Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on post-stroke spasticity, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

Objectives: Realgar has been frequently used for skin disorders in history of herbal medicine. However, the efficacy of realgar has not been examined in atopic dermatitis(AD). In this study, the effects of realgar on AD were investigated, especially on pruritus and inflammation. Methods: AD lesions were induced in the shaved backs of BALB/c mice through repeated application of DNCB. The mice were treated for 11 days with 1% realgar ($100{\mu}L/day$). Histological changes in skin thickness were observed. The anti-pruritic effects of realgar were evaluated by the change in numbers of scratching behavior of mice and expression of substance P. The expressions of cytokines IL-4 and IL-6 were measured. Also, anti-inflammatory effects of realgar were examined on expressions of NF-${\kappa}B$, phospho-$I{\kappa}B{\alpha}$ and mitogen-activated protein kinases (MAPKs). Results: Realgar decreased skin thickness (both dermal and epidermal) 38% and 17% respectively, compared to positive control, DNCB group. The scratching behavior of mice was reduced by 42% and expression of substance P was significantly less. Cytokines IL-4 and IL-6 were significantly reduced by 52.6% and 77.6%, respectively. The expressions of NF-${\kappa}B$, phospho-$I{\kappa}B{\alpha}$ and MAPKs (phospho-ERK1/2, -p38 and -JNK) were significantly suppressed with marked effects on phospho-ERK1/2. Conclusions: The collective results suggest that realgar shows anti-pruritic and anti-inflammatory effects on AD. And realgar might be a potential therapeutic candidate for treatment of atopic dermatitis.

Objectives: This study researched the effect of Gamisoyo-san intravenous pharmacopuncture on restoration of liver function after partial hepatectomy in SD rat. Methods: Twelve rats were randomly divided into three groups: control group (n=4) underwent partial hepatectomy, saline group (n=4) was injected $1m{\ell}$ saline after partial hepatectomy, Gamisoyo-san group (n=4) was injected with 10mg/kg Gamisoyo-san after partial hepatectomy. Liver function and liver regeneration ratio were measured on the seventh day after partial hepatectomy. Results: The results show that the AST, AST and ALT level in Gamisoyo-san group was significantly lower than those of control group and saline group(P<0.05) Conclusion: In partial hepatectomy model, Gamisoyo-san intravenous pharmacopuncture seems to significantly promote the restoration of liver function.

Objectives: The aim of this study was to understand the characteristics of herbal-drug-associated adverse events (AEs) reported in the internet newspaper articles and to take a countermeasure against the safety issue of herbal drugs. Methods: We searched the internet newspaper articles published from 2010 to 2014 in the 3 major portal sites in Korea, NAVER, DAUM, and GOOGLE. Search terms were the Korean words equivalent of 'herbal drug' and 'side effects'. Informations on the type and characteristics of suspected herbal drugs, AEs, and the patient records were extracted from the articles reporting the herbal-drug-associated AE occurred in Korea. Results: From 8,806 articles, a total of 36 AEs were found. The most frequently reported age group was 20s, and women outnumbered men. Obesity was the most common cause of administration. Doctors of Korean medicine clinic were the most commonly referred prescribers and purchasing route (11 cases). The most frequently mentioned medicinal herb was Ephedra sinica (7 cases) and the most commonly reported AEs were abdominal pain (8 cases), dizziness (6 cases), diarrhea (5 cases), and vomiting (5 cases) were followed in order. Ten cases were judged as serious AEs, and the others were not. Conclusions: Current customers demand health care providers to offer them sufficient information on the safety of herbal drugs. To satisfy their requirements, physicians of Korean medicine should be able to explain, predict, prepare, recognize, and deal with the herbal-drug-associated AEs. We propose an establishment of pharmacovigilance system for herbal medicine, in which doctors of Korean medicine are participated as important personnel, to collect and analyze the related AEs and offer credible information on the safety of herbal drug.

Objectives: The purpose of this study was to understand the status of reporting and characteristics of adverse drug reactions (ADRs) induced by herbal drugs and to make a suggestion for the domestic pharmacovigilance system on herbal medicine. Methods: We carried out a hospital-based observational study at Dongguk University Ilsan Oriental Hospital from April 2012 to December 2014. We reviewed all the herbal-drug-associated ADRs reports registered to the spontaneous ADR reporting system in electronic medical records of the hospital in the period. Results: We found out 101 reports including 163 herbal-drug-associated ADRs from 97 patients. Females (69.3%) outnumbered males and the most frequent age group was the 50s (44, 27.0%). No serious adverse event was observed. The most commonly reported ADR was gastro-intestinal system disorders (68, 41.5%) followed by skin-related disorders (42, 25.8%). Diarrhea (29, 17.8%) was the most frequently referred clinical manifestation. Most ADRs were induced by internal medicines (160, 98.2%) including manufactured (36, 22.1%) and self-prepared decoction (160, 76.1%). The pairs of Igi-hwan-diarrhea, gamiboa-tang-vomiting, and Magnoliae Flos-gastro-intestinal-system-related ADRs were observed twice each and the others appeared only once. Conclusions: We propose Korean government to take an initiative in national pharmacovigilance system for herbal medicine. To perform the surveillance on herbal drugs, the Association of Korean Medicine (AKOM) should set up a nationwide network by designating centers connecting the Korean medical hospitals, local Korean medicine clinics, and the public health centers. The government and AKOM should also educate and encourage them to understand the pharmacovigilance system and report the ADRs actively.

