Objectives : Functional dyspepsia is a prevalent disease. It impedes subjective quality of life. The purpose of this research is to examine the effect of acupuncture treatment for functional dyspepsia. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of functional dyspepsia. Volunteers who satisfied the requirements were enrolled in study. Severity of dyspepsia was measured by Nepean Dyspepsia Index(NDI) and Functional Dyspepsia Quality fo Life(FD-QOL) before and after treatments. Results : 68 subjects finished study. There were not difference between two groups on age, sex, weight, height, severity of dyspepsia, subtype, Byeonjeung, surmise of treatment. After treatment total key symptoms score, improve rate of key symptoms were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment "pressure in upper abdomen" and " cramps in upper abdomen" were more decreased in active acupuncture group compared with sham acupuncture group(p=0.001, p=0.014). After treatment total symptom score and QOL of NDI were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment eating status of FD-QOL in active acupuncture group was significantly increased than sham acupuncture group(p=0.008). After treatment liveliness status of FD-QOL and total score of FDQOL in active acupuncture group was increased than sham acupuncture group though statistically insignificant(p=0.095, p=0.077). Conclusion : Acupuncture treatment is effective to improve the symptoms and quality of life in patients with functional dyspepsia.

Objectives : Clinical character of chronic tension-type headache is bilateral, moderate intensity, persistent and chronic, repeating disease and CTTH is a common prevalent disease, but pathophysiology and likely mechanism remain unclear. It impedes subjective quality of life. The purpose of this research is to examine the effect of sa-am acupuncture method for chronic tension-type headache. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of chronic tension-type headache was measured by VAS and Headache Disability Inventory(HDI), Six point Linkert Scale before and after treatments. Results : 26 subjects finished study. There were not difference between two groups on age, sex, weight, height, blood pressure, pulse, respiratory rate, Byeonjeung, sunrise of treatment. In change of VAS, there were not difference between two groups on before treatment. Before treatment per visit, VAS of 6th and 7th visit were significantly decreased in active acupuncture(each p=0.039, p=0.008) and were not decreased in sham acupuncture. In change of VAS on a withdrawing needling after treatment, VAS of 1st, 2nd, 6th and 7th visit were significantly decreased in active acupuncture (each p=0.001, 0.038, 0.035, 0.008) and VAS of 2nd, 4th and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.033, 0.032, 0.035, 0.031). In change of VAS on 2hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.014, 0.023, 0.027) and 5th visit were significantly decreased in sham acupuncture(each p=0.004, 0.009). In change of VAS on 4hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.018, 0.011, 0.015) and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.020, 0.015). In change of VAS on the next day after treatment, VAS of 3th and 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.032, 0.011, 0.005, 0.012) and 4th, 5th visit were significantly decreased in sham acupuncture(each p=0.001, 0.012). In change of VAS according to a current time(before treatment, after a withdrawing needling, 2hrs, 4hrs, the next day), total score of VAS was decreased more active acupuncture group than sham acupuncture group, but there were no statistical significance compared with sham acupuncture group. In change of HDI score, after treatment was decreased than before treatment in two group, but there were no statistical significance compared with two group. In change of Six point Linkert scale score, after treatment was decreased than before treatment in two group on 6th, 7th visit(active acupuncture 6th 7th each p=0.002, 0.003, sham acupuncture 6th 7th each 0.003, 0.009), but there were no statistical significance compared with tow group. Conclusion : Sa-am acupuncture treatment is effective to improve the symptoms and quality of life in patients with chronic tension-type headache.

