bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining an Adequate Dose of Acupuncture Using a Neurophysiological Approach – a Narrative Review of the Literature
Authors: White Adrian , Cummings Mike , Barlas Panos , Cardini Francesco , Filshie Jacqueline , Foster Nadine E , Lundeberg Thomas , Stener-Victorin Elisabet , Witt Claudia 
Published: April 2009

Many different styles of acupuncture practice exist, and lack of agreement on the optimal acupuncture treatment for any particular condition may mean that some patients do not receive the best treatment. This uncertainty also makes the negative results of sham controlled trials difficult to interpret. Unless we can be sure that both adequate acupuncture and an inactive sham were used in a particular trial, then that trial should not be interpreted as dismissing acupuncture for that condition. Acupuncture practice clearly involves much more than needling procedures, but there is a strong argument for elucidating the role of those needling procedure first. The components of acupuncture needling procedures have been described in the STRICTA document, but it is also clear that the patient's perception of needling is relevant for the outcome of treatment. We therefore recommend the concept of ‘dose’ of acupuncture needling, which should include both the stimulus given to the patient, and certain aspects of the patient's perceptions and response that are known to be linked to the subsequent therapeutic response. We propose the following definition of dose: the physical procedures applied in each session, using one or more needles, taking account of the patient's resulting perception (sensory, affective and cognitive) and other responses (including motor). The dose may be affected by the state of the patient (eg nervous, immune and endocrine systems); different doses may be required for different conditions. The constituents of an adequate dose can be established initially by clinical opinion and subsequently by empirical evidence from experimental studies, which may be either clinical or basic research studies. Systematic reviews which do not consider the adequacy of the acupuncture treatment may have unreliable conclusions. Out of 47 recent systematic reviews, only six have applied some criteria for adequacy. Five used a rating system or conducted a subgroup analysis, and one excluded studies from the analysis altogether if they did not meet criteria for adequacy. Research into what constitutes an adequate dose of acupuncture has long been neglected and is now urgent. Clinical studies that compare the effects of different treatment protocols are probably the most reliable source of evidence, and may also demonstrate a dose-response relationship.
A Blinded Randomised Trial of Acupuncture (Manual and Electroacupuncture) Compared with a Non-Penetrating Sham for the Symptoms of Osteoarthritis of the Knee
Authors: Jubb Ronald W , Tukmachi Emad S , Jones Peter W , Dempsey Emma , Waterhouse Lynn , Brailsford Sue 
Published: April 2009

Objectives To compare the effect of acupuncture (manual and electroacupuncture) with that of a non-penetrating sham (‘placebo’ needle) in patients with osteoarthritic knee pain and disability who are blind to the treatment allocation. Methods Acupuncture naive patients with symptomatic and radiological evidence of osteoarthritis of the knee were randomly allocated to a course of either acupuncture or non-penetrating sham acupuncture using a sheathed ‘placebo’ needle system. Acupuncture points for pain and stiffness were selected according to acupuncture theory for treating Bi syndrome. Both manual and electrical stimulation were used. Response was assessed using the WOMAC index for osteoarthritis of the knee, self reported pain scale, the EuroQol score and plasma β-endorphin. The effectiveness of blinding was assessed. Results There were 34 patients in each group. The primary end point was the change in WOMAC pain score after the course of treatment. Comparison between the two treatment groups found a significantly greater improvement with acupuncture (mean difference 60, 95% CI 5 to 116, P=0.035) than with sham. Within the acupuncture group there was a significant improvement in pain (baseline 294, mean change 95, 95% CI 60 to 130, P<0.001) which was not seen by those who had sham acupuncture (baseline 261, mean change 35, 95% CI-10 to 80, P=0.12). Similar effects within group, but not between groups, were seen with the secondary end points of WOMAC stiffness, WOMAC function, and self reported pain. One month after treatment the between group pain difference had been lost (mean difference 46; 95% CI −9 to 100, P=0.10) although the acupuncture group was still benefiting compared to baseline (mean difference 59; 95% CI 16 to 102, P=0.009). The EuroQol score, a generic measure of health related quality of life, was not altered by the treatments. A minority of patients correctly guessed their treatment group (41% in the acupuncture group and 44% in the control group). Plasma β-endorphin levels were not affected by either treatment. Conclusions Acupuncture gives symptomatic improvement for patients with osteoarthritis of the knee, and is significantly superior to non-penetrating sham acupuncture. The study did not confirm earlier reports of release of plasma β-endorphin during acupuncture.
Pupillary Response Induced by Acupuncture Stimulation – An Experimental Study
Authors: Mori Hidetoshi , Ueda Shoichi , Kuge Hiroshi , Taniwaki Eiichi , Tanaka Tim Hideaki , Adachi Kiyoshi , Nishijo Kazushi 
Published: April 2009

