• 대한중풍순환신경학회지
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• 제12권1호
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• pp.1-7
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• 2011

Objectives : The purpose is to discuss the clinical applications of Orungsan(Goreisan: 五苓散) as an alternative management for increased intracranial pressure in the field of neurosurgery in Japan. Methods and Results : Attention has focused on Kampo medicine(traditional Japanese medicine) for some cerebral disease including chronic subdural hematoma(CSDH) and cerebral infarction in Japan. Orungsan and one of its classes, Sirungtang(Saireto: 柴苓湯) are well known their effects on brain edema. After some studies of Orungsan has the anti-edemic effects by the inhibition of aquaporin, this herbal medicine has been used widely in the neurosurgery field in Japan. It is high time to think about where we are and we go ahead for the progress and the integration in medicine. We have reviewed the studies using Orungsan or Sirungtang, that was reported at the 20th annual meeting of 'the Japan society for Kampo medicine and neurological surgery' was held on November 5, 2011 in Tokyo. Fifteen studies related with Orungsan or Sirungtang were reported among all 32 studies at the meeting. Orungsan in ten, and Sirungtang in five among 14 studies contained specific clinical case. In the aspects of disease, thirteen papers were related with SDH, including CSDH(11), SSDH(1), aneurism clipping for SDH prevention(1), and one was acute cerebral infarction and one was multiple metastatic brain tumor. In the report style, case control study was 7(mostly retrospective), and the case report was 8. Conclusions : Orungsan may be plausible to be an alternative method to reduce brain edema after SDH and other brain injury in the field of neurosurgery.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1991년도 제30차 춘계학술대회
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• pp.152.1-152.1
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• 1991

• Journal of Korean Neurosurgical Society
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• 제40권1호
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• pp.11-15
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• 2006

Objective : Acute cerebral infarction is often accompanied by transtentorial herniation which can be fatal. The aim of this study is to determine the timing of surgical intervention and prognostic factors in patients who present with acute cerebral infarction. Methods : We reviewed retrospectively 23 patients with acute cerebral infarction, who received decompressive craniectomy or conservative treatment from January 2002 to December 2004. We divided patients into two groups according to the treatment modalities [Group 1 : conservative treatment, Group 2 : decompressive craniectomy]. In all patients, the outcome was quantified with Glasgow Outcome Scale and Barthel Index. Results : Of the 23 patients, 11 underwent decompressive craniectomy. With decompressive craniectomy at the time of loss of pupillary light reflex, we were able to prevent death secondary to severe brain edema in all cases. Preoperative Glasgow Coma Scale and loss of pupillary light reflex were significant to the clinical outcome statistically. With conservative treatment, 9 of the 12 patients died secondary to transtentorial herniation. The clinical outcomes of remaining 3 patients were poor. Conclusion : This study confirms the value of life-saving procedure of decompressive craniectomy after acute cerebral infarction. We propose that the loss of pupillary light reflex should be considered one of the most important factors to determine the timing of the decompressive craniectomy.

• 동의생리병리학회지
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• 제23권6호
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• pp.1497-1502
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• 2009

The cerebellum processes input from other areas of the brain, spinal cord and sensory receptors to provide precise timing for coordinated, smooth movements of the skeletal muscular system. A stroke affecting the cerebellum may cause vertigo, nausea, balance and coordination problems. The papers on central vertigo caused by cerebellar infarction were reported by Kim, Ku, Ko, Choi, and Han. Their cases were classed as Heo hoon, Dam hoon, and Sangchopungyeul yeul dam, and they treated with Jaeumkunbi-tang, Taeksa-tang, Cheonghunwhadam-tang gami, Cheonginwhadam-tang, Hachulbosim-tang. In this paper, three patients who suffered from vertigo were diagnosed as cerebellar infarction. They felt too giddy to walk without any help. After Oriental medical treatment based on Dongeuibogam, their sequelae of cerebellar infarction - vertigo, nausea, ataxia - had improved dramatically. So we report these cases, and suggest Oriental medical treatment based on Dongeuibogam have effect on cerebellar infarction. But more clinical case reports should be further examined.

