September 4, 2018
Easy to Learn Fertility Acupressure
What is Acupressure Massage?
Acupressure is a therapeutic, non-invasive style of massage based off the acupuncture system of meridians and channels. This style of massage has been used in Traditional Chinese Medicine for over 3500 years! Acupressure massage uses a combination of relaxation & deep tissue massage on specific acupressure points in order to improve circulation & energy in other areas of the body.
One of the best things about acupressure massage is that it can be done entirely at home by you or your partner, making it FREE, easily accessible & convenient.
How does Acupressure help with fertility?
There are a number of ways in which acupressure massage can assist with fertility & conception, here are just a few of the many benefits:
- Helps increase blood flow systemically
- Allows circulation to increase in the uterus and other reproductive organs.
- Promotes relaxation
- Can be used in conjunction with other fertility treatments i.e. IVF
- May support natural hormone balance
Unfortunately acupressure massage isn’t safe to use during pregnancy, so if you are pregnant or think you may be do not use. To book a consultation with Bob Wong to discuss other supportive options please click here.
How do you do it?
Another fantastic benefit of acupressure massage is that it’s relatively quick & easily to administer by either you or your partner. Simply hold each point for the total of 20-30 seconds, release & repeat for 1-2 mins. A sore or achy sensation may be experienced, this is perfectly normal.
li 4
Location: between the index and thumb. mid between at the junction.
Indications: Aside from fertility it also helps with headaches, digestive issues, stress and anxiety.
kd1
Location: On the sole of the foot between the second and third toes, at the depression near ball of the foot.
massage towards the big toe.
Indications: headaches, dizziness, vertigo, stress
sp6
Location: On the inside of the ankle, three finger breadths above the inner ankle.
Indications: period pain, groin pain, irritability, cramping
Upcoming free info workshop
How To Increase Fertility Through Chinese Medicine
Date: TBA
Join email list here: http://eepurl.com/dA9MKn to be notified!
Bob Wong is an AHPRA licensed, sixth generation acupuncturist from the USA. He currently works from his acupuncture Brisbane clinic. He has experience working in China, USA, and Australia with a special focus in chronic pain, Women’s Health, Fertility, Pregnancy Care, Stroke Recovery, Neurological Disorders, Back Pain,Sciatica,Frozen Shoulder,Arthritis,Bell’s palsy, and other musculoskeletal ailments.
May 4, 2018
Three Ways Acupuncture can Improve Fertility & Conception
For many couples, trying to fall pregnant can be a time full of joy & excitement, anticipating the arrival of their bundle of joy. Unfortunately for many others it can become a stressful & frustrating experience,with many couples left feeling defeated & confused. If this is you, you are absolutely not alone, in fact, around 1 in 6 couples experience difficulty with fertility. It’s important to not give up hope & always seek support.
Acupuncture has been successfully utilized in both China & the West for many, many decades to improve fertility outcomes & has been clinically shown to have a positive influence over reproductive health, conception & pregnancy. Acupuncture improves fertility by assisting with a number of factors which greatly impact conception including regulation of hormones, stress reduction & nervous system support, as well as improved blood flow to the uterus.
Here are some ways in which Acupuncture may assist with fertility & conception:
1. Helps Balance Hormones
Regulation of the menstrual cycle & related hormones is essential for improving chances for conception. Pre-conception acupuncture treatment has been shown to have multiple beneficial effects on the menstrual cycle & fertility due to the regulatory & balancing effect it has on female (& male) hormones. Balancing hormones will not only help optimize ovulation but also have positive effects over other areas of reproductive health including:
- follicle & egg quality
- regulation of follicle-stimulating hormone (FSH)
- luteal phase quality > improve progesterone production & implantation chances
- balance of oestrogen & progesterone
- improve sperm count, motility & morphology, in males
2. Helps to Reset the Nervous System & Reduce Stress
Stress has become a relentless & common part of many peoples everyday lives. What most people, especially couples trying to conceive, don’t fully recognize is just how much stress they are experiencing & the impact is can have over reproductive health & fertility.
Studies have shown that acupuncture both directly & indirectly activates the nervous system, helping to restore healthy function. Acupuncture achieves this by re-balancing the parasympathetic (rest-&-digest) & sympathetic (fight-or-flight) arms of the nervous system by decreasing cortisol (stress hormone) & modulating β-endorphins (stress reducing hormone).
