• Journal of Neurocritical Care
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• v.11 no.2
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• pp.110-118
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• 2018

Background: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. Methods: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. Results: The monthly mean number of interventions increased from 8.0 (${\pm}5.7$) to 31.7 (${\pm}12.8$) (P<0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. Conclusion: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.

• Journal of Environmental Health Sciences
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• v.47 no.1
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• pp.64-77
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• 2021

Objective: Biological monitoring of trace elements in human blood samples has become an important indicator of the health environment. The purpose of this study was to detect and evaluate multiple metal items in blood samples based on ICP-MS, to perform comparative evaluation with the existing analysis method, and to develop and verify a new method. Methods: 100 μL of whole blood from 80 healthy subjects was used to analyze ten metals (Sb, tAs, Cd, Pb, Mn, Hg, Mo, Ni, Se, Tl) using ICP-MS. Verification of the analysis method included calculation of linearity, accuracy, precision and detection limits. In addition, a comparative test with the conventional graphite furnace atomic absorption spectroscopy (GF-AAS) method was performed. In the case of Pb, Cd, and Hg in whole blood, cross-analysis between Pb, Cd, and Hg analysis methods was performed to confirm the difference between the existing method and the new method (ICP-MS). Results: The coefficient of determination (R2) was 0.999 or higher in seven items and 0.995 or higher in three items. The Pb result showed that Pearson's correlation coefficient was very high at 0.983, and the intraclass correlation coefficient was 0.966. The Cd result showed that Pearson's correlation coefficient was 0.917 between the existing method and the new analysis concentration value. Its intraclass correlation coefficient was 0.960, and there was no significant difference between the two groups. Hg had a low correlation at 0.687, and the intraclass correlation coefficient was 0.761, which was lower than that of Pb and Cd. The intra-day and inter-day accuracy of Pd and Cd were satisfactory, but Hg did not meet the criteria for both accuracy and precision when compared with the conventional analysis method. Conclusion: This study can be meaningful in that it proposes a more efficient and feasible analysis method by verifying a blood heavy metal concentration experiment using multiple simultaneous analyses. All samples were processed and analyzed using the new ICP-MS. It was confirmed that the agreement between the two methods was very high, with the agreement between the current and new methods being 0.769 to 0.998. This study proposes an efficient simultaneous methodology capable of analyzing multiple elements with small samples. In the future, studies of various applications and the reliability of ICP-MS analysis methods are required, and research on the verification of accurate, precise, and continuous analysis methods is required.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.391-399
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• 2018

Background : The Antimicrobial Stewardship Program promotes interdisciplinary interventions and targeted recommendations for the proper utilization of antibiotics. In particular, the aim of the program is to avoid indiscriminate use of broad-spectrum antibiotics based on the documented literature on the significant impact of unsystematic usage of antibiotics on the distribution of antibiotic-resistant microorganisms. To improve the care process for pneumonia treatment using antimicrobial agents, institution-level guidelines were established and disseminated at the Seoul National University Bundang Hospital in April 2016. In this study, we evaluated changes in the physicians'antibiotic prescribing patterns both before-and after-the implementation of the guidelines. Methods : The electronic medical records of inpatients who were prescribed with one or more antibiotics in May 2014 (Group A) and May 2016 (Group B) were reviewed. Data on demographic characteristics, clinical outcomes, and antibiotic prescriptions were collected and the prescription records were compared both before- and after- the implementation of the guidelines. Results : A total of 180 patients were included in the study: 77 patients in group A and 103 patients in group B. The baseline characteristics of the patients were not significantly different between the two groups. Community-acquired pneumonia was the most common diagnosis in both the groups and the difference was not significant (68.8% vs. 67.9%; p=0.67). The type of antibiotic prescriptions used for empirical treatment was not different between the two groups. The most commonly prescribed empirical antibiotics were cephalosporins, with no significant difference (p=0.31). One of the most inappropriately used antibiotics was piperacillin/tazobactam and the rate of prescription was similar in both the groups (p=0.68). The rates of appropriate empirical selection of antibiotics remained unaltered between the two groups (67.5% vs. 71.8%; p=0.53). Conclusions : Implementation of the guidelines only exhibited no significant effect on the antibiotic prescribing patterns of physicians for the treatment of pneumonia. To improve the adequate use of empiric antibiotics, more active interventions and closer monitoring of the feedbacks should be additionally considered and evaluated in future studies.

