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The fastest aging society with the lowest fertility rate can be buffered by support for healthy pregnancies using sociocultural approaches. We aimed to address adult perceptions of a healthy pregnancy and explored their needs and concerns about childbirth across the lifespan. We conducted a qualitative study using content analysis to investigate general perceptions of a healthy pregnancy after focus-group interviews with adult men and women. We interviewed 60 participants in nine group sessions of 5 to 8 people per group. Three major themes emerged that affect healthy pregnancies: Taking responsibility for a prepared pregnancy, factors that interfere with a healthy pregnancy, and improving strategies for a healthy pregnancy. For the first theme, the two main concerns were financial and parenthood preparation. Factors interfering with a healthy pregnancy had direct and indirect causes, considering personal, social, and cultural changes. Strategies for a healthy pregnancy included family and workplace support, systematic education, and governmental support for financial preparation and health screening. Participants averred that various kinds of support (financial, healthcare, and career) are needed for a healthy pregnancy and childbirth. This public awareness could promote better decisions toward healthy pregnancy with more sociocultural approaches in the various settings of home, school, and the workplace.

To determine the degree to which nurses are aware of cervical cancer and to describe nurses' experiences of caring for patients with cervical cancer. To promote quality of nursing care of cervical cancer, we need to explore their perceptions and nursing experience in doing cervical-cancer care. This study was a qualitative descriptive design. Interviews were conducted with 14 registered nurses. The interviews were audiotaped, transcribed and analyzed. Content analysis was performed. Fourteen nurses who had been working at wards and cancer education centers were recruited in this study. Nine key themes emerged from three categories such as nurses’ awareness of cervical cancer, awareness of cervical cancer patient and caring experience. Nurses expressed fear of cervical cancer and helplessness in the face of a life-threatening prognosis. Nurses stated that they might have prejudice about cervical cancer, since it is caused by a sexually transmitted disease. They also recalled that patients with cervical cancer were more sensitive and demanding. Our findings provide a comprehensive and in-depth perspective in understanding the experience of caring for cervical cancer patients. Clinical nurses showed complex emotional reactions to cervical cancer, and expressed prejudice against the sex life of cervical-cancer patients. More education is required to ensure that clinical nurses can provide a nurse-led intervention with patients by managing nurses’ fear, prejudice, and the care burden.

Backgrounds As HPV is a sexually transmitted virus, men are crucial in the prevention of cervical cancer, but research about men’s awareness on cervical cancer is limited. Therefore, in this study, we investigated men’s awareness toward women’s cervical cancer, to thoroughly understand the viewpoints of men, and to emphasize the centrality of the role of men in the prevention of cervical cancer. Methods A qualitative descriptive design was chosen to explore men’s awareness of women’s cervical cancer. Twelve men aged 20–58 were interviewed. Snowball sampling was conducted to recruit participants. Results Most participants stated that they were not interested in women’s health, and that they did not have much knowledge about cause and prevention of cervical cancer. They acknowledged that cervical cancer was different from other cancers, based on cause and prognosis of disease. The recognition of cervical cancer in participants varied widely depending on their relationship with women. Respondents’ recognition of cervical cancer was classified into four types based on a Situational Awareness (SA) model including individual factors (knowledge about cervical cancer, interest in women’s health) and system/task factors (relationship with women, men’s responsibility). Conclusion This study is one of the few studies describing men’s awareness on cervical cancer. Korean men’s awareness level was low, and their concern and knowledge were not good. Some participants thought that cervical cancer can be treated, can be prevented, and is recognized as a disease of a female with men intervening. Our participants perceived that the role of men is necessary for the prevention of cervical cancer. Therefore, a strategy is needed to develop the awareness and knowledge of men on cervical cancer prevention. When planning cervical cancer education for men, phase and type-specific approaches are required, depending on perception level.