Objectives : The objective of this study was to research delayed growth with acupuncture and moxibustion treatment. Methods : We search the oriental medical literature related to delayed growth, especially loose skull, pigeon chest(龜胸), turtle back(龜背), five kinds of flaccidity(五軟), five kinds of retardations(五遲) and infantile malnutrition(疳證). Results : 1. Loose skull is treated with moxibustion therapy of CV8(神厥) and two points(1.5cm upper and under of CV8) 2. Pigeon chest(龜胸) is treated with moxibustion therapy of GB38(外丘), ST18(乳根) and 6 points around of STl7(乳中). 3. Turtle back(龜背) is treated with moxibustion therapy of BLl3(肺兪), BL15(心兪) and BLl7(膈兪) 4. Acupuncture therapy of five kinds of flaccidity(五軟) was rare. but there are one case to stimulate Hwatahyeopcheok point using plum-blossom needle. 5. Five kinds of retardations(五遲) is treated with moxibustion therapy of BLl5(心兪) and two point of medial malleolus 6. Infantile malnutrition(疳證) is treated with acupuncture therapy of the spleen channel and stomach. channel, therapy using three-edged needle, cutting therapy(LUlO(魚際) and Sabong), moxibustion therapy(LRl3(章門) and BL2l(胃兪), and Ch'una therapy. Conclusion: We expect that acupuncture and moxibustion treatment of delayed growth will be applied practically in clinical medicine due to further study on delayed growth.

목적 : 사암오행침법의 다양한 변형처방과 그 구성 원리에 대한 연구가 여러 편 있지만 아직 처방구성 형태를 완전하게 분석하거나 그러한 구성을 가능하게 하는 기본 이론에 대해서는 충분히 밝혀지지 않은 상태이다. 본 논문은 사암오행침법의 처방구성 기본이론과 형태에 대해 고찰하고자 한다. 방법 : 본 연구는 사암도인침법에 있는 240개의 처방을 사암이 사용한 문장과 용어인 생왕휴수사(生旺休囚死)와 상생자가보(相生者可補) 상극자필사(相克者必瀉)를 중심으로 분석하여 고찰 하였다 결론 : 1. 오행의 초기개념은 별의 움직임이나 계절의 변화, 관직이름 등과 관련되어 있으며, 이것은 하나의 요소라기보다는 변화과정을 나누어 설명하고자 하는 개념이었으며, 또한 오행은 절대적 우위를 지닌 관계가 아니었고 상황에 따라 지배를 받기도 하고, 지배를 하기도 하는 관계로 보았다. 2. 왕상휴수사(旺相休囚死)는 오행의 또 다른 개념이며 왕상휴(旺相休)는 가족의 개념이고 수사(囚死)는 적의 개념으로, 왕상휴(旺相休)는 오행의 상생관계로, 수사(囚死)는 상극관계로 여겨진다. 3. 소위 정격(正格)에 해당하는 처방은 240개의 처방 중 119개가 해당되지만, 21가지 다른 처방형태 중의 하나이다. 이는 주요 처방형태가 될 수 있지만 기본 처방형태라고는 할 수 없으며, 왕상휴수사(旺相休囚死)와 상생자가보(相生者可補) 상극자필윤(相克者必潤)가 결합된 형태가 기본 형태가 되어야 한다. 4. 사암의 처방원칙 중 하나는 상생관계나 상극관계 내에 있는 오행요소끼리는 자신을 포함해 상황에 따라 선택적으로 보(補)나 사(瀉)를 할 수 있다는 것이고, 다른 하나는 실(실)ㅋ한 경우에만 해당하는 것으로 상생관계에 있는 가족 중에서 모(母)나 자신을 보(補)하고 자(子)를 사(瀉)하는 방법을 사용하기도 한다는 것이다.

