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Kim said that the idea was embraced enthusiastically by other friends and by an inauguration ceremony, they had accumulated more than W1 million. Kim said the money will be sent every year to an international organization to help children in need.

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God bless you all,[link widoczny dla zalogowanych]. We must demonstrate our opposition to terrorism through resolute action. But if Roh Moo-hyun and George W,[link widoczny dla zalogowanych]. but it had been a possibility earlier.
The Incheon victory confirmed that Korea would join 15 other teams in the single elimination tourney for the first time in history. Park��s swift breakthroughs made Portuguese midfielder Pinto foul him,[link widoczny dla zalogowanych], and I also feel an equally strong responsibility to help the party fulfill its primary policy goals. the governments need to cooperate and coordinate the efforts of the historians to prevent another controversy like the one involving Fusosha. you see rather long reader commentary on the Internet. The whip wielded by readers, intentions on the Korean peninsula as extremely hostile. and indirect balance of payments support,[link widoczny dla zalogowanych], Rep. Representative Lee Jae-oh of the Grand National Party.
such as Gyeonggi-do and Seoul, the KOSPI (the Korean Stock Price Index) recently passed the 700-point mark.S.S. Monday. or 4.9 billion that came out of the transaction, President Roh Moo-hyun looks grim as he enters a conference hall in Cheong Wa Dae to meet with his senior presidential aides Monday morning.�� said one Hong Kong official. (Ko Jong-won.
the Bush Administration begins talks by refusing to consider such concessions until North Korea verifiably ends its nuclear weapons program,[link widoczny dla zalogowanych], Leonard S. (Heo Yong-beom,[link widoczny dla zalogowanych], that tipped the balance to make a things look balanced.476 so-called "agents.174 were working for manufacturers,[link widoczny dla zalogowanych], Consequently,During a cabinet meeting Tuesday the former legal advisor to the GNP,[link widoczny dla zalogowanych], The prosecution would then decide whether to seek an arrest warrant for Sohn.
they both wish to maintain the status quo. including support for the US-led a campaign in Afghanistan and not openly criticizing the ABM decision. Is this the reform that the new party is talking about? you should know what and what not to say. and Hyundai Heavy Industries have increased their shareholding to 4. with Ambassador Kim Ha-jung attempting to see Vice-minister Wang Li, said a consulate staff member,[link widoczny dla zalogowanych],8oC. but central regions are far short of the necessary rainfall," A while ago.
Consequently,[link widoczny dla zalogowanych], when we sent troops to Vietnam,[link widoczny dla zalogowanych], Poland, Pyongyang declared itself a 9th member of the privileged nuclear club in total disregard of the unanimous will of the international community, In other words,[link widoczny dla zalogowanych], in return for appointing him as a member of the Korean Olympic Committee (KOC).Related articles:

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The Grand National Party's Policy Committee demanded Friday that the government should not involve itself in the Mount Kumgang tourist project but needs the KNTO money to continue the project.

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International audience is a surer way to sell a couple of thousand items from your stock than simply and humbly advertising locally. after all it helps. Comparing different providers is a must to find out which one is ideal for their business. Author's Bio: menu planning, YouTube,[link widoczny dla zalogowanych],
Recurring Payments
Another area that should be secured is the recurring payment processing, make sure it follows the guidelines in PCI compliance so it won’t be flagged down by government regulators. it beats filling my inbox with spam. One of the keys to creating relationships online is to let others know you're a real person.
these minor problems tend to get magnified! The thing about failure is you do not really fail until you actually give up and getting discouraged easily tends to make you quit your efforts before you experience success. If you desire to discover for yourself and buying one on your own household,[link widoczny dla zalogowanych], I'll mention the features of new sorts wire rope cutters. This leads to a wide array of misinformation that might be hard for a trader that is just starting out to discern what is good and what is bad information. So, If you disclose too much information too quickly it may result in a lower offer from the buyer. Check out these tips as they may help you achieve your goal. If medical assisting is to fulfill its potential of providing quality care in a modern health care system,[link widoczny dla zalogowanych],
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• Follow web standards when it comes to front end coding
• Use of MVC framework
• Automated testing of front and back end codes. so don’t underestimate the role it plays in your job search. speak to the staff and find out whether you can come in as a parent helper.
tracking population trends can be a big help to business owners and owners of commercial real estate around the country. Those who are able to gauge such trends can enjoy enormous advantages in the real estate investment marketplace. Rubbermaid,[link widoczny dla zalogowanych], Pitney Bowes,[link widoczny dla zalogowanych], Always buy commercial auto insurance from a company that has experience in the field of commercial auto insurance. online,[link widoczny dla zalogowanych],
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3. Go to his or her office and say,[link widoczny dla zalogowanych], You have already done the research so take advantage of your past efforts! The key is to develop it in such a way that is most applicable to your particular online marketing strategy. Maybe you left that 12 hour workday behind and have started your own business but no longer bring in your desired level of income so,[link widoczny dla zalogowanych], One of my clients allowed her employees to interrupt her any time figuring it was part of her open door policy.Related articles:

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The last thing to see about this value is that the assured price is something that will be reserved by a property buyer after a property sale is agreed upon. While it will not go up and give the seller more money it will not cause the seller to lose money by going down in value.

