A Refractory Livedoid Vasculopathy Accompanied by Methylene Tetrahydrofolate Reductase Gene Polymorphism Successfully Treated with Hyperbaric Oxygen Therapy

Livedoid vasculopathy (LV) is a chronic coagulation disorder characterized by recurrent, painful ulcers on the lower extremities. Methylene tetrahydrofolate reductase (MTHFR) gene polymorphism is associated with coagulopathy. Therapeutic options usually include anti-inflammatory or immunosuppressive agents. However, the condition is still highly challenging to manage and no consensus over the first-line treatment for LV exists. Furthermore, when LV is accompanied with MTHFR gene polymorphism, clinical presentations could be more severe and resistant to treatment. We report a case of refractory LV accompanied by MTHFR gene polymorphism, which was successfully treated with hyperbaric oxygen therapy (HBOT). A 63-year-old female patient presented with multiple painful ulcers, atrophie blanches, and retiform purpura on both lower legs and feet. Histopathologic findings were compatible with LV. LV was diagnosed based on these clinicopathological findings. Following the diagnosis, we treated the patient with pentoxifylline, aspirin, systemic corticosteroid, antihistamine, and antibiotics. In spite of six-month treatment, the skin lesions did not improve; hence, HBOT was performed. It was performed at 2.0 absolute atmosphere for 120 minutes each time, three times a week. After 4 sessions, the ulcers began to heal and after 13 sessions, the skin lesions almost healed. During the eight-month followup period, the skin ulcers did not recur and the symptoms remained stable. Additionally, it was confirmed that she had MTHFR gene polymorphism after a genetic test. In conclusion, we wish to provide evidence regarding the effectiveness of HBOT and suggest that HBOT might be a considerable treatment option in refractory LV.

New Targeted Therapy for Non-Small Cell Lung Cancer / 결핵및호흡기질환

Lung cancer ranks first in cancer mortality in Korea and cancer incidence in Korean men. More than half of Korean lung cancer patients undergo chemotherapy, including adjuvant therapy. Cytotoxic agents, targeted therapy, and immune checkpoint inhibitors are used in chemotherapy according to the biopsy and genetic test results. Among chemotherapy, the one that has developed rapidly is targeted therapy. The National Comprehensive Cancer Network (NCCN) guidelines have been updated recently for targeted therapy of multiple gene mutations, and targeted therapy is used not only for chemotherapy but also for adjuvant therapy. While previously targeted therapies have been developed for common genetic mutations, recently targeted therapies have been developed to overcome uncommon mutations or drug resistance that have occurred since previous targeted therapy. Therefore, this study describes recent, rapidly developing targeted therapies.

Two Cases of Lymphomatoid Papulosis Mimicking Pseudolymphoma Successfully Treated with Low-Dose Methotrexate and 308-nm Ultraviolet Laser Therapy / 대한피부과학회지

Lymphomatoid papulosis (LyP) is a CD30＋ lymphoproliferative disorder characterized by chronic papulonodular eruptions. Highly potent topical steroids and phototherapy are the first-line modalities, and low-dose methotrexate (MTX) combined with folic acid is known to be safe and efficient for the treatment of LyP. However, there are concerns about whether whole-body phototherapy should be performed for limited lesions. Herein, we report the first case series of localized LyP mimicking pseudolymphoma successfully treated with low-dose MTX and 308 nm ultraviolet (UV) laser therapy. Clinicians should consider UV laser therapy as a novel treatment option because it has the advantage of selective treatment.

The Efficacy and Safety of Balneotherapy as an Adjuvant Treatment for Atopic Dermatitis at Samsan Spa, Korea: A Randomized Controlled Split-body Trial / 대한피부과학회지

BACKGROUND@#Atopic dermatitis is a chronic inflammatory disease associated with long-term use of topical and systemic medications. Several articles have described the use of balneotherapy as an adjuvant treatment for atopic dermatitis in many countries, including Korea.@*OBJECTIVE@#The goal of this study was to investigate the therapeutic efficacy and safety of balneotherapy as an adjuvant treatment of atopic dermatitis.@*METHODS@#Ten patients with atopic dermatitis were enrolled in this study and each patient served as their own control. Testing was conducted on the anterior cubital fossa of the arm. A priori binary randomization was completed to determine which arm would receive balneotherapy or tap water. Patients visited clinics 3 times per week for 2 weeks and had a forearm bath for 15 minutes. Assessment was performed at baseline, and after 1 and 2 weeks of treatment.@*RESULTS@#At the last visit, the balneotherapy group showed improvements in their local eczema area, severity index score, and the degree transepidermal water loss. The physician's global assessment, patient's self-global assessment, and skin hydration was increased in both groups.@*CONCLUSION@#Our study suggests that balneotherapy is a safe adjuvant therapy that could be considered for the treatment of atopic dermatitis. However, more studies are required to demonstrate scientific basis for this treatment.