Objectives: The purpose of this study is to investigate the mechanism and effect of moxa bucket moxibustion. Objectively, to be used as the quantitative data through the measurement of temperature, and to grasp the thermodynamic characteristics of moxa bucket moxibustion. Methods: We have selected of the moxa bucket moxibustion. We make a comparative study of the thermodynamic characteristics of moxa bucket moxibustion. We examined combustion times, temperatures, temperature gradients in each period during a combustion of moxa bucket moxibustion made by oak wood. Results: 1. We can design the moxa bucket moxibustion that it has 57.6$^{\circ}C$ maximum temperature with 7g weight and 10mm height, if we use more weight of moxa or lower the height of moxa, we can observe relatively elavated maximum temperature. We observe the maximum temperature following the measuring position of moxa bucket and we can see higher temperature at the center of the moxa bucket and lower temperature at the side of the moxa bucket. 2. We can design the moxa bucket moxibustion with 5g moxa and 10mm height that it has 0.121 $^{\circ}C$/sec of maximum temperature gradient, and it has relatively high temperature gradient at lower weight and height condition. 3. We can design the moxa bucket moxibustion with 7g moxa and 15mm height that it has 4,135sec of the longest effective temperature combustion time, if we use more weight of moxa or higher height of moxa, we can observe relatively extended effective temperature combustion time. We observe the longest effective combustion time following the measuring position of moxa bucket. We can see higher temperature at the center of the moxa bucket and lower temperature at the side of the moxa bucket.

Objectives : The study of Traditional Korean medical therapy has recently become a popular academic field as proven to be an great alternative to the limitation of Western medical treatment. However, there has been little study examining the Quality of life to investigate the Effectiveness of Recent Traditional Korean Medical Therapy on Treating Allergic Rhinitis. Thus, this study aims to reveal the characteristics of Allergic Rhinitis patients, their clinical symptoms, and other accompanying diseases. Moreover, it attempts to investigate the sense of improvement and satisfaction from the Allergic Rhinitis patients treated with Traditional Korean Medical therapy by examining Quality of Life Questionnaires. Subject and Method : A total of 380 subjects that consists of allergic rhinitis patients and non patients were participated in this study. 330 allergic rhinitis patients were divided into two groups; the experimental group (230 subjects) was treated with Traditional Korean Medical therapy, and the control group (100 subjects) was not treated with any other therapy. Also, the normal control group (50 subjects) who had no symptoms of the allergic rhinitis was participated in this study as well. All the subjects were asked to answer to the questionaries that consist of two parts such as recalling the symptoms that they had 3 month ago, and describing the current symptoms that they had the present. The experimental group also was asked to answer the quality of life questionnaire before and after the therapy. Results: The results of investigating recent Traditional Korean therapy are as follows: 1. The reservoir rate of other disease was 39.0% in the control group and 34.8% in the experimental group. These were higher than the rate of the normal control (10.0%), which reveals the clinical characteristics of allergic rhinitis patients. 2. The symptoms of Allergic Rhinitis showed improvement after Traditional Korean medical therapy, which can be shown by its statistical significance. (p=.000<.001). 3. 97.0% of the Allergic Rhinitis patients treated with the Korean Therapy answered the improvement of symptom within 4 weeks, and 88.3% of the patients were satisfied with the Traditional Korean medical therapy. 4. The Nasal symptoms had prominently positive effect at the most as the symptoms significantly affect sleep disturbances, ocular symptoms, activity limitation, and emotional problems.

Objectives : This study was performed to evaluate a recent status of acupunctural treatment in pediatric practice. Methods: 660,893 children, who visited HAMSOA oriental clinic from January 2004 to December 2005 was screened to decide the number treated with acupuncture, the diagnosis and the type of acupuncture. In addition, the questionnaire for clinician about acupuncture therapy was performed and analysed to understand their applications. Results: The number treated with acupuncture was 69,797, 10.56%. Classified with ages, 3 months and below was 729 (1.7%), 1 year - 3 months was 5,035 (11.80%), 2 year - 1 year was 6,875 (16.10%), 3 year - 2 year was 5,540 (12.98%), 6 year - 3 year was 12.636 (31.94%) and 6 year and above was 10,876 (25.48%). The most frequent diagnosis taken acupuncture was atopic dermatitis (14.93%) and the next was rhinitis (13.80%). The most frequent type of acupuncture was laser acupuncture. The clinicians answered questionnaire agreed that acupuncture therapy is effective for pediatric disease treatment and fear about acupuncture of young patients was the most important obstacle. Conclusion : The acupuncture therapy in pediatric practice is not so frequent treatment but in increasing stage. Futhermore, in-depth research about acupuncture therapy in pediatrics is demanded.

