Comparison of Dose Distribution in Regional Lymph Nodes in Whole-Breast Radiotherapy vs. Whole-Breast Plus Regional Lymph Node Irradiation: An In Silico Planning Study in Participating Institutions of the Phase III Randomized Trial (KROG 1701).

The purpose of the current in silico planning study is to compare radiation doses of whole-breast irradiation (WBI) and whole-breast plus regional lymph node irradiation (WBI+RNI) administered to the regional lymph nodes (RLN) in pN1 breast cancer. Twenty-four participating institutions were asked to create plans of WBI and WBI+RNI for two dummy cases. To compare target coverage between the participants, an isodose line equal to 90% of the prescribed dose was converted to an isodose contour (contour90% iso). The relative nodal dose (RND) was obtained using the ratio of RLN dose to the target dose. The Fleiss's kappa values which represent inter-observer agreement of contour90% iso were over 0.68. For RNI, 6 institutions included axillary lymph node (ALN), supraclavicular lymph node (SCN), and internal mammary lymph node (IMN), while 18 hospitals included only ALN and SCN. The median RND between the WBI and WBI+RNI were as follows: 0.64 vs. 1.05 (ALN level I), 0.27 vs. 1.08 (ALN level II), 0.02 vs. 1.12 (ALN level III), 0.01 vs. 1.12 (SCN), and 0.54 vs. 0.82 (IMN). In all nodal regions, the RND was significantly lower in WBI than in WBI+RNI (p < 0.01). In this study, we could identify the nodal dose difference between WBI and WBI+RNI.

The role of autophagy induced by pemetrexed in lung adenocarcinoma cells.

Autophagy is known as an important regulatory mediator for cell survival or death and its important role in cancer. Pemetrexed (PTX) has been used in chemotherapy for lung cancer. However, the underlying molecular mechanisms have not been fully clarified. To investigate the role of autophagy induced by PTX in A549 cells, we performed MTT assay, acridine orange staining, western blotting, Annexin V/PI by using the 3-MA autophagy inhibitor. PTX induced autophagy after 48 h treatment in A549 cells. Furthermore, PTX showed acidic vesicular organelles (AVOs) and expressed LC3-II in A549 cells. The induction of autophagy by PTX was inhibited by 3-MA which was confirmed by reduced AVOs. When the autophagy was inhibited, Annexin V was increased. In addition, PARP cleavage was increased as shown by western blotting. Taken together, PTX induced autophagy in A549 cells and these cellular events possibly cause the apoptotic and/or necrotic cell death of A549 cells.

Autophagy induction by low-dose cisplatin: the role of p53 in autophagy.

The majority of chemotherapy treatments for lung cancer use cisplatin; however, its use is limited as it has several side-effects. Autophagy (or type II cell death) is an important mechanism by which programmed cell death occurs. The purpose of this study was to determine whether low-dose cisplatin treatment induces autophagy in lung cancer cells. We also examined whether autophagy inhibition results in p53-mediated apoptosis. NCI-H460 (wild-type p53) and NCI-H1299 (null-type p53) cells were treated with 5 or 20 µM cisplatin for 12, 24 or 48 h. An MTT assay was performed to measure the cell viability following cisplatin treatment. To detect cisplatin-induced autophagy, cell morphology (autophagic vacuole) and LC3 localization were examined. The outcome of autophagy inhibition was determined using 3-methyladenine (3-MA) to detect Annexin V (+), propidium iodide (PI) (-) and acridine orange (+) cells by FACS analysis. To determine whether cisplatin induced autophagy, we examined the role of p53 as a cell survival regulator in autophagy. Low-doses of cisplatin (5 µM) induced cell death and this was augmented by 3-MA in both cell lines. Autophagic vacuoles and cytoplasmic LC3 formation was more evident in H460 cells than in H1299 cells. The induction of autophagy by low-dose cisplatin was increased by 2-fold in H460 compared to H1299 cells. However, the tests for apoptosis showed no difference between the 2 cell lines. Following 3-MA pretreatment, cisplatin-induced autophagy was found to be markedly reduced (a 3-fold reduction) in wild-type p53 compared to null-type p53 cells. However, cisplatin-induced apoptosis increased in wild-type p53 compared to null-type p53 cells. Autophagy induction and apoptotic shift after autophagy inhibition may be mediated by p53 activation in lung cancer cells treated with low-dose cisplatin.

Effects of nutritional supplement with herbal extract on bone mineral density and height in prepubescent children - a preliminary study.

