Stroke causes systemic immunosuppression. T lymphocytes are involved in infarct size in the early stages of stroke. However, the phenotypes of T lymphocytes and their functions in peripheral immune organs and the brain have not been well analyzed in the acute and chronic phases of stroke. Here, we investigated pathological phenotypic alterations in the systemic immune response, especially changes in T lymphocytes, from one day to six months after ischemic stroke in mice. Impairment in thymocyte numbers, development, proliferation, and apoptosis were observed for up to two weeks. The number of mature T cells in the spleen and blood decreased and showed reduced interferon-γ production. Increased numbers of CD4-CD8-CD3+ double-negative T cells were observed in the mouse brain during the early stages of stroke, whereas interleukin (IL)-10+Foxp3+ regulatory T lymphocytes increased from two weeks during the chronic phase. These phenotypes correlated with body weight and neurological severity scores. The recovery of T lymphocyte numbers and increases in IL-10+Foxp3+ regulatory T lymphocytes may be important for long-term neurological outcomes. Dynamic changes in T lymphocytes between the acute and chronic phases may play different roles in pathogenesis and recovery. This study provides fundamental information regarding the T lymphocyte alterations from the brain to the peripheral immune organs following stroke.

Stroke causes systemic immunosuppression. T lymphocytes are involved in infarct size in the early stages of stroke. However, the phenotypes of T lymphocytes and their functions in peripheral immune organs and the brain have not been well analyzed in the acute and chronic phases of stroke. Here, we investigated pathological phenotypic alterations in the systemic immune response, especially changes in T lymphocytes, from one day to six months after ischemic stroke in mice. Impairment in thymocyte numbers, development, proliferation, and apoptosis were observed for up to two weeks. The number of mature T cells in the spleen and blood decreased and showed reduced interferon-γ production. Increased numbers of CD4-CD8-CD3+ double-negative T cells were observed in the mouse brain during the early stages of stroke, whereas interleukin (IL)-10+Foxp3+ regulatory T lymphocytes increased from two weeks during the chronic phase. These phenotypes correlated with body weight and neurological severity scores. The recovery of T lymphocyte numbers and increases in IL-10+Foxp3+ regulatory T lymphocytes may be important for long-term neurological outcomes. Dynamic changes in T lymphocytes between the acute and chronic phases may play different roles in pathogenesis and recovery. This study provides fundamental information regarding the T lymphocyte alterations from the brain to the peripheral immune organs following stroke.

Transient receptor potential vanilloid subtype 1 (TRPV1) on astrocytes prevents ongoing degeneration of nigrostriatal dopamine (DA) neurons in MPP⁺-lesioned rats via ciliary neurotrophic factor (CNTF). The present study determined whether such a beneficial effect of astrocytic TRPV1 could be achieved after completion of injury of DA neurons, rather than ongoing injury, which seems more relevant to therapeutics. To test this, the MPP⁺-lesioned rat model utilized here exhibited approximately 70~80% degeneration of nigrostriatal DA neurons that was completed at 2 weeks post medial forebrain bundle injection of MPP⁺. TRPV1 agonist, capsaicin (CAP), was intraperitoneally administered. CNTF receptor alpha neutralizing antibody (CNTFRαNAb) was nigral injected to evaluate the role of CNTF endogenously produced by astrocyte through TRPV1 activation on DA neurons. Delayed treatment of CAP produced a significant reduction in amphetamine-induced rotational asymmetry. Accompanying this behavioral recovery, CAP treatment increased CNTF levels and tyrosine hydroxylase (TH) activity in the substantia nigra pars compacta (SNpc), and levels of DA and its metabolites in the striatum compared to controls. Interestingly, behavioral recovery and increases in biochemical indices were not reflected in trophic changes of the DA system. Instead, behavioral recovery was temporal and dependent on the continuous presence of CAP treatment. The results suggest that delayed treatment of CAP increases nigral TH enzyme activity and striatal levels of DA and its metabolites by CNTF endogenously derived from CAP-activated astrocytes through TRPV1, leading to functional recovery. Consequently, these findings may be useful in the treatment of DA imbalances associated with Parkinson's disease.
Animals ; Antibodies, Neutralizing ; Astrocytes ; Capsaicin ; Ciliary Neurotrophic Factor ; Dopamine ; Dopaminergic Neurons ; Medial Forebrain Bundle ; Models, Animal ; Neurons ; Parkinson Disease ; Pars Compacta ; Rats ; Receptor, Ciliary Neurotrophic Factor ; Tyrosine 3-Monooxygenase

OBJECTIVETo obtain fundamental information for the standardization of herbal medicine in Korea.

