Patient-Reported Outcomes From Phase III Neoadjuvant Systemic Trial Comparing Neoadjuvant Chemotherapy With Neoadjuvant Endocrine Therapy in Pre-Menopausal Patients With Estrogen Receptor-Positive and HER2-Negative, Lymph Node-Positive Breast Cancer.

We aimed to evaluate the patient-reported outcomes (PROs) in a prospective phase III clinical trial, comparing neoadjuvant endocrine therapy (NET) with conventional neoadjuvant chemotherapy (NCT) in patients with hormone status positive, lymph node-positive premenopausal breast cancer (NCT01622361). The patients were randomized prospectively to either 24 weeks of NCT with adriamycin plus cyclophosphamide followed by taxane or NET with gonadotropin-releasing hormone agonist and tamoxifen. The patients were examined at the surgery unit of a large tertiary care hospital with a comprehensive cancer center. PROs were assessed on the first day of the trial (day 1, baseline) and at the end of treatment, using the breast cancer module of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 23 (EORTC QLQ BR23). One hundred and eighty-seven patients were randomly assigned to chemotherapy (n=95) or endocrine therapy (n=92), and 174 patients completed 24 weeks of the neoadjuvant treatment period (n=87, in each group). Baseline scores were similar between the groups. After treatment, there were no statistically significant differences in the function scales, including body image, sexual functioning, and sexual enjoyment between the groups, although the endocrine treatment group showed a significant improvement in the future perspective (hazard ratio, 8.3; 95% confidence interval, 1.72-18.38; P = 0.021). Similarly, there were no statistically significant differences in the symptom scales between the groups, including adverse effects of systemic therapy, breast symptoms, arm symptoms, and upset about hair loss. In conclusion, overall PROs were similar in both treatment groups, except for "future perspective," which was significantly better in the NET group than in the NCT group. CLINICAL TRIAL REGISTRATION: ClinicalTrials.Gov, identifier NCT01622361.

Survival in untreated hepatocellular carcinoma: A national cohort study.

This study aimed to analyze the proportion, characteristics and prognosis of untreated hepatocellular carcinoma (HCC) patients in a large representative nationwide study. A cohort study was conducted using the National Health Insurance Service (NHIS) database in Korea. A total of 63,668 newly-diagnosed HCC patients between January 2008 and December 2013 were analyzed. Patients were categorized into treatment group and no treatment group using claim codes after HCC diagnosis. The proportion of untreated HCC patients was 27.6%, decreasing from 33.4% in 2008 to 24.8% in 2013. Compared to treated patients, untreated patients were more likely to be older (P < 0.001), female (P < 0.01), to have a distant SEER stage (P < 0.001), severe liver disease (P < 0.001), and lower income (P < 0.001). The fully-adjusted hazard ratio for all-cause mortality comparing untreated to treated patients was 3.11 (95% CI, 3.04-3.18). The risk of mortality was higher for untreated patients in all pre-defined subgroups, including those with distant SEER stage and those with severe liver disease. About one fourth of newly diagnosed HCC patients did not receive any HCC-specific treatment. Untreated patients showed higher risk of mortality compared to treated patients in all subgroups. Further studies are needed to identify obstacles for HCC treatment and to improve treatment rates.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2017.

PURPOSE: This study reports the cancer statistics and temporal trends in Korea on a nationwide scale, including incidence, survival, prevalence, and mortality in 2017. MATERIALS AND METHODS: The incidence, survival, and prevalence rates of cancer were evaluated using data from the Korea National Cancer Incidence Database from 1999 to 2017 with follow-up until December 31, 2018. Deaths from cancer were assessed using cause-of-death data from 1983 to 2017, obtained from Statistics Korea. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence, and 5-year relative survival rates were calculated and trend analysis was performed. RESULTS: In 2017, newly diagnosed cancer cases and deaths from cancer numbered 232,255 (ASR, 264.4 per 100,000) and 78,863 (ASR, 76.6 per 100,000), respectively. The overall cancer incidence rates increased annually by 3.5% from 1999 to 2011 and decreased by 2.7% annually thereafter. Cancer mortality rates have been decreasing since 2002, by 2.8% annually. The 5-year relative survival rate for all patients diagnosed with cancer between 2013 and 2017 was 70.4%, which contributed to a prevalence of approximately 1.87 million cases by the end of 2017. CONCLUSION: The burden of cancer measured by incidence and mortality rates have improved in Korea, with the exception of a few particular cancers that are associated with increasing incidence or mortality rates. However, cancer prevalence is increasing rapidly, with the dramatic improvement in survival during the past several years. Comprehensive cancer control strategies and efforts should continue, based on the changes of cancer statistics.

