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Background Panax ginseng is a famous traditional medicine in Korea for its beneficial effect on obesity, cardiac and liver associated diseases. The aim of this study was to investigate the metabolite in Panax ginseng (P. ginseng, Aralicaceae) berries depending on the ripen stages and evaluate its potential inhibition on adipocyte differentiation in 3 T3-L1 cells. Methods Different ripening stage samples of P. ginseng berry were analyzed through global metabolite profiling by NMR spectroscopy. Lipid accumulation in the cells was analyzed by Oil Red O staining. Results The PLS-DA clearly distinguished P. ginseng berry extract (PGBE) according to the partial ripe (PR), ripe(R) and fully ripe (FR) stage. Lipid accumulation of PGBE was examined by measuring triglyceride content and Oil-Red O staining. These results suggested that the FR stage of PGBE decrease in lipid accumulation during adipocyte differentiation and the amount of threonine, asparagine, fumarate, tyraine, tyrosine, and phenylalanine increased with longer ripening of ginseng berries. Conclusion Metabolite profiling of P. ginseng was identified by 1H NMR spectra. P. ginseng extract efficiently inhibits adipogenesis in 3 T3-L1 adipocytes concluded that the P. ginseng has the antiobesity properties. [ABSTRACT FROM AUTHOR]

Aims: Dopamine receptors are associated with reward aod dependence towards alcohol. The polymorphisms of dopamine D2 receptor (DRD2) genes have bees reported to be involved in sascepribiliry to alcoholism. Therefore, we investigated the as- sociation of three single-nscleotide polymorphisms (SNPs) is DRD2 and ankyris repeat and kisase domain eostaisisg one (ANKKI) genes with alcohol dependence in Korean sabjects, who were classified by the criteria of the Lesch typology. Methods: The DRD2 -141C (Insertion (Ins)/Deletion (Del)), exoa8 (A/G) and the ANKKI TaqIA (A1/A2) polymorphisms were genotyped in a case-control sample consisting of 245 alcohol-dependent (AD) patients and 110 healthy controls. AD patients were classified into four subtypes by the Lesch typology. The majority of them (77.1%) were Lesch type I. Differences in genotype and allele frequencies were examined between the AD patients and the controls. Also those analyses were done between the Lench type I grasp and the controls. Reaults: There were significant differences in the genotype and allele frequencies of -141 C Ins/Del and TaqIA A 1/A2 between the AD patients and the controls. However, there were no significant differences in genotype or allele frequencies of exon8 A/G between the AD patients and the controls. The -141C Ins/Ins and TaqIA Al+ variants were associated with Lesch type I AD patients. When analysing haplotypes of three SNPs, the odds ratio of -141C Inn-A-Al was 2.286, while the odds ratio of -141C Del-G-A2 was 0.323. Conclusion: The present study showed a significant difference in DRD2 -141C and ANKKI TaqIA poly- morphisms between the AD patients and the controls. Oar findings suggest that -141C Ins and TaqIA A1 alleles can be a predisposing factor for alcohol dependence in the Korean population. [ABSTRACT FROM AUTHOR]

Purpose: This study was done to identify the relationship of malnutrition, social network and health-related quality of life and to investigate the main factors influencing health-related quality of life in elders. Methods: The research design was a descriptive survey design using a convenience sampling. Data were collected by self-report questionnaires from 196 elders. Data analysis was done using SPSS 18.0 pc+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. Results: The average score for health related quality of life was 3.33 (SD=0.86). Differences in health-related quality of life were statistically significant according to age, gender, occupation, presence of spouse, monthly income, source of income, economic status, medicine, and existence of chronic disease. Health-related quality of life was significantly correlated with malnutrition and social network. Major factors affecting health related quality of life for elders were malnutrition, occupation, age, social network, and economic status which explained 52.0% of the variance in health related quality of life. Conclusion: Findings provide a basis for developing nursing interventions to improve health-related quality of life. Future studies are needed a wide variety of variables that might influence health -related quality of life in elders. [ABSTRACT FROM AUTHOR]

