Objectives: This study was to propose a standardized method of retention enema by extracting elements associated with published experimental methods of retention enema. Methods: 1) Literature search (1) Data sources: Retrieval was made, using 'Enema' or 'Retention Enema' as search words in Medline, Cochrane library, KISS, RISS, and KDSL DB. (2) Study selection: Two authors excluded irrelevant papers and chose qualified abstracts from the rest of the papers. The chosen studies were reviewed fully by the authors so that they could screen the significant papers based on the exclusion criteria. (3) Data extraction: Data on the total number of subjects, the target disease, the animal species, the type, quality, length, and diameter of catheter, the insertion length of catheter, the sample, the sample volume, the process of retention enema and the number of retention enemas performed were extracted from the selected studies. 2) Performing preliminary experiments about the elements associated with experimental methods of retention enema. Results & Conclusions: The standardized experimental method is as follows: animal: 280-320g SD rat 1) inserting a rectal tube of 8 Fr that measures 8 cm into the animal's anus, 2) injecting herbal medicines at the volume of 6ml and 3) holding them for 10 minutes.

Objectives: Term standardization is important in every field of study. There have been several attempts to standardize terms in Korean Traditional Medicine (KTM). We undertook a review of Romanized prescription nomenclature of main titles in the Journal of Korean Medicine to analyze the methods of Romanized prescription nomenclature. Methods: We extract Romanized prescription names from Vol. 26, No. 4 to latest Issue Vol. 34, No. 2, Journal of Korean Medicine. Results: The Society of Korean Medicine has guidelines for Romanized prescription nomenclature. However, only 72 out of 142 Romanized prescription names conformed with the guidelines. In addition, 117 out of 142 names were italicized without guideline. Also, there were several ways of marking prescription names. Conclusions: For making information and easy searching of terms, we need normative regulations for Romanized prescription nomenclature by the Society of Korean Medicine.

Objectives: This study investigated the effect of electroacupuncture on swallow function in stroke patients with dysphagia. The purpose was to determine whether electroacupuncture could improve swallow function and quality of life for patients with dysphagia caused by stroke. A pilot double-blind, randomized controlled trial design was used Methods: A total of 17 stroke patients with dysphagia were recruited to this study, 8 assigned to the swallowing electroacupuncture (SE) group and 9 to the control group. Swallowing electroacupuncture was assessed for 5 Hz electrical or sham stimulation for 20 min duration 3 times a week. Outcome measurements were DOSS, 14-item questionnaire from the SWAL-QOL, NIHSS and MBI. Assessment was carried out for baseline, 2 weeks and 4 weeks Results: In the 2 weeks follow up data, the study group showed significant difference in DOSS and SWAL-QOL compared with the baseline. The study group also showed significant difference in DOSS and SWAL-QOL compared with the control group. Similarly in the 4 weeks follow up data, the study group showed improvement tendency in DOSS and SWAL-QOL compared with baseline and also with the control. The NIHSS and MBI scores returned no significant differences. The swallowing electroacupuncture was well tolerated in all cases with no serious adverse effects. Conclusions: The findings from the pilot study indicated that electroacupuncture has significant effects on improvement in swallowing function and quality of life. With both inpatients and outpatients, further larger and longer-term follow-up study is needed to confirm this suggestion.

Objectives: We propose a method to model and represent formulas in Korean medicine information systems. Methods: All the formulas were codified in the form of graphs representing the relationship between a formula and its constituents. To identify a unique formula in a graph, the formula's name, the book in which the formula was written, the book where the formula was extracted, and the page number in the extracted book are used. All the formulas and the relationship between formulas are modelled as an ontology based on graphs. Results: A formula search system was constructed using our ontology, which can represent formula information efficiently by grouping and filtering of formulas. Our formula model was also constructed as a mobile application. Conclusions: The information in our formula search system depends on our ontology. However, our model or our search scenarios could be extended according to formula information.