Effect of raw potato starch on the gut microbiome and metabolome in mice.

The gut microbiome plays a pivotal role in human health and is affected by various factors. To investigate the association between phenotypic and microbiota-related changes in the gut and a raw starch-based diet, we fed mice with different starch substitutes (corn, wheat, rice, and potato) for 16 weeks. The potato starch-fed group showed the lowest weight gain and fat tissue accumulation of all the groups, as well as the highest insulin sensitivity. Taxonomic analysis indicated that the proportions of Akkermansia, Rikenellaceae, and Sutterella showed the greatest increase in the ceca of mice fed raw potato starch. In addition, the gut microbiota of the raw potato starch group showed the highest carbohydrate and energy metabolism of all the groups, as confirmed by cecal metabolite analysis. The raw potato starch group also produced the highest propionic acid content. Our results showed that the differences in the digestibility of each starch, differences in the phenotype in terms of digestibility, and changes in intestinal microbiota were connected, and it was confirmed that potato starch, which had the lowest digestibility, caused the greatest difference in intestinal microbe composition and metabolism.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2016.

PURPOSE: This study presents the 2016 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2016 were obtained from the Korea National Cancer Incidence Database and followed until December 31, 2017. Mortality data from 1983 to 2016 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2017 among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence and 5-year relative survivals were also calculated. RESULTS: Overall, 229,180 and 78,194 Koreans were newly diagnosed and died from cancer in 2016, respectively. The ASRs for cancer incidence and mortality in 2016 were 269.0 and 79.8 per 100,000 individuals, respectively. The all-cancer incidence rate increased significantly by 3.6% annually from 1999 to 2011 and started to decrease after 2011 (2011-2016; annual percent change, -3.1%). However, overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2012 and 2016 was 70.6%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995. CONCLUSION: The cancer prevalence in Korea has increased very fast as survival has improved remarkably. The high prevalence of cancer emphasizes the need for comprehensive cancer control efforts in Korea.

Doxorubicin-induced heart failure in cancer patients: A cohort study based on the Korean National Health Insurance Database.

BACKGROUND: Doxorubicin is a typical anticancer drug that causes cardiomyopathy and heart failure (HF). The aim of our study was to investigate incidence, risk factors for doxorubicin-induced HF in Korean cancer patients and their survival rate, utilizing a nationwide population-based cohort. METHODS: We analyzed 58 541 cancer patients who received doxorubicin between 2003 and 2010. Descriptive analysis was performed in patients with breast cancer, hematologic malignancy, gynecological malignancy, and sarcoma. Risk factors associated with doxorubicin-induced HF were investigated using a Cox proportional hazards model. The survival rate of doxorubicin-induced HF patients was compared with that of patients without doxorubicin-induced HF. RESULTS: A total of 2324 (4%) were diagnosed with doxorubicin-induced HF. In patients with breast cancer, predictive risk factors for doxorubicin-induced HF included age over 65 years [hazard ratio (HR) 1.34, 95% confidence interval (CI) 1.05-1.72], hypertension [HR 2.45 (2.12- 2.84)], diabetes mellitus [HR 1.26 (1.05-1.51)], coronary artery disease [HR 2.08 (1.63-2.66)], advanced stage [HR 1.31 (1.13-1.50)], and trastuzumab administration [HR 2.94 (2.54-3.40)]. In patients with hematologic malignancy, predictive risk factors included age over 65 years [HR 1.75 (1.49-2.07)], hypertension [HR 1.62 (1.37-1.92)], and coronary artery disease [HR 2.28 (1.80-2.89)]. Five-year survival rates of patients with doxorubicin-induced HF were significantly lower relative to those of patients without HF in breast cancer and hematologic malignancy: 80% vs 84% and 69% vs 75%, respectively (P < 0.001). CONCLUSIONS: In cancer patients treated with doxorubicin, management of risk factors, early detection, and treatment for doxorubicin-induced HF might be critical for patient survival.