Objection : The aim of this study was to investigate anti-ischemic effect of LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture. Methods : I designed to investigate whether LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture affects cerebral hemodynamics [regional cerebral blood flow(rCBF), pial arterial diameter(PAD), mean arterial blood pressure (MABP) ] in normal and cerebral ischemia rats by MCA occlusion method, and to make manifest whether LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture is mediated by cyclooxygenase or guanylate cyclase. The changes of rCBF and MABP were determinated by laser-doppler flowmetry(LDF), and the change of PAD was determinated by video microscope and width analyzer. Results: The results were as follows ; 1. LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture was significantly increased rCBF, PAD, but decreased MABP after withdrawing of the needle. This results suggest that LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture induced significantly rCBF by dilating PAD. 2. Pretreatment with indomethacin (1mg/kg, i.v.) was significantly inhibited LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture induced increase of rCBF and PAD, but increased LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture induced decrease of MABP after withdrawing of the needle. 3. Pretreatment with methylene blue(10/${\mu}$g/kg, i.v.) was decreased LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture induced increase of rCBF and MABP, but accelerated LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture induced decrease of PAD. This results suggest that the mechanism of LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture is mediated by cyclooxygenase or guanylate cyclase. Conclusion : I suggest that LR1 ${\cdot}$ HT8 ${\cdot}$ HT9 Reinforcement in Acupuncture has an anti-ischemic effect through the improvement of cerebral hemodynamics, and the mechanism IS mediated by cyclooxygenase.

Objectives: To evaluate the methodological quality of Korean Acupuncture Clinical trials Methods : Two independent researchers reviewed 12 protocols of Acupuncture clinical trials which were conducted in Korea 2006. Also, Survey Principal Investigator of those was conducted. We compare the results of protocol review with investigator reponses of actual practice. Quality assessment consisted of 5 items including random sequence generation, randomization method, allocation concealment, subject blinding, assessor blinding. Results : Randomization was performed using the proper procedure to insure that treatment assignment is unbiased and concealed from subjects in all clinical trials, According to protocols, 6(50%) of 12 clinical trials used computer-generated random numbers, 6(50%) remaining trials didn't describe the randomization method. Also all trials used appropriate randomization methods on the basis of the survey results: 8 trials used computer-generated random number, 2 used random table. Of 7 protocols in which allocation concealment was stated, 5(71%) reported appropriate method (Calling a central office or statisticians, Sealed opaque envelopes). However according to survey, 5(42%) of 12 trials used inappropriate allocation concealment (Keeping a master randomization list and referring to when subject entered the trial). In addition, the result of protocol review and survey response was not coincident in 5(42%) trials. Subject blinding was conducted in all except 1 clinical trials. Although 11(92%) of 12 trials were conducted using assessor blinding in actual practice, only 7(58%) reported that in protocol. Conclusion : Although randomization and blinding were conducted adequately, allocation concealment was used inadequately, Not only appropriate allocation concealment, but also every quality assessment item including randomization, blinding should be stated in more detail in protocol.

Objectives: The purpose of this study is to examine the risk factors and the genetic polymorphism of TNF-alpha associated with rheumatoid arthritis by Sasang constitution Methods : This study was planned to detect the susceptibility of the patients diagnosed by rheumatoid arthritis to Sasang Constitution and to examine the risk factor such as life style and environmental stress (smoking, environmental tobacco smoke, alcohol intake and so on). The genetic polymorphism of TNF-alpha (G308A) were analyzed by PCR-RFLP in rheumatoid arthritis patients and controls. Rheumatoid arthritis patients and matched controls are assessed with QSCCII question for Sasang Typology. Then the genetic polymorphism of patients by Sasang constitution are compared to those of control, which are statistically analyzed and adjusted by age, sex, smoking status, alcohol intake, BMI, and econocmic status. Results: Differential effect of passive smoking on the association between Sasang constitution and rheumatoid arthritis risk was found. This study showed that the genetic polymorphism (TNF-${\alpha}$(G308A)) of rheumatoid arthritis patients and controls associated with the susceptibility to rheumatoid arthritis by sasang constitution was analyzed. Differential effects of TNF-${\alpha}$(G308) genetic polymorphism on the association between rheumatoid arthritis risk and Sasang constitution were found. Conclusion : It is suggested that the genetic polymorphism correlated with susceptibility to rheumatoid arthritis by specific sasang constitution used as its susceptibility marker and further as basic data to prevent the risk factors for rheumatoid arthritis. But larger studies will be needed to confirm these preliminary findings.

