The purpose of this study is to summarize teaching experiences on channel and acupoints. The method of classified teaching is put forward and approached to explore the law of acupoint teaching. It is held that the method could reduce randomness and enhance appropriateness, rationality and scientific validity of the teaching. Class hours are thus optimized and the best teaching result achieved. Acupoints are classified into 4 categories of core points, focal points, regular points and ordinary points according to their use frequency and theoretical importance. Classification methods, principles and categories are then determined. And content of courses, teaching techniques and requirements are introduced as well. Suggestions are offered on enriching teaching contents, for instance, paraphrasing of the acupoint names, indications, point prescriptions and clinical experiences. Thus the conclusion is made that it is imperative to reform the conventional sort of acupoints classified by only focal points and ordinary points as well as the related teaching methods.
Acupuncture ; education ; standards ; Acupuncture Points ; Cyclobutanes ; Humans ; Teaching ; standards

A 24-year old woman presented with hemorrhagic vesicles on her legs. She had taken sibutramine (Reductil(R), Abbott Labs., Seoul, South Korea) for 3 months and developed skin lesions the week before. A skin biopsy showed leukocytoclastic vasculitis with conspicuous eosinophilic infiltration of the tissue. These lesions showed improvement after discontinuation of sibutramine. However, 3 months later the skin lesions recurred on other sites on the lower extremities when the patient was rechallenged with the same drug for 2 weeks. Herein, we report the first case of necrotizing vasculitis induced by sibutramine.
Biopsy ; Cyclobutanes ; Eosinophils ; Female ; Humans ; Leg ; Lower Extremity ; Skin ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

A safe and effective way to control weight in patients with affective disorders is needed, and phentermine is a possible candidate. We performed a PubMed search of articles pertaining to phentermine, sibutramine, and affective disorders. We compared the studies of phentermine with those of sibutramine. The search yielded a small number of reports. Reports concerning phentermine and affective disorders reported that i) its potency in the central nervous system may be comparatively low, and ii) it may induce depression in some patients. We were unable to find more studies on the subject; thus, it is unclear presently whether phentermine use is safe in affective disorder patients. Reports regarding the association of sibutramine and affective disorders were slightly more abundant. A recent study that suggested that sibutramine may have deleterious effects in patients with a psychiatric history may provide a clue for future phentermine research. Three explanations are possible concerning the association between phentermine and affective disorders: i) phentermine, like sibutramine, may have a depression-inducing effect that affects a specific subgroup of patients, ii) phentermine may have a dose-dependent depression-inducing effect, or iii) phentermine may simply not be associated with depression. Large-scale studies with affective disorder patients focusing on these questions are needed to clarify this matter before investigation of its efficacy may be carried out and it can be used in patients with affective disorders.
Anti-Obesity Agents ; Central Nervous System ; Cyclobutanes ; Depression ; Humans ; Mood Disorders ; Obesity ; Phentermine

PURPOSE: In Korea, few studies have examined the acute toxicity of anti-obesity drugs. The purpose of this study is to analyze the general characteristics and clinical aspect of acute anti-obesity drug intoxication. METHODS: We retrospectively investigated patients admitted to the emergency department after anti-obesity drug intoxication between March, 2004 and February, 2012. The medical records of these patients were reviewed for demographic data, toxicologic history, time elapsed to presentation, clinical symptoms and signs, treatment, and outcome. RESULTS: There were a total of 18 anti-obesity intoxication cases during the study period; of 16 which were included in our study. The purchasing route of the anti-obesity drug was mainly through a doctor's prescription (68.8%), however, some were obtained through the internet and the pharmacies. The mean time to The most commonly ingested anti-obesity drug was sibutramine (31.3%) and many of the cases (62.5%) were multi-drug ingestions. The most common clinical manifestations were gastrointestinal symptoms (94%), but, CNS symptoms (75%) and cardiovascular symptoms (75%) were almost equally present. 13 patients (81%) were discharged after clearance of toxic symptoms and signs with a mean observational period of 7.0 hours. 3 patients were admitted for observation and treatment; of which 1 patient died due to fatal complications. CONCLUSION: Most anti-obesity intoxications show mild toxicity and a nonfatal clinical course. However, the recent trend toward prescribing psychostimulant anti-obesity medication, which can be fatal after an acute overdose, calls physicians' attention to treating of anti-obesity intoxications.
Anti-Obesity Agents ; Cyclobutanes ; Emergencies ; Humans ; Internet ; Korea ; Medical Records ; Obesity ; Pharmacies ; Prescriptions ; Retrospective Studies

