Synthesis and Characterization of ß-Tricalcium Phosphate Derived From Haliotis sp. Shells.

PURPOSE: To develop a methodology for the synthesis of ß-tricalcium phosphate (ß-TCP, Ca3(PO4)2) from the shell of Haliotis sp. (abalone shell) and to verify its characterization and biocompatibility. MATERIALS AND METHODS: Calcium oxide (CaO) was synthesized from abalone shell by sintering and was suspended in distilled water to prepare calcium hydroxide (Ca(OH)2). For the synthesis of calcium carbonate (CaCO3), carbon dioxide was used to infuse Ca(OH)2 at pH 7.4. CaCO3 was reacted with phosphoric acid at pH 6.0 to obtain dicalcium phosphate (CaHPO4). Subsequently, ß-TCP was synthesized by a chemical reaction between CaHPO4 and CaO at 950°C to 1100°C for 3 hours. Fourier transform infrared spectroscopy (FT-IR) and x-ray diffraction (XRD) was performed to verify the physiochemical characteristics of the composite synthesized from abalone shell. RESULTS: FT-IR and XRD results showed that ß-TCP was successfully synthesized from abalone shell. The synthesized ß-TCP did not affect cell viability of either normal human oral keratinocytes or osteoblastic MG-63 cells. These data indicate that ß-TCP synthesized from abalone shell is biologically safe. CONCLUSIONS: ß-TCP (Ca3(PO4)2) synthesized from abalone shell can be used as a potential source of bone grafting material.

Methylenetetrahydrofolate reductase 677 genotype-specific reference values for plasma homocysteine and serum folate concentrations in korean population aged 45 to 74 years: the Namwon study.

The reference interval for plasma total homocysteine (tHcy) and serum folate concentrations were estimated. Total of 3,154 reference individuals (1,029 men and 2,125 women) were selected based on stringent exclusion criteria. For plasma tHcy concentration (µM/L), reference values (median [5-95 percentile]) were 7.72 (5.03 to 13.80) and 6.09 (3.95-10.19) in men and women, respectively. For serum folate concentration (nM/L), reference values were 23.71 (11.73-38.44) and 28.95 (15.23-40.44) in men and women, respectively. The tHcy levels of both genders in the present study were lower than those in previous reports from other countries and Korea.

The effect of morphology and crystal structure on the photocatalytic and photoelectrochemical performances of WO3.

A template-based solvothermal method was successfully developed for the controlled synthesis of two-dimensional (2D) monoclinic WO3 nanoplate/nanosheet arrays and three-dimensional (3D) hexagonal WO3 nanosphere/nanocage structures with single crystal petals. The structure-directing agents played an important role in controlling the morphology and phase of WO3 samples. The results showed that the WO3 nanospheres exhibited the highest visible light absorption capacity and a photocurrent density of 0.37 mA cm-2 at 1.23 V vs. RHE under simulated sunlight. Moreover, the photocatalytic dye results displayed 83.2% methylene blue degradation and 87.9% rhodamine B degradation within 120 min under visible light irradiation. The high performance of the WO3 nanospheres, resulted from the hierarchical structure, increased surface area and enhanced light absorption, which improved the photogenerated charge carrier transfer and separation capability.

Average volume of alcohol consumed, drinking patterns, and metabolic syndrome in older Korean adults.

BACKGROUND: Controversial results have been reported on the relationship between alcohol intake and metabolic syndrome (MetS). We examined the association of average volume of alcohol consumed and drinking patterns with MetS and its components. METHODS: This study was conducted as a baseline survey for the Dong-gu Study of adults aged 50 years or older. Drinking patterns were assessed using a structured interview, and average volume of alcohol consumed was calculated. MetS was defined according to the updated version of the National Cholesterol Education Program. RESULTS: Compared with individuals who never drank, the adjusted odds ratio (OR) for the prevalence of MetS was significantly higher in men who consumed 2.1 to 4.0 drinks/day (OR, 1.53; 95% CI, 1.17-2.00) and greater than 4.0 drinks/day (OR, 1.63; 95% CI, 1.23-2.14), whereas no significant association was observed in women. Significant dose-response relationships between average volume of alcohol consumed and all metabolic components were observed in men. A usual quantity of 5 to 6 drinks/drinking day (OR, 1.57; 95% CI, 1.19-2.09), 7 or more drinks/drinking day (OR, 1.88; 95% CI, 1.45-2.44), and binge drinking on at least 1 occasion/week (OR, 1.33; 95% CI, 1.01-1.76) were associated with a significantly higher OR for prevalence of MetS in men; however, none of these drinking patterns were associated with MetS in women. CONCLUSIONS: Unhealthy drinking patterns such as high usual quantity and binge drinking were significantly associated with MetS, suggesting that the effect of alcohol consumption on MetS should be considered in the context of drinking pattern, particularly in men.

