Objectives: To determine the clinical characteristics of Korean patients with sporadic oculopharyngodistal myopathy. Methods: Three consecutive unrelated Korean patients with sporadic oculopharyngodistal myopathy participated in this study. Stepwise approaches were performed including careful clinical examination, electrophysiological study, pathology evaluation and genetic study. The literature on oculopharyngodistal myopathy was reviewed. Results: Clinically, our patients showed consistent features of initial distal limb weakness with variable ophthalmoplegia, bulbar weakness or proximal weakness. All the patients showed rimmed vacuoles and myopathic changes. Conclusion: Through the literature review and this study, we believe that initial distal limb weakness is a characteristic fi nding in patients with oculopharyngodistal myopathy in some ethnic groups.

OBJECTIVERed ginseng (RG, Panax ginseng C.A. Meyer) is one of the widely used herbs for treating type 2 diabetes mellitus (DM). However, no systematic review of the effectiveness of RG for type 2 DM is available. This systematic review aimed to evaluate the current evidence for the effectiveness of RG in patients with type 2 DM.

METHODSElectronic searches of 14 electronic databases were conducted without language restrictions. All randomized clinical trials (RCTs) with RG as a treatment for type 2 DM were considered for inclusion. Their methodological quality was assessed using the Cochrane criteria.

RESULTSFour RCTs met our inclusion criteria. Their methodological quality was variable. Three of the RCTs compared the effectiveness of RG with placebo. The meta-analysis of these data failed to favor RG over placebo for fasting plasma glucose (FPG) [n =76, weighted mean difference (WMD): -0.43 mmol/L; 95% confidence interval (CI): -1.16 to 0.30, =0.25] and fasting plasma insulin (FPI) (n =76, WMD: -8.43 pmol/L; 95% CI: -19.54 to 2.68, P =0.14) for 12 weeks of treatment. One RCT compared the effects of RG with no treatment. The results did not suggest favorable effects of RG on FPG, hemoglobin A(1c) (HbA(1c)) or 2-h blood glucose after a meal (PP2h).

CONCLUSIONSThe evidence for the effectiveness of RG in controlling glucose in type 2 DM is not convincing. Few included studies with various treatment regimens prohibit definitive conclusions. More rigorous studies are needed to clarify the effects of RG on this condition.

Diabetes Mellitus, Type 2 ; drug therapy ; Humans ; Panax ; chemistry ; Phytotherapy ; Plant Extracts ; adverse effects ; therapeutic use ; Publication Bias ; Randomized Controlled Trials as Topic ; Risk Factors ; Treatment Outcome

OBJECTIVETo assess the clinical evidence for and against acupuncture as a treatment for Bell's palsy.

METHODSWe conducted a literature search of 15 databases from their inception to December 2010 without language restrictions. We included all randomized clinical trials (RCTs) regardless of their controls. Methodological quality was evaluated using the Cochrane risk of bias assessment tool.

RESULTSOf the 3 474 articles, only eight RCTs met our inclusion criteria. Four RCTs tested the effects of acupuncture against drug therapy on disease response rate. The meta-analysis of these data showed significant improvements in the acupuncture group [n=463, risk ratio (RR)=1.07, 95% CI: 1.02 to 1.13; P=0.006, I(2)=0%]. Six RCTs tested the effects of acupuncture plus drug therapy versus drug therapy alone. The meta-analysis of this set of RCTs also showed the favorable effects of acupuncture on disease response rate (n=512, RR=1.11, 95% CI: 1.05 to 1.17; P=0.001, I(2)=13%).

CONCLUSIONSThe evidence supporting the effectiveness of acupuncture for treating Bell's palsy is limited. The number and quality of trials are too low to form firm conclusions. Further rigorous RCTs are warranted but need to overcome the many limitations of the current evidence.

