A Review of Research Trends in Gold Implantation Therapy Focused on Gold Thread, Gold Needle and Gold Bead

Dae Hyun Jo; Ariunchimeg Baatarkhuyag; Ye Eun Jo; Sang Hoon Lee; Jae Dong Lee

doi:10.13045/acupunct.2016008

J Acupunct Res > Volume 33(1); 2016 > Article

Jo, Baatarkhuyag, Jo, Lee, and Lee: A Review of Research Trends in Gold Implantation Therapy Focused on Gold Thread, Gold Needle and Gold Bead

Review Article

Acupuncture 2016; 33(1): 79-93.

DOI: https://doi.org/10.13045/acupunct.2016008

A Review of Research Trends in Gold Implantation Therapy Focused on Gold Thread, Gold Needle and Gold Bead

Dae Hyun Jo¹, Ariunchimeg Baatarkhuyag¹, Ye Eun Jo¹, Sang Hoon Lee¹, Jae Dong Lee^1,^*

¹Department of Acupuncture & Moxibustion, College of Korean Medicine Kyung Hee University

^*Corresponding author: Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-872, Republic of Korea,
Tel: +82-2-958-9202, E-mail: ljdacu@khmc.or.kr

Received February 17, 2016 Revised March 01, 2016 Accepted March 02, 2016

See the Original "".

Abstract

Objectives:

The purpose of this study is to explore research trends in gold implantation therapy performed on the animal and human body, through a review of clinical studies focused on gold thread, gold needle and gold bead.

Methods:

Medical databases, including Pubmed, CENTRAL, MEDLINE, EMBASE, RISS4u, KISTI, OASIS and KTKP, were searched for relevant articles published from their launch to December 31, 2015 using the key word ‘gold’ with ‘thread*’, ‘needle*’, ‘acupuncture*’, ‘wire*’, ‘bead*’, ‘embed*’, ‘ implant*’, or ‘insert*’. The results were classified into in vivo studies, clinical trials and clinical reports. Analysis of the results was conducted in several research areas, from the identity of studies such as nationality and published year, to the gold preparations-features and implanted locations and to the outcomes that reflect the clinically favorable or adverse effect of gold implantation therapy.

Results:

A total of 30 studies including 11 in vivo studies, 4 clinical trials and 15 case reports, were found in the search. We observed certain research trends according to the research time, nationality and target indication of the studies. The studies primarily revealed a chronic local inflammatory response which could be a useful mechanism for pain-relief in musculoskeletal diseases and facial rejuvenation. Researches concerning long-term reactions or adverse effects were rare.

Conclusion:

The results show that the efforts to discover the level of clinical efficacy of gold implantation therapy were steady and worldwide. However, further researches on the longterm effect, and more importantly, the safety of gold implantation therapy are required.

Key Words: Gold thread; Gold needle; Gold bead; Research trend; Efficacy; Safety.

Fig. 1

Flowchart of study selection process

*TKM = Traditional Korean Medicine.