Effects of cumulative smoking exposure and duration of smoking cessation on carotid artery structure.

BACKGROUND: While prior epidemiological studies have examined the association between cigarette smoking and carotid atherosclerosis, few studies have evaluated the association of both cumulative smoking exposure and the duration of smoking cessation with carotid artery structure. METHODS AND RESULTS: The study population consisted of 2,503 community-dwelling Korean males aged 50 years and older. Common carotid artery intima-media thickness (CCA-IMT), carotid plaque, and the internal diameter of the common carotid artery (CCA-diameter) were determined by high-resolution B-mode ultrasonography. Data on the characteristics of the subjects, including smoking status, pack-years of smoking, and years since quitting smoking, were collected using a standardized questionnaire. The current smokers had significantly greater CCA-IMT and CCA-diameter and a significantly higher risk of carotid plaque than did the subjects who had never smoked (P=0.009, <0.001, and 0.036, respectively). Dose-response relationships between pack-years and CCA-IMT and CCA-diameter were found among the current smokers (P=0.001 and <0.001, respectively); however, no significant association between pack-years and the carotid artery parameters was observed among the former smokers. For the former smokers, CCA-IMT and CCA-diameter tended to decrease with increasing years since quitting smoking (P=0.009 and 0.012, respectively), whereas no significant association with carotid plaque was found. CONCLUSIONS: Cumulative smoking exposure in current smokers and the duration of smoking cessation in former smokers are significant risk factors for carotid atherosclerosis.

Determining the optimal cut-off value of the urinary albumin-to-creatinine ratio to detect atherosclerotic vascular diseases.

BACKGROUND: We examined whether low-grade albuminuria, below the conventional cut-off value for microalbuminuria, was associated with atherosclerotic vascular diseases in 8897 community-dwelling Koreans aged ≥50 years. METHODS: The urinary albumin-to-creatinine ratio (UACR) was calculated using random spot urine. Common carotid artery (CCA) intimamedia thickness (IMT) and CCA internal diameter were measured using high-resolution B-mode ultrasonography, and carotid plaque was evaluated. Brachial-ankle pulse wave velocity (BaPWV) and the ankle-brachial index (ABI) were examined, and peripheral arterial disease was defined as ABI <0.9. RESULTS: Youden's indices, predicting abnormal atherosclerotic conditions, were greatest at a UACR cut-off value of ∼15 mg/g, below the threshold conventionally used to define microalbuminuria. Compared with low normoalbuminuria (UACR <15.0 mg/g), CCA IMT, CCA diameter, and BaPWV were significantly greater in individuals with high normoalbuminuria (UACR 15.0-29.9 mg/g), who also had a significantly higher risk of carotid plaque than did those with low normoalbuminuria. CONCLUSIONS: Subclinical atherosclerotic vascular diseases developed at lower UACRs, below the conventional classification of microalbuminuria. Further longitudinal studies are needed to investigate the relationship between microalbuminuria and the development of subclinical atherosclerosis.

Partial Replacement of Dietary Fat with Krill Oil or Coconut Oil Alleviates Dyslipidemia by Partly Modulating Lipid Metabolism in Lipopolysaccharide-Injected Rats on a High-Fat Diet.

