Objectives: Formulas for treatment of yin or yang deficiency conditions have been commonly used in traditional Korean medicine. The aim of this study is to examine the possible inhibitory effects of yin- or yang-tonifying formulas on in vivo anti-platelet activity and in vivo anti-thrombotic activity. Methods: We tested the effects of 26 types of yin- or yang-tonifying formulas on platelet aggregation induced by collagen in human whole blood using the impedance method of aggregometry and accessed a biomarker of platelet activation using thromboxane $B_2$ immunoassay. We also tested the anti-thrombotic effects of effective candidates on experimental models of thrombosis in mice. Results: 3 types of yin-tonifying formulas and 3 types of yin-yang-tonifying formulas were selected to be the most effective candidates (p<0.01). Also, through in vivo study, the antithrombotic activities of Igyeong-tang, Gamisipjeondaebo-tang, and Gamisoyo-san-treated groups, with recovery rate of 60, 50, and 45.45%, respectively, were observed to be higher than those of the control group (saline, 36.8%) in mouse acute thrombosis. Conclusion: These results show that yin-tonifying formulas are more effective in anti-platelet and anti-thrombotic activity than yang-tonifying formulas.

Objectives: To clarify the effects of Jungri-tang Gamibang on accelerating small intestinal movement induced by the stimulation of cholinergic neurotransmission. Methods: 500, 250 and 125mg Jungri-Tang Gamibang or 20mg domperidone were dissolved or suspended in distilled water and orally pretreated on the carbachol-accelerated small intestinal transit mice once a day for 7 days at a volume of 10ml/kg (of body weight) using a Zonde needle attached to 1 ml syringes containing test drugs. Result: Significantly (p<0.01) increase of % regions of activated charcoal transit in the small intestine was detected in carbachol control compared to that of intact control. However, significant (p<0.01) decreases of % regions of activated charcoal transit were dose-dependently observed in all Jungri-Tang Gamibang extracts or domperidone-pretreated groups. Conclusions: it was concluded that Jungri-tang Gamibang enhancement in the normal intestinal motility and normalization in the accelerated intestinal motility might interfere with a variety of muscarinic, adrenergic and histaminic receptor activities or with the mobilization of calcium ions required for smooth muscle contraction non-specifically.

Objectives: Little information is available regarding the effect of Lycii cortex radicis (LCR) on cell viability in glioma cells. This study was therefore undertaken to examine the effect of LCR on cell survival in U87MG human glioma cells. Methods: Cell viability and cell death were estimated by MTT assay and trypan blue exclusion assay, respectively. Reactive oxygen species (ROS) generation was measured using the fluorescence probe DCFH-DA. Activation of Akt and extracellular signal-regulated kinase (ERK) and activation of caspase-3 were estimated by Western blot analysis. Results: LCR resulted in apoptotic cell death in a dose- and time-dependent manner. LCR increased reactive oxygen species (ROS) generation and LCR-induced cell death was also prevented by antioxidants, suggesting that ROS generation played a critical role in LCR-induced cell death. Western blot analysis showed that LCR treatment caused down-regulation of Akt and ERK. The LCR-induced cell death was increased by the inhibitors of Akt and ERK. Activation of caspase-3 was stimulated by LCR and caspase inhibitors prevented the LCR-induced cell death. Conclusion: These findings suggest that LCR results in human glioma cell death through a mechanism involving ROS generation, down-regulation of Akt and ERK, and caspase activation.

Objectives: To evaluate the acute toxic effects and approximate lethal dose of Cheonggan extracts (CGX) in SD rats and beagle dogs. Methods: Male and female rats were divided into 4 groups (Control, CGX 1250, CGX 2500, CGX 5000) respectively and male and female dogs were divided into two groups respectively (Control, CGX 5000) respectively. A single oral dose of CGX was treated to the rats and dogs. Mortality, signs of gross toxicity, and behavioral changes were observed over 14 days. All animals were observed every hour for 4 hours after administration and once a day thereafter for 14 days. Body weights were determined at $0_{th}$, $7_{th}$, and $14_{th}$ days. All surviving animals were sacrificed and necrotized. Major organs were inspected visually for gross findings. Results: No animals died in any of the groups during the experimental period (2 weeks), rats or dogs. Body weights of rats and dogs during the experiment continuously increased in all groups but there was no significant change. No abnormal clinical signs were observed for 2 weeks after a single administration of CGX in any dose group of CGX, rats or dogs. No abnormal findings in major organs were observed in any group of rats or dogs. Conclusion: CGX does not have acute toxic effects in rats or dogs. Therefore, an approximate lethal dose is assumed to exceed 5000 mg/kg in both rats and dogs.