• Health Policy and Management
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• v.31 no.1
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• pp.114-124
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• 2021

Background: In this study, we aimed to investigate the interaction effects of individual socioeconomic status and regional deprivation on the onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients. Methods: Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013 were used. A total of 50,954 patients newly diagnosed with type 2 diabetes from 2004 to 2012 and aged 30 years or above were included. We classified patients into six groups according to individual income level and neighborhood deprivation: 'high in advantaged,' 'high in disadvantaged,' 'middle in advantaged,' 'middle in disadvantaged,' 'low in advantaged,' and 'low in disadvantaged.' We calculated hazard ratios (HR) of onset of diabetes complication and diabetes-related hospitalization using the Cox proportional hazard model, with the reference group as diabetes patients with high income in advantaged regions. Results: In terms of the interaction effects of individual income level and regional socioeconomic level, even with the same low individual income level, the group with a high regional socioeconomic level (low in advantaged) showed low HRs for the onset of diabetes complication (HR, 1.04; 95% confidence interval [CI], 1.00-1.08) compared to the 'low in disadvantaged' group (HR, 1.10; 95% CI, 1.05-1.16). In addition, the 'high in advantaged' group showed slightly higher HRs for the onset of diabetes complication (HR, 1.06; 95% CI, 1.00-1.11) compared to the 'low in advantaged' and it appeared to be associated with slight mitigation of the risk of diabetes complication. For the low-income level, the patients in disadvantaged regions showed the highest HRs for diabetes-related hospitalization (HR, 1.29; 95% CI, 1.19-1.41) compared to the other groups. Conclusion: Although we need to perform further investigations to reveal the mechanisms that led to our results, interaction effects individual socioeconomic status and regional deprivation might be associated with on onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.46 no.4
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• pp.403-413
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• 2020

While searching for useful microorganisms, Saccharomycopsis fibuligera which can be used as cosmetic materials were divided from Jeju island's traditional fermented foods. In this study, blackcurrant extract which contains a large amount of anthocyanin glycosides was fermented with S. fibuligera. HPLC analysis was performed to analyze the components of blackcurrant extract (BE) and fermented blackcurrant fruit extract (FBE). As a result, bio-conversion of delphinidin and cyanidin were able to be identified. In order to verify the anti-oxidant effect of BE and FBE, we investigated radical scavenging ability with DPPH and ABTS. In addition, to confirm anti-inflammatory effect, we investigated inhibition effect of nitric oxide (NO) production on lipopolysaccharide (LPS) - stimulated RAW264.7 macrophages, and inhibition effect of the expression of inflammatory-related proteins (iNOS, COX-2) by western blot analysis. As a result, as FBE has anti-oxidant and anti-inflammatory effects, we suggest that it might be used as an active ingredient for cosmetics.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.46 no.4
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• pp.415-424
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• 2020

In the present study, we have refined gomisin N, which represents activity in the proliferation of dermal papilla cells (HFDPCs) from the fruit of Schisandra chinensis (S. chinensis), and have identified optimal extraction conditions for obtaining extracts with high content of gomisin N. The activity of the extracts and fractions was evaluated, and the results indicated approximately 29% proliferation activity in the group treated with 1 ㎍/mL of n-hexane fraction. Column chromatography was used to assess the active ingredient in the n-hexane fraction, and two compounds, namely gomisin N(1) and schisandrin(2), were isolated and identified. When the HFDPCs proliferation activity was tested for the isolated compounds, gomisin N exhibited ≥ 20% proliferation activity. Thus, via response surface methodology (RSM), the optimum extraction conditions to obtain the maximum level of gomisin N from the fruit of S. chinensis were determined, where ethanol proportion, extraction time, and extraction temperature were used as the independent variables. The results revealed coefficient of determination ≥ 0.95 and p-value ≤ 0.05, which confirmed the fit of the model. The optimum extraction conditions to achieve the maximum content of gomisin N were as follows: ethanol proportion 83.8%, extraction temperature 80 ℃, and extraction time 8.7 h. The content of gomisin N using these conditions was predicted as 378,300 ppm, and a mean value close to the predicted value (376,884 ppm) was obtained while validating the aforementioned conditions.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.47 no.2
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• pp.179-184
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• 2021

