The Cytotoxic Constituents of Betula platyphylla and their Effects on Human Lung A549 Cancer Cells

During the screening for cytotoxic compounds from plants grown in Korea, Betula platyphylla (BP) showed potent activity against the adenocarcinomic human alveolar basal epithelial A549 cell line. To identify the cytotoxic components from BP, the CH₂Cl₂ fraction with the most significant cytotoxic effect was applied to the column chromatographies. Seven compounds were isolated: lupeol (1), betulinic acid (2), (−)-rhododendrol (3), platyphyllenone (4), platyphyllone (5), (−)-centrolobol (6), and oleanolic acid (7). Among them, three diarylheptanoids (4 – 6) exhibited cytotoxicity toward A549 cells. Especially, 50 µM of 4 reduced A549 cell viability to 18.93 ± 0.82% compared to control (100.00 ± 21.48%). Lactate dehydrogenase (LDH) leakage and intracellular reactive oxygen species (ROS) production were also induced by 50 µM 4. This is the first report on the cytotoxic effect of BP-derived diarylheptanoids 4–6 against A549 cells. The compound 4 may be useful for the development of early hit compounds for non-small cell lung carcinoma, but the consideration about selectivity of 4 is required since 4 also showed the cytotoxicity in the human normal lung epithelial BEAS-2B cell line.

Dietary behaviors of female marriage immigrants residing in Gwangju, Korea / 한국영양학회지

PURPOSE: This cross-sectional study aimed to document the dietary behaviors, dietary changes, and health status of female marriage immigrants residing in Gwangju, Korea. METHODS: The survey included 92 female immigrants attending Korean language class at a multi-cultural family support center. General characteristics, health status, anthropometric data, dietary behaviors, and dietary changes were collected. RESULTS: Mean age of subjects was 31.3 years, and home countries of subjects were Vietnam (50.0%), China (26.0%), Philippines (12.0%), and others (12.0%). Frequently reported chronic diseases were digestive diseases (13.2%), anemia (12.1%), and neuropsychiatry disorder (8.9%). Seventeen percent of the subjects was obese (BMI ≥ 25 kg/m²). Dietary score by Mini Dietary Assessment was 3.45 out of 5 points. Dietary scores for dairy foods, meat/fish/egg/bean intake, meal regularity, and food variety were low, and those for fried foods and high fat meat intake were also low. Thirty-three percent of subjects answered that they have changed their diet and increased their consumption of fruits and vegetables after immigration. Length of residence in Korea was positively associated with BMI and waist circumference. Length of residence tends to be positively associated with dietary changes and obesity as well as inversely associated with disease prevalence. CONCLUSION: The study shows that length of residence is inversely related to disease prevalence. However, this association is thought to be due to the relatively short period of residence in Korea and thus the transitional phase to adapting to dietary practices. As the length of residence increases, disease patterns related to obesity are subject to change. Healthy dietary behaviors and adaptation to dietary practices in Korea in female marriage immigrants will not only benefit individuals but also their families and social structure. Therefore, varied, long-term, and target-specific studies on female marriage immigrants are highly needed.

Food intake and nutritional status of female marriage immigrants residing in Gwangju, Korea / 한국영양학회지

PURPOSE: This study was conducted to assess the nutritional status of female marriage immigrants attending Korean language class in Gwangju, Korea by analyzing daily food and nutrient intake. METHODS: Eighty-three female immigrants completed a survey. Anthropometric measurements were obtained, and dietary food intake was assessed using a 1-day 24 hour recall method. RESULTS: The average length of residence in Korea was 5.3 years, and mean age of subjects was 31.0 years old. The home countries of subjects were Vietnam (50.6%), China (24.1%), Philippines (13.3%), and others (12%). Due to the length of residence, there were significant differences in body weight (p < 0.05), BMI (p < 0.05), percent body fat (p < 0.05), and diastolic blood pressure (p < 0.05). The subjects who were 30~49 years old consumed more vegetables and less seaweed than the subjects who were 20~29 years old. The other kinds of consumed foods were similar among groups in different age groups or lengths of residence in Korea. Average energy intake of subjects was 1,641.0 Kcal. The group with less than 5 years of residence showed higher cholesterol intake than the group with 5 or more years of residence in Korea (p < 0.05). There was no significant difference in nutrient intake between the groups of different age or length of residence. There was a positive association among dietary cholesterol intake and consumption of eggs, milk. and dairy products, and blood pressure. CONCLUSION: The study shows that length of residence affects rate of obesity and nutritional status. Further extensive research is needed to understand the effect of dietary changes and nutritional status of female marriage immigrants as well as for their successful adaptation to develop a more active and long-term nutrition education program.

