• 대한한방내과학회지
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• 제37권2호
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• pp.298-304
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• 2016

Objective: : This clinical study reports on the effect of Sunghyangjungki-san-gami and Banhabaeckchulchunma-tang-gami on hemiplegia, dizziness, and hiccupping caused by pontine infarction.Methods: This study was performed on one patient with hemiplegia, dizziness, and hiccupping caused by pontine infarction. The patient was treated by Sunghyangjungki-san-gami and Banhabaeckchulchunma-tang-gami from 6 January to 2 March 2015. The National Institutes of Health stroke scale (NIHSS), motor grade, and numerical rating scale (NRS) were used to assess the effectiveness of this treatment.Results: After treatment, the patient’s discomfort decreased significantly, and NIHSS, motor grade, and NRS scores were all improved.Conclusion: This clinical study suggests that traditional Korean medicine may be effective in treating hemiplegia, dizziness, and hiccupping caused by pontine infarction.

• 턱관절균형의학회지
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• 제10권1호
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• pp.21-25
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• 2020

Objectives: The aim of this study was to report the effectiveness of TMJ balancing therapy and Traditional Korean Medicine (TKM) treatments on a thalamus cerebral infarction patient with hemiparesis and gait disturbance. Methods: The patient was treated with TMJ balancing therapy, along with korean herbal medicine, acupuncture, moxibustion, cupping and physical therapy. The motor function was evaluated through the Manual Muscle Test (MMT), Grasp power and Functional Ambulatory Category (FAC). And the daily life ability was evaluated by the Korean version of the Modified Barthel Index (K-MBI) and Korean National Institute of Health Stroke Scale (K-NIHSS). Results: After 17 days of TMJ balancing therapy and TKM treatments, the score of MMT did not improved, but the score of FAC, K-MBI, K-NIHSS improved. Conclusions: This study suggested that TMJ balancing therapy and TKM treatments could be effective for hemiparesis and gait disturbance in patients with thalamus cerebral infarction.

• 대한한방내과학회지
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• 제30권4호
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• pp.719-731
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• 2009

Objectives : Stroke is the most common disabling neurological disease of adult life. The treatment and rehabilitation of stroke patients is an important and challenging area in the field of medicine. In Korea, a lot of stroke patients are treated using oriental medicine and there have been reports on their functional recovery. The aim of this study was to prove the therapeutic effect of oriental medicine on ischemic stroke. We also tried to identify characteristics of patients whose functional recovery was prominent and studied whether or not the use of fluids, anticoagulants, antiplatelets and neuroprotective agents increased the functional recovery of patients. Methods : We studied 794 patients within 2 weeks after first attack of ischemic stroke who were admitted to Kyung-Hee Oriental Medical Center from 1999 to 2000. Their maximum admission period was 60 days. Results : Motor power grade, NIHSS and MBI scores of patients improved during hospitalization significantly. Factors affecting functional recovery were admission period, motor power grade, NIHSS and MBI at admission. Age, waist-hip ratio and HDL cholesterol also affected functional recovery of patients. Whether or not fluids, anticoagulants, antiplatelets and neuroprotective agents were administered had nothing to do with functional recovery. Conclusion : Oriental medicine is effective for treatment and rehabilitation of ischemic stroke patients. When we manage stroke, we have to consider some important factors.

• 대한한방내과학회지
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• 제27권2호
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• pp.416-428
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• 2006

Objectives : Arterial stiffness and pulse pressure are related to cardiovascular and cerebrovascular survival and longevity. This study is aimed at examining the effects of Chungpyesagan-tang on arterial stiffness and Pulse pressure in acute stroke Patients. Methods: The subject of this study was acute strike Patients within 1 week after ictus, with Cardio-ankle vascular index(CAVI) higher than 9.0. They were divided into two groups: A treatment group (n=44) and a control group(n=46). For two weeks, Chungpyesagan-tang was given to the former, other herbal medicines to the latter. used for stroke patients for the control group for 2 weeks. At the end of first and second week, CAVI, pulse Pressure, National Institute of Health stroke scale(NIHSS), Modified Barthel Index(MBI) were measured. Serum lipid Profile, aspartate transaminase(AST), alanine transaminase(ALT). blood urea nitrogen(BUN), creatinine were also measured at the end of the study. Results : After 2 weeks, CAVI and Pulse Pressure in Chungpyesagan-tane group were significantly tower than those in the control group(P<0.05). NIHSS and MBI were improved in both groups. But there was no significant difference between the treatment group and the control group in terms of the NIHSS and MBI. Conclusions : We suggest Chungpyesagan-tanghas desirable effects on arterial stiffness and Pulse Pressure of acute stroke patients. It can improve morbidity and mortality of patients on the basis of influencing vascular stiffness and increased pulse pressure.