Development of 9(th) Revision Korean Food Composition Table and Its Major Changes / 대한지역사회영양학회지

OBJECTIVES: The Korean Food Composition Table (KFCT) was first published in 1970, and has since been updated every five years by the Rural Development Administration (RDA). This study was conducted to introduce the development strategies, features, and challenges of the 9th revision of the KFCT. METHODS: Due to the increasing demands of nutrient database users and generators, the RDA started a new research project in 2013 to improve the quantity and quality of data for the 9th revision of the KFCT. Over 1,000 food items frequently consumed in Korea were selected as key foods using the results of the Korean National Health and Nutrition Examination Survey. About 200 raw materials and processed food items were collected and analyzed every year. Target nutrients that were analyzed by collaborative labs, such as, sugars, selenium, iodine, and biotin, were increased from 22 to 43. Analytical sample handling procedures and data quality evaluation systems were also established in collaboration with 10 contracted labs. Data were evaluated for data quality according to the FAO/INFOODS, CODEX, and AOAC guidelines. RESULTS: The 9th revision contains data on 3,000 food items and up to 43 and 140 food nutrients for the printed table and the excel database file, respectively. Overall, 1,485 data items were newly added, 973 of which were provided by the RDA and 512 were cited from foreign nutrient databases. The remaining 1,515 food items were maintained as in the 8th revision. CONCLUSIONS: The KFCT provides the basic infrastructure for food and nutrition policy, research, and dietary practice in South Korea. The use of the KFCT has increased exponentially in the past few years in both public and private sectors; accordingly, increased efforts should be paid to the preparation, improvement, and maintenance of KFCT.

Development of 9(th) Revision Korean Food Composition Table and Its Major Changes / 대한지역사회영양학회지

OBJECTIVES: The Korean Food Composition Table (KFCT) was first published in 1970, and has since been updated every five years by the Rural Development Administration (RDA). This study was conducted to introduce the development strategies, features, and challenges of the 9th revision of the KFCT. METHODS: Due to the increasing demands of nutrient database users and generators, the RDA started a new research project in 2013 to improve the quantity and quality of data for the 9th revision of the KFCT. Over 1,000 food items frequently consumed in Korea were selected as key foods using the results of the Korean National Health and Nutrition Examination Survey. About 200 raw materials and processed food items were collected and analyzed every year. Target nutrients that were analyzed by collaborative labs, such as, sugars, selenium, iodine, and biotin, were increased from 22 to 43. Analytical sample handling procedures and data quality evaluation systems were also established in collaboration with 10 contracted labs. Data were evaluated for data quality according to the FAO/INFOODS, CODEX, and AOAC guidelines. RESULTS: The 9th revision contains data on 3,000 food items and up to 43 and 140 food nutrients for the printed table and the excel database file, respectively. Overall, 1,485 data items were newly added, 973 of which were provided by the RDA and 512 were cited from foreign nutrient databases. The remaining 1,515 food items were maintained as in the 8th revision. CONCLUSIONS: The KFCT provides the basic infrastructure for food and nutrition policy, research, and dietary practice in South Korea. The use of the KFCT has increased exponentially in the past few years in both public and private sectors; accordingly, increased efforts should be paid to the preparation, improvement, and maintenance of KFCT.

Relationship between pulmonary function and bone mineral density in the Korean National Health and Nutrition Examination Survey

