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Background. The purpose of this study was to evaluate the efficacy and safety of Panax ginseng extract (GS-KG9) in the treatment of hepatic dysfunction. Methods. A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2017 to January 2019. The trial included 60 subjects between the ages of 19 and 70 who had higher alanine transaminase (ALT) levels than the normal upper limit. The subjects were randomly divided into two groups: GS-KG9 (n = 30) and placebo (n = 30). The former was administered three GS-KG9 capsules (3 g/day) and the latter three placebo capsules (3 g/day) twice each day orally after meals in the morning and evening for 12 weeks. The primary goal was to observe the changes in ALT and gamma-glutamyl transferase (GGT) levels. The safety of the treatment was assessed and adverse events (AEs) were recorded. Results. Out of 60 subjects, nine were excluded from the efficacy analysis because they met the exclusion criteria. Therefore, a total of 51 subjects were evaluated for the effectiveness of the treatment (26 in the GS-KG9 group and 25 in the placebo group). After 12 weeks of treatment, the ALT levels were significantly reduced in the GS-KG9 group compared to the placebo group (p=0.009). The GGT level of the GS-KG9 group was significantly lower than that of the placebo group (p=0.036). Mild AEs, such as diarrhea, occurred during the study. There were no significant differences between the two groups. Conclusion. The results of this trial suggest that GS-KG9 might be an effective and safe option for mild hepatic dysfunction. This trial is registered with KCT0004080.

Hyperthermia, which is a noninvasive treatment that causes tumor cells to become heated and that works in synergy with anticancer drugs and radiation therapy, is emerging as a promising treatment for patients with cancer. The purpose of this study is to report the efficacy of hyperthermia combined with chemotherapy (gemcitabine/cisplatin) for the treatment of a patient with unresectable cholangiocarcinoma. A 54-year-old man was diagnosed as hilar cholangiocarcinoma (Klatskin tumor) and was administered neoadjuvant and preoperative radiation with chemotherapy. However, because the treatment with radiation and chemotherapy was not successful, he decided to undergo hyperthermia combined with chemotherapy as a second treatment option. He was suffering from fatigue, dyspepsia, epigastralgia, and jaundice. Hyperthermia combined with chemotherapy was administered 32 times over a period of 4 months. The patient experienced no critical complications, and the patient’s condition improved, with the carbohydrate antigen 19-9 (CA 19-9) and the total bilirubin levels being relatively lowered. In addition, the computed tomography scan showed that the cholangiocarcinoma had not progressed. In conclusion, this case report suggests radiofrequency hyperthermia combined with chemotherapy may be a promising treatment option for patients with unresectable cholangiocarcinoma.

Objectives: This study was designed to evaluate the effi cacy and the safety of constitutional herbal tea for treating chronic fatigue with no diagnosed cause, which is called Mibyeong in Korea. Methods: Males and females with ages between 40 and 59 years who had complained of fatigue for 1 month consistently or for 6 months intermittently without a definite cause were recruited. At the same time, a Chalder fatigue scale (CFS) score of 19 was essential for participation in this study. Sixty five subjects completed the entire pro cess, including blood tests and tests with medical devices. Five assessments of health status were accomplished over 8 weeks by using the CFS and the visual analogue scale (VAS). To ensure that the constitutional herbal tea was being safely used, we conducted and analyzed renal function and liver function tests. For the diagnosis of the Sasang constitution, the Sasang Constitutional Analysis Tool (SCAT) was used, and a specialist in Sasang constitutional medicine made the final diagnosis based on the SCAT result. Constitutional herbal tea was served four weeks after the first visit. The subjects took the constitutional herbal tea twice a day for one month. Results: The results are as follows: The CFS and the VAS scores were significantly improved for the subjects in the constitutional herbal tea. No abnormalities were found on the blood tests to evaluate safety after taking the constitutional herbal tea. The improvements in the CFS and the VAS scores due to the constitutional herbal tea had no significant differences according to the Sasang constitution. Conclusion: Constitutional herbal tea may be used to reduce fatigue and improve health and has no adverse effect on either the kidney or the liver.