• 대한한방내과학회지
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• 제38권2호
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• pp.180-189
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• 2017

Objectives: The aim of this study is to describe the effects of traditional Korean medicine treatment on a patient with an intracerebral hemorrhage (ICH) at the left basal ganglia, thalamus, and posterior limb of the internal capsule. Methods: The patient was treated with acupuncture, moxibustion, Hyangsayukgunja-tang, and Samul-tang-gami. The effect of these treatments were evaluated using the manual muscle test (MMT), modified Barthel index (MBI), and National Institutes of Health Stroke Scale (NIHSS). Results: After the treatments, the patient's status improved, as shown by his MMT grade, which increased from 1/1 to 4/4. In addition, the patient's MBI score improved from 0 to 77, and his NIHSS score declined from 16 to 2. In addition, the patient's Levin tube and Foley catheter were removed. Conclusion: The results suggest that traditional Korean medicine may be effective in the treatment of patients with ICH.

• 대한한방내과학회지
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• 제22권4호
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• pp.633-638
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• 2001

Objective : Stroke is the most frequent cause of death in Korea. Because it remains severe disablities disturbing normal life, it is important to carry out intervention preventing from progression of condition in patients with acute ischemic stroke within therapeutic time window. Thus early thrombolysis is beneficial for patients with acute ischemic stroke. However its therapeutic efficacy is not known in combination with oriental medical therapy. In this study, we investigated the safety and the clinical effect of continous intravenous urokinase therapy and oriental medical therapy. Methods : Twenty eight patients with acute onset of ischemic stroke no later than three days received continous infusion of urokinase and oriental medical therapy. We estimated the subjects's neurological deficit and functional status with National institute of Neurologic Disorders and Stroke Scale(NIHSS) and Europian Stroke Scale (ESS) prior to therapy, on day 3, 7, 14 after the starting urokinase therapy and on day at discharge. Results: After day 7, the scores of NIHSS and ESS were improved significantly. There are no differences in therapeutic effects of the interval between onset of stroke and initiation of therapy. Complication were noted in four(14%) patients, but these are not fatal complication and make no neurological deficiency. Conclusion : The results of these investment suggest that continuous intravenous urokinase with oriental medical therapy could be a safe and effective intervention to prevent from progression in acute ischemic stroke. But this findings should be confirmed in multicenter double blind controlled trial.

• Journal of Korean Neurosurgical Society
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• 제58권5호
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• pp.419-425
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• 2015

Objective : Acute vertebrobasilar artery occlusion (AVBAO) is a devastating disease with a high mortality rate. One of the most important factors affecting favorable clinical outcome is early recanalization. Mechanical thrombectomy is an emerging treatment strategy for achieving a high recanalization rates. However, thrombectomy alone can be insufficient to complete recanalization, especially for acute stroke involving large artery atheromatous disease. The purpose of this study is to investigate the safety and efficacy of mechanical thrombectomy in AVBAO. Methods : Fourteen consecutive patients with AVBAO were treated with mechanical thrombectomy. Additional multimodal treatments were intra-arterial (IA) thrombolysis, balloon angioplasty, or permanent stent placement. Recanalization by thrombectomy alone and multimodal treatments were assessed by the Thrombolysis in Cerebral Infarction (TICI) score. Clinical outcome was determined using the National Institutes of Health Stroke Scale (NIHSS) at 7 days and the modified Rankin Scale (mRS) at 3 months. Results : Thrombectomy alone and multimodal treatments were performed in 10 patients (71.4%) and 4 patients (28.6%), respectively. Successful recanalization (TICI 2b-3) was achieved in 11 (78.6%). Among these 11 patients, 3 (27.3%) underwent multimodal treatment due to underlying atherosclerotic stenosis. Ten (71.4%) of the 14 showed NIHSS score improvement of >10. Overall mortality was 3 (21.4%) of 14. Conclusion : We suggest that mechanical thrombectomy is safe and effective for improving recanalization rates in AVBAO, with low complication rates. Also, in carefully selected patients after the failure of recanalization by thrombectomy alone, additional multimodal treatment such as IA thrombolysis, balloons, or stents can be needed to achieve successful recanalization.

• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.75-80
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• 2012

Objective : To optimize the recanalization of acute cerebral stroke that were not effectively resolved by conventional intraarterial thrombolysis (IAT), we designed a double device technique to allow for rapid and effective reopening. In this article, we describe the feasibility and efficacy of this technique. Methods : From January 2008 to September 2009, twenty patients with acute cerebral arterial occlusion (middle cerebral artery : n=12; internal carotid artery terminus : n=5; basilar artery : n=3) were treated by the double device technique. This technique was applied when conventional thrombolytic methods using drug, microwires, microcatheters and balloons did not result in recanalization. In the double device technique, two devices are simultaneously placed at the lesion (for example, one microcatheter and one balloon or two microcatheters). Chemicomechanical or mechanicomechanical thrombolysis was performed simultaneously using various combinations of two devices. Recanalization rates, procedural time, complications, and clinical outcomes were analyzed. Results : The initial median National Institute of Health Stroke Scale (NIHSS) was 16 (range 5-26). The double device technique was applied after conventional IAT methods failed. Recanalization was achieved in 18 patients (90%). Among them, 55% (11 cases) were complete (thrombolysis in cerebral infarction 2B, 3). The median thrombolytic procedural time including the conventional technique was $135{\pm}83.7$ minutes (range 75-427). Major symptomatic hemorrhages (neurological deterioration ${\geq}4$ points in NIHSS) developed in two patients (10%). Good long term outcomes (modified Rankin Scale ${\leq}2$ at 90 days) occurred in 25% (n=5) of the cases. Mortality within 90 days developed in two cases (10%). Conclusion : The double device technique is a feasible and effective technical option for large vessel occlusion refractory to conventional thrombolysis.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.293-298
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• 2011

Objective : The extracellular matrix (ECM) and cell adhesion molecules play crucial roles in angiogenesis, apoptosis, thrombosis, and inflammation, and also contribute to the pathogenesis of stroke. Integrin, alpha 6 (ITGA6) is a member of ECM adhesion receptors. We investigated whether two single nucleotide polymorphisms (SNPs) (rs11895564, Ala380Thr; rs2293649, Asp694Asp) of ITGA6 were associated with the development and clinical phenotypes of intracerebral hemorrhage (ICH) and ischemic stroke (IS). Methods : We enrolled 199 stroke (78 ICH and 121 IS) and 291 control subjects. Stroke patients were divided into subgroups according to the scores of the National Institutes of Health Stroke Survey (NIHSS, <6 and ${\geq}6$) and Modified Barthel Index (MBI, <60 and ${\geq}60$). SNPStats, SNPAnalyzer, and Helixtree programs were used to calculate odds ratios, 95% confidence intervals, and p values. Multiple logistic regression models were used to analyze genetic data. Results : A missense SNP rs11895564 was associated with the development of ICH (p=0.026 in codominant2, p=0.013 in recessive, p=0.02 in log-additive models; p=0.041 in allele distributions). The A allele frequency of rs11895564 was higher in the ICH group (13.5%) than in the control group (8.1%). In the clinical phenotypes, rs11895564 and rs2293649 showed significant associations in the MBI scores of IS (p=0.014 in codominant1 model; p=0.02 in allele distributions) and NIHSS scores of ICH (p=0.017 in codominant2, p=0.035 in recessive, p=0.035 in log-additive models), respectively. Conclusion : These results suggest that ITGA6 may be associated with the development and clinical phenotypes of stroke in Korean population.

• Journal of Acupuncture Research
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• 제19권5호
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• pp.35-45
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• 2002

Objective : The aim of this study was to investigate the effect of tong's acupuncture on recovery of motor disorders in stroke patients. Methods : Twenty two patients with poststroke-hemiplegia were randomized into two groups. Ten patients(test group) treated by 2 methods-tong's acupuncture and body acupuncture. The other twelve patients(control group) treated only by body acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale(NlHSS) and Modified Barthel Index(MBI). The therapy was performed one a day for 2 weeks. Results: In terms of score of NIHSS. the test group showed statistically meaningful decrease after 2 week treatment. but the control group showed statistically meaningful decrease after I week(p<0.05). And in terms of score of MBI. the test group showed statistically meaningful increase after 2 week treatment. but the control group showed statistically meaningful increase after I week(p<0.05). There was no statistically meaningful difference after 1 and 2 week treatment between the groups. Conclusions: These results support that test group has almost same effectness compared with control group in improvement of the activity of daily living of poststroke-hemiplegic patients.