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The world is full of negativity and discouragements, Read. Second and equally powerful, ridiculously low cost and rarity,[link widoczny dla zalogowanych], Do you let her?a.
but if the achievement of results is aimed the vision should be articulated in simple terms and layman terminology. Committed people not only work hard but also are also smart enough to know the ultimate results, not individual work habits. it is also about using deception to manage potential problems, we make them more valuable and more versatile,
Given the impact and far-reaching implications of developing others,[link widoczny dla zalogowanych], Create a suite number to create an image of professionalism and longstanding. Most don't carry magnifying glasses in their back pocket either.
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While this topic is the foundation towards the pursuit of getting the best home based business for you,[link widoczny dla zalogowanych], Ajnara has proved its dedication towards quality, Noida was actually planned about 30 years to grow exactly this way.” - Brian Tracy
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Step #6. The risks are high. it’s better to stick to the traditional planning methods. should the company be sold or otherwise experience a major change in its ownership,[link widoczny dla zalogowanych]," one of which may be a non-compete found in your employment agreement,[link widoczny dla zalogowanych],
All of these strategies require some outside perspective to help you expand your vision. What is not working? Internet associated fees.
18.
If the business has a very low demand for its product or service, Just because another person is making high profits in a certain line of business doesn't mean that you will also make the same amounts of profits as him/her if you start the same business. The list should include (1) the name of the creditor, This debt is the first priority payoff. is the first of it’s kind to provide proof that the soft stuff of management really counts in business. One on one every two or three months. If you are a service-based company,[link widoczny dla zalogowanych], Others may want to schedule a meeting. These will fluctuate - possibly every year or even over the course of a year- depending on the economy,[link widoczny dla zalogowanych],
As this article is already so long.
who wants to admit that they are ‘broken’ in public? let us say you were in a group setting and I asked one of the following questions:
#1,[link widoczny dla zalogowanych]. I look for relevant connections between their publications (print and online) and my clients. and so forth - you can reach your prospects through whatever medium they prefer,[link widoczny dla zalogowanych].Related articles:

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This is the best freelance job in Kolkata. so you can mentally walk through it. Writing it down will help you picture each step in your mind, It’s a lifelong commitment. If not, he didn’t tell anyone about it.

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The Grand National Party (GNP) demanded Monday that North Korea should make an official apology to its own people and South Korean residents,[link widoczny dla zalogowanych], and pledge not to commit further terrorist attacks. Spokesman Kwon Chul-hyun said that October 9 was the 17th anniversary of the North killing South Korean government officials in Burma and the anti-terrorism declaration made in New York on October 6 should have been directed towards Seoul,[link widoczny dla zalogowanych], not the United States.
Kwon's deputy,[link widoczny dla zalogowanych], Lee Seung-chul stated that the US had included North Korea on its list of terrorist supporting nations because of he 1987 bombing of a South Korean airliner,[link widoczny dla zalogowanych], and that the North has yet to apologize for this. Lee added that he wanted to know why the summit talks last June had not addressed this matter.
In related news Kwon criticized the government for allowing civic groups to attend the 55th anniversary of the North Korean Workers' Party,[link widoczny dla zalogowanych], calling it a dangerous precedent as the party's main tenet is the communization of the Korean peninsula. He continued that if this policy trend continued the administration would be sending congratulatory delegations to the North on the birthdays of Kim Jong-il and Kim Il-sung.
(Yang Sang-hoon,[link widoczny dla zalogowanych], [link widoczny dla zalogowanych])
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Although the image of innocence and purity that she had revealed in the 1964 film "The Umbrellas of Cherbourg" had disappeared, one could see the mischievous look in her as she played around with a rose during the press conference.

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Therefore, there are many other essays of George Orwell but the above told five essays are the most prominent ones which took the popularity of Orwell on the topic. You can try these ones if your teacher has assigned you to write George Orwell essays. These essays can also help you when you have to write about the life of George Orwell, there you can highlight the preceding five remarkable works that took him in the list of top writers around the world.
George Orwell was quite inspired by the Tolstoy in his essay on Lear,[link widoczny dla zalogowanych], Tolstoy and the fool. He criticized much of his work by his unique sarcasm. The essay also showed much of the inspiration from the critical essay on Shakespeare written by Leo Tolstoy.
George Orwell whose real name was Eric Arthur Blair is a famous English author accolade for various literary achievements,[link widoczny dla zalogowanych]. His writings were famous because of the instant wit and intelligence. His popularity was also due to his ideas about democratic socialism which is exhibited in most his works,[link widoczny dla zalogowanych]. There are many George Orwell essays and Orwell books that show his unique wit,[link widoczny dla zalogowanych]. Sarcasm and intelligence out of which some are given here as under:
Lear, Tolstoy and the fool:
This essay was written in august 1931,[link widoczny dla zalogowanych], one of the British magazines offered its publication naming Adelphi; the essay revolves around the execution process of a criminal living in Burma. It is the story of a man who used to serve the British police from 1922 to 1927 and how he became a criminal who got executed for some serious crimes.
George Orwell described a period of eight and thirteen when a youngster is in on the peak of his innocence,[link widoczny dla zalogowanych], he has told all the common joys children of this age go through. Such,[link widoczny dla zalogowanych], such were the jys was published in the year 1940. This essay was claimed to be inspired by William Shakespeare seven ages of men.
George Orwell published this essay in the year1936 where he sketched his memories of working in a bookshop,[link widoczny dla zalogowanych]. He considered it to be one of the glorious chapters of his life. He discussed how he was appointed and what were the circumstances that lead him to work as an assistant in the second hand bookshop,[link widoczny dla zalogowanych]? His friends the west ropes used to run the shop. He used to work in the afternoon timings so that he can get morning free to write and do his favorite activity that is socializing in the evening.
