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Biomedical subjects

Jongbae Park

Publications and source records attributed to Jongbae Park.

14 recordsLinked to original sources

A comparison between directional and proportional methods in locating acupuncture points using dual-energy X-ray absorptiometry in Korean women.

The cun measurement system, an essential and convenient method for locating acupoints, has been widely used in the practice of acupuncture. However, the traditional cun measurement methods have been criticized for their lack of reliability. In addition, new technology has become available to measure the soft tissue and bone mass independently. The present study was conducted in order to determine if one cun, measured by the directional method, is consistent with proportional methods and to investigate whether both methods can be used to locate acupoints. The lengths of bone from several parts of the body in 47 Korean women were measured using Dual-Energy X-ray Absorptiometry. The lengths of each part of the body were compared with 3 cun measured by proportional methods, and the width of all four fingers measured at the level of the proximal inter-phalangeal joint used in the directional method. The results showed that one cun measured by the directional method was significantly different from one cun by proportional methods. The directional method is likely less dependable in locating acupoints than the proportional method.

Absorptiometry, Photon↗

Acupuncture for subacute stroke rehabilitation: a Sham-controlled, subject- and assessor-blind, randomized trial.

BACKGROUND: Any adjunctive therapy that may reduce persistent disability after stroke should be considered. Acupuncture is used for this purpose, but there is conflicting evidence on its effectiveness. METHODS: Patients with a recent (<4 weeks) episode of stroke were randomized to receive 12 sessions of either real or sham acupuncture during 2 weeks. The primary outcome was the change in Barthel activities of daily living score at the end of treatment. Secondary outcome measures included National Institutes of Health Stroke Scale score, motoricity index, and quality of life (EQ-5D [ EuroQoL-5 Dimensional form] and EQ-VAS [EuroQoL-Visual Analog Scale]). Assessments were carried out by blinded physicians. RESULTS: A total of 116 patients (56 in the real acupuncture group and 60 in the sham group) were randomized, and 98 (real, 48; sham, 50) completed treatment and the 2-week assessment. Patient blinding by means of the sham acupuncture device was successful. Acupuncture was well tolerated except for 1 seizure during a real acupuncture session. The improvements in the Barthel scores were 4 points (interquartile range [IQR], 0-8) vs 3 points (IQR, 0-7) in the real and sham acupuncture groups, respectively (P = .38). The secondary outcome measures also essentially showed no significant effect of acupuncture. Post hoc analysis by baseline severity showed a greater improvement in leg function in the subgroup with baseline Barthel score less than the median (median score, 6): 22 points (IQR, 0-37) vs 0 [corrected] points (IQR, 0-4) in the acupuncture and sham control groups, respectively (P = .02). CONCLUSIONS: Acupuncture is not superior to sham treatment for recovery in activities of daily living and health-related quality of life after stroke, although there may be a limited effect on leg function in more severely affected patients.

Activities of Daily Living↗

Ayurvedic medicine for rheumatoid arthritis: a systematic review.

OBJECTIVE: To systematically review all randomized controlled trials (RCTs) on the effectiveness of Ayurvedic medicine for rheumatoid arthritis (RA). METHODS: Computerized literature searches for all RCTs of Ayurvedic medicine for RA in the following databases: Medline (March 1969 to March 2003), Embase (February 1985 to February 2003), AMED (March 1980 to March 2003), Cochrane Controlled Trial Register (October 1997 to March 2003), and the abstract service of Central Council for Research in Ayurveda and Siddha (CCRAS; 1976 to March 2003). Hand searches were performed in 1 Sri Lankan and 3 Indian journals and the authors' personal files. Key data of included studies were extracted and reviewed. The methodological quality of all studies was evaluated with the Jadad scale. RESULTS: Seven studies met our inclusion criteria. Trials tested either Ayurvedic medicine against placebo or other Ayurvedic medicines. In general, patient and physician global assessments on the severity of pain, and morning stiffness were used as endpoints. Of 3 placebo-controlled RCTs, 1 high-quality trial did not show benefit of the active treatment against placebo, while another incompletely reported study indicated beneficial effects of an Ayurvedic medicine. A further incompletely reported study showed no significant difference. The remaining 4 trials were difficult to interpret because they tested an Ayurvedic medicine against other Ayurvedic medicines whose effects were not proven. CONCLUSION: There is a paucity of RCTs of Ayurvedic medicines for RA. The existing RCTs fail to show convincingly that such treatments are effective therapeutic options for RA.