Aims: Reducing craving is a key to success in the treatment of alcohol dependence. The emotion circuit may be involved in pathological craving for alcohol. In this study, we investigated neural correlates of emotional involvement in craving in alcohol dependence. Methods: The study included 17 detoxified alcoholic patients and 25 social drinkers. We used functional magnetic resonance imaging to examine brain activation (blood oxygen level-dependent signals) while participants reported craving and emotion in response to visually presented, alcohol-related stimuli and emotional stimuli. Results: In the craving-rating paradigm, negative emotional stimuli as well as alcohol cues activated craving-related brain regions in alcoholic patients. Activations of the inferior parietal lobule and dorsolateral prefrontal cortex by negative emotional stimuli were negatively correlated with craving; meanwhile limbic activation was positively correlated with craving. For the emotion paradigm, greater limbic activation was evident by alcohol-related stimuli in the alcohol-dependent group. Conclusions: Our findings constitute neural evidence for emotional involvement in pathological craving for alcohol, underscoring the importance of emotion management in abstinent alcoholic patients for relapse prevention. [ABSTRACT FROM AUTHOR]

Health benefits of Kochujang (KCJ) and its bioactive compounds have been reported in several in vitro and animal studies. Objective: The aim of this study was to investigate the efficacy of KCJ supplementation on body composition and blood lipid profiles in overweight adults. Methods: Sixty overweight men and women with BMI ≥23 kg/m2 and waist-hip-ratio (WHR) ≥0.90 for men and ≥0.85 for women were randomly assigned to a KCJ supplement (n=30, 32 g/day) or placebo (n=30, 32 g/day) group for a 12-week, double-blind, placebo controlled study. We measured anthropometric parameters, serum lipid profiles, abdominal fat distribution by computerized tomography and calculated the atherosclerosis indices in 53 subjects (n=26 in KCJ group, n=27 in placebo group) who completed the study. Results: After 12 weeks, the KCJ group showed a significant reduction in visceral fat (cm2) (p<0.05), although body weight (kg) and WHR did not change. Serum concentration of triglycerides and ApoB were decreased when compared to those of the placebo group. Conclusion: KCJ supplementation (32 g/day) for 12 weeks in overweight adults showed anti-atherosclerotic and anti-obesogenic effects. Trial registeration: Clinical trials.gov Identifier: NCT01532375. [ABSTRACT FROM AUTHOR]

Purpose: Human factor is one of the major causes of medication errors. The purpose of this study was to identify nurses' perception and experience of medication errors, examine the relationship of Dominance, Influence, Steadiness, Conscientiousness (DISC) behavior patterns and medication errors by nurses. Methods: A descriptive survey design with a convenience sampling was used. Data collection was done using self-report questionnaires answered by 308 nurses from one university hospital and two general hospitals. Results: The most frequent DISC behavioral style of nurses was influence style (41.9%), followed by steadiness style (23.7%), conscientiousness style (20.4%), and dominance style (14.0%). Differences in the perception and experience level of medication errors by nurses' behavioral pattern were not statistically significant. However, nurses with conscientiousness style had the lowest scores for in experience of medication errors and the highest scores for perception of medication errors. Conclusion: The results of this study show that identification of the behavior pattern of nurses and application of this education program can prevent medication errors by nurses in hospitals. [ABSTRACT FROM AUTHOR]

