Saengmaeksan, a traditional polyherbal formulation containing Panax ginseng, improves energy metabolism during exercise.

Saengmaeksan (SMS), a representative oriental medicine that contains Panax ginseng Meyer, Liriope muscari, and Schisandra chinensis (1:2:1), is used to improve body vitality and enhance physical activity. However, there is limited scientific evidence to validate the benefits of SMS. Here, we investigated the in vitro and in vivo regulatory effects of SMS and its constituents on energy metabolism and the underlying molecular mechanisms. For this, quantitative real-time polymerase chain reaction, 3D holotomographic microscopy, western blotting, and glucose uptake experiments using 18F-fluoro-2-deoxy-D-glucose (18F-FDG) were performed using L6 cells to investigate in vitro energy metabolism changes. In addition, 18F-fluorocholine (18F-FCH) and 18F-FDG positron emission tomography/computed tomography (PET/CT) analyses, immunohistochemistry, and respiratory gas analysis were performed in mice post-endurance exercise on a treadmill. In the energy metabolism of L6 cells, a significant reversal in glucose uptake was observed in the SMS-treated group, as opposed to an increase in uptake over time compared to the untreated control group. Furthermore, P. ginseng alone and SMS significantly decreased the volume of lipid droplets. SMS also regulated the phosphorylation of extracellular signal-regulated kinase (ERK), phosphorylation of p38, mitochondrial morphology, and the expression of apurinic/apyrimidinic endonuclease 1/redox factor-1 (APE/Ref-1) in H2O2-stimulated L6 cells. In addition, SMS treatment was found to regulate whole body and muscle energy metabolism in rats subjected to high-intensity exercise, as well as glucose and lipid metabolism in skeletal muscle. Therefore, SMS containing P. ginseng ameliorated imbalanced energy metabolism through oxidative stress-induced APE/Ref-1 expression. SMS may be a promising supplemental option for metabolic performance.

Gold nanoshell-mediated photothermal therapy for acne vulgaris.

Acne vulgaris, a common and chronic disorder of the pilosebaceous unit, affects up to 85% of adolescent and young adults. Although the current treatment options are effective, they are associated with unwanted side effects, chronicity, relapses, and recurrences. Recently, the Food and Drug Administration approved topical application of gold microparticles for selective photothermolysis to treat acne vulgaris. Here, we report two cases showing the efficacy of gold nanoshell-mediated photothermal therapy for recurrent acne that were refractory to previous treatments. In both cases, three sessions of photothermal therapy prevented the development of new lesions during a follow-up period of 3-4 months without causing any adverse effects. The two cases reported here demonstrate the possibility of gold nanoshell-mediated photothermal therapy as a safe and effective treatment for recurrent acne vulgaris in Asian patients.

Effect of Combined Traditional Acupuncture, Pharmacopuncture and Applied Kinesiology on Lumbar Diseases of Resident Patients.

OBJECTIVES: Recently several Korean medical doctors have begun practicing applied kinesiology (AK). Although the efficacy of combining traditional acupuncture (TA) and pharmacopuncture (PP) on lumbar diseases such as lumbar spinal stenosis (LSS) and lumbar herniation of intervertebral disk (LHID) has been examined, the possible benefits of combining TA, PP and AK approaches have not been examined. Therefore the aim of this study was to develop effective treatment for lumbar disorders by combining TA, PP, and AK treatments. METHODS: Twenty-four patients hospitalized at Samse Korean Traditional Medicine Hospital between March and September 2018 with L5 or S1 root radiculopathy associated with LSS and LHID were included in this study. They were treated for 10 days with TA, PP and AK approaches that included category block, manipulation and strain/counterstrain treatments. The primary outcomes were mainly assessed using Japanese Orthopedic Association lumbar scores (JOALS). JOALS were determined before the start of treatment as well as five and 10 days after treatment started. RESULTS: The treatments improved the lumbar condition of the patients based on JOA pain score. CONCLUSION: The combined TA, PP and AK treatments were effective in treating spinal diseases of resident patients. Prospective, controlled, and relevant protocols using multimodal strategies to define the role of TA, PP and AK are needed.

Topical brimonidine-assisted laser treatment for the prevention of therapy-related erythema and hyperpigmentation.

Postinflammatory hyperpigmentation (PIH) and erythema are the most common adverse effects associated with laser treatment, particularly in dark-skinned individuals. Several methods have been used to prevent or minimize these adverse effects; however, to date, no definitive precautions/strategies are known to prevent post-laser PIH and erythema. We investigated whether the topical application of the α-adrenergic receptor agonist brimonidine could reduce laser treatment-related complications such as erythema and PIH.

Treatment of hesitation marks on the forearm by the pinhole method.