Acupuncture also has positive influence on regulation of regulation of neurotransmitters, chemical messengers which allow the nervous system to communicate efficiently. Examples include:
- GABA (responsible for helping calm & relax)
- Glutamate (excitatory neurotransmitter responsible for cell signalling)
- Dopamine (important for emotional function/control, movement, pleasure & reward)
- Serotonin (mood, sleep, appetite)
- Melatonin (sleep, circadian rhythm)
- Epinephrine/Norepinephrine (essential in engaging the fight-flight response)
3. Increases Blood Flow to the Uterus
Research has suggested that insufficient blood flow to the uterus may explain infertility in some cases. Acupuncture has been clinically shown to improve vasodilation (blood flow) to the uterus & create a healthy endometrial environment, therefore improving the chances of successful implantation & pregnancy.
If you & your partner are planning on or having difficulty falling pregnant book your initial consultation today or email info@artofacupuncture.com.au for further information.
Bob Wong is an AHPRA licensed, sixth generation acupuncturist from the USA. He currently works from his acupuncture Brisbane clinic. He has experience working in China, USA, and Australia with a special focus in chronic pain, Women’s Health, Fertility, Pregnancy Care, Stroke Recovery, Neurological Disorders, Back Pain,Sciatica,Frozen Shoulder,Arthritis, Bell’s palsy, and other musculoskeletal ailments.
Special Offer
Initial Exam $47
Includes: Tongue and Pulse Diagnosis, Full Health History (acupuncture not included)
Call Now
References
(1) Westergaard, L, Qunhui, M, Krogslund, M, Sandrini, S, Lenz, S & Grinsted, J 2006, Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial, Fertility & Sterility, Vol. 85, No. 5(2) Chang, R, Chang, P & Rosenwaks, Z 2002, Role of acupuncture in the treatment of female infertility, Fertility & Sterility, Vol. 78, No. 6(3) Stener-Victorin, E & Humaidan, P 2006, Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer, British Medical Journal, Vol. 24, No. 4(4) Ding, S, Hong, S, Wang, C, Guo, Y, Wang, Z & Xu, Y 2013, Acupuncture modulates the neuro-endocrine-immune network, QJM An International Journal of Medicine, Vol. 107, No. (5) Li, Q, Shi, G, Xu, Q, Wang, J, Liu, C & Wang, L 2013, Acupuncture Effect and Central Autonomic Regulation, Evidence Based Complementary & Alternative Medicine(6) Uchida, S & Hotta, H 2008, Acupuncture Affects Regional Blood Flow in Various Organs, Evidence Based Complementary & Alternative Medicine, Vol 5, No. 2(7) Razik, M, Farag, M & Sheta, M 2015, Uterine and ovarian arteries blood flow during the mid luteal phase in women with unexplained infertility, Middle East Fertility Society Journal, Vol. 20, No. 3
Original post Vive health
December 27, 2017
Acupuncture for Chemotherapy Induced Peripheral Neuropathy
Can Acupuncture help with Peripheral Neuropathy
Chemotherapy-Induced Peripheral Neruopathy (CIPN) is a common and often severe side effect of a number of chemotherapy treatments with symptoms generally appearing in a dose dependent & progressive manner throughout treatment. In fact, up-to 1 in 4 patients receiving chemotherapy may develop some form of peripheral neuropathy. Unfortunately for many, these symptoms rarely alleviate once chemotherapy have been ceased. Acupuncture has showed promising results when administered in adjunct to chemotherapy in order to alleviate symptoms & improve quality of life in a number of cases.
What is Chemotherapy Induced Peripheral Neuropathy?
CIPN is defined as damage to the peripheral nerves resulting in weakness, paraesthesia “pins & needles”, numbness, loss of proprioception & pain. These symptoms mainly appear in the hand & feet of the individual, however can also affect many other areas &/or functionality of the body. The specific set of symptoms a person may experience is reliant upon whether sensory, motor or autonomic nerves have been affected.
- Motor Nerves | control muscle movement.
- Sensory Nerve Damage | control & receive sensations (i.e. temperature, pain, touch, vibration).
- Autonomic Nerve Damage | control automatic processes (i.e. blood pressure, heart rate, digestion & bladder function)
Can acupuncture assist me?