Nocardia pseudobrasiliensis is predominantly associated with invasive infections in immunocompromised patients. We report a case of disseminated mycetoma caused by N. pseudobrasiliensis in a 57-yr-old woman with microscopic polyangiitis, who was treated for 3 months with corticosteroids. The same organism was isolated from mycetoma cultures on the patient's scalp, right arm, and right leg. The phenotypic characteristics of the isolate were consistent with both Nocardia brasiliensis and N. pseudobrasiliensis, i.e., catalase and urease positivity, hydrolysis of esculin, gelatin, casein, hypoxanthine, and tyrosine, but no hydrolysis of xanthine. The isolate was identified as N. pseudobrasiliensis based on 16S rRNA and hsp65 gene sequencing. The patient was treated for 5 days with intravenous ampicillin/sulbactam, at which time both the mycetomas and fever had subsided and discharged on amoxicillin/clavulanate. This case highlights a very rare presentation of mainly cutaneous mycetoma caused by N. pseudobrasiliensis. This is the first reported case of N. pseudobrasiliensis infection in Korea.

Objective To explore and understand how patients with knee osteoarthritis (OA) experience moxibustion. Method This qualitative research was conducted as part of a larger clinical trial of the effectiveness of moxibustion for the treatment of knee OA by qualitative content analysis. Sixteen patients with mild knee OA who participated in a 12-week moxibustion treatment as part of the trial were interviewed using open-ended questions. Results The participants recognised knee OA as a normal ageing process that caused physical and emotional discomfort in daily life. Regardless of any adverse effects of moxibustion, most of the participants were interested in continuous moxibustion treatment as a long-term management strategy and for general health. Conclusions This study suggests that moxibustion can be helpful in managing symptoms related to knee OA. Patients’ attitudes towards moxibustion can affect the treatment result and those who prefer it want to continue the treatment for a long time because they understand that knee OA is a chronic condition which needs continuous care. However, practitioners need to pay more attention to those who are very enthusiastic because they tend to endure treatment-related adverse events in their desire for better effects.

Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease affecting > 10% of children and 1-3% of adults, and can cause significant morbidity. The incidence of AD seems to be increasing. Omalizumab, a monoclonal antibody, has recently been suggested as a potential new systemic treatment for patients with recalcitrant AD with elevated IgE levels, based on its efficacy in treating asthma and allergic rhinitis. We report a study of 10 patients with AD (aged 19-35 years) who received anti-IgE treatment for persistent asthma. All patients, regardless of IgE value, were treated with a fixed schedule of eight cycles of omalizumab 300 mg administered subcutaneously at intervals of 2 weeks. Eczema symptoms were scored at baseline and after 2, 4 and 6 months of treatment. There was a steady improvement in the objective SCORAD (SCORing Atopic Dermatitis), with significantly lower scores observed at the 6-month evaluation. At 2 months after the end of treatment, two patients had a very good result (SCORAD reduction of > 50%), five patients had a satisfactory result (reduction of 25-50%), and three patients had no clinically relevant result (reduction of 25-50%). No patient had worsening of the AD (increase of > 25% in SCORAD), and once a clinical improvement occurred, none of the patients experienced worsening of their eczema symptoms while on omalizumab. With the caveats of the financial expense and unknown long-term risks of malignancy associated with omalizumab, this drug should be considered for treatment-resistant patients with AD, particularly patients with high IgE level whose symptoms are not controlled by routine therapies. Omalizumab has proven useful in treating asthma, but it may also prove valuable for other conditions, such as allergic rhinitis, food allergies, chronic urticaria, and AD, as shown by the present study.

To assess the current level of acceptance in the United States of complementary and alternative medicine, recent research into the prevalence, acceptance, accessibility, and recognition of complementary and alternative therapies were reviewed. Several signs point to an increasing acceptance of complementary and alternative medicine in the United States; the use of complementary and alternative medicine is significantly increasing, many aspects of Chinese medicine and Ayurveda are becoming mainstream, practitioners in the United States are beginning to be licensed, and insurance companies are beginning to cover some complementary and alternative therapies. Remaining challenges to true acceptance include the restrictive Western mindset, the absence of published studies, a lack of consistent manufacturing processes and quality standards, and a fear of adulteration. Although the field still faces many challenges, alternative and complementary medicine, including Chinese medicine and Ayurvedic medicine, is becoming more accepted and accessible in the United States.