Objectives: The main purpose of this study is to find a solution for modernized classification of herbal medicinal preparations in dual medical systems. Through this study, we expect to provide a reasonable foundation of herbal medicine for public health. Methods: We studied legal or technical terms of herbal medicinal preparations from the past regulations, and through this procedure, we could suggest clear definitions of terms for herbal medicinal preparations. We also investigated documents for approval of herbal medicinal preparation from US, EU(European union), The People's Republic of China, Japan, so that we can refer to them to revise regulation for appropriate use of herbal preparations. Results: In Korea pharmaceutical affairs act, any basis of 'Crude drugs' does not exist. But in some subordinary notifications, the way that they use the 'Natural product medicine' is used as a means of limiting basic rights of doctor or pharmacist of Korean medicine compared to doctor or pharmacist. At the same time, in subordinary notifications, provisions are vague and not enough for scientific evidence of Korean medicine. Thus, we re-categorized herbal medicinal preparations into new drugs, drugs made from herbal medicinal preparations and suggested requirements for drug approval. Conclusions: Instead of using the term 'Crude drug preparations', and we should use term 'Herbal medicinal preparations' in related act and notification. And also we suggest to amend subordinary regulations and documents for approval of herbal medicinal preparations. Through this, we can make herbal medicinal preparations be more industrialized.

Objectives: Type 2 diabetes mellitus is a metabolic disease characterized by insulin resistance and high blood glucose level from progressive insulin secretory defect. The rhizome of Atractylodes japonica Koidz. (AJ) has been used for treatment of retention of water in oriental medicine. The aim of this study is to examine the effects of AJ on type 2 diabetes rats. Methods: Type 2 diabetes was induced by 60% high fat diet and low dose streptozotocin. Rats were divided into 4 groups (n = 6); Nor (normal control group), Con (diabetic group treated with vehicle), Met (diabetic group treated with 200 mg/kg metformin) and AJ (diabetic group treated with 100 mg/kg AJ). The body weights and food intakes were measured during the treatment period. After 4 weeks treatment, blood glucose level, HOMA-IR, and protein expressions of IRS-1, p-IRS-1, PPAR-${\gamma}$, and GLUT4 were measured, and histopathological examination of beta cell was performed. Results: Compared with the control group, blood glucose level and HOMA-IR were reduced in rats treated with AJ. Impaired beta cells in pancreas of rats were recovered and phosphorylation of IRS-1 was increased in rats treated with AJ. And also, protein expressions of PPAR-${\gamma}$ and GLUT4 were increased by treatment of AJ. Conclusions: The results suggest that Atractylodes japonica Koidz. may have anti-diabetic effect on type 2 diabetic rats through regulation of blood glucose level and insulin resistance. Therefore Atractylodes japonica Koidz. may have positive effects on patients with type 2 diabetes.

불면을 동반한 건선(乾癬) 환자(患者)에게 불면과 건선(乾癬)의 경중이 비례하는 양상을 보인 환자(患者)에게 불면을 치료(治療)하면 건선(乾癬)이 회복될 것으로 판단되었다. 이와 관련하여 심혈부족(心血不足)이 불면의 원인(原因)이라고 판단되는 건선(乾癬) 환자(患者)에게 귀비탕(歸脾湯)을 투약해서 불면과 건선(乾癬)이 동시에 회복되는 결과(結果)를 확인했다. 아직 명확한 건선(乾癬) 치료(治療) 지침이 확립되지 않은 상황에서 건선(乾癬) 자체를 보고 접근해야 하는 경우도 있지만 건선(乾癬)과 동반된 기저 질환이 건선(乾癬)의 경중과 비례한다면 동반된 질환을 치료(治療)해서 건선(乾癬)을 치료(治療)할 수 있다는 가능성을 얻었다. 앞으로 건선(乾癬) 환자(患者)가 다른 기저 질환을 동반하고 이러한 질환의 경중이 건선(乾癬)과 비례한다면 이 질환의 치료(治療)를 시도하는 것이 건선(乾癬)의 회복에 도움을 줄 수 있을 것으로 보인다.