Ginseng for managing menopausal woman's health : A systematic review of double-blind, randomized, placebo-controlled trials

Lee, Hye Won,Choi, Jiae,Lee, YoungJoo,Kil, Ki-Jung,Lee, Myeong Soo Wolters Kluwer Health 2016 Medicine Vol.95 No.38

<P><B>Abstract</B></P><P><B>Background:</B></P><P>The aim of this systematic review was to update, complete, and critically evaluate the evidence from placebo-controlled randomized clinical trials (RCTs) of ginseng for managing menopausal women's health.</P><P><B>Methods:</B></P><P>We searched the literature using 13 databases (MEDLINE, AMED, EMBASE, the Cochrane Library, 6 Korean Medical, and 3 Chinese Databases) from their inception to July 2016 and included all double-blind RCTs that compared any type of ginseng with a placebo control in postmenopausal women. The methodological quality of all studies was assessed using a Cochrane risk of bias tool.</P><P><B>Results:</B></P><P>Ten RCTs met our inclusion criteria. Most RCTs had unclear risk of bias. One RCT did not show a significant difference in hot flash frequency between Korean red ginseng (KRG) and placebo. The second RCT reported positive effects of KRG on menopausal symptoms. The third RCT found beneficial effects of ginseng (Ginsena) on depression, well-being, and general health. Four RCTs failed to show significant differences in various hormones between KRG and placebo controls except dehydroepiandrosterone. Two other RCTs failed to show effects of KRG on endometrial thickness in menopausal women. The other RCT also failed to show the effects of American ginseng on oxidative stress markers and other antioxidant enzymes.</P><P><B>Conclusion:</B></P><P>Our systematic review provided positive evidence of ginseng for sexual function and KRG for sexual arousal and total hot flashes score in menopausal women. However, the results of KRG or ginseng failed to show specific effects on hot flash frequency, hormones, biomarkers, or endometrial thickness. The level of evidence for these findings was low because of unclear risk of bias.</P>

Predictors of dysfunction and health-related quality of life in the flexion pattern subgroup of patients with chronic lower back pain : The STROBE study

Jung, Sung-hoon,Kwon, Oh-yun,Yi, Chung-Hwi,Cho, Sang-hyun,Jeon, Hye-Seon,Weon, Jong-hyuck,Hwang, Ui-jae Wolters Kluwer Health 2018 Medicine Vol.97 No.29

<P><B>Abstract</B></P><P>Findings about predictors of chronic lower-back pain (CLBP) were inconsistent and inconclusive in previous studies because patients with CLBP are heterogeneous. Subgrouping patients with CLBP, according to a CLBP classification system, might thus clarify the research findings. CLBP in the direction of lumbar flexion movement, that is, the flexion pattern, is common in clinical situations. Therefore, the purpose of this study was to determine the predictors of dysfunction (pain, disability) and health-related quality of life in the flexion pattern subgroup of patients with CLBP.</P><P>A cross-sectional study of prospectively collected data. One hundred eight subjects in the flexion pattern subgroup of CLBP. Thirteen variables were measured: the visual analog scale (VAS), the Oswestry Disability Index (ODI), the Short Form-36 (SF-36), the Beck Depression Inventory (BDI), hip internal rotation range of motion, hip flexion range of motion, knee extension range of motion, knee extension with dorsiflexion range of motion, ratio forward flexion, knee extension strength, hip extension strength, hip flexion strength, and lumbopelvic stability.</P><P>The models for predictors of lower-back pain in the CLBP flexion pattern subgroup included knee extension and the BDI as predictor variables that accounted for 8.1% of the variance in the VAS (<I>P</I> < .05); predictors for disability included the BDI, age, and hip flexion strength, which accounted for 21.2% of the variance in the ODI (<I>P</I> < .05); predictors for health-related quality of life included the BDI, sex, knee extension with dorsiflexion range of motion, and age, which accounted for 38.8% of the variance in the SF-36 (<I>P</I> < .05) in multiple regression models with a stepwise selection procedure.</P><P>The current results suggest that knee extension, the BDI, age, hip flexion strength, knee extension with dorsiflexion, and sex should be considered when determining appropriate prediction, prevention, and intervention in the flexion pattern subgroup of patients with CLBP.</P>

Public opinions on disclosure of tobacco components: Results of a nationwide cross-sectional survey in Republic of Korea

Yun, E Hwa,Park, Young-Ok,Lim, Min Kyung,Oh, Jin-Kyoung,Park, Eun Young,Jeong, Bo Yoon,Hong, Soon-Yeol,Lee, Do-Hoon The Authors. Published by Wolters Kluwer Health, I 2016 Medicine Vol.95 No.27