In this study we investigated the inhibitory effects and possible mechanisms of action of 8'-hydroxydaidzein and 3'-hydroxydaidzein, two ortho-dihydroxyisoflavone derivatives from Korean fermented soybean paste, on melanogenesis in B16 murine melanoma cells. The two hydroxydaidzeins reduced melanin synthesis comparably to treatment with kojic acid, a proven whitening agent, in B16 melanoma cells. Furthermore, when in vitro human skin equivalents were treated with the hydroxydaidzeins, the levels of melanogenesis were significantly reduced relative to a kojic acid control. The RT-PCR results demonstrated that depigmentation was due to transcriptional repression of several melanogenesis genes, including microphthalmia-associated transcription factor (MITF), by the hydroxydaidzeins. The immunoblotting results confirmed that diminution of MITF expression subsequently decreased expression of tyrosinase, and tyrosinase-related proteins 1 and 2. Cumulatively, these results suggest that hydroxydaidzeins would be potent attenuators of melanin synthesis as well as effective inhibitors of hyperpigmentation in human skin. Copyright © 2011 John Wiley & Sons, Ltd.

Ginsenoside (G)-F1 is an enzymatic metabolite generated from G-Rg1. Although this metabolite has been reported to suppress platelet aggregation and to reduce gap junction-mediated intercellular communication, the modulatory activity of G-F1 on the functional role of skin-derived cells has not yet been elucidated. In this study, we evaluated the regulatory role of G-F1 on the cellular responses of B16 melanoma cells. G-F1 strongly suppressed the proliferation of B16 cells up to 60% at 200 μg/mL, while only diminishing the viability of HEK293 cells up to 30%. Furthermore, G-F1 remarkably induced morphological change and clustering of B16 melanoma cells. The melanin production of B16 cells was also significantly blocked by G-F1 up to 70%. Interestingly, intracellular signaling events involved in cell proliferation, migration, and morphological change were up-regulated at 1 h incubation but down-regulated at 12 h. Therefore, our results suggest that G-F1 can be applied as a novel anti?skin cancer drug with anti-proliferative and anti-migration features.

Purpose: The survey was performed to explore nurses` attitudes toward migrant wives in Korean society. Method: Four hundred thirty-eight respondents were recruited from 2 acute hospitals from 2 different geological areas. The attitude inventory to measure attitude toward migrant wives was utilized, which includes 6 factors such as prejudice, reliability, offensiveness, interests, acceptance, and influence. Result: The overall attitude was slightly positive (3.23) and reliability was the only non-positive scoring factor. Among the general characteristics education level showed a significant difference in 5 factors consistently compared to other characteristics. Conclusion: It can be concluded that Korean nurses tend to take a neutral to slightly positive attitude toward migrant wives. Therefore, any influence from nurses` attitudes related to migrant wives can be ignored. Obstacles or barriers which could hamper nursing care for migrant wives need to be identified and studies of strategies to overcome any existing barriers are called for.

Purpose: The present study was performed to identify the perception, attitude, and knowledge regarding the use of physical restraints among nursing personnel working at long-term care facilities. Method: 289 nurses, nurse aids and private caregivers working at 13 wards from 7 facilities participated in the survey. Perception, attitude and knowledge regarding the use of physical restraints were evaluated using the Perceptions of Restraints Use Questionnaire developed by Evans and Strumpf(1993) and Physical Restraint Questionnaire suggested by Janelli, et al(2006). Results: Wrist restraints were used the most frequently. The perception score regarding the use of physical restraints was 3.35, which is a moderate value. Study respondents considered `safety measure` and `safe use of a medical device` as the most important aspects when applying physical restraints to elderly. The respondents reported physical restraints were therapeutic at least to some degree but knowledge level about physical restraints of the respondents was rather low. Conclusion: Perception and attitude toward physical restraints were identified. The lack in knowledge about physical restraints needs to be addressed for more efficient use of them.

is bifunctional enzyme, which catalyzes the hydroxylation of L-tyrosine to L-dopa and enhances the oxidation of L-dopa to dopaquinone. There-fore, inhibitors of tyrosinase should be useful as therapeutic agents for the treatment of melanin hyperpigmentation. Many metal ion chelators, for example, kojic acid

