Objectives: Neuralgia-pharmacopuncture (NP) was recently developed as a water-soluble type of pharmacopuncture inspired by CS (care special pain)-pharmacopuncture. I aimed to evaluate the toxic response and approximate lethal dose of when NP when administered intramuscularly to Sprague Dawley rats. Methods: The experimental group was divided into the NP test substance group and the saline control group and administered at a dose of 1.0 mL/animal to the posterior thigh muscles on both sides using a 1 mL syringe; each group consisted of five males and five females. Each rat was monitored for clinical signs and changes in body weight for 14 days after a single intramuscular injection. After completing observation, necropsy findings and localized tolerance at the injection site were assessed via gross necropsy and histopathological examination. Results: No deaths occurred in the NP or control group, regardless of sex. During the observation period, no changes (such as general symptoms, weight change, or visual observation results at the time of autopsy) were judged to be due to the test substance. Histopathological examination showed no changes at the administration site judged to be caused by the test substance in either the male or female test substance administration groups. In addition, mononuclear cell infiltration of the outer membrane of the femoris muscle at the administration site was observed at the same frequency and extent in the control and NP groups, and was judged to be caused by physical stimulation by the injection needle; therefore, it had no toxicological significance. Conclusion: Based on the above results, the approximate lethal dose for a single intramuscular administration of the test substance NP in Sprague-Dawley rats was judged to be > 1.0 mL/animal, and there were no findings that were judged to be due to the test substance at the administration site.
Objectives: This study aims to evaluate the efficacy of urinary incontinence treatment using catgut embedding therapy. Methods: Using electronic databases including Pubmed, EMBASE, and CAJ, we looked for randomized controlled trials that treated urinary incontinence with catgut embedding that were published between January 2000 and December 2023. The chosen clinical studies' interventions and outcomes were examined. Results: Ultimately, eight randomized controlled trials met the inclusion and exclusion criteria. Treatment group was treated with catgut embedding alone in 3 studies, and with Biofeedback Electrical Stimulation Therapy (Biofeedback EST), Kegel exercises, Herbal Medicine and Acupuncture Injection in 5 studies. Control group was treated with Biofeedback EST, Kegel exercises, Herbal Medicine, Vitamin B, Electroacupuncture (EA), Denitine Tolterodine Tartrat with Bladder Drill, Tension-free Vaginal Tape Obturator (TVT-O) and Acupoint Injection Therapy. Outcome measures are total efficacy rate, Urine pad test, Urinary frequency, Maximum bladder capacity, VRP, POP-Q, etc. 關元 (CV4) was the most frequently used acupoint in catgut embedding therapy. In all of 8 studies, treatment group was more effective for urinary incontinence than the control group. Conclusions: According to this study, catgut embedding may be useful in enhancing the therapeutic outcome for urine incontinence, either by itself or in conjunction with standard medical treatment.
The objective of this study is to report the clinical effects of applying an integrated rehabilitation protocol to four patients with traumatic cervical spinal cord injuries. The treatments applied included acupuncture, cupping and moxibustion, chuna manual therapy, functional electrical stimulation, and other physical therapies. The evaluation methods included American Spinal Injury Association Impairment Scale, functional independence measure (FIM), modified Barthel index (MBI), numeric rating scale (NRS) and other scales. All patients presented marked improvements in FIM, MBI, NRS and other scales, along with increased muscle strength in the manual muscle test. The application of our protocol resulted in clear clinical benefits and enhanced the recovery and quality of life for the patients in this study.
Cho, Min Kyoung;Lee, In;Kwon, Jung Nam;Shin, Byung Cheul;Ko, Sung Hwa;Ko, Hyun Yoon;Shin, Yong Il;Hong, Jin Woo
대한한의학회지
/
제36권4호
/
pp.8-18
/
2015
Objectives: There have been several studies evaluated effect of electroacupuncture (EA) on spasticity but most studies could not assess spasticity quantitatively because they used clinical rating scales for assessment spasticity. The objective of this study is to evaluate effect of EA on poststroke spasticity quantitatively using tendon reflex (T-reflex). Methods: 29 stroke patients with upper extremity spasticity were randomized to EA group and control group. The EA group received combined EA and rehabilitation therapy 5 times a week for 3 weeks. Acupuncture treatment was given at Jian Yu (LI 15), Qu Chi (LI 11), Shao Hai (HT 3), Wai Guan (TE 5), He Gu (LI 4), Lie Que (LU 7), Hou Xi (SI 3) of the affected side, 30 minutes of electrical stimulation with a frequency of 40/13 Hz was applied at Qu Chi (LI 11), He Gu (LI 4). The control group received only rehabilitation therapy. The efficacy of treatment was assessed using T-reflex latency and amplitude, modified Ashworth scale (MAS) of biceps brachii, brachioradialis and triceps brachii. Fugl-Meyer motor function assessment (FMA) and functional independence measure (FIM) were also measured to assess motor function and functional independence. All outcomes were measured before treatment, immediately after 3 weeks of treatment and 1 week after 3 weeks of treatment. Results: No statistically significant differences were found in outcomes including T-reflex between the study groups except for FIM values immediately after 3 weeks of treatment (p=0.037). Conclusions: These results suggest that 3 weeks of EA does not reduce poststroke upper extremity spasticity electrophysiologically and clinically. However, small sample sizes and contradictory tendency between results from T-reflex and those from MAS require cautious judgement on interpretation of the results. A larger, well-designed clinical trials for quantitative evaluation of effect of EA on poststroke spasticity will be needed.
