Korean Guidelines for Pharmacoeconomic Evaluations: Updates in the Third Version.

The first version of the pharmacoeconomic (PE) guidelines was published in South Korea in 2006. Despite its first revision in 2011, there were still ambiguities in its interpretation. Moreover, methodologies for estimating effectiveness and costs have also evolved since then. Under these circumstances, the Health Insurance Review and Assessment Service published the third version in January 2021. This article reviews the revision process and major changes made in the new edition of the PE guidelines. The revision was processed through reviews of the previous 50 PE submissions, international guidelines, academic literature, and surveys and advisory meetings to obtain stakeholders' opinions. The analysis perspective has changed from a limited societal perspective to a healthcare system perspective. In addition to the drug with the highest market share, drugs used in clinical trials can be selected as comparators under certain conditions. The discount rate decreased from 5% to 4.5%. Furthermore, the revised guidelines provide more detailed and specific instructions for items including non-inferiority margin, extrapolation, utility elicitation, and uncertainty. Treatment switch and co-dependent technology guidelines are newly included; the budget impact analysis guideline is deleted. Through this revision, transparency and consistency of decision-making is expected to improve.

Cordycepin induces apoptosis in human bladder cancer T24 cells through ROS-dependent inhibition of the PI3K/Akt signaling pathway.

Cordycepin, a derivative of nucleoside adenosine, is one of the active ingredients extracted from the fungi of genus Cordyceps, which have been used for traditional herbal remedies. In this study, we examined the effect of cordycepin on the proliferation and apoptosis of human bladder cancer T24 cells and its mechanism of action. Cordycepin treatment significantly reduced the cell survival rate of T24 cells in a concentration-dependent manner, which was associated with the induction of apoptosis. Cordycepin activated caspase-8 and -9, which are involved in the initiation of extrinsic and intrinsic apoptosis pathways, respectively, and also increased caspase-3 activity, a typical effect caspase, subsequently leading to poly (ADP-ribose) polymerase cleavage. Additionally, cordycepin increased the Bax/Bcl-2 ratio and truncation of Bid, and destroyed the integrity of mitochondria, which contributed to the cytosolic release of cytochrome c. Moreover, cordycepin effectively inactivated the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway, while LY294002, a PI3K/Akt inhibitor, increased the apoptosis-inducing effect of cordycepin. Cordycepin further enhanced the intracellular levels of reactive oxygen species (ROS), while the addition of N-acetyl cysteine (NAC), a ROS inhibitor, significantly diminished cordycepin-induced mitochondrial dysfunction and growth inhibition, and also blocked the inactivation of PI3K/Akt signaling pathway. Furthermore, the presence of NAC significantly attenuated the enhanced apoptotic cell death and reduction of cell viability by treatment with cordycepin and LY294002. Collectively, the data indicate that cordycepin induces apoptosis through the activation of extrinsic and intrinsic apoptosis pathways and the ROS-dependent inactivation of PI3K/Akt signaling in human bladder cancer T24 cells.

Breast and Cervical Cancer Screening Behavior in Female Cancer Survivors: The Korea National Health and Nutrition Examination Survey, 2007-2012.

BACKGROUND: The aim of this study was to compare breast and cervical cancer screening rates between female cancer survivors and a population without cancer to identify factors related to cervical and breast cancer screening in cancer survivors. METHODS: We included 17,765 adults (738 cancer survivors and 17,027 individuals without cancer) in this study, all of whom who were 30 years of age or older and participated in the Fourth and Fifth Korean National Health and Nutritional Examination Surveys from 2007-2012. Multiple logistic regression analysis was performed to identify factors related to cervical and breast cancer screening uptake in female cancer survivors. RESULTS: The screening rate for breast cancer was 56.6%, which was higher than that in the non-cancer control group (P=0.001). The screening rate for cervical cancer was 51.4%, which was not different from that of the non-cancer control group. In terms of breast cancer screening, cancer survivors showed no significant difference in the rate of screening 5 years after their cancer diagnosis. However, cervical cancer survivors were less likely to have cervical cancer screening 10 years after their cancer diagnosis. There was no significant association between cancer screening and sociodemographic factors. CONCLUSION: Breast and cervical cancer screening rates in Korean female cancer survivors are low. Secondary primary cancer screening of female cancer survivors needs to be planned in a comprehensive manner, with the consideration of influences beyond sociodemographic factors.

Needs analysis and development of a tailored mobile message program linked with electronic health records for weight reduction.

OBJECTIVE: We developed and pilot-tested a personalized text messaging service program based on data from electronic health records (EHRs) and lifestyle questionnaires for weight control. METHODS: In the health promotion center of a hospital, 340 participants with a body mass index (BMI) greater than 25 were recruited and surveyed for the development of a text messaging program. After developing the interface linking the EHRs with personalized text messages for weight loss, we pilot-tested this program in 102 participants for its feasibility, acceptability and satisfaction. RESULTS: According to the needs analysis, the participants desired additional information about personalized nutrition and exercise. We selected many variables from the EHRs and questionnaires to create text messages with a more personalized program. After a 1-month trial of the text messaging program, the participants' satisfaction score was 7.9 ± 1.5 and recommendation score was 7.5 ± 1.8. CONCLUSIONS: A personalized short message service (SMS) linked with EHRs was feasible, and the pilot test showed high satisfaction and recommendation scores. Further evaluation using a well-designed trial will be needed.

Chlorella methanol extract reduces lipid accumulation in and increases the number of apoptotic 3T3-L1 cells.

Obesity is a fast-growing problem that is reaching pandemic proportions. Chlorella has many biological merits for promoting health, including detoxification, boosting the immune system, and even reversing cancer. In this study, we found that methanol extract of Chlorella reduces lipid accumulation in 3T3-L1 adipocytes. It has been postulated that these antiobesity effects could be a result of reducing adipogenesis. First, the MTT assay indicated that Chlorella significantly inhibited cell growth of 3T3-L1 preadipocytes. The accumulation of triacylglycerol in 3T3-L1 adipocytes decreased in cells treated with Chlorella versus those in untreated cells by Oil Red O staining. In parallel, Chlorella showed a significant dose-dependent increase in lactate dehydrogenase activity in culture medium of differentiated 3T3-L1 adipocytes. Second, we investigated the effects of Chlorella on the induction of apoptosis by fluorescence-activated cell sorting analysis. Chlorella showed that apoptotic cells increased in a time- and dose-dependent manner in cell apoptosis analysis by propidium iodide (PI) staining. Treatment with Chlorella decreased the number of normal cells and increased the number of apoptotic cells in a dose-dependent manner in annexin V-fluorescein isothiocyanate/PI double staining. Therefore, Chlorella is expected to efficiently reduce adipogenesis in 3T3-L1 adipocytes and to induce apoptosis in 3T3-L1 preadipocytes.