The purpose of this study was to identify job frequency and the training needs of dieticians in elderly health care facilities. This study consisted of dieticians working in elderly health care facilities with a capacity of over 50 elderly. Survey questionnaires were distributed to 190 dieticians through the mail and 106 dieticians (55.8%) participated in this study. The results of the survey showed that dieticians in elderly health care facilities frequently performed the following job: work management, safety and sanitation management, purchase management, human resource management, finance management, nutrition management, and marketing management. The job frequency in safety and sanitation management (p<0.05) and nutrition management (p<0.01) areas were significantly different by the number of dieticians. Safety and sanitation management and menu management were considered job areas that needed further training and education. Dieticians in elderly health care facilities responded that the following jobs should require not only training but are also frequently performed: safety and sanitation management, menu management, work management, and human resource management. Thus, based on the results of this study, continuous training programs in these fields should be offered to satisfy the needs of dieticians.
Aged ; Delivery of Health Care ; Humans ; Marketing ; Postal Service ; Surveys and Questionnaires ; Safety Management ; Sanitation

BACKGROUND: Rapid species identification of enterococci is necessary for optimal treatment of infected patients as they are frequently resistant to various antimicrobial agents. Minimal identification scheme is necessary to cut the laboratory cost. In this study, a minimal identification system was modified to expand the identifiable species. METHODS: Performance of MGP test was compared to that of MIO motility test. Colonies on blood agar were used to inoculate primary identification media: SFA, BEAA, mannitol agar, tellurite agar, sorbose agar and MGP agar, which were prepared in biplates. Pigment production was tested when necessary using colonies on a blood agar. Isolates, which were not identifiable by the primary test, were inoculated to secondary test media: ADH, and arabinose-, raffinose- and sucrose-containing CTA. Vitek GPI cards were used to test isolates with a doubtful identification or no identification. RESULTS: MGP test was selected for the modified scheme, as it was more rapid and accurate than motility test. Among the 879 clinical isolates of enterococci, 462 (52.6%) and 3 (0.3%) were identified as E. faecalis and E. casseliflavus, respectively, by the primary test only. With the additional secondary tests, 379 (43.1%) isolates were identified as E. faecium. Vitek test showed the identification of 4 isolates with atypical test results and 5 isolates of rare species by modified scheme were correct. Nine isolates (1.0 %) were not identifiable by the modified scheme. CONCLUSIONS: The modified minimal identification scheme which included MGP test identified most E. faecalis isolates rapidly and accurately. Most of E. faecium isolates were identified with the additional secondary tests. In conclusion, the system is useful for the identification of commonly isolated species of enterococci.
Agar ; Anti-Infective Agents ; Humans ; Mannitol ; Sorbose

The anti-inflammatory effects of an ethanol extract of Angelica gigas (EAG) were investigated in vitro and in vivo using croton oil-induced inflammation models. Croton oil (20 microgram/mL) up-regulated mRNA expression of cyclooxygenase (COX)-I and COX-II in the macrophage cell line, RAW 264.7, resulting in the release of high concentrations of prostaglandin E2 (PGE2). EAG (1~10 microgram/mL) markedly suppressed croton oil-induced COX-II mRNA expression and PGE2 production. Application of croton oil (5% in acetone) to mouse ears caused severe local erythema, edema and vascular leakage, which were significantly attenuated by oral pre-treatment with EAG (50~500 mg/kg). Croton oil dramatically increased blood levels of interleukin (IL)-6 and PGE2 without affecting tumor-necrosis factor (TNF)-alpha and nitric oxide (NO) levels. EAG pre-treatment remarkably lowered IL-6 and PGE2, but did not alter TNF-alpha or NO concentrations. These results indicate that EAG attenuates inflammatory responses in part by blocking the COX-PGE2 pathway. Therefore, EAG could be a promising candidate for the treatment of inflammatory diseases.
Angelica/*immunology ; Animals ; Cell Line ; Cyclooxygenase 1/genetics/*immunology ; Cyclooxygenase 2/genetics/*immunology ; Dinoprostone/genetics/immunology ; Inflammation/drug therapy/enzymology/*immunology ; Interleukin-6/blood ; Macrophages ; Male ; Mice ; Mice, Inbred ICR ; Nitric Oxide/blood ; Phytotherapy/*methods ; Plant Extracts/*pharmacology/therapeutic use ; Plant Roots/immunology ; RNA, Messenger/chemistry/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha/blood