Background: The treatment of knee osteoarthritis, which is a major cause of disability among the elderly, is typically selected from multidisciplinary options, including complementary and alternative medicine. Moxibustion has been used in the treatment of knee osteoarthritis in Korea to reduce pain and improve physical activity. However, there is no sufficient evidence of its effectiveness, and it cannot therefore be widely recommended for treating knee osteoarthritis. We designed a randomised controlled clinical trial to evaluate the effectiveness, safety, cost-effectiveness, and qualitative characteristics of moxibustion treatment of knee osteoarthritis compared to usual care. Methods/designs: This is a protocol for a multicentre, pragmatic, randomised, assessor-blinded, controlled, parallel-group study. A total of 212 participants will be assigned to the moxibustion group (n = 106) and the usual care group (n = 106) at 4 clinical research centres. The participants assigned to the moxibustion group will receive moxibustion treatment of the affected knee(s) at 6 standard acupuncture points (ST36, ST35, ST34, SP9, Ex-LE04, and SP10) 3 times per week for 4 weeks (a total of 12 sessions). Participants in the usual care group will not receive moxibustion treatment during the study period. Follow-up will be performed on the 5th and 13th weeks after random allocation. Both groups will be allowed to use any type of treatment, including surgery, conventional medication, physical treatment, acupuncture, herbal medicine, over-the-counter drugs, and other active treatments. Educational material that explains knee osteoarthritis, the current management options, and self-exercise will be provided to each group. The global scale of the Korean Western Ontario and McMaster Osteoarthritis Index (KWOMAC) will be the primary outcome measurement used in this study. Other subscales (pain, stiffness, and function) of the K-WOMAC, the Short-Form 36v2 Health Survey, the Beck Depression Inventory, the Physical Function test, Patient Global Assessment, and the Pain Numerical Rating Scale will be used as outcome variables to evaluate the effectiveness of moxibustion. Safety will be assessed at every visit. In addition, an economic evaluation and a qualitative study will be conducted as a mixed-methods approach. Discussion: This trial may contribute to developing evidence for the effectiveness and safety of moxibustion for treating knee osteoarthritis. Trial registration: Clinical Research information Service: KCT0000130 [ABSTRACT FROM AUTHOR]

Background. An objective method for determining the location of the cancer with respect to peritoneal reflection would be helpful to decide the treatment modality for rectal cancer. This study was designed to evaluate the accuracy and usefulness of rectal MRI to determine spatial relations between the peritoneal reflection and rectal cancer and to compare these with operative findings. Patients and methods. Patients that underwent a rectal cancer operation after a rectal MRI check between November 2008 and June 2010 were considered for the study. The patients that received preoperative concurrent chemoradiation or trans-anal local excision were excluded. Results. Fifty-four patients constituted the study cohort. By comparing surgical and radiologic findings, the accuracy for predicting tumour location in relation to the peritoneal reflection by rectal MRI in all patients was 90.7%. In terms of tumour location in relation to peritoneal reflection, the accuracy of rectal MRI was 93.5% in patients with a tumour located above the peritoneal reflection, 90.0% in patients with a tumour located on the peritoneal reflection, and 84.6% in patients with a tumour located below the peritoneal reflection (p=0.061). When the cohort was subdivided by gender, body mass index (BMI), operative findings, or tumour size, no significant difference was observed among subgroups. Conclusions. Rectal MRI could be a useful tool for evaluating the relation between rectal cancer and peritoneal reflection especially when tumour size is less than 8cm. Rectal MRI can provide information regarding the location of rectal cancer in relation to the peritoneal reflection for treatment planning purposes. [ABSTRACT FROM AUTHOR]

Background: Previous research demonstrated that the crude saponins of Platycodi radix improve glucose metabolism by enhancing insulin sensitivity in type 2 diabetic animals; however, which individual saponins are the most potent insulin sensitizers is unknown. Objectives: This study investigated which saponin(s) have anti-diabetic action in vitro and in vivo. Methods: The insulin-stimulated glucose uptake and PPAR-γ agonistic actions of six saponins from Platycodi radix were investigated in 3T3-L1 adipocytes, and glucose-stimulated insulin secretion was determined in Min6 cells. Four individual saponins (20 mg/kg body weight) were orally administered to low-dose streptozotocin-injected diabetic mice fed a high-fat diet for 8 weeks to evaluate glucose tolerance by oral glucose tolerance testing (OGTT), insulin sensitivity by insulin tolerance testing, and insulin signaling in the liver and adipose tissues. Results: Platyconic acid (PA) most effectively increased insulin-stimulated glucose uptake in 3T3-L1 adipocytes, possibly in part by working as a peroxisome proliferator-activated receptors (PPAR)-γ activator; however, none of the saponins improved glucose-stimulated insulin secretion in insulinoma cells. PA-treated diabetic mice exhibited the lowest peak serum glucose levels and highest serum insulin levels during the first part of OGTT. PA also improved insulin sensitivity: PA increased glycogen accumulation and decreased triacylglycerol storage in liver, which was associated with enhanced hepatic insulin signaling, while PA potentiated the expression of adiponectin and PPAR -γ in adipose tissue, and improved insulin signaling and increased GLUT4 translocation into the membranes. Conclusions: PA improves glucose homeostasis in type 2 diabetic mice, partly by enhancing hepatic and adipocyte insulin sensitivity, possibly by activating PPAR-γ. [ABSTRACT FROM AUTHOR]

