Objectives: This study presents Korean medicine clinical practice guidelines for bladder cancer, of which the 5-year survival rate has still been about 75% since the 1990s despite the rapid development of medical science. Methods: A consensus was reached by an expert committee composed of professors and researchers who specialize in Korean medicine on the basis of a literature review that included other countries' clinical guidelines and a textbook. Results: Traditional Chinese medicine clinical practice guidelines were published for the first time in 2014. In Korea, the medical system is different from China in that Korea has completely dualized Korean and Western medicine and a low availability of proprietary herbal medicines. Therefore, these Korean medicine clinical practice guidelines for treating bladder cancer based on the previously published guidelines of Chinese medicine will help first-line Korean medicine doctors. Conclusions: Further studies related to Korean medicine are necessary to develop more advanced Korean medicine clinical practice guidelines for treating bladder cancer.

Objectives: Strokes have diverse symptoms and signs. One of ten stroke patients has chronic pain after a stroke. Pain after a stroke interrupts rehabilitation and worsens quality of life, but there is no efficient treatment for this pain. This study surveyed and reports on the clinical studies of treatment for chronic pain after a stroke. Methods: We searched journals for reports on clinical studies of treatment for chronic pain after a stroke through the databases OASIS (http://oasis.kiom.re.kr), NDSL (ndsl.kr), Kmbase (http://kmbase.medric.or.kr/), and PubMed (http://www. pubmed.com). The search words were "stroke & pain", "jungpung中風 & pain", "pungbi風痺", "cerebral hemorrhage & pain", and "cerebral infarction & pain". Results: Twenty-nine studies of treatment for chronic pain after a stroke were found. Of these, 15 were randomized controlled trials, 10 were nonrandomized controlled trials, and 4 were "before and after" studies. Treatments were diverse, including acupuncture, electroacupuncture, herbal acupuncture, herbal medicine, and more. The treatment periods were longer than 3 weeks on average. Conclusions: These results show that good quality randomized controlled trials of treatment for chronic pain after a stroke are small in number. We need larger and more diverse studies of treatment for chronic pain after a stroke.

Objectives: This exploratory trial evaluated the possibility of quantitatively measuring several aspects during the "abdominal examination" of traditional Korean medicine. The main results of this study will be used to develop a new diagnostic device for abdominal examinations. Methods: Fifteen healthy volunteers were recruited for this study. Three certified Korean medical doctors assessed the existence of pressure pain, the elasticity of the abdominal muscle, and the tonus at CV12 as gold standards. Then, 2 well-trained investigators measured the pressure pain threshold (PPT), the indentation depth of a bar, and repelling force by pressing CV12. Each investigator measured the above 3 variables 2 times at 1 min intervals using a modified digital algometer. Reliability and validity tests of the 3 variables were performed. Results: There were statistically significant coefficients of intraclass correlation on the 3 variables both between and within the investigators (P<0.001). Also, PPT and repelling force showed statistically significant high sensitivity and specificity in a ROC curve. However, the indentation depth of the bar presented relatively low sensitivity. Conclusions: This new diagnostic method using a modified digital algometer could be a useful tool for quantitative measurement in "abdominal examinations". However, future rigorous clinical studies with a large population will be needed for the verification of its usefulness.

Objectives: This study reviewed experimental studies on the effects of herbal medicines in treating hyperthyroidism. Methods: We analyzed the experimental studies of herbal medicines done in Korea to treat hyperthyroidism that have been reported since 2000 by searching 4 Korean databases with the keyword "hyperthyroidism". Results: Two single herbal medicines and 15 complex herbal medicines were used in 15 experimental studies. There was 1 clinical study and 14 nonclinical studies, among them, 2 in vitro experiments and 12 in vivo experiments. It was confirmed that the herbal medicines used have improving effects on hyperthyroidism by inhibiting the oversupplied thyroid hormones and hypermetabolic symptoms. Conclusions: There should be further studies on the antioxidative effects and acting mechanisms of herbal medicines and more clinical studies on hyperthyroidism.

Objectives: This study was designed to analyze the treatment effects of Eunhwayeongyo-tang through retrospective chart reviews. We also checked the correlation between each pair of variables of the symptoms and curative rates of patients with cough. Methods: Thirty-three patients with cough who had satisfied the selection criteria were retrospectively reviewed through their basic medical records, nasal endoscopy, and questionnaires about cough on their first and second visits. The questionnaires used were "The questionnaire on clinical symptoms of cough & sputum", Leicester Cough Questionnaire Korean Version (LCQ-K), Total Nasal Symptom Scores (TNSS), Visual Analog Scale (VAS), and "Cold-heat patterns". The improvement rate, calculated by "The questionnaire on clinical symptoms of cough & sputum" was considered to be clinically effective if reduction of symptoms scored more than 30%. The state of nasopharyngeal mucosa was assessed to categorize the cold-heat patterns of the upper respiratory tract and for diagnosis. Results: According to this study, cough and sputum improved by $57.22{\pm}37.76%$. Most patients (76%) improved significantly after $12.18{\pm}6.59days$ of taking Eunhwayeongyo-tang. The cure rates of 26 patients among the 33 patients were judged as effective. All the mean scores of the questionnaires and the anterior nasal cavity states were significantly improved on the patients' second visits. After $18.39{\pm}15.68days$, 30 patients were completely cured and ended treatment. The nasopharyngeal mucosa states of all patients were categorized as heat patterns. Conclusions: The conditions of the patients with nasopharyngitis significantly improved after taking Eunhwayeongyo-tang. All of the patients had pharyngitis or rhinitis. The cold-heat pattern of nasopharyngeal mucosa was a significant indicator of upper respiratory inflammation diagnosis.

