Preventive Effect of Korean Red Ginseng for Acute Respiratory Illness: A Randomized and Double-Blind Clinical Trial

Korean Red Ginseng (KRG) is a functional food and has been well known for keeping good health due to its anti-fatigue and immunomodulating activities. However, there is no data on Korean red ginseng for its preventive activity against acute respiratory illness (ARI). The study was conducted in a randomized, double-blinded, placebo-controlled trial in healthy volunteers (Clinical Trial Number: NCT01478009). Our primary efficacy end point was the number of ARI reported and secondary efficacy end point was severity of symptoms, number of symptoms, and duration of ARI. A total of 100 volunteers were enrolled in the study. Fewer subjects in the KRG group reported contracting at least 1 ARI than in the placebo group (12 [24.5%] vs 22 [44.9%], P = 0.034), the difference was statistically significant between the two groups. The symptom duration of the subjects who experienced the ARI, was similar between the two groups (KRG vs placebo; 5.2 +/- 2.3 vs 6.3 +/- 5.0, P = 0.475). The symptom scores were low tendency in KRG group (KRG vs placebo; 9.5 +/- 4.5 vs 17.6 +/- 23.1, P = 0.241). The study suggests that KRG may be effective in protecting subjects from contracting ARI, and may have the tendency to decrease the duration and scores of ARI symptoms.

Feasibility Study of Early Oral Intake after Gastrectomy for Gastric Carcinoma

PURPOSE: Despite the compelling scientific and clinical data supporting the use of early oral nutrition after major gastrointestinal surgery, traditional bowel rest and intravenous nutrition for several postoperative days is still being used widely after gastric cancer surgery. MATERIALS AND METHODS: A phase II study was carried out to evaluate the feasibility and safety of postoperative early oral intake (water intake on postoperative days (POD) 1-2, and soft diet on POD 3) after a gastrectomy. The primary outcome was morbidity within 30 postoperative days, which was targeted at <25% based on pilot study data. RESULTS: The study subjects were 90 males and 42 females with a mean age 61.5 years. One hundred and four (79%) and 28 (21%) patients underwent a distal and total gastrectomy, respectively. The postoperative morbidity rate was within the targeted range (15.2%, 95% CI, 10.0~22.3%), and there was no hospital mortality. Of the 132 patients, 117 (89%) successfully completed a postoperative early oral intake regimen without deviation; deviation in 10 (8%) due to gastrointestinal symptoms and in five (4%) due to the management of postoperative complications. The mean times to water intake and a soft diet were 1.0+/-0.2 and 3.2+/-0.7 days, respectively, and the mean hospital stay was 10.0+/-6.1 days. CONCLUSIONS: Postoperative early oral intake after a gastrectomy is feasible and safe, and can be adopted as a standard perioperative care after a gastrectomy. Nevertheless, further clinical trials will be needed to evaluate the benefits of early oral nutrition after upper gastrointestinal surgery.

Intraperitoneal Bronchogenic Cyst Misidentified as Gastric Submucosal Tumor

Most bronchogenic cysts originate in the mediastinum, while 15% to 20% occur in the lung parenchyma. According to the literature, most intrapulmonary cysts occur in the lower lobes. But, they are rarely located in an extrathoracic site, such as subdiaphragmatic retroperitoneal area. We describe a paraesophageal intra-abdominal bronchogenic cyst, first considered as gastric submucosal tumor. Resection was successfully realized by laparoscopy. A 20-year-old female was admitted to our hospital with incidentally detected gastric submucosal tumor. At operation, there was a 2.5x2 cm sized cystic tumor that was isolated from the gastric wall. We performed tumor resection laparoscopically. The postoperative course was uneventful and the patient was discharged on the second postoperative day. Histological examination reported a bronchogenic cyst. We, herein, report this case.

The Surgical Diagnosis for Detecting Early Gastric Cancer and Lymph Node Metastasis: Its Role for Making the Decision of the Limited Surgery

PURPOSE: The aim of this study is to evaluate the accuracy of surgically diagnosing early gastric cancer (EGC) and lymph node metastasis, and to determine its role for performing limited surgery for EGC. MATERIALS AND METHODS: We reviewed 369 patients who underwent gastrectomy for primary gastric carcinoma. The surgical diagnosis was evaluated by determining its sensitivity, specificity and accuracy, and this was compared with the preoperative examinations. RESULTS: The sensitivity, specificity, and accuracy of the intraoperative diagnosis for EGC were 74.5%, 95.7% and 83.7%, respectively. The predictive value for EGC according to the intraoperative diagnosis was 95.7%. The surgical diagnosis of EGC showed higher specificity and a higher predictive value than preoperative examinations, which significantly reduced the risk of underestimating advanced gastric cancer (AGC) to EGC. The sensitivity, specificity, and accuracy for lymph node metastasis according to the surgical diagnosis were 73.2%, 78.1% and 76.4%, respectively. For 70 patients with a discrepancy in the diagnosis of EGC between the pre- and intra-operative diagnosis, the surgical diagnosis was correct in 63 (90%) patients, but the preoperative examinations were correct in only 7 (10%) patients. CONCLUSION: The surgical diagnosis showed better accuracy than the preoperative examinations for detecting EGC and lymph node metastasis. Our results suggest that the decision for conducting limited surgery based on the surgical diagnosis might reduce the risk of under-treatment of AGC to EGC better than the preoperative examinations.

