SNA077, an Extract of Marine Streptomyces sp., Inhibits Melanogenesis by Downregulating Melanogenic Proteins via Inactivation of cAMP/PKA/CREB Signaling.

Excess melanin in skin is known to be the main cause of hyper-pigmentary skin diseases such as freckles and lentigo. This study aimed to evaluate the depigmenting efficacy of an extract from the marine microorganism strain, Streptomyces sp. SNA077. To determine the anti-melanogenic efficacy of SNA077, we assessed the melanin contents of SNA077-treated B16, Melan-a, and MNT-1 cells. We observed the expression of key enzymes in melanogenesis via qRT-PCR and Western blot analyses. We further estimated the skin-whitening effect of SNA077 using a skin-equivalent model. SNA077 dramatically decreased the melanin production of B16 cells, Melan-a, and MNT-1 cells. In B16 cells treated with SNA077, the activity of cellular tyrosinase was clearly inhibited. In addition, the mRNA and protein expression levels of melanogenic genes were suppressed by SNA077 treatment in B16 and MNT-1 cells. Upstream of tyrosinase, the expression levels of phospho-CREB, phospho-p38, PKA activity, cyclic AMP production, and MC1R gene expression were inhibited by SNA077. Finally, SNA077 clearly showed a skin-brightening effect with a reduced melanin content in the skin tissue model. Collectively, our results suggest for the first time that an extract of marine Streptomyces sp. SNA077 could be a novel anti-melanogenic material for skin whitening.

Imaging Surveillance After Breast-Conserving Surgery for Cancer With Acellular Dermal Matrix Reconstruction.

OBJECTIVE: The aim of this study was to investigate postoperative imaging findings of patients who underwent breast-conserving surgery for cancer and reconstruction with MegaDerm® (sheet-type and pellet-type), analyzing false positives and recurrences, using multi-modality images. MATERIALS AND METHODS: This study included 201 women (age range: 28-81 years, mean age ± standard deviation: 53.2 ± 8.6 years) who underwent breast-conserving surgery and immediate reconstruction with MegaDerm®. Post-surgery, each patient underwent at least one mammography (MG), ultrasonography (US), and MRI, totaling 713 MG, 1063 US, and 607 MRI examinations. Postoperative images were reviewed separately for the two types of MegaDerm®, and suspicious imaging findings (false positives and recurrences) were analyzed, with a particular focus on the findings in direct contact with MegaDerm®. RESULTS: MegaDerm® appeared as a circumscribed mass with homogeneous iso- or high density on MG, posterior shadowing on US, and no enhancement on MRI. Calcification was more common and increased in size in sheet-type MegaDerm®, while pellet-type often exhibited irregular margins. Nine out of 17 false positives had suspicious findings in direct contact with MegaDerm®, and six out of nine recurrences showed similar findings. Common suspicious findings included calcifications, asymmetries, and MegaDerm® irregularities on MG; masses and MegaDerm® irregularities on US; and enhancing masses and MegaDerm® irregularities with enhancement on MRI. Notably, MegaDerm® irregularity with calcification was observed on MG and US in only one recurrence case. In 44.4% (4/9) of false-positives in direct contact with MegaDerm®, suspicious findings showed no change or resolution on follow-up. CONCLUSION: Suspicious imaging findings in direct contact with MegaDerm® may be associated with false positives or recurrences. Therefore, it is essential to recognize these characteristic findings and review the patient's history of MegaDerm® insertion when in doubt.

National Trends in Hospitalization for Ambulatory Care Sensitive Conditions among Korean Adults between 2008 and 2019.

PURPOSE: This study aimed to examine 12-year trends in hospitalization rates for ambulatory care sensitive conditions (ACSC) and factors affecting hospitalization. MATERIALS AND METHODS: This study used data on Korean National Health Insurance and Medical Aid patients aged 19 and over who used medical services at least once between January 2008 and December 2019 with an ACSC as their major diagnosis. As of 2019, a total of 12324071 patients were included. To check for any changes in hospitalization, age- and sex-standardized hospitalization rates were obtained for each condition and insurance type, and multiple logistic regression was performed to identify factors affecting hospitalization. RESULTS: The collective average ACSC hospitalization rate decreased from 5.0% in 2008 to 4.2% in 2019. Specifically, hospitalization rates for hypertension (1.4% in 2008; 0.8% in 2019), diabetes (5.8% in 2008; 3.3% in 2019), and chronic obstructive pulmonary disease and asthma (4.1% in 2008; 3.2% in 2019) decreased, while rates for pneumonia (24.5% in 2008; 28.1% in 2019) and urinary tract infection (UTI) (5.7% in 2008; 6.4% in 2019) increased. The rate for heart failure decreased 2.3% between 2008 and 2012 and then rebounded. The odds of hospitalization among Medical Aid patients were 1.45-4.20 times higher than those of National Health Insurance patients. CONCLUSION: Differences in trends were confirmed for ACSC hospitalization rates among different conditions and insurance types in Korea. These results suggest the need for policy reforms aimed at reducing hospitalization for heart failure, pneumonia, and UTI, especially among Medical Aid patients.

