Importance of dietary supplementation of soluble and insoluble fibers to sows subjected to high ambient temperatures during late gestation and effects on lactation performance.

Heat stress adversely affects sows' performance, which can be improved by applying proper nutritional strategies. This study was conducted to investigate the interactive effects of dietary fiber levels and sources on sows' reproductive performance, metabolic response during gestation, and the carry-over influence on litter performance in the lactation period during heat stress (average room temperature of 27.1 °C). Fifty-four multiparous sows (Landrace × Yorkshire; initial body weight of 236.3 ± 16 kg; 2, 3 and 4 parities) at d 90 of gestation were assigned to a 2 × 3 factorial arrangement (9 sows/treatment), involving 2 dietary fiber levels (4.5% and 6% crude fiber) and 3 dietary fiber sources (wheat bran [WB], palm kernel meal [PK], and beet pulp [BP]). Sows fed the BP diet had highest (P < 0.01) feed intake and constipation index and lowest (P < 0.01) farrowing duration. Piglet weight (P = 0.041) and litter weight (P < 0.01) at weaning were higher in sows in the BP treatment compared to PK treatment. Sows in the BP treatment showed the greatest (P < 0.01) digestibility of crude protein and neutral detergent fiber. The fecal concentration of acetate was the lowest (P < 0.01) in the PK treatment. Total short-chain fatty acid production was increased in the WB and BP treatments compared with the PK. Sows in the BP treatment showed the lowest (P = 0.036) hair cortisol. The blood insulin concentration of sows was higher (P = 0.026) in the high fiber (6%) treatment compared with the low fiber (4.5%) treatment at 90 min and 120 min after the meal. The concentration of phthalic acid, succinic acid, phenylethylamine, hydrocinnamic acid, iron, linoleic acid, glycerol, ketone, and formamide were increased (P < 0.05) in the BP treatment compared with the WB. The BP treatment with high soluble fiber content improved the constipation index, farrowing duration, and litter performance, while high insoluble fibers increased sows comfort and reduced stress factors including respiratory rate and rectal temperature. Therefore, both soluble and insoluble sources of fiber are necessary to be added to the diet of gestating sows.

Cervi Parvum Cornu complex for men with lower urinary tract symptoms: a multicenter, randomized, double-blind, placebo-controlled trial.

Background: To evaluate the efficacy and safety of Cervi Parvum Cornu, Angelicae Gigantis Radix and Glycyrrhizae Radix complex (CAG) in men with moderate lower urinary tract symptoms (LUTS). Materials and methods: From November 2020 to January 2022, participants with International Prostate Symptom Score (IPSS) of 12-19 in two centers were recruited and randomize into three groups: a CAG 500 mg/day group (CAG 500), a CAG 1000 mg/day group (CAG 1000), and a placebo group (PG). They were treated for 12 weeks. The primary endpoint was change of IPSS at the end of study from baseline. Secondary end points included change of prostate specific antigen (PSA), testosterone, dihydrotestosterone (DHT), maximum urinary flow rate (Q max), post-void residual volume (PVR), International Index of Erectile Function (IIEF), and drug safety. Results: A total of 103 patients were able to finish the study according to the study protocol. Total IPSS and sub-scores (residual urine sensation, frequency, weak stream, hesistancy, nocturia, and quality of life) in CAG 500 and CAG 1000 were significantly improved at the 12th week compared to those of the PG. Changes of serum PSA, DHT, and testosterone levels at the 12th week from baseline did not show significant differences among the three groups. Q max and PVR changes did not show significant differences among the three groups either. Total IIEF and sub-scores (erectile function, orgasmic function, sexual desire, intercourse satisfaction) in CAG 1000 were significantly improved at 12th week compared to those in PG. No significant adverse events were found. Conclusions: CAG is well tolerated in patients with moderate LUTS. Treatment with CAG for 12 weeks has a therapeutic effect on moderate LUTS.

Bioconverted Fruit Extract of Akebia Quinata Exhibits Anti-Obesity Effects in High-Fat Diet-Induced Obese Rats.