Background Ovarian cancer is one of the major causes of death among females in worldwide. Cisplatin is a primary anti-cancer drug against ovarian cancer, but the recurrent tumors after treatment frequently show acquired chemoresistance. Extract of Scutellaria baicalensis (SbE) has been reported to have functional compounds including baicalin, which has anti-cancer effects. However, the anti-cancer effects of SbE in ovarian cancer and its underlying mechanisms are elusive. Methods We investigated that the effects of SbE and/or cisplatin on cell death in the cisplatin sensitive ovarian cancer cell line A2780 (CSC) and the counterpart cell line that has cisplatin resistance (CRC). Molecular mechanisms of the effects, focusing on apoptosis and autophagy, were examined. Results Treatment of cisplatin or SbE reduced cell viability significantly in CSC and too much lesser extent in CRC. Cisplatin-induced cell death in CSC was mediated by p53-induced apoptosis acompanied by expresson of damage-regulated autophagy modulator (DRAM). In CRC, decreased DRAM expression (p

Objectives: This study was designed to investigate the effects of Calculus Bovis-Fel Uris-Moschus pharmacopuncture (BUM) on the regional cerebral blood flow (rCBF) and the mean arterial blood pressure (MABP) in normal and cerebral ischemic rats and to investigate a possible pathway involved in the effects of BUM. Methods: The changes in the rCBF and the MABP fol lowing BUM into Fengfu (GV16) were determined by using a laser-Doppler flow meter and a pressure trans ducer, respectively. Results: BUM significantly increased the rCBF and de creased the MABP in normal rats in a dose-dependent manner. The effect on the rCBF was significantly inhib ited by pretreatment with methylene blue (0.01 mg/kg, intraperitoneal), an inhibitor of guanylate cyclase, but was not affected by pretreatment with indomethacin (1 mg/kg, intraperitoneal), an inhibitor of cyclooxygenase. The BUM-induced decrease of the MABP was changed neither by methylene blue nor by indomethacin pretreatment. In the cerebral ischemic rats, the rCBF was stably increased upon cerebral reperfusion in the BUM group in contrast to the rapid and marked increase in the control group. Conclusion: This study demonstrated that BUM into Fengbu (GV16) increased the rCBF in a dose-dependent manner in the normal state; furthermore, it improved the stability of the rCBF in the ischemic state upon reperfusion. Also, the effects of BUM on the rCBF were attenuated by inhibition of guanylate cyclase, suggesting that the effects involved the guanylate cy clase pathway.

Houttuynia cordata Thunb ( H cordata), a medicinal plant, has anticancer activity, as it inhibits cell growth and induces cell apoptosis in cancer. However, the potential anti-cancer activity and mechanism of H cordata for human liver cancer cells is not well understood. Recently, we identified hypoxia-inducible factor (HIF)-1A, Forkhead box (FOX)O3, and MEF2A as proapoptotic factors induced by H cordata, suggesting that HIF-1A, FOXO3, and MEF2A contribute to the apoptosis of HepG2 hepatocellular carcinoma cells. FOXO3 transcription factors regulate target genes involved in apoptosis. H cordata significantly increased the mRNA and protein expression of HIF-1A and FOXO3 and stimulated MEF2A expression in addition to increased apoptosis in HepG2 cells within 24 hours. Therefore, we determined the potential role of FOXO3 on apoptosis and on H cordata–induced MEF2A in HepG2 cells. HIF-1A silencing by siRNA attenuated MEF2A and H cordata–mediated FOXO3 upregulation in HepG2 cells. Furthermore, H cordata–mediated MEF2A expression enhanced caspase-3 and caspase-7, which were abolished on silencing FOXO3 with siRNA. In addition, H cordata inhibited growth of human hepatocellular carcinoma xenografts in nude mice. Taken together, our results demonstrate that H cordata enhances HIF-1A/FOXO3 signaling, leading to MEF2A upregulation in HepG2 cells, and in parallel, it disturbs the expression of Bcl-2 family proteins (Bax, Bcl-2, and Bcl-xL), which results in apoptosis. Taken together, these findings demonstrate that H cordata promotes the activation of HIF-1A–FOXO3 and MEF2A pathways to induce apoptosis in human HepG2 hepatocellular carcinoma cells and is, therefore, a promising candidate for antitumor drug development.