Antirheumatic Agents↗

The effectiveness of acupuncture for depression--a systematic review of randomised controlled trials.

OBJECTIVE: To summarise the existing evidence on acupuncture as a therapy for depression. METHODS: RCTs were included, in which either manual acupuncture or electroacupuncture was compared with any control procedure in subjects with depression. Data were extracted independently by two authors. The methodological quality was assessed. Pre and post means and SDs for depression specific measures were extracted, when available, for meta-analysis. RESULTS: Seven randomised comparative trials involving 509 patients were included. The evidence is inconsistent on whether manual acupuncture is superior to sham, and suggests that acupuncture was not superior to waiting list. Evidence suggests that the effect of electroacupuncture may not be significantly different from antidepressant medication, weighted mean difference -0.43(95% CI -5.61 to 4.76). There is inconclusive evidence on whether acupuncture has an additive effect when given as an adjunct to antidepressant drugs. CONCLUSION: The evidence from controlled trials is insufficient to conclude whether acupuncture is an effective treatment for depression, but justifies further trials of electroacupuncture.

Acupuncture Therapy↗

Deqi sensation between the acupuncture-experienced and the naïve: a Korean study II.

Previous experience of acupuncture is believed to affect people's expectation of future treatments. Therefore, subjects who have had acupuncture are generally excluded from sham-controlled acupuncture clinical trials. However, this assumption has not been proven, but just accepted because of the lack of evidence to the contrary. To investigate the difference in frequency and intensity of acupuncture sensation between subjects who have had acupuncture and those who have not, 36 acupuncture-experienced subjects were invited to take part in the study. After informed consent was obtained, participants were asked to complete the acupuncture sensation scale (ASS) according to what they expected needling to feel like. The needling was done at the left Hegu (LI 4) point and consisted of insertion, stimulation for 30 seconds and removal. After needling, the subjects were asked to complete the same ASS according to what they actually experienced. Adverse events were monitored. The frequency of each sensation expected and experienced, as well as acupuncture sensation scores were compared. More than 60% of the subjects expected to feel sensations of penetrating (87.6% to 100%), aching (71.2% to 95.5%), tingling (87.6% to 100%), pricking (79.7% to 99.2%) and throbbing (64.2% to 91.4%). In fact, the subjects experienced sharp (60.9% to 89.1%), intense (60.9% to 89.1%), radiating (71.2% to 95.5%) and heavy (74.8% to 97.4%) sensations just as much. The subjects expected more hurting (p = 0.001), tingling (p < 0.001), pricking (p = 0.010), stinging (p = 0.012), burning (p = 0.001) and pulsing (p = 0.009) than they experienced, while more heaviness (p = 0.011) was experienced than expected. The same outcome measures were also compared between experienced and naive groups. Apart from the fact that the acupuncture-experienced participants expected to feel pricking (p = 0.030) and stinging (p = 0.002), and experienced hurting (p = 0.022) and stinging (p = 0.028) significantly less than those who had not had acupuncture before, there was no significant difference between first time and experienced subjects. The results indicate that previous experience does not affect the people's expectation and does not hinder people from experiencing Deqi. In addition, a constellation of Deqi-related acupuncture-specific sensations is more than just a general pain intensity dimension, which requires a biochemical and physiological exploration.

Acupuncture Therapy↗

Safety and efficacy needs to be tested in an appropriate design.

The Chungpyesagan-tang was developed for one of four human constitutional types in Korea. In order to test the effectiveness and efficacy, randomized controlled trials and placebo controlled trials, respectively are required. The safety question should be answered through control studies within the same constitutional population.

Drugs, Chinese Herbal↗

Validating a new non-penetrating sham acupuncture device: two randomised controlled trials.