Objectives: This study evaluated the diagnostic values of measuring the number of fungiform papillae in patients with burning mouth syndrome (BMS). Methods: Seventy participants (35 BMS patients and 35 Healthy control) participated in this study. The number of fungiform papillae (FP) was measured on the anterior part of the tongue within an area of $9mm^2$ using a digital camera. The subjects were evaluated on their yin deficiency and blood stasis conditions using the Yin-Deficiency Questionnaire (YDQ) and Blood Stasis Questionnaire (BSQ). Moreover, the severities of subjective tongue pain in the BMS patients were assessed using Visual Analog Scale. Results: There were significant differences in the number of FP and the YDQ and BSQ scores between the two groups. The number of FP and the YDQ scores in the BMS group showed statistically significant correlations with the VAS score of tongue pain. In the bivariate logistic regression analysis, the factor that most strongly contributed to BMS was the number of FP. The optimal cut-off value of the number of fungiform papillae was calculated as 5.5 with 71.4% sensitivity and 82.9% specificity. There was no statistically significant correlation between the number of FP and the YDQ or BSQ score. Conclusions: According to these findings, measuring the number of FP could be a valuable evaluation indicator of BMS.

Objectives: This study observed changes in gait pattern according to the motor grade of the paretic lower limb in patients with basal ganglia stroke who are in the subacute phase. Methods: We used the Manual Muscle Test (MMT) to evaluate the motor grade of the paretic lower limb of 21 patients with subacute basal ganglia stroke and then divided them into two groups based on the MMT results. Stroke patients with a motor grade above Gr. III were put in group I (15 people) and those with a grade less than Gr. III in group II (6 people). We also estimated spatiotemporal factors using treadmill gait analysis equipment. The values were gait velocity, step length, step time, double support phase, and cadence. The first measure was conducted during the early period of admission and the second was between four and five weeks after admission. Results: In Group I, the gait velocity and step length of both legs significantly increased. In Group II, the step length and step time of the paretic side and the gait velocity tended to decrease, but not significantly. The step length of the paretic side in Group II was significantly longer than that in Group I at the first measure. The step time of the paretic side in Group I was significantly shorter than that in Group II and gait velocity and cadence in Group I were significantly higher than in Group II at the second measure. Conclusions: The gait parameters of all stroke patients improved in terms of time. In addition, the changes in gait pattern were different depending on the motor grade of the paretic lower limb.

Objectives: This study measured the thickness of the abdominal wall at abdominal acupoints using ultrasonography and then investigated the correlations between the thickness of the abdominal wall and other characteristics of patients with functional dyspepsia (FD). Methods: Thirty patients with FD were enrolled in the study from September 2015 to March 2016. The thickness of the abdominal wall was measured at Shangwan (CV12), Zhongwan (CV13), and the left Liangmen (ST21). In addition, height, weight, body mass index (BMI), duration of FD, and the sternocostal angle were investigated. The severities of spleen qi deficiency and the dyspepsia symptoms were assessed by the Spleen Qi Deficiency Questionnaire (SQDQ) and the Nepean Dyspepsia Index-Korean version (NDI-K). Results: The average thickness of the abdominal wall was $24.66{\pm}6.69mm$ at Shangwan, $21.17{\pm}5.83mm$ at Zhongwan, and $21.72{\pm}5.72mm$ at Linagmen, and there were significant differences between the thickness at Shangwan and Zhongwan (p=0.046). Furthermore, there were significant differences between the thickness of the abdominal wall at Zhongwan and the sternocostal angle (r=0.396, p=0.037). Conclusions: These findings indicate the possibility of estimating the thickness of the abdominal wall by looking at the characteristics of patients with FD, including the sternocostal angle.

This study investigated the effects of Wolbiga-banha-tang (WBBT) on high fat diet-induced rats. We divided the rats into 4 groups: normal (fed a general-fat diet), control (fed a high-fat diet and no treatment), $WBBT{\times}1$ (fed a high-fat diet and 250 mg/kg of Wolbiga-banha-tang extracts), and $WBBT{\times}2$ (fed a high-fat diet and 500 mg/kg of Wolbiga-banha-tang extracts). We measured the body weight, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, free fatty acids, total lipids, AST, ALT, and CBC in the serum of the obese rats for 7 weeks. There was a significant decrease in the control group, $WBBT{\times}1$, and $WBBT{\times}2$ in triglycerides and free fatty acids. The results suggest that WBBT is effective for lowering triglycerides and free fatty acids. Therefore, WBBT may be applied to the treatment of lipid metabolism in obesity and further clinical studies are needed.

