• Journal of Gastric Cancer
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• v.19 no.3
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• pp.235-253
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• 2019

Gastric cancer (GC) is one of the deadliest malignancies in the world. Currently, clinical treatment decisions are mostly made based on the extent of the tumor and its anatomy, such as tumor-node-metastasis staging. Recent advances in genome-wide molecular technology have enabled delineation of the molecular characteristics of GC. Based on this, efforts have been made to classify GC into molecular subtypes with distinct prognosis and therapeutic response. Simplified algorithms based on protein and RNA expressions have been proposed to reproduce the GC classification in the clinical field. Furthermore, a recent study established a single patient classifier (SPC) predicting the prognosis and chemotherapy response of resectable GC patients based on a 4-gene real-time polymerase chain reaction assay. GC patient stratification according to SPC will enable personalized therapeutic strategies in adjuvant settings. At the same time, patient-derived xenografts and patient-derived organoids are now emerging as novel preclinical models for the treatment of GC. These models recapitulate the complex features of the primary tumor, which is expected to facilitate both drug development and clinical therapeutic decision making. An integrated approach applying molecular patient stratification and patient-derived models in the clinical realm is considered a turning point in precision medicine in GC.

• The Journal of Korean Medicine
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• v.35 no.2
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• pp.12-18
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• 2014

Objectives: This was a retrospective case series about the clinical effect of integrated approach with behavior therapy for obstructive sleep apnea (OSA). Methods: Medical records of twelve patients with OSA who were treated with behavior modification including nasal breathing with oral appliances and sleep in lateral position, oral administration of herbal medicines and acupuncture treatment between January and September of 2013 were reviewed. Apnea-hypopnea index (AHI), day time sleepiness, apneas and hypopneas counts during sleep, risk indicator (RI), oxygen desaturation index, average saturation during sleep, lowest desaturation, lowest saturation, snoring events ratio and number of desaturations (%) were assessed before and after treatments with the ApneaLink device, which is a portable diagnostic apparatus for monitoring airflows of the patient's breath at home. Results: After an average 62.67 (SD 37.16) days of treatment, AHI (from 17.67, 12.79 to 8.75, 8.25, p=0.007), RI (from 22.00, 13.26 to 12.09, 8.03, p=0.004), oxygen desaturation index (from 17.33, 12.17 to 8.17, 7.86, p=0.005), and number of desaturations (from 7.00 times, 9.79 to 0.92 times, 1.39, p=0.044) showed significant improvement. Daytime sleepiness improved from 6.5 (3.2) to 3.8 (1.8) but there was no significant difference after treatment (p=0.17). No adverse events related to treatment were observed during participation in the treatment. Conclusion: From this case series, we found that behavior modification with herbal medication and acupuncture may be effective for improving sleep apnea without serious adverse events. Future randomized controlled trials with larger sample size will be necessary for concrete evidence on the benefit of this integrated treatment for OSA.

• Biomolecules & Therapeutics
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• v.30 no.4
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• pp.368-379
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• 2022

Hyaluronic acid (HA), a ligand of CD44, accumulates in some types of tumors and is responsible for tumor progression. The nuclear factor erythroid 2-like 2 (NRF2) regulates cytoprotective genes and drug transporters, which promotes therapy resistance in tumors. Previously, we showed that high levels of CD44 are associated with NRF2 activation in cancer stem like-cells. Herein, we demonstrate that HA production was increased in doxorubicin-resistant breast cancer MCF7 cells (MCF7-DR) via the upregulation of HA synthase-2 (HAS2). HA incubation increased NRF2, aldo-keto reductase 1C1 (AKR1C1), and multidrug resistance gene 1 (MDR1) levels. Silencing of HAS2 or CD44 suppressed NRF2 signaling in MCF7-DR, which was accompanied by increased doxorubicin sensitivity. The treatment with a HAS2 inhibitor, 4-methylumbelliferone (4-MU), decreased NRF2, AKR1C1, and MDR1 levels in MCF7-DR. Subsequently, 4-MU treatment inhibited sphere formation and doxorubicin resistance in MCF7-DR. The Cancer Genome Atlas (TCGA) data analysis across 32 types of tumors indicates the amplification of HAS2 gene is a common genetic alteration and is negatively correlated with the overall survival rate. In addition, high HAS2 mRNA levels are associated with increased NRF2 signaling and poor clinical outcome in breast cancer patients. Collectively, these indicate that HAS2 elevation contributes to chemoresistance and sphere formation capacity of drug-resistant MCF7 cells by activating CD44/NRF2 signaling, suggesting a potential benefit of HAS2 inhibition.