METHODSWe analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam (Dong Yi Bao Jian) to classify prescribed herbal medicines.

RESULTSThe study revealed that the most frequently prescribed herbal medicine was 'Liuwei Dihuang Pill (LWDHP, )' which was used for invigorating 'Shen (Kidndy)-yin'. 'LWDHP' was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and 'Xionggui Tiaoxue Decoction (XGTXD, )' was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases (ICD) codes, 'Diseases of the musculoskeletal system and connective tissue' showed the highest prevalence. 'LWDHP' and 'XGTXD' was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, 'Ziyin Jianghuo Decoction ()' was prescribed to mainly male patients, and 'XGTXD' with 'Guima Geban Decoction ()' were prescribed to mainly female patients.

CONCLUSIONThis study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.

Adult ; Aged ; Cross-Sectional Studies ; Drug Prescriptions ; Electronic Health Records ; Female ; Herbal Medicine ; Hospitals ; Humans ; Male ; Medicine, Korean Traditional ; Middle Aged ; Phytotherapy ; Republic of Korea

OBJECTIVETo evaluate the clinical efficacy of electrical stimulation (ES) of auricular acupressure on reducing the ocular symptoms and signs before and after treatment for dry eye.

METHODSThe inclusion criteria were the tear film break-up time (TFBUT) below 5 s and a Schirmer test-I below 5 mm in dry eyes with ocular symptoms for at least 6 months. Subjects were randomized into a treatment group (50 cases) with continuous low frequency ES under auricular acupressure at acupoints and a no ES under auricular acupressure (no-ES, control group, 50 cases) on the same acupoints. Auricular acupressure were stimulated with ES at 4 master points of both ears, which were performed twice a week for 4 weeks at each point for 30 s. The ocular symptoms, the TFBUT, and Schirmer test-I were evaluated before and after this procedure.

RESULTSThere were significantly better scores in TFBUT (P=0.032), the Schirmer test-I (P=0.044) and ocular symptoms (P=0.029) at 3 months post-treatment in the treatment group than in the control group. The total effective rate in the treatment group was accomplished in 41 (82%) of the 50 cases of dry eye.

CONCLUSIONSAuricular acupressure with ES at auricular acupoint improves ocular symptoms and signs of dry eye for a period of at least 3 months.

OBJECTIVETo evaluate the effectiveness of scalp acupuncture (SA), a modern acupuncture technique specialized to neurological disorders, in managing motor function and symptoms for Parkinson's disease (PD) patients.

METHODSTwo independent reviewers extracted data from all of the randomized clinical trials (RCTs) that assessed the efficacy of SA for PD compared with conventional therapies (CTs). Sixteen electronic databases were searched. The risk of bias was appraised with the Cochrane Collaboration tool, and the reporting of the included studies was evaluated by the Consolidated Standards of Reporting Trials (CONSORT) 2010 checklist and the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines.

RESULTSIn total, 4 RCTs met the inclusion criteria. As assessed by the Unified PD Rating Scale (UPDRS), 2 RCTs showed that SA combined with CTs proved superior to CTs alone [60 cases; weighted mean difference, -3.94; 95% confidence interval (CI), -6.05 to -1.84, P=0.01; I(2) =0%]. Based on the Webster scale, however, 3 RCTs showed no superior effect of SA when combined with CTs with high heterogeneity (154 cases; risk ratio, 1.29; 95% CI, 0.79 to 2.12, P=0.30; I(2) =84%). The Cochrane risk of bias, adherence to the CONSORT and the STRICTA checklist showed that the quality of all the included RCTs was generally low.

CONCLUSIONSThe result of our systematic review and meta-analysis suggested that the effectiveness of SA for PD is promising, however, the evidence is not convincing. A sham-controlled RCT design that adheres to the CONSORT and STRICTA guidelines to overcome methodological weakness and that includes a large sample size is strongly recommended to confirm the precise effect of SA on PD.