Refinement and Evaluation of Korean Outpatient Groups for Visits with Multiple Procedures and Chemotherapy, and Medical Visit Indicators / 보건행정학회지

BACKGROUND: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. METHODS: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. RESULTS: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. CONCLUSION: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.

A Comparison of the In Vitro Inhibitory Effects of Thelephoric Acid and SKF-525A on Human Cytochrome P450 Activity

Thelephoric acid is an antioxidant produced by the hydrolysis of polyozellin, which is isolated from Polyozellus multiplex. In the present study, the inhibitory effects of polyozellin and thelephoric acid on 9 cytochrome P450 (CYP) family members (CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1, and CYP3A4) were examined in pooled human liver microsomes (HLMs) using a cocktail probe assay. Polyozellin exhibited weak inhibitory effects on the activities of all 9 CYPs examined, whereas thelephoric acid exhibited dose- and time-dependent inhibition of all 9 CYP isoforms (IC50 values, 3.2-33.7 muM). Dixon plots of CYP inhibition indicated that thelephoric acid was a competitive inhibitor of CYP1A2 and CYP3A4. In contrast, thelephoric acid was a noncompetitive inhibitor of CYP2D6. Our findings indicate that thelephoric acid may be a novel, non-specific CYP inhibitor, suggesting that it could replace SKF-525A in inhibitory studies designed to investigate the effects of CYP enzymes on the metabolism of given compounds.

Nutritional roles and health effects of eggs / 한국영양학회지

PURPOSE: The aim of this study is to examine the effects of egg consumption and suggest proper guidelines for consumption of eggs by determining the relationship between eggs and cholesterol. METHODS: Literature review was conducted on the relationship between nutritional, functional properties of eggs and serum cholesterol, as well as cardiovascular disease. RESULTS: Eggs, which are a good protein food with complete amino acid composition, contain vitamin A, riboflavin, vitamin B1(2), folic acid, vitamin D, vitamin E, vitamin K, calcium, iron, choline, selenium, beta-carotene, lutein, zeaxanthin, etc. However the egg yolk has a high cholesterol content, which is associated with chronic diseases, including heart disease and hypertension. As a result, its intake is subject to regulation. Outbreak of heart disease by yolk intake can show different results depending on the characteristics of the subjects, amount of egg intake, and the implications of other foods eaten. It is difficult to determine whether eggs are beneficial, as they are the main supplying source for other major nutritive elements as well. Several research studies insist that when cholesterol intake increases by 100 mg, the level of serum cholesterol increases by 2.2~4.5 mg/dL and when serum cholesterol increases by 1%, the risk of heart disease increases by 2%. This indicates that a large intake of eggs can increase the risk of heart disease. Although the cholesterol of egg yolk and serum cholesterol are correlated, it is insufficient to conclude that only cholesterol and not other components are related to heart disease. In fact, other components in egg such as various unsaturated fatty acids and phospholipids could be related as well. Rather than concluding egg as a 'good' or 'bad' food according to its cholesterol content, it is important to define egg as a part of dietary patterns. CONCLUSION: Generalizing an indiscriminate and uniform amount of egg intake for all seems inadequate. However, patients with diabetes or heart disease should pay particular attention to the amount of egg intake. As for the norm, eating egg with vegetables as a substitute for other animal products seems beneficial.

Comparison of dietary food and nutrient intakes by supplement use in pregnant and lactating women in Seoul

This study was performed to compare the dietary food and nutrient intakes according to supplement use in pregnant and lactating women in Seoul. The subjects were composed of 201 pregnant and 104 lactating women, and their dietary food intake was assessed using the 24-h recall method. General information on demographic and socioeconomic factors, as well as health-related behaviors, including the use of dietary supplements, were collected. About 88% and 60% of the pregnant and lactating women took dietary supplements, respectively. The proportion of dietary supplements used was higher in pregnant women with a higher level of education. After adjusting for potential confounders, among the pregnant women, supplement users were found to consume 45% more vegetables, and those among the lactating women were found to consume 96% more beans and 58% more vegetables. The intakes of dietary fiber and beta-carotene among supplement users were higher than those of non-users, by 23% and 39%, respectively. Among pregnant women, the proportion of women with an intake of vitamin C (from diet alone) below the estimated average requirements (EAR) was lower among supplement users [users (44%) vs. non-users (68%)], and the proportion of lactating women with intakes of iron (from diet alone) below the EAR was lower among supplement users [usesr (17%) vs. non-users (38%)]. These results suggest that among pregnant and lactating women, those who do not use dietary supplements tend to have a lower intake of healthy foods, such as beans and vegetables, as well as a lower intake of dietary fiber and beta-carotene, which are abundant in these foods, and non-users are more likely than users to have inadequate intake of micro-nutrient such as vitamin C and iron.