Akebia quinata, commonly called chocolate vine, has various bioactivities, including antioxidant and anti-obesity properties. However, the anti-obesity effects of bioconverted extracts of A. quinate have not been examined. In this study, A. quinata fruit extracts was bioconverted using the enzyme isolated from the soybean paste fungi Aspergillus kawachii. To determine whether the bioconversion process could influence the anti-obesity effects of A. quinata fruit extracts, we employed 3T3-L1 adipocytes and HFD-induced obese rats. We observed that the bioconverted fruit extract of A. quinata (BFE) afforded anti-obesity effects, which were stronger than that for the non-bioconverted fruit extract (FE) of A. quinata. In 3T3-L1 adipocytes, treatment with BFE at concentrations of 20 and 40 µg reduced intracellular lipids by 74.8 (p < 0.05) and 54.9% (p < 0.01), respectively, without inducing cytotoxicity in preadipocytes. Moreover, the oral administration of BFE at the concentration of 300 mg/kg/day significantly reduced body and adipose tissue weights (p < 0.01) in HFD-induced obese rats. Plasma cholesterol values were reduced, whereas HDL was increased in BFE receiving rats. Although FE could exert anti-obesity effects, BFE supplementation induced more robust effects than FE. These results could be attributed to the bioconversion-induced alteration of bioactive compound content within the extract.

Vitamin C supplementation promotes mental vitality in healthy young adults: results from a cross-sectional analysis and a randomized, double-blind, placebo-controlled trial.

PURPOSE: We aimed to investigate the link of vitamin C status with vitality and psychological functions in a cross-sectional study, and examine their causal relationship through a randomized controlled trial (RCT). METHODS: We first conducted a population-based cross-sectional investigation of healthy young adults (n = 214, 20-39 years), and analyzed the associations of serum vitamin C concentrations with vitality (fatigue and attention) and mood status (stress, depression, and positive and negative affect) using Pearson's correlation and multiple linear regression analyses. Next, we performed a double-blind RCT in healthy subjects whose serum vitamin C concentrations were inadequate (< 50 µmol/L). Subjects were randomly allocated to receive 500 mg of vitamin C twice a day for 4 weeks (n = 24) or a placebo (n = 22). We assessed vitality, which included fatigue, attention, work engagement, and self-control resources, and measured mood status, including stress, depression, positive and negative affect, and anxiety. ELISA determined serum brain-derived neurotrophic factor (BDNF), and a Stroop color-word test evaluated attention capacity and processing speed. RESULTS: In the cross-sectional data, the serum vitamin C concentration was positively associated with the level of attention (r = 0.16, p = 0.02; standardized ß = 0.21, p = 0.003), while no significant associations with the levels of fatigue and mood variables being found. In the RCT, compared to the placebo, the vitamin C supplementation significantly increased attention (p = 0.03) and work absorption (p = 0.03) with distinct tendency of improvement on fatigue (p = 0.06) and comprehensive work engagement (p = 0.07). The vitamin C supplementation did not affect mood and serum concentrations of BDNF. However, in the Stroop color-word test, the subjects supplemented with vitamin C showed better performance than those in the placebo group (p = 0.04). CONCLUSION: Inadequate vitamin C status is related to a low level of mental vitality. Vitamin C supplementation effectively increased work motivation and attentional focus and contributed to better performance on cognitive tasks requiring sustained attention. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: Cross-sectional study: KCT0005074 (cris.nih.go.kr)/1 June, 2020 (retrospectively registered). Intervention study: KCT0004276 (cris.nih.go.kr)/4 September, 2019.

Evaluation of Estrogen Receptor Agonistic Activity of Medicinal Herbs Using Organization for Economic Cooperation and Development Transactivation Assay with Rat Liver S9 Fraction.

A number of studies employing different in vitro assays have demonstrated the estrogen-like activity of natural substances. All assays have their advantages and limitations as a screening tool. No single in vitro assay is considered ideal for predicting estrogenic action in a complex in vivo system. To assess agonistic activities of several medicinal herbs on the estrogen receptor (ER) and their metabolic alteration, the Organization for Economic Cooperation and Development (OECD) Performance-Based Test Guideline No. 455 in vitro assay was performed in this study using recombinant VM7Luc4E2 cells in combination with rat liver S9 fractions. Ethanol extracts of medicinal herbs showed binding affinities for ER-α and ER-ß at different levels. However, luciferase reporter assay using VM7Luc4E2 cells revealed that only two test extracts [Pueraria lobata root extract (PLE); Glycyrrhiza glabra root extract (GGE)] exhibited ER transcriptional activity when their activities were compared with the response by 17ß-estradiol. Importantly, incubation of PLE or GGE with rat liver S9 fractions increased their ER transcriptional activities, in particular when phase I metabolic enzymes were activated. Puerarin and glabridin were the most abundant isoflavones found in PLE and GGE, respectively. The present results demonstrate that PLE and GGE possess potential as ER agonists with their metabolic activation. This study also suggests that the application of OECD in vitro assay with rat liver S9 fraction is an efficient screening tool to evaluate estrogenic activities of natural substances.

