Pharmacoacupuncture for the Treatment of Frozen Shoulder: protocol for a systematic review and meta-analysis.

Objectives: Frozen shoulder (FS) is one of the most challenging shoulder disorders for patients and clinicians. Its symptoms mainly include any combination of stiffness, nocturnal pain, and limitation of active and passive glenohumeral joint movement. Conventional treatment options for FS are physical therapy, nonsteroidal anti-inflammatory drugs, injection therapy, and arthroscopic capsular release, but adverse and limited effects continue to present problems. As a result, pharmacoacupuncture (PA) is getting attention as an alternative therapy for patients with FS. PA is a new form of acupuncture treatment in traditional Korean medicine (TKM) that is mainly used for musculoskeletal diseases. It has similarity and specificity compared to corticosteroid injection and hydrodilatation, making it a potential alternative injection therapy for FS. However, no systematic reviews investigating the utilization of PA for FS have been published. Therefore, this review aims to standardize the clinical use of PA for FS and validate its therapeutic effect. Methods: The protocol was registered in Prospero (CRD42023445708) on 18 July 2023. Until Aug. 31, 2023, seven electronic databases will be searched for randomized controlled trials of PA for FS. Authors will be contacted, and manual searches will also be performed. Two reviewers will independently screen and collect data from retrieved articles according to predefined criteria. The primary outcome will be pain intensity, and secondary outcomes will be effective rate, Constant-Murley Score, Shoulder Pain and Disability Index, range of motion, quality of life, and adverse events. Bias and quality of the included trials will be assessed using the Cochrane handbook's risk-of-bias tool for randomized trials. Meta analyses will be conducted using Review Manager V.5.3 software. GRADE will be used to evaluate the level of evidence for each outcome. Results: This systematic review and meta-analysis will be conducted following PRISMA statement. The results will be published in a peer-reviewed journal. Conclusion: This review will provide scientific evidence to support health insurance policy as well as the standardization of PA in clinical practice.

A survey of the clinical practice followed by Korean medicine doctors for scoliosis: Preliminary data for clinical practice guidelines.

Scoliosis is a spinal disease in which the Cobb angle is >10°. Scoliosis treatment can be surgical or conservative, and clinical practice guidelines (CPGs) for conservative treatments have been updated since 2006. There have been several articles regarding the efficacy and safety of Korean medicine (KM) in treating scoliosis, but there are no CPGs. Our study investigated the current clinical practice using a survey for the future establishment of KM-CPGs. The survey mainly comprised clinical practice status, diagnosis, treatment, progress and prognosis, and perception of KM on scoliosis, with reference to existing surveys of other musculoskeletal disorders and scoliosis-related articles. A web-based survey was conducted from February 16, 2021 to February 28, 2021. We found that 60% of KM doctors (KMDs) respondents treated patients with scoliosis, and they valued radiographical measurements and scoliosis-related factors in the diagnosis. KMDs used multiple KM treatments, including acupuncture, Chuna, cupping, pharmacopuncture, and herbal medicine, and they emphasized the importance of KM more in nonstructural scoliosis than in structural scoliosis. Although the perception of the prognosis of scoliosis was in agreement with that suggested by previous guidelines, KMDs showed outstanding focus on reduction of symptoms of scoliosis and improvement of quality of life. Despite some limitations, including low participation and the need for consulting other medical practitioners, our study may be helpful for the development of KM-CPGs because it is the first to analyze the perceptions of KMDs on scoliosis and to collect preliminary data that are of significance for preparing clinical guidelines.

Chryseobacterium panacisoli sp. nov., isolated from ginseng-cultivation soil with ginsenoside-converting activity.