Fig. 2

Published years of 30 articles

Fig. 3

Nationality of 30 articles

Table 1

Summary of 7 in vivo Studies about Gold Implantation Treatment on Animals

Study	Subject Information	Gold Preparation	Intervention	Comparison	Outcome	Results
SW Lee (1980, Korea) [9]	Male rats	A thread. 0.2×5 mm	1) BL23 (N=5) 2) GB30 (N=5)	No thread (N=5)	Urine 17-KS	Significantly increased only in the BL23 group (p<0.05).
	Kidney Injury induced by HgCI₂				BUN	Not significantly decreased in the BL23 and GB30 group
	Kidney Injury induced by HgCI₂				Creatinine	Not significantly decreased in the BL23 and GB30 group
HK Ko (1984, Korea) [10]	Mice in healthy condition	A thread, 0.2×5 mm	1) ST36 (N=6) 2) GB39 (N=6) 3) BL23 (N=6) 4) CV4 (N=6) 5) Ba feng (N=6)	No thread (N=6)	Foot Volume	Significantly reduced only in ST36 group (p<0.001)
	Mice in healthy condition				Writhing test	All of gold-implanted groups showed significant
	Rats with paw edema induced by carrageenin				Randall Selllito Test	analgesic effect (p<0.01)
	Rats with paw edema induced by carrageenin				Forced Swim Test	There was not any remarkable gulf among all 6 groups.
YP Hong (1988, Korea) [11]	Male rats	A Thread, 0.2×3 mm	1)CV4(N=10) 2) ST36 (N=10) 3) BL23 (N=10) 4) Combined (N=10)	1) No thread (N=10) 2) The Root of tail. (N=10)	Serum Testosterone	Significantly increased in all of gold-implanted groups
YP Hong (1988, Korea) [11]	Normal condition	A Thread, 0.2×3 mm		1) No thread (N=10) 2) The Root of tail. (N=10)	Serum Oestrogen	Significantly decreased in BL23 and combined groups
HN Kim (1991, Korea) [4]	Male rats	A thread, 0.2×5 mm	1) Gold thread at BL23 (N=6) 2) Silver thread at BL23 (N=6)	1) Normal: Healthy rats, no thread (N=6) 2) Control: No thread (N=6)	Serum Cortisol	The levels of serum Cortisol, Na+, 17-OHCS and adrenal weight were significantly increased only in group with gold thread compared to the others (p<0.01, p<0.05, p<0.001, p<0.02), but other results were not significant.
	Male rats				Serum Na⁺, K⁺
	Induced Adrenal dysfunction				Urine 17-KS
					Urine 17-OHCS
					Adrenal weight
HY Kim, (2009, US) [6]	Male Rats	A wire, 24 K, 0.15×25 mm,	Implantation in forearm (N=10) (from SI8 to SI6)	No gold wire (N=14)	Bone regeneration	The incidence of complete or partial union was much higher in the gold group (60 % vs 7 %, p<0.05).
HY Kim, (2009, US) [6]	Induced Ulnar bone defect	A wire, 24 K, 0.15×25 mm,	Implantation in forearm (N=10) (from SI8 to SI6)	No gold wire (N=14)	Bone accumulation	Significantly more extensive in the gold group (1.09 mm vs 0.35 mm, p<0.05)
Kl Lie (2011, Norway) [12]	Dogs	3 beads, 24 K, 1×2 mm	Periarticular insertion at 5 points around the head of femur	No	Histological features	Chronic local inflammatory changes including lymphocyte infiltration and eosinophilic material containing were shown in all treated dogs, without a typical foreign body reaction
Kl Lie (2011, Norway) [12]	Hip OA	3 beads, 24 K, 1×2 mm		No	Histological features
M. Kurita (2011, Japan) [13]	Rats	1) Pure gold thread: 0.1×20 mm 2) Gold coated cog: Gold was coated over nonabsorbabale polypropylene. 0.54×20 mm	One of three threads 1) Pure gold thread 2) Polypropylene cog thread 3) Gold-coated polypropylene cog thread was inserted at the subcutaneous tissue of the back.	No	Histological evaluation of capsule formation	Acute tissue reactions were indicated to the regular cog thread involving myofibroblasts.
	Normal condition				Qualitative evaluation of thread capsules	And delayed tissue reactions were indicated to the pure gold thread involving giant cells.
	Normal condition				Number of αSMA-positive myofibroblasts	The gold coated cog thread shows a combination of the histological reactions associated with the cog thread and the pure gold thread, including faint early reactions, strong delayed reactions, and long-lasting capsule formation

Table 2

Summary of 4 Veterinary Clinical Studies about Gold Implantation Treatment on Animals