Objectives To investigate whether acupuncture stimulation affects autonomic nerve function by measuring pupil diameters with electronic pupillography. Methods Two studies were conducted (Experiment 1 and 2) in the Tsukuba University of Technology, Tsukuba, Japan. Experiment 1 examined the responses before, during and after acupuncture. Experiment 2 compared acupuncture and a no acupuncture control in a two period, repeated measurement crossover design. Twelve healthy male university students were recruited for Experiment 1 and nine healthy male university students for Experiment 2. The intervention was superficial acupuncture at the acupuncture point TE5. Following the insertion, gentle repetitive tapping stimulation was applied during the subject's exhalation phase in a sitting position for 90 seconds. The main outcome measures in Experiment 1 were pupil diameter, heart rate, pulse wave and blood pressure. In both experiments, pupil diameter was measured for three minutes before acupuncture stimulation, during stimulation and for three minutes after stimulation. Results In Experiment 1, a decrease in pupil diameter was observed after acupuncture stimulation (P=0.018) and a decrease in heart rate was observed during the stimulation (P=0.049). Moreover, a significant decrease of pulse wave amplitude was observed during and after acupuncture stimulation. In Experiment 2, a decrease in pupil diameter occurred after acupuncture stimulation (P=0.007), whereas no change occurred under the no acupuncture control. Conclusions It is thought that the pupillary constriction observed after gentle, superficial acupuncture stimulation may be attributed to an increase of parasympathetic nerve function. Further study is necessary in order to further clarify the duration of the observed response and to elucidate the mechanisms behind it.
The Effect of Electrical Stimulation of the Pudendal Nerve on Sciatic Nerve Blood Flow in Animals
Authors: Inoue Motohiro , Hojo Tatsuya , Nakajima Miwa , Kitakoji Hiroshi , Itoi Megumi , Katsumi Yasukazu 
Published: April 2009

Objective To investigate the mechanism of the clinical effect of electroacupuncture of the pudendal nerve on the lumbar and lower limb symptoms caused by lumbar spinal canal stenosis, we studied changes in sciatic nerve blood flow during electrical stimulation of the pudendal nerve in the rat. Methods Using rats (n=5), efferent electrical stimulation to the pudendal nerve was performed and sciatic nerve blood flow was measured with laser Doppler flowmetry. Simultaneously, changes in the blood pressure and cardiac rate were measured. Furthermore, the effect of atropine on these responses to the stimulation was also studied. Results Electrical stimulation of the pudendal nerve significantly increased blood flow in the sciatic nerve transiently without increasing heart rate and systemic blood pressure. The significant increase in the sciatic nerve blood flow disappeared after administration of atropine. Conclusion Electrical stimulation of the pudendal nerve causes a transient and significant increase in sciatic nerve blood flow. This response is eliminated or attenuated by administration of atropine, indicating that it occurs mainly via cholinergic nerves.
Intramuscular and Periosteal Acupuncture in Patients Suffering from Chronic Musculoskeletal Pain – a Controlled Trial
Authors: Hansson Ylva , Carlsson Christer , Olsson Elisabeth 
Published: April 2009