Objectives: Hwangryunhaedok-tang (HRHDT), a prescription composed of four herbs, has been wi dely used in Oriental Medicine for the treatment of cerebral infarction. However, the mechanisms by which the herbal formula affects on the production of pro- and anti-inflammatory cytokines in cerebral infarction patients remain unknown yet. Methods: The levels of pro- and anti-inflammatory cytokines, including tumor necrosis factor (TNF)-a, interleukin (IL)-1b, and IL-6, IL-10, and TGF-${\beta}1$ were determined in peripheral blood mononuclear cells (PBMCs) from cerebral infarction patients under our experimental conditions. Results: The secretory levels of pro- and anti-inflammatory cytokines, including tumor necrosis factor (TNF)-a, interleukin (IL)-1b, and IL-6, and IL-10 were significantly increased in phytohemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMCs) from cerebral infarction patients. However, pretreatment with HRHDT significantly inhibited the secretion of pro- and anti-inflammatory in PBMCs. Also, HRHDT induced a significant increase of transforming growth factor (TGF)-b1 in PBMCs. Conclusions: These data indicate that HRHDT may be beneficial in the suppression of inflammatory processes of cerebral infarct through suppression of TNF-$\alpha$, IL-$1{\beta}$, IL-6, and IL-10 and induction of TGF-${\beta}1$.

Objectives: This study was performed to evaluate the influence of different extracting solvents (water, methanol, ethanol, or n-hexane) on the anti-inflammatory efficacy of Scutellaria baicalensis (Lamiaceae), which has been used widely as a traditional herbal medicine for its anti-inflammatory properties. Methods: The ability of each extract to inhibit the production of pro-inflammatory mediators such as NO, TNF-$\alpha$, and $PGE_2$ by lipopolysaccharide (LPS)-stimulated mouse macrophage RAW 264.7 cells was measured. Results: The results showed that extraction solvents (except n-hexane) for S. baicalensis showed significant inhibitory effects on NO, TNF-$\alpha$ and $PGE_2$ production. Especially, methanol was the solvent with the greatest activity against NO and $PGE_2$ production. However, there was no difference between the extracts for inhibitory activity of TNF-$\alpha$. Conclusion: The present study suggests that methanol is a superior extraction solvent than water, ethanol, or n-hexane for maintaining the anti-inflammatory effects of S. baicalensis.

Objectives: This study demonstrates the neurological effects of Bojungikki-tang and Bojungikki-tang-gamibang on the focal cerebral ischemia of rats with ischemic damage caused by middle cerebral artery occlusion (MCAO). Methods: Rats were treated with Bojungikki-tang and Bojungikki-tang-gamibang extracts for about five days after MCAO, and the size and volume of cerebral infarction and the ratio of cerebral edema were observed. From the immunohistochemical view, significant changes of outbreak of Bax, Bcl-2, c-Fos, HSP72, and iNOS were observed in the brain tissues. Results: Bojungikki-tang repressed only brain edema and iNOS revelation led by focal cerebral ischemia, when considering significance. In contrast, Bojungikki-tang-gamibang demonstrated significant suppression of cerebral infarction, brain edema, Bax, c-Fos, HSP72, and iNOS induced by focal cerebral ischemia. Conclusions: Bojungikki-tang is considered functional treatment for cerebral ischemic damage; it can be effective to relieve secondary brain edema and immune response. Bojungikki-tang-gamibang can have a direct function to alleviate brain infarct and to control the natural death of nerve cells which cerebral ischemic damage brings about.

Objective: In this study, the immunomodulatory activity of a mixture of wild Panax ginseng and red-mold rice extracts (MPR) on RAW 264.7 macrophage cells in the presence and absence of methotrexate (MTX), an anti-cancer drug, was investigated. Methods and Results: In the cell viability, MPR showed a significant cell proliferation and inhibited cell regression by red-mold rice (RMR) alone or MTX alone. MPR induced moderate increase in nitric oxide (NO) production. NO production and inducible nitric oxide synthase (iNOS) mRNA expression by LPS decreased after MPR treatment. In addition, MPR slightly induced COX-2 mRNA expression, but it did not affect the expression of COX-2 mRNA by LPS treatment. In RT-PCR analyses, MPR induced IL-$1{\alpha}$, IL-$1{\beta}$, IL-6, and TNF-$\alpha$ mRNA expression, but had no effect on IL-10 and TGF-$\beta$, regardless of MTX treatment. Furthermore, MPR did not interfere with the cytotoxicity of MTX against MCF-7 human breast carcinoma cells. Conclusions: MPR is efficacious in protecting against MTX-induced cell regression as a result of macrophage activation, resulting in induction of cytokine expression, implying that MPR could be considered an adjuvant in MTX-chemotherapy.

Objective: This study aimed to build an overview of randomized clinical controlled trials (RCTs) for chronic fatigue-related symptoms to extract the useful data for management of patients and development of therapeutics using Korean traditional medicine in the future. Methods: All RCT-derived papers for chronic fatigue-related symptoms were collected via PubMed Database. We surveyed elementary information of RCTs such as clinical question, study design, and its quality and results. Results: A total of fifty-three RCTs met these review criteria. Most of the RCTs were performed in Western countries, particularly the UK and USA. The major portion of RCTs focused on chronic fatigue syndrome using immune modulators, psychotherapeutic and anti-depressants. Five RCTs using complementary and alternative medicine, including herbal remedies, showed positive results. Conclusions: Fatigue-related symptoms are a main target of Oriental medicine. This study provides helpful information for planning clinical study of chronic fatigue-related symptoms using traditional Korean medicine.