This study investigated the effects of partial replacement of dietary fat with krill oil (KO) or coconut oil (CO) on dyslipidemia and lipid metabolism in rats fed with a high-fat diet (HFD). Sprague Dawley rats were divided into three groups as follows: HFD, HFD + KO, and HFD + CO. The rats were fed each diet for 10 weeks and then intraperitoneally injected with phosphate-buffered saline (PBS) or lipopolysaccharide (LPS) (1 mg/kg). The KO- and CO-fed rats exhibited lower levels of serum lipids and aspartate aminotransferases than those of the HFD-fed rats. Rats fed with HFD + KO displayed significantly lower hepatic histological scores and hepatic triglyceride (TG) content than rats fed with HFD. The KO supplementation also downregulated the adipogenic gene expression in the liver. When treated with LPS, the HFD + KO and HFD + CO groups reduced the adipocyte size in the epididymal white adipose tissues (EAT) relative to the HFD group. These results suggest that KO and CO could improve lipid metabolism dysfunction.

Cumulative smoking exposure, duration of smoking cessation, and peripheral arterial disease in middle-aged and older Korean men.

BACKGROUND: We investigated the association of cumulative smoking exposure and duration of smoking cessation with peripheral arterial disease (PAD). METHODS: The study population consisted of 2517 community-dwelling Korean men aged 50 years and older. Information on smoking characteristics such as smoking status, pack-years of smoking, and years since quitting smoking was collected using a standardized questionnaire. PAD was defined as an ankle-brachial index (ABI) less than 0.90 in either leg. RESULTS: The odds ratio (OR, 95% confidence interval) of PAD was 2.31 (1.20-4.42) for former smokers and 4.30 (2.13-8.66) for current smokers, after adjusting for other cardiovascular risk factors. There was a significant dose-response relationship between pack-years of smoking and PAD. Compared with those who had never smoked, the multivariate-adjusted ORs of PAD for smokers of 0.1-20.0, 20.1-40.0, and >40.0 pack-years were 2.15 (1.06-4.38), 2.24 (1.08-4.65), and 2.93 (1.41-6.09), respectively. There was a significant decrease in PAD risk as the years since quitting smoking increased. The multivariate-adjusted ORs of PAD for 11-20 and ≥ 21 years smoking cessation were 0.41 (0.19-0.86) and 0.49 (0.24-0.98), compared with current smokers. CONCLUSIONS: Cumulative smoking exposure and duration of smoking cessation were significantly associated with PAD in middle aged and older Korean men.

The Relationships Between Hardiness and Life Satisfaction or Expectation of Korean Multicultural Children: Focused on Mediating Effect of Acculturative Stress Moderated by Resilience.

This study identified the relationship between hardiness and life satisfaction or expectation of multicultural Korean children, and examined the mediating models of acculturative stress moderated by resilience on hardiness and life satisfaction or life expectation. The participants in the study were 201 male and female children from Korean multicultural families. PROCESS Macro 3.5 Model 14 was used for the analysis of the moderated mediating effects. The results revealed that hardiness and resilience were positively correlated with life satisfaction and life expectation, whereas acculturative stress was negatively correlated with life satisfaction and life expectation of multicultural children. In a moderated mediating model for life satisfaction, there was no interaction effect of acculturative stress and resilience, but a conditionally indirect effect of acculturative stress was only significant in groups with low resilience. In a moderated mediating model for life expectation, there was a significant interaction effect of acculturative stress and resilience, and a conditionally indirect effect of acculturative stress was only significant in groups with low resilience and with very high resilience. These findings suggest that only when multicultural children have low resilience, the mediating effect of acculturative stress is significant in relations of hardiness and life satisfaction, as well as hardiness and life expectation. In particular, resilience moderates the influence of acculturative stress on life expectations.

Synthesis of vertical WO3 nanoarrays with different morphologies using the same protocol for enhanced photocatalytic and photoelectrocatalytic performances.

Tungsten trioxide (WO3) nanoarrays with different morphologies were successfully synthesized by a hydrothermal method on an FTO substrate. Various nanostructures of WO3 including nanoflakes, nanoplates, nanoflowers and nanorods were obtained by adjusting only the acidity of the precursor solution. XRD patterns confirmed that the as-prepared orthorhombic WO3·0.33H2O transformed to the monoclinic WO3 phase under annealing at 500 °C. UV-Vis absorbance spectroscopy indicated that the absorption edge of WO3 nanoflowers exhibited a slight red-shift compared to other morphologies of WO3. The obtained WO3 nanoflower arrays exhibit the highest photocurrent density and photocatalytic degradation activity towards methylene blue. Finally, the mechanism of the photocatalytic degradation of methylene blue by WO3 is discussed.