A Gram-stain-negative, non-motile, non-spore-forming, aerobic, rod-shaped and yellow-pigmented bacterium, designated strain Gsoil 183T, was isolated from ginseng-cultivation soil sampled in Pocheon Province, Republic of Korea. This bacterium was characterized to determine its taxonomic position by using a polyphasic approach. Strain Gsoil 183T grew at 10-37 °C and at pH 5.0-9.0 on tryptic soy agar. Strain Gsoil 183T had ß-glucosidase activity, which was responsible for its ability to convert ginsenoside Rb1 (one of the dominant active components of ginseng) to F2. Based on 16S rRNA gene sequencing, strain Gsoil 183T clustered with species of the genus Chryseobacterium and appeared to be closely related to Chryseobacterium sediminis LMG 28695T (99.1 % sequence similarity), Chryseobacterium lactis NCTC 11390T (98.6%), Chryseobacterium rhizoplanae LMG 28481T (98.6%), Chryseobacterium oncorhynchi CCUG 60105T (98.5%), Chryseobacterium viscerum CCUG 60103T (98.4%) and Chryseobacterium joostei DSM 16927T (98.3%). Menaquinone MK-6 was the predominant respiratory quinone and the major fatty acids were iso-C15 : 0, iso-C17 : 0-3OH and summed feature 3 (C16 : 1 ω6c and/or C16 : 1 ω7c). The polar lipids were phosphatidylethanolamine, six unidentified glycolipids, five unidentified aminolipids and three unidentified lipids. The G+C content of the genomic DNA was 36.6 mol%. Digital DNA-DNA hybridization between strain Gsoil 183T and the type strains of C. sediminis, C. lactis, C. rhizoplanae, C. oncorhynchi, C. viscerum and C. joostei resulted in values below 70 %. Strain Gsoil 183T could be differentiated genotypically and phenotypically from the recognized species of the genus Chryseobacterium. The isolate therefore represents a novel species, for which the name Chryseobacterium panacisoli sp. nov. is proposed, with the type strain Gsoil 183T (=KACC 15033T=LMG 23397T).

The effectiveness and safety of Chuna manual therapy on scoliosis: A protocol for systematic review and meta-analysis.

BACKGROUND: Scoliosis is a spinal deformity and is diagnosed as Cobb angle being greater than 10°. Because it is accompanied with structural dysfunction, it can cause pain, worsen the patient's general health and quality of life. The prevalence of scoliosis has been increasing and many treatments, including surgical treatment and conservative treatment, such as observation, bracing, physiotherapy, and Chuna manual therapy (CMT), have been suggested. CMT is a manual therapy in Korean medicine that provides effective stimulation to the patient's body structure to treat structural dysfunction. After Korean national health insurance's coverage of CMT in 2019, the application of CMT for scoliosis has increased, and many studies have been reported. There have been attempts to elucidate the effectiveness of CMT on scoliosis; however, its effectiveness still remains unconfirmed. Therefore, the aim of this study is to evaluate the effectiveness and safety of CMT on scoliosis. METHODS: The published randomized controlled trials that evaluated the effectiveness and safety of CMT for scoliosis will be searched for in multiple electronic databases without the limitation of country and language. Data on characteristics of studies, interventions, comparators, outcome measures, results, and information for assessment of study quality will be extracted. The primary outcome will be the Cobb angle and the secondary outcomes will be the scales of pain, function, quality of life and disability, and adverse events. Data synthesis and analysis will be conducted using the Review Manager software for Windows (RevMan ver. 5.3.; Copenhagen; The Nordic Cochrane Center, The Cochrane Collaboration, 2014). Subgroup analysis to identify the differences between different CMT maneuvers will also be performed. For risk of bias assessment, the "risk of bias" tool from Cochrane Collaboration will be used. RESULTS: This study will present the clinical evidence on the effectiveness and safety of CMT on scoliosis. CONCLUSION: This study will propose useful evidence for treatment, further research, and health policies in the future.

The effectiveness and safety of acupuncture for scoliosis: A protocol for systematic review and/or meta-analysis.

BACKGROUND: Scoliosis is a disease that affects all age groups and alters the three-dimensional deviation of the spinal axis. It is diagnosed when Cobb angle presents over 10 degrees and the reasons include aging, traumatic injuries, unknown origin, and disorders of congenital, neurological, musculoskeletal, and connective tissue. Scoliosis treatments are divided into surgical and conservative options. Surgery can correct the curved spine but has associated risks and economic burden. Conservative treatments, particularly bracing, prevent the progression of scoliosis, but still remains potential ingredient of curvation and patients poor compliance. Recent studies reported that various types of acupuncture can improve the curvation and the associated pain. However, there has been no systematic review on this issue. Therefore, this study will review the effectiveness and safety of acupuncture on scoliosis. METHODS: Searching randomized controlled trials about the use of acupuncture for scoliosis will be performed using multiple electronic databases, manual search, and contact to authors e-mail if needed. We will select studies by the pre-defined criteria and summarize the data on study participants, interventions, control groups, outcome measurement, adverse events, and risk of bias. The primary outcome will be the Cobb angle, which is objective, and the secondary outcomes are associated with patient-centered indices (pain, functional status, and quality of life), which are subjective and adverse events. We will use Review Manager software (Version 5.3; Copenhagen; The Nordic Cochrane Center, The Cochrane Collaboration, 2014) to perform a meta-analysis and Cochrane Collaboration "risk of bias" tools to assess the risk of bias. RESULTS: Our study will investigate the clinical evidence on the effectiveness and safety of acupuncture on scoliosis. CONCLUSION: Our study will be informative to scoliosis patients, clinicians, policy makers, and researchers working with conservative management for scoliosis.