Population pharmacokinetic (PK) and pharmacodynamic (PD) modeling of clopidogrel was developed from pooled data from healthy volunteers (n = 44) and stroke patients (n = 35). The PK modeling used plasma concentrations of the clopidogrel metabolite (SR26334), and the PD modeling used platelet aggregation. The models were developed using NONMEM and evaluated via visual predictive check (VPC). Data were analyzed by 2-compartment modeling with Erlang’s absorption and first-order elimination. There was no statistically significant covariate for each model parameter. The typical point estimates of PK were ktr (identical transfer rate constant) = 5.97 h−1, ke (elimination rate constant) = 0.126 h−1, kd (distribution rate constant) = 0.212 h−1, V2 (volume of central compartment) = 21.0 L, and V3 (volume of peripheral compartment) = 38.8 L. The typical point estimates of PD were kin (input rate) = 27.9 h−1, Emax (maximum effect on input rate) = 0.292 h−1, EC50 (median effective concentration) = 0.00629 ng/mL, and BASE (predose aggregation) = 66.7%. The final model was used to estimate individual parameters using patient data and showed good predictions using VPC. [ABSTRACT FROM PUBLISHER]

Background: Surgical site infection (SSI) is a potentially morbid and costly complication of surgery. We conducted a multicentre case-control study to determine the risk factors for SSI in patients undergoing gastric surgery and to establish strategies to reduce the risk of SSI. Methods: Between January 2007 and December 2008, 121 patients who developed an SSI after gastric surgery were matched with controls who had undergone surgery on the dates closest to those of the cases, at 13 centres in Korea. Results: The results of multivariate analyses showed that the independent risk factors for SSI after gastric surgery were older age ( p = 0.016), higher body mass index (BMI) ( p = 0.033), male gender ( p = 0.047), and longer duration of prophylactic antibiotic use ( p < 0.001). Conclusion: Older age, higher BMI, male gender, and longer duration of prophylactic antibiotic use were independently associated with significant increases in the risk of SSI. Additional prospective randomized studies are required to confirm these results. [ABSTRACT FROM AUTHOR]

Aims. The study compared the levels of symptoms and uncertainty, their associated factors, relationships between them and predictors of uncertainty by treatment trajectory among breast cancer survivors. Background. Little is known with regard to how uncertainty and symptoms are related to treatment trajectory among breast cancer survivors. Design. A cross-sectional descriptive design was used. Method. A total of 252 women with breast cancer, receiving cancer therapy, or having completed their therapy were recruited from the National Cancer Center in Korea. Measurements used included symptom subscales of the European Organization of Research and Therapy for Cancer QLQ-C30 and Breast Cancer Module BR23 and the Mishel Uncertainty in Illness Scale. Results. Women in treatment reported more severe symptoms and higher levels of uncertainty than women having completed treatment. During treatment, most symptoms were positively correlated with the level of uncertainty, whereas, in women who had completed treatment, only dyspnoea, insomnia, systemic therapy side effects and arm symptoms positively correlated with uncertainty. There were also differences in predictors of uncertainty by treatment trajectory. Age, marital status and pain were significant predictors of uncertainty during treatment, while monthly income, dyspnoea and insomnia were predictors of uncertainty after treatment. Conclusions. Among breast cancer survivors, levels of symptoms and uncertainty, associated factors, relationships between them and predictors of uncertainty differed depending on treatment trajectory. Relevance to clinical practice. To provide trajectory-sensitive nursing intervention for uncertainty among breast cancer survivors, age, marital status and pain should be considered during treatment, while factors such as economic status, dyspnoea and insomnia should be taken into account after treatment. [ABSTRACT FROM AUTHOR]