Evidence-based Complementary and Alternative Medicine - recent issues

eCAM: Proteomics, BioArt and Integrative Medicine?

Cooper, E. L. — Wed, 03 Feb 2010 19:56:29 PST

Traditional Chinese Medicine for Chronic Fatigue Syndrome

Chen, R., Moriya, J., Yamakawa, J.-i., Takahashi, T., Kanda, T. — Wed, 03 Feb 2010 19:56:29 PST

More and more patients have been diagnosed as having chronic fatigue syndrome (CFS) in recent years. Western drug use for this syndrome is often associated with many side-effects and little clinical benefit. As an alternative medicine, traditional Chinese medicine (TCM) has provided some evidences based upon ancient texts and recent studies, not only to offer clinical benefit but also offer insights into their mechanisms of action. It has perceived advantages such as being natural, effective and safe to ameliorate symptoms of CFS such as fatigue, disordered sleep, cognitive handicaps and other complex complaints, although there are some limitations regarding the diagnostic standards and methodology in related clinical or experimental studies. Modern mechanisms of TCM on CFS mainly focus on adjusting immune dysfunction, regulating abnormal activity in the hypothalamic-pituitary-adrenal (HPA) axis and serving as an antioxidant. It is vitally important for the further development to establish standards for ‘zheng’ of CFS, i.e. the different types of CFS pathogenesis in TCM, to perform randomized and controlled trials of TCM on CFS and to make full use of the latest biological, biochemical, molecular and immunological approaches in the experimental design.

Who Uses CAM? A Narrative Review of Demographic Characteristics and Health Factors Associated with CAM Use

Bishop, F. L., Lewith, G. T. — Wed, 03 Feb 2010 19:56:29 PST

Complementary and Alternative Medicines (CAM) are used by an extensive number of patients in the UK and elsewhere. In order to understand this pattern of behavior, it is helpful to examine the characteristics of people who use CAM. This narrative review collates and evaluates the evidence concerning the demographic characteristics and health status factors associated with CAM use in community-based non-clinical populations. A systematic literature search of computerized databases was conducted, and published research papers which present evidence concerning associations between CAM use and demographic and health characteristics are discussed and evaluated. The evidence suggests that people who use CAM tend to be female, of middle age and have more education. In terms of their health, CAM users tend to have more than one medical condition, but might not be more likely than non-users to have specific conditions such as cancer or to rate their own general health as poor. The multivariate studies that have been conducted suggest that both demographic and health characteristics contribute independently to CAM use. In conclusion, demographic characteristics and factors related to an individual's health status are associated with CAM use. Future research is needed to address methodological limitations in existing studies.

Geffen Faculty Highlight Concerns Linking CAIM and Conventional Researchers at UCLA Symposium

Logue, E. H. — Wed, 03 Feb 2010 19:56:29 PST

David Geffen School of Medicine faculty, representing a wide range of disciplines, engaged speakers nationally known for their expertise on complementary, alternative and integrative medicine (CAIM) and its investigation at a January, 2008 symposium on the campus of the University of California, Los Angeles. The forum was created to educate the UCLA Institutional Review Board (IRB), and lively participation by School of Medicine faculty helped bring IRB members up to speed on controversies surrounding CAIM research. The symposium demonstrated that academics who are neither proponents nor detractors of CAIM can facilitate cross talk between opposing camps, elucidating questions important to its evaluation by those charged with protecting research subjects. It also brought attention to the universality of quandaries facing CAIM investigators and to the ingenuity with which they have addressed many of them.

The Curious Case of Charles Darwin and Homeopathy

Ullman, D. — Wed, 03 Feb 2010 19:56:30 PST

In 1849, Charles Darwin was so ill that he was unable to work one out of every 3 days, and after having various troubling symptoms for 2–12 years, he wrote to a friend that he was ‘going the way of all flesh’. He sought treatment from Dr James Manby Gully, a medical doctor who used water cure and homeopathic medicines. Despite being highly skeptical of these treatments, he experienced a dramatic improvement in his health, though some of his digestive and skin symptoms returned various times in his life. He grew to appreciate water cure, but remained skeptical of homeopathy, even though his own experiments on insectivore plants using what can be described as homeopathic doses of ammonia salts surprised and shocked him with their significant biological effect. Darwin even expressed concern that he should publish these results. Two of Darwin's sons were as incredulous as he was, but their observations confirmed the results of his experiments. Darwin was also known to have read a book on evolution written by a homeopathic physician that Darwin described as similar to his own but ‘goes much deeper.’

Inhibitory Potencies of Several Iridoids on Cyclooxygenase-1, Cyclooxygnase-2 Enzymes Activities, Tumor Necrosis factor-{alpha} and Nitric Oxide Production In Vitro

Park, K. S., Kim, B. H., Chang, I.-M. — Wed, 03 Feb 2010 19:56:30 PST

To verify the anti-inflammatory potency of iridoids, seven iridoid glucosides (aucubin, catalpol, gentiopicroside, swertiamarin, geniposide, geniposidic acid and loganin) and an iridoid aglycone (genipin) were investigated with in vitro testing model systems based on inhibition of cyclooxygenase (COX)-1/-2 enzymes, the tumor necrosis factor- (TNF-) formation and nitric oxide (NO) production. The hydrolyzed-iridoid products (H-iridoid) with β-gludosidase treatment only showed inhibitory activities, and revealed different potencies, depending on their chemical structures. Without the β-gludosidase treatment, no single iridoid glycoside exhibited any activities. The aglycone form (genipin) also did not show inhibitory activities. To compare anti-inflammatory potency, the inhibitory concentrations (IC₅₀) in each testing system were measured. The hydrolyzed-aucubin product (H-aucubin) with β-gludosidase treatment showed a moderate inhibition on COX-2 with IC₅₀ of 8.83 µM, but much less inhibition (IC₅₀, 68.9 µM) on COX-1 was noted. Of the other H-iridoid products, the H-loganin and the H-geniposide exhibited higher inhibitory effects on COX-1, revealing IC₅₀ values of 3.55 and 5.37 µM, respectively. In the case of TNF- assay, four H-iridoid products: H-aucubin, H-catalpol, H-geniposide and H-loganin suppressed the TNF- formation with IC₅₀ values of 11.2, 33.3, 58.2 and 154.6 µM, respectively. But other H-iridoid products manifested no significant activity. Additional experiments on NO production were conducted. We observed that only the H-aucubin exhibited a significant suppression with IC₅₀ value of 14.1 µM. Genipin, an agycone form, showed no inhibitory effects on all testing models, implying the hydrolysis of the glycosidic bond of iridoid glycoside is a pre-requisite step to produce various biological activities.