Flexivirga caeni sp. nov., isolated from activated sludge.

A Gram-stain-positive, strictly aerobic, non-motile, non-spore-forming and oval-shaped bacterium, designated strain BO-16T was isolated from activated sludge. In this study, we describe the taxonomic characterization and classification of this bacterium by using the polyphasic approach. Growth of BO-16T was observed at 10-40 °C (optimum, 25-37 °C) and at pH 5.0-10.0 (optimum, pH 7.0) on R2A agar. The major fatty acids it contained were iso-C16:0, anteiso-C17:0 and iso-C17 : 0 and the major polar lipids were diphosphatidylglycerol, phosphatidylinositol and phosphatidylethanolamine. This isoprenoid quinones included MK-8 (H4) and MK-8 (H6). The peptidoglycan contained lysine, serine, alanine, glycine and glutamic acid and represented the peptidoglycan type A4α. On the basis of 16S rRNA gene sequence similarity, BO-16T was shown to represent a member of the genus Flexivirga and to be related to Flexivirga oryzae KACC 18597T (98.4 % sequence similarity), Flexivirga endophytica KCTC 39536T (97.5 %), Flexivirga alba DSM 24460T (97.4 %) and Flexivirga lutea KCTC 39625T (97.3 %). The G+C content of the genomic DNA was 68.0 mol%. The DNA-DNA relatedness values between BO-16T and its closest phylogenetic neighbours were much lower than 70 %. BO-16T could be differentiated phylogenetically and phenotypically from the species of the genus Flexivirga with validly published names. Therefore the isolate represents a novel species, for which the name Flexivirga caeni sp. nov. is proposed, with the type strain BO-16T (=KACC 19647T=LMG 30859T).

Does creating a trough on the anterior glenoid rim make a difference in Arthroscopic Bankart repair using suture anchors? A mid-term follow-up retrospective study.

PURPOSE: Creating a trough on the anterior glenoid rim is one of the methods used for arthroscopic Bankart repair with suture anchors. The purpose of this study was to analyze clinical and radiological outcomes of arthroscopic Bankart repair with suture anchors; to compare between the outcomes of surgical procedures with and without trough. METHODS: Clinical and radiological outcomes were evaluated for 116 patients who underwent arthroscopic Bankart repair at our institute from 2005 to 2011. The mean follow-up was 5.2 years (range, 2-8.8 years). All data were divided into trough group (n = 62) and non-trough group (n = 71). Clinical and functional outcomes were assessed pre- and postoperatively as range of motion (ROM), pain on the visual analog scale (p-VAS), function on the visual analog scale (f-VAS), and Rowe score. Radiological outcomes were also evaluated. RESULTS: The overall postoperative clinical and functional outcomes improved significantly (P < .001). A total of 8 patients (6.8%) showed recurrent instability. Radiologic findings showed mild arthritis in 27 cases (23.1%), moderate arthritis in 6 cases (5.1%), and no severe arthritis. 32 patients showed anterior apprehension after surgery, and 22 out of those 32 patients were from non-trough group. However, no significant difference between the trough and non-trough groups was found with respect to clinical and functional outcomes (P > .05). CONCLUSION: The additional procedure of creating a trough did not improve clinical outcomes in terms of frank dislocation; however, at the final follow-up, patients with the trough showed less anterior apprehension. Overall, arthroscopic Bankart repair using suture anchors had relatively good clinical outcome, with a redislocation rate of 6.8%. LEVEL OF EVIDENCE: Level III, Case series.