The Effect of Hearing Music on Pain Response during Blood Sampling in Neonates

PURPOSE: We studied this study to see the effect of hearing music on response to pain during needling. We hypothesized that music would reduce pain in newborns. METHODS: Twenty term and near-term newborns were enrolled for the study. They were admitted to neonatal intensive care unit of Hanyang University Guri Hospital from May 1, 2011 to September 30, 2011. We evaluated pain response to needling, such as arterial puncture or heel prick, by using Neonatal Infant Pain Scale (NIPS; facial expression, crying, breathing patterns, arms, legs, state of arousal) and duration of crying through video recording. We started video recording when the newborns were stable with 0 score of NIPS, and continued for 3 minutes after needling. Each newborn took video-recordings in 2 separate periods. One was done with hearing music (Music group) and the other without music (Control group). Two observers reviewed the videotapes and gave final scores in agreement. T-test was done for comparisons of pain scale and duration of crying between music and control groups. RESULTS: Mean age and hospital days at test of the subjects were 6+/-5 days of life (1-16 days of life) and 3+/-2 days, respectively. Twenty-one of 40 needlings (52.5%) for blood sample were from radial arterial puncture and 19 (47.5%) from heel prick. The music group had lower NIPS score than the controls (5.6+/-1.1 vs 6.5+/-0.7, P=0.006). Among the NIPS parameters, the music group had lower scores in crying and arm (crying, 1.6+/-0.5 vs 1.9+/-0.3, P=0.028; arm, 0.3+/-0.5 vs 0.7+/-0.5, P=0.01) parameters. The remaining parameters such as facial expression, leg, breathing patterns and state of arousal, and duration of crying were not significantly different in 2 groups. CONCLUSION: c reduced pain response to needling in newborns. Music could be one of modalities to relieve pain during routine medical procedures in newborns.

Glycine- and GABA-mimetic Actions of Shilajit on the Substantia Gelatinosa Neurons of the Trigeminal Subnucleus Caudalis in Mice

Shilajit, a medicine herb commonly used in Ayurveda, has been reported to contain at least 85 minerals in ionic form that act on a variety of chemical, biological, and physical stressors. The substantia gelatinosa (SG) neurons of the trigeminal subnucleus caudalis (Vc) are involved in orofacial nociceptive processing. Shilajit has been reported to be an injury and muscular pain reliever but there have been few functional studies of the effect of Shilajit on the SG neurons of the Vc. Therefore, whole cell and gramicidin-perfotrated patch clamp studies were performed to examine the action mechanism of Shilajit on the SG neurons of Vc from mouse brainstem slices. In the whole cell patch clamp mode, Shilajit induced short-lived and repeatable inward currents under the condition of a high chloride pipette solution on all the SG neurons tested. The Shilajit-induced inward currents were concentration dependent and maintained in the presence of tetrodotoxin (TTX), a voltage gated Na+ channel blocker, CNQX, a non-NMDA glutamate receptor antagonist, and AP5, an NMDA receptor antagonist. The Shilajit-induced responses were partially suppressed by picrotoxin, a GABAA receptor antagonist, and totally blocked in the presence of strychnine, a glycine receptor antagonist, however not affected by mecamylamine hydrochloride (MCH), a nicotinic acetylcholine receptor antagonist. Under the potassium gluconate pipette solution at holding potential 0 mV, Shilajit induced repeatable outward current. These results show that Shilajit has inhibitory effects on the SG neurons of Vc through chloride ion channels by activation of the glycine receptor and GABAA receptor, indicating that Shilajit contains sedating ingredients for the central nervous system. These results also suggest that Shilajit may be a potential target for modulating orofacial pain processing.