The aim of this study was to investigate the efficacy of a nutritional supplement with herbal extracts on height and on the bone mineral density (BMD) development of prepubescent children who were in the 25th percentile of standard height of their age. All children were administered a supplement for 6 months, with height and BMD measured. The supplement increased significantly the height and BMD, compared with the baseline in both boys and girls. The annual growth rate was higher than the standard rate. These preliminary data indicate that supplements enhanced the rate of BMD and height development, although this result must be replicated in a large population-based study and placebo-controlled trials to confirm the conclusions.

Effects of multifunctional fabrics on cardiac autonomic tone and psychological state.

Heart rate variability was compared in 20 subjects wearing multifunctionalfabric (experimental sessions) and cotton (control sessions) clothing. Anxiety, depression, fatigue, and stress levels were lower and emotional levels were higher during the experimental sessions than in the control sessions. Multifunctional fabrics reduced the low-frequency/high-frequency power ratio of heart rate variability. These results support the hypothesis that multifunctional fabrics increase cardiac parasympathetic tone. In addition, subjects had lower heart rates during the experimental sessions compared with controls, suggesting a stabilizing effect on the autonomic nervous system. In conclusion, multifunctional fabrics may act to stabilize both the autonomic nervous system and psychological state.

Effects of a Korean traditional herbal remedy on psychoneuroendocrine responses to examination stress in medical students: a randomized placebo-controlled trial.

The aim of this study was to investigate the efficacy of Ondamtanggamibang, a Korean traditional herbal remedy, as a treatment of stress-related psychophysiological variables in healthy medical students experiencing examination stress. Forty volunteers were randomly assigned to either an herbal remedy group (n = 20) or a placebo control group (n = 20). After treatment, systolic blood pressure and plasma concentrations of norepinephrine and cortisol concentrations decreased significantly in the herbal remedy group. The herbal remedy group also exhibited beneficial changes in psychological variables such as anxiety, depression, stress and emotional state. These results suggest that a Korean traditional herbal remedy may reduce systolic blood pressure and catecholamine levels, possibly by stabilizing the sympathetic nervous system. This herbal remedy also reduced the negative psychological symptoms, stress and heightened the emotional state experienced by medical students during examinations.

External Qi therapy to treat symptoms of Agent Orange Sequelae in Korean combat veterans of the Vietnam War.

We investigated the efficacy of Qi therapy as a non-pharmacological treatment for various symptoms presented by Korean combat veterans of the Vietnam War with Agent Orange Sequelae. Nine subjects volunteered to receive 30 minutes of Qi therapy, twice per day for 7 days. There was marked improvement in 89% of the patients with impaired physical activity, 86% of those with psychological disorder, 78% of those with heavy drug use, and 67% of those with fatigue, indigestion and high blood glucose levels. This data suggests that Qi therapy combined with conventional treatment has positive effects in reducing and managing the pain, psychosomatic disorders, and substance abuse in patients with Agent Orange Sequelae. We cannot completely discount the possible influence of the placebo effect, and more objective, clinical measures are needed to study the long-term effects of Qi therapy.

Endocrine and immune effects of Qi-training.

Psychoneuroimmunological approaches have shown that Qi-training influences the holistic health state in men. We found that Qi-training increased the plasma level of growth hormone (GH) and insulin-like growth factor (IGF)-I. In addition, the respiratory function and adhesion capacity of neutrophil was increased after Qi-training. In an in vitro analysis, GH primed and increased the respiratory function and adhesion of neutrophils through tyrosin kinase passway. Taken together, in vivo and in vitro data suggest that the beneficial effects of Qi-training on immunological functions are mediated via neuroendocrine responses.

Effect of multi-functional fabric on sleep stages and growth hormone levels during sleep.

Nine young girls participated in cross-over sessions, sleeping with either multi-functional fabric (experimental session) or cotton (control session). The relative duration of slow-wave sleep (SWS) was 1.89-fold higher in the experimental session than in the control session. The peak growth hormone (GH) secretion in the experimental session was more than 2.4-fold higher than during the control session (p <.001). The quality of sleep during the experimental session was significantly better than in the control session (p <.01). These results suggest that multi-functional fabric wear is effective in inducing deep sleep, increasing GH, and improving the quality of sleep.

Survey of the use of complementary and alternative medicine among Korean diabetes mellitus patients.