The current recommendations for the treatment of obese people include increased physical activity and reduced calories intake. When the behavioral approach is not sufficient, a pharmacologic treatment is recommended. In past years, numerous drugs have been approved for the treatment of obesity; however, most of them have been withdrawn from the market because of their adverse effects. In fact, amphetamine, rimonabant and sibutramine licenses have been withdrawn due to an increased risk of psychiatric disorders and non-fatal myocardial infarction or stroke. Even if orlistat is not as effective as other drugs in reducing body weight, orlistat is presently the only available choice for the treatment of obesity because of its safety for cardiovascular events and positive effects on diabetic control. Hopefully, more effective and better tolerated anti-obesity drugs will be developed through an improved understanding of the multiple mechanisms and complex physiological systems targeting appetite.
Amphetamine ; Anti-Obesity Agents ; Appetite ; Body Weight ; Cyclobutanes ; Lactones ; Licensure ; Motor Activity ; Myocardial Infarction ; Obesity ; Piperidines ; Pyrazoles ; Stroke

AIMTo study the binding of sibutramine hydrochloride (SH) and bovine serum albumin (BSA) in physiological condition by spectroscopic method.

METHODSThe quenching mechanism of the fluorescence of bovine serum albumin by sibutramine hydrochloride was studied with the fluorescence and the absorption spectroscopy. The binding constants K and the number of binding sites were determined at different temperatures according to Scatchard equation and the main binding force was discussed by thermodynamic equations. The effect of the drug on bovine serum albumin conformation was also studied by using synchronous fluorescence spectroscopy.

RESULTSThe quenching mechanism of sibutramine hydrochloride to bovine serum albumin was static quenching. The binding constants K at 8 degrees C, 25 degrees C, 37 degrees C were 1.21 x 10(5), 8.31 x 10(4), 6.97 x 10(4) L x mol(-1) with one binding site, respectively. The thermodynamic parameters of the reaction were deltaH = -9.70 kJ x mol(-1), deltaS = 56.41 J x mol(-1) x K(-1).

CONCLUSIONThe binding force is electrostatic interaction. Sibutramine hydrochloride can be deposited and transported by serum protein in vivo. Sibutramine hydrochloride has nearly no effect on the serum protein conformation.

Animals ; Binding Sites ; Cattle ; Cyclobutanes ; metabolism ; Protein Binding ; Serum Albumin, Bovine ; metabolism ; Spectrometry, Fluorescence ; methods ; Spectrophotometry, Ultraviolet ; methods

OBJECTIVETo observe the difference between the therapeutic effect of Du-moxibustion (Moxibustion on the Governor Vessel) combined with western medicine and that of simple western medication for the remission stage of chronic obstructive pulmonary disease.

METHODSTwo hundred and ten cases were randomly divided into an observation group (108 cases)and a control group (102 cases). The observation group was treated by routine treatment of western medicine combined with herb-partitioned spread moxibustion on the Governor Vessel between Dazhui (GV 14)and Yaoshu (GV 2). Simple western medicine was used in control group. The therapeutic effects of two groups were compared with the changes of symptom scores and pulmonary function before and after treatment.

RESULTSThe total effective rate of observation group (90.7%, 98/108) was higher than that of control group (74.5%, 76/102) (P < 0.01). The symptom scores and some pulmonary function indices such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), the percentage of force expiratory volume in one second in predicted value(FEV1%) and maximal expiratory flow(PEF) after treatment were improved obviously than those before treatment in observation group (P < 0.05, P < 0.01), and the improvement degree was better than that of control group (all P < 0.01).