Antiobesity Effects of Extract from Spergularia marina Griseb in Adipocytes and High-Fat Diet-Induced Obese Rats.

Obesity has recently risen and become a serious health concern in Korea according to the westernized diet and altered lifestyle. Hence, there is a growing interest in the supplementation of phytochemicals to find a safe and effective functional ingredient to treat obesity. Spergularia marina Griseb (SM) has traditionally been used as a natural herb against chronic diseases in Korea. In this study, we investigated the antiobesity effects of SM in vitro and in vivo. SM ethanol extract (SME) inhibited proliferation and differentiation in murine adipocytes and primary porcine pre-adipocytes in a dose-dependent manner. In the in vivo study, supplementation of SM powder (SMP) remarkably attenuated fat accumulation in HFD-induced obese rats. In addition, SMP supplementation improved lipid profiles in the serum and tissues of high-fat induced obese rats. Collectively, these data indicated that SME exhibited antiobesity effects by modulating adipogenesis and lipolysis. Furthermore, SMP could be developed as an obesity-induced metabolic syndrome treatment.

Alcohol consumption and carotid artery structure in Korean adults aged 50 years and older.

BACKGROUND: Epidemiologic studies of the association between alcohol consumption and carotid artery structure have reported conflicting results. We investigated the association between alcohol consumption and carotid atherosclerosis by evaluating the effects of alcohol intake on carotid artery enlargement. METHODS: The study population consisted of 4302 community-dwelling Koreans (1577 men and 2725 women) aged 50 years and over. All the subjects had participated in the baseline survey of the Dong-gu Study conducted between 2007 and 2008. Daily alcohol consumption was determined by the number and frequency of alcoholic beverages consumed. We measured common carotid artery intima-media thickness (CCA-IMT), common carotid and bulb IMT (CB-IMT), carotid plaques, and the diameter of the common carotid artery (CCA-diameter) using high-resolution B-mode ultrasonography. We used analysis of covariance and multiple logistic regressions to determine the relationship between alcohol consumption and carotid artery parameters. RESULTS: CCA-IMT and CB-IMT were negatively correlated with alcohol consumption after controlling for cardiovascular risk factors in men (p for linear trend = 0.009 and = 0.038, respectively). The multivariate-adjusted odds ratio (OR) for carotid plaques was significantly higher in men who consumed >40.0 g/d (OR = 1.81, 95% CI = 1.13-2.91), although a significant positive correlation was observed between alcohol consumption and carotid plaques (p for linear trend = 0.027). Neither carotid IMT nor carotid plaques were correlated with alcohol intake in women. Alcohol intake was positively correlated with CCA-diameter adjusted for carotid IMT and plaques in the multivariate-adjusted model in both sexes (p for linear trend <0.001 for men and 0.020 for women). CONCLUSION: The results of our study indicate that alcohol consumption is inversely related to carotid IMT and positively related to carotid plaques in men, but not women. However, alcohol intake is positively associated with CCA-diameter in both men and women. Additional large population-based prospective studies are needed to confirm the effects of alcohol consumption on carotid artery structure.

Synthesis and evaluation of antitumor activity of novel 2-[Nmethyl-N-(4-methyl-1,3-benzothiazol-2-yl)aminomethyl]-5,8-diacyloxy-1,4-naphthoquinones.

A series of nine new compounds bridged by acyl groups at the 5,8-dihydroxyl group of DHNQ were synthesized and their cytotoxic activity against L1210 and P388 cancer cells was examined. Their antitumor action in mice bearing S-180 cells in the peritoneal cavity was also assessed. Increasing the size of the acyl group (compounds 7-9) up to propyl increased the antitumor activity (T/C value), whereas the cytotoxicity of these compounds was comparable against L1210 (lymphocytic leukemia) and P388 (lymphoid neoplasm) cancer cells. Further increasing in the chain length (compounds 11-15) decreased the potency. Thus, acyl group chains of three carbon atoms is optimal for antitumor activity. The most potent compound of this series was 2-[N-methyl-N-(4-methyl-1,3-benzothiazol-2-yl)aminomethyl]-5,8-dipropylcarbonyloxy-1,4-naphthoquinone (compound 9) with a T/C (%) value of 354.

