The purpose of this paper is to explore the strategy of future Korean medicine(KM) clinical research through the study on the proposals for KM clinical research worldwide. In this study, the papers published in English through Pubmed were investigated mainly. Among them, we analyzed the methodological proposals from the clinical research papers that were published in the KM related fields. Various proposals for improving the problems in KM clinical studies are as follows. First, KM clinical research should be designed based on understanding for the theory, backgrounds, paradigms and worldviews of KM. In addition, considering the model validity, KM clinical research model should include the diagnosis, interventions and outcomes measurement methods reflecting the characteristics and real practice in KM. The internal validity and external validity should be also taken into account. One of the most important thing is to identify the contents about various and complex 'real practice' in KM. A prospective observational study was suitable for the purpose of this study. Finally, we suggested a few improvement directions for RCTs studies in KM. First, we would be able to improve the quality and the internal validity in KM clinical research using the checklists of CONSORT(Consolidated Standards for Reporting Trials) Statement and STRICTA(Standards for Reporting Interventions in Clinical Trials of Acupuncture). Second, we could use various clinical research methods and the modified research of RCTs such as PCT(pragmatic clinical trial) to reflect the characteristics of actual KM practice. Consequently, we would be able to improve the external validity. Third, the KM diagnosis and outcomes measurement methods should be developed based on an actual KM practice and it should reflect a real practice. The 'pattern identification(辨證)' is the core to KM diagnosis. But in order to be applied to the clinical research, the pattern identification(辨證) should be objectified and standardized. Future KM clinical research model should reflect the characteristics and a real practice in KM. In addition, it should include the advantage of rigorous RCTs research.Specially, the diagnosis, interventions and outcomes measurement methods in KM clinical research should reflect this view.

In order to grasp the clear concepts and variables to treat Shanghan diseases which has complex meaning by each medical literature, several concepts and analytic method of structuralism from early to late stage encompassing Saussure and Derrida were used. Main concepts are langue and parole, signifiant and signifie, syntagme and paradigme, denotation and connotation, synchronie and diachronie, identity of structure and differance etc. and methods are substituting these concepts to historical Shanghan theories from Zhongjing to Ming-Qing dynasty and comparisons of synchronie about their era. Essential qualities of Shanghan diseases are pathologic phenomena under the order of unification of nature and man formed through concrescence between individual human body and geo-climatico-socio-cultural environmental conditions, neither injuries by cold pathogen nor five types of exopathogenic febrile diseases. The former environmental elements can be inferred from general traits of desires and public pathological aspects of social members, and the latter personal factors from corresponding features to those pathogenic variables. In addition, the concepts of Shanghan disease are added successively up to now via Jin-Yuan's four great masters and Wenbing masters, and thus the new concepts of denotation became another connotation obtaining new signifiant. In this way, for the treatment of Shanghan diseases, new theories should be made for ranging prescription over the wenbing field; reflecting not only climatical variables but also each patient's physio-pathological features and sociocultural variables. Thereby an appropriate and reasonable therapeutical systems can be designed and can guide research direction hereafter.

This study aimed to investigate flow of defense qi(衛氣) through the relationship among the collateral meridians(絡脈), Pyobon(標本), Kika(氣街) and Geungyul(根結). The nutrient qi(營氣) and defense qi have a same origin and are transformed from the food and drink(水穀), the nutrient qi flows in the meridian(經脈) and the defense qi flows outside of the meridian. The defense qi flows in the collateral meridians where meridians divide into smaller ones. The beginnig of the collateral meridian division is called Bon(本) and the finishing point is called Pyo(標). The defense qi flows from Pyo(標) to outside of the collateral meridian which is called Kika and then flows to skins(皮膚) and muscles (肌肉). The defense qi enters the meridian at Geun(根) and it joins the other qi within the meridian at Gyul(結). In this study, we suggest that the collateral meridian, Pyobon, Kika and Geungyul are continuos pathways where the defense qi circulates.

This study was aimed at investigating the syndrome differentiation and herbal medicine of Thromboangiitis Obliterans by reviewing Chinese traditional medicine's journals. The journal search was carried out using China National Knowledge Infrastructure(CNKI) and PubMed from September 2009 to August 2014. Searching key words were the various combination of "Thromboangiitis Obliterans", "traditional chinese medicine", "syndrome differentiation", "herbal medicine". The final selection of 33 studies were selected and summarized by researchers. The syndrome differentiation was classified as yang deficiency, cold syncope and blood stasis. The most frequently herbs were blood-activating and stasis-resolving medicinals.

