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Ethnopharmacological relevance Tongue diagnosis is a significant procedure to examine the physiological and pathological changes of the human body in oriental medicine. However, the conventional method of tongue diagnosis including direct observation of tongue has limitations because of various external factors and subjective factors. Therefore, the current study investigated the usefulness of the tongue diagnosis system (TDS) as a diagnostic tool for evaluating tongue coating thickness (TCT) by assessing the agreement between the TDS and a gold standard established by assessors using the conventional method. Materials and methods The present study was designed as a prospective clinical trial including 60 patients with functional dyspepsia. The TDS was used to capture tongue images twice within a 30-min interval to assess its reproducibility. Tongue coating percentage was measured by the TDS, and TCT was classified as either no coating, thin coating, or thick coating according to the existing diagnostic criteria. After both TDS examinations, the weight of tongue coating was quantitatively measured, and the correlation between the actual quantity of tongue coating and the percentage of the coating measured by the TDS was analyzed using Pearson's correlation. After collecting tongue images in all 60 patients, tongue coating was evaluated using a conventional method by 5 well-trained assessors to establish the gold standard for evaluating TCT, which allowed us to assess the diagnostic agreement between the TDS and the gold standard. After 2 weeks, TCT evaluation was repeated by the same assessors using the same images but in a random order. Results The agreement between the TDS and the gold standard for evaluating TCT was almost perfect (weighted kappa, 0.840), as was the reproducibility of the TDS (weighted kappa, 0.851). The percentage of tongue coating measured by the TDS was significantly correlated with the weight of tongue coating (r=0.442, p <0.001). The levels of intra-rater reliability ranged from substantial to almost perfect (range of weighted kappa, 0.777-0.923). The inter-rater reliability of 5 assessors was moderate (weighted kappa, 0.563). Conclusions The present study demonstrated that the TDS can be used as a diagnostic tool for the objective and standardized evaluation of TCT in actual clinical practice. [ABSTRACT FROM AUTHOR]

Despite the importance of airway surface liquid pH in the lung's defenses against infection, the mechanism of airway HCO3- secretion remains unclear. Our aim was to assess the contribution of apical and basolateral Cl-/HCO3- exchangers to Cl- and HCO3- transport in the Calu-3 cell line, derived from human airway submucosal glands. Changes in intracellular pH (pHi) were measured following substitution of Cl- with gluconate. Apical Cl- substitution led to an alkalinization in forskolin-stimulated cells, indicative of Cl-/HCO3- exchange. This was unaffected by the anion exchange inhibitor DIDS but inhibited by the CFTR blocker CFTRinh-172, suggesting that the HCO3- influx might occur via CFTR, rather than a solute carrier family 26 (SLC26) exchanger, as recently proposed. The anion selectivity of the recovery process more closely resembled that of CFTR than an SLC26 exchanger, and quantitative RT-PCR showed only low levels of SLC26 exchanger transcripts relative to CFTR and anion exchanger 2 (AE2). For pHi to rise to observed values (~7.8) through HCO3- entry via CFTR, the apical membrane potential must reverse to at least +20 mV following Cl- substitution; this was confirmed by perforated-patch recordings. Substitution of basolateral Cl- evoked a DIDS-sensitive alkalinization, attributed to Cl-/HCO3- exchange via AE2. This appeared to be abolished in forskolin-stimulated cells but was unmasked by blocking apical efflux of HCO3- via CFTR. We conclude that Calu-3 cells secrete HCO3- predominantly via CFTR, and, contrary to previous reports, the basolateral anion exchanger AE2 remains active during stimulation, providing an important pathway for basolateral Cl- uptake. [ABSTRACT FROM AUTHOR]

Background: Xerostomia, a subjective sense of dry mouth, is not generally regarded a disease despite its high prevalence among the elderly, and therefore continues to impair affected patients' quality of life. In traditional Korean medicine, 'Yin-Deficiency' has been implicated in the pathogenesis of xerostomia among the elderly. Yukmijihwang-tang is a famous herbal prescription used to relieve 'Yin-Deficiency', and reportedly has antioxidant effects; therefore, it is postulated that Yukmijihwang-tang can be used to treat xerostomia in the elderly. However, to our knowledge, no clinical trial has been conducted on the effects of Yukmijihwang-tang on xerostomia. Thus, we designed a randomized clinical trial to investigate the effects and safety of Yukmijihwang-tang on xerostomia in the elderly. In addition, we will clarify the aforementioned assumption that 'Yin-Deficiency' is the major cause of xerostomia in the elderly by identifying a correlation between xerostomia and 'Yin-Deficiency'. Methods/Design: This randomized, double-blind, placebo-controlled trial will be carried out at two centers: Kyung Hee University Korean Medicine Hospital and Kyung Hee University Hospital at Gangdong. We will recruit 96 subjects aged 60-80 years who have experienced xerostomia for 3 months prior to participation. Subjects who present with score >40 on the visual analogue scale for xerostomia and unstimulated salivary flow rate under 0.3mL/min will be included and the randomization will be carried out by an independent statistician by using a random number creation program. The subjects and all researchers except the statistician will be blinded to the group assignment. Yukmijihwang-tang or placebo will be administered to each group for 8 weeks. The primary outcome is change in the scores for the visual analogue scale for xerostomia and the dry mouth symptom questionnaire from 0 to 8 weeks. Discussion: It will be assessed whether Yukmijihwang-tang can be used as a new herbal treatment for xerostomia in the elderly by demonstrating its therapeutic effects in a well-designed clinical trial. [ABSTRACT FROM AUTHOR]