Vaccinium myrtillus (Bilberry) Extracts Reduce Angiogenesis In Vitro and In Vivo

Matsunaga, N., Chikaraishi, Y., Shimazawa, M., Yokota, S., Hara, H. — Wed, 03 Feb 2010 19:56:30 PST

Vaccinium myrtillus (Bilberry) extracts (VME) were tested for effects on angiogenesis in vitro and in vivo. VME (0.3–30 µg ml^–1) and GM6001 (0.1–100 µM; a matrix metalloproteinase inhibitor) concentration-dependently inhibited both tube formation and migration of human umbilical vein endothelial cells (HUVECs) induced by vascular endothelial growth factor-A (VEGF-A). In addition, VME inhibited VEGF-A-induced proliferation of HUVECs. VME inhibited VEGF-A-induced phosphorylations of extracellular signal-regulated kinase 1/2 (ERK 1/2) and serine/threonine protein kinase family protein kinase B (Akt), but not that of phospholipase C (PLC). In an in vivo assay, intravitreal administration of VME inhibited the formation of neovascular tufts during oxygen-induced retinopathy in mice. Thus, VME inhibited angiogenesis both in vitro and in vivo, presumably by inhibiting the phosphorylations of ERK 1/2 and Akt. These findings indicate that VME may be effective against retinal diseases involving angiogenesis, providing it can reach the retina after its administration. Further investigations will be needed to clarify the major angiogenesis-modulating constituent(s) of VME.

In vitro Evaluation of the Antiviral Activity of an Extract of Date Palm (Phoenix dactylifera L.) Pits on a Pseudomonas Phage

Jassim, S. A. A., Naji, M. A. — Wed, 03 Feb 2010 19:56:30 PST

A crude acetone extract of the pit of date palm (Phoenix dactylifera L.) was prepared and its antiviral activity evaluated against lytic Pseudomonas phage ATCC 14209-B1, using Pseudomonas aeruginosa ATCC 25668 as the host cell. The antiviral activity of date pits was found to be mediated by binding to the phage, with minimum inhibitory concentration (MIC) of <10 µg ml^–1. The decimal reduction time (D-values), the concentration exponent () and the phage inactivation kinetics were determined. The date pit extracts show a strong ability to inhibit the infectivity of Pseudomonas phage ATCC 14209-B1 and completely prevented bacterial lysis, which it is hoped will promote research into its potential as a novel antiviral agent against pathogenic human viruses.

AMP N1-oxide, a unique compound of royal jelly, induces neurite outgrowth from PC12 cells via signaling by protein kinase A independent of that by mitogen-activated protein kinase

Hattori, N., Nomoto, H., Fukumitsu, H., Mishima, S., Furukawa, S. — Wed, 03 Feb 2010 19:56:30 PST

Earlier we identified adenosine monophosphate (AMP) N₁-oxide as a unique compound of royal jelly (RJ) that induces neurite outgrowth (neuritegenesis) from cultured rat pheochromocytoma PC12 cells via the adenosine A_2A receptor. Now, we found that AMP N₁-oxide stimulated the phosphorylation of not only mitogen-activated protein kinase (MAPK) but also that of cAMP/calcium-response element-binding protein (CREB) in a dose-dependent manner. Inhibition of MAPK activation by a MEK inhibitor, PD98059, did not influence the AMP N₁-oxide-induced neuritegenesis, whereas that of protein kinase A (PKA) by a selective inhibitor, KT5720, significantly reduced neurite outgrowth. AMP N₁-oxide also had the activity of suppressing the growth of PC12 cells, which correlated well with the neurite outgrowth-promoting activity. KT5720 restored the growth of AMP N₁-oxide-treated PC12 cells. It is well known that nerve growth factor suppresses proliferation of PC12 cells before causing stimulation of neuronal differentiation. Thus, AMP N₁-oxide elicited neuronal differentiation of PC12 cells, as evidenced by generation of neurites, and inhibited cell growth through adenosine A_2A receptor-mediated PKA signaling, which may be responsible for characteristic actions of RJ.

Hochuekkito, a Kampo (traditional Japanese herbal) Medicine, Enhances Mucosal IgA Antibody Response in Mice Immunized with Antigen-entrapped Biodegradable Microparticles

Matsumoto, T., Noguchi, M., Hayashi, O., Makino, K., Yamada, H. — Wed, 03 Feb 2010 19:56:30 PST

The effect of oral administration of Hochuekkito (HET; Bu-Zhong-Yi-Qi-Tang in Chinese), a traditional Japanese herbal medicine, on mucosal IgA immune response was investigated. To induce the antigen-specific antibodies in mucosal site, ovalbumin (OVA)-entrapped biodegradable microparticles (OVA-microparticles) were used as an antigen. Mice were orally immunized with OVA-microparticles for 3 successive days with intragastric gavage. From 7 days after the onset of immunization, the mice were boosted twice a week with the same antigen for 2 weeks. HET or water alone was orally administered to the mice via the intragastric route from 7 days before to 27 days after the onset of immunization. Although no significant change in total secretory IgA antibody level was observed in intestinal and nasal washes, OVA-specific IgA titers in intestinal washes were significantly enhanced by oral administration of HET. When lymphocytes from spleen, peripheral blood and Payer's patches were investigated for cytokines production, it was found that the IFN- secretion from the lymphocytes was increased by the administration of HET. Microarray analysis of Peyer's patch cells revealed enhanced expression of L-selectin gene. The increase of L-selectin positive cells in B lymphocytes fraction was observed in Peyer's patch cells and peripheral blood mononuclear cells by flow cytometry. These results suggest that the enhanced IFN- secretion and increased population of L-selectin positive B lymphocytes by orally administered HET may partly contribute to enhancement of IgA immune response against intestinal antigens, and orally administered HET may strengthen defensive systems against various pathogens and food antigens in intestine.

Anti-inflammatory and Immune-regulatory Effects of Subcutaneous Perillae Fructus Extract Injections on OVA-induced Asthma in Mice

Wed, 03 Feb 2010 19:56:30 PST

Perillae fructus (perilla seed) is a traditional medicinal herb used to treat bronchial asthma in Oriental medical clinics. ST36 is one of the most widely used acupuncture points, particularly for immune system regulation. Injection of an herbal extract into an acupuncture point (herbal acupuncture) is a therapeutic technique combining both acupuncture and herbal treatment. Perillae fructus extract was injected subcutaneously (Perillae fructus herbal acupuncture; PF-HA) at acupoint ST36 of OVA-induced asthmatic mice. The lung weight, bronchoalveolar fluid (BALF) cell count, the number of CCR3+, CD11b+, CD4+ and CD3e+/CD69+ cells in the lung, and the level of IgE, IL-4, IL-5 and IL-13 in BALF and serum were then measured. RT-PCR was used to measure the mRNA expression of IL-4, IL-5, IL-13 and TNF- in the lung. Lung sections were analyzed histologically. PF-HA significantly reduced lung weight, the number of inflammatory cells in the lung and BALF, the levels of IgE and Th2 cytokines in BALF and serum, mRNA expression of Th2 cytokines in the lung, and pathological changes in lung tissue. Our results suggest that PF-HA may have an anti-inflammatory and immune-regulatory effect on bronchial allergic asthma by restoring the Th1/Th2 imbalance in the immune system and suppressing eosinophilic inflammation in airways.