• Journal of Korean Academy of Nursing
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• v.48 no.6
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• pp.669-678
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• 2018

Purpose: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. Methods: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. Results: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. Conclusion: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.113-120
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• 2022

Purpose : Lymphedema is a common complication in mastectomy patients and is usually characterized by pain, swelling, and limited range of motion (ROM) in the arm. Electromyostimulation (EMS) is widely used for the rehabilitation and recovery of subjects with various neuromusculoskeletal disorders after breast cancer. However, EMS has not yet been used in many Pilates exercises. This study was aimed at comparing the effects of instrument Pilates integrated with EMS on pain, lymphedema, and ROM of the upper extremity (UE) in breast cancer subjects after mastectomy. Methods : Nine female breast cancer subjects who had undergone mastectomy participated in the study. The subjects underwent instrument Pilates with EMS (experimental group) or instrument Pilates only (control group). Pain, lymphedema, and ROM of the UE were measured using the visual analog scale (VAS), the circumference length of the UE, and the ROM of the UE. The Wilcoxon signed-rank test was used to compare the pain, lymphedema, and ROM of the arm before and after the intervention, and the Mann-Whitney U test was used to compare the two groups. The statistical significance level was set to p < .05. Results : In the experimental group, there were significant differences in pain (p<.05) and UE circumference (p<.05) before and after intervention. However, there was no significant difference between the two groups in VAS (p>.05) or circumference length of the UE (p>.05). There was one significant difference between the groups in terms of internal rotation of the ROM of the UE (p<.05). Conclusion : These results show that instrument Pilates exercises combined with EMS may positively affect the internal rotation of the ROM of the UE in breast cancer patients after mastectomy, thus contributing to existing knowledge about instrument Pilates using EMS for the effective management of in breast cancer subjects after mastectomy.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.187-197
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• 2022

Purpose: This study aimed to investigate the changes in the muscle activity of the trunk stabilizer muscles before and after incorporating Pilates breathing during three types of Pilates chair exercises. Methods: This study included 33 healthy men and women in their 20's; they were recruited according to the inclusion and exclusion criteria. sEMG was used to measure the changes in the muscle activity in the internal oblique/transverse abdominis, rectus abdominis, and erector spinae during the three types of Pilates chair movements (footwork, twist footwork, and bridging) without and with the Pilates breathing integration. The muscle activities of the trunk stabilizers between without and with Pilates breathing were statistically analyzed and compared. Results: The internal oblique/transverse abdominis showed an increase and a significant difference in the muscle activity in all three movements of footwork, twist footwork, and bridging after the Pilates breathing integration (p<.001). The muscle activity of the rectus abdominis (p<.05) and the erector spinae (p<.05) also increased and showed a significant difference after the Pilates breathing incorporation, except in the bridging movement for the erector spinae. The increase in the rate after integrating Pilates breathing was relatively greater in internal oblique/transverse abdominis than in other muscles. Conclusion: When Pilates breathing was applied, the activities of the trunk stabilizer muscles increased significantly and immediately in all three movements of Pilates chair footwork, twist footwork, and bridging. This means that the use of breathing is expected to have a positive and immediate effect on the activation of trunk stabilizers, thus indicating that it can possibly be an effective re-enforcing tool to promote trunk stability when it is integrated to the Pilates chair exercise. Incorporating Pilates breathing also seemed to have a tendency to activate the deep trunk stabilizer muscles more than the superficial stabilizer muscles.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.3
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• pp.25-45
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• 2023

Objectives: The purpose of this study is to review the clinical research trends of ovarian cysts and to recognize the efficacy of Korean medicine intervention. Methods: Based on four domestic databases, including Korean studies Information Service System (KISS), Oriental Medicine Advanced Searching Integrated System (OASIS), Korean Medical Database (KMbase) and Research Information Sharing Service (RISS), we analyzed the case reports using Korean medicine intervention, which include acupuncture, moxibustion and herbal medicine. Data retrieval was carried out from May 12^th, to 18^th, 2022, and a total of 9 papers were included. Results: All papers were published in Korea and they contain seventeen case reports in total. The most frequently used intervention was herbal medicine, especially Gyejibokryeong-hwan-gami (桂枝茯苓丸加味), Guichulpajing-tang-gagam (歸朮破癥湯加減), Guibiondam-tang-gami (歸脾溫膽湯加味). Most cases reported statistically significant results on using Korean-medicine intervention. Also, there was no serious side effect of Korean medicine. Conclusions: In this study, we investigated the efficacy of Korean medicine intervention as an adjuvant therapy for ovarian cyst patients and research trends on ovarian cysts. Further studies are needed to supplement the safety and the evaluation of Korean medicine. However, the results should be taken cautiously as more clinical studies are needed.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.2
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• pp.1-13
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• 2017