One new ortho-dihydroxyisoflavone, 7,3',4'-trihydroxyisoflavone (2), and two known ortho-dihydroxyisoflavone derivatives were isolated from 5-year-old Doenjang (Korean fermented soypaste), and evaluated as potent antioxidant by comparing with other known isoflavones. 7,8,4'-Trihydroxyisoflavone (1), 7,3',4'-trihydroxyisoflavone (2), and 6,7,4'-trihydroxyisoflavone (3) inhibited DPPH (Diphenyl-1-picryl hydrazyl) formation by 50% at a concentration of 21.5+/-0.2, 28.7+/-0.4 and 32.6+/-0.6 (IC(50)), respectively, whereas three isoflavones showed weak DPPH radical scavenging activity. In xanthine oxidase (XO) system, in which both inhibition of xanthine oxidase and superoxide scavenging effect were measured in one assay. Compound 1 (IC(50)= 6.6+/-0.4 microM) and 2 (IC(50)=16.8+/-1.2 microM) show significant inhibitory activity and greater effect than allopurinol. But, compound 3 and other isoflavones showed lower inhibition activity. This study shows that the position of hydroxyl substituent at the aromatic ring of isoflavone plays an important role in radical scavenging effect.

Objectives Korean adolescent girls are unprepared for cervical cancer prevention due to the lack of a mandatory policy regarding human papilloma virus (HPV) vaccination and school health education regarding cervical cancer. The aim of this study was to determine how aware mothers are about cervical cancer prevention in their adolescent daughters, with a view to developing strategies for expanding primary cervical cancer prevention for adolescent girls through the mothers’ involvement. Design A qualitative design was employed. Nine mothers with adolescent daughters participated in this study and were interviewed using open-ended questions. The themes were extracted by content analysis. Setting A general living area in Seoul, South Korea. Participants The snowball method was used to select mothers. Results Five themes emerged. In general, the mothers’ awareness of cervical cancer was not clear, and they exhibited a lack of awareness of the importance of having a regular Papanicolaou screening test. The mothers recognised that they were role models for their daughters, and realised and accepted the necessity of educating their daughters regarding cervical cancer; however, they perceived barriers related to the prevention of cervical cancer in their daughters. The mothers recommended enforcing sex education in schools and the provision of financial support for HPV vaccination. Conclusions The mothers’ awareness and preparedness with respect to the prevention of cervical cancer in their adolescent daughters were low and inadequate. Mothers should be informed and motivated to play a role in the education of their daughters regarding cervical cancer prevention. Strategies for disseminating information regarding early cervical cancer prevention for adolescent girls are recommended by communicating with both the girls and their mothers and providing them with education regarding cervical cancer prevention.

Lipid peroxidation has been suggested to play a key role in damaging biological processes resulting from excessive exposure to UV light. Aging of skin has been associated with increased peroxidation of skin lipid. In particular, squalene, which is a main component of skin surface polyunsaturated lipids, is easily peroxidized. Squalene-monohydroperoxide (Sq-OOH), the initial product of peroxidized squalene, is produced at the human skin by natural exposure to sunlight during day time activities. Recently, a few researchers reported on the damages of hairless mice skin by the topical application of Sq-OOH. Repeated application of Sq-OOH to the hairless mice induced its the skin wrinkles with clear and fine appearance. Histologically were seen, more keratinocyte hypertrophy with Sq-OOH treated skin than with chronic UVB irradiated group in epidermis. In dermis, characteristics, found in UVB irradiated skin, such as the loss of polarity, fractured collagen bundle and elastosis, were not observed severely. The alteration of epidermal layer might be the main factor for the formation of wrinkle caused by Sq-OOH. From the previous works, Sq-OOH is considered as an important source of damage in the early stage of aging process to result in epidermal wrinkle. Thus, it is very important to minimize such damage that would be induced mainly by Sq-OOH against healthy skin condition. Therefore, we tried to develop new anti-aging materials for protecting skin damage by Sq-OOH. Hydroxamic acids, the naturally occurring products exhibit low toxicities in general, and are of interest for many therapeutic applications. Recently, hydroxamic acids and derivatives were reported largely as effective antibacterial and antifungal agents. Their activities originate from their ability to coordinate on metal ions. That is, hydroxamic acid group is regarded as an one electron donor. Hydroxamic acid moiety has also drawn much attention as a reactive oxygen species (ROS) scavenger. In this study, a new skin protecting compound, (4-(Nhydroxycarbamoyl)phenyl)-N-adamantanylcarboxamide (1) is synthesized to show inhibitory activities of lipid peroxidation both in vitro and in vivo. The targeted compound 1 is a hydroxamic acid derivative which possesses an amide linker between hydroxamic acid and adamantane moiety. Adamantane group was adopted as a hydrophobic moiety to optimize antioxidant activity of hydroxamic acid in animal test. Compound 1 is believed to be adequate in skin permeation because of its balance in hydrophilic and hydrophobic character.