A Kampo Medicine, Boi-ogi-to, Inhibits Obesity in Ovariectomized Rats

Wed, 03 Feb 2010 19:56:30 PST

In women facing menopause, end of menstrual activity is accompanied by lower levels of estrogen and gradual weight gain. Postmenopausal weight gain sounds an alarm for women's health and may lead to hyperlipidemia, a lipid increase and glucose intolerance. These phenomena are connected to lifestyle-related diseases such as hypertension, type II diabetes mellitus, arteriosclerosis and metabolic syndrome, making it essential to prevent weight gain in women. A Kampo medicine, Boi-ogi-to, is traditionally used to treat obese conditions, but the mechanism has not yet been investigated. In this experiment, we tested the antiobesity properties of Boi-ogi-to in ovariectomized rats by measuring changes of serum cytokine levels and adipocytokines in fat cells. After treatment with this extract for 6 weeks (20-week-old rats), we found that there was a significant weight decrease in rats treated with Boi-ogi-to as compared with that in the control group. Serum tumor necrosis factor (TNF)- levels increased significantly in a dose-dependent manner. Gene expression of adipose tissue in uterus also dose dependently showed a significant increase of TNF- levels, suggesting that secretion of TNF- by fat cells might play a role in the ability of Boi-ogi-to to inhibit weight gain. While peroxisome proliferators-activated receptor- and adiponectin levels did not show a significant difference as compared with those in the control, levels of mRNA expression showed a tendency to increase dose dependently. Resistin did not show any significant change. These results suggest that Boi-ogi-to might be useful for the prevention of obesity that occurs in women with reduction of estrogen.

N-butanol Extract from Melilotus Suaveolens Ledeb Affects Pro- and Anti-Inflammatory Cytokines and Mediators

Zhao, L., Tao, J.-Y., Zhang, S.-L., Jin, F., Pang, R., Dong, J.-H. — Wed, 03 Feb 2010 19:56:30 PST

Melilotus suaveolens Ledeb is a traditional medicinal plant for treating inflammation-related disease. This explores the inner anti-inflammatory mechanism of n-butanol extract from M. suaveolens Ledeb. Inflammatory cellular model was established by lipopolysaccharide intervention on RAW264.7 cell line. Levels of secreted cytokines TNF-, IL-1β, IL-6, NO and IL-10 in supernatant, mRNA expression of TNF-, COX-2, iNOS and HO-1, protein expression of COX-2 and HO-1, activation of NF-B and ingredients in the extract were assayed by ELISA, real time quantitative PCR, western blot, immunocytochemical test and HPLC fingerprint test, respectively. As a result, the extract could not only markedly reduce the production of pro-inflammatory mediators to different extents by blocking NF-B activation but also promote the release of anti-inflammatory mediator HO-1 significantly. Each 1 g extract contained 0.023531 mg coumarin and another two high polar ingredients, probably saponins. It can be concluded that the extract has similar effects on antagonizing pro-inflammatory mediators and cytokines like Dexamethasone, and has effects on promoting the production of anti-inflammatory mediators.

Dietary Supplement Polypharmacy: An Unrecognized Public Health Problem?

Nisly, N. L., Gryzlak, B. M., Zimmerman, M. B., Wallace, R. B. — Wed, 03 Feb 2010 19:56:30 PST

Excessive and inappropriate use of medications, or ‘polypharmacy’, has been recognized as a public health problem. In addition, there is growing use of dietary supplements in the United States; however, little is known about the patterns of supplement use. Recent reports in the literature of cases of excessive or inappropriate use of herbal dietary supplements leading to the term ‘polyherbacy’. The clinical vignettes described in this article highlight the need for further research on the nature and extent of multiple and inappropriate dietary supplement use or ‘dietary supplement polypharmacy’. Clinical interviewing and population surveys both address this issue in complementary ways, and provide a further understanding of dietary supplement use patterns.

Potential Use of Plectranthus amboinicus in the Treatment of Rheumatoid Arthritis

Chang, J.-M., Cheng, C.-M., Hung, L.-M., Chung, Y.-S., Wu, R.-Y. — Wed, 03 Feb 2010 19:56:30 PST

Plectranthus amboinicus (P. amboinicus) is a folk herb that is used to treat inflammatory diseases or swelling symptoms in Taiwan. We investigated therapeutic efficacy of P. amboinicus in treating Rheumatoid Arthritis (RA) using collagen-induced arthritis animal model. Arthritis was induced in Lewis rats by immunization with bovine type II collagen. Serum anti-collagen IgG, IgM and C-reactive protein (CRP) were analyzed. To understand the inflammation condition of treated animals, production of TNF-, IL-6 and IL-1β from peritoneal exudates cells (PEC) were also analyzed. P. amboinicus significantly inhibited the footpad swelling and arthritic symptoms in collagen-induced arthritic rats, while the serum anti-collagen IgM and CRP levels were consistently decreased. The production of pro-inflammatory cytokines TNF-, IL-6 and IL-1β were also decreased in the high dosage of P. amboinicus group. Here, we demonstrate the potential anti-arthritic effect of P. amboinicus for treating RA, which might confer its anti-rheumatic activity. This differs the pharmacological action mode of indomethacin.

Regional Brain Activation During Meditation Shows Time and Practice Effects: An Exploratory FMRI Study{dagger}

Wed, 03 Feb 2010 19:56:30 PST

Meditation involves attentional regulation and may lead to increased activity in brain regions associated with attention such as dorsal lateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC). Using functional magnetic resonance imaging, we examined whether DLPFC and ACC were activated during meditation. Subjects who meditate were recruited and scanned on a 3.0 Tesla scanner. Subjects meditated for four sessions of 12 min and performed four sessions of a 6 min control task. Individual and group t-maps were generated of overall meditation response versus control response and late meditation response versus early meditation response for each subject and time courses were plotted. For the overall group (n = 13), and using an overall brain analysis, there were no statistically significant regional activations of interest using conservative thresholds. A region of interest analysis of the entire group time courses of DLPFC and ACC were statistically more active throughout meditation in comparison to the control task. Moreover, dividing the cohort into short (n = 8) and long-term (n = 5) practitioners (>10 years) revealed that the time courses of long-term practitioners had significantly more consistent and sustained activation in the DLPFC and the ACC during meditation versus control in comparison to short-term practitioners. The regional brain activations in the more practised subjects may correlate with better sustained attention and attentional error monitoring. In summary, brain regions associated with attention vary over the time of a meditation session and may differ between long- and short-term meditation practitioners.

Can Homeopathy Bring Additional Benefits to Thalassemic Patients on Hydroxyurea Therapy? Encouraging Results of a Preliminary Study

Wed, 03 Feb 2010 19:56:30 PST

Several homeopathic remedies, namely, Pulsatilla Nigricans (30th potency), Ceanothus Americanus (both mother tincture and 6th potency) and Ferrum Metallicum (30th potency) selected as per similia principles were administered to 38 thalassemic patients receiving Hydroxyurea (HU) therapy for a varying period of time. Levels of serum ferritin (SF), fetal hemoglobin (HbF), hemoglobin (Hb), platelet count (PC), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), white blood cell (WBC) count, bilirubin content, alanine amino transferase (ALT), aspartate amino transferase (AST) and serum total protein content of patients were determined before and 3 months after administration of the homeopathic remedies in combination with HU to evaluate additional benefits, if any, derived by the homeopathic remedies, by comparing the data with those of 38 subjects receiving only HU therapy. Preliminary results indicated that there was a significant decrease in the SF and increase in HbF levels in the combined, treated subjects. Although the changes in other parameters were not so significant, there was a significant decrease in size of spleen in most patients with spleenomegaly and improvement in general health conditions along with an increased gap between transfusions in most patients receiving the combined homeopathic treatment. The homeopathic remedies being inexpensive and without any known side-effects seem to have great potentials in bringing additional benefits to thalassemic patients; particularly in the developing world where blood transfusions suffer from inadequate screening and fall short of the stringent safety standards followed in the developed countries. Further independent studies are encouraged.

