Objectives: To interpret the meanings of Ryodoraku data and to use it as diagnosis tool, study on relationship between Ryodoraku and autonomic nervous reaction (ANR) has to be preceded prior to disease studies. This study aims to observe the change of Ryodoraku characteristics with ANR caused by treadmill exercise via a feasibility study. Methods: The electric current at 24 Ryodoraku points(H1~H6 at left/right wrists and F1~F6 at left/right feet) and vital signs were measured at rest, immediately after the treadmill exercise test, and at later recovery times(10min, 20min, 30min, 60min, 120min after the exercise test). The calculated Ryodoraku scores (RSs) were analyzed using repeated ANOVA test. Results: The RSs in the wrist Ryodoraku points were significantly increased immediately after the exercise (p<.05) and at 10min recovery time (p<.01), and no significant differences were found during the rest of the experimental sets. To the contrary, the RSs in the feet Ryodoraku points showed less difference throughout all the measurement time. Conclusions: The Ryodoraku characteristics change more sensitively in the wrists than in the feet in accordance with the previously reported sweat gland responses of the treadmill exercise. This is the first feasibility study to observe the change of Ryodoraku characteristics caused by treadmill exercise, and it shows the Ryodoraku characteristics are in accordance with known ANS responses.

Objectives: The objective of this review is to investigate the use of conventional Western medicine (WM) and complementary and alternative medicine (CAM) on leg cramps. Leg cramps are the occurrence of muscular spasm in the leg muscles which occur frequently in the elderly and are frequently observed in the clinical field. Methods: Relevant clinical studies were searched from five medical databases including PubMed, KISS, RISS, OASIS, and J-STAGE. Systematic review, clinical studies, and clinical practice guideline were included in this review. Results: In total, 27 clinical studies, 9 systematic review and meta-analysis, and 1 clinical practice guideline met the inclusion criteria. Included studies were classified and analyzed according to the type of intervention. Studies on quinine and magnesium have been most studied in WM and CAM, respectively. Although quinine shows some clinical effects on leg cramps, however, the risk of side effects are suggested. In addition, magnesium failed to improve the clinically significant effects in most studies. Five case reports using Oriental herbal medicine (OHM) were included and OHMs were effective in improving leg cramps without side effects, however, the quality of evidence was low. Clinical studies on other interventions were lacking. Conclusions: The results of this study indicate that there is no definite treatment standard for leg cramps until now, and there are limitations such as low level of evidence and side effects for each treatment. OHM can be an effective alternative to conventional intervention on leg cramps, therefore, related clinical studies are needed.

Objectives: The purpose of this study was to investigate the effects of Angelica gigas Nakai extract(AGNE) and Bacillus polyfermenticus KJS-2 (BP2) on atopic dermatitis (AD) induced by 2, 4-dinitrochlorobenzene (DNCB) in mice. Methods: In the experiment, we divided mice into four groups: a control group, a DNCB group, an AGNE group, and an AGNE+BP2 group. Then we examined the changes in scratching frequency, clinical aspects on dorsum skin, immunoglobulin (IgE), cytokines ($TNF-{\alpha}$, IL-6) and expression of COX-2. Resutls: From the experiment, the scratching frequency was significantly dropped in AGNE group and AGNE+BP2 group. Clinical observations of dorsum skin, there were a severe keratotic lesion and drop of dead skin cell in DNCB group, but symptoms of AD were decreased 39.6% in AGNE group and 49.6% in AGNE+BP2 group during 3 weeks. IgE, $TNF-{\alpha}$ and IL-6 were decreased significantly in both AGNE and AGNE+BP2 group. Expression of COX-2 was also decreased significantly in both groups. Conclusions: In conclusion, these data suggest that AGNE can decrease symptoms of AD and BP2 makes AGNE more effective. So AGNE can be useful herbal therapy for AD.

Objectives: We performed this study to evaluate the antioxidative and hypolipidemic effect of Artemisia iwayomogi (韓茵蔯), Curcuma longa L. (鬱金) and Raphanus sativus L. (蘿?子) (ACR). Method: We enriched Artemisiae Capillaris, Curcumae Longae and Raphani Semen compound with alcohol. ACR extract is treated to HepG2 cell. Cell groups are devided into 3 groups: normal, control and ACR treated group. We measured polyphenol, flavonoids, DPPH and ABTS radical scavenging activity, ROS, glutathione, GSH peroxidase, GSH reductase, SOD, catalase, free fatty acid, lipid peroxidation and suppression of ACAT1 and HMG-CoA reductase expression on mRNA level. Results: 1. ACR contained polyphenol and flavonoids and increased GSH significantly in HepG2 cell. 2. ACR increased GPx, GR, and catalase activity significantly in HepG2 cell. 3. ACR increased DPPH and ABTS radical scavenging activity significantly in HepG2 cell and decreased ROS. 4. ACR decreased free fatty acid and MDA significantly in HepG2 cell. 5. ACR suppressed ACAT1 and HMG-CoA reductase expression on mRNA level in HepG2 cell. Conclusion: This study suggests that ACR has antioxidative and hypolipidemic effect and might be effective in prevention and treatment of dyslipidemia.