Acupuncture has been clinically trialled & found to be up to effective in the management of CIPN. Research conducted by Donald, Tobin & Stringer (2011) reported 82% of patients receiving a total of 6 acupuncture sessions reported an improvement in CIPN symptoms. Treatment was also found to have additional benefits including improved sleep quality, stress reduction & improved moods.
A systematic review conducted by Franconi et. al (2013) found acupuncture to be effective in reducing pain scores in patients experiencing CIPN across most studies included in the review. A number of studies showed positive effects of acupuncture on motor & sensory symptoms associate with CIPN & improve quality of life for the participants significantly.
Acupuncture may also have a beneficial influence over inflammatory pathways which may contribute & precipitate CIPN symptoms such as pain & loss of mobility. Activation of the nervous system may also be responsible for the reduction of symptoms & rehabilitation of normal functionality including mobility, muscle control & sensory
For more information regarding CIPN & acupuncture please email info@artofacupuncture.com.au or click here to book a consultation.
Special Offer
Initial Exam $47
Call Now
Bob Wong was raised in a traditional Chinese medicine family and moved to mainland China to study and train for almost a decade. During that time, he was able to learn from some of the top acupuncturists and Chinese Medicine practitioners in at the Guangzhou University of Chinese Medicine. His mission is not bring that knowledge and experience to help his patients.
*Results may vary from person to person. The owner of this website does not claim to cure, or prevent any disease or illness. For more information on how acupuncture works, contact info@artofacupuncture.com.au
December 11, 2017
Can Acupuncture Assist in Management of Anxiety?
Anxiety is a very common condition, in fact, it’s the most common mental health condition in Australia. On average 1 in 4 people will experience anxiety at some stage in their life. That’s a lot of people experiencing anxiety.
It’s important to understand that anxiety is much more than just feeling stressed or worried from time to time, It’s a chronic mental health condition & for many individuals can become a lifelong battle. It is characterised by ‘a persistent feeling of dread, apprehension & impending disaster or tension and uneasiness’ and so much so that it’s significant impairs the individual’s ability to live a normal life. Everyday tasks can become incredibly difficult & even a major trigger in some cases.
Acupuncture is a non-invasive alternative medicine modality which has been successfully used in the treatment of anxiety for many years. So how exactly does it help manage anxiety & how do I know if I’m the right candidate?….
Can Acupuncture help manage Anxiety?
There are many different strategies that can be utilised to aid in the management of anxiety. Acupuncture may be successfully used to alleviate symptoms associated with anxiety & assist the individuals’ recovery. In fact, research is beginning to catch up & prove the capability of acupuncture to reduce chronic symptoms associated with anxiety.
A literature review published in the prestigious British Medical Journal (BMJ) (2007), focusing on the efficacy of using acupuncture to relieve anxiety, compared results from 10 randomised control trials. They concluded that acupuncture was beneficial for the management of both situational & generalised anxiety. In a separate literature review published in CNS Neuroscience & Therapeutics (2011) researchers found that acupuncture was as effective as cognitive behavioural therapy (CBT) in the treatment of anxiety.
Will Acupuncture be right for me?
Due to acupuncture’s non-invasive & gentle nature it really is suitable for anyone. However always consult with your health care professional prior to commencement of any new treatment strategies.
How does Acupuncture help manage anxiety?
The principle by which acupuncture is able to assist individuals manage their anxiety is based upon the Traditional Chinese Medicine (TCM) philosophy that health is dependent of the fluent & balanced movement of energy throughout the main channels of the body. Intense stress & emotion, as experienced during anxiety, begins to disrupt & block this flow of energy resulting in a number of the chronic physical & psychological symptoms suffers may experience including panic, sweating, headaches, muscle tension & even insomnia.
Acupuncture seeks to address imbalances between body, mind, emotions & spirit. It achieves this by improving circulation & oxygenation of the entire body, particularly the brain. Acupuncture may also stimulate the nervous system & facilitate natural production of endorphins & enkephalins, the body’s natural feel good hormones. This essentially means that acupuncture aims to alleviate stress & reduce the impact it has on physical & emotional health by essentially “resetting the nervous system”.
If you or a loved one are experiencing anxiety and would like to inquire about treatment options please email info@artofacupuncture.com.au or click here to book a consultation.