Mucuna pruriens Reduces Stress and Improves the Quality of Semen in Infertile Men

Wed, 03 Feb 2010 19:56:31 PST

The present investigation was undertaken to assess the role of Mucuna pruriens in infertile men who were under psychological stress. Study included 60 subjects who were undergoing infertility screening and were found to be suffering from psychological stress, assessed on the basis of a questionnaire and elevated serum cortisol levels. Age-matched 60 healthy men having normal semen parameters and who had previously initiated at least one pregnancy were included as controls. Infertile subjects were administered with M. pruriens seed powder (5 g day^–1) orally. For carrying out morphological and biochemical analysis, semen samples were collected twice, first before starting treatment and second after 3 months of treatment. The results demonstrated decreased sperm count and motility in subjects who were under psychological stress. Moreover, serum cortisol and seminal plasma lipid peroxide levels were also found elevated along with decreased seminal plasma glutathione (GSH) and ascorbic acid contents and reduced superoxide dismutase (SOD) and catalase activity. Treatment with M. pruriens significantly ameliorated psychological stress and seminal plasma lipid peroxide levels along with improved sperm count and motility. Treatment also restored the levels of SOD, catalase, GSH and ascorbic acid in seminal plasma of infertile men. On the basis of results of the present study, it may be concluded that M. pruriens not only reactivates the anti-oxidant defense system of infertile men but it also helps in the management of stress and improves semen quality.

'The Science of CAIM: What's Next for Complementary, Alternative and Integrative Medical Research?'

Logue, E. H. — Wed, 03 Feb 2010 19:56:31 PST

eCAM: Darwin and Metchnikoff

Cooper, E. L. — Tue, 24 Nov 2009 07:14:54 PST

Ginseng on Hyperglycemia: Effects and Mechanisms

Luo, J. Z., Luo, L. — Tue, 24 Nov 2009 07:14:54 PST

It has been reported that American ginseng attenuates hyperglycemia and may present itself as a supplement to diabetes therapy. However, the lack of standardization in the usage of ginseng root leads to inconclusive results when applied to diabetes treatment. The mechanisms of American ginseng root in the treatment of diabetes remains a mystery. This greatly limits the effective utilization of American ginseng in facilitating diabetic therapy. Initiating studies have shown that American ginseng increases insulin production and reduces cell death in pancreatic β-cells. Also, studies have revealed American ginseng's ability to decrease blood glucose in type II diabetes patients as well as in streptozotocin-induced diabetic animals (STZ-diabetic mice). These data suggest that effects of ginseng in improving hyperglycemia may alter mitochondrial function as well as apoptosis cascades to ensure cell viability in pancreatic islet cells. This review briefly summarizes current knowledge of ginseng components and clinical studies related to diabetes. Further research will be needed to explore and identify the component(s) of ginseng, which may be responsible for the beneficial effects observed in animal studies which could then be extrapolated to human islets.

Pediatric Acupuncture: A Review of Clinical Research

Tue, 24 Nov 2009 07:14:54 PST

Practiced in China for more than 2000 years, acupuncture has recently gained increased attention in the United States as an alternative treatment approach for a variety of medical conditions. Despite its growing prevalence and anecdotal reports of success among pediatric populations, few empirically based studies have assessed the efficacy of acupuncture for children and adolescents. This article presents a review of the current literature, including a systematic appraisal of the methodological value of each study and a discussion of potential benefits and adverse effects of acupuncture. While acupuncture holds great promise as a treatment modality for diverse pediatric conditions, a significant amount of additional research is necessary to establish an empirical basis for the incorporation of acupuncture into standard care.

Evaluating the Quality of Randomized Controlled Trials that Examine the Efficacy of Natural Health Products: A Systematic Review of Critical Appraisal Instruments

Whelan, A. M., Jurgens, T. M., Lord, L. — Tue, 24 Nov 2009 07:14:55 PST

The purpose of this project was to conduct a systematic review to identify instruments designed to evaluate the quality of randomized controlled trials (RCTs) of natural health products (NHPs). Instruments were examined for inclusion of items assessing methods, identity and content of the NHP, generalizability of results and instructions for use. Online databases, websites, textbooks and reference lists were searched to identify instruments. Relevance assessment and data extraction of articles were completed by two investigators and disagreements were settled by the third investigator. Data were analyzed using descriptive statistics. Of the 4442 citations identified, 29 were potentially relevant with 16 meeting the criteria for inclusion. None of the instruments stated they were validated; content in the four areas of interest varied considerably. The most common items included randomization sequence generation (100%), blinding (100%), allocation concealment (75%) and participant flow (75%). Only nine of the NHP instruments included at least one item to appraise the specific content of the NHP. The CONSORT Statement for Herbal Interventions most closely addressed the four areas of interest; however, this instrument was specific for herbs. There is a need for the development of a validated instrument for assessment of the quality of RCTs that would be useful for herbs as well as other NHPs.

Macroscopic Quantum Coherence in Patient-Practitioner-Remedy Entanglement: The Quantized Fluctuation Field Perspective

Hankey, A. — Tue, 24 Nov 2009 07:14:55 PST

Assessment of antimalarial activity against Plasmodium falciparum and phytochemical screening of some Yemeni medicinal plants

Tue, 24 Nov 2009 07:14:55 PST

Developing countries, where malaria is one of the most prevalent diseases, still rely on traditional medicine as a source for the treatment of this disease. In the present study, six selected plants (Acalypha fruticosa, Azadirachta indica, Cissus rotundifolia, Echium rauwalfii, Dendrosicyos socotrana and Boswellia elongata) commonly used in Yemen by traditional healers for the treatment of malaria as well as other diseases, were collected from different localities of Yemen, dried and extracted with methanol and water successfully. The antiplasmodial activity of the extracts was evaluated against fresh clinical isolates of Plasmodium falciparum. The selectivity parameters to evaluate the efficacy of these medicinal plants were measured by in vitro micro test (Mark III) according to World Health Organization (WHO) 1996 & WHO 2001 protocols of antimalarial drug tests. Among the investigated 12 extracts, three were found to have significant antiplasmodial activity with IC₅₀ values less than 4 µg/ml, namely the water extracts of A. fruticosa, A. indica and D. socotrana. Six extracts showed moderate activity with IC₅₀ values ranging from 10 to 30 µg/ml and three appeared to be inactive with IC₅₀ values more than 30 µg/ml. In addition, preliminary phytochemical screening of the methanolic and aqueous extracts indicated the presence of saponins, tannins, flavonoids, terpenoids, polysaccharides and peptides.