Effects of Nutritional Education Program through Discretional Activities in Middle School Students

The effects of a nutritional education program for first grade middle school students were evaluated from August to December, 2006. The study subjects were 82 boys and 90 girls, residing in Gwangju, Korea. To assess the effects of the nutritional education program, pre- and post-questionnaires examining nutritional knowledge, dietary attitudes, and dietary habits were developed. Paired t-test and repeated measures ANOVA were used to evaluate the effects of the nutritional education program. In the general subject, the main after-school activities were studying, watching TV, and using computer (85.5%), and sports (9.3%), suggesting their low physical activity. Parents (46.5%) were indicated as the source of nutritional education rather than teachers (13.4%). Twenty-five percent of girl students had diet experience of skipping meals (54.6%), suggesting the need of proper nutritional education for adolescents' health care. In dietary attitudes, both genders showed some improvement of recognition after education. In the changes in dietary habits, both genders had a significant effect on 'three meals a day, eating breakfast, and regular meal' after education. After education, the rate of having breakfast everyday increased from 52.4% to 65.9% for boys and from 33.3%to 57.8% for girls. In the changes in nutritional knowledge, the appreciation of the importance of school meals increased in both genders from 50.6% to 80.8% after education. The nutritional knowledge, scores of regular eating and well-mannered eating increased in both genders regardless of the students' characteristics. The study results revealed that this education provided an important motivation to improve basic nutritional knowledge and dietary habit. It is recommended to develop systematic and various educational programs and learning materials tailored to subjects before nutritional education.

The Analysis of Geriatric Nutritional Risk Index (GNRI) for Nutritional Assessment and Health Care in Elderly Women

Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (> or = 60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbA1c, ferritin, Zn, Ca, Na, K, Vit E, Vit B12, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit B12). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

Effect of Young Barley Leaf on Lipid Contents and Hepatic Lipid-Regulating Enzyme Activities in Mice Fed High-Fat Diet

This study was conducted to investigate the effects of powdered young barley leaf and its water extract on body weight and lipid metabolism in high-fat fed mice. Male mice were divided into normal group, high-fat (HF) group, highfat group supplemented with powdered young barley leaf (HF-YBL) and high-fat group supplemented with water extract of the powdered young barley leaf (HF-WYBL). The powdered young barley leaf or its water extract was added to a standard diet based on 1% dried young barley leaf (1 g YBL/100 diet and 0.28 g WYBL/100 g diet) for 8 weeks. Supplementation of YBL and WYBL significantly reduced body weight and epididymal adipose tissue weight in highfat fed mice. Food intake and daily energy intake were significantly lower in the YBL group than in the HF group. After 8 weeks, plasma triglyceride and cholesterol concentrations were significantly higher in the HF group than in the Normal group; however, both YBL and WYBL significantly lowered those of the high-fat fed mice. The ratio of HDL-cholesterol/ total cholesterol of the YBL and WYBL groups were significantly elevated compared to that of HF group. Both YBL and WYBL significantly increased fecal excretion of triglyceride in high-fat fed mice, whereas they did not affect fecal cholesterol concentration. The triglyceride levels of liver, adipose tissue and heart were significantly lower in the YBL and WYBL groups than in the HF group. Supplementation of WYBL also lowered the kidney triglyceride and heart cholesterol concentrations compared to those of HF group. Hepatic lipid regulating enzyme activities, fatty acid synthase, HMG-CoA reductase and acyl-coenzyme A: cholesterol acyltransferase, were significantly lower in the YBL and WYBL groups than in the HF group. Accordingly, these results suggest that YBL and WYBL improve plasma and organ lipid levels partly by increasing fecal lipid excretion and inhibiting fatty acid and cholesterol biosynthesis in the liver.

Nutritional Status and Health Risks of Low Income Elderly Women in Gwangju Area

This study was performed to identify association between nutritional status and health risks of the elderly. This was a cross-sectional study involving low income elderly women in Gwangju, Korea (> or = 65y, n = 92). Socio-demographics, life style characteristics, health conditions, dietary intakes based on 24h-recall method, anthropometric measures, and clinical biochemistry parameters were examined. Anthropometric and clinical parameters included wt, ht, waist, hip, body protein, body fat, abdominal fat, total cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, hemoglobin, hematocrit, fasting blood glucose, ferritin, IL-2, IL-6, TNF-alpha, CRP, TAS, TBARS, systolic blood pressure, and diastolic blood pressure. The subjects were divided into three groups based on age (65-74y, 75-84y, 85y 3). Mean and frequency of variables were estimated. Analysis of Variance, Tukey test, Chi-square test, and Multiple linear regression analyses were performed. Mean BMI and body fat were 25.1 kg/m2 and 40.0%, respectively. However, for over 80% of subjects, the intakes of energy, fiber, thiamin, riboflavin, niacin, folate, Ca, K, and Zn were less than the Korean DRI (EAR or AI). The subjects who had lower NSI score tended to have better health status, eat meals frequently, have less depression, and exercise regularly. The subjects who had higher NSI score tended to have tooth problems, to eat alone most of time, and to be physically unable to cook or feed. Serum IL-6 and TNF-alpha were significantly related with nutritional status which suggested higher tendency of inflammatory response. Serum IL-2, TAS, and glucose were significantly correlated with body fat (%) or abdominal fat (%). These results suggest that improving the nutritional status, increasing regular exercise, maintaining normal weight are beneficial to health care of low income elderly women.