As for medical education, not only acquirement of knowledge but also practical clinical competence is important because it is needed on primary medicine. Under this trend, Clinical Performance Examination(CPX) is already being practiced in medical college. But in spite of its importance, CPX is not yet practiced in Korean medical college. So, by contemplating necessity and outcome of CPX, We try to offer basic data for future imposition and improvement of CPX in Korean medical education. 49 students of grade 3 in a Daejeon Korean Medical College were targets of investigation. After educated about CPX in advance, They treated simulated patient and answered questionnaire about CPX. Then, their treatment was scored by Professor and simulated patients. Total 49 members responded to the survey and the results of the analysis were as follows. The answer that CPX is useful(Mean=4.12) and essential for acquiring professionalism of treatment(Mean=4.02) was got high scores. But many respondents replied about necessity of better CPX environment and felt difficulty about PPI(45%). Meanwhile, Professor group(Mean=9.24) tended to give more high score than Simulated patient group(Mean=7.94). This study can be very useful for composing basic data of CPX in Korean medical College and improving practical clinical competence of students. But this study has also some limits like area, respondent selection, group module etc. So, more detailed and comprehensive survey is needed. This work was supported by the Daejeon University Research Grant.

The purpose of this study was to investigate the correlation of Intima-Media Thickness of common carotid artery(CCA-IMT) and The Second Derivative of Photoplethysmogram Waveforms(SDPTG). 38 subjects with acute ischemic stroke were recruited from the patients admitted to Dong-Eui Medical Center from the June 2013 to January 2014. We assessed 38 patient's SDPTG data and CCA-IMT data by B Mode ultrasonography. then 38 subjects were divided into two groups by the CCA-IMT difference; CCA-IMT 〈 0.8 mm group(n=11), CCA-IMT $$\geq_-$$ 0.8 mm group(n=27). We analyzed their characteristics, risk factor, blood test result, life style by CCA-IMT difference. As a result, Age, Hypertension were significantly higher in the CCA-IMT $$\geq_-$$ 0.8 mm group then in the CCA-IMT < 0.8 mm group. Regular exercise were significantly higher in the CCA-IMT < 0.8 mm group then in the CCA-IMT $$\geq_-$$ 0.8 mm group. The result of Multiple regression analysis on the factors affecting the CCA-IMT was hypertension, total cholesterol, age. and The result of Pearson's Correlation analysis on CCA-IMT and SDPTG is that e/a ratio, SDPTG AI were respectively and significantly correlated with CCA-IMT. According to the analysis, the Relationship between CCA-IMT and SDPTG in Ischemic Stroke Patients were founded. We suggest that further investigation with larger and better controlled trials of the Relationship between CCA-IMT and SDPTG could contribute to better understand the effects of risk factors on atherosclerosis.

Bangpungtongseong-san(BPTSS, Fangfengtongsheng-san in Chineses) is a traditional herbal formula comprising 18 medicinal herbs. In the present study, we performed the simultaneous analysis for four compounds of BPTSS and examined anti-allergic effects in human keratinocytes and mouse splenocytes. The column for separation of four compounds was used Luna C18 column and maintained at 40℃. The mobile phase for gradient elution consisted of two solvent systems. The analysis was carried out at a flow rate of 1.0 mL/min with PDA detection at 254 and 280 nm. To evaluate production and expression of Th2 chemokines, ELISA and RT-PCR were conducted in tumor necrosis factor (TNF)-α and interferon (IFN)-γ-stimulated HaCaT cells with or without BPTSS or silymarin, a positive control for skin inflammation. To measure Th2 cytokines, primary mouse splenocytes were treated with BPTSS and performed ELISA for interleukin (IL)-4, 5, 13. Calibration curves were acquired with r2>0.9999. The contents of geniposide, liquiritin, baicalin, and glycyrrhizin in BPTSS were 5.06 ㎎/g, 7.33 ㎎/g, 27.56 ㎎/g, and 7.81 ㎎/g, respectively. BPTSS reduced TARC and RANTES production and mRNA expression in TNF-α and IFN-γ-treated HaCaT cells. BPTSS inhibited IL-4, 5, and 13 production in mouse splenocytes. Our data will be a helpful information to upgrade quality control and anti-allergic effects of BPTSS.

Transcription factor, Nrf2 was well known to protect cell from oxidative stress by up-regulating it's dependent anti-oxidative genes such as HO-1 and NQO1. Cheongjogupye-tang (CJGPT), a traditional herbal formula was originally recorded in 『EuiMunBeopRyul』, still having been used to treat pulmonary disease such as asthma and pulmonary inflammation, in Eastern Asian countries. However, the underlying therapeutic mechanisms remain elusive. The purpose of this study is to investigate the anti-inflammatory or anti-oxidative effects of CJGPT on the RAW 264.7 cells. To examine the anti-inflammatory or anti-oxidative effects of CJGPT, MTT assay, immunoblotting, RT-PCR and reporter gene assays were performed. Although CJGPT slightly suppressed the nuclear NF-κB expression, it did not decreased the expression of pro-inflammatory genes in LPS-stimulated RAW 264.7 cells. Moreover, it did not increased the transcriptional activity of NF-κB in reporter gene assay. However, CJGPT upregulated the nuclear expression of Nrf2, as well as increased the expression of Nrf2-dependent genes such as HO-1 and NQO1. In addition, CJGPT incresed the transcriptional activity of Nrf2. Taken together, our results showed that CJGPT exerts functions as an anti-oxidant mainly by activating Nrf2.