Farrerol Induces Cancer Cell Death via ERK Activation in SKOV3 Cells and Attenuates TNF-α-Mediated Lipolysis.

Farrerol (FA) is a flavanone isolated from the Chinese herbal medicine "Man-shan-hong" (Rhododendron dauricum L.). In the present study, FA decreased the viability of SKOV3 cells in a dose- and time-dependent manner, and it induced G2/M cell cycle arrest and cell apoptosis. Cell cycle distribution analysis via flow cytometry showed that FA decreased G1 populations and increased G2/M populations in SKOV3 cells. Additionally, Western blotting confirmed an increase in the expression level of proteins involved in the cell cycle, e.g., CDK and cyclins. FA-induced apoptosis in SKOV3 cells was also investigated using a TUNEL assay, and increased expression levels of proapoptotic factors, including Caspase-3 and poly ADP ribose polymerase (PARP), through the Extracellular signal-regulated kinase (ERK)/MAPK pathway were investigated. Proinflammatory cytokines (e.g., IL-6, TNF-α, and IL-1) have been identified as a driver of the pathological mechanisms underlying involuntary weight loss and impaired physical function, i.e., cachexia, during cancer; in the present study, we showed that farrerol attenuates TNF-α-induced lipolysis and increases adipogenic differentiation in 3T3-L1 cells. Thus, farrerol could potentially be used as an anticancer agent or anticachetic drug.

Prediction of calcium and phosphorus requirements for pigs in different bodyweight ranges using a meta-analysis.

Several studies have focused on Ca and P requirements for pigs. These requirements are estimated from their retention and bone formation. However, modern pig breeds have different responses to dietary Ca and P than traditional breeds, and their requirements are expected to change on an annual basis. Besides individual Ca and P needs, the Ca to P ratio (Ca/P) is an important factor in determining requirements. This study aimed to implement a linear and quadratic regression analysis to estimate Ca and P requirements based on average daily gain (ADG), apparent total tract digestibility (ATTD) of Ca (ATTD-Ca), ATTD of P (ATTD-P), and crude protein (CP) digestibility. Results show that Ca/P had linear and quadratic effects on ADG in the phytase-supplemented (PS) group in both the 6-11 kg and 11-25 kg categories. In the latter category, the CP digestibility was linearly increased in response to increasing Ca/P in the without-phytase (WP) group. In the 25-50 kg category, there was a linear response of ADG and linear and quadratic responses of CP digestibility to Ca/P in the PS group, while a linear and quadratic increase in CP digestibility and a quadratic effect on ATTD-Ca were observed in the WP group. In the 50-75 kg category, Ca/P had significant quadratic effects on ADG in the PS and WP groups, along with significant linear and quadratic effects on ATTD-Ca. In addition, Ca/P had significant quadratic effects on ATTD-P and led to a significant linear and quadratic increase in the CP digestibility in the WP group. In the 75-100 kg category, analysis showed a significant decrease in ATTD-Ca and ATTD-P in the PS and WP groups; in the latter, ATTD-P and ATTD-Ca were linearly decreased by increasing Ca/P. In conclusion, our equations predicted a higher Ca/P in the 6-25 kg bodyweight categories and a lower Ca/P in the 50-100 kg category than that recommended in the literature.

Anti­angiogenic effect of mountain ginseng in vitro and in vivo: Comparison with farm­cultivated ginseng.