Objectives: This study was performed to evaluate effects of Sochungryong-tang Extract(SRE) on osteoclast differentiation and bone resorptionin order to find out the possibility for clinical use in preventing and treating osteoporosis. Methods: To evaluate the effect of SRE on osteoclast differentiation, we induced RAW 264. 7 cells to be differentiated to osteoclasts by RANKL (receptor activator of nuclear $factor-{\kappa}B$ ligand). We measured effect on TRAP (Tartrate-resistant acid phosphatase), NFATc, cathepsin K, MMP-9, inflammation related factors, histogenesis factors and bone resorption. Results: SRE decreased osteoclast differentiation, and also decreased expression of bone resorbing factors such as MMP-9, cathepsin K, TRAP, NFATc1, MITF, c-Fos, osteoclast stimulatory transmembrane protein, calcitonin receptor in RANKL-induced osteoclast. SRE also decreased Cyclooxygenase-2, indusible nitric oxide synthase, $TNF-{\alpha}$, which are thought to be related with the inflammatory bone destruction. Conclusion: SRE inhibits osteoclast differentiation and bone resorption. The results indicate that the BHT extract can potentially be applied for preventing and treating osteoporosis.

Objectives: The purpose of this study was to investigate the status of Korean medicine treatment, and to analyze problems and demands to provide basic data on Korean medicine in military medical services. Methods: This survey was completed by 30 volunteer Korean medicine military doctors on service via a web-based questionnaire system. The questionnaire was developed through in-depth interviews with Korean medicine military doctors and consisted of general information on the subject, overall characteristics of the medical environment, current status of Korean medicine care in each workplace, problems and needs, and related clinical evidence and education. Results: Korean medicine military doctors administered acupuncture treatment most frequently in clinical practice. The most common complaints were related to musculoskeletal diseases, which accounted for 86.5% of all diseases, including those of the respiratory, digestive, and nervous systems. Most of the problems in Korean medicine care were pointed out as being due to a lack of awareness of Korean medicine in the military. Many doctors were aware that it is necessary to establish clinical evidence for Korean medicine in the military, and were also positive about the possibility of performing clinical research in the military, but the experience of actual participation in clinical research or related education was uncommon. Conclusions: Korean medicine military treatment differs from private medical care due to the specificity of each workplace and the military medical system. In the future, it will be necessary to establish an appropriate Korean medicine treatment model in the military suitable for these characteristics and strategic plans for clinical evidence.

Objectives: The purpose of this clinical research was to investigate the effects of herbal cosmetics containing Caffeic acid phenethyl ester (CAPE), an ingredient compound of various herbs including Vespae Nidus, on the Whitening Effects. Methods: A total of 20 subjects who visited Pusan National University Hospital from March 2nd, 2017 to April 11th, 2017 were included. In this study, we evaluated the visual evaluation, the melanin index (M) and erythema index (E) through skin analysis equipment, the subjective whitening improvement analysis, and the adverse reaction according to product use. Statistical analysis was performed with independent t-test and Mann-Whitney's U test. Statistical significance was achieved if the probability was less than 5% (p<0.05) Results: As a result of the visual evaluation, it was effective in improving skin whitening. The subjective whitening improvement analysis also showed positive results. However, no statistically significant differences were found between the test and control cosmetics in the melanin index (M) and erythema index (E) through skin analysis equipment. In the safety evaluation, some adverse reactions were reported, but no significant were observed directly from cosmetics. Conclusions: Considering the above results, we have confirmed the possibility of herbal cosmetics containing containing CAPE of Vespae Nidus Extracts.