Acori graminei rhizoma Ameliorated Ibotenic Acid-Induced Amnesia in Rats

Kim, J. H., Hahm, D.-H., Lee, H.-J., Pyun, K. H., Shim, I. — Tue, 24 Nov 2009 07:14:55 PST

In the present study, we investigated the effects of Acori graminei rhizoma (AGR) on learning and memory for the Morris water maze task and on the central cholinergic system of the rats with excitotoxic medial septum (MS) lesion. On the water maze test, the rats were trained to find a platform that was in a fixed position during 6 days and then they received a 60 s probe trial in which the platform was removed from the pool on the 7th day. Ibotenic lesioning of the MS impaired the performance on the maze test and it caused degeneration of choline acetyltransferase and acetylcholine esterase in the hippocampus, which are markers of the central cholinergic system. Daily administrations of AGR (100 mg kg^–1, i.p.) for 21 consecutive days produced reversals of the ibotenic acid-induced deficit in learning and memory. These treatments also reduced the loss of cholinergic immunoreactivity in the hippocampus that was induced by ibotenic acid. These results demonstrated that AGR ameliorated learning and memory deficits through their effects on the central nervous system, and neuroprotection was partly evaluated through the effect of AGR on the cholinergic system. Our studies suggest that AGR can possibly be used as treatment for Alzheimer's disease.

Evaluating Complementary Therapies for Canine Osteoarthritis--Part II: A Homeopathic Combination Preparation (Zeel(R))

Hielm-Bjorkman, A., Tulamo, R.-M., Salonen, H., Raekallio, M. — Tue, 24 Nov 2009 07:14:55 PST

A homeopathic combination preparation (HCP) for canine osteoarthritic pain was evaluated in a randomized, double-controlled and double-blinded clinical trial. Forty-four dogs with osteoarthritis (OA) that were randomly allocated into one of three groups completed the study. All dogs were fed test products or placebo for 8 weeks. The dogs were evaluated at the clinic four times, with 4-week intervals. Six different variables were assessed: veterinary-assessed mobility, two force plate variables, an owner-evaluated chronic pain index and pain and locomotion visual analogue scales (VASs). Intake of extra non-steroidal anti-inflammatory drugs was also evaluated. A Chi-squared test and a Mann–Whitney test were used to determine significant improvement between groups. When changed into dichotomous responses of ‘improved’ or ‘not improved’ three out of the six variables showed a significant difference (P = 0.016, P = 0.008, P = 0.039) in improved dogs per group, between the HCP group and the placebo group. The odds ratios were over one for the same variables. As extent of improvement in the variables from start to end of treatment, the HCP product was significantly more improved in four (P = 0.015, P = 0.028, P = 0.049, P = 0.020) of the six variables, compared with the placebo. Our results indicated that the HCP Zeel® was beneficial in alleviating chronic orthopedic pain in dogs although it was not as effective as carprofen.

Touch and Massage for Medically Fragile Infants

Tue, 24 Nov 2009 07:14:55 PST

Research investigating the efficacy of infant massage has largely focused on premature and low birth weight infants. The majority of investigations have neglected highly acute patients in academic neonatal intensive care units (NICUs). The current study was developed with two aims: (Phase 1) to develop, implement and demonstrate the feasibility and safety of a parent-trained compassionate touch/massage program for infants with complex medical conditions and (Phase 2) to conduct a longitudinal randomized control trial (RCT) of hand containment/massage versus standard of care in a level III academic Center for Newborn and Infant Critical Care (CNICC). Certified infant massage instructors (CIMIs) taught parents to massage their hospitalized infants. Massage therapy and instruction were performed for seven consecutive days and health outcomes were collected for up to 1 month following treatment. Caregivers, nurses and certified infant massage therapists indicated moderate to high levels of satisfaction and feasibility with the implementation of hand containment/massage in a level III academic center CNICC. In addition, infant behavioral and physiological measures were within safe limits during the massage sessions. All caregivers participating in the massage group reported high levels of satisfaction 7 days into the intervention and at the 1-month follow-up with regards to their relationship with their infant, the massage program's impact on that relationship and the massage program. Due to unequal and small sample sizes, between group analyses (control versus massage) were not conducted. Descriptive infant characteristics of health outcomes are described. Preliminary data from this study indicates feasibility and safety of infant massage and satisfaction among the caregivers, CIMIs and the nurses in the CNICC. An important contribution from this study was the demonstration of the infants’ safety based on physiological stability and no change in agitation/pain scores of the infants receiving massage. Massage in a tertiary urban academic NICU continues to be an area of needed study. Future studies examining infant health outcomes, such as weight gain, decreased length of hospitalization and caregiver–infant bonding, would provide greater insight into the impact of massage for medically fragile infants.

In vitro Cytotoxic Effect of Brazilian Green Propolis on Human Laryngeal Epidermoid Carcinoma (HEp-2) Cells

Bufalo, M. C., Candeias, J. M. G., Sforcin, J. M. — Tue, 24 Nov 2009 07:14:55 PST

Propolis is a sticky dark-colored material showing a very complex chemical composition that honeybees collect from plants. It has been used in folk medicine since ancient times, due to several biological properties, such as antimicrobial, anti-inflammatory, antioxidant and immunomodulatory activities, among others. Its antitumor action in vivo and in vitro has also been reported, using propolis extracts or its isolated compounds. The goal of this work was to evaluate propolis's cytotoxic action in vitro on human laryngeal epidermoid carcinoma (Hep-2) cells. These cells were incubated with different concentrations of this bee product for different time periods, and morphology and the number of viable HEp-2 cells analyzed. Data showed that propolis exhibited a cytotoxic effect in vitro against HEp-2 cells, in a dose- and time-dependent way. Propolis solvent had no effects on morphology and number of viable cells, proving that the cytotoxic effects were exclusively due to propolis components. Since humans have been using propolis for a long time, further assays will provide a better comprehension of propolis's antitumor action.

10-Hydroxy-2-decenoic Acid, a Major Fatty Acid from Royal Jelly, Inhibits VEGF-induced Angiogenesis in Human Umbilical Vein Endothelial Cells

Izuta, H., Chikaraishi, Y., Shimazawa, M., Mishima, S., Hara, H. — Tue, 24 Nov 2009 07:14:55 PST

Vascular endothelial growth factor (VEGF) is reported to be a potent pro-angiogenic factor that plays a pivotal role in both physiological and pathological angiogenesis. Royal jelly (RJ) is a honeybee product containing various proteins, sugars, lipids, vitamins and free amino acids. 10-Hydroxy-2-decenoic acid (10HDA), a major fatty acid component of RJ, is known to have various pharmacological effects; its antitumor activity being especially noteworthy. However, the mechanism underlying this effect is unclear. We examined the effect of 10HDA on VEGF-induced proliferation, migration and tube formation in human umbilical vein endothelial cells (HUVECs). Our findings showed that, 10HDA at 20 µM or more significantly inhibited such proliferation, migration and tube formation. Similarly, 10 µM GM6001, a matrix metalloprotease inhibitor, prevented VEGF-induced migration and tube formation. These findings indicate that 10HDA exerts an inhibitory effect on VEGF-induced angiogenesis, partly by inhibiting both cell proliferation and migration. Further experiments will be needed to clarify the detailed mechanism.