CONCLUSIONMoxibustion on the Governor Vessel combined with western medicine can improve the clinical symptoms and pulmonary function of chronic obstructive pulmonary disease of lung and kidney qi deficiency type effectively,and the effect is better than that of simple western medication.

Adult ; Aged ; Cyclobutanes ; Female ; Humans ; Kidney ; physiopathology ; Lung ; physiopathology ; Male ; Middle Aged ; Moxibustion ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; therapy ; Qi

A 38-year-old woman was admitted to our hospital due to agitation, nausea, chest discomfort, tachycardia and hypertension 6h after ingesting approximately 60 capsules of sibutramine. The woman developed the clinical features of acute psychosis, including auditory hallucination, agitation and paranoid ideation, on day 2. No relevant changes were detected on the laboratory examinations or on the electrocardiogram throughout the period of hospitalization. She was treated with risperidone and benzodiazepine. The symptoms subsequently resolved completely with cessation of the provoking agent. The patient was discharged on day 7 and the follow-up revealed no sequelae for 5 months.
Adult ; Benzodiazepines ; Capsules ; Cyclobutanes ; Dihydroergotamine ; Eating ; Electrocardiography ; Female ; Follow-Up Studies ; Hallucinations ; Hospitalization ; Humans ; Hypertension ; Nausea ; Psychotic Disorders ; Risperidone ; Tachycardia ; Thorax

Obesity is a major public health problem and significant risk factor for many serious diseases including coronary artery disease, cancer, and diabetes. This study was performed to investigate the hypolipidemic effects and anti-hypertensive effect of Dangyuja (Citrus grandis Osbeck) peel, which is bred on Jeju island, in rats fed a high-fat diet. This study was conducted on 4 equal rat groups which were fed as follows; normal diet group (ND), high fat diet group (HFD), high fat diet supplemented with powdered peel of Dangyuja (1%, wt/wt) group (HFD+Dangyuja), and high fat diet treated with sibutramine simultaneously at a dose of 10 mg/kg group (HFD+Sibutramine). After feeding the high fat diet, body weight gain and relative weight of adipose tissues and liver significantly increased in HFD group, but Dangyuja peel supplementation protected these HFD-induced changes. The levels of serum triglyceride, total cholesterol, low-density lipoprotein (LDL)-cholesterol, and the atherogenic index significantly decreased in the HFD+Dangyuja peel group compared with the HFD group. The systolic blood pressure was significantly increased by feeding the high fat diet, whereas the supplementation of Dangyuja peel effectively prevented the elevation of blood pressure. Therefore, these results suggest that Dangyuja exerts a beneficial effect on obesity by improving lipid metabolism and alleviating obesity-related hypertension.
Animals ; Blood Pressure ; Body Weight ; Cholesterol ; Coronary Artery Disease ; Cyclobutanes ; Diet ; Diet, High-Fat ; Hypertension ; Lipid Metabolism ; Lipoproteins ; Liver ; Obesity ; Public Health ; Rats ; Risk Factors

Sibutramine, which acts as an anti-obesity drug by inhibiting reuptake of serotonin and norepinephrine, has now been banned due to cardiovascular adverse effects. However, despite being banned, it is not uncommon for people to purchase products with sibutramine or its analogues used as adulterants in non-prescription slimming products or health foods available on the internet. Sibutramine has been associated with rare but serious adverse reactions such as cardiac arrhythmia including QT interval prolongation, myocardial infarction, and cardiomyopathy, as well as increases in blood pressure and pulse rate. Here, we report a case of a 32-year-old male who presented with dilated cardiomyopathy with massive left ventricular thrombus after taking unauthorized sibutramine-containing slimming pills sold over the internet.
Adult ; Anti-Obesity Agents ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cyclobutanes ; Food, Organic ; Heart Rate ; Humans ; Internet ; Male ; Myocardial Infarction ; Norepinephrine ; Serotonin ; Thrombosis