The ubiquitous transcription factor, NF-κB, has been reported to inhibit apoptosis and induce drug resistance in cancer cells. Cordyceps militaris extract (CME) is involved in the regulation of the NF-κB signaling pathway. However, the detailed role of CME in the suppression of the NF-κB signaling pathway is unclear. We found that CME dose-dependently inhibited tumor necrosis factor-α (TNF-α)-induced NF-κB activation in TK-10 human renal cell carcinoma. CME prevented NF-κB from translocating to the nucleus, which resulted in the downregulation of GADD45B, upregulation of MKK7, and phosphorylation of JNK (p-JNK). The increased activation of Bax led to pronounced CME-induced apoptosis, which occurred through caspase-3. Furthermore, the siRNA-mediated knockdown of GADD45B inhibited MKK7 expression, whereas the siRNA-mediated inhibition of MKK7 downregulated p-JNK and the JNK inhibitor, SP600125, inhibited Bax expression. Thus, these results indicated that CME inhibited the activation of GADD45B via the inhibition of NF-κB activation, which upregulated the MKK7-JNK signaling pathway to induce apoptosis in TK-10 cells. Thus, this study reveals a novel anticancer function of CME.

1. Objectives: To evaluate effects of bee venom acupuncture on cardiovascular system and differences according to each constitution. 2. Methods: Heart rate variability, pulse wave and the velocity of cerebral blood flow were measured before bee venom acupuncture(BVA), right after and after 30 minuets, had been applied to 20 subjects. 3. Results: 1. BVA did not have effects on measurement variables of heart rate variability. 2. BVA had effects on pulse wave, showing total time, radial augmentation index up and height of percussion wave, time to percussion wave, sum of pulse pressure down. 3. BVA did not have effects on the cerebral blood flow velocity when considering not Sasang Constitution 4. Considering Sasang Constitution, BVA demonstrates different responses in time to preincisura wave, mean blood flow velocity, peak systolic velocity and end diastolic velocity. 4.Conclusion: From those results, the following conclusions are obtained. Cause BVA alters pulse wave and makes differences in the cerebral blood flow velocity according to Sasang Constitution. Various methods of BVA treatment are needed considering Sasang Constitution.

Multidrug resistance 1 (MDR1) is a gene that expresses P-glycoprotein (P-gp), a drug transporter protein. Genetic polymorphisms ofMDR1can be associated with Sasang constitutions because Sasang constitutional medicine (SCM) prescribes different drugs according to different constitutions. A Questionnaire for Sasang Constitution Classification II (QSCC II) was used to diagnose Sasang constitutions. Two hundred and seven healthy people whose Sasang constitutions had been identified were tested. Genotype analyses, restriction fragment length polymorphism (RFLP) and pyrosequencing were used in MDR1 C1236T, and in MDR1 G2677T/A and C3435T, respectively. Significant differences inMDR1 C1236Tgenotypes were found between So-yangin and So-eumin.MDR1 G2677T/Agenotype also showed significant differences in allele distribution between So-yangin and Tae-eumin. So-yangin and So-eumin showed significant differences in the distribution of both 1236C-2677G-3435C and 1236T-2677G-3435T, haplotypes ofMDR1. The genetic polymorphism of theMDR1gene was thus shown to be an indicator that could distinguish So-yangin from other constitutions.

This study was performed to determine whether a pulse analyzer was useful 1) to characterize the variables of pulse wave of cerebral infarction patieno (CI), compared with those of healthy subjects, as well as 2) to determine Sasang Constitution in CI and healthy subjects. 1. Calibrated in Gwan, the amount of energy(Energy), height of main peak(H1), height of aorticvalley(H2), height of aortic peak(H3), total area of pulse wave(At), and area of main peak width(Aw) of the CI group were higher than those of the healthy group. 2. Calibrated in Cheek, Energy, H1, H2, H3, height of valve valley(H4), At, Aw, and main peak angle(MPA) of the CI group were higher than those of the healthy group. 3. Among the healthy (subjects) group, Taeumin showed the highest contact pressure(CP) and height of valve peak(H5) calibrated in Chon. The main peak width divided by whole time of pulse wave(MPW/T) calibrated in Gwan and Cheok, was highest in Soyangin and was lowest in Taeumin. The H3 divided by H1(H3/H1) and the time to valve valley minus the time to main peak and divided by T[(T4-T1)/T] calibrated in Cheek were highest in Soyangin. The time to main peak(T1) was longest in Soumin. 4. Among the CI group, At calibrated in Chon was widest in Taeumin and was narrowest in Soumin The time to aortic peak(T3) calibrated in Cheek was longest in Soumin and was shortest in Soyangin. The time to valve peak(T5) was shortest in Soyangin. 5. There were main effects of cerebral infarction in the area of systolic period(As) and area of diastolic period(Ad) calibrated in Chon, Energy calibrated in Cwan, and Energy, H1, H2, H3, (H4+H5)/Hl, and MPA calibrated in Cheek. 6. There were main effects of Sasang Constitution in (T4-T1)/T, area of systolic period(As), and Ad calibrated in Chon. 7. The interactions between the cerebral infarction and Sasang Constitution were observed in H5/H1 , T, At, As, Ad, and MPA calibrated in Chon, H4, T4, (T4-T1)/T, As, and Ad calibrated in Cwan, and 74,75, and MPW calibrated in Cheok. Therefore, we concluded that pulse analyzer was useful to determine the risk degree of cerebral infarction and Sasang Constitution.