Background Although retinoids have potential efficacy in aged skin, their side effect (skin irritation) remains a clinical problem. We designed a novel synthetic retinoid, seletinoid G, by using computer-aided molecular modeling, and investigated its effects on the expression of extracellular matrix proteins in human skin in vivo. Methods Twenty-three subjects were tested on the buttocks using 4-day occlusive application of seletinoid G and all- trans retinoic acid ( t RA). Skin irritation after topical application was quantified by the degree of erythema and cutaneous blood flow. The expression of extracellular matrix proteins and interstitial collagenase (MMP-1) in skin biopsies was investigated by immunohistochemical staining and Western blotting. Results The topical application of seletinoid G under occlusion induced no skin irritation in contrast to t RA, which caused severe erythema. The topical treatment with seletinoid G increased the expressions of type I procollagen, tropoelastin, and fibrillin-1, and reduced MMP-1 in old skin in vivo. Seletinoid G was found to inhibit not only the UV-induced decrease of type I procollagen but the UV-induced increase of MMP-1 and c-Jun protein in young skin in vivo. Conclusions Seletinoid G is a novel synthetic retinoid, which has little the side effect of skin irritation after topical application. Seletinoid G can repair altered connective tissue in old skin and inhibit UV-induced collagen deficiency in young skin.

A stable derivative of kojic acid, 5-[(3-aminopropyl)phosphinooxy]-2-(hydroxymethyl)-4H-pyran-4-one (Kojyl-APPA), was synthesized in good yield. The effects of Kojyl-APPA on tyrosinase activity and melanin synthesis were investigated. Kojyl-APPA showed tyrosinase inhibition effect (30%) in situ, but not in vitro. Kojyl-APPA inhibited tyrosinase activity significantly at 24 h after treatment in normal human melanocytes. It means that Kojyl-APPA is not a direct inhibitor of tyrosinase itself, but it is converted to a potential inhibitor kojic acid enzymatically in cells. In addition, Kojyl-APPA decreased melanin content to 75% of control in melanoma cells and decreased neomelanin synthesis to 43% of control in normal human melanocytes. Its permeation through skin increased by about 8 times as compared with kojic acid.

Tyrosinase is a copper-containing enzyme, which catalyzes two distinct reactions of melanin synthesis, the hydroxylation of L-tyrosine to L-dopa and the oxidation of L-dopa to dopaquinone. These processes are involved in local hyperpigmentation such as melasma and lentigo. Therefore, the inhibition of tyrosinase to treat the pigmentation disorders has been a recent subject of many studies. Kojic acid (1) is well known as one of the most popular tyrosinase inhibitors and it has been widely used as a skin-whitening agent. However, the inhibitory activity of kojic acid is not potent enough. To overcome this drawback, many semi-synthetic kojic acid derivatives were synthesized usually by the modification of C-2 hydroxyl group into ester, hydroxyphenyl ether, and glycoside. Recently, two molecules of kojic acid were connected by ester and ethylene. Their inhibitory activities were dramatically enhanced. Thus we became interested in new kojic acid derivatives containing two molecules of kojic acid. In this study, we connected two molecules of kojic acid by various chemical bonds such as ester, amide, and thioether. Anti-melanogenic activities of compounds (4a-4f) were compared with that of kojic acid (Figure 1).

Summary Background. Melasma is a common pigmentary disorder that poses therapeutic challenges. Mixed-type melasma usually does not respond to conventional monotherapy. Objective. To evaluate the effectiveness and safety of 1064-nm Q-switched neodymium-doped yttrium–aluminium–garnet laser (1064 QNYL) and 30% glycolic acid (GA) peel in the treatment of melasma. Methods. This was a split-face study, in which 16 patients were treated with 1064 QNYL (6-mm spot size, 2.0–2.3 J/cm2 fluence) for six sessions at 1-week intervals to the entire face, and with GA for three sessions at 2-week intervals to the experimental side of the face. Clinical evaluations, measurements on a pigment measuring device (Mexameter), and assessment of patient satisfaction and adverse events were performed at baseline and every visit. Results. After treatment, significant improvements from baseline were seen in Mexameter and modified Melasma Area and Severity Index (mMASI) on both sides of the face. The combined therapy side achieved an average 32.6% improvement in Mexameter readings and 37.4% improvement in mMASI, compared with 22% and 16.7%, respectively, on the side treated with laser only (P ≤ 0.05). Both the physician and patient assessments correlated with the Mexameter results and mMASI. Conclusion. Combined 1064 QNYL and GA seems to be superior to 1064 QNYL alone in the treatment of mixed-type melasma.