BACKGROUND/AIMS: Osteoporosis is common in chronic obstructive pulmonary disease (COPD) patients. The relationship between osteoporosis and COPD has been primarily reported in patients with moderate to severe COPD, but there is no report in the general population. The aim of this study is to investigate the relationship between bone mineral density (BMD) and lung function in the general Korean population. METHODS: This study was based on data acquired from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (KNHANES IV and V), conducted from 2008 to 2010. The study population included 4,501 subjects (aged ≥ 50 years) who underwent both spirometry and BMD. The study populations were divided into two groups by sex to correct for the effects of gender on BMD. All female participants were postmenopausal women. RESULTS: The BMD values of the femur neck, total femur, and L-spine tended to decrease with degree of airflow limitation in both genders. To correct confounding factors, data were analyzed and adjusted for age, body mass index, fat free mass index, body fat percentage, smoking amount, parathyroid hormone levels, daily calcium and phosphorus intake, and alkaline phosphatase (ALP) levels. While the BMD of the femur neck, total femur, and L-spine was reduced significantly as age and ALP increased, the correlation between airway obstruction and BMD of all regions disappeared in both genders. CONCLUSIONS: In the general population aged 50 years and older, diminution of BMD is not associated with airway obstruction. Further investigation along other factors is needed to determine the possible role of pulmonary function and BMD.

Effects of High-dose Atorvastatin Pretreatment in Patients with ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Cardiac Magnetic Resonance Study

It is uncertain that atorvastatin pretreatment can reduce myocardial damage in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). The aim of this study was to investigate the effects of atorvastatin pretreatment on infarct size measured by contrast-enhanced magnetic resonance imaging (CE-MRI) in STEMI patients. Patients undergoing primary PCI for STEMI within 12 hr after symptom onset were randomized to an atorvastatin group (n = 30, 80 mg before PCI and for 5 days after PCI) or a control group (n = 37, 10 mg daily after PCI). The primary end point was infarct size evaluated as the volume of delayed hyperenhancement by CE-MRI within 14 days after the index event. The median infarct size was 19% (IQR 11.1%-31.4%) in the atorvastatin group vs. 16.3% (7.2%-27.2%) in the control group (P = 0.27). The myocardial salvage index (37.1% [26.9%-58.7%] vs. 46.9% [39.9-52.4], P = 0.46) and area of microvascular obstruction (1.1% [0%-2.0%] vs. 0.7% [0%-1.8%], P = 0.37) did not differ significantly between the groups. Frequency of the hemorrhagic and transmural infarctions was not significantly different in the 2 groups. Pretreatment with a high-dose atorvastatin followed by further treatment for 5 days in STEMI patients undergoing primary PCI failed to reduce the extent of myocardial damage or improve myocardial salvage.

Efficacy and Safety of Ustekinumab in Korean Patients with Moderate-to-severe Psoriasis / 대한피부과학회지

BACKGROUND: Psoriasis is a chronic, relapsing inflammatory disease that affects approximately 2~3% of the population worldwide and often requires lifelong care. Recent advances in understanding the immunogenesis of psoriasis has led to the development of biological agents that target specific immunological pathways. Ustekinumab is a human monoclonal antibody that binds to the p40 subunit common to interleukin-12 and 23, key cytokines in the pathogenesis of psoriasis. OBJECTIVE: This study aims to address the efficacy and safety of ustekinumab in Korean patients with moderate-to-severe psoriasis. METHODS: The clinical records of 32 consecutive patients treated with ustekinumab were reviewed retrospectively. Treatment effectiveness was estimated based on reported Psoriasis Area and Severity Index (PASI) 50, 75, and 90 response rates, defined as a > or =50%, > or =75%, or > or =90% reduction from baseline PASI scores, respectively. A stereotyped questionnaire was completed by the physician, and information about adverse events and quality of life was collected. RESULTS: The average baseline PASI score was 25.7. Overall 38%, 56%, and 80% patients achieved PASI 75 response rates at weeks 4, 16, and 52 respectively. Thirteen patients (41%) experienced a mild adverse event such as upper respiratory infection, pruritus, urticaria, nasopharyngitis, headache, hyperglycemia, abnormal hepatic function, or arthralgia. CONCLUSION: Ustekinumab provides an effective, safe, and well-tolerated alternative for the symptomatic treatment of Korean patients with moderate-to-severe psoriasis.

Ginsenoside Rg1 and 20(S)-Rg3 Induce IgA Production by Mouse B Cells

Ginsenosides are the major components of ginseng, which is known to modulate blood pressure, metabolism, and immune function, and has been used to treat various diseases. It has been reported that ginseng and several ginsenosides have immunoregulatory effects on the innate and T cell-mediated immune response. However, their effects on the humoral immune response have not been fully explored. The present study examined the direct effects of red ginseng extract (RGE) and ginsenosides on mouse B cell proliferation and on antibody production and the expression of germline transcripts (GLT) by mouse B cells in vitro. RGE slightly reduced B cell proliferation, but increased IgA production by LPS-stimulated B cells. Furthermore, ginsenoside Rg1 and 20(S)-Rg3 selectively induced IgA production and expression of GLTalpha transcripts by LPS-stimulated B cells. Collectively, these results suggest that ginsenoside Rg1 and 20(S)-Rg3 can drive the differentiation of B cells into IgA-producing cells through the selective induction of GLTalpha expression.