Effects of raw potato starch on body weight with controlled glucose delivery.

Starch digestion in the gastrointestinal tract has different properties depending on its botanical source. In this study, corn, wheat, rice, and potato starches were used to test the digestion properties of mammalian mucosal α-glucosidase in an in vitro assay, and their physiological effects were investigated in male C57BL/6 mice. The results clearly demonstrated that potato starch caused the lowest rates of glucose generation, suggesting that it can attenuate the postprandial glucose spike. Interestingly, a potato starch-based diet caused significantly (P < 0.05) lower weight gain and fat accumulation compared to diets based on other starches, through increased insulin sensitivity. This result suggests that potato starch-based products can be used to regulate postprandial blood glucose levels, aiding in the control of metabolic diseases.

Effects of bentonite Bgp35b-p on the gut microbiota of mice fed a high-fat diet.

BACKGROUND: Bentonite is a natural clay mineral with health-promoting effects due to its high adsorption abilities with high cation-exchange capacity. Previously, we found an anti-obesity effect for Bgp35b-p bentonite produced in South Korea, where its high adsorbent ability of dietary lipids possibly partially removed the lipidic environment in the gut (unpublished). It is hypothesized that Bgp35b-p affects the intestinal microbial community, and thus the microbial changes were investigated via next-generation sequencing targeting the bacterial 16S rRNA gene and bioinformatics using QIIME (Quantitative Insights Into Microbial Ecology) were performed on feces of C57BL/6 male mice fed a high-fat diet (HFD) with the Bgp35b-p. RESULTS: The HFD caused microbial dysbiosis, characterized by a decrease in the relative abundance of Bacteroidetes and an increase in abundance of Firmicutes and Proteobacteria. It was found that HFD + Bgp35b-p led to significant changes in the microbial compositions of family-level bacteria known as short-chain fatty-acid-producing bacteria. The relative abundance of Ruminococcaceae was significantly increased, and the abundances of Clostridiaceae and Lachnospiraceae were decreased by HFD + Bgp35b-p, shifting close to that in mice fed a normal diet. CONCLUSION: Bgp35b-p induced compositional changes in intestinal microbiota, which can be considered as a prebiotic effect, thus suggesting that bentonite may be a potential prebiotic functional supplement. © 2018 Society of Chemical Industry.

Wound Healing Effects of Rose Placenta in a Mouse Model of Full-Thickness Wounds.

BACKGROUND: Rosa damascena, a type of herb, has been used for wound healing in Eastern folk medicine. The goal of this study was to evaluate the effectiveness of rose placenta from R. damascena in a full-thickness wound model in mice. METHODS: Sixty six-week-old C57BL/6N mice were used. Full-thickness wounds were made with an 8-mm diameter punch. Two wounds were made on each side of the back, and wounds were assigned randomly to the control and experimental groups. Rose placenta (250 µg) was injected in the experimental group, and normal saline was injected in the control group. Wound sizes were measured with digital photography, and specimens were harvested. Immunohistochemical staining was performed to assess the expression of epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), transforming growth factor-ß1 (TGF-ß1), and CD31. Vessel density was measured. Quantitative analysis using an enzyme-linked immunosorbent assay (ELISA) for EGF was performed. All evaluations were performed on postoperative days 0, 2, 4, 7, and 10. Statistical analyses were performed using the paired t-test. RESULTS: On days 4, 7, and 10, the wounds treated with rose placenta were significantly smaller. On day 2, VEGF and EGF expression increased in the experimental group. On days 7 and 10, TGF-ß1 expression decreased in the experimental group. On day 10, vessel density increased in the experimental group. The increase in EGF on day 2 was confirmed with ELISA. CONCLUSIONS: Rose placenta was found to be associated with improved wound healing in a mouse full-thickness wound model via increased EGF release. Rose placenta may potentially be a novel drug candidate for enhancing wound healing.

Effect of the fragrance inhalation of essential oil from Asarum heterotropoides on depression-like behaviors in mice.