Background: The erythrocyte sedimentation rate (ESR) test has been considered to be a simple procedure, not requiring quality control (QC). However, QC is essential for accuracy and precision. We evaluated the TEST 1 ESR system and performed QC procedures using newly developed latex control materials in three hospitals. Methods: Using tripotassium ethylenediaminetetraacetic acid blood samples (n=184), we compared TEST 1 ESR values with Westergren ESR data and evaluated intra-assay precision. Three levels of latex control materials were used to assess inter-assay precision. Reference range assessment was done using samples from 220 healthy individuals. Inter-laboratory QC with latex control materials in three hospitals was performed. Results: Correlation between TEST 1 ESR and Westergren ESR results was good (p Conclusions: Our results demonstrate that the TEST 1 QC is reliable and the latex control materials are valuable for inter-laboratory proficiency testing. Clin Chem Lab Med 2010;48:1043–8.

We compared the TEST 1 (Alifax, Padova, Italy) and Westergren methods of measuring the erythrocyte sedimentation rate (ESR) to assess inflammation. The ESR was measured by both methods in 154 blood samples from patients with malignancy (n = 69), autoimmune disease (n = 44), or infection (n = 41). Total protein, albumin, and C-reactive protein (CRP) levels were measured in each plasma sample, and albumin and α1-, α2-, β1-, β2-, and γ-globulin fractions were measured by capillary electrophoresis. TEST 1 ESR values were significantly lower than the Westergren values, by 10.9 mm/h. We found that the correlations of TEST 1 ESR values with inflammatory protein levels (total protein, globulin, CRP, and α1-, α2-, β2-, and γ-globulin) were better than those obtained using the Westergren method. These findings indicate that ESR measurements by TEST 1 reflect inflammation better than do those by the Westergren method in patients with malignancy, autoimmune disease, or infection.

The methanol extract from Selaginella tamariscina significantly inhibited UV irradiation induced activity of matrix metalloproteinase-1 (MMP-1) in primary fibroblasts from human skin. Using the technique of bioassay-directed chromatographic separation, five biflavonoids were isolated from the ethyl acetate soluble fraction of S. tamariscina. Here, we investigated the effect of these five biflavonoids on the regulation of MMP-1 and -2 in UV irradiated cultured dermal fibroblasts from human neonatal foreskins. Among these biflavonoids, sumaflavone and amentoflavone showed significant MMP-1 inhibitory activity in primary human dermal fibroblasts after UV irradiation. The IC(50) values of sumaflavone, amentoflavone and retinoic acid, which was used as a positive control, were 0.78, 1.8, and 10microM, respectively.

Kojic acid, 5-hydroxy-2-(hydroxymethyl)-4H-pyran-4one, is produced from carbohydrate sources in an aerobic process by a variety of microorganisms. It showed broad biological activities such as inhibition of tyrosinase, scavenging of the free radicals, chelating activity of metal ions and prevention of photodamage. Its various activities are due to γ-pyranone structure having enolic hydroxyl group. Recently, enolic hydroxyl group of kojic acid has been focused as an alternative of carboxylic acid in retinoid structure. We synthesized 3,4-methylenedioxy cinnamic acid ester of kojic acid as a new retinoidal compound. In this study, we evaluated biological activities of new kojic acid derivative 1, 2-((3E)-4(2H,3H-benzo[3,4-d]1,3-dioxolan-5yl)-2-oxo-but-3-enyloxy)-5-hydroxy-4H-pyran-4-one.