PURPOSE: This study was designed to measure the prevalence of complementary and alternative medicine (CAM) use among Korean diabetes mellitus (DM) patients. METHODS: A 23-question survey on DM was used and included questions on demographic information (7), clinical information (7) and the utilisation of CAM (9). RESULTS: Of 223 respondents, 145 (65%) had taken CAM products, while 78 (35%) had not. At the suggestion of family members and relatives, 43.5% of the respondents started taking CAM products. A total of 57.9% of the users felt that it was effective, 30.3% considered that it regulated the blood glucose level and 27.6% felt it was effective in achieving psychological relaxation. Of 93 CAM materials used by respondents, 63.7% were various types of plants, 21.6% were animal material and 14.7% were a mixture of both. The majority of DM patients (81.2%) were trying a new type of CAM, and one third of all patients were trying to start using a new type of CAM after consulting with their physicians. CONCLUSIONS: Doctors should recognise that complementary medicines are widely used by diabetic patients and should appreciate that these medicines can cause adverse effects. Doctors should therefore be prepared to question patients to determine what non-conventional medicines they are using.

Hydrodynamic analysis of waveforms induced by vibrational stimuli at meridian and non-meridian points.

Meridian theory is an important part of traditional Chinese medicine (TCM). Although acupuncture has been accepted in many countries, the nature of the meridian theory and the principles of acupuncture are still unclear in the modern scientific view. The purpose of this study was to determine the differences in wave propagation of mechanical vibrations (optimal stimulator frequency of 40 Hz) through the pericardium meridian [EH-4 (Chieh-Men) and EH-5 (Chien-Shih)] and adjacent control regions in 20 subjects using hydrodynamic analysis. The mean transfer speed was significantly lower in the meridian (4 m/s) than in the adjacent control region (8.5 m/s, P < 0.001). There were also significant differences between the meridian and control points in the attenuation rate (P < 0.001) and peak amplitude (P < 0.001). In conclusion, these results imply that the substance of the meridian differs from that of the adjacent control regions.

Effects of Qi-training (Qigong) on forearm blood gas concentrations.

Using an ABA' design, the authors investigated the effects of Qi-training on blood gas concentrations with a 20 min control rest period (A), 1 h of Qi-training (B), and a 20-min rest period (A'). The blood partial pressures of oxygen (PO2) and carbon dioxide (PCO2), and oxygen content, oxygen saturation, and pH were significantly altered. The mean PO2 value increased significantly during Qi-training by 14 mmHg (about 24%, p < .01) compared with control A. During Qi-training, the mean decrease in PCO2 was 3 mmHg (about 10%). These results suggest that the practical application of Qi-training may exert a positive regulatory function on physiological status.

Retrospective survey on therapeutic efficacy of Qigong in Korea.

Qigong is a complementary intervention for preventing and curing disease, and protecting and improving health through regulation of body and mind. Recently, we have been studying the psychoneuroimmunological effects of Qigong on the promotion of health. However, there are not many studies on the therapeutic efficacy of Qigong on various symptoms in Korea, hence the need to survey the clinical efficacy of Qigong. To evaluate the impact of Qigong in health care we categorized its effectiveness on the basis of ten years of subjects' memoranda. Among the 768 subjects, the motivation for doing Qigong was mostly to attend to health problems (81.5%), and males were more likely to use Qigong than females. The most improved symptoms were associated with psychological and musculoskeletal problems. Furthermore 66.9% of subjects reported improvements of perceived physical health and 40.3% of perceived psychological health. Other symptoms reduced by Qigong were pain (43.1%), fatigue (22.1%), and insomnia (8.7%). Wound healing was also surveyed (n = 332), and 84% of respondents reported improvement in recovery time, 66.6% reported reduced inflammation after Qigong and 50.3% reported no scarring as compared to before. In addition, 59.9% of respondents reported an increase in resistance to the common cold after four months of Qigong. The limitation of the study is that it is a retrospective survey on the basis of trainees' experiences of Qigong. Although this may constitute a potential bias, the study despite its limitations does provide precious empirical evidence of the effectiveness of Qigong.

Qigong reduced blood pressure and catecholamine levels of patients with essential hypertension.

This study was designed to investigate the efficacy of Qigong as a non-pharmacological treatment of hypertension and evaluate the contribution of Qigong in the blood pressure (BP) reduction of essential hypertension patients. Fifty-eight patients volunteered to participate in this study and were randomly divided into either a Qigong group (n = 29), or a wait list control group (n = 29). In response to 10 weeks of Qigong, systolic blood pressure (SBP), diastolic blood pressure (DBP), and rate pressure product (RPP) were decreased significantly. There was a significant reduction of norepinephrine, epinephrine, cortisol, and stress level by the Qigong. These results suggest that Qigong may reduce BP and catecholamines via stabilizing the sympathetic nervous system. Therefore, Qigong is an effective nonpharmacological modality to reduce BP in essential hypertensive patients.