BACKGROUND: Salvia miltiorrhiza (SM) has been used to treat inflammatory diseases including edema and arthritis; however, the anti-inflammatory mechanism of SM action remains unresolved. METHODS: The effects of an ethanol extract of SM (ESM) on pro-inflammatory cytokines such as TNF-alpha, IL-1beta, IL-6, and NO, on anti-inflammatory cytokines including IL-4, IL-10, TGF-beta, and IL-1Ra have been studied in an attempt to elucidate the anti-inflammatory mechanism in murine macrophages. RESULTS: ESM inhibited the production of pro-inflammatory cytokines via down-regulation of gene and protein expression whereas it increased the anti-inflammatory cytokines. Furthermore, ESM inhibited the expression of the chemokines, RANTES and CX3CL1, as well as of inflammatory mediators such as TLR-4 and 11beta-HSD1. CONCLUSION: These results indicated that the regulatory effects of ESM may be mediated though the suppression of pro-inflammatory cytokines as well as the induction of anti-inflammatory cytokines. Consequently, we speculate that ESM has therapeutic potential for inflammation-associated disorders.
Chemokine CCL5 ; Chemokines ; Cytokines ; Down-Regulation ; Edema ; Ethanol ; Inflammation ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-10 ; Interleukin-4 ; Interleukin-6 ; Salvia ; Salvia miltiorrhiza ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

BACKGROUND: Salvia miltiorrhiza (SM) has been used to treat inflammatory diseases including edema and arthritis; however, the anti-inflammatory mechanism of SM action remains unresolved. METHODS: The effects of an ethanol extract of SM (ESM) on pro-inflammatory cytokines such as TNF-alpha, IL-1beta, IL-6, and NO, on anti-inflammatory cytokines including IL-4, IL-10, TGF-beta, and IL-1Ra have been studied in an attempt to elucidate the anti-inflammatory mechanism in murine macrophages. RESULTS: ESM inhibited the production of pro-inflammatory cytokines via down-regulation of gene and protein expression whereas it increased the anti-inflammatory cytokines. Furthermore, ESM inhibited the expression of the chemokines, RANTES and CX3CL1, as well as of inflammatory mediators such as TLR-4 and 11beta-HSD1. CONCLUSION: These results indicated that the regulatory effects of ESM may be mediated though the suppression of pro-inflammatory cytokines as well as the induction of anti-inflammatory cytokines. Consequently, we speculate that ESM has therapeutic potential for inflammation-associated disorders.
Chemokine CCL5 ; Chemokines ; Cytokines ; Down-Regulation ; Edema ; Ethanol ; Inflammation ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-10 ; Interleukin-4 ; Interleukin-6 ; Salvia ; Salvia miltiorrhiza ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

BACKGROUND: It has been recently noticed that type 2 diabetes (T2D), one of the most common metabolic diseases, causes a chronic low-grade inflammation and activation of the innate immune system that are closely involved in the pathogenesis of T2D. Cordyceps militaris, a traditional medicinal mushroom, produces a component compound, cordycepin (3'-deoxyadenosine). Cordycepin has been known to have many pharmacological activities including immunological stimulating, anti-cancer, and anti-infection activities. The molecular mechanisms of cordycepin in T2D are not clear. In the present study, we tested the role of cordycepin on the anti-diabetic effect and anti-inflammatory cascades in LPS-stimulated RAW 264.7 cells. METHODS: We confirmed the levels of diabetes regulating genes mRNA and protein of cytokines through RT-PCR and western blot analysis and followed by FACS analysis for the surface molecules. RESULTS: Cordycepin inhibited the production of NO and pro-inflammatory cytokines such as IL-1beta, IL-6, and TNF-alpha in LPS-activated macrophages via suppressing protein expression of pro-inflammatory mediators. T2D regulating genes such as 11beta-HSD1 and PPARgamma were decreased as well as expression of co-stimulatory molecules such as ICAM-1 and B7-1/-2 were also decreased with the increment of its concentration. In accordance with suppressed pro-inflammatory cytokine production lead to inhibition of diabetic regulating genes in activated macrophages. Cordycepin suppressed NF-kappaB activation in LPS-activated macrophages. CONCLUSION: Based on these observations, cordycepin suppressed T2D regulating genes through the inactivation of NF-kappaB dependent inflammatory responses and suggesting that cordycepin will provide potential use as an immunomodulatory agent for treating immunological diseases.
11-beta-Hydroxysteroid Dehydrogenase Type 1 ; Agaricales ; Blotting, Western ; Cordyceps ; Cytokines ; Deoxyadenosines ; Immune System ; Inflammation ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Macrophages ; Metabolic Diseases ; NF-kappa B ; PPAR gamma ; RNA, Messenger ; Tumor Necrosis Factor-alpha

We report here on a case of fibrovascular polyp arising in the hypopharynx of a 62-year-old man. Laryngomicroscopic surgery with laser ablation was performed to excise the mass. Histopathologically, the surface of the polyp was covered with mature squamous epithelium. The polyp showed a characteristic lobular proliferation of mature adipose tissue that was separated by myxoid or collagenous connective tissue. Some scattered skeletal muscle bundles were seen in the central portions of the polyp and these bundles were surrounded by a concentric proliferation of the spindle cells; this was reminiscent of Pacinian corpuscles. Regarding their location and the intermingled pattern of proliferating tissues, it is more plausible that the skeletal muscle is a hamartomatous component rather than entrapped, preexisting tissue.