Effectiveness of interventions to increase the participation rate of gastric cancer screening in the Republic of Korea: a pilot study.

This study assessed the effectiveness of three intervention strategies to improve the participation rate of gastric cancer screening among people who had never undergone such screening, and those who had been screened for the disease, but not recently. It was conducted in the Ilsandong-gu District of Goyang City, Korea. The population for the current study was restricted to male residents, aged 40-65 years, who received an invitation letter to undergo gastric cancer screening from the National Health Insurance (NHI) Corporation at the beginning of 2010. The subjects were divided into two categories according to their screening history: never-screened, and ever-screened. A total of 2,065 men were eligible: 803 never-screened and 1,262 ever-screened. In each screening category they were randomly assigned to one of three intervention groups: 1) tailored telephone counseling; 2) tailored postcard reminder after tailored telephone counseling;and 3) tailored telephone counseling after tailored postcard reminder. At 3 months post-intervention, never- screened men with any intervention were more likely to undergo gastric cancer screening (OR=2.75, 95% CI: 1.22-6.18) compared to those in the reference group (no intervention). However, there was no statistically significant intervention effect in ever-screened men (OR=1.21, 95% CI: 0.65-2.27). Examination of the intervention effects by intervention group among never-screened men showed that those in the postcard reminder after telephone counseling group to be statistically significantly more likely to undergo gastric cancer screening (OR=4.49, 95% CI: 1.79-11.29) than the reference group (no intervention). Our results highlight that use of tailored postcard reminders after tailored telephone counseling is an effective method to increase participation in gastric cancer screening among men who had never been screened.

On-schedule mammography rescreening in the National Cancer Screening Program for breast cancer in Korea.

Breast cancer is the most commonly diagnosed cancer among women in the Republic of Korea. However, many women are not aware of the importance of on-schedule mammography screening for breast cancer. The objectives of this study were to estimate the percentage of women that attended on-schedule mammography rescreening, and to examine the factors associated with rescreening, among the target screening population (women aged ≥ 40 years) in Korea. The study population was derived from the National Health Insurance (NHI) Corporation database for the National Cancer Screening Program (NCSP), and included 2,511,976 women from the target screening population who attended the NCSP for breast cancer in 2005-2006 (baseline). Study participants were followed-up to determine whether they attended mammography rescreening after 2 years as recommended. Among those who attended mammography screening in 2005-2006, 61.3% were rescreened on schedule 2 years later. The odds of being rescreened were the highest in study participants aged 60-69 years. NHI beneficiaries with a higher premium were significantly more likely to be rescreened than Medical Aid Program recipients. A false-positive screening result at baseline adversely affected subsequent screening behavior. Furthermore, those who had a history of mammography screening before baseline were more likely to return for rescreening. Therefore, assessment of a woman's screening history and socioeconomic status, in combination with interventions to reduce anxiety, such as involving primary care physicians or better informing women about breast cancer and mammography screening, are needed. Efforts to reduce false-positive results and improve the quality of mammography may also increase compliance with breast cancer screening recommendations.

Facile synthesis of MOF-177 by a sonochemical method using 1-methyl-2-pyrrolidinone as a solvent.

High quality MOF-177 crystals in the size range of 5-20 microm were successfully synthesized via a sonochemical route in a substantially reduced synthesis time (40 min) in the presence of low-cost NMP (1-methyl-2-pyrrolidone) as a solvent. Microwave heating in NMP also produced MOF-177 under similar conditions (35 min, 5-50 microm) but exhibited inferior crystallinity. In comparison, a conventional solvothermal route in DEF (diethylformamide) took 48 h to produce MOF-177 crystals 0.5-1.5 mm in size. The BET surface areas of the MOF-177 samples decreased in the order of sonochemical (4898 m(2) g(-1)) > conventional (4833 m(2) g(-1)) > microwave route (4197 m(2) g(-1)). In line with this trend, MOF-177 prepared via the sonochemical route resulted in the highest CO(2) adsorption capacity, 1315 mg g(-1) at 30 bar and 298 K. The product yield of MOF-177 synthesized via the sonochemical route was 95.6%, and was significantly higher than the product yields of other methods.