Scars from self-inflicted wounds, referred to as "hesitation marks," are usually linear, flat, poorly oriented, white in color, and often located on the forearm. Many patients do not undergo treatment for these due to limited available modalities. The aim of this study was to evaluate the efficacy and safety of the pinhole method using a 10,600 nm carbon dioxide (CO2) laser for treating hesitation marks on the forearm. We conducted a retrospective chart review of patients with hesitation marks treated by the pinhole method from March 2010 to April 2014. Eleven patients with hesitation marks (mean age 37.8 years; range, 23-67 years) were treated with the pinhole method over the 4-year study period. Subjects were treated via the pinhole method in one to six treatment sessions at 4- to 8-week intervals. Two blinded observers evaluated photographs taken at baseline and 3 months after the final treatment and assessed improvement using a quartile grading scale. Compared with baseline, there was mild to moderate improvement in all patients (mean score 3.0). The patient satisfaction survey revealed a mean improvement score of 2.82. The pinhole method using a CO2 laser may be an effective treatment option in patients with hesitation marks on the forearm.

Treatment of periorbital syringoma by the pinhole method using a carbon dioxide laser in 29 Asian patients.

BACKGROUND: Pinhole method has been used to treat various types of scars and dermal tumors by making multiple small holes in target tissues of the deep dermis using an ablative 10,600-nm carbon dioxide (CO2) laser. OBJECTIVES: We prospectively investigated the efficacy and safety of using a CO2 laser to treat periorbital syringomas via the pinhole method. METHODS: A total of 29 patients with periorbital syringomas were treated with two sessions of CO2 laser treatment using the pinhole method at two-month intervals. Laser fluences were delivered under the following settings: pulse duration of 200 µs, frequency of 50 Hz, on time of 0.04, and an off time of 0.01. RESULTS: Among the 29 patients, 13 patients (44.8%) presented with small discrete papular syringomas, 10 (34.5%) had plaque-type lesions, and six (20.7%) had mixed lesions. Evaluation of the clinical results at 2 months after the second treatment session revealed marked clinical improvement (51-75%) in 10 of the 29 patients (34.5%), moderate clinical improvement (26-50%) in eight (27.6%), near-total improvement (≥ 75%) in seven (24.1%), and minimal improvement (0-25%) in four patients (13.8%). CONCLUSIONS: Our observations indicated that application of the pinhole method using a CO2 laser exerts positive therapeutic effects in Asian patients with periorbital syringomas.

A patient with cupping-related post-inflammatory hyperpigmentation successfully treated with a 1,927 nm thulium fiber fractional laser.

Post-inflammatory hyperpigmentation is a rare complication following cupping therapy. We report a case of a 26-year-old woman who presented with hyper-pigmented skin lesions on her lower back which was persistent for 6 months following cupping therapy. The 1,927 nm thulium fiber laser (Fraxel re:store Dual, Solta Medical Inc., Hayward, CA) was tested leading to near complete resolution within four sessions.

Combination of 595-nm pulsed dye laser, long-pulsed 755-nm alexandrite laser, and microdermabrasion treatment for keratosis pilaris: retrospective analysis of 26 Korean patients.

Keratosis pilaris (KP) has beenpresented as small keratotic follicular papules with or without surrounding erythema. Various treatments with laser or light therapy have been used for the management of KP with various clinical outcomes. In the present study, we investigated the efficacy and safety of a combination therapy for KP. A total of 29 anatomical sites with KP in 26 patients were treated using a 595-nm pulsed dye laser (PDL) with nonpurpuragenic fluences, a long-pulsed 755-nm alexandrite laser, and microdermabrasion. Clinical improvement was assessed by comparing preand posttreatment clinical photographs and patient satisfaction rates. Evaluation of the clinical results three months after the treatments showed that 12 of the 29 anatomical sites (41.4%) demonstrated Grade 3 clinical improvement, ten (34.5%) had Grade 2 clinical improvement, four (13.8%) showed Grade 1 improvement, and three (10.3%) showed Grade 4 improvement. We observed that KP lesions improved not only in erythema and skin texture, but also in brownish dyschromias. Potential adverse events were not observed, except prolonged posttherapy scaling. Our observations demonstrate that combination therapy using a 595-nm PDL, a long-pulsed 755-nm alexandrite laser, and microdermabrasion can have a positive therapeutic effect on KP.

Use of fractionated microneedle radiofrequency for the treatment of inflammatory acne vulgaris in 18 Korean patients.

