• 한국산학기술학회논문지
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• 제22권4호
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• pp.504-512
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• 2021

TCDD로 유발할 수 있는 남성 난임 원인 중 가장 큰 비율을 차지하는 것은 정자형성 장애와 정자의 질적 저하가 있다. 이를 해결하기 위해 GYB의 한의학적 처방을 이용하여 TCDD-유도 생식독성을 유발한 랫드에서 내분비기능 및 생식독성 관련 지표에 미치는 영향을 조사하고자 본 연구를 시행하였다. 수컷 SD 랫드를 5개의 그룹으로 7마리씩 나누어 실험하였다. 정상 대조군은 vehicle 및 saline을 투여하였으며, TCDD 단독투여그룹은 TCDD(2 ㎍/kg, weeks) 및 생리식염수를 복강 내 투여하였으며, 시험 군은 6주 동안 GYB (75, 150, 300 mg/kg)를 3가지 농도로 나누어 경구로 투여하였다. TCDD를 투여한 모든 군에서 체중 감소가 나타났으며, 호르몬 변화에서 GYB 300 mg/kg 투여군에서 free testosterone의 유의한(p<0.01) 감소가 나타났다. 또한 GYB 투여군의 고환조직에서 생식세포 일부 파괴, 정세관 위축 그리고 정자 수의 감소가 농도 의존적으로 개선되는 것이 관찰되었다. 또한 Johnsen's score, serotoli cell index(SCI)에서도 농도 의존적으로 개선되었다(p<0.05). 이러한 발견은 향후 남성 난임의 해결방안으로 의학적 시술이 아닌 약물요법을 효과적으로 사용할 수 있을 것으로 기대할 수 있다.

• Korean Journal of Acupuncture
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• 제40권3호
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• pp.79-89
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• 2023

Objectives : The purpose of this study is to investigate various application methods of focused ultrasound and apply them to clinical use in Korean medicine. Methods : Search was performed using the search engines of electronic databases, including PubMed, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), China National Knowledge Infrastructure (CNKI), Wanfang Data, Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii), from inception to July 2023 without language limitation. Inclusion criteria were clinical studies including randomized controlled trials (RCTs), and animal experimental studies related with focused ultrasound treatments for acupoints or meridian sinews. Results : Total 17 papers, 7 for RCT, 6 for in vivo animal studies, and other experimental studies, were finally selected. Indications used in studies were shoulder pain, back pain, chronic back pain, and degenerative knee arthritis. In experimental studies, studies on animal models of hypoxic ischemic brain damage and hyperlipidemia were also conducted. As for the acupoints, LR3, LI4, and ST36 were used in clinical studies and, in animal experimental studies, GV20, KI1, and ST36 were used. As for the dose, 4 studies below 3 W/cm² and 3 studies in the range of 0.625 to 5 W/cm² in clinical studies, and all studies did not exceed 5 W/cm². In animal experimental studies, 0.5 W/cm², 2 W/cm², 7.5 WW/cm², 15 W/cm², 10~20 W/cm² were used. In all three studies describing the penetration depth during irradiation, it was less than 1 cm. Conclusions : We suggest that focused ultrasound is an appropriate treatment tool for stimulating the acupoints to transfer heat energy. Future studies with rigorous and well-designed RCTs for various diseases will be required to ascertain the focused ultrasound stimulate acupoints or meridian sinews.

• Korean Journal of Acupuncture
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• 제40권4호
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• pp.141-148
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• 2023