Objectives To explore perceptions and experiences of patients with chronic fatigue with traditional Korean medicine (TKM) and their motivation for choosing TKM. Design Qualitative, one-on-one, in-depth interview study. Setting Primary TKM hospitals in Seoul, Incheon and Daejeon, South Korea. Results 15 patients with chronic fatigue were interviewed in this study. Patients with chronic fatigue experienced physical and psychological symptoms that resulted in severe difficulties associated with routine daily activities. The motivations for choosing TKM were primarily dissatisfaction with conventional medicine and previous positive experiences with TKM. While undergoing TKM treatment, patients found that TKM practitioners considered fatigue to be a treatable illness; also, patients felt comfortable with the doctor–patient relationship in TKM. Conclusions Healthcare providers need to be concerned about the symptoms of chronic fatigue to a degree that is in line with the patient9s own perceptions. Korean patients with chronic fatigue choose TKM as an alternative to fulfil their long-term needs that were unmet by conventional medicine, and they are greatly positively influenced by TKM. TKM may present a possible therapy to alleviate symptoms of diseases that conventional medicine does not address and is an approach that has a considerable effect on Korean patients.

The binding of sphingoid bases to peroxisome proliferator-activated receptor (PPAR) has been detected in a solid-phase binding assay. However, sphingoid base-induced changes in PPAR transactivation activity have not been examined. In this report, we show by reporter gene analyses that phytosphingosine (PS), a natural sphingoid base, activates the transcriptional activity of PPARs in the immortalized human keratinocyte, HaCaT. Real-time PCR analyses showed that the mRNA level of PPARgamma was increased after PS treatment in HaCaT cells in a dose- and time-dependent manner. Because PPARs play important roles in skin barrier homeostasis by regulating epidermal cell growth, terminal differentiation, and inflammatory response, we examined the effect of PS on normal human epidermal keratinocytes (NHEKs) and mouse skin. PS increased the production of cornified envelope in NHEKs by approximately 1.8-fold compared with controls. Epidermal differentiation marker proteins such as involucrin, loricrin, and keratin1 were also increased in PS-treated NHEKs, by ELISA or Western blotting analysis. A [(3)H]thymidine incorporation assay showed that PS inhibited DNA synthesis in NHEKs to 20% compared with controls. The antiproliferative and anti-inflammatory effects of PS were examined in a mouse model of irritant contact dermatitis produced by topical application of 12-O-tetradecanoylphorbol-13-acetate (TPA). PS blocked epidermal thickening and edema and the infiltration of inflammatory cells into the dermis in the skin of TPA-treated hairless mice. The anti-inflammatory effects of PS were confirmed by the observation that PS blocked the TPA-induced generation of prostaglandin E(2) in peripheral mononuclear leukocytes. Taken together, our results provide an insight into the multiple regulatory roles of PS in epidermal homeostasis, and furthermore point to the potential use of PS as a therapeutic agent in the treatment of inflammatory and proliferative cutaneous diseases.

Although evidences are emerging that dietary isoflavones have beneficial effects in treatment of hyperlipidemia and cardiovascular diseases, the underlying molecular mechanism has not yet been extensively characterized. In this report, we showed that genistein, one of the major isoflavones, increased expression of genes involved in lipid catabolism such as carnitine palmitoyltransferase 1, liver form (CPT1L) in HepG2 cells, when assayed by real-time reverse-transcriptase polymerase chain reactions as well as Western blotting analysis. The increase in mRNA-level of CPT1L after genistein treatment was not changed in the presence of ICI182780, a potent inhibitor of estrogen receptor, suggesting that this effect of genistein was estrogen receptor-independent. Since these genes involved in fatty acid catabolism are considered putative downstream target genes of peroxisome proliferators-activated receptor alpha (PPARalpha), we examined whether expression of PPARalpha was modulated by genistein treatment. Interestingly, genistein induced expression of PPARalpha at both mRNA- and protein-level. Further, genistein activated transcriptional activity of PPARalpha, when determined by reporter gene analysis, suggesting genistein as a potential ligand for PPARalpha. Taken together, this study provides a picture of the regulatory action of genistein, as an activator of PPARalpha in fatty acid catabolism and potential use of genistein as lipid-lowering agent.