Study	Design	Condition	Gold preparation	Intervention	Control	Outcomes	Results
GT Jaeger (2006, Norway) [14]	Animal RCT	Dogs with Canine Hip Dysplasia	3 beads, 24 K, 1×2 mm, 35~40 mg.	Peri-articular insertion at 5 points around the head of femur (N=38) (The numbers of acupoints were assigned after their clockwise positions Point 3(GB30), 5, 7, 9(GB29), 12(BL54))	Placebo (N=42)	Behavior improvement (Owner)	The prevalence of dogs with improvements was significantly larger in the gold group at sixth months (30 of 36 vs 22 of 42, p<0.02)
						Pain (Owner)	Improved significantly at sixth months (5.6 to 1.9 vs 4.8 to 3.1, p<0.01)
						Dysfunction (Owner)	Score was improved significantly at sixth months (4.6 to 1.6 vs 4.1 to 2.4, p<0.03)
						Pain (Veterinarian)	Improved significantly at sixth months (4.4 to 3.4 vs 5.4 to 4.8, p<0.001)
						Lameness (Veterinarian)	Improved significantly at sixth months (−42.1 % vs −28.7 %)
GT Jaeger (2007, Norway) [15]	F/U study	Dogs with Canine Hip Dysplasia	3 beads, 24 K, 1×2 mm, 35~40 mg.	1) GG group (N=34): Peri-articular insertion at 5 points around the head of femur from day 0 2) PG group (N=32): nsertion was not executed at the day 0 but at sixth month	3) PC group: Researcher feigned the process of implantation without bead (N=7)	Pain (Veterinarian)	Significantly reduced in pooled gold group (4.8 to 4.2 vs 4.4 to 5.0, p=0.012)
						Dysfunction (Veterinarian)	Not significantly improved. (1.9 to 1.2 vs 2.6 to 3.0)
						Pain (Owner)	Reduced significantly (p<0.01) but the intergroup change was not significant. (5.1 to 2.4 vs 4.4 to 3.0, p=0.13)
						Dysfunction (Owner)	Improved significantly (4.4 to 2.2 vs 3.9 to 4.0, p<0.01)
						Behavior (Owner)	The prevalence of dogs with behavior improvements was significantly larger in the gold group (81.8 % vs 14.3 %)
G. Marquez (2009, Mexico) [16]	Animal CT	Dogs with Idiopathic Epilepsy	Gold wire, 3mm long	Subdermal Insertion at GB20, GV23, GV21, GV20, GV16, GV14, ErShenMen, YinTang, LI4, LV3, ST40,	No	Frequency	Reduced significantly (p<0.003)
						Severity	Reduced significantly (p<0.015)
						EEG record	No significant differences in relative power or in intra-hemispheric coherence in EEG record.
GT Jaeger (2012, Norway) [17]	Animal RCT	Identical to that of article 14	Identical to that of article 14	Identical to that of article 14 (This study is a record of undesired effects caused by the intervention)	Identical to that of article 14	Leakage of Body fluid	Blood was observed significantly more frequently than synovia (73.7 % vs 36.8 %)
						Pain aggravation	Pain aggravation occurred significantly more frequently in the gold group. (15 of 38 vs 6 of 42, p=0.036)
						Others	No signs of infection was reported. 2 out of 710 gold beads were migrated without pain

Table 3

Summary of 4 Clinical Trials about Gold Implantation Treatment on Humans

Study	Design	Patient Information	Gold preparation	Intervention	Comparison	Outcome Measures	Result
W Rondo (1996, Brazil) [18]	CT	Humans, condition unclear	A thread, 24K, No details	nserted in deep dermis of anterior region of arm (N=10)	No	Histological Features	A tuberculoid type granuloma reaction a large quantity of reticulum fibers, the presence of epithelioid cells, no giant multinuclear cells. No foreign body reaction
K. Nejrup, (2008, Denmark) [19]	RCT, pilot study	Knee OA, over 1 year.	3 beads, 24K, 1×2.5 mm	Subdermal insertion at Heding, Xi-yian, ST35, GB33, and LV8 (N=21)	Placebo (N=19)	WOMAC	Reduced in both groups: pain −1.92/−2.18 (p=0.95), stiffness −0.93/−0.43 (p=0.11), function −7.23/−3.36 (p=0.63)
K. Nejrup, (2008, Denmark) [19]	RCT, pilot study	Knee OA, over 1 year.	3 beads, 24K, 1×2.5 mm		Placebo (N=19)	KSCRS	Improved in both groups knee score +16.4/+8.2(p=0.65), function +10.5/+5.8 (p=0.79)
H. Kjerkegaard (2011, Denmark) [20]	RCT	Cervical OA, over 1 year, VAS〉6	3 beads, 24K, 1×2.5 mm	Insertion at Hua Tua points. reaching lamina region (N=24)	Placebo (N=22)	VAS	Significantly Reduced from 7 to 2 in gold group (p<0.001)
H. Kjerkegaard (2011, Denmark) [20]	RCT	Cervical OA, over 1 year, VAS〉6	3 beads, 24K, 1×2.5 mm	Insertion at Hua Tua points. reaching lamina region (N=24)	Placebo (N=22)	Consumption of painkillers	In gold bead group 16/24 and in placebo group 2/22 patients reduced the use of painkillers by 30 % or more
KC Shin (2012, Korea) [8]	CT	Periorbital Wrinkle	6 threads, 0.1×40 mm	Around wrinkle	No	WSRS	Significantly reduced from 3.21 to 2.41 (p<0.0001)
KC Shin (2012, Korea) [8]	CT	Periorbital Wrinkle	6 threads, 0.1×40 mm	Around wrinkle	No	VAS	Significantly reduced from 69.61 to 28.09 (p<0.00001)