*Results may vary from person to person. The owner of this website does not claim to cure, or prevent any disease or illness. For more information on how acupuncture works, contact info@artofacupuncture.com.au
Reference
- Beyond Blue (Anxiety) https://www.beyondblue.org.au/the-facts/anxiety
- Pilkington K, Kirkwood G, Rampes H, et al’ Acupuncture for anxiety and anxiety disorders – a systematic literature review’, Acupuncture in Medicine 2007;25:1-10.
- Errington-Evans, N, ‘Acupuncture for Anxiety’, CNS Neuroscience & Therapeutics2011,
April 2, 2017
Plantar Fasciitis Treatment with Acupuncture
Plantar fasciitis acupuncture treatment in Brisbane
Plantar Fasciitis is inflammation of the plantar fascia, which is on the bottom of your foot. What happens is patients usually wake up early in the morning and their feet is really, really sore and takes about 10-20 minutes to really warm-up. They feel like they are walking in razor blades, there’s a sharp sensation at the bottom of the heel. Plantar Fasciitis is also common in runners. Roughly takes 10% of running injuries. It also accounts 11-15% of all heel pain.
Traditional treatments include Orthotics, going to Physio, doing exercises, shockwave therapy, PRP injections and these treatments are often expensive and ineffective. If you tried all these and nothing else has worked for you, acupuncture maybe an option for you.
With acupuncture, what happens is needles are placed either on the fingers, on the hands or on the scalp. This is used to stimulate the body’s limbic system. Once the body’s limbic system is stimulated the brain produces endorphins, which is your body’s natural pain killer. From then on, the patient is encouraged to move, stretch and actually do some exercises to encourage local blood flow. As treatments progressed should be able to see improvement with each and every session.
Thank you for watching this video. If you have any questions about treatment of Plantar Fasciitis using Chinese medicine, please send us an email at info@artofacupuncture.com.au
example case study below:
*All Videos Filmed With Written Informed Consent
*Results may vary from person to person. The owner of this website does not claim to cure, or prevent any disease or illness. For more information on how acupuncture works, contact info@artofacupuncture.com.au
Bob Wong was raised in a traditional Chinese medicine family and moved to mainland China to study and train for almost a decade. During that time, he was able to learn from some of the top acupuncturists and Chinese Medicine practitioners in at the Guangzhou University of Chinese Medicine. His mission is not bring that knowledge and experience to help his patients.
Bob Wong currently maintains an acupuncture practice in the Brisbane area and lectures at the Endeavour College of Natural Health. For more information you can read his full bio or schedule and appointment.
*The owner of this site is not liable for any misfortune that should befall a visitor to this site.This site does not offer personal advice & no information on it can be construed as personal advice. In the event that you may feel our therapies may be of benefit, we advise you to contact the clinic to make an appointment for diagnosis and treatment.
March 27, 2017
Treating Arthritis: A Chinese Medicine Approach
Acupuncture for Arthritis
Acupuncture for Arthritis
Western medicine and Treatment
According to The Current Medical Diagnosis, Rheumatoid arthritis is a chronic systemic inflammatory disease whose major manifestation is synovitis of multiple joints. The cause is not known.Untreated, rheumatoid arthritis causes joint destruction with consequent disability and shortens life expectancy. Early, aggressive treatment is the standard of care.
Patients usually wake up complaining of stiffness in affected joints (usually hands and feet.) Deformities are common as the disease progresses. MRI and imaging usually find narrowing or joint spaces and osteoporosis along with joint erosion. Patients may also complain about dry eye and nodules forming over bony prominences.
NSAIDs (non-steroidal anti-inflammatories) provide some symptomatic relief in rheumatoid arthritis but do not prevent erosions or alter disease progression. Large dosages of these drugs over time can cause gastro-intestinal ulcers and bleeding in the stomach. Steroids such as Prednisone may also be used but over time this too can lead to osteoporosis.
A Chinese Medicine Approach
Acupuncture Therapy
According to Chinese Medicine, Rheumatoid arthritis is classified as wind dampness pathogen. Contributing factors such as long living in a damp environment and contraction of wind, cold, for long periods of time affect the joints. Because blood flow is unable flow properly to that area for long periods of time, energy gets “stuck.” The goal of treatment of RA would be to expel wind and dispel dampness pathogens and warm the channels of the body.