Mountain ginseng (Panax ginseng) has been used for cancer patient therapy in Northeast Asia. Although it is well known that cancer cells are able to induce angiogenesis, the effect of mountain ginseng on angiogenesis is still unknown. In the present study, we investigated whether ethanolic extract of mountain ginseng (MGE) could inhibit angiogenesis in in vitro and in vivo models. In comparison with farm­cultivated ginseng extract (FGE), MGE more strongly inhibited cell migration and formation of capillary­like network within non­cytotoxic ranges in SVEC4­10 cells. In addition, MGE dose­dependently suppressed Transwell cell migration of the cells. Moreover, MGE reduced the phosphorylation and expression of VEGF­R2 as well as the phosphorylation of FAK, Src, Akt and ERK, the intermediate proteins in the VEGF­R2 signaling cascade, in the cells. As expected, MGE dramatically decreased hemoglobin content in Matrigel plugs in mice. In conclusion, MGE possesses stronger anti­angiogenic properties than FGE in vascular endothelial cells. Such effect of MGE is correlated with inhibition of activation of the VEGF­R2 signaling pathway. Therefore, the novel features of MGE may be helpful for understanding its anticancer mechanism for the treatment of cancer patients.

Improvement of Fatigue Symptoms and Endurance Capacity by the Combined Administration of Cervus elaphus L., Angelica gigas Nakai, and Astragalus membranaceus Bunge.

Fatigue is a common phenomenon usually observed in healthy, as well as in nonhealthy, individuals that affects their performance and quality of life. Efficient supplementation to relieve fatigue is of significant importance. This study was designed to investigate the efficacy of three prescreened natural resources (Cervus elaphus L. [CEL], Angelica gigas Nakai [AGN], and Astragalus membranaceus Bunge [AMB]) against fatigue symptoms induced by heavy exercise. Effects on muscle fatigue and endurance capacity during exercise were investigated in C2C12 myoblasts and exercised mice. A combination of CEL, AGN, and AMB (CEL:AGN:AMB, 1:2:1) treatment in myoblasts reduced intracellular reactive oxygen species levels induced by hydrogen peroxide by ∼20 times (P < .001). The optimal mixture extract combination was determined as CEL:AGN:AMB, 1:2:1 (CAA), which was recombined by applying the extraction yield of individual substance for in vivo study. Compared to the exercise control (EC) group, the serum lactate dehydrogenase level decreased by ∼40% due to CAA administration. The proliferator-activated receptor gamma coactivator 1-alpha protein expression increased significantly (P < .05) after CAA administration compared to that observed in the normal control group. In parallel, CAA treatment significantly (P < .05) enhanced the maximum running time compared to the EC group. Overall, combinatorial administration exhibited greater efficacy compared to each individual treatment, indicating that CAA could be used as an efficient ergogenic and antifatigue supplement.

Mountain ginseng inhibits skeletal muscle atrophy by decreasing muscle RING finger protein-1 and atrogin1 through forkhead box O3 in L6 myotubes.

ETHNOPHARMACOLOGICAL RELEVANCE: Mountain ginseng (Panax ginseng C.A. Meyer) is a medicinal herb with immune effects, muscle damage protection and energy metabolism effects. However, the pharmacological role of mountain ginseng in dexamethasone (DEXA)-induced muscle atrophy through the forkhead box O (FOXO) family is not understood. Therefore, we hypothesized that mountain ginseng inhibits skeletal muscle atrophy by decreasing muscle RING finger protein-1 (MuRF1) and atrogin1 through FOXO3 in L6 myotubes. METHODS: Rat myoblast (L6) cells or Sprague-Dawley (SD) rats were exposed to DEXA and mountain ginseng. The expressions of muscle atrophy targets such as MuRF1, atrogin1, MyHC (myosin heavy chain), HSP90, p-Akt, Akt, p-ERK1/2, ERK, FOXO3a, FOXO1, myostatin, and follistatin were analyzed by using Western blot analysis or real-time PCR. The diameter of myotubes was measured. Recruitment of glucocorticoid receptor (GR) or FOXO3a was analyzed by performing a chromatin immunoprecipitation (ChIP) assay. RESULTS: Mountain ginseng treatment reduced muscle weight loss and collagen deposition in DEXA-induced rats. Mountain ginseng treatment led to decreases in MuRF1, atrogin1, p-ERK1/2, FOXO3a, FOXO1, and myostatin. Also, mountain ginseng treatment led to increases in the diameter of myotubes, MyHC, HSP90, p-Akt, and follistatin. Treatment with mountain ginseng reduced enrichment of GR, FOXO3a, and RNA polymerase II on the promoters. CONCLUSIONS: These results suggest that mountain ginseng inhibits skeletal muscle atrophy by decreasing MuRF1 and atrogin1 through FOXO3a in L6 myotubes.