• Journal of Korean Neurosurgical Society
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• 제43권2호
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• pp.90-96
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• 2008

Objective: Delayed ischemic deficit or cerebral infarction is the leading cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study is to reassess the prognostic impact of intraoperative elements, including factors related to surgery and anesthesia, on the development of cerebral infarction in patients with ruptured cerebral aneurysms. Methods: Variables related to surgery and anesthesia as well as predetermined factors were all evaluated via a retrospective study on 398 consecutive patients who underwent early microsurgery for ruptured cerebral aneurysms in the last 7 years. Patients were dichotomized as following; good clinical grade (Hunt-Hess grade I to III) and poor clinical grade (IV and V). The end-point events were cerebral infarctions and the clinical outcomes were measured at postoperative 6 months. Results: The occurrence of cerebral infarction was eminent when there was an intraoperative rupture, prolonged temporary clipping and retraction time, intraoperative hypotension, or decreased $O_2$ saturation, but there was no statistical significance between the two different clinical groups. Besides the Fisher Grade, multiple logistic regression analyses showed that temporary clipping time, hypotension, and low $O_2$ saturation had odds ratios of 1.574, 3.016, and 1.528, respectively. Cerebral infarction and outcome had a meaningful correlation (${\gamma}$=0.147, p=0.038). Conclusion: This study results indicate that early surgery for poor grade SAH patients carries a significant risk of ongoing ischemic complication due to the brain's vulnerability or accompanying cardio-pulmonary dysfunction. Thus, these patients should be approached very cautiously to overcome any anticipated intraoperative threat by concerted efforts with neuro-anesthesiologist in point to point manner.

• 대한한방내과학회지
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• 제40권4호
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• pp.675-696
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• 2019

Objective: This study was aimed at evaluating the effect and clarifying the treatment period of Korean medicine treatment for cerebral infarction. Method: This study was carried out on patients with hemiplegia who were hospitalized in the Department of Korean Internal Medicine of Jecheon Korean Medicine Hospital of Semyung University from June 2014 to May 2019. A retrospective study was performed on 253 patients who were diagnosed with cerebral infarction by brain CT or nuclear magnetic resonance imaging. Results and Conclusion: 1. Korean medicine treatment has a significant effect on improving the movement disorder and daily life independence of cerebral infarction. 2. In the group that started Korean medical treatment within one month after the onset of cerebral infarction, with the exception of MMSE-K, the indicators related to the movement disorder and daily life independence showed significant effect. 3. MMSE-K showed no statistically significant change in any of the patient groups. 4. Within three months after the onset date, the longer the period of treatment with Korean medicine, the better the symptom improvement of upper extremity movement disorder. 5. The longer the hospital stays, the better the symptom improvement of the lower extremity movement disorder. 6. The combination of Korean and Western medicine did not affect liver or kidney function.

• 동의생리병리학회지
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• 제18권3호
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• pp.797-807
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• 2004

This research investigates the effect of the Hibiscus syriacus(HSS) on Alzheimer's disease. The effects of the HSS extract on the behavior in the Morris water maze experiment; the expression of IL-1β, TNF-α, IL-1β mRNA, TNF-α mRNA, CD68/GFAP and RDS; the the infarction area of the hippocampus, and brain tissue injury in Alzheimer's diseased mice induced with M were investigated. The HSS extract group showed a significant inhibitory effect on the memory deficit on the mice with Alzheimer's disease induced by βA in the Morris water maze experiment. The HSS extract group suppressed the over-expression of IL-1β, TNF-α, IL-1β and TNF-α mRNA, CD68/GFAP, RDS in the mice with Alzheimer's disease induced by βA. The HSS extract reduced the infarction area of hippocampus, and controlled the injury of brain tissue in the mice with Alzheimer's disease induced by βA. This study suggest that HSS may be effective for the prevention and treatment of Alzheimer's disease

