[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.
[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.
[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.
[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.
[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.

PURPOSE:The prevalence of childhood obesity has been increased rapidly, associated with high morbidity of dyslipidemia, cardiovascular risk factors and insulin resistance/hyperinsulinemia. Hyperinsulinemia in obese children may depend on either increased insulin secretion or decreased insulin clearance. We investigate whether insulin secretion and clearance are different between obese and normal weight children. METHODS:The body mass index(BMI), fasting serum glucose, insulin and C-peptide levels were measured in 101 children(52 obese children and 49 non-obese controls) in Ansan area, from 6 to 14 years old. Fasting serum C-peptide/insulin ratio, insulin/glucose ratio, homeostasis model assessment(HOMA) were calculated and compared between obese and control group. RESULTS:The fasting serum insulin and C-peptide levels were significantly higher in obese group than in controls. The C-peptide/insulin ratio was significantly lower and insulin/glucose ratio was significantly higher in obese group than in controls. There were positive correlations between BMI and fasting serum insulin level, fasting insulin/glucose ratio and HOMA. The prevalence of hyperinsulinemia is higher in obese adolescents than in controls. CONCLUSION: Our findings suggest that increased insulin secretion and decreased insulin clearance may contribute to hyperinsulinemia in obese children.
Adolescent ; Blood Glucose* ; C-Peptide* ; Child* ; Dyslipidemias ; Fasting* ; Gyeonggi-do ; Homeostasis ; Humans ; Hyperinsulinism ; Insulin* ; Obesity* ; Pediatric Obesity ; Prevalence ; Risk Factors

No abstract available.
Follow-Up Studies* ; Spinal Stenosis*

PURPOSE: In order to elucidate the actual mechanism and the optimal concentration of Lamotrigine(LTG) that suppresses epileptiform discharges, we observed epileptiform discharges from hippocampal slices of immature rat in 4-aminopyridine(4-AP) added Mg2+ - free medium of artificial cerebrospinal fluid(aCSF) with various LTG concentrations. METHODS: We divided 19-23 day-old Sprague-Dawley rats into 4 groups; control group(n=12) and 3 LTG groups depending on the concentrations of LTG such as 400 (n=9), 800(n=7), and 1,000(n=8) microM. The rats were anesthetized and their brains were taken, soaked in aCSF(NaCl 125 mM, KCl 2.5 mM, NaH2PO4 2 mM, MgSO4 1.25 mM NaHCO3 25 mM, CaCl2 2 mM, Glucose 10 mM, pH 7.3-7.4). And then the brains were cut into 400 microm hippocampal slices by a vibratome. The slices of control group were soaked in 200 microM 4-AP added Mg2+ -free medium of aCSF for 1 hour, and then extracellular recordings were performed in hippocampal CA1 pyramidal region. The slices of LTG groups were soaked in the solution containing 400, 800, and 1,000 microM LTG, then extracellular recordings were performed. RESULTS: Interictal discharges were observed in all the control and the LTG groups. The latency to the first interictal discharges after 4-AP addition was 52.7+/-26.9 sec in control group, but was 225.0+/-28.2 sec in 800 microM and 322.1+/-116.4 sec in 1,000 microM group of LTG(P<0.05). The duration of interictal discharges was 64.6+/-35.6 sec in control group, but was the shortest in 800 microM group of LTG at 39.3+/-12.6 sec. Ictal discharges were observed in all of control and 400 microM group, but the frequency was decreased as the concentration of LTG increases, 57.1% in 800 microM, 12.5% in 1,000 microM group. The latency to ictal discharge after 4-AP addition was 142.1+/-52.6 sec in control group, but increased as the concentration of LTG increases, 304.4+/-84.5 sec in 400 microM group and 689.8+/-213.1 sec in 800 microM group(P<0.05). The duration of ictal discharges was 1,534.7/-339.3 sec in control group, but decreased as the concentration of LTG increases, it was 126.5+/-76.1 sec in 800 microM group(P <0.05) and 42 sec in 1,000 microM group. CONCLUSION: The antiepileptic effects of LTG were most significant when the concentration, inhibiting epileptiform discharges induced by 4-AP and Mg2+ -free medium in hippocampal slices of immature rats, was 800 microM or higher. Although the basic pharmacologic mechanism of LTG is the inhibition of sodium channel, it may also work on potassium channel at higher concentrations.
4-Aminopyridine* ; Animals ; Brain ; Glucose ; Hydrogen-Ion Concentration ; Potassium Channels ; Rats* ; Rats, Sprague-Dawley ; Sodium Channels

The antihypertensive effect of carteolol hydrochloride was observed in 20 cases of essential hypertension, and following results were obtained. 1. Mean drops in systolic and diastolic blood pressure by carteolol hydrochloride were 13mmHg and 9mmHg. The results of antihypertensive therapy revealed good control in 25%, fair control in 35%, poor in 20% and failure in 20% of the cases. 2. After the administration of carteolol hydrochloride, no drop in average heart rate was observed. 3. The side effect of carteolol was mild indigestion in two cases.
Blood Pressure ; Carteolol* ; Dyspepsia ; Heart Rate ; Hypertension