Orthosiphon Versus Placebo in Nephrolithiasis with Multiple Chronic Complaints: A Randomized Control Trial

Tue, 24 Nov 2009 07:14:55 PST

Nephrolithiasis in the communities of Northeast Thailand frequently presents with multiple chronic health complaints, i.e. myofascial pain, back pain, dyspepsia, arthralgia, headache, fatigue, frank paresthesia, dysuria and any of these aggravated by purine-rich food (PRF). We assessed the efficacy of Orthosiphon in treating subjects with at least two active symptoms and negative for urine white blood cells. Subjects were randomly allocated to two groups. Crude extract of Orthosiphon given in a capsule (equivalent to 1.6–1.8 g of dried leaves of Orthosiphon) two times a day to Group 1 (n = 36) and a placebo to Group 2 (n = 40) for 14 days. The medication for each subject was packed and its code kept secret until the data analysis. Both groups were asked not to consume any of 25 purine-rich foods (PRFs) during treatment. The primary measure was the reduced sum of active severity symptoms as recorded using the visual analog scale before and after therapy (i.e. on day 7 and 14). The data on 76 subjects were processed. The mean of the total scores (95% CI) of the symptoms in each group were decreased significantly (P < 0.001); 185.6 (153.3, 218.0) to 94.7 (58.2, 131.2) in the Orthosiphon group and 196.1 (164.4, 227.8) to 89.6 (62.8, 116.5) in the placebo group. When comparing between groups, no statistically significant difference was found. The mean consumption in PRFs was significantly decreased (P < 0.001) in both groups; however, Orthosiphon did not have additional benefit over placebo at 7 and 14 days of treatment during which they reduced these foods.

Scleroderma, Stress and CAM Utilization

Hui, K.-K., Johnston, M. F., Brodsky, M., Tafur, J., Kim Ho, M. — Tue, 24 Nov 2009 07:14:55 PST

Scleroderma is an autoimmune disease influenced by interplay among genetic and environmental factors, of which one is stress. Complementary and alternative medicine (CAM) is frequently used to treat stress and those diseases in which stress has been implicated. Results are presented from a survey of patients with scleroderma. Respondents were a convenient sample of those attending a national conference in Las Vegas in 2002. Findings implicate stress in the onset, continuation and exacerbation of scleroderma. The implication is that CAM providers may be filling an important patient need in their provision of services that identify and treat stress and its related disorders.

The Homeopathic Preparation Nervoheel N can Offer an Alternative to Lorazepam Therapy for Mild Nervous Disorders

van den Meerschaut, L., Sunder, A. — Tue, 24 Nov 2009 07:14:55 PST

In an open-label, prospective non-randomized cohort study, we compared the effectiveness and tolerability profiles of the homeopathic remedy Nervoheel N with those of the benzodiazepine, lorazepam, in 248 patients with insomnia, distress, anxieties, restlessness or burnout and similar nervous conditions (‘mild nervous disorders’). Patients were treated with Nervoheel N or lorazepam at the recommended doses for a maximum of 4 weeks. Dose variations were allowed if in the patient's best interest. Treatment effects were evaluated by the practitioner in a dialogue with the patient at the start of treatment, after 2 weeks and after maximally 4 weeks of treatment. Tolerability data were recorded as adverse events. At baseline, lorazepam patients were on average slightly older and there was a somewhat greater percentage of men in this group than in the Nervoheel group. Both treatment groups reported significant symptomatic improvements of similar magnitude during the course of the study. The sum of symptom scores improved by 4.4 points with Nervoheel N and by 4.2 points with lorazepam. The differences between the treatment groups were not significant. All differences between treatments were within 10% of the maximum score ranges, demonstrating non-inferiority of Nervoheel N. Both treatments were well tolerated, with few adverse events and very good self-assessed tolerability ratings by the patients. Thus, in patients who opt for a homeopathic treatment regimen for the short-term relief of mild nervous disorders, the effects of Nervoheel N are non-inferior to those of lorazepam.

Antiviral Activity of Some Plants Used in Nepalese Traditional Medicine

Tue, 24 Nov 2009 07:14:55 PST

Methanolic extracts of 41 plant species belonging to 27 families used in the traditional medicine in Nepal have been investigated for in vitro antiviral activity against Herpes simplex virus type 1 (HSV-1) and influenza virus A by dye uptake assay in the systems HSV-1/Vero cells and influenza virus A/MDCK cells. The extracts of Astilbe rivularis, Bergenia ciliata, Cassiope fastigiata and Thymus linearis showed potent anti-herpes viral activity. The extracts of Allium oreoprasum, Androsace strigilosa, Asparagus filicinus, Astilbe rivularis, Bergenia ciliata and Verbascum thapsus exhibited strong anti-influenza viral activity. Only the extracts of A. rivularis and B. ciliata demonstrated remarkable activity against both viruses.

Differential Growth Suppression of Human Melanoma Cells by Tea (Camellia sinensis) Epicatechins (ECG, EGC and EGCG)

Ravindranath, M. H., Ramasamy, V., Moon, S., Ruiz, C., Muthugounder, S. — Tue, 24 Nov 2009 07:14:55 PST

We previously reported that catechins of green tea have different antiproliferative effects on cell lines derived from gender-dependent cancers; epicatechin 3-gallate (ECG) had the strongest inhibitory effect. In the present study, we examined the effects of epigallocatechin (EGC), epicatechin-gallate (ECG) and EGC 3-gallate (EGCG) on the viability, density, doubling time and cycle number of cell lines derived from melanoma metastasized to lymph nodes (MB-1133 and SE-0154) or distant organs (CH-0356, JK-0346, SA-1171, GE-0208, NS-1176 and LF-0023). These catechins have been documented to have no growth suppressive or apoptotic effects on normal melanocytes (Nihal et al., Int J Cancer 2005;114:513–21). EGCG (50 µM) showed greater inhibitory potency than EGC (50 µM) in SE-0154, NS-1176, GE-0208 and LF-0023 cell lines but the two catechins produced similar inhibitory effects in CH-0356, JK-0346 and SA-1171 cell lines. The IC₅₀ (50% inhibitory concentration) was lower for EGC than EGCG in MB-1133 and CH-0356 cells, higher for EGC than EGCG in GE-0208 cells and comparable (11–12 µM) for both the catechins in LF-0023 cells. When compared with EGC, the cytotoxic effect (% dead cell counts) and the suppression of the growth (change in cell number) of all melanoma cell lines tested were pronounced with EGCG. This investigation validates the hypothesis that anticancer action of the various catechins may vary with the type of malignancy and provides a model for tumor cell heterogeneity based on susceptibility and resistance of tumor cells to different green tea catechins. Therefore, this information is critical for undertaking chemopreventive or chemotherapeutic trials against melanoma and gender-based cancers.

Contributions of Sasang Constitutional Medicine

Cooper, E. L. — Sun, 06 Sep 2009 23:33:34 PDT

Could there be a Synthesis between Western and Oriental Medicine, and with Sasang Constitutional Medicine in Particular?

Noble, D. — Sun, 06 Sep 2009 23:33:34 PDT

Attitudes towards oriental medicine are changing for two major reasons. The first is that many patients, even in the West, are choosing to use its practitioners and methods. The second is that the rise of Systems Biology may offer a better basis for dialogue, and even for synthesis, between the oriental and Western traditions. However, a lot of work is needed to clear the way for such dialogue and synthesis. Much of this work should be devoted to clarifying the meanings of the terms used, and the framework of theory and practice within which oriental methods operate. But it is also necessary for Systems Biology itself to mature as a discipline, particularly at the higher levels of biological organization since it is at these levels that oriental medicine derives its ideas and practice. Higher level Systems Biology could be a basis for interpretation of the Korean version of oriental medicine: Sasang constitutional medicine since it seeks patient specific analysis and treatment, and the mathematical methods of systems biology could be used to analyze the central concept of balance in Sasang.