• Journal of Acupuncture Research
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• 제27권4호
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• pp.29-38
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• 2010

Objectives : The purpose of the study is to determine the neuroprotective effect of modified Boyanghwano-tang(mBHT), a traditional Korean medicine, on the transient focal cerebral ischemia in rats. Methods : Focal ischemia and reperfusion were induced by middle cerebral artery occlusion(MCAO) for 90 min, followed by 144 h reperfusion in rats. mBHT(200mg/kg body weight, p.o.) was administrated in rats once a day during reperfusion. At the end of treatment, brain infarction was measured by TTC staining, and histological change was observed by H&E staining. The expressions of Bax, Bcl-2 and cytochrome c in ischemic brains were determined by immunofluorescent analysis. Results : mBHT significantly reduced the cerebral infarct volumes of the MCAO rats. mBHT also attenuated the neuronal cell death and the expressions of pro-apoptotic molecules, bax and cytochrome c in ischemic brains. Further, mBHT significantly increased the survival time of ischemeic rats and the expression of anti-apoptotic molecule, Bcl-2 in ischemic brains. Conclusions : Our results suggest that mBHT is neuroprotective and may prove to be useful adjunct in the treatment of ischemic stroke.

• Investigative Magnetic Resonance Imaging
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• 제18권4호
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• pp.362-365
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• 2014

중추 신경계 병터에 의해 손가락의 일부에만 위약감이 발생하는 것을 거짓 말초 마비라고 한다. 두 명의 환자가 뇌의 국소 병터에 의해 요측에 국한된 특정 손가락의 위약감을 가지고 내원하였다. 51세 여자 환자는 갑자기 발생한 왼쪽 검지와 중지의 위약감으로 내원하였으며, 뇌 자기공명영상검사에서 오른쪽 중심앞이랑에 뇌경색이 관찰되었다. 67세 남자환자는 갑자기 오른쪽 엄지와 검지로 위약감이 발생하였으며, 뇌 자기공명영상검사에서 왼쪽 중심앞이랑에 뇌경색이 관찰되었다.

• Biomolecules & Therapeutics
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• 제21권1호
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• pp.1-9
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• 2013

Polyamines, putrescine, spermidine and spermine, are ubiquitous in living cells and are essential for eukaryotic cell growth. These polycations interact with negatively charged molecules such as DNA, RNA, acidic proteins and phospholipids and modulate various cellular functions including macromolecular synthesis. Dysregulation of the polyamine pathway leads to pathological conditions including cancer, inflammation, stroke, renal failure and diabetes. Increase in polyamines and polyamine synthesis enzymes is often associated with tumor growth, and urinary and plasma contents of polyamines and their metabolites have been investigated as diagnostic markers for cancers. Of these, diacetylated derivatives of spermidine and spermine are elevated in the urine of cancer patients and present potential markers for early detection. Enhanced catabolism of cellular polyamines by polyamine oxidases (PAO), spermine oxidase (SMO) or acetylpolyamine oxidase (AcPAO), increases cellular oxidative stress and generates hydrogen peroxide and a reactive toxic metabolite, acrolein, which covalently incorporates into lysine residues of cellular proteins. Levels of protein-conjuagated acrolein (PC-Acro) and polyamine oxidizing enzymes were increased in the locus of brain infarction and in plasma in a mouse model of stroke and also in the plasma of stroke patients. When the combined measurements of PC-Acro, interleukin 6 (IL-6), and C-reactive protein (CRP) were evaluated, even silent brain infarction (SBI) was detected with high sensitivity and specificity. Considering that there are no reliable biochemical markers for early stage of stroke, PC-Acro and PAOs present promising markers. Thus the polyamine metabolites in plasma or urine provide useful tools in early diagnosis of cancer and stroke.