Overview of the National Cancer Screening Program for Colorectal Cancer in Korea over 14 Years (2004-2017) / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to evaluate the participation and follow-up test compliance rates and key performance indicators of the National Cancer Screening Program (NCSP) for colorectal cancer (CRC) from 2004 to 2017. @*Materials and Methods@#The overall outcomes of the NCSP for CRC were analyzed using the NCSP data collected from 2004 to 2017 and the Korean Central Cancer Registry for CRC from 2005 to 2017. We cross-sectionally analyzed the participation and follow-up test compliance rates and performance indicators for each year. The trend of participation rates as an annual percentage change was assessed, and other statistical analyses were performed. @*Results@#The screening participation rates increased from 7.3% in 2004 to 30.5% in 2017. Additionally, the screening rates were higher among individuals aged 60-69 years and National Health Insurance Service beneficiaries of low-income status. However, the adherence to the follow-up test decreased from 63% in 2004 to 32% in 2017. The follow-up tests using the double-contrast barium enema method decreased from 42.2% in 2004 to 0.3% in 2017. However, follow-up tests by colonoscopy increased from 21.0% in 2004 to 31.8% in 2017. Furthermore, the positivity, false-positive, and interval CRC rates decreased, whereas the specificity increased from 2004 to 2016, indicating improved performance of CRC. @*Conclusion@#The participation rates and performance of the NCSP for CRC have steadily improved, whereas adherence to follow-up tests has decreased. Additionally, there is a rapid growth in colonoscopy volume as a follow-up test. Continued efforts are required to improve the follow-up rates.

Comparison of the Efficacy and Safety of Atorvastatin 40 mg/ω-3 Fatty Acids 4 g Fixed-dose Combination and Atorvastatin 40 mg Monotherapy in Hypertriglyceridemic Patients who Poorly Respond to Atorvastatin 40 mg Monotherapy: An 8-week, Multicenter, Randomized, Double-blind Phase III Study.

PURPOSE: Residual cardiovascular risk in patients with hypertriglyceridemia, despite optimal low-density lipoprotein cholesterol levels being achieved with intensive statin treatment, is a global health issue. The purpose of this study was to investigate the efficacy and tolerability of treatment with a combination of high-dose atorvastatin/Ω-3 fatty acid compared to atorvastatin + placebo in patients with hypertriglyceridemia who did not respond to statin treatment. METHODS: In this multicenter, randomized, double-blind, placebo-controlled study, patients who had residual hypertriglyceridemia after a 4-week run-in period of atorvastatin treatment were randomly assigned to receive UI-018 (fixed-dose combination atorvastatin/Ω-3 fatty acid 40 mg/4 g) or atorvastatin 40 mg + placebo (control). The primary efficacy end points were the percentage change from baseline in non-high density lipoprotein cholesterol (non-HDL-C) level at the end of treatment and the adverse events recorded during treatment. A secondary end point was the percentage change from baseline in triglyceride level. FINDINGS: After 8 weeks of treatment, the percentage changes from baseline in non-HDL-C (-4.4% vs +0.6%; p = 0.02) and triglycerides (-18.5% vs +0.9%; p < 0.01) were significantly greater in the UI-018 group (n = 101) than in the control group (n = 99). These changes were present in subgroups of advanced age (≥65 years), status (body mass index ≥25 kg/m2), or without diabetes. The prevalences of adverse events did not differ between the 2 treatment groups. IMPLICATIONS: In patients with residual hypertriglyceridemia despite receiving statin treatment, a combination of high-dose atorvastatin/Ω-3 fatty acid was associated with a greater reduction of triglyceride and non-HDL-C compared with atorvastatin + placebo, without significant adverse events.

Comparative pharmacokinetics of three marker compounds in mBHT and single-herb extract after oral administration to rats.

Modified Bo-Yang-Hwan-O-Tang (mBHT) is a decoction of 12 herbs traditionally used in the treatment of cerebral and cardiac stroke and vascular dementia. Paeoniflorin (PF), calycosin-7-O-ß-D-glycoside (CY), and salvianolic acid B (SB) are marker compounds for extracts of the herbs Paeoniae Radix, Astragali Radix, and Salviae Miltiorrhizae Radix, respectively, and are used to assess the quality of mBHT. This study examined the pharmacokinetics of these three marker compounds following oral administration of each herb extract alone and in combination as mBHT in rats. The concentrations of the three compounds in rat plasma were determined by high-performance liquid chromatography, using a C18 column (2.1×150 mm, 5 µm) and mobile phases of methanol-water-formic acid (10:90:0.05, v/v) and methanol-water (90:10, v/v). The results indicated that the pharmacokinetic parameters of Paeoniae Radix extract group and mBHT group were very similar, while those of Salviae Miltiorrhizae Radix extract group and mBHT group were significantly different (P<0.05, t-test). The T(max), AUC and T(1/2) of SB for Salviae Miltiorrhizae Radix extract group were 54.7 min, 598.7 µg min/ml and 37.4 min, respectively. However, these values increased to 77.6 min, 915.9 µg min/ml and 53.7 min for mBHT group, supposing that excretion of SB could be more retarded when administered in mBHT than in Salviae Miltiorrhizae Radix extract.