The Effect of Fermented Porcine Placental Extract on Fatigue-Related Parameters in Healthy Adults: A Double-Blind, Randomized, Placebo-Controlled Trial.

BACKGROUND: Fatigue is one of the major health conditions induced by excessive stress or abnormal immune function or defective antioxidant systems. Placental extract has been reported to have various effects such as immune modulation and cellular regeneration. Fermented porcine placenta (FPP) is a safe nontoxic material, which is highly valuable as a functional food. The aim of this study was to investigate the anti-fatigue effects of FPP supplementation compared with a placebo product. METHODS: In this double-blind, parallel, randomized, and placebo-controlled trial 84 healthy males and females, aged between 30 and 60 years were randomized to 320 mg of FPP once daily or placebo. The main outcome measures included efficacy of fatigue-inducing treadmill exercise on physical fatigue and fatigue-related parameters based on the questionnaire administered. RESULTS: The IL-1ß mRNA expression and fatigue severity scale were changed significantly after 8 weeks of treatment with fermented porcine placenta compared with placebo (p < 0.05). Cortisol levels were significantly improved in participants younger than 45 years following treatment with FPP compared with placebo. Furthermore, the lactate and myoglobin levels were improved significantly in participants with BMI ≥ 23 kg/m2 (p = 0.045 and p = 0.011, respectively) following treatment with FPP versus placebo. CONCLUSIONS: Our study showed that FPP supplementation significantly ameliorated fatigue-related parameters and subjective symptoms in healthy adults. Therefore, our results indicate that FPP supplementation induced anti-fatigue effect by regulating the inflammatory response.

Effects of Zinc Oxide and Arginine on the Intestinal Microbiota and Immune Status of Weaned Pigs Subjected to High Ambient Temperature.

This study aimed to investigate the effect of the l-arginine (Arg) inclusion and different doses of ZnO on the growth performance, intestinal microbiota and integrity, and immune status of weaned pigs. A total of 180 pigs (28-day-old) were randomly allotted to six treatments with six replicate pens in each treatment and five pigs per pen. The dietary treatments were Con (1.1% Arg); P-Zn (1.1% Arg + 2500 mg Zn as ZnO/kg diet); ARG (1.6% Arg); ZnArg1 (500 mg of Zn as ZnO/kg diet + 1.6% Arg); ZnArg2 (1000 mg of Zn as ZnO/kg diet + 1.6% Arg); ZnArg3 (2500 mg of Zn as ZnO/kg diet + 1.6% Arg). The overall result showed that the inclusion of ZnArg3 significantly improved the average daily gain of pigs compared with the Con treatment. There was a reduction in feed intake in pigs fed the Con diet compared with pigs fed the ZnArg3 diet at phase 1 and overall. At phase 1, pigs fed the ZnArg3 diet and P-Zn diet showed a decreased population of Clostridium spp. in the ileum compared with those of the Con treatment. In addition, a lower ileal Clostridium spp. population was detected in pigs fed the ZnArg2 diet compared with pigs fed the Con diet. The pigs fed ZnArg1 and ZnArg3 diets showed a greater villus height of duodenum compared with the Con and P-Zn treatments. The pigs in the Con treatment showed increased mRNA expression of heat shock protein-27 in the liver compared with the P-Zn, ZnArg1, ZnArg2, and ZnArg3 treatments. When fed the basal diet, mRNA expressions of interleukin-6 were increased in the muscle compared with the ZnArg3 treatment. Dietary supplementation with ZnArg2 decreased the mRNA expressions of interferon-γ in the muscle compared with the Con treatment. Supplementation with P-Zn, ZnArg1, ZnArg2, and ZnArg3 decreased mRNA expressions of tumor necrosis factor-α (TNF-α) compared with the Con treatment. The mRNA gene expressions of interleukin-4 were decreased in the jejunum of pigs fed P-Zn, ARG, ZnArg1, ZnArg2, and ZnArg3 diets compared with pigs fed the Con diet. The jejunum gene expression of toll-like receptor-4 was upregulated in the Con and ARG treatments compared with the ZnArg1 and ZnArg3. The ZnArg1, ZnArg2, and ZnArg3 treatments showed lower mRNA expression of TNF-α compared with the Con treatment. In conclusion, there was no difference in growth performance, intestinal microbiota, gene expression of interleukins between ZnArg1 and ZnArg3 treatments. Therefore, the low level of ZnO (500 mg/kg) plus 1.6% dietary Arg may be recommended for pigs during the weaning stress.