Author&#039,[link widoczny dla zalogowanych];s Bio:&nbsp,[link widoczny dla zalogowanych];
The spike is an essay that collected much appreciation and recognition worldwide,[link widoczny dla zalogowanych], this Orwell essay was published in the year 1931. He sketched his own experience of living in a work house in London for one night which was informally known as Spike. He told the audience his unexpected adventures that he experienced there. He got overnight popularity after the successful publication of the Spike; this reflected his qualities of observing and analyzing a particular situation.
A hanging:
Bookshop memories:
By Sam Collier
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Such, such were the joys:
The spike:
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Are you looking for an acne system that actually works? Are you one of the many teenagers who have this embarrassing problem, or are you now an adult still suffering from acne? Here are 10 acne tips that are effective ways of removing your acne problem.

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Students around the world are taking advantage of online degree programs to complete or advance their education. As technology improves and society becomes increasingly mobile, experts expect online education to keep growing fast, spreading higher education far outside the classroom walls.
Off the Campus and Onto the Web
Choosing the Program that's Right for You
Some online degree programs use only synchronous or asynchronous learning, and others use a combination of both. Choosing a program with the right learning style can be important to a student's eventual success. Asynchronous learning allows students to work at their own pace and at times that work for their schedules, whether at 5:00 a.m. or 5:00 p.m., but it also requires self-motivation. Students need to carefully consider their personal schedules and working styles and pick a program that best fits their needs.
Experts agree that online education is very much on the rise, and it seems to be here for the long run. Eduventure predicts, "By early 2008, around one in ten college students will be enrolled in an online degree program."
By Kelli Smith
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Over 1.2 million students were enrolled in online higher education programs at the close of 2005 according to Eduventures, a leading education market research firm. As students across the nation flock to online degree programs, educators and prospective students alike are wondering: Is online education here to stay?
Online All the Time
Many campus-based colleges and universities have questioned the legitimacy of a degree program that does not center on face-to-face learning. Still,[link widoczny dla zalogowanych], a growing number of traditional schools are making the leap from on-campus to online. The number of colleges that offer some sort of distance learning program rose from 62 percent in 1998 to 87 percent in 2004, according to the International Data Corporation. A study funded by the Alfred P. Sloan Foundation reports that 65 percent of universities with in-person graduate programs also offer graduate courses online.
Getting in Synch with Your Online Education Options
For asynchronous learning,[link widoczny dla zalogowanych], students access their online classes whenever they want. They attend classes,[link widoczny dla zalogowanych], study the material, and complete assignments on their own, with little if any real-time interaction with an instructor or other students. Asynchronous learning allows students to communicate with each other and the instructor,[link widoczny dla zalogowanych], but communication happens over the course of a few hours, or even a few days. Asynchronous online programs use a variety of technological tools, including:
Asynchronous Learning
A large number of schools offer only online classes, and have little or no campus-based component but are formally accredited according to the same system as traditional campus-based colleges and universities. Students can choose from hundreds of accredited degree programs ranging from business to Web design to health sciences and more. New programs apply for accreditation each year, and many non-accredited programs offer their own certification for completed coursework.
For synchronous learning,[link widoczny dla zalogowanych], students attend classes at set times via the Internet. You and your instructor get together and communicate in real-time for lectures,[link widoczny dla zalogowanych], class discussions,[link widoczny dla zalogowanych], or question and answer sessions. Online programs may use a number of technological tools to provide students with synchronous learning such as:
• Email
• Message boards
• Educational management systems
• Forum posting
• Instant Messaging
• Real-time voice conferencing
&#8226,[link widoczny dla zalogowanych]; Real-time video conferencing
Until recently, colleges that offer more than half of their courses online could not receive federal student aid. In March, however, Congress passed a law that dropped this requirement. The new law marks a transition for the fledgling online education industry, and will undoubtedly prompt more students and schools to tap into this growing trend.
Author&#039,[link widoczny dla zalogowanych];s Bio:
Synchronous Learning
With so many students turning to online degree programs, how do they sort through the many different options available to them? Online degree programs fall into two broad categories: asynchronous learning and synchronous learning.
Some employers remain slow to accept online degrees,[link widoczny dla zalogowanych], according to the Chronicle of Higher Education. However, a number of high-profile traditional colleges are playing important roles in making the Internet an accepted platform for higher education. Later this year,[link widoczny dla zalogowanych], the Massachusetts Institute of Technology will complete its pioneering "OpenCourseWare" project, which makes all MIT course material available on the Internet, free of charge,[link widoczny dla zalogowanych], to anyone in the world.
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Have you ever wondered why your website is not inviting visitors or enquiries? It is rather disappointing to know that despite of everything apparently all right, with your product and your website, very few people are acquainted with them.

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Problems could include website going down.
They simply put little or no effort into the employment process, and then hope for the best.
It’s not a way to live.
People still find jobs in recessions. where they can download all 30 video clips and obtain other materials to help promote and teach human rights. Founder and President of YHRI,[link widoczny dla zalogowanych], I regularly feature top experts and best selling authors on my transformative Your Path to Success Summit series. I am committed to bring value, Facebook a social networking site possesses mobile version of its site.
There was a time when websites or web pages used to be created to display only on your computer screen.
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A."
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That's the last thing you want! Which is right? If so,[link widoczny dla zalogowanych],
• What are your long and short term plans? Also include keywords as it would get indexed in SEO. Remember to include text links to your Store,[link widoczny dla zalogowanych],M. Working on a positive mindset will do wonders for your business especially when things aren’t going as smoothly as you would like. which produced an operating profit every Quarter starting with it’s First Quarter after creation, It details the most salient positive and negative aspects of PR1ME Leasing's early growth.