Multiple component quantitative analysis for the pattern recognition and quality evaluation of Kalopanacis Cortex using HPLC.

A quantitative and pattern recognition analyses were conducted for quality evaluation of Kalopanacis Cortex (KC) using HPLC. For quantitative analysis, four bioactive compounds, liriodendrin, pinoresinol O-ß-D-glucopyranoside, acanthoside B and kalopanaxin B, were determined. The analysis method was optimized and validated using ODS column with mobile phase of methanol and aqueous phosphoric acid. The validation gave acceptable linearities (r > 0.9995), recoveries (98.4% to 101.9%) and precisions (RSD < 2.20). The limit of detection of compounds ranged from 0.4 to 0.9 µg/mL. Among the four compounds, liriodendrin was recommended as a marker compound for the quality control of KC. The pattern analysis was successfully carried out by analyzing thirty two samples from four species, and the authentic KC samples were completely discriminated from other inauthentic species by linear discriminant analysis. The results indicated that the method was suitable for the quantitative analysis of liriodendrin and the quality evaluation of KC.

Healthy cities approach as a new paradigm of public health policy

The healthy cities approach emphasizes the role of the leadership of local governments in promoting the health of the population in city settings. The concept emerged from public health strategies declared in the Ottawa Charter for Health Promotion, and reflects the characteristics of the third public health revolution. The Korean healthy cities movement, characterized by voluntary participation of local governments in the Alliance for Healthy Cities, has grown rapidly in recent years. A strong push of the healthy cities movement by a local government without a profound commitment to the vision may hinder the effective and sustainable development of the movement. By reviewing the historical background and significance of the healthy cities movement and its underlying concepts, and illustrating the main strategies and goals of the movement, that is, the development of partnerships, community participation and empowerment, and working in networks for stimulating change, this article argues that the healthy cities movement is a potent vehicle for implementing the new paradigm of public health introduced to local governments. We also argue that the Korean healthy cities movement needs more active participants and more support of the central government and other related stakeholders.

The impact of climate change on aeroalleregen and pediatric allergic diseases

The etiology of allergic diseases has been considered multi-factorial, comprising genetic, epigenetic, developmental, and environmental factors, as well as their complex interactions. The rising prevalence of allergic disease in recent decades could be explained by changes in environmental factors rather than genetic factors. Climate change has many significant impacts on aeroallergens such as pollen and mold. Therefore, climate changes are considered to be a key environmental factor affecting not only the prevalence but also the severity of allergic disease. In addition, these environmental factors might be more important for young children than for adults. While the concept that environmental factors including climate change would affect the characteristics of allergic disease is generally accepted, it is not enough to explain the mechanisms of the increase in the prevalence and severity of allergic diseases. Nevertheless, evidence exists that climate change has spurred changes in aeroallergens such as pollen and outdoor fungi, and that these changes are associated with the increased incidence of pediatric allergic disease.

Results of Colorectal Cancer Screening of the National Cancer Screening Program in Korea, 2008 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study aims to investigate the current situation of national colorectal cancer screening by analyzing participation rates, positive rates of screening methods and screening rate of secondary screening tests in colorectal screening of the national cancer screening program in 2008. MATERIALS AND METHODS: With database about target population and screened individuals of the national cancer screening program, the results of target population and participants of colorectal cancer screening in 2008 were analyzed. Among adults aged over 50 years of medical aid and beneficiaries of national health insurance paying lower 50% premiums in the total subscribers, 4,640,365 were target population of colorectal cancer screening and the data of 984,915 undergoing fecal occult blood test (FOBT) as a primary screening were analyzed. RESULTS: The colorectal cancer screening rate was 21.2% and the rates of national health insurance subscribers, females and the elderly aged 60-64 years were higher than those of others. The recipients with a positive result in FOBT recorded approximately 7.5%. Medical aid beneficiaries (7.9%), males (8.8%) and seniors aged over 75 years (9.1%) showed higher positive rates than the average one. Out of the FOBT positive recipients, 43.0% took a secondary screening and the rate undergoing colonoscopy (31.4%) was higher than that of doing double-contrast barium enema test (11.6%). CONCLUSION: Colorectal cancer screening rate of medical aid beneficiaries and people paying lower 50% premiums among national health insurance subscribers, was different according to demographic characters (gender, age and types of health insurance). This finding meant that screening for the vulnerable needed to be encouraged by considering socio-demographic characters. Additionally, more efforts were necessary to increase the secondary screening rate of people with a positive result in primary one.