BACKGROUND: Psychological stressors may cause affective disorders, such as depression and anxiety, by altering expressions of corticotropin releasing factor (CRF), serotonin (5-HT), and tyrosine hydroxylase (TH) in the brain. This study investigated the effects of essential oil from Asarum heterotropoides (EOAH) on depression-like behaviors and brain expressions of CRF, 5-HT, and TH in mice challenged with stress. METHODS: Male ICR mice received fragrance inhalation of EOAH (0.25, 0.5, 1.0, and 2.0 g) for 3 h in the special cage capped with a filter paper before start of the forced swimming test (FST) and tail suspension test (TST). The duration of immobility was measured for the determination of depression-like behavior in the FST and TST. The selective serotonin reuptake inhibitor fluoxetine as positive control was administered at a dose of 15 mg/kg (i.p.) 30 min before start of behavioral testing. Immunoreactivities of CRF, 5-HT, and TH in the brain were also measured using separate groups of mice subjected to the FST. RESULTS: EOAH at higher doses (1.0 and 2.0 g) reduced immobility time in the FST and TST. In addition, EOAH at a dose of 1.0 g significantly reduced the expected increases in the expression of CRF positive neurons in the paraventricular nucleus and the expression of TH positive neurons in the locus coeruleus, and the expected decreases of the 5-HT positive neurons in the dorsal raphe nucleus. CONCLUSION: These results provide strong evidence that EOAH effectively inhibits depression-like behavioral responses, brain CRF and TH expression increases, and brain 5-HT expression decreases in mice challenged with stress.

Chemical composition and antimicrobial activity of the essential oil of apricot seed.

In traditional oriental medicine, apricot (Prunus armeniaca L.) seed has been used to treat skin diseases such as furuncle, acne vulgaris and dandruff, as well as coughing, asthma and constipation. This study describes the phytochemical profile and antimicrobial potential of the essential oil obtained from apricot seeds (Armeniacae Semen). The essential oil isolated by hydrodistillation was analysed by gas chromatography-mass spectroscopy. Benzaldehyde (90.6%), mandelonitrile (5.2%) and benzoic acid (4.1%) were identified. Disc diffusion, agar dilution and gaseous contact methods were performed to determine the antimicrobial activity against 16 bacteria and two yeast species. The minimum inhibitory concentrations ranged from 250 to 4000, 500 to 2000 and 250 to 1000 µg/mL for Gram-positive bacteria, Gram-negative bacteria and yeast strains, respectively. The minimum inhibitory doses by gaseous contact ranged from 12.5 to 50, 12.5 to 50 and 3.13 to 12.5 mg/L air for Gram-positive bacteria, Gram-negative bacteria and yeast strains, respectively. The essential oil exhibited a variable degree of antimicrobial activity against a range of bacteria and yeasts tested.

Modulation of melanin synthesis by rengyolone isolated from the root of Eurya emarginata in melan-a cells.

In the course of screening for the melanogenesis inhibitors, rengyolone was isolated from Eurya emarginata (Thumb) Makino. Its chemical structure was determined on the basis of spectroscopic analysis including mass spectroscopy and nuclear magnetic resonance analysis. Rengyolone inhibited potent melanogenesis in melan-a cells with an IC50 value of 65 µM without cytotoxicity. Also, rengyolone showed a melanin biosynthesis inhibition zone in a culture plate of Streptomyces bikiniensis, which is commonly used as an indicator organism. Moreover, rengyolone dramatically reduced protein expression of melanogenic enzyme, tyrosinase. Furthermore, rengyolone presented inhibition on the body pigmentation in zebrafish model system and decreased melanin contents and tyrosinase activity. These results suggest that rengyolone isolated from E. emarginata may be an effective skin-whitening agent that regulates the expression of melanogenic enzymes.

Prognostic implication of thyroglobulin and quantified whole body scan after initial radioiodine therapy on early prediction of ablation and clinical response for the patients with differentiated thyroid cancer.

