The Efficacy and Underlying Mechanism of Moxibustion in Preventing Cognitive Impairment: A Systematic Review of Animal Studies

Cognitive impairment is age-related and manageable only with early diagnosis and prevention. Moxibustion is widely accepted in East Asia as useful for preventing cognitive impairment. This systematic review of animal studies was conducted to verify the efficacy of moxibustion in preventing cognitive impairment and to elucidate the underlying mechanism. Randomized controlled animal trials that established the efficacy of moxibustion in preventing cognitive impairment were included in the analysis. Results of behavioral tests and the signaling pathways elucidated were extracted and a meta-analysis was conducted with the behavioral test results. The risk of bias was evaluated using 9 items, and reporting quality was evaluated using the ARRIVE (Animal Research: Reporting In Vivo Experiments) Guidelines Checklist. Ten trials involving 410 animals met the inclusion criteria. All studies reported the benefit of moxibustion in preventing cognitive deficits caused by Alzheimer's disease (AD). Among five studies using the Morris water maze test, a significant effect of moxibustion in decreasing the escape time was reported in three studies, increasing the crossing times in four studies, and prolonging the dwelling time in two studies. The effects of moxibustion were demonstrated to be mediated by an increase in the activity of neurotrophins and heat shock protein, modulation of the cell cycle, and suppression of apoptosis and inflammation. However, considering the small number of included studies, the lack of studies investigating entire signaling pathways, and a high risk of bias and low reporting quality, our results need to be confirmed through more detailed studies.

The Influence of Donguibogam during the Middle Joseon Era Based on Clinical Records on Low Back Pain in Seungjeongwon ilgi / 의사학

The recently increasing interest in historical records has led to more research on historical records in various fields of study. This trend has also affected medical research, with the medical climate and popular treatment modalities of the past now being revealed based on historical records. However, most research on medical history during the Joseon era has been based on the most well-known record, Joseon wangjo sillok or Annals of the Joseon Dynasty. Joseon wangjo sillok is a comprehensive and organized record of society during the Joseon era and contains key knowledge about medical history during the period, but it lacks details on the treatment of common disorders at the time. Seungjeongwon ilgi or Diary of the Royal Secretariat has detailed records of daily events and is a valuable resource for the daily activities of the era. And in the middle Josoen era, a variety of medical books - especially Donguibogam - was published. Therefore, the authors focused on the under-researched Seungjeongwon ilgi, Donguibogam and attempted to assess and evaluate low back pain treatment performed on Joseon royalty. The most notable characteristic of low back treatment records within the Seungjeongwon ilgi is that diagnosis and treatment was made based on an independent Korean medicine, rather than conventional Chinese medicine. This paradigm shift is represented in Dongeuibogam, and can be seen in the close relationship between Dongeuibogam and national medical exams of the day. Along with the pragmatism of the middle Joseon era, medical treatment also put more focus on pragmatic treatment methods, and records show emphasis on acupuncture and moxibustion and other points in accord with this. The authors also observed meaning and limitations of low back pain treatment during that era through comparison with current diagnosis and treatment.

Association of Toll-Like Receptor 5 Gene Polymorphism with Susceptibility to Ossification of the Posterior Longitudinal Ligament of the Spine in Korean Population

OBJECTIVE: Ossification of the posterior longitudinal ligament (OPLL) has a strong genetic component. Specific gene polymorphisms may be associated with OPLL in several genes which regulate calcification in chondrocytes, change of extracellular collagen matrix and secretions of many growth factors and cytokines controlling bone morphogenesis. Toll-like receptor 5 (TLR5) may play a role in the pathogenesis of OPLL by intermediate nuclear factor-kappa B (NF-kappaB). The current study focused on coding single nucleotide polymorphisms (SNPs) of TLR5 for a case-control study investigating the relationship between TLR5 and OPLL in a Korean population. METHODS: A total of 166 patients with OPLL and 231 controls were recruited for a case-control association study investigating the relationship between SNPs of TLR5 gene and OPLL. Four SNPs were genotyped by direct sequencing (rs5744168, rs5744169, rs2072493, and rs5744174). SNP data were analyzed using the SNPStats, SNPAnalyzer, Haploview, and Helixtree programs. Multiple logistic regression analysis with adjustment for age and gender was performed to calculate an odds ratio (OR). RESULTS: None of SNPs were associated with OPLL in three alternative models (codominant, dominant, and recessive models; p > 0.05). A strong linkage disequilibrium block, including all 4 SNPs, was constructed using the Gabriel method. No haplotype was significantly associated with OPLL in three alternative models. CONCLUSION: These results suggest that Toll-like receptor 5 gene may not be associated with ossification of the posterior longitudinal ligament risk in Korean population.

Ankle Lesions, Associated with Anterior Soft Tissue Impingement / 대한족부족관절학회지

PURPOSE: To evaluate clinical features of ankle lesions, associated with anterior soft tissue impingement. MATERIALS AND METHODS: We retrospectively reviewed 21 patients who had chronic anterior ankle pain as initial symptom and associated ankle lesions with anterior soft tissue impingement. Based on preoperative radiologic findings, physical examination intra-operative findings, appropriate procedures were done for lesions by either arthroscopic or minimal open procedure or combined. Clinical evaluation was done using American Orthopedic Foot and Ankle Society, ankle-hind foot score (AOFAS score) and visual analog scale (VAS) on last follow up. RESULTS: Associated lesion(s) to anterior soft tissue impingement of the ankle were 16 cases of osteochondral lesion of talus, 14 cases of bony impingement, 6 cases of ankle lateral instability, 5 cases of loose body, 4 cases of os subfibulare. AOFAS score was 58.9 +/- 5.1 preoperatively and 74 +/- 9.1 on last follow up. Clinical satisfaction score using VAS showed excellent in 3 cases, good in 11, fair in 3, poor in 4. CONCLUSION: The patients who had anterior soft tissue impingement would have various associated lesions on their ankle. In such cases, preoperative counseling for variety of postoperative results would be needed.

A Case of Diffuse Tuberculous Arachnoiditis Accompanying Tuberculous Meningoencephalitis

Tuberculous arachnoiditis is a rare complication of tuberculous meningoencephalitis. Few cases of diffuse involvement of tuberculous arachnoiditis are reported. We describe a 35-year-old HIV-negative male with diffuse tuberculous arachnoiditis aggravated during the steroid tapering. The arachnoiditis accompanied the meningoencephalitis and involved the entire surface of the brainstem and whole segments of the spinal cord. The patient showed flaccid quadriplegia and paradoxical respiration, which are thought to be due to arachnoiditis.