Objectives: To establish the expiration date of herbal decoction pouch, the change in antimicrobial activities was measured according to storage temperature and period. Methods: Five herbal formulas, Gyeji-tang, Jakyakgamcho-tang, Saengmaek-san, Paljung-san, and Dangguisu-san, with antimicrobial activity were selected from 51 herbal formulas commonly used in traditional Korean medical institutions. Five herbal formula decoction pouches were prepared and stored at room temperature (RT) or 4℃ from 0 to 12 weeks to evaluate the antimicrobial activity against Bacillus cereus, Listeria monocytogenes, or Vibrio parahaemolyticus. The antimicrobial activities were evaluated by the disk diffusion method (disk size: 10 mm). Results: The decoction pouches of Gyeji-tang and Jakyakgamcho-tang maintained antimicrobial activity against V. parahaemolyticus from week 0 (14 mm) to week 12 (14 mm) at both temperatures. Saengmaek-san pouch had antimicrobial activities against V. parahaemolyticus and B. cereus from week 0 (19 mm and 20 mm) to week 12 (both 18 mm), respectively. At RT and 4℃, the antimicrobial activity of Paljung-san pouch was maintained week 0 (17 mm) to week 12 (both 13 mm) against B. cereus. Against L. monocytogenes, the antimicrobial activity of Dangguisu-san pouch showed 27 mm at week 0 and 23 mm (RT) and 24 mm (4℃) at week 12, respectively. Conclusion: According to increase of the storage duration, the antimicrobial activities of 5 herbal formula decoction pouches decreased slightly but remained up to 12 weeks. These results can be used as important data to establish the expiration date of herbal formula decoction pouches.

Objectives: The purpose of this study is to consider the concept of Meridian Points(經穴) and to establish the directions in further research. Methods: First, based on the latest results from the researches of Meridian and Collateral(經絡), it was to infer the original concept of Meridian Points(經穴). Second, the meaning of Meridian Points(經穴) has been investigated and its directions in further research was studied founded upon Symbolic Mathematical Study(象數學). Results ＆ Conclusions : Firstly, Meridian Points(經穴) are considered to be the source of information that contains 365 numbers of human physiological information which includes physiological information of Viscera and Bowels(藏府) and Meridian and Collateral(經絡). Secondly, advanced researches are required further to clarify the meaning of Meridian Points(經穴) as Symbolic Mathematical Study(象數學) has established the systems of Meridian Points(經穴). In addition, the efficacy of each Meridian Points(經穴) needs to be revised through literature studies. Clinical studies are essential to practically verify the results from the former theoretical research. Thirdly, the contention to oppose the presence of Meridian and Collateral(經絡) and Meridian Points(經穴) was acknowledged to be incorrect. Lastly, for broadening the theoretical systems of Korean Medicine(韓醫學) with integration of Western scientific knowledge, a paradigm shift is necessary to revise the concepts of Viscera and Bowls(藏府), Meridian and Collateral (經絡) and Meridian Points(經穴) in Korean Medicine(韓醫學). In order to accomplish the shift, the ambiguity in theories of Korean Medicine(韓醫學) should be clarified through the study of Symbolic Mathematical Study(象數學).

Objectives: To investigate the prevalence of pain, clinical characteristics of pain, association between clinical features and pain of patients with Parkinson's Disease(PD). Methods: We undertook a retrospective review of the medical records of patients diagnosed with PD between 2012 and 2019 at Kyung Hee University Korean Medicine Hospital at Gangdong in South Korea. Results: A total of 172 PD patients met entry criteria and 147 out of 172 patients(85.5%) reported pain. In comparison with general population, PD patients has high prevalence of pain. Female PD patients more frequently reported pain than male (P=0.03). 102 out of 147patients(69.3) complained of musculoskeletal pain, and musculoskeletal pain show significant difference depending on the PD motor subtypes (P=0.039). Pain was mainly locatedin the leg (57.8%) in all PD motor subtypes. Tremor-dominant PD more frequently felt pain in upper limb than postural instability-gait difficulty dominant(PIGD) PD, but it was not statistically significant. Conclusions: These findings showed high prevalence of pain in PD patients, the correlation between female and pain, and the relationship between PD motor subtype and pain type. Our study can contribute to the clinical approach based on a more in-depth understanding of PD patients with pain.