OBJECTIVE: To investigate predictors for successful ablation and disease-free status after high-dose radioiodine therapy in patients with differentiated thyroid cancer. METHODS: We enrolled 173 consecutive patients with differentiated thyroid cancer between November 2001 and December 2004 retrospectively (female 145, 46 ± 12 years). All patients underwent total thyroidectomy and I-131 ablative therapy (IAT) (3.7-5.4 GBq). The success or failure of ablation was assessed 6-9 months after the IAT with reference to undetectable thyroglobulin (Tg) and negative I-131 whole body scan (WBS). Afterward, the decision for disease-free status was evaluated using Tg and WBS (follow-up period after 1st IAT 7-81 months, median 43 months, criteria of disease-free: less than 10 ng/ml TSH-stimulated Tg or less than 2 ng/ml TSH-unstimulated Tg and/or negative WBS). Clinical and tumoral factors such as sex, age, pathologic type, the size of tumor, quantified cervical uptake in WBS1, pattern in WBS1, ablative therapy dose, AJCC stage, lymph node (LN) stage, Tg just before IAT (Tg1), and ablation status were assessed using logistic regression analyses. RESULTS: There were 93 successful ablations (54 %). Significant predictors for the ablation failure were Tg1 (OR = 8.42; 95 % CI = 2.76-25.69; p < 0.0001), LN metastasis (OR = 3.05; 95 % CI = 1.11-8.37; p = 0.031), and quantified cervical uptake in WBS1 (OR = 4.95; 95 % CI = 1.07-22.88; p = 0.041). One hundred fifty-five patients were determined as disease-free after follow-up. All the eighteen patients with persistent disease were identified as ablation failure after first IAT. Significant predictors for the disease-free status were Tg1 (OR = 0.98; 95 % CI = 0.97-0.99; p = 0.028), tumor size (OR = 0.53; 95 % CI = 0.28-0.96; p = 0.044), and quantified cervical uptake in WBS1 (OR = 0.87; 95 % CI = 0.76-0.98; p = 0.024). CONCLUSIONS: The thyroglobulin and quantified cervical uptake in whole body scan are significant predictors for the successful ablation and disease-free status after follow-up.

Web-based tailored education program for disease-free cancer survivors with cancer-related fatigue: a randomized controlled trial.

PURPOSE: To determine whether an Internet-based tailored education program is effective for disease-free cancer survivors with cancer-related fatigue (CRF). PATIENTS AND METHODS: We randomly assigned patients who had completed primary cancer treatment within the past 24 months in any of four Korean hospitals and had reported moderate to severe fatigue for at least 1 week to participate in a 12-week, Internet-based, individually tailored CRF education program or to receive routine care. We based the program on the CRF guidelines of the National Comprehensive Cancer Network (NCCN) and incorporated the transtheoretic model (TTM). At baseline and 12 weeks, we used the Brief Fatigue Inventory (BFI) and Fatigue Severity Scale (FSS) as primary outcomes and the Hospital Anxiety and Depression Scale (HADS) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) for secondary outcomes. RESULTS: We recruited 273 participants and randomly assigned 136 to the intervention group. Compared with the control group, the intervention group had an improvement in fatigue as shown by a significantly greater decrease in BFI global score (-0.66 points; 95% CI -1.04 to -0.27) and FSS total score (-0.49; 95% CI, -0.78 to -0.21). In secondary outcomes, the intervention group experienced a significantly greater decrease in HADS anxiety score (-0.90; 95% CI, -1.51 to -0.29) as well as global quality of life (5.22; 95% CI, 0.93 to 9.50) and several functioning scores of the EORTC QLQ-C30. CONCLUSION: An Internet-based education program based on NCCN guidelines and TTM may help patients manage CRF.

Osteoblastogenesis and osteoprotection enhanced by flavonolignan silibinin in osteoblasts and osteoclasts.