Essential Oil Prepared from Cymbopogon citrates Exerted an Antimicrobial Activity Against Plant Pathogenic and Medical Microorganisms

Essential oils are mixtures of volatile, lipophilic compounds originating from plants. Some essential oils have useful biological activities including antimicrobial, spasmolytic, antiplasmodial, and insect-repelling activities. In this study, we tested the antimicrobial activity of essential oil prepared from the aromatic plant, Cymbopogon citrates, against three important plant pathogenic and medical microorganisms, Pectobacterium carotovorum, Colletotrichum gloeosporioides, and Aspergillus niger. It effectively inhibited the growth of the bacterium, Pectobacterium carotovorum, in a dose-dependent fashion, and 0.5% of the oil inhibited the growth of bacteria completely. Similarly, the essential oil inhibited the growth of plant pathogenic fungus, Colletotrichum gloeosporioides, and the addition of 1% of essential oil completely inhibited the growth of fungus even after 5 days of culture. Finally, it effectively inhibited the growth of the medically and industrially important fungal species, Aspergillus spp. These results suggest that the essential oil from Cymbopogon citrates may be an environmentally safe alternative to inhibit antimicrobial agents for various uses.

Antimicrobial Activity of Methanol Extract from Ficus carica Leaves Against Oral Bacteria

Ficus carica L. (fig) belongs to the mulberry tree (Moraceae) which is one of the oldest fruits in the world. It has been used as a digestion promoter and a cure for ulcerative inflammation and eruption in Korea. The present study investigated the antimicrobial activity of methanol (MeOH) extract of figs against oral bacteria. The MeOH extract (MICs, 0.156 to 5 mg/ml; MBCs, 0.313 to 5 mg/ml) showed a strong antibacterial activity against oral bacteria. The combination effects of MeOH extract with ampicillin or gentamicin were synergistic against oral bacteria. We suggest that figs could be employed as a natural antibacterial agent in oral care products.

The Usefulness of Serum Tumor Markers as a Predictor of Peritoneal Metastasis in Patients with Gastric Carcinoma: CA 19-9 and CEA

PURPOSE: The usefulness of serum tumor markers for assessing gastric carcinoma is very limited compared to that for neoplasms in other digestive organs. Many reports have shown that serum tumor markers are closely associated with the prognosis and tumor recurrence in gastric cancer patients. However, little is known about the usefulness of serum tumor markers as a predictor of distant metastasis for gastric carcinoma. MATERIALS AND METHODS: With excluding the non-specific causes of elevated tumor markers, a total of 788 patients with gastric carcinoma and who were seen at our hospitals between 2004 and 2006 were included in this study. The correlation between the preoperative level of tumor makers and the clinicopathological features was analyzed. RESULTS: CEA was significantly correlated with age, gender and nodal metastasis, but not with the depth of tumor. The CEA level was not correlated with distant metastasis, such as peritoneal or hematogenous metastasis. In contrast, the CA 19-9 level was significantly correlated not only with the depth of tumor and nodal metastasis, but also with peritoneal metastasis. Especially, the patients with over 500% elevation of the CA 19-9 level had a significant risk of peritoneal metastasis. CONCLUSION: CA 19-9 is useful for predicting peritoneal metastasis in gastric cancer patients. It can be used efficiently in making the diagnostic and the treatment plan, in combination with other diagnostic tools, for gastric cancer patients.

Evaluation of the Safety and Feasibility of D2 Lymphadenectomy in Elderly Patients with Gastric Cancer

PURPOSE: The aim of this study was to evaluate the safety and feasibility of D2 lymphadenectomy in elderly patients with gastric cancerby comparing the surgical outcomes and postoperative courses between an elderly group and a control group undergoing the same procedure. MATERIALS AND METHODS: Clinical information was reviewed for 1251 patients with gastric cancer who underwent gastrectomy between May 2004 and May 2007. Patients were classified into the following two groups: an elderly group (older than the average life span in Korea) and a control group (younger than the elderly group). Clinicopathologic features and postoperative courses after D2 lymphadenectomy were reviewed and compared between the two groups. RESULTS: There were a total of 120 (9%) elderly group patients among all those reviewed, and 86 (72.2%) of them underwent D2 lymphadenectomy. There was 27.5% postoperative morbidity in the elderly group, which was significantly different from thecontrol group (12.8%, p=0.003). However, on multivariate analysis, ASA score and combined resection were independent predictive factors of postoperative complications, while age was not predictive. CONCLUSION: Older age is not a predictive factor of postoperative complications in itself, and D2 lymphadenectomy can be safely performed in elderly patients with gastric cancer, provided they have good ASA scores and do not undergo accompanying combined resection.