Treatment strategy and outcomes in locally advanced head and neck squamous cell carcinoma: a nationwide retrospective cohort study (KCSG HN13-01).

BACKGROUND: By investigating treatment patterns and outcomes in locally advanced head and neck squamous cell carcinoma (LA-HNSCC), we aimed at providing valuable insights into the optimal therapeutic strategy for physicians in real-world practice. METHODS: This is a multi-institutional study enrolled the patients with stage III to IVB LA-HNSCC, except for nasopharyngeal carcinoma, from 2004 to 2015 in thirteen referral hospitals capable of multidisciplinary care. RESULTS: A total of 445 LA-HNSCC patients were analyzed. The median age was 61 years (range, 24-89). The primary tumor location was the oropharynx in 191 (43%), oral cavity in 106 (24%), hypopharynx in 64 (14%), larynx in 57 (13%) and other sites in 27 (6%). The most common stage was T2 in 172 (39%), and N2 in 245 (55%). Based on treatment intents, 229 (52%) of the patients received definitive concurrent chemoradiotherapy (CCRT) and 187 (42%) underwent surgery. Approximately 158 (36%) of the study population received induction chemotherapy (IC). Taken together, 385 (87%) of the patients underwent combined therapeutic modalities. The regimen for definitive CCRT was weekly cisplatin in 58%, 3-weekly cisplatin in 28% and cetuximab in 3%. The preferred regimen for IC was docetaxel with cisplatin in 49%, and docetaxel, cisplatin plus fluorouracil in 27%. With a median follow-up of 39 months, one-year and two-year survival rates were 89 and 80%, respectively. Overall survival was not significantly different between CCRT and surgery group (p = 0.620). CONCLUSIONS: In patients with LA-HNSCC, the majority of patients received combined therapeutic modalities. Definitive CCRT, IC then definitive CCRT, and surgery followed by adjuvant CCRT or radiotherapy are the preferred multidisciplinary strategies in real-world practice.

Anticancer Effect of Mountain Ginseng on Human Breast Cancer: Comparison with Farm-Cultivated Ginseng.

Mountain ginseng has been used generally as a pharmacopuncture for cancer therapy in clinical practice in Northeast Asia. Nonetheless, there have been few scientific reports for the anticancer action of mountain ginseng. In this study, we investigated whether mountain ginseng extract (MGE) could inhibit the growth of breast cancer in in vitro and in vivo models. MGE showed stronger cytotoxicity than farm-cultivated ginseng extract (FGE) through promoting ROS generation. Also MGE dose-dependently brought about mitochondrial dysfunction in MCF-7 cells. In addition, MGE induced apoptosis through enhancing the activities of caspase-3/7 by regulation of expression of Bcl-2, Bax, cytochrome c, and cleaved caspase-3 in the MCF-7 cells. Consistent with the in vitro results, MGE significantly reduced tumor weights compared with FGE in mice transplanted with MCF-7 cells, and it regulated the expression of apoptosis-related proteins, such as Bcl-2, Bax, cytochrome c, cleaved caspase-3, and cleaved PARP, in the tumor tissues. Additionally, MGE included higher total ginsenoside contents than FGE. In conclusion, MGE, which is richer in ginsenosides, exerts a stronger anticancer action than FGE in breast cancer. The anticancer action of MGE may be closely correlated with caspase-mediated apoptosis through upregulating ROS generation. Therefore, these findings may be helpful for a clinical understanding of the anticancer mechanism of MGE for breast cancer patients.

Temporal Raphe Sign in Elderly Patients With Large Optic Disc Cupping: Its Evaluation as a Predictive Factor for Glaucoma Conversion.