Bone-remodeling imbalance induced by decreased osteoblastogenesis and increased bone resorption is known to cause skeletal diseases such as osteoporosis. Silibinin is the major active constituent of silymarin, the mixture of flavonolignans extracted from blessed milk thistle (Silybum marianum). Numerous studies suggest that silibinin is a powerful antioxidant and has anti-hepatotoxic properties and anti-cancer effects against carcinoma cells. This study investigated that silibinin had bone-forming and osteoprotective effects in in vitro cell systems of murine osteoblastic MC3T3-E1 cells and RAW 264.7 murine macrophages. MC3T3-E1 cells were incubated in osteogenic media in the presence of 1-20 µM silibinin up to 15 days. Silibinin accelerated cell proliferation and promoted matrix mineralization by enhancing bone nodule formation by calcium deposits. In addition, silibinin furthered the induction of osteoblastogenic biomarkers of alkaline phosphatase, collagen type 1, connective tissue growth factor, and bone morphogenetic protein-2. Differentiated MC3T3-E1 cells enhanced secretion of receptor activator of nuclear factor-κB ligand (RANKL) essential for osteoclastogenesis, which was reversed by silibinin. On the other hand, RAW 264.7 cells were pre-incubated with 1-20 µM silibinin for 5 days in the presence of RANKL. Non-toxic silibinin markedly attenuated RANK transcription and intracellular adhesion molecule-1 expression elevated by RANKL, thereby suppressing the differentiation of macrophages to multi-nucleated osteoclasts. It was also found that silibinin retarded tartrate-resistant acid phosphatase and cathepsin K induction and matrix metalloproteinase-9 activity elevated by RANKL through disturbing TRAF6-c-Src signaling pathways. These results demonstrate that silibinin was a potential therapeutic agent promoting bone-forming osteoblastogenesis and encumbering osteoclastic bone resorption.

Oleanolic acid reduces markers of differentiation in 3T3-L1 adipocytes.

Oleanolic acid is a triterpenoid compound that is widely present in vegetables, medicinal herbs, and other plants and has potent antioxidant and antiinflammatory properties. However, the potential of oleanolic acid to offset obesity is not clear. This study tested the hypothesis that oleanolic acid suppresses the differentiation of 3T3-L1 adipocytes by downregulating cellular induction of peroxisome proliferators-activated receptor γ (PPARγ) and cytidine-cytidine-adenosine-adenosine-thymidine (CCAAT) enhancer binding protein α (C/EBPα). The 3T3-L1 adipocytes were cultured and differentiated in Dulbecco modified Eagle medium containing 10% fetal bovine serum for 6 to 8 days in the absence and presence of 1 to 25 µmol/L oleanolic acid according to differentiating protocols. Nontoxic oleanolic acid, at 25 µmol/L or less, dose-dependently attenuated lipid accumulation in differentiated adipocytes as evidenced by Oil Red O staining. Western blot analysis showed that the induction of PPARγ and C/EBPα was markedly attenuated in differentiated and oleanolic acid-treated adipocytes at their transcriptional messenger RNA levels. Furthermore, this study examined whether oleanolic acid dampened the induction of visfatin, a proinflammatory and visceral fat-specific adipokine expressed in adipocytes. Visfatin expression was inhibited in differentiated adipocytes exposed to a PPARγ inhibitor GW9662. In addition, the visfatin production was significantly repressed in 25 µmol/L oleanolic acid-treated adipocytes, possibly through blocking PPARγ activation. These results demonstrate that oleanolic acid may be a promising agent to disturb adipocyte differentiation and suppress obesity-associated inflammation.

Fatty fish and fish omega-3 fatty acid intakes decrease the breast cancer risk: a case-control study.

BACKGROUND: Although it is believed that fish omega-3 fatty acids may decrease breast cancer risk, epidemiological evidence has been inconclusive. This study examined the association between fish and fish omega-3 fatty acids intake with the risk of breast cancer in a case-control study of Korean women. METHODS: We recruited 358 incident breast cancer patients and 360 controls with no history of malignant neoplasm from the National Cancer Center Hospital between July 2007 and April 2008. The study participants were given a 103-item food intake frequency questionnaire to determine their dietary consumption of fish (fatty and lean fish) and omega-3 fatty acids derived from fish (eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)). RESULTS: Using a multivariate logistic regression model, high intake of fatty fish was associated with a reduced risk for breast cancer in both pre- and postmenopausal women (OR [95% CI] for highest vs. lowest intake quartiles, p for trend: 0.19 [0.08 to 0.45], p < 0.001 for premenopausal women, 0.27 [0.11 to 0.66], p = 0.005 for postmenopausal women). Similarly, reductions in breast cancer risk were observed among postmenopausal subjects who consumed more than 0.101 g of EPA (OR [95% CI]: 0.38 [0.15 to 0.96]) and 0.213 g of DHA (OR [95% CI]: 0.32 [0.13 to 0.82]) from fish per day compared to the reference group who consumed less than 0.014 g of EPA and 0.037 g of DHA per day. Among premenopausal women, there was a significant reduction in breast cancer risk for the highest intake quartiles of omega-3 fatty acids (ORs [95% CI]: 0.46 [0.22 to 0.96]), compared to the reference group who consumed the lowest quartile of intake. CONCLUSION: These results suggest that high consumption of fatty fish is associated with a reduced risk for breast cancer, and that the intake of omega-3 fatty acids from fish is inversely associated with postmenopausal breast cancer risk.