BACKGROUND: Chronic low grade inflammation is closely linked to type II diabetes, obesity, and atherosclerosis. Macrophages play a key role in the regulation of pro- or anti-inflammatory actions at the lesion sites of disease. Components of cordyceps militaris, cordycepin and adenosine, have been used for the modulation of inflammatory diseases. The effects of cordycepin in the modulation of macrophages have yet to be elucidated. We investigated the effects of cordycepin and adenosine on the morphological changes of macrophages under the inflammatory condition of LPS and an anti-inflammatory condition involving high concentrations of adenosine. METHODS: We confirmed the mRNA levels of the M1/M2 cytokine genes through RT-PCR and morphological change. RESULTS: LPS-activated macrophages returned to their inactivated original shape, i.e., they looked like naive macrophages, through the treatment with high concentrations of cordycepin (40 microgram/ml). LPS and adenosine activated macrophages also returned to their original inactivated shapes after cordycepin treatment; however, at relatively higher levels of cordycepin than adenosine. This change did not occur with relatively low concentrations of cordycepin. Adenosine down-regulated the gene expression of M1 cytokines (IL-1beta, TNF-alpha) and chemokines (CX3CR1, RANTES), as well as cordycepin. Additionally, M2 cytokines (IL-10, IL-1ra, TGF-beta) were up-regulated by both cordycepin and adenosine. CONCLUSION: Based on these observations, both cordycepin and adenosine regulated the phenotypic switch on macrophages and suggested that cordycepin and adenosine may potentially be used as immunomodulatory agents in the treatment of inflammatory disease.
Adenosine ; Atherosclerosis ; Chemokines ; Cordyceps ; Cytokines ; Deoxyadenosines ; Gene Expression ; Inflammation ; Interleukin 1 Receptor Antagonist Protein ; Macrophages ; Obesity ; RNA, Messenger

A 50-year-old woman was admitted to our hospital due to multiple lung nodules detected incidentally on a chest X-ray. A video-assisted thoracoscopic lung biopsy revealed low-grade endometrial stromal sarcoma (LG-ESS). She had undergone a simple hysterectomy 1 year earlier owing to a diagnosis of adenomyosis. A review of her previous hysterectomy specimen showed not endometriosis but LG-ESS. According to the patient's levels of serum follicle stimulating hormone and estradiol, she was in the premenopausal state with retained and normally functioning ovaries. She then underwent ovarian ablation by radiotherapy, after which she was administered 2.5 mg of letrozole once per day. Three months later, the size of the metastatic nodules in both lungs had decreased. The patient was followed up for 24 months while continuing on letrozole, and maintained a partial remission. We report herein on a case of metastatic LG-ESS treated with letrozole after ovarian ablation by radiotherapy.
Adenomyosis ; Biopsy ; Diagnosis ; Endometrial Stromal Tumors ; Endometriosis ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hysterectomy ; Lung ; Middle Aged ; Ovary ; Radiotherapy* ; Sarcoma, Endometrial Stromal* ; Thorax

PURPOSE: The skin pH is maintained by epidermal lactate, free fatty acids (FFAs), and free amino acids (FAAs). As a significant determinant of skin health, the skin pH is increased (less acidic) under abnormal and aged skin conditions. In a search for dietary alternatives that would promote an acidic skin pH, this study investigated the dietary effects of Lactobacillus plantarum CJLP55 isolated from Korean kimchi on the skin pH, and epidermal levels of lactate, FFAs, and FAAs in adult subjects. METHODS: Seventy eight subjects (mean age 24.9 ± 0.5 years, range 19 ~ 37 years) were assigned randomly to ingest CJLP55, Lactobacillus strain from kimchi, (n = 39, CJLP group) or placebo supplements (n = 39, placebo group) for 12 weeks in a double-blind, placebo-controlled trial. Skin pH and epidermal levels of lactate, FFAs and FFAs were assessed at 0, 6 and 12 weeks. RESULTS: Although significant decreases in skin pH were observed in both the CJLP and placebo groups at 6 weeks, the skin pH was decreased significantly only in the CJLP group at 12 weeks. In parallel, the epidermal level of lactate in the CJLP group was also increased by 25.6% at 12 weeks. On the other hand, the epidermal level of FAAs were not altered in the CJLP and placebo groups, but the epidermal level of total FFAs, including palmitic acid and stearic acid, was lower in the CJLP group than in the placebo group over 12 weeks. The changes in the other FFAs, such as palmitoleic acid and oleic acid, were similar in the CJLP and placebo groups over 12 weeks. CONCLUSION: Overall, a dietary supplement of CJLP55 promotes acidic skin pH with a selective increase in epidermal lactate in adult subjects.
Adult ; Amino Acids ; Dietary Supplements ; Fatty Acids, Nonesterified ; Hand ; Humans ; Hydrogen-Ion Concentration ; Lactic Acid ; Lactobacillus plantarum ; Lactobacillus ; Oleic Acid ; Palmitic Acid ; Skin