Table 4

Summary of 12 Clinical Reports about Gold Implantation Treatment on Humans

Report	Subject’s information	Type of implantation	Duration of Implantation	Location of implantation	Presented Condition
1 Clinical observation
K.Y. Han (1974, Korea) [21]	1,725 patients taken KUB due to urogenital problem	Gold needle or Gold thread	Unclear	Para-vertebral region. (total 322): Cervical region(2), Thoracic region (21) Lumbar region (295), Sacral region(3), Coccyx region(1)	Final diagnosis: Urethral stone(12), BPH(7), Cystitis(6), Renal stone(5), Pyelonephritis(5), Bladder tumor(5), Prostatitis(5), OA of L-spine(5), Female polygoid(4), Urethritis(3), HNP(3), Renal Tbc(2), Anterior urethritis(2) et al.
8 Case Reports
B. Behrstock (1974, US) [22]	F/44, Mid-back pain	Gold needle	5 years	Subcutaneous tissue along the entire back and supra-clavicular regions.	1) Fleeting mid back and right posterior chest pain 2) Hyper-pigmented skin change
G. Stark (2007, Germany) [23]	F/47, Facial rejuvenation	Gold thread	12 years	All over the middle and lower facial soft tissues and upper neck	Soaring pain within the soft tissue all over the inserted region without inflammatory signs
K.S. Park (2008, Korea) [24]	F/61, Myalgia at hip joints	Gold thread	Unclear	Painful areas of the body	Pain and weakness in both thighs
G. Alsaadi (2008, Belgium) [25]	F/60, Facial rejuvenation	Gold wire	10 years	Bilaterally overlapping with the ramus ascendens and the rest of mandible	Oral rehabilitation by means of oral implants
D. Armstrong (2008, US) [26]	F/62, RA of hand	Gold thread	Unclear	Hand wrist	Long lasting, erosive, seropositive RA with increased wrist pain and swelling.
H.G. Yoo (2013, US) [27]	F/65, OA of Knee	Gold thread	Unclear	Around the knee joint	Pain in both knees
Y. Wang (2013, Taiwan) [28]	F/54, Facial rejuvenation	Gold thread	Unclear	Soft tissue of face & neck	Traffic accident
B. Mizrahi(2014, England) [29]	F/58, Facial rejuvenation	Gold thread	Unclear	Facial part	No complaint was presented
I. Moulonguet (2014, France) [30]	F/77, Facial rejuvenation	Gold thread	10 years	Cheek subcutis	Histopathology showed a non-polarizing exogenous material surrounded by a fibrous capsule and by a discrete inflammatory reaction with no adverse reaction.
J. Keestra (2014, Belgium) [31]	F/76, Facial rejuvenation	Gold wire	25 years	Soft tissues of cheek, bilaterally	Vague toothache in right maxilla, far away from the location of gold-wires
J.Y Cho (2015, Korea) [32]	F/39, Chronic headache	Gold thread	Unclear	All over the skull region	Chronic cough from unrevealed cause

VI.

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