BACKGROUND: Nonablative radiofrequency (RF) devices have been shown to be clinically effective for the treatment of moderate to severe acne lesions. OBJECTIVE: To evaluate the efficacy and safety of a fractionated microneedle RF device in the treatment of inflammatory acne vulgaris. METHODS: Eighteen patients (15 male, 3 female; mean age 27, range: 19-33; Fitzpatrick skin type IV) with moderate to severe acne vulgaris who were treated with two sessions of fractionated microneedle RF at 1-month intervals were enrolled in this study. RESULTS: Evaluation of improvement, which took into account number of inflammatory acne lesions, showed that two of the 18 patients had grade 4 clinical improvement, eight had grade 3 improvement, and six had grade 2 improvement. Improvement scores in terms of lesion severity were also evaluated. One of the 18 patients had grade 4 clinical improvement, eight grade 3, and seven grade 2. No patient had worsening of inflammatory acne lesions. CONCLUSION: Fractionated microneedle RF can have a positive therapeutic effect on inflammatory acne vulgaris and related scars. In addition, this technique does not worsen active acne lesions.

A clinical pilot study comparing traditional acupuncture to combined acupuncture for treating headache, trigeminal neuralgia and retro-auricular pain in facial palsy.

Traditional acupuncture (TA) and ear acupuncture (EA) are used for treatment of headache, trigeminal neuralgia, and retro-auricular pain. The purpose of this study is to develop effective treatment using combined acupuncture (CA) which consists of TA and EA and to set clinical protocols for future trials. Participants were divided into TA (n = 15) control and CA (n = 34) experimental groups. Obligatory points among Korean Five Element Acupuncture and optional individual points along with symptom points were used in the TA group. The CA group was exposed to ear points of Fossion and TA. Acupuncture treatment consisted of six mandatory sessions per patient over 3 weeks and extended to 12 sessions. Pain was assessed using the visual analogue scale. We compared TA to CA and researched their relevant publications. No significant difference was observed between the two groups (p = 0.968) which showed pain-alleviating tendency. Pain alleviation was significantly different after the fifth and sixth sessions (p = 0.021, p = 0.025), with headache being the most significantly relieved (F = 4.399, p = 0.018) among the diseases. When assessing pain intensity, both the Headache Impact Test and the Migraine Disability Assessment Scale should be adopted for headache and the fractal electroencephalography method be used in pain diseases. In the future, studies should consist of TA, EA, and CA groups; each group having 20 patients. Treatment number should to be no less than 10 sessions. Korean Five Element Acupuncture should be a compulsory inclusion along with individual points being optional inclusion in TA. EA could be selected from Nogier, Fossion and so forth. In conclusion, acupuncture treatment, whether TA or CA, showed pain alleviation in headache, trigeminal neuralgia, and retro-auricular pain, but no significant difference was seen between groups. Prospective, well-controlled, and relevant protocols using multimodal strategies to define the role of TA, EA, and CA are needed.

Lower-fluence, higher-density versus higher-fluence, lower-density treatment with a 10,600-nm carbon dioxide fractional laser system: a split-face, evaluator-blinded study.

BACKGROUND: Adequate laser settings in the treatment of scars using a carbon dioxide fractional laser system (CO(2) FS) have not been established. OBJECTIVE: To compare the efficacy and safety of low-fluence, high-density with high-fluence, low-density treatment with CO(2) FS on acne scars and enlarged pores. METHODS: Ten patients with mild to severe atrophic acne scars and enlarged pores were enrolled. Half of each subject's face was treated with a single session of CO(2) FS with a fluence of 70 mJ and a density of 150 spots/cm(2) ; the other half was treated with a fluence of 30 mJ and a density of 250 spots/cm(2) . RESULTS: Follow-up results 3 months after a single low-fluence, high-density treatment with CO(2) FS showed that four of 10 participants had clinical improvement of 51% to 75% from baseline. After the high-fluence, low-density CO(2) FS treatment, five of 10 patients demonstrated marked clinical improvements of more than 76%. CONCLUSION: Higher-energy, lower-density laser settings seem to be more effective than lower-energy, higher-density settings for acne scars and enlarged pores, although our results do not constitute a conclusive comparison of the two different modes of CO(2) FS.

Combination of Q-switched and quasi long-pulsed 1064-nm Nd:YAG laser, non-ablative 1450-nm diode laser, and ablative 10 600-nm carbon dioxide fractional laser for enlarged pores.

Currently, there is no gold standard for the treatment of enlarged facial pores. In this report, we describe a patient with enlarged nasal pores which were treated with a combination of a non-ablative 1450-nm diode laser, a Q-switched and quasi long-pulsed 1064-nm Nd:YAG laser, and an ablative 10 600-nm carbon dioxide fractional laser system. Four months after the final treatment, the condition of the patient's pores had markedly improved, and the patient was satisfied with the results.