Objectives: The purpose of this study was to examine whether Temporomandibular Joint Balance Appliance-Golf (TBA-G) can improve postural control ability of healthy adults. Methods: Twenty participants (10 male, 10 female) aged 20 to 39 years were involved. Postural control ability of all participants was assessed before and after applying TBA-G with Balance $Master^{(R)}$ system. Modified clinical test sensory interaction on balance (mCTSIB), unilateral stance, weight bearing and rhythmic weight shift were used to evaluate postural control ability. Results: After applying TBA-G, mCTSIB on a firm plate with eyes open increased from 0.2 to 0.23 (p<0.05) but directional control was improved in slow and moderate velocity of front/back rhythmic weight shift test (P<0.05). In two cases with postural imbalance, most of the postural control measures improved after applying TBA-G. Conclusions: The results suggest that TBA-G could improve balance control ability. A larger controlled trial is needed to determine more accurately the effect of TBA-G on balance control ability.

Objectives: The purpose of this study was to analyze the current status of legal disputes in the Oriental medical clinics and hospitals in South Korea, and to suggest their possible solutions. Methods: Legal dispute cases advised by the Association of Korean Medicine from January 2005 to April 2012 were collected and analyzed. Results: 196 Oriental medical dispute cases were analyzed for the study. Problems in musculoskeletal system and connective tissues (37 cases) were the most common cause of Oriental medical disputes. As per treatment methods related to the dispute, acupuncture (66 cases) and herbal medicine (63 cases) were indicated as the two most common causes. The most common initial problems the patients had at the beginning of their treatment were musculoskeletal system and connective tissues problems (87 cases). Out of 196 dispute cases, only 49 were found to be the fault of Oriental medical doctors. Conclusions: This study can be used as a basis to prevent possible Oriental medical disputes. Subsequent studies should be based on a more comprehensive and extensive range of data.

Objectives: To analyze the growth pattern of the functional food market in Korea, and thus produce essential information in mapping out a strategy for Korean medicine. Methods: A survey of literature or analysis reports about market changes related to functional foods in Korea was undertaken. Results: The Korean functional food market has been growing rapidly, to 1.4 trillion won in 2012 compared to 250 billion won in 2004, which is an annual growth rate of about 14%. In particular, individually-approved functional food is worthy of notice regarding its growth rate and functional position, which is similar to herbal drugs. The expanding growth of functional food affects negatively the decrease of herbal drug industry in Korea to date. Conclusions: To compete with functional foods, the Korean medicine community needs to develop patient-friendly and cost-effective herbal drugs, and strategies to adopt them as therapeutic modalities.

Objectives: This study aimed to analyze the utilization of Korean medical clinics by sex. Methods: Data was based on reports about usage and consumption of Korean medicine in 2011 by the Ministry of Health and Welfare and Korea Institute for Health and Social Affairs. 171 Korean medical hospitals and more than 300 Korean medical clinics were selected after 2 rounds of extraction, from the 12,250 Korean medical institutions throughout the country. The investigation was carried out between August 25 and September 30, 2011. The study group was composed of 290 men and 813 women; Korean medical institutions including clinics and hospitals were mainly used for their health care. Results: 1. For sociodemographic distribution, sex, marital status, education level, occupation status, and income level showed statistically significant differences. 2. Females had a lower subjective health status than did males. Muscle injury, hwa-byung, gastric disorder, lumbago, common cold, weight loss, and herbal tonics showed differences in prevalence rates between the sexes. 3. Arthritis, muscle injury, gastric disorder, ankle sprain, herbal tonics, and stroke showed differences in usage rates between the sexes. Likewise, major treatment methods had differences between the sexes. 4. There were no statistically significant differences between the sexes concerning acupuncture. Conclusions: Females were lower than males in several aspects of income and education level and occupation status. Males had a higher subjective health status than did females. Differences by sex of treatment methods and prevalence rates of several diseases existed.