Background Periosteal acupuncture has shown promising results in clinical practice. The aim was to compare three patient groups: one with intramuscular acupuncture, one with periosteal acupuncture, and a third information control group, with respect to clinically relevant pain relief, physical functioning and intake of analgesics in patients with chronic musculoskeletal pain in the neck or low back or both. We reported the psychological changes in these patients in a previous issue of this journal. Methods 144 consecutive patients with nociceptive pain for >3 months, aged 18–70 years were alternately allocated to: intramuscular acupuncture (n=59); periosteal acupuncture (n=55); or control group with information only (n=30). All patients were encouraged to stay active. Acupuncture was administered with eight treatments during five weeks, and two optional additional treatments after one month. Pain was estimated with a daily VAS in a pain diary and with an average weekly pain score. Clinically relevant pain relief was defined as at least a 30% decrease from the initial value. Physical functioning was evaluated with Disability Rating Index. All estimations were performed prior to treatment, one week after, and one, three and six months after treatment. Results There were no differences between the effects of the two acupuncture methods. There were differences between each of the two acupuncture groups compared with the control group on all test occasions up to one month after treatment with respect to the pain diary and one week after treatment with respect to pain last week (P<0.05). Pain relief as measured by a pain diary was obtained in 29 patients in the intramuscular acupuncture group, 25 in the periosteal acupuncture group, and 5 patients in the control group. Six months after treatment, 46% of the intramuscular acupuncture patients and 45% of the periosteal acupuncture patients had obtained pain relief in terms of the pain diary. The corresponding figure for pain last week was 29% in each group. Conclusion Periosteal pecking was no more effective than standard intramuscular acupuncture, but both were more effective than information only.
Laser Acupuncture Analgesia: An Overview
Authors: Baxter David 
Published: April 2009

In recent years, low power laser therapy has become a popular treatment modality. While its use as an alternative to needles in acupuncture is contentious, the studies reviewed above demonstrate the possibility of analgesic effects with such treatments. However, the majority of the trials conducted to date can be criticised on a number of points. This has contributed to the criticism surrounding the technique. Furthermore, the clinical significance of such treatment parameters as wavelength, energy density and pulsing frequency are poorly understood. Further research is therefore necessary on a number of levels: clinically to validate the claims made on behalf of lasers, and experimentally to identify optimum values for treatment parameters. Hopefully, as research in this field progresses, clinicians will benefit from firm treatment guidelines. While in the final analysis lasers will probably never be able to replace needles, the potential advantages in their use in HLTVor hepatitis patients are obvious. Squeamish or very young patients may also react more favourably to laser rather than needle acupuncture. To this end, laser acupuncture represents a challenging and interesting field for future research.
Characterization of organic matter in the fine-grained siliciclastic sediments of the Shemshak Group (Upper Triassic–Middle Jurassic) in the Alborz Range, Northern Iran
Authors: Shekarifard Ali , Baudin François , Schnyder Johann , Seyed-Emami Kazem 
Published: April 2009

Abstract

Bulk organic geochemical and microscopic studies (Rock-Eval pyrolysis, light transmitted–uv microscope) were carried out on the shales of the Upper Triassic–Middle Jurassic Shemshak Group in the northern, central and southern Alborz Range of northern Iran. Total organic carbon (TOC) values range from 0 to 29.4 wt% (1.2 wt% on average) indicating a generally poor–moderate organic carbon content. Upper Triassic shales in the lower part of the Shemshak Group have been mainly deposited in marine/lake settings under dysoxic–anoxic conditions, with TOC=0.7 wt% on average. Toarcian–Aalenian shales in the upper part of the Shemshak Group were deposited under comparatively deeper marine oxic–dysoxic conditions with the lowest TOC contents recorded (0.3 wt% on average). Carbonaceous shales at different stratigraphic levels of the Shemshak Group show the highest TOC contents (14.2 wt% on average).
T
max
values range from 439 to 599 °C (average 500 °C), indicating that the organic matter has experienced high temperatures during deep burial and active post-sedimentary tectonics. The hydrogen index (HI)–
T
max
diagram shows the presence of Type IV kerogen of altered organic matter with a very low mean HI value. The palynofacies is characterized by the dominance of amorphous organic matter probably predominately derived from degradation of marine–non-marine phytoplankton. The Upper Shemshak Group has low potential to produce petroleum, whereas the Lower Shemshak Group is an important effective petroleum source rock in the Alborz Range. The latter may have generated a considerable amount of petroleum at some localities (e.g. Tazareh and Paland) in the geological past.
The Mid-Cimmerian tectonic event (Bajocian) in the Alborz Mountains, Northern Iran: evidence of the break-up unconformity of the South Caspian Basin
Authors: Fürsich Franz Theodor , Wilmsen Markus , Seyed-Emami Kazem , Majidifard Mahmoud Reza 
Published: April 2009