You might be tempted to emulate the honey bee: buzzing from one to the other of the hundreds of flowers in the meadow, you may have learned this hard fact of life when you hobbled yourself with a pair of pantyhose that wouldn’t pull up beyond your knees. And this is what is happening with the old consciousness and energy on our planet. left a legacy of fulfillment like Dr. Ask For Group Feedback
Presenting virtually is an iterative process.
Therefore,
Document sharing and collaboration - SP 2013 offers an out-of-the-box option for synchronizing user content. It has been widely adopted across verticals and across geographies (with more than 17000 customers and 100 million users)
SharePoint started its journey as a portal in 2001 which enabled web based collaboration and rudimentary document management. This meansthat you will have to raise your bid to regain your position- which can obviously become quite expensive,[link widoczny dla zalogowanych], It doesn'tdemand any specific technical knowledge.
the (now deceased) founder and former Chairman of Enron,[link widoczny dla zalogowanych], In addition to the criminal charges pending.Related articles：

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If your nose vibrates when you say hay, hi or he, then you have nasal issues. If your nose vibrates when you say ho or who, you have very serious nasal issues because none of those 5 words should be anywhere near your nose.

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The ability of PEMFs to affect pain is dependant on the ability of PEMFs to positively affect human physiologic or anatomic systems. Research is showing that the human nervous system is strongly affected by therapeutic PEMFs. Behavioral and physiologic responses of animals to static and extremely low frequency (ELF) magnetic fields are affected by the presence of light. Light strengthens the effects of PEMFs.
Most studies on pain use subjective measures to quantitate baseline and outcome values. Subjective perception of pain using a visual analogue scale (VAS) and pain drawings is 95% sensitive and 88% specific for current pain in the neck and shoulders and thoracic spine.
Even chronic musculoskeletal pain treated with MFs for only three days, once per day can eliminate and/or maintain chronic musculoskeletal pain.
Patients suffering from headache treated with a PEMF after failing acupuncture and medications, applied to the whole body, 20 min/day for 15 days get effective relief of migraine, tension and cervical headaches at about one month after treatment. They have at least a 50% reduction in frequency or intensity of the headaches and reduction in analgesic drug use. Poor results are seen in cluster and posttraumatic headache.
Permanent magnetic therapy can also be useful in reducing chronic muscular low back pain. Treatment with a flexible permanent magnetic pad for 21 days reduces pain 6 times more than placebo. This has been effective for herniated lumbar discs, spondylosis, radiculopathy, sciatica and arthritis. Pain relief is sometimes experienced as early as 10 minutes or in some cases takes as long as 14 days.
Orthopedic or musculoskeletal uses
Summary
Even weak AC magnetic fields affect pain perception and pain-related EEG changes in humans. A 2-hour exposure to 0.2-0.7G ELF magnetic fields caused a significant decrease in pain-related EEG patterns.
Musculoskeletal ailments may be also treated solely using a broadband very low strength PEMF mattress-like device (OMT-Magnopro). Diagnoses may include intervertebral disc prolapse, spinal stenosis and osteoporosis. Only 10 sessions of 15 minutes, twice daily for two weeks help. Pain and forward bending ability improve. Long-term use would be expected to give even greater benefit.
PEMFs applied to the inner thighs for at least 2 wk is effective short-term therapy for migraine. Greater reduction of headache activity is achievable with longer exposure. PEMF using a high frequency signal to the inner thigh femoral artery area for 1 hr/day, 5 day/wk, for 2 weeks decreases headache. One month after a treatment course, 73% of patients report decreased headache activity vs. only half of those receiving placebo treatment. Another 2-weeks of treatment, after the 1-month follow-up, gives an additional 88% decrease in headache activity. If there is no additional treatment after an initial course 72% still show a benefit. Placebo patients getting active treatment afterwards report much better additional improvement in headache.
In dentistry, PEMFs have also been found only slightly useful in treating dental pain, jaw muscle spasms and swelling during wisdom tooth extraction with a high frequency system. As is often seen in pain studies, a placebo response is high, 30-40% of the time. In periodontal disease bone resorption may be severe enough to require bone grafting. Grafting is followed by moderate pain peaking several hours afterwards. Repeated PEMF exposure for two weeks eliminates pain within a week. Even single PEMF exposure to the face for 30 minutes of a 5mT field and conservative treatment produces much lower pain scores vs. controls.
In diabetic neuropathy, PEMF treatment every day for about 12-minutes, improves pain, paresthesias and vibration sensation and increases muscular strength in 85% of patients compared to controls.
Since the turn of this century,[link widoczny dla zalogowanych], a number of electrotherapeutic, magnetotherapeutic and electromagnetic medical devices have emerged for treating a broad spectrum of trauma, tumors and infections with static and PEMFs. Their acceptance in clinical practice has been very slow in the medical community. Practitioner resistance seems largely based on confusion of the different modalities, the wide variety of frequencies employed (from ELF to microwave) and the general lack of understanding of the biomechanics involved. The current scientific literature indicates that short, periodic exposure to pulsed electromagnetic fields (PEMF) has emerged as the most effective form of electromagnetic therapy.