Objectives: The purpose of this study is to investigate the relationship between bone age, chronological age, anthropometric parameters, and diagnosed pulse rate on child-adolescence's growth according to sex and the revelation of secondary sexual characteristics. Methods: Growth-concerned 44 children and adolescence (from 6 to 16 years) were analyzed in retrospective study. They visited Korean Medical Clinic in Suwon, Korea from January 2012 to October 2013. Individual bone age (BA), chronological age (CA), Risser sign, anthropometric parameters, and pulse rate were measured. The correlations of each variable were done by Pearson analysis, Spearman analysis and Regression analysis. Results: 1. The female group was shown to have stronger negative correlation between pulse rate and BA, CA than the male group. In gender analysis, the female group showed negative correlation between weight and pulse rate. 2. In a further analysis according to the revelation of secondary sexual characteristics, the group of child-adolescent without secondary sexual characteristics was shown to have stronger negative correlation between pulse rate and BA, CA than the group with secondary sexual characteristics. The height percentile and pulse rate were negative correlation in secondary sexual character being. 3. The Risser sign and pulse rate were not correlated in this study. Conclusions: These findings suggested that a regular and continual measurement of pulse rate is effective in estimating potential for growth in child-adolescent group.

Objectives: To provide theoretical basis for the classification of medicinal moxibustion(藥灸劑) in Health Insurance Medical Benefit in Korea through investigating trend of judicial precedents on indirect moxibustion and usage of medicinal moxibustion in "Donguibogam". Methods: We analyzed statistical data of moxibustion from Health Insurance Review & Assessment Service and National Health Insurance Statistical Yearbook. We investigated major judicial precedents on indirect moxibustion to find out some trend and we searched the usages of medicinal moxibustion in "ZhenJiuDaCheng" and "Donguibogam". Results: According to recent judicial precedents, indirect moxibustion with equipment is no loner regarded as Korean Medical Procedure. In composition of 'Oriental Health Treatment', amount for acupuncture has gradually decreased instead, amount for moxibustion has increased steadily for 5 years. Medicinal moxibustion(藥灸劑) is often used as a form of indirect medicinal moxibustion with moxa in "Donguibogam". Argyi Folium, Moschus, Natrii Chloridium, Radix Preparata, Realgar and Olibanum are most frequently used for medicinal moxibustion in "Donguibogam". Medicinal moxibustions are composed of simple prescription or herb-pair or multiple prescription in "Donguibogam". Conclusions: In Health Insurance Medical Benefit in Korea, under the division of moxibustion, direct medicinal moxibustion and indirect medicinal moxibustion should be classified in addition.

Objectives: Evidence-based medicine(EBM) advocates the use of up-to-date "best" scientific evidence from health care research as the basis for making medical decisions. EBM also has been applied to traditional Korean medicine(TKM), especially in the field of safety. Recently, the standard prescription for TKM by Korea Institute of Oriental Medicine was published based on toxic index from various toxicity tests. However, there are some limitations when the results from the study based on EBM are applied in clinics. To overcome these imitations, the term "evidence-based practical medicine" was developed and defined as clinically applicable results from the study based on EBM. And safety classification for TKM was suggested as an example of evidence-based practical medicine. Methods: For safety classification for TKM, the data for $LD_{50}$(50% lethal dose), which was transformed to theoretical $LD_1$(1% lethal dose), was analyzed as one of tools for EMB study and divided by maximum dose used in clinics. Results and Conclusions: As a result, human equivalent dose(HED)-based MOS(margin of safety) for korean traditional medicine was calculated and used for safety classification with 5 categories. These categories would be helpful for oriental medicine clinicians to decide the increase and decrease of dosage according to various factors such as patient's sensitivity, potential toxicity of herbal medicines, clinician's experience for better cure. Thus, this safety classification provides some evidences enough that evidence-based practical medicine should be not the same with EBM and defined differently from EBM.

Objectives: Metabolic syndrome is considered a coronary heart disease risk factor and its prevalence rate is increasing in Korea. Because obesity is relevant to metabolic syndrome, we investigated the relationship between metabolic syndrome and the Obesity Pattern Identification Questionnaire in middle-aged health check-up examinees. Methods: This was a cross-sectional study with 125 patients who visited a health promotion center of university hospital from October 2012 to January 2013. We analyzed the association of Obesity Pattern Identification Questionnaire and the diagnostic criteria of metabolic syndrome. Results: Pi deficiency (脾虛), phlegm (痰飮), liver stasis (肝鬱) and food accumulation (食積) pattern showed significantly highs score in the group with hypertriglyceridemia. Also, females demonstrated significantly high scores of liver stasis (肝鬱) and food accumulation (食積) in the group with hypertriglyceridemia. The questions of Pattern Identification that showed especially significant high score in the group of hypertriglyceridemia are as follows: 'Easily get annoyed', 'Usually worried', 'Frequently overeating or bingeing', and 'Having more after getting full'. There are positive correlations between triglyceride and the score of Pi deficiency (脾虛), phlegm (痰飮) and food accumulation (食積) pattern. Conclusions: Obesity Pattern Identification Questionnaire can be used for the management of hypertriglyceridemia in an effort to prevent metabolic syndrome.