Abstract
The Mid-Cimmerian tectonic event of Bajocian age can be documented all across the Iran Plate (Alborz Mountains of northern Iran, NE Iran, east-central Iran) and the southern Koppeh Dagh (northeastern Iran). In the Alborz area, the tectonic event consisted of two main pulses. A distinct unconformity (near the Lower–Upper Bajocian boundary) at or near the base of the Dansirit Formation is the sedimentary expression of rapid basin shallowing due to uplift and erosion. Another unconformity is developed in the early Upper Bajocian, close to or at the top of the Dansirit Formation. Locally, it is expressed as an angular unconformity due to block rotation and is overlain by a thin transgressive conglomerate followed by silty marls of the deep-marine Upper Bajocian–Callovian Dalichai Formation. This upper unconformity signals a rapid subsidence pulse. On the Tabas Block of east-central Iran, a single unconformity can be documented that is time-equivalent to those bounding the Dansirit Formation (i.e. ‘mid-Bajocian’). Local folding gives direct evidence of compressional tectonics, and conglomerates indicate subaerial denudation of older Mesozoic or Palaeozoic strata. After a stratigraphic gap, transgressive sediments of ?Late Bajocian–Bathonian age follow, suggesting a fusion of the lower and upper Mid-Cimmerian unconformities in east-central Iran. Along the southern margin of the Koppeh Dagh Mountains (NE Iran), a Late Bajocian subsidence pulse initiated the opening of the strongly subsiding Kashafrud Basin, an eastwards extension of the South Caspian Basin. In all of these areas, one phase of uplift and erosion took place followed by a pronounced pulse of subsidence running counter to trends of the eustatic sea-level curve. Thus, what is generally understood as the Mid-Cimmerian tectonic event is now thought to consist of a tectonic phase, confined to the Bajocian. This phase is explained as the expression of the onset of sea-floor spreading within the South Caspian Basin situated to the north of the present-day Alborz Mountains. This strongly subsiding basin developed close to the Palaeotethys suture during the Toarcian–Aalenian and went through a change from the rifting- to the spreading-stage during the Bajocian. The Mid-Cimmerian event therefore reflects the break-up unconformity of the South Caspian Basin.
αvβ3/αvβ5 Integrins-FAK-RhoB: A Novel Pathway for Hypoxia Regulation in Glioblastoma
Authors: Skuli Nicolas , Monferran Sylvie , Delmas Caroline , Favre Gilles , Bonnet Jacques , Toulas Christine , Cohen-Jonathan Moyal Elizabeth 
Published: April 2009

Abstract
The presence of hypoxic areas in glioblastoma is an important determinant in tumor response to therapy and, in particular, to radiotherapy. Here we have explored the involvement of integrins, up to now known as regulators of angiogenesis and invasion, in the regulation of tumor hypoxia driven from the tumor cell. We first show that hypoxia induces the recruitment of αvβ3 and αvβ5 integrins to the cellular membrane of U87 and SF763 glioblastoma cells, thereby activating the focal adhesion kinase (FAK). We then show that inhibiting αvβ3 or αvβ5 integrins in hypoxic cells with a specific inhibitor or with siRNA decreases the hypoxia-inducible factor 1α (HIF-1α) intracellular level. This integrin-dependent regulation of HIF-1α is mediated through the regulation of FAK, which in turn activates the small GTPase RhoB, leading to the inhibition of GSK3-β. Furthermore, silencing this pathway in glioma cells of established xenografts dramatically reduces glioma hypoxia, associated with a significant decrease in vessel density. Our present results unravel a new mechanism of hypoxia regulation by establishing the existence of an αvβ3/αvβ5 integrin–dependent loop of hypoxia autoregulation in glioma. Targeting this hypoxia loop may be crucial to optimizing radiotherapy efficiency. [Cancer Res 2009;69(8):3308–16]
Connective Tissue Growth Factor Confers Drug Resistance in Breast Cancer through Concomitant Up-regulation of Bcl-xL and cIAP1
Authors: Wang Ming-Yang , Chen Pai-Sheng , Prakash Ekambaranellore , Hsu Hsing-Chih , Huang Hsin-Yi , Lin Ming-Tsan , Chang King-Jen , Kuo Min-Liang 
Published: April 2009