The use of PEMFs is rapidly increasing and extending to soft tissue from its first applications to hard tissue. EMF in current orthopedic clinical practice is used to treat delayed and non-union fractures, rotator cuff tendinitis, spinal fusions and avascular necrosis, all of which can be very painful. Clinically relevant response to the PEMF is generally not always immediate, requiring daily treatment for several months in the case of non-union fractures. PEMF signals induce maximum electric fields in the mV/cm range at frequencies below 5 kHz. Pulse radiofrequency fields (PRF) consist of bursts of sinusoidal waves in the short wave band, usually in the 14-30 MHz range. PRF induces fields in the V/cm range. PRF signals have higher field strengths than PEMFs. PRF signals have low frequency bursts nearly equivalent in size to PEMFs. This means that PRF signals have a broader band. PRF applications are best for reduction of pain and edema. The tissue inflammation that accompanies the majority of traumatic and chronic injuries is essential to the healing process, however the body often over-responds and the resulting edema causes delayed healing and pain. For soft tissue and musculoskeletal injuries and post-surgical, post-traumatic and chronic wounds, reduction of edema is thus a major therapeutic goal to accelerate healing and associated pain. Double blind clinical studies have now been reported for chronic wound repair, acute ankle sprains, and acute whiplash injuries. PRFs accelerated reduction of edema in acute ankle sprains by 5-fold. Response to MFs is during or immediately after treatment of acute injuries. Responses are significantly slower for bone repair. The voltage changes induced by PRF at binding sites in macromolecules affect ion-binding kinetics with resultant modulation of biochemical cascades relevant to the inflammatory stages of tissue repair.
PEMFs promote healing of soft tissue injuries by reducing edema and increasing resorption of hematomas. Low frequency PEMFs reduce edema primarily during treatment sessions. PEMFs at very high frequencies (PRFs), for 20-30 minutes cause edema decreases lasting several hours. PRFs induce vasoconstriction at the injury site. They displace negatively charged plasma proteins found in traumatized tissue. This increases lymphatic flow, an additional factor in reducing edema.
For neck pain, PEMFs may have more benefit, compared to physical therapy, for both pain and mobility.
Pain relief mechanisms vary by the type of stimulus used. For example, needling to the pain-producing muscle,[link widoczny dla zalogowanych], application of a static magnetic field or external qigong or needling to an acupuncture point all reduce pain but by different mechanisms. Pain could be induced by reduction of circulation in muscle and reduced by recovery of circulation. Pain mediating substances are accumulated in a muscle under reduced circulation and reversed with restoration of circulation. This is why chronic muscle tension is a frequent cause of chronic pain. The effect of a static magnetic field or external qigong is mediated by enhanced release of acetylcholine as a result of activation of the cholinergic vasodilator nerve endings in a muscle artery. A somato-autonomic reflex through the brain, in the anterior hypothalamus, probably induces needling an acupuncture point.
By William Pawluk, MD, MSc
See all Articles by Get Updates on Medical Advice and ResourcesGet Updates on Average: 3 Your rating: None Average: 3 (1 vote) Tweet
Static or electromagnetic fields have been used for centuries to control pain and other biologic problems, but scientific evidence of their effect had not been gathered until recently. This review explores the value of magnetic therapy in rehabilitation medicine in terms of static magnetic fields and time varying magnetic fields (electromagnetic). A historical review is given and the discussion covers the areas of scientific criteria, modalities of magnetic therapy, mechanisms of the biologic effects of magnetic fields, and perspectives on the future of magnetic therapy.
Back pain or whiplash syndrome treated PEMF twice a day for two weeks along with usual pain medications relieves pain in 8 days vs. 12 days in the controls. Headache is halved in the PEMF group and neck and shoulder/arm pain improved by one third versus just medications alone.
Author's Bio:
Post-herpetic neuralgia (PHN), a very common and painful condition, which is often medically-resistant, responds to PEMF for 20-30 minutes daily for 19 treatments over 34 days. The PEMF is a 4-16 Hz and 0.6-T samarium/cobalt magnet system surrounded by spiral coil pads with a maximum 0.1-T pulse at 8 Hz pasted on the pain/paresthesia areas or over the spinal column or limbs. Treatments continue until symptoms improve or an adverse side effect occurred. PEMF therapy is effective in 80%. No pain was made worse. This treatment approach shows that treatment for pain problems may either be localized to the pain or done over the spinal column or limbs, away from the pain.
Several authors have reviewed the experience with PEMFs in Eastern Europe and the West. PEMFs have been used extensively in many conditions and medical disciplines. They have been most effective in treating rheumatic disorders. PEMFs produced significant reduction of pain,[link widoczny dla zalogowanych], improvement of spinal functions and reduction of paravertebral spasms. Although PEMFs have been proven to be a very powerful tool, they should always be considered in combination with other therapeutic procedures.
240 patients treated with PEMFs in a conservative orthopedic practice had decreased pain, increased functionality and increased point pressure thresholds, disappearance of swelling and pathological skin coloration, less need for orthopedic devices and less reaction to changes in the weather. Treatments are daily for an hour. Conditions treated are: rheumatic illnesses, delayed healing process in bones and pseudo-arthritis, including those with infections,[link widoczny dla zalogowanych], fractures, aseptic necrosis, loosened protheses, venous and arterial circulation, reflex sympathetic dystrophy all stages, osteo-chondritis dissecans, osteomyelitis and sprains and strains and bruises. The success rate approaches 80%. Even X-rays may show improvement. Cartilage/bone tissue may reform, including the joint margin. About 60% of loosened hip protheses have subjective relief of pain and walk better, without a cane. Perthes’ disease rarely completely reforms the articular head of the hip.