Objectives: The purpose of this study was to investigate the effects of Korean Medicine on postural instability and gait difficulty(PIGD) in patient with parkinsonism. Methods: We reviewed the charts of patients with parkinsonism who were admitted to the department of Korean internal medicine, stroke and neurological disorders center, Kyung Hee University Hospital at Gangdong from October 2009 to May 2017. We analyzed the data of UPDRS (Unified Parkinson's disease rating scale) and calculated PIGD related UPDRS before and after the admission. Results: The average of PIGD score for the 23 patients of Parkinsonism significantly decreased from $8.35{\pm}5.13$ to $4.52{\pm}3.68$ after treatment. The average of PIGD score for the 16 patients of idiopathic parkinson's disease and 7 patients of atypical Parkinsonism decreased from $9.13{\pm}4.46$ to $4.63{\pm}4.15$ and from $6.57{\pm}6.45$ to $4.29{\pm}2.56$ after treatment, respectively. Conclusions: These results provide that Korean Medicine has an effect on the motor function of patients who suffer from Parkinsonism with Postural Instability and Gait Difficulty. Furthermore it could be effective for improving activities of daily life.

Objectives: The purpose of this study was to examine trends in duplicate publication in Korean medical articles indexed in the Oriental Medicine Advanced Searching Integrated System(OASIS). Methods: We searched the list of papers published in Korean medical journals by using OASIS. We randomly extracted 10% of total articles (n=1,162). We searched using OASIS by entering keywords from the title and names of the first and last authors of each indexed article. After the librarian selected the candidates of duplicate publication, three authors reviewed the full texts of the articles independently. When their opinions were not in agreement, reconciliation was made by discussion. The patterns of duplicate publication, such as copy, salami slicing (fragmentation), and aggregation (imalas), were also determined. Results: A total of 1162 articles were evaluated, 24 (2.1%) index articles of which were duplicate articles. Among 24 index articles, Two were triple publications and 22 were double publications. The patterns of duplication publication were as follows; (1) copy (n=8, 33.3%); (2) salami (9, 37.5%), (3) imalas (5, 20.8%) (4) others (2, 8.3%). Conclusion: Duplicate publications have appeared in Korean medical journals in a small proportion. Education on publication ethics and authors'ethical awareness is needed.

Objectives: To develop and investigate the reliability of the pathologic aging scale based on korean medical theory and korean medical pattern identification for dementia. Methods: We searched the textbook of korean neurophychiatry and Donguibogam and selected items through professional consensus. We compared between dementia(n=40) and normal elderly(n=38) and tested the reliability of two scales. Results: After professional consensus, we drafted the Korean Medical Pathologic Aging Scale(12 items, Likert 3 scale) and Korean Medical Pattern Identification for Dementia(4 patterns, 28 items, Likert 5 scale). On Korean Medical Pathologic Aging Scale, There is no significant difference between two groups. We had good internal consistency(Cronbach's alpha = 0.6) and test-retest reliability(r=0.631) but low inter-rater reliability(r=0.430). On Korean Medical Pattern Identification for Dementia, dementia patients diagnosed with Qi deficiency are significantly more than those in normal group. We had fairly good internal consistency(Cronbach's alpha = 0.574) and excellent test-retest(kappa= .800) and inter-rater reliability(kappa = .733). Conclusions: Korean Medical Pattern Identification for Dementia is appropriate for diagnosing korean medical pattern. But Korean Medical Pathologic Aging Scale isn't appropriate to discriminate dementia from normal elderly because of many subjective items. Therefore objective measurement of sensory dysfunction would be needed to measure pathologic aging based on korean medical theory.

Objectives: This study aimed to learn what should be considered in [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer)] by analyzing the existing guidelines and clinical trials. Methods: The development committee searched guidelines for herbal medicinal product or gastric cancer developed already. Then, clinical trials for gastric cancer using herbal medicine were searched. The searched trials were analyzed in terms of inclusion and exclusion of participants, intervention, comparator, outcomes and trial design. Then, we compared the results of analysis with the regulations and guidelines of Ministry of Food and Drug Safety to suggest the issue that we will have to consider when making the [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer]. Results: As a result, few guidelines for anti-tumor agent and clinical trial with herbal medicinal product were searched in the national institution homepage. In addition, 10 articles were searched by using the combination following search term; 'stomach neoplasm', 'herbal medicine', 'Medicine, Korean traditional', 'Medicine, Chinese Traditional', 'TCM', 'TKM', 'trial'. Most trials included gastric cancer participants with medical history of operation. The type of intervention was various such as decoction, granules, and fluid of intravenous injection. Comparators were diverse such as placebo, conventional treatment including chemotherapy and nutritional supplement. The most frequently used outcome for efficacy was quality of life. Besides, the symptom score, tumor response, and survival rate were used. Safety was investigated by recording adverse events. Conclusion: We found out some issue by reviewing the existing guidelines and comparing it with clinical trials for gastric cancer and herbal medicinal products. These results will be utilized for developing [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer].