A Case of Prosthetic Knee Joint Infection Caused by Streptococcus agalactiae

Recently the incidence of Group B streptococcus (Streptococcus agalactiae) infection has been increased in nonpregnant adults, especially including the elderly and those with underlying diseases. One year ago, a 72-year-old diabetic woman underwent both total knee replacement and then received intermittently acupuncture due to both knee pain. Five days ago, she developed painful swelling on right knee joint. The synovial fluid showed leukocytosis (WBC 8,200/mm3), she was diagnosed as prosthetic joint infection, and treated with cefazolin. Her condition was rapidly aggravated despite of antibiotics therapy, open debridement and drainage was performed. But she expired due to sepsis. Both blood and synovial fluid culture yielded S. agalactiae. We reported a case of prosthetic knee joint infection caused by S. agalactiae.

Virtual Reality Alcohol Treatment : Craving and EEG Responding to Multi-Sensory Stimulation in Patient with Alcohol Dependence / 신경정신의학

OBJECTIVES : In our previous report, alcohol dependent patients (ADP) with virtual reality treatment showed a greater decrease in cravings for alcohol and increase in alpha power of the frontal lobe, compared to ADP who underwent general treatment. For the showing different responsibility on alcohol consumption situation between ADP and healthy comparisons, we compared the change in cravings and alpha waves in frontal lobe during virtual reality treatment for alcohol dependence (VRT). METHODS : Thirty seven alcohol-dependent male inpatients diagnosed using DSM-IV, and 25 ageand education-matched healthy adult males were recruited. We measured the changes in cravings and Electroencephalogram (EEG) activity between alcoholic patients and healthy control subjects during VRT. RESULTS : During the VRT, ADP reported higher craving for alcohol during the high risk situation and lower craving for alcohol during aversive situation, compared to healthy controls. The alpha wave of frontal lobe activity in ADP was decreased while that in healthy subject was increased from relaxation to high risk situation (HRS). In ADP, the changes of EEG {Fp1-A1 (r=-0.48, p=0.04), F7-A1 (r=-0.49, p=0.03), Fp2-A2 (r=-0.46, p<0.05), and F8-A2 (r=-0.54, p=0.02)} in the frontal lobe were negatively correlated with the change of craving for alcohol. CONCLUSION : The present study demonstrated that the ready availability and the affinity of alcohol cues in ADP appear to be correlated with decreased function of the frontal lobe.

Virtual Reality Alcohol Treatment : Craving and EEG Responding to Multi-Sensory Stimulation in Patient with Alcohol Dependence / 신경정신의학

OBJECTIVES : In our previous report, alcohol dependent patients (ADP) with virtual reality treatment showed a greater decrease in cravings for alcohol and increase in alpha power of the frontal lobe, compared to ADP who underwent general treatment. For the showing different responsibility on alcohol consumption situation between ADP and healthy comparisons, we compared the change in cravings and alpha waves in frontal lobe during virtual reality treatment for alcohol dependence (VRT). METHODS : Thirty seven alcohol-dependent male inpatients diagnosed using DSM-IV, and 25 ageand education-matched healthy adult males were recruited. We measured the changes in cravings and Electroencephalogram (EEG) activity between alcoholic patients and healthy control subjects during VRT. RESULTS : During the VRT, ADP reported higher craving for alcohol during the high risk situation and lower craving for alcohol during aversive situation, compared to healthy controls. The alpha wave of frontal lobe activity in ADP was decreased while that in healthy subject was increased from relaxation to high risk situation (HRS). In ADP, the changes of EEG {Fp1-A1 (r=-0.48, p=0.04), F7-A1 (r=-0.49, p=0.03), Fp2-A2 (r=-0.46, p<0.05), and F8-A2 (r=-0.54, p=0.02)} in the frontal lobe were negatively correlated with the change of craving for alcohol. CONCLUSION : The present study demonstrated that the ready availability and the affinity of alcohol cues in ADP appear to be correlated with decreased function of the frontal lobe.