Objectives : Juglandis Semen herbal acupuncture solution(JSS) has a broad array of clinical applications in oriental medicine, including treatment of chronic musculoskeletal diseases such as arthritis. This study was performed to investigate the global gene expression profiles using microarray assay in RAW 264.7 cell line treated with JSS and to advance our understanding of the pharmacologic effect of JSS. Methods : Change of the gene expression profile in RAW cell line following treatment with lipopolysaccharide(LPS) alone, or with LPS plus JSS was investigated with a cut-off level of 2 fold change in the expression. Especially, Change of the gene expression by treatment with LPS alone was compared with that by treatment with LPS plus JSS with a cut-off level of 1/2 fold change in the expression. Results: Of the 8170 genes profiled in this study, 51 were upragulated and 21 downregulated following LPS treatment, and 88 were upregulated and 69 downregulated following costimulation of JSS and LPS. Of the 51 genes upregulated following LPS treatment, 10 were downregulated following costimulation of JSS and LPS. Of the 21 genes downregulated following LPS treatment, 3 were upregulated following costimulation of JSS and LPS. Conclusion : JSS treatment induced upregulation of some genes including IL-10 and downregulation of that including MMP13 with its possible implication in an antiinflammatory action of JSS. However, further research on expression profile changes induced by JSS treatment is expected.

Objectives : This study anus to investigate the effects of Rosa Rugosae Radix (RU) herbal acupuncture on the metabolic syndrome in high-fat diet-fed mice. Methods : The experimental groups were fed with high-fat diet (HFD) for 8 weeks to induce metabolic syndrome. During the induction of metabolic syndrome, RU herbal acupuncture at a dosage of 50 mg/kg was carried out on the point of Sinsu(BL23) every day to measure the body weight, feed efficiency, blood glucose levels, insulin resistance index, lipid levels, blood pressure, and weight of liver and adipose tissues (brown adipose tissue from interscapular fat and white adipose tissue from epididymal fat). And after five weeks' induction of metabolic syndrome, RU herbal acupuncture was also performed for 6 weeks to measure the body weight and blood glucose levels. Results: 1. RU herbal acupuncture inhibited increasing body weight and blood glucose levels, with improved insulin resistance. 2. RU herbal acupuncture inhibited increasing levels of total cholesterol, LDL-cholesterol and free fatty acid, while increased HDL-cholesterol levels. 3. RU herbal acupuncture activated anti-hypertensive action. 4. RU herbal acupuncture inhibited increasing weight of white adipose tissues, but not in brown adipose tissues and liver. 5. RU herbal acupuncture lowered blood glucose levels and inhibited increasing body weight in metabolic syndrome-induced ICR mice. Conclusion : Rosa Rugosae Radix (RU) herbal acupuncture showed effectiveeness in prevention and management of metabolic syndrome in clinical application.