Objectives: The aim of this study was to investigate the current status of and seek for measures to activate Korean medicine in stroke care. Methods: This is an e-mail survey targeting the members of Korean medical doctors registered at the association of Korean medicine. The project team of the society of stroke on Korean medicine for the development of clinical practice guideline for stroke has devised the items for the questionnaire. The survey was conducted for 15 days in November 2016. Results: The percentage of the respondents who have treated patients with stroke for the past month was 11.2% in the acute phase, 20.5% in the convalescent phase, and 32.4% in the chronic phase. Approximately 80% of the respondents answered they had a decrease in the number of patients compared to 10 years ago, regardless of the stroke phase. Most of the respondents were using Western medicine together with traditional Korean medicine for physical examination. Acupuncture and herbal medicine were the main therapeutic interventions. The two measures chosen by the most respondents to activate the Korean medicine usage for stroke care were the expansion of the insurance coverage (34.9%) and the generation of evidence on the effectiveness of traditional Korean medicine (25.1%) Conclusion: It is necessary to actively show the role of the Korean medicine through the establishment of the evidence on the effectiveness of Korean medicine and the promotion based on the evidence. In addition, optimal treatment methods should be derived based on the traditional knowledge and modern scientific research and the methods should be educated to every Korean medical clinics and hospitals so that they can be implemented in clinical practice. At the same time, the government should provide policy support to ensure that the optimal treatment can be timely and appropriately implemented.

Objectives: Health in adolescent is very important in the whole life. But, students in Korea are very busy and hard to care about their health. This study is aimed to effectiveness and safety of effectiveness of School Doctor program in Korean Medicine. Method: From august to december, 2015, Korean medicine association in Sungnam city conducted school doctor program for 12 middle and 8 high school. School doctor visitied 8 times and treat, lecture and consulting for students and teachers. The number of students participating in health lecture is 1,905. The number of students participating in the school project was 147 students in junior high school and 187 students in high school, totaling 334 students. Results: The overall satisfaction rate of students was very high (83.2%) for school doctor program in Korean medicine. 92.8% of respondents answered that they should continue to school doctor program in Korean medicine. Conclusions: We find that Korean medicine is suitable for the school doctor program. But this study have some limitations. Large-scale prospective study will be needed.

Objectives: The objective of this study was to summarize randomized clinical trials (RCTs) that have assessed efficacy and safety of mahuang and ephedrine on treatment of obesity and to propose better process of study. Methods: NLM Medline (pubmed), the Cochrane library, Scopus, Science Direct, RISS, KISS were systemically searched for clinical trials investigating the efficacy, safety of mahuang and ephedrine on treatment of obesity from 2000 to 2017. Results: 16 RCTs met all the inclusion criteria. In most reports, mahuang and ephedrine significantly reduced body weight, body fat mass. There were no serious adverse events associated with mahuang and ephedrine in all studies. Conclusions: In appropriate dose of mahuang and ephedrine for healthy adult was safe, and weight loss effect of mahuang and ephedrine was better than control group. Improved clinical practice guidelines should be developed for safe use of mahuang and ephedrine.

Backgrounds: Inpatient Classification System for Korean Medicine (KDRG-KM) was developed and has been applied for monitoring the costs of KM hospitals. Yet severity of patients' condition is not applied in the KDRG-KM. Objectives: This study aimed to develop the severity classification methods for KDRG-KM and assessed the explanation powers of severity adjusted KDRG-KM. Methods: Clinical experts panel was organized based on the recommendations from 12 clinical societies of Korean Medicine. Two expert panel workshops were held to develop the severity classification options, and the Delphi survey was performed to measure CCL(Complexity and Comorbidity Level) scores. Explanation powers were calculated using the inpatient EDI claim data issued by hospitals and clinics in 2012. Results: Two options for severity classification were deduced based on the severity classification principle in the domestic and foreign DRG systems. The option one is to classify severity groups using CCL and PCCL(Patient Clinical Complexity Level) scores, and the option two is to form a severity group with patients who belonged principal diagnosis-secondary diagnosis combinations which prolonged length of stay. All two options enhanced explanation powers less than 1%. For third option, patients who received certain treatments for severe conditions were grouped into severity group. The treatment expense of the severity group was significantly higher than that of other patients groups. Conclusions: Applying the severity classifications using principal diagnosis and secondary diagnoses can advance the KDRG-KM for genuine KM hospitalization. More practically, including patients with procedures for severe conditions in a severity group needs to be considered.