Coptis chinensis Extract Inhibits the Production of Inflammatory Mediators and Delayed Type Hypersensitivity in Mice

BACKGROUND: Coptis chinensis rhizome has been used as a medicinal herb in traditional Oriental medicine. We investigated the effects of Coptis chinensis extract on inflammatory mediators and delayed type hypersensitivity in mice. METHODS: The inhibitory effect of ethanolic extract of Coptis chinensis (CCE) on cell proliferation was evaluated using MTS assay. The lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages and the Con A-activated mouse splenocytes were cultured with various concentrations of CCE. Total nitric oxide (NO) production was determined by Griess reaction. The amounts of secreted prostaglandine E2 (PGE(2)), interleukin (IL)-2 and IFN-gamma were measured by ELISA. To investigate the in vivo anti-inflammatory effect of CCE, oxazolone-induced delayed type hypersensitivity (DTH) model was used. RESULTS: The CCE at 100 microgram/ml significantly blocked the LPS-induced production of pro-inflammatory mediators (NO and PGE) in RAW264.7 macrophages. Also, it significantly inhibited cell proliferation and cytokine (IL-2 and IFN-gamma) production in splenocytes. Furthermore, when splenocytes from CCE fed mice (200 mg/kg for 2 weeks) were activated with Con A, cell proliferation and cytokine production were significantly inhibited. In addition, CCE decreased in vivo inflammation in oxazolone-induced DTH model mice. CONCLUSION: We suggest that Coptis chinensis can be used as an anti-inflammatory drug by exerting an inhibitory effect in inflammatory mediator- and cell-mediated inflammation.

Coptis chinensis Extract Inhibits the Production of Inflammatory Mediators and Delayed Type Hypersensitivity in Mice

BACKGROUND: Coptis chinensis rhizome has been used as a medicinal herb in traditional Oriental medicine. We investigated the effects of Coptis chinensis extract on inflammatory mediators and delayed type hypersensitivity in mice. METHODS: The inhibitory effect of ethanolic extract of Coptis chinensis (CCE) on cell proliferation was evaluated using MTS assay. The lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages and the Con A-activated mouse splenocytes were cultured with various concentrations of CCE. Total nitric oxide (NO) production was determined by Griess reaction. The amounts of secreted prostaglandine E2 (PGE(2)), interleukin (IL)-2 and IFN-gamma were measured by ELISA. To investigate the in vivo anti-inflammatory effect of CCE, oxazolone-induced delayed type hypersensitivity (DTH) model was used. RESULTS: The CCE at 100 microgram/ml significantly blocked the LPS-induced production of pro-inflammatory mediators (NO and PGE) in RAW264.7 macrophages. Also, it significantly inhibited cell proliferation and cytokine (IL-2 and IFN-gamma) production in splenocytes. Furthermore, when splenocytes from CCE fed mice (200 mg/kg for 2 weeks) were activated with Con A, cell proliferation and cytokine production were significantly inhibited. In addition, CCE decreased in vivo inflammation in oxazolone-induced DTH model mice. CONCLUSION: We suggest that Coptis chinensis can be used as an anti-inflammatory drug by exerting an inhibitory effect in inflammatory mediator- and cell-mediated inflammation.

Glinical Trials in Japan and Korea-The Present State and Issues to be Solved- / 全日本鍼灸学会雑誌

The purpose of this workshop was to discuss on various issues for the development of a protocol for the Ja pan-Korea research collaboration. An important issue is to select/develop the experimental design of the clinical trial for individualized therapy done in Japan and Korea. Randomizedn-of-1 trial and randomization test were proposed as an possible candidate. A pilot study using randomized n-of-1 trial was done using intradermal acupuncture on pollinosis, and the methodological issues on the generalizability of randomized n-of-1 trial and the need of the selection of target disease were discussed. Onthe other hand, the literature survey has shown that the individualized acupuncture therapy is more effective than those of the standardized' fixed acupuncture therapy in usual RCTs. The diagnosis and selection of acupuncture point and method of manipulation were also shown to be an important factor. Further discussions will be required for the development of the adequate protocol for the individualized therapy.