Objectives: The purpose of this study is to evaluate the effects of Metabolic Syndrome care program with Korean Medicine in public health center. Methods: The data were collected from 28 participations who joined Korean Medicine care program. The program was started from April of 2013 and finished November of 2013. The effect of Metabolic Syndrome were evaluated with blood pressure check and blood test, physical test. Results: The number of Metabolic Syndrome patients decreased after the program(-24.9%). Specially TG decreased from 83.321 to 80.036(p<0.05) and FBS also decreased 8.607(p<0.01) after the program. HDL increased from 47.821 to 53.000(p<0.01) but blood pressure didn't change. BMI decreased 0.789(p<0.01) and abdominal obesity decreased 2.607(p<0.01) after the program significantly. Conclusions: From these study, the Metabolic Syndrome care program with Korean Medicine is worthy for treating Metabolic Syndrome.

Objectives: Korean medicine hospitals, since they first emerged in the early 1970s, have rapidly become a new member of the hospital population. As it was a new organizational frame for traditional medicine, we tried to analyze the changes of Korean medicine hospitals coping with institutional environment and their relative positioning in the whole health care sector. Methods: On the basis of Scott and his colleagues' identification of the three components of institutional environments, changes in organizational logics, actors, and governance of Korean medicine hospitals during the period from 1971 to 2010 were analyzed. Results: First, Similar to previous literature on institutional eras of Korean health sector, three distinct periods were characterized: the foundation of Korean medicine hospitals to consolidate the legal status(1971~1986), a rapid increase of entrepreneurial hospitals through cultural-cognitive legitimacy(1987~2001), and the reinforcement of specialization and competition(2002~present). Conclusions: Results suggested that: (1) changes in institutional environments hada heavy impact on structural and behavioral changes among Korean medicine hospitals, but the pace was slower than that of western medicine hospitals. (2) In structure, Korean medicine hospitals have positioned themselves as unofficial long-term care hospitals, focusing on chronic diseases(e.g. cerebrovascular disease). Our study demonstrated that organizational theories can provide useful framework for the analysis of Korean medicine and related policies. Indeed, one of the most important implications of this study is that understanding changes in institutional environments is important to understand the process of how members of the health care sector live, grow, change, decline and survive.

Objectives: The purpose of this study was to develop a standard instrument of diagnosis and assessment for spleen qi deficiency pattern. Methods: Reports published in Korea and China related to spleen qi deficiency pattern were selected. Assessments of selected references were performed to select major symptoms of spleen qi deficiency pattern. Korean translation and review by a Korean linguist were performed to create a draft of [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)]. The final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment on inclusion or exclusion, on importance of items and on validity of translation by an expert committee, consisting of professors from the National College of Korean Medicine. Results & Conclusions: 1. 14 major symptoms were selected by frequency from 45 references which were related to standard identification of spleen qi deficiency pattern, translated into Korean and reviewed by a Korean linguist. 2. 11 symptoms were selected after assessment on inclusion yes or no by the expert group. Items were listed in order of importance: tiredness of extremities (肢体倦怠), sallow complexion (面色萎黃), reduced appetite (食欲减退), abdominal distension after eating (腹胀食後尤甚), inability to eat (納少), pale tongue and white fur (舌淡苔白), lethargy (神疲), emaciation (消瘦), loose stool (大便溏薄), shortness of breath and reluctance to speak (少氣懶言), and weak pulse (脈緩弱). 3. Final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment of translation validity, reflection of individual opinions by the expert committee, and application of weighted value computed from assessment on importance of items.