Background and Objectives: The purpose of this study was to examine the relationship between between one's quality of life (QoL) level and the arterial stiffness estimated by the second derivative of photoplethysmogram (SDPTG) for women patients. Methods: A retrospective chart review was performed on charts of 407 women patients (38.38±11.82 years) who visited Gangdong Kyung Hee Hospital between April 1st and September 30th, 2011. Vascular aging index (VAI, (b-c-d)/a), b/a, c/a, and d/a were considered as the arterial stiffness indexes, and the Korean version of the Short-Form 36 (SF-36) were completed to estimate one's physical and mental QoL. Results: Physical and mental components of the SF-36 in older group (50, 60, and 70 years-group) were lower than those in younger group (20 and 30 years-group). Large arterial stiffness-related b/a in older group was higher that in younger group, while small arterial stiffness-related d/a in older group was lower that in younger group. Physical and mental component scores of the SF-36 had the negative correlations with VAI and b/a (r; -0.153~-0.195), while had the positive correlations with c/a and d/a (r; 0.147~0.228). Conclusions: In conclusion, this study suggests that convenient and cost-effective SDPTG test may serve as an auxiliary tool to estimate one's physical and mental QoL.

Objectives: The purpose of this study was to investigate the effect of Phellinus linteus cheonghyeol plus (PLCP) on antioxidant and inhibition of inflammatory factor expression associated with dyslipidemia in HUVEC. Methods: The scavenging activity of DPPH and ABTS radical of PLCP was measured in HUVEC. The expression levels of NF-κB, p-IκBα, ERK, JNK, and p38 proteins were measured after treating with TNF-α in HUVEC. The expression levels of MCP-1, ICAM-1, and VCAM-1 mRNA and biomarkers were measured after treatment with TNF-α in HUVEC Results: 1. PLCP increases DPPH and ABTS radical scavenging activity in a concentration dependent manner. 2. PLCP significantly decreased the concentration of NF-κB, p-IκBα, ERK, JNK protein compared to the control at concentrations of 100 ㎍/㎖ or more, and significantly decreased concentration of p38 protein at all concentrations. 3. PLCP significantly decreased MCP-1 mRNA expression levels at 100㎍/㎖ or more compared to the control. ICAM-1 and VCAM-1 mRNA expression levels were significantly reduced at all concentrations compared to the control. MCP-1, ICAM-1 protein expression levels were significantly reduced compared to the control at concentrations of 100 ㎍/㎖ or more, and VCAM-1 protein expression levels were reduced at all concentrations. Conclusions: These results suggest that PLCP has an antioxidant effect, and it has been experimentally confirmed that it can prevent or inhibit inflammatory diseases caused by dyslipidemia due to its inhibitory effect on inflammation-related factors in HUVEC.

Objectives: The purpose of this study is to predict the weight loss by applying machine learning using real-world clinical data from overweight and obese adults on weight loss program in 4 Korean Medicine obesity clinics. Methods: From January, 2017 to May, 2019, we collected data from overweight and obese adults (BMI≥23 kg/m2) who registered for a 3-month Gamitaeeumjowi-tang prescription program. Predictive analysis was conducted at the time of three prescriptions, and the expected reduced rate and reduced weight at the next order of prescription were predicted as binary classification (classification benchmark: highest quartile, median, lowest quartile). For the median, further analysis was conducted after using the variable selection method. The data set for each analysis was 25,988 in the first, 6,304 in the second, and 833 in the third. 5-fold cross validation was used to prevent overfitting. Results: Prediction accuracy was increased from 1^st to 2^nd and 3^rd analysis. After selecting the variables based on the median, artificial neural network showed the highest accuracy in 1^st (54.69%), 2^nd (73.52%), and 3^rd (81.88%) prediction analysis based on reduced rate. The prediction performance was additionally confirmed through AUC, Random Forest showed the highest in 1^st (0.640), 2^nd (0.816), and 3^rd (0.939) prediction analysis based on reduced weight. Conclusions: The prediction of weight loss by applying machine learning showed that the accuracy was improved by using the initial weight loss information. There is a possibility that it can be used to screen patients who need intensive intervention when expected weight loss is low.

Objectives: The purpose of this study is to assess the quality of the Journal of Korean medicine case reports. Methods: Case reports published in the Journal of Korean Medicine from January 2015 to March 2020 were selected by using Oriental Medicine Advanced Searching Integrated System (OASIS) and the journal search system of the Korean Medical Association (https://www.jkom.org). The quality of the case reports was assessed using the Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines. Results: 33 case reports were selected for the assessment. Based on the CARE guidelines, 61.54% of the case reports included necessary information, but the quality level was uneven. More than 60% of the reports were missing data regarding 'Discussion of the strengths and limitations in your approach to this case', 'Intervention adherence and tolerability', 'Timeline', 'Medical, family, and psychosocial history including relevant genetic information', 'Patient perspective or experience', 'Adverse and unanticipated events', 'Administration of intervention', and 'De-identified demographic information and other patient specific information'. In most reports of over 90%, data regarding 'Diagnostic challenges', 'Intervention adherence and tolerability', and 'Key word' were not included. Conclusions: Efforts are needed to improve the quality of case reports in the Journal of Korean Medicine, and it is necessary to develop appropriate guidelines for case reporting for the Journal of Korean Medicine. In addition, all articles submitted to the Journal of Korean Medicine are to be complied with submission instructions and CARE guidelines.