Synthesis and electrical properties of (Bi(1/2)Na(1/2))TiO3 (BNT) ferroelectric thin films by liquid sprayed mist chemical vapor deposition technique.

This study aims to synthesize lead-free ferroelectric material, (Bi(1/2)Na(1/2))TiO3 using the Liquid Sprayed Mist Chemical Vapor Deposition (LSMCVD) technique. The mist of precursor solution was vaporized and deposited on two different substrates of Si(100) and (111)Pt/TiO2/SiO2/Si(100) in an oxygen atmosphere. The deposition temperature and time were varied in the range of 400-600 degrees C and 30-90 min. (Bi(1/2)Na(1/2))TiO3 thin film had preferred orientations of (110). The thickness of the thin film deposited was 35-162 nm. The remnant polarization (2Pr) and the dielectric constant were 4.6-16.8 microC/cm2, 325-350, respectively.

Synthesis and evaluation of antitumor activity of novel 1,4-naphthoquinone derivatives (IV).

1,4-Naphthoquinones are widely distributed in nature and many clinically important antitumor drugs containing a quinone moiety, such as anthracyclines, mitoxantrones and saintopin, show excellent anticancer activity. In this study, 2- or 6-substituted 5,8-dimethoxy-1,4-naphthoquinone (DMNQ) and 5,8-dihydroxy-1,4-naphthoquinone (DHNQ) derivatives were synthesized, and their cytotoxic activity against L1210 and P388 cancer cells was examined. Their antitumor activity was also assessed in mice bearing S-180 cells in the peritoneal cavity. In comparison with the DMNQ derivatives, the DHNQ derivatives exhibited more potent bioactivities than the DMNQ derivatives against both L1210 and P388 cells in vitro and S-180 cells in vivo. The ED50 values of the DHNQ derivatives against P388 cells were in the range of 0.18-1.81 microg/mL whereas those of the DMNQ derivatives were in the range of 0.26-40.41 microg/mL. The T/C (%) values of the DHNQ derivatives, 8, 17, 18, 19, and 20, were found to be comparable to or even better than that of adriamycin. It was also observed that the 2-substituted derivatives (8, 19, 20) showed better antitumor activity than the 6-substituted derivatives (7, 17, 18) in the mice bearing S-180 cells in the peritoneal cavity.

HbA1c is significantly associated with arterial stiffness but not with carotid atherosclerosis in a community-based population without type 2 diabetes: The Dong-gu study.

OBJECTIVES: We examined the associations between HbA1c levels and various atherosclerotic vascular parameters among adults without diabetes from the general population. METHODS: A total of 6500 community-dwelling adults, who were free of type 2 diabetes and ≥50 years of age, were included. High-resolution B-mode ultrasound was used to evaluate carotid artery structure, including intima-media thickness (IMT), plaque, and luminal diameter. Brachial-ankle pulse wave velocity (baPWV), which is a useful indicator of systemic arterial stiffness, was determined using an automatic waveform analysis device. RESULTS: No significant associations were observed between HbA1c, carotid IMT, plaque, or luminal diameter in a fully adjusted model. However, the odds ratio (95% confidence interval) for high baPWV (defined as the highest quartile) increased by 1.43 (1.19-1.71) per 1% HbA1c increase after adjusting for conventional risk factors in a multivariate logistic regression analysis. In addition, HbA1c was independently associated with baPWV in a multivariate linear regression analysis. CONCLUSIONS: High-normal HbA1c level was independently associated with arterial stiffness, but not with carotid atherosclerotic parameters, in the general population without diabetes. Our results suggest that the functional atherosclerotic process may already be accelerated according to HbA1c level, even at a level below the diagnostic threshold for diabetes.

Berberine-induced anticancer activities in FaDu head and neck squamous cell carcinoma cells.