Acupuncture for Rheumatoid Arthritis:
Youtube Video HERE
Youtube Video HERE
Herbal Therapy
Du Huo Ji Sheng Wan (独活寄生丸)
Chinese Herbal are used expel the cold and dampness in the body (often seen in RA patients) when patients are not receiving treatment and give the body that extra boost it needs to keep the inflammation away.
There is a very effective patent formula called Du Huo Ji Sheng Wan (独活寄生丸) for for lower back pain. The main ingredients include Angelica pubescens root and Loranthus stem which are used to treat arthritic and orthopedic disorders. These both have anti- inflammatory and analgesic properties.Your practitioner may prescribe these herbs to help relieve inflammation and kick start the healing process.
Tumeric supplements
turmeric can also be an additional aid for arthritic pain For more info please click HERE
*All Videos Filmed With Written Informed Consent
*Results may vary from person to person. Pain relief lasts generally for up to 72 hours. Further assessment is needed to determine treatment outcomes. Videos are for demonstration purposes only. The owner of this website does not claim to cure, or prevent any disease or illness. For more information on how acupuncture works, contact info@artofacupuncture.com.au
Bob Wong was raised in a traditional Chinese medicine family and moved to mainland China to study and train for almost a decade. During that time, he was able to learn from some of the top acupuncturists and Chinese Medicine practitioners in at the Guangzhou University of Chinese Medicine. His mission is not bring that knowledge and experience to help his patients.
Bob Wong currently maintains an acupuncture practice in the Brisbane area and lectures at the Endeavour College of Natural Health. For more information you can read his full bio or schedule and appointment.
*The owner of this site is not liable for any misfortune that should befall a visitor to this site.This site does not offer personal advice & no information on it can be construed as personal advice. In the event that you may feel our therapies may be of benefit, we advise you to contact the clinic to make an appointment for diagnosis and treatment.
December 16, 2016
Wife’s Knee Pain
Wife’s Knee Pain was getting kind of out of hand when I saw her hobbling around a bit after she gave birth to our daughter. We had some extra time so decided to do a knee pain treatment I learned from Dr.Zhu.
music: davidcuttermusic.co.uk
Bob Wong was raised in a traditional Chinese medicine family and moved to mainland China to study and train for almost a decade. During that time, he was able to learn from some of the top acupuncturists and Chinese Medicine practitioners in at the Guangzhou University of Chinese Medicine. His mission is not bring that knowledge and experience to help his patients.
Bob Wong currently maintains an acupuncture practice in the Brisbane Hawthorne area and lectures at the Endeavour College of Natural Health. For more information you can read his full bio or schedule and appointment.
*The owner of this site is not liable for any misfortune that should befall a visitor to this site.This site does not offer personal advice & no information on it can be construed as personal advice. In the event that you may feel our therapies may be of benefit, we advise you to contact the clinic to make an appointment for diagnosis and treatment.
December 11, 2016
Shoulder Pain Acupuncture Treatment Instant Relief Scalp Points
Shoulder Pain Acupuncture Treatment Using ZSA (Zhu Scalp Acupuncture)
I recently have been getting quite a bit of shoulder pain patients come in and we have been using the scalp system to get rid of pain. Originally, the patient could not lift his arm above his head the first session. The shoulder was hurt from playing football. He was getting ready for a surfing trip and decided to give acupuncture a try. After the first session he was able lift his arm and was even able to paddle during surfing which he was not able to do for over 8 months. I’s hard to get rid of 100% of the pain in one session but we were able to make great progress with this type of old sports injury. This was the second treatment:
Youtube Video HERE
music: https://soundcloud.com/rogiermuller
All videos filmed with informed consent.
Bob Wong was raised in a traditional Chinese medicine family and moved to mainland China to study and train for almost a decade. During that time, he was able to learn from some of the top acupuncturists and Chinese Medicine practitioners in at the Guangzhou University of Chinese Medicine. His mission is not bring that knowledge and experience to help his patients.
Bob Wong currently maintains an acupuncture practice in the Brisbane area and lectures at the Endeavour College of Natural Health. For more information you can read his full bio or schedule and appointment.