Stratum corneum known as a skin barrier, which maintains water in skin, is the outer layer of the skin. Natural moisturizing factors (NMF) are one of the constituents in stratum corneum and amino acids are the highest components among NMF. In this study, we designed stearic acid-based solid lipid nanoparticles (SLNs) for improved skin penetration of serine (Ser). Ser-capsulated SLN was manufactured by double-melting emulsification method. The mean particle size and zeta potential of SLNs were 256.30 ~ 416.93 nm and -17.60 ~ -35.27 mV, respectively. The higher the degree of hydrophobicity or hydrophilicity of emulsifiers, the smaller the particle size and the higher the stability and capsulation rate. In addition, skin penetration was conducted using SkinEthic^TM RHE which is one of the reconstructed human epidermis models. The results of Ser penetration demonstrated that all SLNs enhanced than serine solution. The amount of enhanced Ser penetration from SLNs were approximately 4.1 ~ 6.2 times higher than that from Ser solution. Therefore, Ser-loaded SLN might be a promising drug delivery system for moisturizing formulation in cosmeceutical.

• Microbiology and Biotechnology Letters
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• v.50 no.1
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• pp.31-39
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• 2022

The purpose of this study was to investigate the whitening effects of hot water (AMPW) and ethanol (AMPE) extracts of Mangifera indica L. peel. To verify the whitening effects, tyrosinase inhibitory activity was measured. 9.51% inhibitory activity, and 35.98% inhibitory activity at 1,000 ㎍/ml. The effects of AMPW and AMPE on cell viability were measured using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay in B16-F10 melanoma cells. Greater than 95% cell viability was observed at 100 ㎍/ml. Thus, subsequent experiments were performed at concentrations less than 100 ㎍/ml. The whitening effects were confirmed by measuring the protein and mRNA expression levels of microphthalmia-associated transcription factor, tyrosinase, tyrosinase-related protein 1 (TRP-1), and TRP-2, which are factors involved in melanin synthesis. Western blotting and reverse transcription-polymerase chain reaction results confirmed that 100 ㎍/ml AMPW and AMPE showed superior inhibitory effects than the control treatment (alpha-melanocyte stimulating hormone only). Therefore, Mangifera indica L. peel extract had a whitening effect, and thus, has potential as a natural material for use in cosmetics.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.47 no.4
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• pp.297-304
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• 2021

In this study, we prepared a pigmented skin model, KeraSkin-M^TM for the in vitro evaluation of whitening agents. For the purpose of complementing the existing mono-layer cell culture testing method, KeraSkin-M^TM was produced through the co-culture of human skin-derived keratinocytes and melanocytes. The efficacy of four well-known whitening agents (arbutin, ascorbic acid, kojic acid, niacinamide) was evaluated in KeraSkin-M^TM in order to assess its usefulness in assessing whitening efficacy. As a result, it was possible to observe additional details such as the distribution of melanin granules and melanin capping in each skin layer through KeraSkin-M^TM, which was previously difficult to assess in the traditional 2D cell culture system. In addition, quantification through image analysis of KeraSkin-M^TM allowed for a statistical analysis of the whitening effects. These results suggest that the KeraSkin-M^TM can be used as a new evaluation method of evaluating whitening efficacy, as well as complement the traditional total melanin content and tyrosinase inhibition assays.

• The Journal of the Korea Contents Association
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• v.22 no.1
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• pp.601-610
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• 2022

Although the number of people insured by private health insurance in Korea is steadily increasing, the household burden or the status of multiple purchasing for private health insurance has not been addressed. In this study, data of the 2011-2018 Korea Health Panel Survey was used to examine the purchasing trend of Korean households' private health insurance. Households with more than three private health insurance per household member were defined as the 'poly-purchases'. The logit model was applied to analyze factors associated with poly-purchase of private health insurance using 2018 cross-sectional data. From 2011 to 2018, the number of insurances purchased by Korean households increased (4.0 to 4.6), the number of insurances per capita increased (1.3 to 1.6), and the proportion of the poly-purchasing households increased (5.2% to 10.8%). As a result of logit analysis, the probability of poly-purchasing was increased when the household head was a woman, with a high level of education and income, and when the job of the household head was a service or sales. Poly-purchasing was less likely when the family was subsidized with Medical Aids and suffered with more chronic diseases. The results of this study serve basic evidence for establishing policies regarding private health insurance, such as establishing the relationship between public and private insurance.