PURPOSE: To determine baseline clinical features associated with conversion to glaucoma in elderly patients with large optic-disc cupping. DESIGN: Retrospective cohort study. METHODS: Seventy-two eyes of 72 untreated elderly (≥65-year-old) patients with large vertical cup-to-disc ratio (CDR ≥0.7) and without any other glaucomatous findings were included. They had undergone a full ophthalmologic examination twice per year for at least 5 years. The optic nerve head (ONH), peripapillary retinal nerve fiber layer (RNFL), and macular ganglion cell-inner plexiform layer (GCIPL) were imaged with Cirrus high-definition optical coherence tomography (OCT). Presence of temporal raphe sign on the OCT's GCIPL thickness map was assessed as one of the morphologic factors. Conversion to normal-tension glaucoma (NTG) was defined as structural or functional deterioration on either red-free RNFL photography or standard automated perimetry, respectively. The utility of the baseline factors associated with conversion to NTG were identified. RESULTS: During the 5.5-year follow-up, 19 eyes (26.4%) converted to NTG. There were no significant differences in demographics, systemic factors, intraocular pressure factors, or OCT parameters between the nonconverters and converters. Interestingly, the temporal raphe sign was observed in the converters (18/19, 94.7%) much more frequently than in the nonconverters (3/53, 5.7%, P < .001) at baseline. A Cox proportional hazards model indicated the significant influences of temporal raphe sign positivity (hazard ratio 6.823, 95% confidence interval 2.574, 18.088, P < .001) on conversion to NTG. CONCLUSIONS: In elderly subjects with large CDR, temporal raphe sign positivity on the baseline macular GCIPL thickness map was associated with faster conversion to NTG.

Anti-hyperuricemic effect of Alpinia oxyphylla seed extract by enhancing uric acid excretion in the kidney.

BACKGROUND: Alpinia oxyphylla is a well-known traditional medicine used in China and Korea to treat intestinal disorders, urosis, diuresis, and chronic glomerulonephritis. PURPOSE: We investigated the anti-hyperuricemic effects of Alpinia oxyphylla seed extract (AE), and the underlying mechanisms of action through in vitro and in vivo studies. METHODS: We evaluated levels of uric acid in the serum and urine, the expression of renal urate transport proteins, and levels of inflammatory cytokines in potassium oxonate (PO)-induced hyperuricemic rats. Xanthine oxidase activity was analyzed in vitro, while cellular uric acid uptake was assessed in oocytes expressing the human urate transporter 1 (hURAT1). Moreover, the main components of AE were analyzed using UPLC. RESULTS: In PO-induced hyperuricemic rats, 200 and 400 mg/kg of AE significantly decreased levels of uric acid in serum, while 400 mg/kg of AE increased uric acid levels in urine. AE did not inhibit xanthine oxidase in vitro; however, 1, 10, and 100 µg/ml of AE significantly decreased uric acid uptake into oocytes expressing hURAT1. Furthermore, 400 mg/kg of AE increased levels of organic anion transporter (OAT) 1 protein, while 200 and 400 mg/kg of AE decreased the protein content of urate transporter, URAT1 and inflammatory cytokines in the kidneys. Nootkatone was identified as one the main chemical components in AE from UPLC analysis. CONCLUSIONS: These findings suggest that AE exerts anti-hyperuricemic and uricosuric effects, which are related to the promotion of uric acid excretion via enhanced secretion and inhibition of uric acid reabsorption in the kidneys. Thus, AE may be a potential treatment for hyperuricemia and gout.

Kahweol inhibits adipogenesis of 3T3-L1 adipocytes through downregulation of PPARγ.

Kahweol, a compound from Coffea arabica, possesses antioxidant, anti-inflammatory, and antitumour properties. However, an anti-adipogenic effect has not yet been reported. In this study, we have shown that kahweol has an anti-adipogenic effect on 3T3-L1 adipocytes. Kahweol significantly inhibited the differentiation of intracellular lipid accumulation in 3T3-L1 adipocytes, without being cytotoxic. It also downregulated the expression of adipogenesis-related gene, including an adipocytokine, adiponectin. This anti-adipogenic effect stems from an ability to inhibit key adipogenic regulators, including PPARγ and C/EBPα. These results demonstrate that kahweol significantly inhibits the differentiation of 3T3-L1 cells, and suggest that it has potential as a novel anti-obesity treatment.

Bioconverted Orostachys japonicas Extracts Suppress Angiogenic Activity of Ms-1 Endothelial Cells.