Abstract
Connective tissue growth factor (CTGF) expression is elevated in advanced breast cancer and promotes metastasis. Chemotherapy response is only transient in most metastatic diseases. In the present study, we examined whether CTGF expression could confer drug resistance in human breast cancer. In breast cancer patients who received neoadjuvant chemotherapy, CTGF expression was inversely associated with chemotherapy response. Overexpression of CTGF in MCF7 cells (MCF7/CTGF) enhanced clonogenic ability, cell viability, and resistance to apoptosis on exposure to doxorubicin and paclitaxel. Reducing the CTGF level in MDA-MB-231 (MDA231) cells by antisense CTGF cDNA (MDA231/AS cells) mitigated this drug resistance capacity. CTGF overexpression resulted in resistance to doxorubicin- and paclitaxel-induced apoptosis by up-regulation of Bcl-xL and cellular inhibitor of apoptosis protein 1 (cIAP1). Knockdown of Bcl-xL or cIAP1 with specific small interfering RNAs abolished the CTGF-mediated resistance to apoptosis induced by the chemotherapeutic agents in MCF7/CTGF cells. Inhibition of extracellular signal–regulated kinase (ERK)-1/2 effectively reversed the resistance to apoptosis as well as the up-regulation of Bcl-xL and cIAP1 in MCF7/CTGF cells. A neutralizing antibody against integrin αvβ3 significantly attenuated CTGF-mediated ERK1/2 activation and up-regulation of Bcl-xL and cIAP1, indicating that the integrin αvβ3/ERK1/2 signaling pathway is essential for CTGF functions. The Bcl-xL level also correlated with the CTGF level in breast cancer patients. We also found that a COOH-terminal domain peptide from CTGF could exert activities similar to full-length CTGF, in activation of ERK1/2, up-regulation of Bcl-xL/cIAP1, and resistance to apoptosis. We conclude that CTGF expression could confer resistance to chemotherapeutic agents through augmenting a survival pathway through ERK1/2-dependent Bcl-xL/cIAP1 up-regulation. [Cancer Res 2009;69(8):3482–91]
Histone Deacetylase Inhibitor Sodium Butyrate Enhances the Cell Killing Effect of Psoralen plus UVA by Attenuating Nucleotide Excision Repair
Authors: Toyooka Tatsushi , Ibuki Yuko 
Published: April 2009

Abstract
The use of histone deacetylase inhibitors (HDACI), a promising new class of antineoplastic agents, in combination with cytotoxic agents, such as ionizing radiation and anticancer drugs, has been attracting attention. In this study, we found that sodium butyrate (SB), a widely studied HDACI, remarkably enhanced the cell killing effect of psoralen plus UVA (PUVA) in several cancer cell lines, including skin melanoma. Although a single treatment with PUVA or SB did not greatly affect cell survival, combined treatment with SB and PUVA induced marked apoptosis within 24 hours. The SB-induced augmentation of the cell killing effect was more dramatic in combination with PUVA than with anticancer drugs. The number of double-strand breaks that formed during the repair of PUVA-induced interstrand cross-links (ICL) in chromosomal DNA was significantly reduced in SB-pretreated cells, suggesting that the ability to repair ICL was attenuated by SB. In addition, the incorporation of bromodeoxyuridine and the formation of repair foci of proliferating cell nuclear antigen after PUVA treatment, associated with nucleotide excision repair (NER) in the removal of ICL, were not observed in SB-pretreated cells. Furthermore, the repair kinetics of UV-induced cyclobutane pyrimidine dimers (well-known photolesions repaired by NER) were much slower in SB-pretreated cells than in untreated cells. These results indicated that the enhanced cell killing effect of PUVA by SB was attributable to an attenuated ability to repair DNA and, especially, dysfunctional NER. [Cancer Res 2009;69(8):3492–500]