Acupuncture Points ; Acupuncture Therapy ; adverse effects ; Bell Palsy ; therapy ; Humans ; Randomized Controlled Trials as Topic ; Treatment Outcome

BACKGROUND: A pharmacist's participation in medical rounds in intensive care unit (ICU) is becoming popular nowadays. In this study, we investigated the effect of pharmacologic intervention by a pharmacist's participation in medical round in ICU on prevention of adverse drug events (ADEs). METHODS: From March 2011 to July 2011, the intervention data were obtained by participating in medical round two or three times a week, and by reviewing electronic medical records of patients admitted to surgical ICU. The incidence, cause, and type of ADEs were noted, respectively. Expected cost avoidance was calculated from interventions, which were considered to be preventive of ADEs. The acceptance rate of pharmacologic interventions was noted. RESULTS: Among 2781 patients, a total of 159 intervention data were collected in 90 patients. Recommendation for drug dosage adjustment or monitoring in patients with potential overdose and sub-therapeutic dose made up 82% of the total interventions. In 8% of interventions, initiation of drug therapy was recommended. 83% of the interventions were accepted and the acceptance rate of interventions within 24 hrs was 58%. The rate of the interventions, which were considered to be preventive of ADEs was 62%. Expected cost reduction obtained by preventing ADEs was 25,867,083 Won during a 5-month period. CONCLUSIONS: A pharmacist's participation in physician rounds in ICU was associated with prevention of ADEs and subsequent reduction of the cost in drug therapy.
Drug Toxicity ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pharmacists

Comprehension of the medical diagnoses of doctors and treatment of diseases is important to understand the underlying principle in selecting appropriate acupoints. The pattern recognition process that pertains to symptoms and diseases and informs acupuncture treatment in a clinical setting was explored. A total of 232 clinical records were collected using a Charting Language program. The relationship between symptom information and selected acupoints was trained using an artificial neural network (ANN). A total of 11 hidden nodes with the highest average precision score were selected through a tenfold cross-validation. Our ANN model could predict the selected acupoints based on symptom and disease information with an average precision score of 0.865 (precision, 0.911; recall, 0.811). This model is a useful tool for diagnostic classification or pattern recognition and for the prediction and modeling of acupuncture treatment based on clinical data obtained in a real-world setting. The relationship between symptoms and selected acupoints could be systematically characterized through knowledge discovery processes, such as pattern identification.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Neural Networks (Computer) ; Republic of Korea ; Syndrome

OBJECTIVE: Acupotomy is a modern acupuncture method that includes modern surgical methods. Since acupotomy is relatively more invasive than filiform acupuncture treatment, it is important to establish the safety profile of this practice. To justify further large-scale prospective observational studies, this preliminary study was performed to assess the feasibility of the approach and investigate the safety profile and factors potentially associated with adverse events (AEs). METHODS: This was a prospective pilot study that assessed the feasibility of a large-scale forthcoming safety study on acupotomy treatment in a real-world setting. The feasibility (call response rate, drop-out rate, response rate for each variable and recruitment per month) and safety profile (incidence, type, severity and causality of AEs, and factors potentially associated with AEs) were measured. RESULTS: A total of 28 participants joined the study from January to May 2018. A follow-up assessment was achieved in 258 (1185 treatment points) out of 261 sessions (1214 treatment points). The response rate via telephone on the day after treatment was 87.3%. There were 8 systemic AEs in all the sessions (8/258; 3.11%) and 27 local AEs on the total points treated (27/1185; 2.28%). Severe AEs did not occur. Total AE and local AE occurrence were associated with blade width and the number of needle stimulations per treatment point. CONCLUSION: The findings suggest that it could be feasible to analyze the safety of acupotomy in a real-world setting. Moreover, the primary data on some relevant AEs could be determined. We are planning large-scale prospective studies based on these findings. TRIAL REGISTRATION Clinical Research Information Service (CRIS) KCT0002849 (https://cris.nih.go.kr/cris/search/detailSearch.do/11487).
Humans ; Feasibility Studies ; Prospective Studies ; Pilot Projects ; Acupuncture Therapy/methods* ; Research Design ; Treatment Outcome