Tongue diagnosis is an important procedure in traditional Korean medicine (TKM). In particular, tongue coating thickness (TCT) is deemed to show the progression of the disease. However, conventional tongue diagnosis has limitations because of various external factors. Therefore, it is necessary to investigate the availability of tongue diagnosis system (TDS) in the assessment of TCT. This study has been designed as a prospective clinical trial involving 60 patients with functional dyspepsia. Tongue images will be obtained by TDS twice with a 30 min interval. The system will measure the percentage of TCT and classify it as either no coating, thin coating, or thick coating according to the existing diagnostic criteria. After finishing the collection of 60 patients' tongue images, TCT on the images will be simultaneously evaluated by the conventional method to establish the gold standard for assessing TCT by 5 well-trained clinicians. The evaluation will be repeated by the same clinicians after 2 weeks, but the order of the images will be changed. This trial is expected to provide clinical evidence for the availability of TDS as a diagnostic tool and to contribute to the standardization of the diagnosis system used in TKM. This trial is registered with ClinicalTrials.gov NCT01864837. [ABSTRACT FROM AUTHOR]

This study evaluated the effects of a nonwoven polypropylene (NPP) covering during overwintering with different mulch types and transplant times on bulb onion growth and yield of intermediate-day onions (Allium cepa L.) during the 2015/2016 and 2016/2017 growing seasons. Field experiments were conducted using a split-split plot design with three replicates. Treatments included main plots containing different mulch types (transparent plastic mulch, black plastic mulch, or bare ground), subplots with different transplanting times (20 Oct., 5 Nov., and 20 Nov.), and sub-subplots containing two onion cultivars (Sunpower and Katamaru). NPP was used to cover all plots on 1 Dec., and it was removed on 28 Feb. Mean daily air temperatures during transplanting and root establishment were 2.6 8C higher during the 2015/2016 growing season compared with the 2016/2017 season. NPP covering on bare ground increased soil temperature by 2.1 8C compared with no treatment. Soil water potential with transparent and blackmulches and NPP continued to be more than L10 kPa until early March. Number of leaves, and root and leaf weight were significantly greater during the 2015/2016 growing season than during the 2016/2017 growing season; there were also significantly greater for onion plants grown with transparent plastic mulch than for those grown with black plastic mulch or no mulch on 4 Apr. and 5 May. Marketable bulb yield was lower during 2015/2016 (32.0Mg·ha-1) than during 2016/2017 (38.5Mg·ha-1); this was due to the increased unmarketable bulb yield, with 33.2 Mg·ha-1 bolters and 3.9 Mg·ha-1 doubled bulbs during 2015/2016 compared with 3.9 Mg·haL1 bolters and 0.3Mg·ha-1 doubled bulbs during 2016/2017. Marketable bulb yield of 'Katamaru' (38.9 Mg·ha-1) was greater than that of 'Sunpower' (31.6 Mg·ha-1). Marketable bulb yield increased with later transplanting times, and onions grown with black plastic mulch achieved the highest bulb yield (43.0 Mg·ha-1), followed by transparent mulch (34.7 Mg·ha-1) and no mulch (28.0 Mg·haL1). When the temperatures from early November to early December were similar to the 30-year average temperatures, marketable bulb yield could increase with the NPP covering, especially for onions grown with black plastic mulch or no mulch when transplanted from late October to early November. [ABSTRACT FROM AUTHOR]

This study aimed to compare agricultural practices, soil physical and chemical properties, growth characteristics, and nutrient uptake of bulb onions from organic and conventional farms in southeastern Korea during the 2011-12 growing season. Soil and plant samples were collected from eight certified organic fields managed organically for more than 5 years and eight conventional fields adjacent to the organic fields. The amounts of nutrients applied to onion fields were approximately two times greater with the conventional methods than with organic methods. However, the soil physical and chemical properties were not significantly different between the organic and conventional systems, except for NO3-N in early May. Growth characteristics were significantly different in early April with organic bulb yield of 55.9 t⋅ha-1, which was 21.8% lower than conventionally produced onions. Yield reduction in organic onions was the result of lower large-sized (8 cm or greater) bulb yield compared with conventional production. In the conventional system, phosphorus (P) and potassium (K) content of leaf tissue in early April, and nitrogen (N) and P content of bulb tissue in early May were higher than those in the organic system. Uptake of all nutrients was greater in the conventional onions compared with the organic onions, except for leaf tissue at harvest. In conclusion, organic onions began to grow and absorb soil nutrients later than the conventional onions in the initial vegetative growth stage. Moreover, it led to an organic onion producing a lower bulb yield. To accelerate the initial growth of the organic onion plant, agricultural practices need to be modified. Modifications that may help include using larger sized seedlings at transplanting, covering the plants with nonwoven fabric or transparent plastic film to increase warmth during winter, and harvesting the onions 1 week later than the conventional onions. [ABSTRACT FROM AUTHOR]