Ginsenosides, the major active ingredients of ginseng, show a variety of biomedical efficacies such as antiaging and antioxidation. Here, we investigate the protective activity of the ginsenoside F1, an enzymatically modified derivative of ginsenoside Rg1, against ultraviolet-B-induced damage in human HaCaT keratinocytes. Ginsenoside F1 significantly reduced ultraviolet-B-induced cell death and protected HaCaT cells from apoptosis caused by ultraviolet B irradiation. Furthermore, ginsenoside F1 prevented ultraviolet-B-induced cleavage of poly(ADP-ribose) polymerase in HaCaT cells. In search of the molecular mechanism responsible for the antiapoptotic effect of ginsenoside F1, we find that protection from ultraviolet-B-induced apoptosis is tightly correlated with ginsenoside-F1-mediated inhibition of ultraviolet-B-induced downregulation of Bcl-2 and Brn-3a expression.

Skin is a highly complicated tissue which possesses the largest surface area in the body and serves as the protective layer for internal organs. It is designed to give both physical and biochemical protection, and is equipped with a large number of defense mechanisms. 1 However, skin is very susceptible to oxidative reaction, because there are rich contents of lipids, proteins and DNA in the skin cell, all of which are very sensitive to the oxidation process. 2 Lipid peroxidation could be induced from excessive exposure to UV light, and has been considered as a major factor for skin aging processes. 3 In particular, squalene, main component of skin surface polyunsaturated lipids, is easily peroxidized. 4 The initial product of peroxidized squalene, squalene-monohydroperoxide (Sq-OOH), is produced at the human skin by natural exposure to sun light. Recently, the damages of hairless mice skin by the topical application of Sq-OOH 5 have been reported. Repeated application of Sq-OOH to the hairless mice induced clear skin wrinkles. Thus, in order to prevent or retard skin aging process, prevention of skin lipid peroxidation by natural or chemical antioxidants is desirable. To identify efficient antioxidants in cosmetic applications, a convenient assay method suitable for the estimation of skin lipid peroxidation is necessary. Rancimat 6 is a convenient method which can evaluate the lipid peroxidation by observing the change of electrical conductivity due to the formation of volatile dicarboxylic acids. It has been used in food industry to determine the peroxidation of unsaturated fatty acid components. However, the rancimat method is not suited for skin research, because the composition of oils used as a lipid source in this method is very different from that of skin lipid. 6c In this report, we demonstrate that modified rancimat method is a powerful tool for screening natural antioxidants for skin lipid peroxidation. We changed composition of lipid source to what is very close to skin lipid. At first, we tested antioxidative activities of several natural extracts by using general rancimat method. As shown in Table 1, extracts from Korean medicinal plants presented different induction time on retarding the peroxidation of corn oil. Their activities were compared with BHT as a positive control. Among the three natural extracts, Scutellaria baicalensis Georgi (SBG) extract was found to have the most powerful antioxidative activity. Portulaca oleracea L. (POL) extracts appeared to be the compound with the next activity and Rheum coreanum Nakai (RCN) extract was less active than other extracts. The order of activity is BHT > SBG > POL > RCN. However, ranges of Pf values of tested natural product are too small (from 1.2 to 1.6). Thus, sensitivity is not enough for primary screening of antioxidative activity. To establish the modified rancimat system suitable for skin lipid peroxidation studies, we prepared the artificial skin lipid and used it instead of corn oil. The prepared artificial skin lipid 7 was consisted of pork lard (33%), stearic acid (24%), lanolin (22%), squalene (12%) and cholesterol (4%). This composition is similar to that of human skin. According to the Table 2, the results of new rancimat method were different from previous general rancimat data. Surprisingly, SBG extract shows the strongest antioxidative activity among the tested samples. Induction period of SBG was 11.4 times longer than that of control with this new method. The sensitivity for evaluation of antioxidative activity was dramatically increased due to the wide ranges of Pf value (from 2.2 to 11.4). It is interesting to observe that the order of activity between RCN and ROL was reversed. In contrast to previous rancimat data, RCN is more active than POL. These interesting and meaningful differences between general rancimat and modified method may be due to changing of lipid composition which is suited to skin research. In search of new antioxidant applicable to prevent skin lipid peroxidation, we selected meso-dihydroguaiaretic acid (MDGA) 8 as a candidate. MDGA, a naturally occurring polyphenol

Purpose: The purpose of this study was to identify cultural competence and factors influencing cultural competence of nursing students in South Korea. Methods: Participants in this study were 248 nursing students who agreed to participate in the study. Data were collected during November and December, 2012 using structured questionnaires. Data were analyzed using PASW/WIN 20.0 program and included t-test, one-way ANOVA