In the present study, we investigated berberine­induced apoptosis and the signaling pathways underlying its activity in FaDu head and neck squamous cell carcinoma cells. Berberine did not affect the viability of primary human normal oral keratinocytes. In contrast, the cytotoxicity of berberine was significantly increased in FaDu cells stimulated with berberine for 24 h. Furthermore, berberine increased nuclear condensation and apoptosis rates in FaDu cells than those in untreated control cells. Berberine also induced the upregulation of apoptotic ligands, such as FasL and TNF-related apoptosis-inducing ligand, and triggered the activation of caspase-8, -7 and -3, and poly(ADP ribose) polymerase, characteristic of death receptor-dependent extrinsic apoptosis. Moreover, berberine activated the mitochondria­dependent apoptotic signaling pathway by upregulating pro-apoptotic factors, such as Bax, Bad, Apaf-1, and the active form of caspase-9, and downregulating anti-apoptotic factors, such as Bcl-2 and Bcl-xL. In addition, berberine increased the expression of the tumor suppressor p53 in FaDu cells. The pan-caspase inhibitor Z-VAD-fmk suppressed the activation of caspase-3 and prevented cytotoxicity in FaDu cells treated with berberine. Interestingly, berberine suppressed cell migration through downregulation of vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP)-2, and MMP-9. Moreover, the phosphorylation of extracellular signal-regulated kinase (ERK1/2) and p38, components of the mitogen-activated protein kinase pathway that are associated with the expression of MMP and VEGF, was suppressed in FaDu cells treated with berberine for 24 h. Therefore, these data suggested that berberine exerted anticancer effects in FaDu cells through induction of apoptosis and suppression of migration. Berberine may have potential applications as a chemotherapeutic agent for the management of head and neck squamous carcinoma.

Under-reporting of Energy Intake from 24-hour Dietary Recalls in the Korean National Health and Nutrition Examination Survey.

OBJECTIVES: Chronic degenerative diseases are closely related to daily eating habits, nutritional status, and, in particular, energy intake. In clarifying these relationships it is very important for dietary surveys to report accurate information about energy intake. This study attempted to identify the prevalence of the under-reporting of energy intake and its related characteristics based on the Korean National Health and Nutrition Examination Survey conducted in the years 2007-2009. METHODS: The present study analyzed dietary intake data from 15,133 adults aged ≥19 years using 24-hour dietary recalls. Basal metabolic rates were calculated from the age- and gender-specific equations of Schofield and under-reporting was defined as an energy intake <0.9, represented by the ratio of energy intake to estimated basal metabolic rate. RESULTS: Under-reporters (URs) accounted for 14.4% of men and 23.0% of women and the under-reporting rate was higher in the age group 30-49 years for both men and women. The results from an analysis of the age-specific socioeconomic characteristics of participants classified as URs showed that under-reporting was high in women living alone and in women with only elementary school education or no education. The results from an analysis of the health-specific characteristics of URs showed that a large proportion of URs had poor self-rated health or were obese, or both, compared with non-URs. The proportion of participants who consumed less than the estimated average requirements for nutrients was significantly higher in URs compared with non-URs. CONCLUSION: The under-reporting of energy intake was associated with age, gender, education level, income level, household status (single-person or multi-person), self-rated health, physical activity, and obesity.

Cohort Profile: The Namwon Study and the Dong-gu Study.

These two cohorts were designed to examine the increasing burden of chronic diseases among Korean populations. The studies investigated determinants for stroke, osteoporosis, dementia and cancer among middle-aged and elderly Korean populations. The Namwon Study baseline survey was performed between 2004 and 2007 (n = 10 667), and followed up 4 years later (n = 8157, follow-up rate = 76.5%). The baseline survey of the Dong-gu Study was administered over 2007-2010 (n = 9260), and will be followed up between 2014 and 2015. Questionnaires included assessment of cognitive function, psychiatric health and lifestyle factors. Clinical examinations, biochemical tests and genotyping focused on evaluating the determinants of target diseases and their intermediate phenotypes. Potential collaborators will be invited to contact the chief investigators.

The effect of a nutritional education program on the nutritional status of elderly patients in a long-term care hospital in Jeollanamdo province: health behavior, dietary behavior, nutrition risk level and nutrient intake.

This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P < 0.001) and of depression (P < 0.001) improved significantly and that dietary behavior scores also improved significantly (P < 0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P < 0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.