Sasang Constitutional Medicine as a Holistic Tailored Medicine

Kim, J. Y., Pham, D. D. — Sun, 06 Sep 2009 23:33:35 PDT

Sasang constitutional medicine (SCM) is a unique traditional Korean therapeutic alternative form of medicine. Based on the Yin and Yang theory and on Confucianism, humans are classified into four constitutions. These differ in terms of (i) sensitivity to certain groups of herbs and medicines, (ii) equilibrium among internal organic functions, (iii) physical features and (iv) psychological characteristics. We propose that two main axes in the physiopathology of SCM (food intake/waste discharge and consuming/storing Qi and body fluids) are equivalent to the process of internal–external exchange and catabolism/anabolism in modern physiology, respectively. We then used this hypothesis to discuss the physiological and pathological principles of SCM. Constitution-based medicine is based on the theory that some medicinal herbs and remedies are only appropriate for certain constitutions and can cause adverse effects in others. The constitutional approach of SCM share the same vision as tailored medicine; an individualized therapy that can minimize the risk of adverse reaction while increasing the efficacy and an individualized self-regulation that can help prevent specific susceptible chronic disease and live healthily. There is still a long way to this goal for both SCM and tailored medicine, but we may benefit from systems approaches such as systems biology. We suggest that constitutional perspective of SCM and our hypothesis of two main processes may provide a novel insight for further studies.

Psychological Profile of Sasang Typology: A Systematic Review

Chae, H., Park, S. H., Lee, S. J., Kim, M.-g., Wedding, D., Kwon, Y.-K. — Sun, 06 Sep 2009 23:33:35 PDT

A systematic review of studies related to the psychological characteristics of Sasang types was conducted with the goal of delineating generalizable psychological profiles based on Sasang typology, a traditional Korean medical typology with medical herbs and acupuncture that is characterized as personalized medicine. Journal articles pertaining to Sasang typology were collected using five electronic database systems in Korea and in the USA. As a result, 64 potentially relevant studies were identified and 21 peer-reviewed research articles that employed psychometric inventories were included. Beginning with the use of the Minnesota Multiphasic Personality Inventory in 1992, Myers-Briggs Type Indicator, NEO-Personality Inventory, Temperament and Character Inventory and other personality assessment tools were employed in the identified studies. Because data synthesis could not be carried out due to the heterogeneity of the studies, the present review article sought to delineate the mutual relevance of the studies based on research results pertaining to the correlation between the aforementioned psychological assessment instruments. Results of the review indicate that two super-factors, Extraversion and Neuroticism, serve as the foundation in regards to delineating personality constructs, such that the So-Yang type scored high on the Extraversion dimension and low on the Neuroticism dimension, while the So-Eum type scored low on the Extraversion dimension and high on the Neuroticism dimension. The present systematic review indicates that Sasang typology shares similarities with the Western psychological tradition.

Perspective of the Human Body in Sasang Constitutional Medicine

Lee, J., Jung, Y., Yoo, J., Lee, E., Koh, B. — Sun, 06 Sep 2009 23:33:35 PDT

The Sasang constitutional medicine (SCM), a medical tradition originating from Korea, is distinguished from the traditional Chinese medicine in its philosophical background, theoretical development and especially, the fundamental rationale that analyzes the structure and function of the human body within a quadrifocal scheme. In SCM, the structure of the body is comprehended within the Sasang quadrifocal scheme, and the function of the body is understood within the context of the energy–fluid metabolism and the water–food metabolism controlled by the four main organs (lung, spleen, liver and kidney). Also, the concept of Seong–Jeong is used to explain the structural and functional variations between different constitutional types that arise from the constitutional variations in organ system scheme, which are in turn caused by deviations in the constitutional Seong–Jeong. Therefore, understanding the SCM perspective of the human body is essential in order to fully appreciate the advantages of the constitutional typological system (which focuses on individual idiosyncrasies) found in SCM.

Current Researches on the Methods of Diagnosing Sasang Constitution: An Overview

Lee, S.-W., Jang, E.-S., Lee, J., Kim, J. Y. — Sun, 06 Sep 2009 23:33:35 PDT

Sasang constitution diagnosis has traditionally been conducted by a Sasang constitutional medicine (SCM) doctor who examines the external appearance, temperament and various symptoms of an individual and then collectively analyzes this information to determine their own constitutions. However, because this process is subjective and not quantitative, many researchers have been attempting to develop objective and reasonable methods of determining constitutions. In Korea, even though a wide range of research regarding SCM has been conducted, most of the work has not been revealed internationally. So in this review, the authors have searched the Journal of Sasang Constitutional Medicine, as well as other Korean domestic journal databases and Pubmed for research regarding modernized constitution diagnosis methods so to provide the understanding of current research state and outlook for future research.

Genetic Approach to Elucidation of Sasang Constitutional Medicine

Kim, B.-Y., Cha, S., Jin, H.-J., Jeong, S. — Sun, 06 Sep 2009 23:33:35 PDT

Sasang Constitutional Medicine (SCM) offers a medical principle that classifies humans into four constitution groups and guides their treatment with constitution-matched medical assistance. The principle of this traditional medicine, although requires significant scientific support, appears to suggest a genetic influence on constitution type. The relative frequency of constitution types in a population, for instance, has remained relatively constant since Jema Lee first described them from his observations. In addition, the body compartment concept of SCM appears to be related to the anterio–posterior patterning of the embryonic gut and associated internal organs. This study describes the attributes of the constitution concept of SCM that can be interpreted in the language of genetics and current approaches to identity the genetic factors that make up the constitution. These efforts should make it possible to interpret the principle of this traditional medicine scientifically. Considering the recent trend in medicine that pursues individualized or tailored medical offerings, once SCM is proven to be explainable with scientific evidence, it will be able to contribute to and take a place in the rapidly evolving medicine environment.

Randomized Clinical Trials of Constitutional Acupuncture: A Systematic Review

Lee, M. S., Shin, B.-C., Choi, S.-M., Kim, J. Y. — Sun, 06 Sep 2009 23:33:35 PDT

The aim of this systematic review is to compile and critically evaluate the evidence from randomized clinical trials (RCTs) for the effectiveness of acupuncture using constitutional medicine compared to standard acupuncture. Ten databases were searched through to December 2008 without language restrictions. We also hand-searched nine Korean journals of oriental medicine. We included prospective RCTs of any form of acupuncture with or without electrical stimulation. The included trials had to investigate constitutional medicine. There were no restrictions on population characteristics. Forty-one relevant studies were identified, and three RCTs were included. The methodological quality of the trials was variable. One RCT found Sasang constitutional acupuncture to be superior to standard acupuncture in terms of the Unified PD Rating Scale and freezing gate in Parkinson's disease (PD). Another two RCTs reported favorable effects of eight constitutional acupuncture on pain reduction in patients with herniated nucleus pulposi and knee osteoarthritis. Meta-analysis demonstrated positive results for eight constitutional acupuncture compared to standard acupuncture on pain reduction (weighted mean difference: 10 cm VAS, 1.69, 95% CI 0.85–2.54, P < 0.0001; heterogeneity: ² = 0.00, ² = 0.00, P = 0.96, I² = 0%). Our results provide suggestive evidence for the effectiveness of constitutional acupuncture in treating pain conditions compared to standard acupuncture. However, the total number of RCTs and the total sample size included in our analysis were too small to draw definite conclusions. Future RCTs should assess larger patient samples with longer treatment periods and appropriate controls.