Conjunctival tuberculosis is a very rare disease, but importance of tuberculosis in Korea is high. We experienced a 49 year-old female patient with a small mass like lesion at inferior fornix with conjunctivitis. We performed excisional biopsy. Biopsy result was conjunctival tuberculosis. So we searched other body tuberculosis focus, but, not found. we emphasize differential diagnosis chronic conjunctivitis and conjunctival tuberculosis. Brief clinical history and clinical findings will be presented with pictures of the pathology findings and some literatures will be reviewd.
Biopsy ; Conjunctiva ; Conjunctivitis ; Diagnosis, Differential ; Female ; Humans ; Korea ; Middle Aged ; Pathology ; Rare Diseases ; Tuberculosis*

Osteoma cutis is a primary cutaneous ossification, which has no preceding trauma or skin disease and no evidence of Albrights hereditary osteodystrophy n the patient or his family. The lesion appears as hard, round to irregular, sharply defined tumor of varying size within the skin or subcutis, and color ranges from flesh-colored to purple or brown. We report herein a case of osteoma cutis in a 32-year-old female, who had a 1 x 1cm sized, asymptomatic, round, flesh colored, hard nodule on the right side of her forehead for 5 years. Histopathologic examination showed mature bone with many ostocytes, osteoblasts, cement lines and Haversian canals in the dermis.
Adult ; Dermis ; Female ; Forehead ; Haversian System ; Humans ; Osteoblasts ; Osteoma* ; Skin ; Skin Diseases

BACKGROUND: Herpes zoster is characterized by vesicular skin lesions over the unilateral sensory dermatomes being caused by the reactivation of varicella-zoster virus and its incidence seems to be increasing recently. OBJECTIVE: The purpose of this study was to elucidate the epidemiology and the clinical characteristics of herpes zoster. METHODS: The authors observed 877 cases of herpes zoster clinically for annual incidence, age, sex, monthly distribution, predilection site, associated disease, and complications at the Department of Dermatology in Chung-Ang University Hospital during a 10 years period(1982.9-1992.8). RESULTS: 1) The annual incidence averaged over 10 years was 2.26%(877 cases of total 38.717 outpatients) being on the increase recently. 2) The age distribution was in the range of 2-86 years old being most prevalent in the 6th decade and there was equal sex ratio(444:433). 3) There was no statistically significant monthly or seasonal variation in the incidence of herpes zoster. 4) The most common anatomical distribution was thoracic dermatome(51.7%), followed by trigeminal(17.1%), cervical(16.1%), lumbar (10.6%), sacral(1.4%)and multiple deramatomic involvement(3.1%). Left or right side was affected in about the same ratio(439:437), and bilateral involvement was in 1 case. 5) Associated disease of herpes zoster were observed in 210 patients(23.9%) ; hypertension(7.0%), diabetes mellitus(4.1%), tuberculosis(1.8%), postoperative status(0.7%), malignancy(0.7%), gastric ulcer(0.7%), and so on, 6) The most common complication of herpes zoster was postherpetic neuralgia(7.4%), followed by eye complication(2.1%), bacterial infection(1.4%), scar formation(0.7%), neurogenic bladder(0.2%), Ramsay-Hunt syndrome(0.2%), motor paralysis(0.1%), herpes zoster generalisatus(0.1%) 7) The incidence of postherpetic neuralgia increased with age and was highest in trigeminal dermatome. 8) Recurrence of herpes zoster was observed in 4 patients(0.5%). CONCLUSION: According to this study, the annual incidence of herpes zoster showed a tendency to increase recently but there was no significant monthly or seasonal variation. The anatomical distribution was most commom on the thoracic dermatome. The incidenc of postherpetic neuralgia increased with age being most common in trigeminal nerve.
Age Distribution ; Cicatrix ; Dermatology ; Epidemiology ; Herpes Zoster* ; Herpesvirus 3, Human ; Incidence ; Neuralgia, Postherpetic ; Recurrence ; Seasons ; Skin ; Trigeminal Nerve

Forty five patients with inferior vena cava (IVC) thrombosis were studied with the use of ultrasonography (US) and computed tomography (CT). Thirty seven cases were cased by tumor extension and the primary neoplasms were hepatocellular Ca. (26cases), renal cell Ca. (6 cases), Wilms' tumor (1 case), IVC leiomyosarcoma (1 case) and retroperitoneal metastatic tumor (3 cases). Non-tumor thrombus were 8 cases which included 5 cases of Budd-Chiari syndrome and 3 cases of thrombophlebitis. US and CT both were good for the diagnosis of IVC thrombosis. Cranial extension was better demonstrated by US whereas CT yielded better delineation of the lower extension. Even though, differentiation of tumor non-tumor thrombi by the echogenecity and density of the thrombus was not possible, the finkdings of adjacent tumor mass, complete obstructive thrombus within dilated lumen with bulging wall, and nontapered acute margin of thrombus made the possibility of tumor thrombus more likely.
Budd-Chiari Syndrome ; Diagnosis ; Humans ; Leiomyosarcoma ; Thrombophlebitis ; Thrombosis* ; Ultrasonography ; Vena Cava, Inferior* ; Wilms Tumor

No abstract available.
Axis, Cervical Vertebra* ; Spondylolysis*