Inhibitory effects of calycosin isolated from the root of Astragalus membranaceus on melanin biosynthesis.

Tyrosinase is a key enzyme for melanin biosynthesis, and hyperpigmentation disorders are associated with abnormal accumulation of melanin pigments, which can be reduced by treatment with depigmenting agents. A methanol extract of Astragalus membranaceus showed inhibitory activity against mushroom tyrosinase. The active compound was purified from the methanol extract of A. membranaceus and, following several chromatographic methods, was identified as calycosin via spectroscopic analysis. The results showed that calycosin exhibited tyrosinase inhibitory activity with an IC(50) value of 38.4 microM. Moreover, calycosin showed a melanin biosynthesis inhibition zone in a culture plate of Streptomyces bikiniensis, which is commonly used as an indicator organism. Furthermore, calycosin dramatically reduced melanin synthesis of Melan-a cells without any apparent cytotoxicity and reduced expression of melanogenic enzyme, tyrosinase. These results suggest that calycosin may be an effective skin-lightening agent that regulates the expression of melanogenic enzymes.

Analysis of chemotherapy-induced amenorrhea rates by three different anthracycline and taxane containing regimens for early breast cancer.

PURPOSE: Chemotherapy-induced amenorrhea (CIA) by newer taxane-containing regimens was evaluated in early breast cancer (EBC) patients. METHODS: A prospective cohort of 122 premenopausal EBC patients participated in a phase III trial of preoperative docetaxel/capecitabine (TX) versus doxorubicin/cyclophosphamide (AC); 34 patients received adjuvant AC followed by paclitaxel (T) and 129 patients received 5-fluorouracil/doxorubicin/cyclophosphamide (FAC). RESULTS: The CIA rate was 90.2% with TX/AC, 73.5% with AC followed by T, and 72.1% with FAC at 1 year (P = 0.002), and 66.7%, 73.3%, and 58.9%, respectively, at 3 years (P = 0.268). At one year, age (P < 0.001) and taxane use (P = 0.002), and after two years, age and tamoxifen use were significant factors for CIA in multivariate analysis. Serum estradiol and follicle-stimulating hormone levels were significantly correlated with menstrual status, age, and tamoxifen use. CONCLUSION: Taxanes resulted in higher CIA rates in the first year, but age and tamoxifen use were significant factors for persistent CIA.

Randomized control trial of hand acupuncture for female stress urinary incontinence.

This study was designed to evaluate the effect of Hand acupuncture treatment on the stress urinary incontinence of 52 women randomly assigned to Experimental hand acupuncture treatment group (n = 25) and Control group (n = 27). 11 hand acupuncture points were established as a basic treatment formula. Among them, 5 points on the midline of the palm represent the major acupoints of external genitals, bladder, abdominal aorta, stomach and heart, while the other 6 points were applied as supplementary ones (2 points on the mid line of the palm for adrenal glands and heart, 2 points near the wrist for kidneys and 2 points on the back of the hand for bladder). This basic treatment formula was applied to all subjects in the Experimental group. Additional treatments were given to the subjects with tenderness at ST27, CV4 or SP15, while no treatment to the subjects in Control group for 12 weeks. Assessment was made before and after 12 weeks of clinical study. In the present study, Hand acupuncture treatment significantly reduced the frequency of urinary incontinence compared to Control group. Similarly, the prevalence score of urinary incontinence was significantly reduced up to 37% of Control group in Experimental group. Furthermore, vaginal contraction pressure of the Experimental group was significantly increased 1.6 fold compared to Control group. In addition, Hand acupuncture treatment significantly improved the scores of making friends, sexual life and social community in Experimental group compared to Control group. Overall, these findings suggest that Hand acupuncture can be a potent alternative therapy for stress urinary incontinence.