This study was conducted to investigate the relaxation effects and its mechanisms of Nelumbinis Semen(NS) extract in isolated rabbit corpus cavernous tissues. In order to examine the relaxation effects and its mechanisms of NS, we treated the ethanol extract of NS(0.01-3.0 mg/ml) and indomethacin(IM), tetraethylammonium chloride(TEA), Nω -nitro-L-arginine (L-NNA), methylene blue(MB) were treated before NS extract to contracted strips induced by PE 1 μM. We also treated calcium chloride(Ca) 1 mM after pretreatment of NS extract in Ca²⁺-free krebs-ringer solution to contracted strips induced by PE. Cell viability and NO concentration on human umbilical vein endothelial cell(HUVEC) was measured by MTT assay, Griess reagent system. eNOS production was investigated by histochemical and immunohistochemical staining. NS extract was significantly affected on the relaxation of cavernous strips and NS extract-induced relaxation was not different by pretreatment of IM, TEA, MB, but inhibited by the pretreatment of L-NNA. And increase of contraction induced by Ca²⁺ addition, in a Ca²⁺-free solution, was decreased by pretreatment of NS. NO concentration on HUVEC was increased. When NS extract was applicated on corpus cavernosum of penis(CCP) in SHR, ratio of smooth muscles to collage fibers by PE was decreased and formation of eNOS around helicine artery was increased. These results suggest that CCP relaxation effects of NS extract are shown by suppressing influx of extracellular Ca²⁺ through the production of NO and eNOS.

Streptococcus mutans (S. mutans) is one of the most important bacteria in the formation of dental plaque and dental caries. S. mutans adheres to an acquired pellicle formed on the tooth surface, and aggregates with many oral bacteria, and initiates plaque formation by synthesizing glucan from sucrose, which is catalyzed by glucosyltransferases. S. mutans metabolizes the dietary sugar to the organic acids. The organic acids demineralize tooth surface and result in dental caries. Galla Chinensis have been traditionally used for stopping bleeding of gingiva, removing edema and halitosis, drainage, fixing the teeth and as an antiphlogistic agent. In previous reports, antibacterial effects of Galla Chinensis have been investigated whereas anti-cariogenic effects is still not examined enough. Therefore we tested effects of ethanol extracts of Galla Chinensis on the cariogenic properties such as the growth, acid production, adhesion, and insoluble glucan synthesis of S. mutans. In the result, ethanol extracts of Galla Chinensis showed the inhibition of S. mutans growth and organic acids production over 0.031 mg/ml concentrations. The adhesion of S. mutans to Saliva-coated Hydroxyapatite beads S-HAs has decreased with the increase of concentration of ethanol extracts of Galla Chinensis. And it seems to have adhesion inhibitory effect in concentration of over 0.25 mg/ml. It gives us the result that Galla Chinensis have anti-caries effects. But ethanol extract of Galla Chinensis didn't have inhibitory effect on insoluble glucan synthesis. Preliminary phytochemical analysis of the ethanol extract of Galla Chinensis showed strong phenolic compounds, medium steroids & terpenoids and glycosides, and weak organic acids and peptides. These results suggest that the ethanol extracts of Galla Chinensis may have anti-cariogenic properties, which may be able to be related with strong phenolic compounds.

The aim of the study is to investigate the anti-cancer effects of Scutellaria barbata in AGS human gastric adenocarcinoma cells. MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) assay and caspase 3 or 9 activity assay were carried out to examine cell death with Scutellaria barbata. To elucidate the inhibitory effects of Scutellaria barbata, cell cycle (sub-G1) analysis and mitochondrial membrane potential were performed in AGS cells after 24 h incubation with Scutellaria barbata. Scutellaria barbata induced apoptosis in AGS cells by using the MTT assay, the sub-G1 analysis and mitochondrial membrane potential assay. The stronger inhibition effects of AGS cell growth was observed by application of Scutellaria barbata combined with several anti-cancer drugs (paclitaxel, 5-fluorouracil, cisplatin, ectoposide, doxorubicin and docetaxel) in comparison to the application of Scutellaria barbata or anti-cancer drugs. Our findings provide insight into unraveling the effects of Scutellaria barbata in human gastric cancer cells and developing therapeutic agents against gastric cancer.