Feature Selection from a Facial Image for Distinction of Sasang Constitution

Koo, I., Kim, J. Y., Kim, M. G., Kim, K. H. — Sun, 06 Sep 2009 23:33:35 PDT

Recently, oriental medicine has received attention for providing personalized medicine through consideration of the unique nature and constitution of individual patients. With the eventual goal of globalization, the current trend in oriental medicine research is the standardization by adopting western scientific methods, which could represent a scientific revolution. The purpose of this study is to establish methods for finding statistically significant features in a facial image with respect to distinguishing constitution and to show the meaning of those features. From facial photo images, facial elements are analyzed in terms of the distance, angle and the distance ratios, for which there are 1225, 61 250 and 749 700 features, respectively. Due to the very large number of facial features, it is quite difficult to determine truly meaningful features. We suggest a process for the efficient analysis of facial features including the removal of outliers, control for missing data to guarantee data confidence and calculation of statistical significance by applying ANOVA. We show the statistical properties of selected features according to different constitutions using the nine distances, 10 angles and 10 rates of distance features that are finally established. Additionally, the Sasang constitutional meaning of the selected features is shown here.

Association between Genetic Polymorphism of Multidrug Resistance 1 Gene and Sasang Constitutions

Sun, 06 Sep 2009 23:33:35 PDT

Multidrug resistance 1 (MDR1) is a gene that expresses P-glycoprotein (P-gp), a drug transporter protein. Genetic polymorphisms of MDR1 can be associated with Sasang constitutions because Sasang constitutional medicine (SCM) prescribes different drugs according to different constitutions. A Questionnaire for Sasang Constitution Classification II (QSCC II) was used to diagnose Sasang constitutions. Two hundred and seven healthy people whose Sasang constitutions had been identified were tested. Genotype analyses, restriction fragment length polymorphism (RFLP) and pyrosequencing were used in MDR1 C1236T, and in MDR1 G2677T/A and C3435T, respectively. Significant differences in MDR1 C1236T genotypes were found between So-yangin and So-eumin. MDR1 G2677T/A genotype also showed significant differences in allele distribution between So-yangin and Tae-eumin. So-yangin and So-eumin showed significant differences in the distribution of both 1236C-2677G-3435C and 1236T-2677G-3435T, haplotypes of MDR1. The genetic polymorphism of the MDR1 gene was thus shown to be an indicator that could distinguish So-yangin from other constitutions.

Taeyeumjoweetang Affects Body Weight and Obesity-related Genes in Mice

Lee, S.-W., Yoo, J.-H., Lee, S.-K., Keum, K.-S., Ryu, D.-G., Kwon, K.-B. — Sun, 06 Sep 2009 23:33:35 PDT

Taeyeumjoweetang (TYJWT) is a herbal medication that was mentioned in Jema Lee's Donguisusebowon, which is a book about Sasang constitutional medicine. Tae-eumnis, one of the four constitutions, tend to suffer from metabolic diseases such as obesity and diabetes. It is widely used to treat the digestive problems and obesity of Tae-eumins. We divided mice that were fed a normal diet for 48 days into control, TYJWT 250 mg kg^–1 and TYJWT 500 mg kg^–1 groups. After carrying out the experiments, the serum levels of leptin, adiponectin, ghrelin and resistin were measured. The results showed that TYJWT significantly reduced the weights of mice that were fed a normal diet, and that this was due to a decrease in food intake. Also, the two TYJWT groups had lower serum levels of leptin compared to the control group, and the ghrelin levels were proportionately increased by the dosage of TYJWT given. These results show that TYJWT has obesity-suppressing effects similar to those previously reported using high fat diets. In addition, these results also provide evidence that TYJWT has anti-obesity effects.

Analysis of Skin Humidity Variation Between Sasang Types

Sun, 06 Sep 2009 23:33:35 PDT

The purpose of this study was to examine the relationship between variations in skin humidity (SH) induced by perspiration across Sasang types and to identify novel and effective Sasang classification factors. We also analyzed the responses of each Sasang type to sweating-related QSCC II items. The results revealed a significant difference in SH across gender and significant differences in SH before and after perspiration between Tae-Eum and So-Eum men. In addition, Tae-Eum women showed significant differences in SH compared with women classified as another Sasang type. Furthermore, evaluation of the items related to sweating in the QSCC II and their relationship to each constitution revealed a significant difference between Tae-Eum and other Sasang types. Overall, the results of this study indicate that there is a distinct SH difference following perspiration between Tae-Eum and other Sasang types. Such findings may aid in Sasang typology diagnostic testing with the support of further sophisticated clinical studies.

Quantitative Sasang Constitution Diagnosis Method for Distinguishing between Tae-eumin and Soeumin Types Based on Elasticity Measurements of the Skin of the Human Hand

Song, H. W., Lee, S., Park, Y. K., Woo, S. Y. — Sun, 06 Sep 2009 23:33:35 PDT

The usefulness of constitutional diagnoses based on skin measurements has been established in oriental medicine. However, it is very difficult to standardize traditional diagnosis methods. According to Sasang constitutional medicine, humans can be distinguished based on properties of the skin, including its texture, roughness, hardness and elasticity. The elasticity of the skin was previously used to distinguish between people with Tae-eumin (TE) and Soeumin (SE) constitutions. The present study designed a system that uses a compression method to measure the elasticity of hand skin and evaluated its measurement repeatability. The proposed system was used to compare the skin elasticity between SE and TE subjects, which produced a measurement repeatability error of <3%. The proposed system is suitable for use as a quantitative constitution diagnosis method for distinguishing between TE and SE subjects with an acceptable level of uncertainty.

Sasang Constitution as a Risk Factor for Diabetes Mellitus: A Cross-Sectional Study

Lee, T.-G., Koh, B., Lee, S. — Sun, 06 Sep 2009 23:33:35 PDT

Sasang Constitutional Medicine, which is a branch of traditional Korean medicine, states that medications for diabetes should be individualized according to the patient's individual constitution. However, the effect of constitution on diabetes has not been evaluated to date. Therefore, this study was conducted to determine if constitution is an independent risk factor for diabetes by comparing the prevalence and odds ratios (ORs) of the disease according to constitution. The medical records of 1443 adults who had been examined and classified based on their constitution at Kyung Hee University Hospital in Seoul, Korea were reviewed. A chi-squared test and Fisher's exact test were used to compare the prevalence of diabetes according to constitution, and multiple logistic regression was used to calculate the ORs for diabetes. The prevalence of diabetes differed significantly according to constitution (² = 36.20, df = 2, P < 0.001). Specifically, the prevalence of the disease was higher in Tae-eumin (11.4%) individuals than in Soyangin (5.0%) or Soeumin (1.7%) individuals. In addition, multiple logistic regression revealed that Tae-eumin individuals had a greater risk for diabetes than Soeumin individuals. When compared to Soeumin individuals, the adjusted ORs were 2.01 (95% CI 0.77–5.26) for Soyangin individuals and 3.96 (95% CI 1.48–10.60) for Tae-eumin individuals. These results show that constitution has a significant and independent association with diabetes, which suggests that constitution is an independent risk factor for diabetes that should be considered when attempting to detect and prevent the disease.