Objectives : This paper serves to explore current trends of systems biology in Traditional Chinese Medicine (TCM) and examine how it may influence the Traditional Korean medicine. Methods : Literature review method was collectively used to classify Introduction to systems biology, diagnosis and syndrome classification of systems biology in TCM perspective, physiotherapy including acupuncture, herbs and formula functions, TCM systems biology, and directions of academic development. Results : The term 'Systems biology' is coined as a combination of systems science and biology. It is a field of study that tries to understand living organism by establishing a theory based on an ideal model that analyzes and predicts the desired output with understanding of interrelationships and dynamics between variables. Systems biology has an integrated and multi-dimensional nature that observes the interaction among the elements constructing the network. The current state of systems biology in TCM is categorized into 4 parts: diagnosis and syndrome, physical therapy, herbs and formulas and academic development of TCM systems biology and its technology. Diagnosis and syndrome field is focusing on developing TCM into personalized medicine by clarifying Kidney yin deficiency patterns and metabolic differences among five patterns of diabetes and analyzing plasma metabolism and biomarkers of coronary heart disease patients. In the field of physical therapy such as acupuncture and moxibustion, researchers discovered the effect of stimulating acupoint ST40 on gene expression and the effects of acupuncture on treating functional dyspepsia and acute ischemic stroke. Herbs and formulas were analyzed with TCM network pharmacology. The therapeutic mechanisms of Si Wu Tang and its series formulas are explained by identifying potential active substances, targets and mechanism of action, including metabolic pathways of amino acid and fatty acid. For the academic development of TCM systems biology and its technology, it is necessary to integrate massive database, integrate pharmacokinetics and pharmacodynamics, as well as systems biology. It is also essential to establish a platform to maximize herbal treatment through accumulation of research data and diseases-specific, or drug-specific network combined with clinical experiences, and identify functions and roles of molecules in herbs and conduct animal-based studies within TCM frame. So far, few literature reviews exist for systems biology in traditional Korean medicine and they merely re-examine known efficacies of simple substances, herbs and formulas. For the future, it is necessary to identify specific mechanisms of working agents and targets to maximize the effects of traditional medicine modalities. Conclusions : Systems biology is widely accepted and studied in TCM and already advanced into a field known as 'TCM systems biology', which calls for the study of incorporating TCM and systems biology. It is time for traditional Korean medicine to acknowledge the importance of systems biology and present scientific basis of traditional medicine and establish the principles of diagnosis, prevention and treatment of diseases. By doing so, traditional Korean medicine would be innovated and further developed into a personalized medicine.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.87-103
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• 2021

Objectives The purpose of this study was to investigate the development process and describe the diagnosis methods, theories and treatments of Mongolian traditional medicine and Korean traditional medicine through literature records and prior studies. Methods Literature records and previous studies on traditional medicine of both countries were collected through various sites in Mongolia (Esan, Mongoliajol, Kok, Yumpu, Scribd, Science and Technology Foundation [STF]) and Korea (Koreanstudies Information Service System [KISS], Korea Institute of Science and Technology Information [KISTI], National Digital Science Library [NDSL], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS]). Also the English database was searched through PubMed. In the case of Mongolian traditional medicine, medical books published in Mongolia were mainly referenced and used for research. Results Studying the development process, basic concepts and the system of diagnosis and treatment of the two traditional medicine, several commonalities and differences were revealed. Conclusions This study showed that the scope of diagnosis methods between Mongolian and Korean traditional medicine were slightly different, and that the medical terminology for the diagnosis method had slightly different contents from each other. Although there were many similarities in treatments of Mongolian and Korean traditional medicine, the Chuna therapy is found in Korean traditional medicine only. The basic theories constituting traditional medicine were the same, but the five-element theory used by the two countries differs in the following two factors. Mongolia uses elements of air and space as the theory of five elements, while Korea uses elements of wood and iron.

• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.3
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• pp.96-113
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• 2021

Objectives: The purpose of this study is to analyze the effectiveness of herbal medicine that are used for endometrial hyperplasia. Methods: We searched on three databases [PubMed, China national knowledge infrastructure (CNKI), and Oriental medicine advanced searching integrated system (OASIS)] with keywords for Endometrial hyperplasia(English, Korean, and Chinese) and evaluated the risk of bias. Meta-analysis was performed on the selected studies. Results: 15 RCTs were finally selected. According to the analysis, Most of the participants were endometrial hyperplasia without atypia. And the combined therapeutic effects of hormonal medicine and herbal medicine were statistically significant (RR 1.21 [95% CI 1.15, 1.28], P<0.00001), The endometrial thickness tended to be thinner when treated combined therapy. And they also showed improvement on levels of pictorial blood assessment chart (PBAC) and hemoglobin. Also, the therapeutic effects of herbal medicine can be identified as similar to Western medicine, and no superior effects have been confirmed (RR 1.05 [95% CI 0.87, 1.28], P=0.60). Conclusion: The combination Western and herbal medicine was more effective than Western medicine alone treated for endometrial hyperplasia without atypia. Moreover there were also significant improvements in endometrial thickness, PBAC and hemoglobin levels.