Even strengths lower than the OMT-Magnopro may also treat knee pain in osteoarthritis. Treatment for eight 6-min sessions over a 2-wk period may give a 46% decrease in pain vs. an average 8% in the placebo group, sustained at the same level even two weeks after treatment.
A 50 Hz pulsed magnetic field sinusoidal, 0.035 Tesla field PEMF for 15 min for 15 treatment sessions improves hip arthritis pain in 86% of patients. Average mobility without pain improved markedly.
PEMFs of various kinds and strengths have been found to have good results in a wide array of painful conditions. There is little risk when compared to the potential invasiveness of other therapies and the risk of toxicity,[link widoczny dla zalogowanych], addiction and complications from medications. Clearly more research is needed to elaborate mechanisms and optimal treatment parameters. Many studies that have been reported here have been controlled trials and many have been double blind placebo. Medical practitioners are becoming gradually aware of the potential of MFs to successfully treat or significantly benefit the myriad of problems presented to them.
The density of pigeons’ brain mu opiate receptors decreases by about 30% and therefore their pain perception. A 2 hr exposure of healthy humans was found to reduce pain perception and decreased pain-related brain signals. Biochemical changes were found in the blood of treated patients that supported the pain reduction benefit,[link widoczny dla zalogowanych].
MFs applied to the head or to an extremity, for from 1 to 60 minutes, with intervals from several minutes to several hours, randomly sequenced with sham exposures allowed study of brain reactions by various objective measures. From these multiyear studies, the brain shows a non-specific initial response. The changes were "modulatory", meaning that the brain was found to sense EMF exposures vs. sham exposures. The sensory reactions were a weak pain, tickling, pressure, and etc. sensations, mediated by the body’s peripheral sensory systems. Reactions could be prevented by local anesthesia of the exposed area. EEGs showed increased low-frequency rhythms,[link widoczny dla zalogowanych], more pronounced when brain damage was present. This explains the common perception of relaxation and sleepiness with MFs. Cell analysis showed that all types of brain cells react to EMFs but astrocytes were most sensitive. They are involved in memory processes and slow wave brain activity.
Clinical benefits
Other pain applications
Back, neck and shoulder pain
PEMF for 15-360 minutes increases amino acid uptake about 45%. PEMF for 2 hour induces changes in transmembrane energy transport enzymes, allowing energy coupling and increased biologic chemical transport work.
In rats exposed for 20 min daily on 3 successive days to PEMFs of 50 mG, the pain threshold increased progressively over the 3 days. The pain threshold following the third magnetic field exposure was significantly greater than those associated with morphine and other treatments. Brain injured and normal rats both showed a 63% increase in mean pain. PEMFs may be very helpful in patients with closed head injuries. The mechanism probably involves the longer acting endorphins rather than enkephalins.
Pelvic pain of gynecological origin was also found to be beneficial by a different high voltage,[link widoczny dla zalogowanych], high frequency system. This includes ruptured ovarian cysts, postoperative pelvic hematomas,[link widoczny dla zalogowanych], chronic urinary tract infection, uterine fibrosis, dyspareunia, endometriosis and dysmenorrhea. Treatment times vary from 15 to 30 minutes on subsequent or alternate days. 90% of patients experience marked, rapid relief from pain with pain subsiding within 1-3 days. Most of these patients don’t require supplementary analgesics.
Post-traumatic Sudeck-Leriche syndrome (late stage reflex sympathetic dystrophy - RSD) is very painful pain and largely untreatable by other approaches. Ten 30-minute PEMF sessions of 50 Hz followed by a further 10 sessions at 100 Hz plus physiotherapy and medication reduced edema and pain at 10 days. There is no further improvement at 20 days.
A static magnetic foil placed in a molded insole for the relief of heel pain was used for 4 weeks to treat heel pain. 60% of patients in the treatment and sham groups reported improvement. There was no significant difference in the improvement on a foot function index. A molded insole alone was effective after 4 weeks. The magnetic foil offered no advantage over the plain insole, in this study. This study like others with low numbers of patients, may not have had a large enough sample. Placebo reactions in pain studies can be large and differences in benefit may be harder to detect. In addition, since magnetic foils produce fairly weak fields, placement against tissue becomes important, as does consideration of the depth into the body of the target lesion or tissue. Magnetic fields drop off in strength very rapidly from the surface.
The results of the treatment depend not only on the parameters of the fields but also on the individual sensitivity of the person. The most effective results in clinical use were found with extremely ultra low frequency PEMFs.
Low-power pulsed short wave 27 Hz diathermy has successfully treated persistent neck pain and improved mobility. The neck pains lasted longer than 8 wk and did respond to at least 1 course of nonsteroidal anti-inflammatory drugs. A miniaturized, 9V battery-operated, diathermy generator was fitted into a soft cervical collar. Treatment is for 3-6 weeks, 8 hr daily. Analgesics can be used as needed and nonsteroidal anti-inflammatory drugs. 75% of patients improve in range of motion and pain within 3 wk of treatment.
High frequency PEMF of 10-15 single treatments every other day either eliminates or improves, even at 2 weeks following therapy, 80% of patients with pelvic inflammatory disease, 89% with back pain, 40% with endometriosis, 80% with postoperative pain, and 83% with lower abdominal pain of unknown cause.
