• The Journal of the Society of Stroke on Korean Medicine
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• v.10 no.1
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• pp.54-61
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• 2009

Arteriosclerosis is a pathologic term that contains hardening of arterial wall, loss of arterial elasticity and stenosis of artery. To diagnose this disease, conventional angiography, MRA, transcranial doppler ultrasonography are commonly used. And it causes various clinical phases by a region of the disease. In oriental medicine, arteriosclerosis is classified into congested fluids(痰飮), blood stasis(瘀血), stagnation of Gi(氣滯) and treated by Herb-Med, acupuncture, cupping, moxibustion, and the like. The purpose of this study was to investigate the effect of oriental medical therapy on cerebral arteriosclerosis. A patient with cerebrovascular disease admitted due to dizziness, mild dysarthria, tinnitus, anxiety disorder and his Brain MRA showed severe arteriosclerosis in right anterior cerebral artery(ACA) and middle cerebral artery(MCA). Every day, we administered to patient Herb Med and Herb pills. Also, acupuncture, moxibustion were done, too. As a result of the treatment, the patient's follow up Brain MRA showed improved state of ACA stenosis.

• Journal of Korean Clinical Nursing Research
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• v.19 no.1
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• pp.57-68
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• 2013

Purpose: In assessing patients' neurological status following a stroke it is very important to have a valid tool for early detection of neurological deterioration. NIHSS is considered the best tool to reflect neurological status in patients with ischemic stroke. An education program on use of NIHSS was planned for nurses caring for these patients and the effects of the program were evaluated. Methods: The NIHSS education program (NEP) which includes online and video lectures, and practical education was provided to the nurses from April to July, 2010. To examine the effect of NEP, nursing records of patients with ischemic stroke who were admitted to a stroke center were analyzed. Two groups, a historical control group (n=100) and the study group (n=115) were included. Results: Nursing records for neurologic symptoms for each patient increased (41.0% versus 100.0%, p<.001), and especially, visual disturbance, facial palsy. limb paralysis and ataxia, language disturbance, dysarthria, and neglect symptoms significantly increased (all p<.001). Nurse notification to the doctor of patients with neurological changes increased (21.0% versus 39.1%, p=.004), and nurses' neurological deterioration detection rates also increased (37.5% versus 84.6%, p=.009). Conclusion: NEP improved the quality of nursing records for neurological assessment and the detection rate of neurological deterioration.

• Investigative Magnetic Resonance Imaging
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• v.15 no.2
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• pp.165-169
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• 2011

Cardiac myxoma is the most common benign tumor of the heart. However, low incidence of recurrence and metastasis has been reported. A 49-year-old female patient was admitted in the hospital due to sudden onset of left side weakness. Magnetic resonance imaging (MRI) of brain showed multifocal areas of diffusion restriction on diffusion weighted images. Echocardiography was performed to evaluate the cause of embolic brain infarction and cardiac myxoma was found in the left atrium. The patient underwent complete excision of the mass. One year later, the patient was readmitted with symptoms of dysarthria. Brain MRI showed newly developed multiple hemorrhagic metastatic lesions. The patient underwent radiotherapy of the metastatic lesions. Although rare, cardiac myxoma can cause delayed metastasis. We report a rare case of delayed multiple cerebral metastases from the completely resected cardiac myxoma.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.733-740
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• 2007

Objective : This study investigated the relationship between warning signs and Sasang constitution (SC) in acute stroke patients. Methods : From October in 2005 to March in 2007, 629 acute stroke patients were studied. Patients were hospitalized within 14 days after the onset ofstroke at one of 3 oriental medical hospitals in Seoul and Kyong-gi province. We assessed the type of SC of acute stroke patients by Questionnaire for Sasang Constitution Classification II (QSCC II). We investigated warning signs (motor weakness, blindness, dysarthria, sensory disturbance, finger dullness, facial & eyelid spasm, neck stiffness), general characteristics, etc. Results : This study showed a higher proportion of Tae-eum & So-eum experience upper extremity sensory disturbance but So-yangexperience lower extremity sensory disturbance. Smoker So-eumexperience 1st & 2nd finger dullness more than non-smoker So-eum. So-eum women experience motor weakness more than So-eum men. Conclusion : Besides these results, we could observe almost no relationship between warning signs and Sasang constitution (SC) in acute stroke patients. More data from prospective cohort studies will help people better understand the relationship between warning signs and Sasang constitution (SC) in acute stroke patients.