Laparoscopy-assisted Surgical Removal of a Retained Wireless Capsule Endoscopy: A case report

Occult bleeding of the gastrointestinal tract is a major cause of iron deficiency anemia. Even with endoscopic evaluation of the upper and the lower gastrointestinal tract in these patients, in 30~50% of the cases, the cause of bleeding still remains undiscovered. Wireless capsule endoscopy (WCE) is a novel method of evaluating the small bowel mucosa by using a small capsule equipped with a camera and transmission device. Complications of WCE include impaction within the gastrointestinal tract, sometimes requiring surgical removal. The authors report a case of capsule impaction in the small bowel in a patient evaluated for anemia due to occult gastrointestinal tract bleeding. The patient is a 19 year-old female with a history of anemia since age 4. The stool guaiac test was positive, but upper and lower gastrointestinal tract endoscopy showed no abnormalities, so WCE was done. A short segment of circular ulcers with lumen narrowing were seen in the distal jejunum. Seven days after ingestion of the capsule, the patient denied passage of the capsule. Small bowel enteroclysis was performed, and the capsule was seen along with a segment of lumen narrowing distal to the site of retention. Surgery was done, and upon laparoscopic examination, the entire bowel appeared normal. Retrieval of the capsule was done along with a resection of an 8 cm segment of the small bowel. Three linear ulcers were seen in the resected bowel specimen. Pathology revealed no evidence of Crohn's disease or tuberculosis. The patient is still on iron supplements, but her hemoglobin level remains stable at 11~12 g/dl.

Acute Effects of Caffeine on Arterial Stiffness in Young Healthy Subjects

BACKGROUND AND OBJECTIVES: Coffee is one of the most popular beverages in the world. Caffeine is one of the substances contained in coffee and it is well known to increase blood pressure and the peripheral vascular resistance, in part because it stimulates the sympathetic nervous system. Arterial stiffness is an important factor for the performance of the cardiovascular system and it is an independent prognosticator of cardiovascular disease. We investigated the acute effect of caffeine on arterial stiffness in young healthy subjects. SUBJECTS AND METHODS: We enrolled 20 young healthy subjects, who were randomly divided two groups. The caffeine group (10 subjects, 4 males, mean age: 23.3+/-1.1 years) received 520 mL caffeinated coffee and the control group (10 subjects, 4 males, mean age: 23.1+/-1.3 years) received 520 mL water. The arterial stiffness was evaluated by the carotid-radial pulse wave velocity and the augmentation index as corrected by heart rate (75 bpm), and all the hemodynamic measurements were obtained at baseline, 30, 60, 120 and 180 minutes after ingestion of the coffee or water. RESULTS: Arterial stiffness measured by carotid-radial pulse wave velocity increased progressively from 9.4+/-1.2 m/sec at baseline to 11.5+/-1.6 m/sec (p<0.05) at 30 minutes after the coffee intake. In addition, peripheral systolic pressure increased progressively from 107.1+/-10.2 mmHg at baseline to 114.4+/-12.9 mmHg (p<0.05) at 60 minutes after the coffee intake. Such changes were not seen in control group. CONCLUSION: Caffeine affects increased the pulse wave velocity and systolic blood pressure. This means that coffee might have an adverse effect on arterial stiffness.

Review of Pragmatic Clinical Trials on Acupuncture / 全日本鍼灸学会雑誌

[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.<BR>[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.<BR>[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.<BR>[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.<BR>[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

Report on the 1st Japan-Korea Workshop on Acupuncture and EBM-Proposal of Clinical Trials for the Future Japan-Korea Collaboration- / 全日本鍼灸学会雑誌

The first Japan-Korea workshop on acupuncture and EBM was held on June 4, 2004 at Chiba in the 53rd annual scientific meeting of the JSAM. The purpose of this workshop was to exchange the experiences of clinical researches on acupuncture and moxibustion therapies, and to find out the issues and their solutions for developing the excellent clinical research to establish strong evidence. The final purpose was to develop aprotocol for the collaborative work between both countries.<BR>Drs. Kawakita (JSAM) and Jang (KAMS) chaired the workshop. Three speakers from Japan (Drs Takahashi, Nabeta, and Tsukayama) and three Korean speakers (Drs Seo, Lee and Moon) presented their data on the clinical researches of acupuncture, moxibustion and bee-venom injection. After their paper presentations, various issues were discussed on their research methodology for establishing more strong evidence of acupuncture.We got interesting new findings and understood various issues for conducting clinical researches especially RCT.<BR>Although we could not develop a protocol for the collaborative research in this workshop, it was very fruitful workshop as the first step for the future Japan-Korea collaborative clinical study. The most important product of this workshop was we could understand each other and we confirmed the necessity of the future collaborative clinical research on acupuncture.