Objectives: The purpose of this study was to research the demographical and gynecologic characteristics, quality of life, and analyze the pattern identification in female patients with cold hypersensitivity of hands and feet. Methods: 112 participants were recruited from May 2018 to April 2019 from three korean medical hospitals. The data was composed of general characteristics, degree of coldness of hands and feet, gynecological questionnaire, score of WHOQOL-BREF and pattern identification. We divided data into 2 groups: The group of patients who meet the criteria for diagnosis of coldness on feet and the group of patients who meet the criteria for diagnosis of coldness on feet and hands. We tried to compare data by groups using Excel 2016 for windows and SPSS for windows (Ver. 23.0). Results: Throughout the study, we found differences between 2 groups in weight, body mass index (BMI), VAS score of cold hypersensitivity on feet, temperature of PC8, ST32, and pattern identification. Conclusions: After the study, we confirmed that even though both groups suffer from cold hypersensitivity of hands and feet, they show clinical differences in each group and differences in pattern identification.

Objectives: The purpose of this study was to identify the characteristics of patients who visited the emergency room (ER) of a Korean medicine (KM) hospital and to provide basic data for further research. Methods: We conducted a retrospective analysis using electronic medical records of 263 patients who visited the ER of OO University Oriental Hospital from January 1 to December 31, 2019. Results: Of the 263 patients' medical records, 245 were included in this analysis. The male-to-female ratio was 1.09:1. The average age was 52 years, with patients in their 40s having the largest distribution. The district where the hospital was located had the largest number of patients. The distribution by visit time was the lowest in the early morning. Most patients visited on Sunday, in September, and on the day of onset. The admission rate was 39.18%, and largest number of patients was admitted to the Department of Acupuncture and Moxibustion. The percentage of patients who revisited the KM hospital as an outpatient were 26.17%. The diagnosis for most patients was musculoskeletal disease. Acupuncture was the most common treatment, accounting for 62.45% of the cases, followed by herbal medicines, accounting for 54.69% of the cases. National health insurance was the most common type of insurance registered. Most patients visited the ER of the KM hospital via the ER of the hospital. Conclusions: This clinical analysis helped us identify the characteristics of patients visiting the ER of a KM hospital. Continuous data accumulation is required in relation to this for further studies.

Objectives: A case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. The purpose of this study is to evaluate the quality of case reports from the Journal of Korean Medicine by the CARE (CAse REport) Guideline. Methods: Case reports published in the Journal of Korean Medicine from January 2016 to March 2020 were searched from Oriental Medicine Advanced Searching Integrated System (OASIS). We assessed the quality of reporting based on CARE (CAse REport) guideline as 'Sufficient', 'Not-Sufficient' and 'Not-Report'. Results: A total of 22 case reports were finally included for the assessment. The reporting items were reported as of reporting quality. After checking the result, there was a deviation in the sub-item reporting rate by a maximum 89.29%, a minimum 66.67% and a median 82.14% in case reports. Also after checking the quality in case reports by 28 detailed items in CARE guidelines, there were not reported 77% or more in the 5 sub-items 'Intervention adherence and tolerability', 'Informed consent', 'Adverse and unanticipated events', 'Diagnostic challenges', 'Patient perspective'. Conclusion: There is a need to improve the quality of case reports in the journal of Korean Medicine based on various studies using CARE guideline.

Background: Opioids are a class of drugs found in the opium poppy, and used primarily as a pain reliever. About 130 people die every day from opioid abuse in the U.S., and the number of deaths was 6 times higher than it was 20 years ago. Objectives: To derive the implications on Korean Medicine(KM), this study aimed to investigate the current state of opioids abuse in the U.S. and analyze cases to solve opioids abuse using acupuncture. Methods: Literature on opioids abuse in the U.S. were searched through the websites of government, agency, and research institute. Results: There were several cases using acupuncture on opioids abuse. First, the Act on the use of acupuncture was enacted. Second, the clinical practice guidelines by the American College of Physicians recommended using acupuncture. Third, a large clinical study was conducted on whether acupuncture could replace opioids. Fourth, Vermont and Washington State conducted pilot projects on insurance coverage of acupuncture. Conclusions: As opioids issues are also valid in Korea, KM can serve a critical role in pain management to pursue expanded insurance coverage. In order to do so, building the discourses of KM in opioid issues is critical by defining its medical advantage, conducting large-scale clinical researches and implementing pilot projects to tackle social problems.