• Journal of Sasang Constitutional Medicine
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• v.19 no.1
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• pp.137-147
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• 2007

1. Objectvies This study is to examine the expected general condition change, clinical distinctive feature about using Ohgapichangchuk-Tang and Mihooteungshikchang-Tang and the range of using them based on the patient taken care by Taeyangin herb-medicines. 2. Methods We had observed 20 patients who visited Sasang Constitutional medical department in Dongguk Univ. oriental medical hospital from October 2003 to October 2006, diagnosed as Taeyangin and took Taeyangin herb-medicines more than twice. 3. Results and Conclusions 1) The chief complains of Taeyangins were 5 skin problem, 5 rhinitis, 2 digestion problem, 2 neurological problem, 3 fatigue ${\cdot}$ general weakness, 2 hand and foot hyperhidosis, 2 chest pain and discomfort, 2 genecological problem, 1 halitosis. Ohgapichangchuk-Tang was used for 4 rhinitis, 2 atopy, 1 fatigue, 1 halitosis. Mihooteungshikchang-Tang was used for 3 skin problem, 2 digestion problem, 2 neurological problem like dizziness or dysphagia ${\cdot}$ dysarthria, 2 hand and foot hyperhidosis, 2 chest pain and discomfort and 2 genecological problem. 2) The meaningful part after using Ohgapichangchuk-Tang and Mihooteungshikchang-Tang is 'dyspepsia', 'insomnia', 'dyspnea', 'dry skin' and 'sialosis'. It is necessary to check the general symptom. 3) Taeyangin used to have hard stool and not to sweat. 4) Ohgapichangchuk-Tang seemed to be used when there is digestion problem comparing with Mihooteungshikchang-Tang however it is not significant differences. 5) We require further examination to study Taeyangin's prescriptions.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.198-201
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• 2006

Hyponatremia is a dangerous electrolyte disturbance in patients on chemotherapy and may cause sudden death if not detected early. SIADH (syndrome of inappropriate antidiuretic hormone) is one of the known causes of hyponatremia in patients undergoing chemotherapy. Few chemotherapeutic agents, however, are reported to cause SIADH. The current study reports that SIADH developed in a 55 year old woman on S-1 ($80\;mg/m^{2}$) and cisplatin ($60\;mg/m^{2}$) chemotherapy for the peritoneal metastasis of gastric cancer. The patient underwent a total gastrectomy, a splenectomy, and a segmental resection of the transverse colon for gastric cancer. She had used thiazide and ${\beta}-blocker$ to treat hyperiension for 12 years. She admitted to our hospital with complaining of general weakness, dysarthria, loss of appetite, and urinary discomfort. The serum level of sodium and potassium were 94 mEq/L and 2.2 mEq/L respectively. The hyponatremia completely resolved uneventfully after 3% saline infusion, which led to normalized electrolyte balance. The patient was discharged on the 13th hospital day.

• Investigative Magnetic Resonance Imaging
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• v.19 no.3
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• pp.186-190
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• 2015

Acute disseminated encephalomyelitis (ADEM) is a demyelinating and inflammatory condition of the central nervous system, occurring predominantly in white matter. ADEM involving the rhombencephalon without affecting the white matter is very rare. Here, we present an unusual case of ADEM involving only the rhombencephalon in a 4-year-old Asian girl. The patient complained of pain in the right lower extremities, general weakness, ataxia, and dysarthria. The initial brain CT showed subtle ill-defined low-density lesions in the pons and medulla. On brain MRI, T2 high signal intensity (T2-HSI) lesions with mild swelling were present in the pons, both middle cerebellar peduncles, and the anterior medulla. The initial diagnosis was viral encephalitis involving the rhombencephalon. Curiously, a cerebrospinal fluid (CSF) study revealed no cellularity, and negative viral marker findings. Three weeks later, follow up brain MRI showed that the extent of the T2-HSI lesions in the brain stem had decreased. After reinvestigation, it was found that she had a prior history of upper respiratory infection. In this case, we report the very rare case of a patient showing isolated involvement of the rhombencephalon in ADEM, mimicking viral rhombencephalitis on CT and MR imaging. ADEM can involve unusual sites such as the rhombencephalon in isolation, without involvement of the white matter or deep gray matter and, therefore, should be considered even when it appears in unusual anatomical areas. Thorough history taking is important for making a correct diagnosis.