The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.
Objectives : Paeonia lactiflora Pallas (PLP) have been reported to have pharmacological effects such as anti-inflammatory and analgesic. However, it is not yet known whether PLP extract has anti-inflammatory effect on HaCaT cells, human keratinocyte. Methods : To confirm the anti-inflammatory effect of PLP on keratinocyte, TNF-𝛼/IFN-𝛾-stimulated HaCaT cells were used. HaCaT cells were pre-treated with PLP for 1h before stimulation with TNF-𝛼/IFN-𝛾. Then HaCaT cells were stimulated with TNF-𝛼/IFN-𝛾 for 24 h, the cells and media were harvested to measure the inflammatory cytokines levels. Granulocyte-macrophage colony stimulating factor (GM-CSF), monocyte chemoattractant protein-1 (MCP-1), interleukin 1 beta (IL-1𝛽), and TNF-𝛼 were analyzed by enzyme-linked immunosorbent assay (ELISA), and the mRNA expression of thymus and activation-regulated chemokines (TARC), IL-6, and IL-8 were measured by reverse transcription-polymerase chain reaction (RT-PCR). We also investigated the inhibitory mechanism of the mitogen-activated protein kinase (MAPKs) including ERK, JNK, and p38 and nuclear factor-kappaB (NF-𝜅B) by PLP using western blot. Results : PLP did not show cytotoxicity in HaCaT cells. In TNF-𝛼/IFN-𝛾-stimulated HaCaT cells, PLP significantly inhibited the expression of GM-CSF, MCP-1 IL-1𝛽, TNF-𝛼, TARC and IL-6. PLP inhibited the phosphorylation of ERK and translocation of NF-𝜅B into the nucleus. Conclusions : These results indicate that PLP could ameliorate the TNF-𝛼/IFN-𝛾-stimulated inflammatory response through inhibition of MAPK and NF-kB signal pathway. This suggests that PLP could be used beneficial agent to improve skin inflammation.
Objective : The purpose of this study is to investigate the mechanism and effect of moxibustion with ginger objectively, to be used as the quantitative data through the measurement of temperature, and to grasp the thermodynamic characteristics of moxibustion with ginger. Methods : We have selected the indirect moxibustion with ginger among many indirect moxibustions. We produced a slice of ginger to a thickness of 3, 4, 5mm and the moxa cone having a diameter of 8mm, a height of 10mm for making a comparative study of characteristics of moxa cone according to change the density. We have made a comparative study of the thermodynamic characteristics of moxibustion with ginger with or without holes. We measured combustion times and calculated temperatures, temperature gradients in each period during a combustion of moxa. Results : 1. We found out it was not significantly influenced by the existence of the punched holes in a slice of ginger because the punched holes grow smaller immediately. 2. The duration of the preheating period became longer according to thickness of a slice of ginger and was not directly proportional to the density of moxa cone. The duration of the preheating period was extremely short when it burned a 100mg moxa cone. That was influenced by the density of moxa cone. 3. The duration of the heating period became longer according to thickness of a slice of ginger likewise the preheating period bacause the density of moxa cone had effected on the combustion characteristics. The duration of the heating period was extremely long when it burned a 100mg moxa cone. On the other hand the maximum temperature in the heating period was appeared that the combustion with a thin slice of ginger was highest and measured that the large density of moxa cone was higher. But the maximum temperature in the heating period was about $37.8^{\circ}C{\sim}44.2^{\circ}C$respectively lower in others. 4. The duration of the retaining period was some doubling shorter than that of the heating period that is concerned the shape of moxa cone. The temperature measured the close of a retaining period was $36.6^{\circ}C{\sim}41.8^{\circ}C$, that was considerably lower temperature. 5. The mean ascending temperature velocity and the mean descending temperature velocity were $0.042{\sim}0.073^{\circ}C/sec$, $-0.027{\sim}-0.064^{\circ}C/sec$ respectively. Then, the ascending temperature velocity was some faster than the ascending temperature velocity. Conclusions : The quantitative standard for obtaining the effective heating stimulation is that if the slice of ginger made a hole in it, we had to use the needle above 1.5mm diameter. The recommended size of a slice ginger is the 14mm diameter and the 2~3mm thickness. The moxa cone is formed the conical shape that the base diameter was 8mm, the height was 10mm, the density was $600mg/cm^2$.
According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.
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