The purpose of this study is to evaluate the clinical effect of Hwangryunhaedok-tang Herbal-Acupuncture. Hwangryunhaedok-tang is used in all heating diseases. Chest Heating Sensation is a unique concept in Oriental Medicine. So we applied Hwangryunhaedok-tang Herbal-Acupuncture to treat the Chest Heating Sensation. We used DITI(Digital Infrared Thermographic Imaging) to estimate the temperatures of chest surface for the outcome assessment. We came to know that the chest surface temperatures were all reduced in both cases after Herbal-Acupuncture treatment. The reduced average temperature was 1.5℃ in case 1 and 0.9℃ in case 2. The above result indicates that Hwangryunhaedok-tang Herbal-Acupuncture treatment has an effect on Chest Heating Sensation, thus continuous Hwangryunhaedok-tang Herbal-Acupuncture study will be needed for more clinical applications.

During the last decade, a growing corpus of evidence has indicated an important role of cytokines in the development of brain damage following cerebral ischemia. Tumor necrosis factor-alpha (TNF-alpha), a potent immunomodulator and pro-inflammatory cytokine, has been implicated in many pathological processes. In this study, we examined whether promoter region polymorphism in the TNF-alpha gene at position -308 affects the odds of cerebral infarction (CI) and whether genetic risk is enhanced by Sasang constitutional classification. Two hundred and twelve CI patients and 610 healthy controls were genotyped and determined according to Sasang constitutional classification. A significant decrease was found for the TNF-alpha A allele in CI patients compared with controls (p = 0.033, odds ratio, OR: 0.622). However, there was no significant association between TNF-alpha polymorphism and Sasang constitution in CI patients. Our finding suggests that TNF-alpha promoter region polymorphism is responsible for susceptibility to CI in Koreans.

Background: The Paeonia lactiflora extract (PLE) has been reported to have neuroprotective effect against neurodegeneration that are induced by cellular stress such as oxidative stress. Its underlying mechanisms, however, remain unclear. In latest decades, emerging evidence has suggested that epigenetic mechanisms play a key role in gene regulation in response to the cellular stress. We investigated whether epigenetic modulation was involved in neuronal cell death by the neurotoxicant, 1-Methyl-4-phenylpyridinium (MPP+), and the neuroprotective effect of PLE. Methods: Differentiated SH-SY5Y, which is a well-established dopaminergic cell line model, was treated with 0 similar to 200 mu g/ml PLE for 4 h prior to MPP+ treatment. The effect of PLE on cell viability was determined by MTT assays. Gene expression levels of oxidative stress responsive genes, such as Heme oxygenase 1 (HMOX1), and histone modifiers, such as histone acetyltransferases (HATs) and deacetylases (HDACs) were measured by quantitative RT PCR. In order to investigate the changes in epigenetic modifications, the acetylated lysine 9 (H3K9ac) and lysine 27 (H3K27ac) of Histone H3 were measured by western blot using histones extracted from the cells. Results: MPP+-induced cell death in SH-SY5Y cells was significantly reduced by PLE pretreatment in a dose-dependent manner, indicating the potent neuroprotective effects of PLE. It was accompanied by induced expression of HMOX1. MPP+ treatment increased the expression of HATs and consistently increased H3K9ac and H3K27ac of Histone H3. PLE pretreatment impeded the changes in H3K9ac and H3K27ac, coincided with increased expression of HDAC5 without changes in HAT expression. Conclusions: The results suggested that MPP+-induced cell death in the dopaminergic SH-SY5Y cells was related with transcriptional induction of HATs and increased histone H3 acetylation and that PLE might prevent the cells from MPP+-induced cell death via tempering histone H3 acetylation.