Simulated Stiff-knee Gait in Healthy Adults

OBJECTIVE: To investigate the effect of simulated stiff knee on the gait parameters. METHOD: Twenty healthy male adults were recruited. The temporospatial, kinematic & kinetic parameters and energy consumption were analyzed under three different conditions which were free gait, fixed knee flexion in neutral position and limited knee flexion to 30 degrees using knee orthosis. RESULTS: When knee flexion was fixed in neutral position, the cadence and walking speed significantly decreased, and the step time, step width, O2 cost significantly increased compared to free gait. When knee flexion was limited or fixed in neutral position, the kinematic and kinetic parameters in pelvis, hip, knee and ankle joints significantly changed compared with free gait. CONCLUSION: Simulated stiff-knee may affect not only knee joint but also pelvis, hip and ankle joints with increased energy consumption. These findings help us to understand the compensatory mechanism and energy conservation of stiff-knee gait.

Diagnosis and Clinical Features of Children with Language Delay

OBJECTIVE: To determine the diagnosis and investigate the clinical features of children with language delay. METHOD: One hundred seventy-eight children who were referred to the Developmental Delay Clinic for the evaluation of suspected language delay were prospectively enrolled. Multidisciplinary assessment was done by a physiatrist, pediatric neurologist and pediatric psychiatrist. All patients took speech evaluation, full battery of cognitive assessment and hearing test. RESULTS: The common diagnoses of children with language delay were mental retardation (MR), specific language impairment (SLI) and autism spectrum disorder (ASD) in the order of frequency. The early developmental history showed delay of acquisition of motor milestone in MR group. The brain magnetic resonance image (MRI) and single photon emission computerized tomography (SPECT) findings couldn't help to distinguish the brain pathology in SLI, MR and ASD. The result of speech evaluation showed more severely involved in ASD and MR rather than SLI. CONCLUSION: In the clinical assesment and management of the children with language delay, the comprehensive assessment which includes cognition and personal-social area as well as language itself would be helpful for the understanding and setting up the therapeutic plan of these children.

Susceptibility of several strains of mice to Echinostoma hortense infection

Susceptibilities of 5 different mice strains, including C3H/HeN, BALB/c, C57BL6, FvB and ICR, to Echinostoma hortense infection, was evaluated. The worm expulsion rate, worm size and egg production were observed from 1 to 8 weeks after infection with 30 metacercariae. C3H/HeN and ICR mice showed the highest worm maturation rates. The worm recovery rate and the number of eggs per gram (EPG) of feces was also higher in C3H/HeN and ICR mice than in BALB/c, C57BL6, and FvB mice. It is suggested that E. hortense is highly infectious to ICR and C3H/HeN mice, but not to the other strains of mice. Based on the results obtained, we believe that the susceptibility of different mouse strains to E. hortense infection is dependent on the genetic and immunologic background of mice.

Status of intestinal parasite infections among children in Bat Dambang, Cambodia

A survey was conducted to determine the extent of intestinal parasite infection in Bat Dambang, Cambodia in March 2004. A total of 623 fecal specimens was collected from kindergarten and schoolchildren and examined using the formalin-ether sedimentation technique. The overall infection rate of intestinal parasites was 25.7% (boys, 26.2%; girls, 25.1%), and the infection rates of intestinal helminthes by species were as follows: Echinostoma sp. 4.8%, hookworm 3.4%, Hymenolepis nana 1.3%, and Rhabditis sp. 1.3%. The infection rates of intestinal protozoa were; Entamoeba coli 4.8%, Giardia lamblia 2.9%, Iodamoeba butschlii 1.4%, Entamoeba polecki 1.1%, and Entamoeba histolytica 0.8%. There were no egg positive cases of Ascaris lumbricoides or Trichuris trichiura. All children infected were treated with albendazole, praziquantel, or metronidazole according to parasite species. The results showed that intestinal parasites are highly endemic in Bat Dambang, Cambodia.