For clinical trials of acupuncture, it would be desirable to have a sham procedure that is indistinguishable from the real treatment, yet inactive. A sham needle has been designed which telescopes instead of penetrating the skin. The Park Sham Device involves an improved method of supporting the sham needle and requires validation. The objective of these studies was to test whether the sham procedure using the new device was 1) indistinguishable from the same procedure using real needles in acupuncture naïve subjects, and 2) inactive, where the specific needle sensation (de qi) is taken as a surrogate measure of activity. The studies were designed as subject and assessor blind, randomised controlled trials. Study 1) included 58 patients enrolled in a clinical trial of acupuncture for acute stroke. Study 2) included 63 healthy, acupuncture naïve, adult volunteers. The interventions used were real or sham acupuncture using the Park Sham Device. Study 1) was set in a district general hospital, and study 2) in a university laboratory. The outcome measure in study 1) was the form of treatment that patients believed they had received. In study 2) the outcome measure was experience of de qi, as judged by three acupuncture experts. No patient in either group(study 1) believed he or she had been treated with the sham needle. In 40 volunteers (study 2) for whom experts achieved consensus, the relative risk of experiencing de qi with real acupuncture to that with sham acupuncture was 15.38 (95% CI 2.26 to 104.86). The inter-rater reliability of all 13 experts (study 2), calculated from their judgements on 10 subjects selected by randomisation, was 0.52 (95% CI 0.19 to 0.61). In conclusion, the results suggest that the procedure using the new device is indistinguishable from the same procedure using real needles in acupuncture naïve subjects, and is inactive, where the specific needle sensation (de qi) is taken as a surrogate measure of activity. It is therefore a valid control for acupuncture trials. The findings also lend support to the existence of de qi, a major concept underlying traditional Chinese acupuncture.

Acupuncture Points↗

Does Deqi (needle sensation) exist?

The mechanism, by which acupuncture works is not yet clear, therefore there is no unequivocal consensus about styles and sensations of needling. To enhance the scientific base of acupuncture, needling somehow should be objectified. The term Deqi is understood to represent all or at least the main form of phenomena to acupuncture stimulation. The characteristics of Deqi, however, have always been based on a translation of original Chinese description. Hoping to find a clue to develop sham (placebo) method for subject blinding, we investigated which sensations are frequently expected and experienced, and whether or not these expectations and experiences of sensations are similar in naive subjects. The acupuncture sensation scale developed by Vincent et al. (1989) was translated into Korean. Thirty-eight healthy acupuncture naïve female volunteers (mean age 29.1, range 25-39) were asked to complete the sensation scale of acupuncture according to what they expected needling to feel like before needling. Needling was done on left Hegu (LI4) point in the hand and consisted of insertion, stimulation for 30 seconds, and removal. Directly after needling, the subjects were asked to complete the same sensation scale according to what they experienced. The subjects expected to feel hurting, penetrating, sharp, tingling, pricking and stinging, and actually experienced aching, spreading, radiating, pricking and stinging more than 60% of the time. Comparison between expectation and experience, the subjects expected more penetrating, tingling, pricking and burning than they experienced, and on the contrary experienced more aching, pulling, heavy, dull, electric and throbbing than they expected. Traditionally described sensations of Deqi are something beyond just a general pain dimension in the Korean population. Further study involving acupuncture experienced subjects or subjects from other cultures need to confirm this finding. Moreover, sham acupuncture should be studied.

Acupuncture↗

What's in a name? A systematic review of the nomenclature of Chinese medical formulae.

Traditional Chinese Medicine (TCM) has been modified to some extent in other Far Eastern countries such as Korea and Japan. Researchers of each of the three countries seem to use different English names for the same Chinese medicinal formulae. Lack of knowledge of the Chinese characters is destined to increase this confusion. In order to investigate this matter systematically, all investigations of Chinese medicine formulae published in the American Journal of Chinese Medicine (AJCM, 1997-March 2001) were evaluated. Moreover, PubMed (1966-June 2001) was searched using keywords differentiated by language, location and number of hyphens, and upper-or lower-case of the first letter of the English equivalent of each Chinese character. Fifty-four formulae of TCM were identified in 45 reports published in AJCM. Thirty-two were named in Chinese only (23 reports); six in Japanese (six reports); and five in Korean (five reports). Ten formulae were named in Japanese with the Chinese name in brackets (ten reports); and one in Chinese with the Japanese name in brackets (one report). By computerized literature search, different numbers of research papers were retrieved by using keywords differentiated by language, location and number of hyphens. Such confusion may prevent progress in the evaluation of TCM. To increase the efficiency of studies on Chinese medical formulae, standardization of terminology is required.

Chemistry, Pharmaceutical↗