*The owner of this site is not liable for any misfortune that should befall a visitor to this site.This site does not offer personal advice & no information on it can be construed as personal advice. In the event that you may feel our therapies may be of benefit, we advise you to contact the clinic to make an appointment for diagnosis and treatment.
November 6, 2016
Acupuncture point SI3
Acupuncture point SI3 后溪
SI3 后溪
This Personal fav point for neck and lower back pain. Located on the ulnar border of the hand, in the substantial depres- sion proximal to the head of the fifth metacarpal bone (Deadman, 2007.)
It is a great point for neck and lower back pain because bladder channel (tai yang treats tai yang) and also because it is the shu-stream point of the Small intestine channel. As the confluent point of the Du channel it can treat spine. Shu-stream points on yang channels pertain to wood, which treat tendons and sinews as well. According to The Classic of Difficulties, the shu-stream points are indicated for “heaviness of the body and pain of the joints.””Moreover, the shu stream points are situated in the middle of the five transport points, which can be thought of as between interior and exterior.. which is why shu-stream points are excellent for treating conditions that come and go.” (Young, 2013.)
SI3 can be used as an image of the upper or lower back and occipital headaches as well. It works better when paired with BL65 which is also another shu stream point. As acupuncturists, we treat a wide range of of pain most of the time and it is definitely a great point to have in the tool box.
References:
Deadman, Peter, Mazin Al-Khafaji, and Kevin Baker. A Manual of Acupuncture. Hove, East Sussex, England: Journal of Chinese Medicine Publications, 2007. Print.
Young, Wei-Chieh, and Jingchang Dong. The Five Transport Points. Rowland Heights, CA: American Chinese Medical Culture Center, 2008. Print.
Bob Wong was raised in a traditional Chinese medicine family and moved to mainland China to study and train for almost a decade. During that time, he was able to learn from some of the top acupuncturists and Chinese Medicine practitioners in at the Guangzhou University of Chinese Medicine. His mission is not bring that knowledge and experience to help his patients.
Bob Wong currently maintains an acupuncture practice in the Brisbane area and lectures at the Endeavour College of Natural Health. For more information you can read his full bio or schedule and appointment.
*The owner of this site is not liable for any misfortune that should befall a visitor to this site.This site does not offer personal advice & no information on it can be construed as personal advice. In the event that you may feel our therapies may be of benefit, we advise you to contact the clinic to make an appointment for diagnosis and treatment.
November 6, 2016
Scalp Acupuncture: Mom’s Neck Pain
Instant Neck Pain Relief Using Zhu Scalp Acupuncture
One of the best times of the year is when my Korean mother in law comes to town. She’s cooks the best food, takes care of the kids, and we get along great. I don’t speak Korean and she does not speak English so there’s nothing to argue over.
However, she’s been suffering from severe neck and shoulder pain from many years of working so hard. She had a very stiff neck to begin with and the flight over to Australia was very long as well. The pain was along the Du,GB,BL,LI & Sj channels. We decided to do scalp acupuncture first. After needling the areas over hypothalamus (part of the brain responsible for controlling pain/ motor sensory) and neck area scalp points we had her do some breathing and stretching exercises and after about 5 minutes half the pain was gone.
We kind of hit a wall after that and the pain wouldn’t budge. The neck was alot looser and free but the pain along the Trap and shoulder was still there. We included opposite side Lv4 (shu stream point for pain) and same side San Cha San (Sj2) and Sj3. After a few more stretches and several minutes later the pain was completely gone.
The pain came back but much lower the next day and it will probably take a few more treatments along with plenty of stretching and exercises.
Bob Wong was raised in a traditional Chinese medicine family and moved to mainland China to study and train for almost a decade. During that time, he was able to learn from some of the top acupuncturists and Chinese Medicine practitioners in at the Guangzhou University of Chinese Medicine. His mission is not bring that knowledge and experience to help his patients.
Bob Wong currently maintains an acupuncture practice in the Brisbane area and lectures at the Endeavour College of Natural Health. For more information you can read his full bio or schedule and appointment.
*The owner of this site is not liable for any misfortune that should befall a visitor to this site.This site does not offer personal advice & no information on it can be construed as personal advice. In the event that you may feel our therapies may be of benefit, we advise you to contact the clinic to make an appointment for diagnosis and treatment.