Effects of in vitro and in vivo Qi-therapy on neutrophil superoxide generation in healthy male subjects.

The present study investigated the effects of in vitro and in vivo Korean ChunSoo Qi-Energy Healing on neutrophil superoxide generation. Neutrophil superoxide generation was measured by a chemiluminescence assay. Superoxide generation was significantly increased in vitro by emitted Qi-therapy (QT) of 60-second duration and 150-second duration compared to control (1.59-fold for 60 seconds, p < 0.05; 1.50-fold for 150 seconds, p < 0.05). Neutrophil superoxide generation increased significantly immediately after 5 minutes of QT in vivo (1.42-fold, p < 0.05). These results show that QT in vivo and in vitro has an acute stimulatory effect on neutrophil superoxide generation. This study provides direct scientific support that Qi as such may positively affect human innate immunity.

Hibiscus extract inhibits the lipid droplet accumulation and adipogenic transcription factors expression of 3T3-L1 preadipocytes.

OBJECTIVES: This study was designed to investigate the effect of hibiscus (Hibiscus sabdariffa) on adipogenic differentiation of 3T3-L1 cells at the cellular and molecular levels. DESIGN: Various concentrations of hibiscus extract were added to confluent 3T3-L1 preadipocytes at the outset of the differentiation program and further incubated for 36 hours. Cells were maintained in postdifferentiation medium containing insulin with hibiscus extract in complete culture medium. RESULTS: Hibiscus extract inhibited the adipocyte differentiation of 3T3-L1 preadipocytes induced by insulin, dexamethasone, and isobutylmethylxanthine (IBMX) in a dose-dependent manner. Hibiscus blocked the cytoplasmic lipid accumulation when administered at the onset of differentiation and 4 days after induction of differentiation. The inhibitory effect of hibiscus on adipogenic lipid accumulation of preadipocytes was significant (p < 0.01) between control cells and cells treated with hibiscus. Hibiscus extract significantly attenuated the expression of key adipogenic transcription factors, including CCAAT element binding protein (C/EBP)alpha and peroxisome proliferator-activated receptor (PPAR)gamma at protein levels. CONCLUSION: These results suggest that hibiscus extract blocks adipogenesis, in part, by its suppression on the expression of adipogenic transcription factors, including C/EBPalpha and PPARgamma.

Qi-training enhances respiratory burst function and adhesive capacity of neutrophils in young adults: a preliminary study.

The main objective of this study is to examine the effect of Qi-training on the immune system, especially neutrophil bactericidal function. Nine healthy male subjects were studied for the effects of one bout of ChunDoSunBup (CDSB) Qi-training on superoxide (O2- production and adhesion capacity of neutrophils at times immediately after (Post I) and 2 hours after the Qi-training (Post II). The Qi-training enhanced O2- production, reaction velocity and neutrophil adhesion capacity and there were significant differences at Post I compared to before Qi-training (Pre). In addition, the number of white blood cells (WBC), monocytes and lymphocytes were changed significantly through Qi-training.Therefore, it seems that CDSB Qi-training may increase the resistance of trained individuals against common infection and inflammation.

Palgin sensitizes the adriamycin-induced apoptosis via the enhancement of Fas/Fas ligand expression.

This study was designed to evaluate the synergistic cytotoxicity of herb prescription, Palgin, in adriamycin-treated cancer cells. The combination of Palgin and adriamycin synergistically augmented the cytotoxicity of Chang and HL-60 cells, but not in Hep3B and Alexander cells. The cytotoxicity of two drugs was revealed as apoptosis characterized by nuclear fragmentation. The apoptotic cell death was accompanied by the activation of caspase-3 as well as cleavage of poly(ADP) ribose polymerase (PARP) in Chang cells. Interestingly, a synergistic increase in apoptosis by the combination of two drugs was accompanied by the enhancement of Fas and Fas ligand (FasL) expression in Chang cells. Taken together, the combination of Palgin and adriamycin significantly augmented the apoptotic cytotoxicity of Fas-positive cells, such as Chang and HL-60 cells, via activation of caspase signaling pathway. This notion will provide a new trial to treat cancer patients in clinical fields as a complementary treatment of Western and Oriental medicine.