of nutritional and respiration support (noninvasive positive pressure ventilation [NIPPV], tracheostomy, gastrostomy, and nasogastric tube) at 6-month intervals from the first outpatient visit. Results: Among the 143 included patients, 73.4% were admitted at least once, 18.9% experienced unplanned admissions, and 30.1% visited the ED at least once during the study period.The most-common reason for ED visits was neurological symptoms during the first 6 months (59.1%), followed by respiratory symptoms. One fifth of patients who visited the ED underwent tracheostomy (20.9%) or NIPPV (20.9%). Two years after the first visit, 32.2% used a ventilator, and 13.3%, 26.6%, and 6.3% had undergone tracheostomy, gastrostomy, and nasogastric tube insertion, respectively. Conclusions During the 2 years following their first outpatient visit, 20% of patients with ALS experienced unplanned admissions and 30% visited the ED. An active and prompt supportivecare program should be implemented to ensure timely functional support in order to reduce these risks of unplanned admissions.

BACKGROUND: Although Asian people are known to have lower bone mass than that of Caucasians, little is known about coffee-associated bone health in Asian. This study aimed to assess the relationship between coffee consumption and bone mineral density (BMD) in Korean premenopausal women. METHODS: Data were obtained from the Fourth Korea National Health and Nutrition Examination Survey 2008-2009. The study population consisted of 1,761 Korean premenopausal women (mean age 36 years) who were measured for lumbar spine and femoral neck BMD and who completed a standardized questionnaire about coffee intake frequency. We excluded the participants who took hormone replacement therapy or medication for osteoporosis. The cross-sectional relationship between coffee consumption and impaired bone health (osteopenia or osteoporosis) was investigated by bone densitometry. RESULTS: Coffee consumption showed no significant association with BMD of either femoral neck or lumbar spine, independent of other factors. The adjusted odds ratios for BMD for those who consumed once in a day, twice a day and three times a day were 0.94 (0.70-1.26), 0.93 (0.67-1.28), and 1.02 (0.69-1.50), respectively (P for trend = 0.927). CONCLUSION: This study does not support the idea that coffee is a risk factor for impaired bone health in Korean premenopausal women.
Asian Continental Ancestry Group ; Bone Density* ; Coffee* ; Densitometry ; Female ; Femur Neck ; Hormone Replacement Therapy ; Humans ; Korea ; Nutrition Surveys ; Odds Ratio ; Osteoporosis ; Premenopause ; Surveys and Questionnaires ; Risk Factors ; Spine