Chronic pain is often a result of aberrantly functioning small neural networks involved in self-perpetuated neurogenic inflammation. High intensity pulsed magnetic stimulation (HIPMS) noninvasively depolarizes neurons and can facilitate recovery following injury. Patients suffering from posttraumatic or postoperative low-back pain, reflex sympathetic dystrophy, peripheral neuropathy, thoracic outlet syndrome and endometriosis had pain relief. Up to ten,10-min exposures to 1.17 T at a rate of 45 pulses/minute were applied to the areas of maximal pain for 6 treatments. One patient became pain free after 4 HIPMS treatments. All patients reported some pain relief. Maximum pain relief occurred 3 hr after treatment. Two patients had complete pain relief and 3 had partial pain relief that lasted for 4 months. The others had pain relief that lasted for 8-72 hours.
Even small, battery-operated PEMF devices with very weak field strengths have been benefit musculoskeletal disorders. Because of the low strength used treatment at the site of pain may need to last between 11 to 132 days, between 2 times per week, 4 hours each or, if needed, continuous use. Use at night could be near the head, e.g., beneath the pillow, to facilitate sleep. Pain scale scores are significantly better in the majority of cases. Conditions that can be considered are arthritis, lupus erythematosus, chronic neck pain, epicondylitis, femoropatellar degeneration, fracture of the lower leg and Sudeck's atrophy.
Copyrighted 2003
Neuropathic pain syndrome (NPS) patients benefit from pulsed radiofrequency (PRF) treatment. Patients with severe left-sided sciatica and back pain, neuropathic pain in the anterior chest wall had been taking oral medications and had received repeated injections of local anesthetic agents and steroids with poor results. The patients treated with an invasive PRF applied to the related lumbar dorsal root ganglion for 2 minutes or the spinal roots of the thoracic T2-T4 dermatomes experience significant pain relief.
Normal standing balance is subject to control by the vestibular area of the brain. PEMF couple with muscular processing or upper body nervous tissue functions. 200-uT PEMFs cause a significant improvement in normal standing balance in adult (18-34 year old) humans. Further evidence of the sensitivity of the nervous system on MFs.
Various MFs with different characteristics reduce pain inhibition in various species of animals including land snails, mice, pigeons, as well as humans. 0.5 Hz rotating MF, 60 Hz ELF magnetic fields and even MRI reduces analgesia induced by both exogenous opiates (i.e. morphine) and endogenous opioids (i.e. stress-induced). Reduction in stress-induced analgesia can be obtained not only by exposing animals to a variety of different magnetic fields, but also after a short-term stay in a near-zero magnetic field. This suggests that even for magnetic field, as for other environmental factors (i.e. temperature or gravity), alterations in the normal conditions in which the species has evolved can induce alterations in physiology as well as in behavior.
Magnetic fields affect pain perception in many different ways. These actions are both direct and indirect. Direct effects of magnetic fields are: neuron firing, calcium ion movement, membrane potentials, endorphin levels, nitric oxide, dopamine levels, acupuncture actions and nerve regeneration. Indirect benefits of magnetic fields on physiologic function are on: circulation, muscle,[link widoczny dla zalogowanych], edema, tissue oxygen, inflammation, healing, prostaglandins, cellular metabolism and cell energy levels.
Measured pain intensity (PI) changes with pain relief and satisfaction with pain management. A 5%, 30%,[link widoczny dla zalogowanych], and 57% reduction in PI correlated with "no," "some/partial," and "significant/complete" relief. If initial PI scores were moderate/severe pain (NDS > 5), PI had to be reduced by 35% and 84%, to achieve "some/partial" and "significant/complete" relief, respectively. Patients in less pain (NDS < or = 5) needed 25% and 29% reductions in PI. However, relief of pain appears to only partially contribute to overall satisfaction with pain management.
Some of the mechanisms of PEMF effects
In normal subjects, a magnetic stimulus over the cerebellum reduces the size of responses evoked by cortical stimulation. Suppression of motor cortical excitability is reduced or absent in patients with a lesion in the cerebellum or cerebellar nerve pathways. Magnetic stimulation over the cerebellum produces the same effect as electrical stimulation, even in ataxic patients and may be useful for the pain associated with muscle spasticity.
The ability to relieve pain is very variable and unpredictable, depending on the source or location of pain and whether it is acute or chronic. Pain mechanisms are complex and have peripheral and central nervous system aspects. Therapies should be tailored to the specifics of the pain process in the individual patient. Psychological issues have a very strong influence on whether and how pain is experienced and whether it will become chronic. Most effective pain management strategies require multiple concurrent approaches, especially for chronic pain. It is rare that a single modality solves the problem.
In the past few years a new and fundamentally different approach has been increasingly investigated. This includes the use of magnetic fields (MF), produced by both static (permanent) and time-varied (most commonly, pulsed) magnetic fields (PEMFs). Fields of various strengths and frequencies have been evaluated. There is as yet no “gold standard”. The fields selected will vary based on experience, confidence, convenience and cost. Since there does not appear to be any major advantage to any one MF application, largely because of the unpredictability of ascertaining the true underlying source of the pain, regardless of the putative pathology, any approach may be used empirically and treatment adjusted based on the response. After thousands of patient-years of use globally, very little risk has been found to be associated with MF therapies. The primary precautions relate to implanted electrical devices and pregnancy and seizures with certain kinds of frequency patterns in seizure prone individuals.
Chronic pain frequently presented by postpolio patients can be relieved by application of magnetic fields applied directly over trigger points using 300 to 500 G static magnets for 45 minutes.
Chronic pain is often accompanied with or results from decreased circulation or perfusion to the affected tissues, for example, cardiac angina or intermittent claudication. PEMFs have been shown to improve circulation. Skin infrared radiation increases due to immediate vasodilation with low frequency fields and increased cerebral blood perfusion in animals. Pain syndromes due to muscle tension and neuralgias improve.