• Journal of Oriental Neuropsychiatry
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• v.11 no.1
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• pp.115-130
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• 2000

Object: Show the treatment about Jungkijeung (Zhongqizheng) by distinguishing Apoplexy(Zhongfeng), yujungfung(Leizhongfeng), gualjung(Juezheng), and observation of cause, process, quality. Method: Researched definition, cause, process, treatment and herb med through chinese & korean medical publication refered to Jungkijeung(Zhongqizheng) Result: 1. Jungkijeung(Zhongqizheng) is simmilar to Apoplexy(Zhongfeng) that spiritual shock occurred to syncope, dysarthria, trismus, quadriplegia. But the symptom of Jungkijeung(Zhongqizheng) is coldness, no-sputum, sink-pluse; that of Apoplexy(Zhongfeng) is warmness, much secretion, float-pulse. 2. Jungkijeung(Zhongqizheng) is mainly caused by the serious anger and the reverse movement of spints by the seven emotional factor. The process of Jungkijeung(Zhongqizheng) are "Fire and Fever(huore)" "Weatness and sputum(shitan)", and most importantly "Weakness of vital-qi(qixi)" 3. The treatment of Jungkijeung(Zhongqizheng) is adjustment and circulation of jiao. In early stage, don't use of Apoplexial- Med. 4. As following herb-med are used for Jungkijeung (Zhongqizheng). Sohaphang-won(Suhexiangyan) is 18 times; Palmisungi-san(Baweishunqisan) is 13 times; Kang-tang(Jiangtang) is 8 times: Mokhyangsungi san(Muxiangshunqisan) is 6 times. 5. Atractylodes macrocephala KOIDZ(Baishu) is used for 40 times most frequently, Saussurea lappa CLARKE (Muxiang), Cyperus rotundus L (Xiangfuzi), Citrus unshiu MARCOR(Chenpi), Glycyrrhiza uralensis FISCH (Gancao), poria cocos WOLF (Furing), Panax ginseng NESS (Renshen) etc are orderly used. 6. Acupoints same as GV20(Baihui), LI4(Hegu), Liv2(Xingjian), 12 Junghyul(Jingxue) is used for acupunture. And CV8(Shenque), CV4(Guanyan) is used for moxibustion. Conclusion: As Jungkijeung(Zhangqizheng) is differed from Apoplexy(Zhongfeng), yujungfung(Leizhongfeng), gualjung(Juezheng), we must also cure Jungkijeung (Zhongqizheng) to the other disease. It is need to distinguishment Jungkijeung(Zhongqizheng) from neurotic, psychotic disease, though similar to conversation neurosis.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.149-163
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• 2000

The purposes of this study were to investigate the pathway which stroke patients take in seeking medical care and to identify factors which influence that pathway. This study was conducted by a survey. The subjects were 130 adults, who were diagnosed with a stroke between January and April of 2000. Data was collected by means of a interview, questionnaires, and an Activity Index. The result of this study are summarized as follows: 1. The mean age of subject was 61.58 years. Forty-nine percent were men and fifty percent were women. The majority of the subjects were married. For educational level, thirty-three percent finished elementary school, and twenty-three percent, high school. Most of the subjects reported 'middle' economic status. Ninety-two percent lived with their spouse and children. The diagnosis for seventy-two percent was ischemic stroke and for twenty-two percent, hemorrhagic stroke. 2 The most frequent early sign of stroke was hemiplegia(43.3%), loss of consciousness (36.7%), dysarthria(33.3%). The type of hospital first used was a herb hospital(40.8%), or a western hospital(59.2%). The factors in their choice were ; distance from the hospital to the place that the stroke occurred(47.5%), desire for a herb hospital(15.8%), and an invitation(12.9%). The ischemic stroke patients preferred herb hospitals, but hemorrhagic stroke patients preferred a western hospitals. 3. The pattern of stroke patients seeking medical care was that forty-three percent of stroke patients pass through step 1, forty-six percent, through step 2, and 8.5% through step 3. The more steps, the higher the use of herb hospitals. 4. The factors influencing the pathway of stroke patients seeking medical care were diagnosis, and level of consciousness. Ischemic stroke patients used herb hospitals, more frequently hemorrhagic stroke patients, who used western hospitals. The alert patient preferred a herb hospital, but stupor patients preferred a western hospital. 5. The Activity Index was not related to the pathway which stroke patients used in seeking medical care.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.25-30
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• 2013

Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia ($Na^+$ 98 mEq/L), hypokalemia ($K^+$ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.