<P>This study aimed to explore public views on disclosure of tobacco components in an effort to develop a comprehensive regulatory system facilitating implementation of the Framework Convention on Tobacco Control (FCTC) Articles 9 and 10 in Korea. In all, 1200 representative Koreans 19 years old or older were enrolled and information on their general characteristics, smoking status, awareness of the effects of smoking on health, and views on the public disclosure of tobacco components was collected by telephone using a structured questionnaire. Factors associated with acceptance of the need for public disclosure of tobacco components were identified via multivariate analysis. Most participants considered it necessary to publicly disclose tobacco components (95.9%) and were aware of the risk to health posed by smoking (76.0%). The prevalent view was that tobacco companies should be legally required to publicly disclose details of the components of cigarettes, their levels per cigarette, and their effects on health. The most effective means of disclosure were considered to be the mass media, printed materials, and labels on cigarette packs. Females and never-smokers (odds ratio [OR]: 4.39, 95% confidence interval [95% CI]: 1.76-10.94) more readily accepted the need for public disclosure, whereas those of lower educational level and/or who were less aware of the harm to health posed by smoking (OR: 0.05, 95% CI: 0.01-0.18) were less likely to be accepting. The attitude of the general population ensures that FCTC Articles 9 and 10 will be successfully implemented in Korea. Further public consultation on the details of disclosure would be useful for the development of a comprehensive regulatory system.</P>

Disruption of frontal–parietal connectivity during conscious sedation by propofol administration

Kim, Pil-Jong,Kim, Hong-Gee,Noh, Gyu-Jeong,Koo, Yong-Seo,Shin, Teo Jeon Wolters Kluwer Health | Lippincott Williams Wilkin 2017 NEUROREPORT - Vol.28 No.14

<P>The sedative state is a transitional state from wakefulness to general anesthesia. However, little is understood regarding the mechanism of conscious sedation, different from general anesthesia while maintaining wakefulness. In this study, we aimed to investigate changes in functional connectivity of the parietal-frontal network, implicated in wakefulness during conscious sedation induced by propofol infusion. The electroencephalography was obtained at the frontal and parietal areas of adult volunteers who maintain wakefulness during low-dose propofol infusion (1.5 mg/kg/h) over 1 h. Spectral Granger causality (GC) (delta, theta, alpha, beta and gamma frequency bands) and time-domain GC were calculated during each stage of awake (before propofol administration), sedation, and recovery (after discontinuation of propofol). We also calculated the phase-locking index and compared it with GC during each stage. A decrease in GC from the frontal to parietal areas was observed particularly in the low-frequency bands during propofol administration. Contrary to the GC changes in the frontoparietal direction, GC from the parietal to frontal areas was increased in the high-frequency bands during propofol administration and significantly decreased after discontinuation of propofol. In summary, we showed that frontal-parietal neural networks were significantly changed differently by the frequency of the brain rhythm and the directions of connections during sedation by propofol administration. Our result suggests that the alteration of brain interaction may induce sedative state lying between awake and general anesthesia. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.</P>

Greater corticostriatal activation associated with facial motor imagery compared with motor execution: a functional MRI study

Makary, Meena M.,Eun, Seulgi,Park, Kyungmo Wolters Kluwer Health | Lippincott Williams Wilkin 2017 NEUROREPORT - Vol.28 No.10

<P>Motor imagery (MI) relies on conscious mental simulation of a motor act without overt motor output and can promote motor skill acquisition and facilitate rehabilitation for patients with stroke or neurological conditions. Although a plethora of neuroimaging studies have investigated the neural network of MI regarding different body parts, exploration of the neural correlates to facial MI remains warranted. Here, we used functional MRI with a large cohort of 41 participants who underwent motor execution (ME) and MI runs of mouth-stretching tasks. Then, we carried out conjunction and contrast analyses to investigate the commonalities and differences between the two conditions. Conjunction analysis, representing the shared neural network between ME and MI, showed activation in the primary motor cortex, primary and secondary somatosensory cortices, premotor cortex, parietal lobe, anterior insula, supplementary motor area (SMA) and pre-SMA, thalamus, putamen, and caudate. Contrast analysis showed greater activation of primary motor cortex, primary and secondary somatosensory cortices, SMA, anterior insula, and the thalamus in response to ME than MI and greater activation of the premotor cortex, pre-SMA, putamen, and caudate in response to MI than ME. Interestingly, we found exclusive activation in the anterior cingulate cortex and left ventrolateral prefrontal cortex in response to MI, reflecting the motor inhibition network responsible for blocking the transmission of motor commands to peripheral effectors during mental rehearsal. Taken together, these findings show that, despite the neural overlap between ME and MI, there are different degrees of activation within this overlap, and that MI normally involves motor command inhibition possibly mediated by the anterior cingulate cortex and ventrolateral prefrontal cortex. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.</P>

Appropriate margin thresholds for isocontour metabolic volumetry of fluorine-18 fluorodeoxyglucose PET in sarcoma: a hybrid PET/MRI study