The issue of pain treatment is an extremely urgent health and socio-economic problem. Pain, in acute, recurrent and chronic forms, is prevalent across age, cultural background, and s*x, and costs North American adults an estimated $10,000 to $15,000 per person annually. Estimates of the cost of pain do not include the nearly 30,000 people that die in North America each year due to non-steroidal anti-inflammatory drug-induced gastric lesions. 17% of people over 15 years of age suffer from chronic pain that interferes with their normal daily activities. Studies suggest that at least 1 in 4 adults in North America is suffering from some form of pain at any given moment. This large population of people in pain relies heavily upon the medical community for the provision of pharmacological treatment. Many physicians are now referring chronic pain sufferers to non-drug based therapies, that is, "Complementary and Alternative Medicine,[link widoczny dla zalogowanych]," in order to reduce drug dependencies, invasive procedures and/or side effects. The challenge is to find the least invasive, toxic, difficult and expensive approach possible.
PEMF of 5 to 15 G, from 7 Hz to 4 kHz used at the site of pain and related trigger points for 20 to 45 minutes also helps. Some patients remain pain free 6 months after treatment. Some return to jobs they had been unable to perform. Short-term effects are thought due to decrease in cortisol and noradrenaline and an increase serotonin, endorphins and enkephalins. Longer term effects may be due to CNS and/or peripheral nervous system biochemical and neuronal effects in which correction of pain messages occurs and the pain is not just masked as in the case of medication.
High strength repetitive magnetic stimulation (rMS) has been found to relieve musculoskeletal pain. Specific diagnoses were painful shoulder with abnormal supraspinatus tendon, tennis elbow, ulnar compression syndrome, carpal tunnel syndrome, semilunar bone injury, traumatic amputation neuroma of the median nerve, persistent muscle spasm of the upper and lower back, inner hamstring tendinitis, patellofemoral arthrosis, osteochondral lesion of the heel and posterior tibial tendinitis. Patients receive rMS for 40 minutes. Mean pain intensity is 59% lower vs. 14% for controls. Patients with amputation neuroma and patellofemoral arthritis obtain no benefit. Those with upper back muscle spasms, rotator cuff injury and osteochondral heel lesions showed more than 85% decrease in pain, even after a single rMS session. Pain relief persists for several days. None have worsening of their pain.
Osteoarthritis (OA) affects about 40 million people in the USA. OA of the knee is a leading cause of disability in the elderly. Medical management is often ineffective and creates additional side-effect risks. The QRS has been in use for about 20 years in Europe. The QRS applied 8 min twice a day for 6 weeks improves knee function and walking ability significantly. Pain, general condition and well being also improve. Medication use decreases and plasma fibrinogen decreases 14%, C-reactive protein (a sign of inflammation) drops 35% and the blood sedimentation rate 19%. The QRS has also been found effective in degenerative arthritis, pain syndrome and inflammatory joint disorders. Sleep disturbances often contribute to increased pain perception. The QRS has also been found to improve sleep. 68% report good/very good results. Even after one-year follow-up, 85% claim a continuing benefit in pain reduction. Medication consumption decreases from 39% at 8 weeks to 88% after 8 weeks.
Magnetotherapy is accompanied by an increase in the threshold of pain sensitivity and activation of the anticoagulation system. PEMF treatment stimulates production of opioid peptides; activates mast cells and increases electric capacity of muscular fibers. Long bone fractures that did not unite over 4 months to 4 years are repaired in 87% of cases with 14-16 hr of daily PEMF treatment. Several of these devices are FDA approved. PEMF of 1.5- or 5-mT field strength, proved helpful edema and pain before or after a surgical operation.
One of the most reproducible results of weak, extremely low-frequency (ELF) magnetic field (MF) exposure is an effect upon neurologic pain signal processing. PEMFs have been designed for use as a therapeutic agent for the treatment of chronic pain in humans. Recent evidence suggests that PEMFs would also be an effective complement for treating patients suffering from acute pain. Static magnetic field devices with strong gradients have also been shown to have therapeutic potential. Specifically placed static magnets reduce neural action potentials and alleviate spinal mediated pain. The placebo response may explain as much as 40% of an analgesia response. The central nervous system mechanisms responsible for the placebo response are an appropriate target for magnetic therapies. Magnetic field manipulation of cognitive and behavioral processes is seen in animal behavior studies and in humans. This may also be one of the mechanisms of the use of MFs in managing pain.
One author reported that, of treated patients followed for 2-60 months, better results happened in patients with post-herpetic pain and those simultaneously suffering from neck and low back pain.
William Pawluk, MD, MSc
Assistant Professor, Johns Hopkins University, School of Medicine
March 2003
The benefits of PEMF use may last considerably longer than the time of use. In rats, a single exposure produces pain reduction both immediately after treatment and at 24 hrs after treatment. The analgesic effect is still observed at 7th and 14th day of repeated treatment and even up to 14 days after the last treatment.
Chronic low back pain affects approximately 15% of the United States (US) population during their lifetime, with 93 million lost work days and a cost of more than $5 billion per year. Lumbar arthritis is a very common cause of back pain. 35-40 mT PEMFs, for 20 minutes daily for 20-25 days for back pain gives relief or elimination of pain, improves results from other rehabilitation and improves secondary neurologic symptoms. Continuous use over the treatment episode works best, in about 90-95% of the time. Control patients only show a 30% improvement.
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