Objectives: It has been demonstrated that acupuncture treats diseases while that the widespread use of that clinically and experimentally. It also has shown that electro-acupuncture(EA) is more effective than manual-acupuncture (MA). The purpose of this study was to investigate effect of EA and MA at combined acupoints on sex and age in rats. Methods: This study measured the effects of acupuncture treatment on small intestinal motility in rats. MA and EA(intensity, 5 times muscle twitch threshold) was applied for 30 minutes to the combined left and right sides acupoints on ST36, ST37, ST39 under enflurane anesthesia. EA and MA applied to the ST36, ST37, ST39 acupoints produced an elevation of small intestinal motility. Results: In experimental groups of combined left and right sides acupoints, only specified groups show elevation of small intestinal motility in male rats, 5 weeks age. Furthermore, combined left and right sides acupoints in EA and MA show differences effects according to the sex, male and female, and the age as 5, 6, 7, 8 weeks. Conclusion : Although these different according to the sex and age in rats do not have a established tendency, the present study suggest that effect of EA and MA are experimentally dependent upon the sex and age on small intestinal motility in rats.

Objectives: The purpose of this study is to observe the suppressive effect of Asthma and Immune response improvement of FF(Farfarae Flos) Herbal-acupuncture into Joksamni(ST36) on ovalbumin-induced asthma in mice. Methods : C57BL/6 mice were sensitized and challenged with OVA(ovalbumin) for 12 weeks. Experimental group was treated with concentration (1%) of FF-HA at Joksamni(ST36) for the later 8 weeks(3times/week). Results: 1. The weight and total cells in the mice lung treated with FF-HA decreased significantly compared with that of control group. 2. Total leukocytes and eosinophils in BALF of the mice group treated with FF-HA decreased remarkably compared with those of control group. 3. The sticking of collagen on histological analysis of lung sections, the mice group treated with FF-HA decreased significantly compared with those of Control group. 4. The concentrations of IgE, IL-4, IL-5 in BALF, and IL-4, IL-5, IL-13 in serum of the mice group treated with FF-HA decreased significantly compared with those of control group 5. The number of Gr-l+/CDllb+, CDll+ cells, CCR3+ cells, CD4+ cells, and CD3e+/CD69+ in the lungs of the mice group treated with FF-HA decreased significantly compared with those of control group. 6. The mRNA expression of TNF-a, IL-4, IL-5, IL-13 in the mice group treated with FF-HA with RT-PCR decreased remarkably compared with those of control group. Conclusion : These result suggests that Farfarae Flos Herbal-acupuncture at Joksamni(ST36) in C57BL/6mice may be an effective part to OVA-induced asthma in C57BL/6 mice.

Objectives : To review and summarize the existing evidence on acupuncture treatment for cancer and cancer related symptoms. Methods: Literature searches were made through domestic and international databases. Data were extracted according to pre-defined criteria. The methodological quality was assessed using the Modified Jadad scale. Results: Seven studies were included. Two of the studies were high in methodological quality. One study concerning acupuncture treatment for cancerous dyspnea reported insignificant differences between the treatment group and placebo group. The other study concerning auricular acupuncture for cancer related pain showed significant pain relief compared with the control group. All the other studies were non-blinded or uncontrolled trials. Conclusion : The hypothesis that acupuncture may be effective for the treatment of cancer is not supported by the data in recent clinical trials. More accurately designed randomized control trials (RCT) are needed.

Objectives: This sutdy aims to research the trend of the studies related with acupuncture treatment of asthma. Methods: We searched the electronic database and reviewed ReT studies comparing the effect of sham and real acupuncture published after 2000 Results: We selected eight articles. Effectiveness of asthma acupuncture treatment was generally insufficient. Three articles reported acupuncture to be effective in subjective symptoms and quality of life. Other three articles reported that acupucture treatment was moderately effective but, insignificant compared to sham acupuncture treatment. Some articles reported that acupucture treatment was significant in the decrease of drug dosage and immunologic regulation. Conclusion : For the study on acupuncture treatments in asthma, it is necessary that we conduct research on the various natures of acupuncture. More clinical data would be needed to prove the effects of acupuncture treatment in asthma.

Objectives : This study is to report three cases of the paralytic strabismus by acupuncture and herb medicine. Methods & Results : All patient were treated with Acupuncture and herb medicine, and the symptoms were resolved in 2 cases by above treatment during about 10 weeks. Conclusion : The cases showed proper oriental medical treatment based on the exact differentiation of symptoms had good effect on this disease as one of conservative therapies.