Lee, Hyunjong,Paeng, Jin Chul,Hong, Sung Hwan,Yoo, Hye Jin,Cheon, Gi Jeong,Lee, Dong Soo,Chung, June-Key,Kang, Keon Wook Wolters Kluwer Health, Inc. All rights reserved. 2016 Nuclear medicine communications Vol.37 No.10

<P>ObjectivesMetabolic volumetry and heterogeneity indexes are increasingly being used in fluorine-18 fluorodeoxyglucose (F-18-FDG) PET, mostly using isocontour methods. However, there is no standard method to determine optimal margin thresholds for isocontour volume of interest (VOIiso). Here, VOIiso with various margin thresholds were compared with exact anatomical tumor volumes in sarcoma using a hybrid PET/MRI scanner.Patients and methods(18)F-FDG PET/MRI images were retrospectively analyzed for 36 lesions of soft tissue or bone sarcoma. VOIiso of tumors was drawn with varying margin thresholds; standardized uptake value (SUV) 1.0-4.0 with an increment of 0.5 and 30-70% of maximal SUV (SUVmax) with an increment of 10%. Exact anatomical tumor volumes (VOIMRI) were drawn manually on the basis of MRI. In each VOI, metabolic tumor volume, SUVmean, total lesion glycolysis, and SD were measured and compared between VOIiso and VOIMRI.ResultsSignificant correlations were observed between the indexes from VOIiso and VOIMRI. For metabolic tumor volume, no significant difference existed between VOIiso and VOIMRI with margin thresholds of 30 and 40% of SUVmax, and SUV 1.5. For SUVmean, no significant difference existed with 30% of SUVmax, and SUV 1.5. For total lesion glycolysis, no significant difference existed with 40% of SUVmax, SUV 1.5, and 2.0. For SD, no significant difference existed with 30% of SUVmax, SUV 1.5, and 2.0.ConclusionMargin thresholds of 30 or 40% of SUVmax and SUV 1.5 or 2.0 may be used for the VOIiso method in F-18-FDG PET images of sarcoma. VOIiso with these margin thresholds are expected to produce reliable metabolic, volumetric, and heterogeneity indexes on F-18-FDG PET images.Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.</P>

Frontal Lobe Function and Risk of Hip Fracture in Patient With Alzheimer Disease : An Analysis of Linked Data

Roh, Hyun Woong,Hong, Chang Hyung,Lee, SooJin,Lee, Yunhwan,Lee, Kang Soo,Chang, Ki Jung,Oh, Byoung Hoon,Choi, Seong Hye,Kim, Seong Yoon,Back, Joung Hwan,Chung, Young Ki,Lim, Ki Young,Noh, Jai Sung,Son Wolters Kluwer Health 2015 Medicine Vol.94 No.45

<P><B>Abstract</B></P><P>To determine the association between frontal lobe function and risk of hip fracture in patients with Alzheimer disease (AD).</P><P>Retrospective cohort study using multicenter hospital-based dementia registry and national health insurance claim data was done. Participants who had available data of neuropsychological test, national health insurance claim, and other covariates were included. A total of 1660 patients with AD were included based on Stroop Test results. A total of 1563 patients with AD were included based on the Controlled Oral Word Association Test (COWAT) results. Hip fracture was measured by validated identification criteria using national health insurance claim data. Frontal lobe function was measured by Stroop Test and COWAT at baseline.</P><P>After adjusting for potential covariates, including cognitive function in other domains (language, verbal and nonverbal memory, and attention), the Cox proportional hazard regression analysis revealed that risk of a hip fracture was decreased with a hazard ratio (HR) of 0.98 per one point of increase in the Stroop Test (adjusted HR = 0.98, 95% confidence interval [CI]: 0.97–1.00) and 0.93 per one point increase in COWAT (adjusted HR = 0.93, 95% CI: 0.88–0.99).</P><P>The risk of hip fracture in AD patients was associated with baseline frontal lobe function. The result of this research presents evidence of association between frontal lobe function and risk of hip fracture in patients with AD.</P>

Effect of Coronary Artery Calcification Score by Lifestyle and Correlation With Coronary Artery Stenosis by Multidetector Computed Tomography

Lee, Sang-Hong,Cho, Jae-Hwan,Kim, Hee-Eun,Kim, Sung-Chul Wolters Kluwer Health, Inc. All rights reserved. 2017 Journal of computer assisted tomography Vol.41 No.2