Objectives: This study surveyed doctors of Korean medicine on how they treat hypertension in their Korean clinical practices. Methods: An invitation to take an Internet-based questionnaire was sent to doctors who were registered in the Association of Korean Medicine in September 2016. Participants were first asked general profile questions, which included age, gender, work experience as a practitioner, and specialties. Second, they were asked whether they had experience with hypertension treatment and additional questions related to hypertension. Results: A total of 991 replies were received to the questionnaire. Most of the Korean medical doctors (95%) had blood pressure units and had monitored blood pressure. A majority of the Korean medicine doctors (55%) had provided hypertension treatment. Acupuncture and herbal medicine were commonly used for the treatment of hypertensive patients. In addition, bloodletting, moxibustion, pharmacopuncture, cupping, Chuna, Qigong exercise, meditation, and Tai Chi were used. Many doctors also recommended lifestyle modification. The respondents said that Korean medicine improves general health conditions (42.6%) and has low adverse effects (29.9%). One of the most common opinions about the revitalization measures of Korean medicine was expanding health insurance benefits (20.8%). Conclusions: Through this survey, we found out information about the present situation of hypertension treatment in Korean medicine. In the future, it is possible that hypertension treatment using Korean medicine will be demanded and used by practitioners if it is covered by public health insurance.

Objectives: This study investigated the administration of Jeungmiyijin-tang (JYT) to rats with reflux esophagitis (RE) induced by pylorus and forestomach ligation operations. Methods: Twenty laboratory rats were divided into three groups with 5~7 rats in each group. The control group consisted of rats with no inflammation (CON). The RE group had rats with gastroesophageal reflux elicited by pylorus and forestomach ligation operations. The JYT group had rats that were orally administered Jeungmiyijin-tang (1.5 ml/day/300 g) once a day for 14 days before reflux esophagitis was induced by the pylorus and forestomach ligation operations. Six hours after the operations, the rats were sacrificed, morphological changes were observed, and histological examinations were done in the stomach and esophagus lesion areas. If apoptosis was observed, the apoptotic cells in the esophagus lesion areas were counted. Results: The morphological and histochemical changes consisted of various injuries from hemorrhagic erosion in the RE group, while there were significantly fewer in the JYT group. The RE group marked increases of gastric mucosa erosion and infiltration of inflammatory cells in the submucosa, as well as cell division in the epithelial layer, the proliferation and degranulation of mast cells, and increases in the IL-$1{\beta}$, TNF-${\alpha}$, and MMP-9 expressions in the esophagus of the rats. The JYT group was inhibited above expression compared with the RE group. Apoptosis was statistically significantly decreased in the JYT group compared with the RE group. Conclusions: According to the above results, it appears that Jeungmiyijin-tang inhibits the expression of pro-inflammatory cytokines (TNF-${\alpha}$, IL-$1{\beta}$, and MMP-9) and apoptosis in the esophagus mucosa, thereby preventing esophageal mucosal damage from esophageal reflux.

This case study reports on the effect of Korean medicine on a catheter-associated urinary tract infection (CAUTI) caused by multidrug-resistant Pseudomonas aeruginosa. An 83-year-old man diagnosed with stroke had dysuria, and it was found that an indwelling urinary catheter led to CAUTI. From laboratory tests, we identified multidrug-resistant Pseudomonas aeruginosa and applied Korean medicine to him. After herbal medication with acupuncture and moxibustion, we studied a urinalysis and urine culture again for follow-up. We found meaningful improvement in bacteriuria and bacterial identification. This case suggests that Korean medicine could have a beneficial effect on urinary tract infections caused by multidrug-resistant Pseudomonas aeruginosa.

Objectives: This case study reports on a case of rhabdomyolysis that occurred after spinning exercise. Methods: A patient diagnosed with rhabdomyolysis received Korean medical treatment and Western medical treatment for 6 days. We observed the patient for 13 days. Clinical symptoms were evaluated with the Numerical Rating Scale (NRS) and laboratory tests that included Liver Function Test, Renal Function Test, creatinine phosphokinase (CPK), myoglobin, and urine. Results: The clinical symptoms improved after treatment. In this case, acute renal failure has not occurred. The Laboratory results, including AST, ALT, CPK, and LDH, improved. Conclusions: Rhabdomyolysis can be treated with Korean medical and Western medical cooperative treatment.

Objectives: This study reports on the efficacy of treating patients with general weakness symptoms with Korean medicine. Methods: Two patients with general weakness symptoms were treated with Korean medical treatment modalities, including acupuncture, moxibustion, and herbal medicines. Blood tests, the visual analogue scale (VAS), and patients' complaints were used to assess the treatment effects. Results and Conclusions: dehydroepiandrosterone sulphate (DHEAS), DHEAS/cortisol index, VAS, and the patients' complaints improved after treatment. Korean medical treatment is effective in improving DHEAS and the DHEAS/cortisol index according to the improvements in the patients' conditions. However, more studies are required to validate its use with other patients.