Objectives: This study aimed to examine the difference of external appearance measurements in subjects of different regional lineages as subgroups within the Tae-eumin Sasang grouping. Methods: We chose 51 Tae-eumin subjects diagnosed by Korean Sasang constitutional medical doctors aided by voice analysis. The subjects were divided into two groups, the northern and southern lineages, by an expert on facial characteristics of the two lineages. We took pictures of their frontal and lateral views by Martin's method, measured projected length of face with the Facial Feature Measurement Program, and analyzed anthropometric facial differences between the northern and southern types. Results: Results show differences between the northern and southern types. First, the northern type of face has bigger measurements than the southern type on the frontal face. Second, the northern type of face has higher measurements of "height", which means distance from pupil to a specific measurement point, than the southern type on the frontal face. Third, on the frontal face, the northern and southern types have differences with respect to eyebrow, point of sellion, and eye. Fourth, on the side face, the northern and southern types have differences in lip, mandible and ear. Conclusions: We found our anthropometric facial measurements of the northern and southern lineages to be in accordance with previous literature. Knowledge of the differences between the northern and southern lineages can be a hint in constitutional diagnosis when differentiation is clinically confusing.

Objectives: Traditional Korean herbal formulae are composed of multiple medicinal plants. This situation of multiple-ingredient mixtures has been considered as a major obstacle to new drug development using herbal formulae in the world market, despite the effectiveness of such mixtures. This study reviewed Liv-52 as a representative model of successful drug development using a multiple-herb mixture. Methods: All articles for Liv-52 were collected from the PubMed database. The history, composition of Liv-52, its pharmaceutical efficacy and mechanisms, and data from clinical studies including its market size were analyzed. Results: Liv-52 is composed of seven herbal plants and it is the best known in Ayurvedic medicine for treating liver disorders. Since its 1955 introduction, forty four international papers have been published based on pre-clinical and clinical trials. The efficacy and mechanisms of Liv-52 were intensively studied. Currently, Liv-52 is one of the top-selling products, with over 10 million dollars sales annually, in the world market. Conclusions: These results indicate that Korean herbal formulae could be new global drugs if scientific evidence for efficacy and standardization are produced via literature researches.

Objectives: To investigate the possibility of GamiSamgieum (SGMX) as a combination therapy with statins on hyperlipidemia using an animal model. Methods: Forty eight ICR mice (male) were divided into six groups of eight mice each: naive, induced, Lipitor 5 mg/kg, Lipitor 5 mg/kg plus SGMX 100 mg/kg, Lipitor 10 mg/kg, and Lipitor 10 mg/kg plus SGMX mg/kg treatment group. Hyperlipidemia was induced by feeding a purified high fat diet for all groups (except naive) along with treatment of drugs for 6 weeks, and then biological parameters were examined on the last experiential day. Results: Lipitor treatment lowered total cholesterol and increased HDL-cholesterol compared to the induced group with no statistical significance. However, co-treatment of SGMX with Lipitor revealed synergic effects on total cholesterol and HDL-cholesterol significantly (P < 0.05) in both. SGMX co-treatment also significantly protected liver tissues from the oxidative stress in liver tissues (P < 0.05) and augmented inhibitory effect of Lipitor against fat accumulation in the body. Conclusion: These results indicate the possibility of that SGMX can be used for patients having hyperlipidemia as a combination therapy with statin drugs.

Objective: Rhus verniciflua Stokes (RVS) has anticancer effect confirmed by preclinical studies and historical records. We thus tried to evaluate retrospectively the effect of RVS as a complementary medicine for patients with advanced non-small-cell lung cancer (NSCLC) showing refractory to conventional chemotherapy. Patients and Methods: From June 1, 2006 to June 30, 2007, patients with advanced NSCLC who received both the standardized RVS extract and a standard course of second or more line therapy such as pemetrexed ($Alimta^{(R)}$), erlotinib ($Tarceva^{(R)}$), and gefitinib ($Iressa^{(R)}$) were checked. A total of 13 patients were eligible for the final analysis after fulfilling inclusion/exclusion criteria. Time to progression (TTP) of these patients treated with the standardized RVS extract was checked in the aftercare period. Results: Patients received RVS treatment for a median period of 296 (range 84-698) days. The median TTP was 220.5 (range 36-489) days, and three patients (23.1%) had TTP values of 15 more months. No significant side effects from RVS treatment have been observed. Conclusion: The standardized RVS extract might have synergetic effects by assisting apoptosis in advanced NSCLC with concurrent standard therapy agents, since it prolonged TTP without significant adverse effects. This study suggests that the standardized RVS extract is beneficial to patients with chemotherapy-refractory NSCLC. Further clinical trials and preclinical studies are necessary to determine the efficacy and safety of the standardized RVS extract in NSCLC.