<P>Objective: This study examined the effect of coronary artery calcification score by lifestyle and correlation with coronary artery stenosis in persons who underwent coronary artery computed tomography (CT) angiography among health examinees for heart diseases in Korea. Methods and Materials: The study included 506 subjects (256 men and 250 women) who underwent coronary artery CT angiography among health examines for heart diseases at the Incheon Branch of the Korea Association of Health Promotion between January 2, 2014, and December 31, 2014. The demographical variables of the subjects were determined by frequency analysis, and the difference by sex was compared and analyzed using chi(2) independence test. Independent 2-sample t test was performed to determine any difference in main factors by coronary artery calcification. Results: According to the results, 175 (34.6%) had calcification, men showed statistically higher scores than women, and calcification seemed higher in those who were older, taller, heavier, and thicker in waist. Regarding blood pressure, calcification was shown if contraction phase and relaxation blood pressure was higher, blood sugar before meal was higher, and neutral fat was higher. By lifestyle, calcification seemed to be higher in those with more alcohol drinking per week, long past smoking years, and higher smoking amount per day in the past and present. In addition, coronary artery stenosis rate showed statistical correlation with calcification from the left anterior descending artery, right coronary artery, left circumflex artery, and left main coronary artery in sequence. Conclusions: In conclusion, coronary artery calcification score CT is deemed to be a suitable method for the estimation of coronary artery stenosis with short examination time, low radiation exposure, and noninvasive method.</P>

Blood pressure level associated with lowest cardiovascular event in hypertensive diabetic patients

Lee, Chan Joo,Hwang, Jinseub,Lee, Yong-ho,Oh, Jaewon,Lee, Sang-Hak,Kang, Seok-Min,Choi, Donghoon,Kim, Hyeon Chang,Park, Sungha Wolters Kluwer Health, Inc. All rights reserved. 2018 Journal of Hypertension Vol.36 No.12

BACKGROUND:: The ACCORD BP trial failed to show the benefit of strict blood pressure (BP) control on cardiovascular events in diabetics with high cardiovascular risk. However, this result cannot be generalized to all diabetics. We investigated whether lower mean BP in diabetic people with hypertension is associated with better prognosis. METHODS:: Participants from the Korea National Health Insurance Service Health Examinee Cohort who were diagnosed with diabetes and hypertension between 2003 and 2006 were included in the analysis (N = 7926). Mortality and cardiovascular events were compared among three groups according to mean SBP (<130, 130–<140, ≥140 mmHg) and mean DBP (<80, 80–<90, ≥ 90 mmHg) recorded during follow-up health examinations for up to 11 years. RESULTS:: Significant reductions in the risk of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and end-stage renal disease were observed in patients with a mean SBP of 130 mmHg to less than 140 mmHg, as compared with patients with a mean SBP of at least 140 mmHg. The additional clinical benefit of a mean SBP of less than 130 mmHg was unclear. Lower risk of all-cause death, cardiovascular mortality, and nonfatal strokes was observed in patients with a mean DBP of 80 mmHg to less than 90 mmHg. A mean DBP of less than 80 mmHg was associated with further reduction in all-cause mortality, cardiovascular mortality, ischaemic stroke, and total stroke. CONCLUSION:: A mean BP of less than 140/80 mmHg was associated with further reduction in the risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients.

Neuroanatomical assessment of the impact of negative emotion on explicit memory in patients with obsessive-compulsive disorder

Jang, In-Soo,Kim, Gwang-Won,Jeong, Gwang-Woo Wolters Kluwer Health | Lippincott Williams Wilkin 2017 NEUROREPORT - Vol.28 No.1

<P>The aim of this study was to identify the brain activation patterns associated with emotionally neutral or unpleasant words during explicit memory tasks in patients with obsessive-compulsive disorder (OCD) using a functional MRI. Sixteen patients with OCD (mean age= 31.4 +/- 10.1 years) and 16 healthy controls (mean age= 32.6 +/- 5.8 years) who had no history of neurological or psychiatric illness underwent functional MRI examinations on a 3-T Siemens MR Scanner. The stimulation paradigm consisted of five times rest-condition, two times encoding of two-syllable words, and two times explicit retrieval of the previously learned words. Six different words were presented for 3 s each in the encoding and retrieval tasks. In the retrieval task, the same words as those used at the encoding task were presented randomly. Brain activation maps were quantified and analyzed using SPM8 and MRIcron software. During the explicit retrieval tasks with emotionally neutral words, the predominant activation areas observed in patients with OCD included the angular gyrus and the supramarginal gyrus, whereas healthy controls showed significantly higher activity in the postcentral gyrus (P< 0.005). During the explicit retrieval tasks with unpleasant words, patients with OCD showed significantly higher activity, compared with healthy controls, in the cerebellum, posterior cingulate gyrus, middle occipital gyrus, middle temporal gyrus, and inferior frontal gyrus (P< 0.005); however, no predominant activation areas in healthy controls over patients with OCD were observed. This study showed differential brain activation patterns in response to emotionally neutral and unpleasant words in patients with OCD. This finding will be useful in assessing the neural mechanisms associated with emotional effect on the impairment of memory retrieval in OCD. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.</P>