Acupuncture Points ; Acupuncture Therapy ; adverse effects ; Humans ; Parkinson Disease ; therapy ; Randomized Controlled Trials as Topic ; Scalp ; pathology ; Treatment Outcome

Syndrome pattern (SP) is a core concept of Chinese medicine (CM) and is used to diagnose and treat patients based on an overall analysis of symptoms and signs. This study aimed to systematically review randomized controlled trials (RCTs) using the SP concept and to demonstrate how the SP concept could be applied to the study design of parallel RCTs, considering a gold standard of clinical research. After conducting a brief systematic review by way of a PubMed search, we analyzed how the SP concept was applied to the design of RCT in a CM herbal medicine trial. We then formulated possible research questions, applied the SP concept to answer the research questions, and suggested possible RCT designs to be used for conducting future trials. Fourteen RCTs were included in our systematic review, and three key points of the SP concept were formulated for the design of parallel RCTs: the time point of SP diagnosis between before and after randomization; the relationship between the international classification of diseases (ICD) and SP for the inclusion of target population; and the proper diagnostic method of SP. In this study, we formulated three possible research questions and then suggested perspectives for five possible RCT models arrived at using SP concepts. Future trials applying SP concept to RCTs should overcome the shortcomings of past SP trials, moving CM forward from experience-based to evidence-based medicine.
Humans ; Randomized Controlled Trials as Topic ; Research Design ; Syndrome ; Treatment Outcome

The narrow bony cochlear nerve canal in high resolution temporal bone computed tomography is frequently found in patients of congenital sensorineural hearing loss. But this bony structural anomaly could not conclude the functional outcome of cochlear nerve. Here, we present a case of a 14-month-old girl having bilateral narrow bony cochlear nerve canals. In magnetic resonance imaging, both the cochlear nerves were identified to be intact. Moreover, acoustic brainstem response threshold and auditory steady state response revealed nearly normal hearing thresholds. Therefore, we suggest that the narrow bony cochlear nerve canal itself does not necessarily indicate a substantial degree of hearing loss.
Acoustics ; Brain Stem ; Cochlear Nerve ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Magnetic Resonance Imaging ; Multidetector Computed Tomography ; Temporal Bone

The narrow bony cochlear nerve canal in high resolution temporal bone computed tomography is frequently found in patients of congenital sensorineural hearing loss. But this bony structural anomaly could not conclude the functional outcome of cochlear nerve. Here, we present a case of a 14-month-old girl having bilateral narrow bony cochlear nerve canals. In magnetic resonance imaging, both the cochlear nerves were identified to be intact. Moreover, acoustic brainstem response threshold and auditory steady state response revealed nearly normal hearing thresholds. Therefore, we suggest that the narrow bony cochlear nerve canal itself does not necessarily indicate a substantial degree of hearing loss.
Acoustics ; Brain Stem ; Cochlear Nerve ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Magnetic Resonance Imaging ; Multidetector Computed Tomography ; Temporal Bone

OBJECTIVETo summarize and critically evaluate the evidence for and against the effectiveness of Eastern-Western integrative medicine (EWIM) for health care compared to Eastern medicine (EM) or Western medicine (WM) alone.

METHODSSystematic searches were conducted on five Korean medical databases. Manual searches were also conducted through nine major Korean medical journals. Prospective randomized clinical trials (RCTs) were included if EWIM was tested for any type of conditions compared to EM or WM.

RESULTSThere were one hundred forty-one possibly relevant studies were identified, and seven RCTs were included. The risk of bias was high in most studies. The EWIM methods were compared with EM or WM in patients with pain conditions in four studies. These studies showed favorable effects of EWIM on pain reduction in patients with shoulder pain and chronic headache compared with EM, while the other RCTs failed to do so in traffic injury patients. Two studies tested EWIM in patients with Bell's palsy compared with EM and found acute functional improvement. An RCT comparing EWIM with WM in patients with acne showed a significant difference.

CONCLUSIONThe results of our systematic review suggest that there is limited evidence for the superiority of EWIM over EM or WM in the treatment of pain and acute symptom improvement in patients with Bell's palsy. The evidence from our analysis was limited from the low number of RCTs included and the high risk of bias. Future RCTs appear to be warranted.

Delivery of Health Care ; statistics & numerical data ; Humans ; Integrative Medicine ; statistics & numerical data ; Publication Bias ; Randomized Controlled Trials as Topic ; statistics & numerical data ; Republic of Korea ; Treatment Outcome