Orostachys japonicus A. Berger (), known as Wa-song in Korea, has been reported to exert various biological effects, such as anti-tumor, anti-oxidant, and anti-febrile effects. However, the anti-angiogenic effects of O.japonicus extracts remain to be investigated. In the present study, we demonstrated the anti-angiogenic effects of bioconverted O. japonicus extract (BOE) in Ms-1 mouse endothelial cells and compared them with the bioactivities of O. japonicus extract (OE). BOE, but not OE, were found to exert anti-angiogenic effects, including inhibition of cell migration, cell adhesion, tube formation of Ms-1 cells, and blood vessel formation of matrigel plug assay in vivo. Furthermore, protein levels of phosphorylated Src kinase were lower in BOE-treated cells than in OE-treated cells. Treatment with OE or BOE did not influence cell viability during the experimental period. Bioconverted extract of O.japonicus have anti-angiogenic effects in vitro and vivo, but non-bioconverted extract do not. We suggest that these observed anti-angiogenic effects are caused by the changes in the composition of bioactive compounds in the extracts as a result of biological conversion.

Hovenia Dulcis Extract Reduces Lipid Accumulation in Oleic Acid-Induced Steatosis of Hep G2 Cells via Activation of AMPK and PPARα/CPT-1 Pathway and in Acute Hyperlipidemia Mouse Model.

Hovenia dulcis Thunb. (HDT) was known to have anti-fatigue, anti-diabetes, neuroprotective, and hepatoprotective effects. In the present study, the anti-fatty liver mechanism of HDT was elucidated in oleic acid (OA)-treated Hep G2 cells and acute hyperlipidemia mouse model using Triton WR-1339. Here, HDT activated p-AMP-activated protein kinase (p-AMPK), proliferator activated receptor-α, carnitine palmitoyltransferase and also inhibited the expression of lipogenesis and cholesterol synthesis proteins, such as 3-hydroxy-3-methylglutaryl-CoA reductase, sterol regulatory element binding protein-1c, SREBP-2, and fatty acid synthase in OA-treated Hep G2 cells. Conversely, AMPK inhibitor compound C blocked the anti-fatty liver effect of HDT to induce AMPK phosphorylation and decrease 3-hydroxy-3-methylglutaryl-CoA reductase and lipid accumulation by oil red O staining in OA-treated Hep G2 cells. Additionally, HDT pretreatment protected against the increase of serum total cholesterol, triglyceride, low-density lipoprotein cholesterol and phospholipid in an acute hyperlipidemia mouse model with enhancement of glutathione reductase, glutathione peroxidase, superoxide dismutase, and catalase activities. Taken together, HDT inhibits OA-induced hepatic lipid accumulation via activation of AMPK and proliferator activated receptor-α/carnitine palmitoyltransferase signaling and enhancement of antioxidant activity as a potent candidate for nonalcoholic fatty liver disease and hyperlipidemia. Copyright © 2016 John Wiley & Sons, Ltd.

17 Cases of Acupuncture Related Pneumothorax and Factors Influencing Pneumothorax.

OBJECTIVES: Acupuncture is increasing in popularity as a complementary and alternative medicine. Pneumothorax is the most common and potentially serious adverse effect after acupuncture. This complication can cause fatality in the absence of rapid treatment. Here, we analyze the clinical presentation and discuss prevention of post-acupuncture pneumothorax and an approach to reducing this complication. METHODS: Patients presenting with post-acupuncture pneumothorax in our hospital center during 2011-2015 were retrospectively analyzed. Body mass index (BMI), patient's pre-acupuncture chief complaint and disease, and the characteristics associated with pneumothorax were assessed. The diagnosis of pneumothorax was based on clinical presentation and chest radiography. Conservative treatment or thoracostomy was performed. RESULTS: Seventeen patients (15 women and 2 men) with a mean age of 42 years (range: 18-73 years) were included; three were underweight (BMI < 18.5kg/m2), 11 patients had a healthy weight (BMI= 18.5-22.95kg/m2), one was overweight (BMI = 23- 24.95kg/m2), and two were obese (BMI ≥ 25 kg/m2). All but one case of bilateral pneumothorax had unilateral pneumothorax (right side: 6; left side: 10). Chest pain or dyspnea, or both. were the initial symptoms in all patients. Twelve patients underwent immediate thoracostomy. The patient with bilateral pneumothorax underwent right-side thoracostomy, and subsequently left-side thoracostomy, due to progression of the left-side pneumothorax. Five patients were successfully managed conservatively. All patients had an excellent outcome; all were asymptomatic and exhibited a normal chest X-ray at follow-up. CONCLUSION: Acupuncturists must be aware that delayed diagnosis and management of pneumothorax are life-threatening, and when symptoms of possible pneumothorax arise, patients should be advised to undergo an appropriate evaluation and intervention, particularly so in those with abnormal BMI.