Objectives : The purpose of this study is to investigate on the application of the yttrium aluminum garnet (YAG) lasers for acupoints irradiation. Methods : We conducted a systematic search for peer-reviewed studies published from inception to November 2023, in the following electronic databases: PubMed, Scopus, and Web of Science in English, Science ON, Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS) in Korean, and China National Knowledge Infrastructure (CNKI) and Wanfang in Chinese, and Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii) in Japanese. Inclusion criteria were original articles including clinical and experimental studies related with YAG lasers for acupoints including Ashi or meridian sinews. Results : Among the 8 selected studies, there were 7 studies on human subjects and 1 study on animals, 7 studies on Nd:YAG (1,064 nm) laser, and 1 study on Er:YAG (2,940 nm) laser. A total of 16 acupoints were used, 15 of which were in the face and 1 of which was located in the foot. In addition, there were two studies using Ashi. 4 studies looked at the effect of pain relief, 2 studies looked at safety, 1 study looked at changes in blood flow, and 1 study looked at the effect of skin care. There were no reported adverse events, and the YAG laser was confirmed to be safe and effective in pain relief, beautifying the skin, and increasing blood flow. Conclusions : We suggest that high intensity YAG lasers can be applied to laser acupuncture or laser moxibustion. YAG lasers are considered to be worth using for various clinical indications of Korean medicine because of photobiomodulation effects, analgesic action, and deep penetration depth. Further scientific research and clinical evidences should be warranted.

• 한방재활의학과학회지
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• 제33권4호
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• pp.125-144
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• 2023

Objectives This study aimed to investigate domestic clinical research trends in Shinbaro pharmacopuncture, identify diseases managed using Shinbaro pharmacopuncture, and suggest the direction for future studies to increase its clinical utilization. Methods This study used five steps proposed by Arksey and O'Malley and the PRISMA-extension for scoping reviews checklist. We examined published literature on Shinbaro pharmacopuncture studies reported until June 5, 2023, in the following eight databases (Research Information Sharing Service, Science ON, Oriental Medicine Advanced Searching Integrated System, KMBASE, The Society of Internal Korean Medicine, PubMed, EMBASE, and the Cochrane Library). The search terms used were 'Shinbaro' or 'Sinbaro'. Results A total of 47 studies were included in our analysis. Of these, 37 (78.7%) were interference time series studies. Shinbaro pharmacopuncture was the most frequently used treatment for lumbosacral disease (n=15). In the facial area, ST4 and ST6 were used in five out of six studies, and in the shoulder area, TE14 and LI15 were used in all studies. Nine of the 15 studies in the lumbosacral area used the EX-B2. The other parts mostly used the pressure points. Compared to other pharmacopuncture methods, the treatment effect was similar to that of bee venom, and faster than that of jungsongouhyul. Conclusions This is the first scoping review of Shinbaro pharmacopuncture therapy in South Korea. Studies with a high level of evidence based on sole treatment, large capacities, and standardization of Shinbaro pharmacopuncture need to be conducted to increase its clinical utilization.

• 한국한의학연구원논문집
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• 제18권2호
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• pp.65-89
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• 2012

Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

• 한국식품과학회지
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• 제38권3호
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• pp.452-455
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• 2006

퇴행성뇌질환인 치매의 정확한 원인은 아직 불분명하나 빠른 뇌세포사멸이 주요한 원인으로 알려져 있다. 특히, 알츠하이머형 치매는 다량 생성되는 활성산소에 의한 뇌세포사멸이 주요원인인 것으로 입증되고 있다. 따라서 본 연구에서는 웅담활성성분인 UDCA의 세포보호 및 항산화효과로부터 알츠하이머형 치매와 같은 퇴행성 뇌질환억제 또는 치료물질로서의 가능성을 입증하고자 하였고 뇌의 대식세포인 소교세포(microglia)를 cell model로 하였다. MTT 실험결과 UDCA에 의한 세포보호효과는 $7.5\;{\mu}g/mL$ 주변 농도에서 관찰되었고 NO에 의한 세포손상 유도억제효과를 확인하였다(Fig. 2). 이와 같은 결과는 형광현미경하에서 보다 명확히 관찰되어(Fig. 3) 결국 UDCA에 의한 항세포사효과가 있음을 알 수 있었다. UDCA의 항산효과는 활성산소인 $H_2O_2$의 단백질 분해 저해능을 관찰하는 금속이온촉매 산화효과를 통해 확인하였다(Fig. 4). 즉, UDCA는 농도의존적으로$(1{\sim}100\;{\mu}g/mL)$ 단백질 분해억제능을 보였으며 $100\;{\mu}g/mL$ 이상의 농도에서 양성대조군인 ascorbic acid와 유사한 억제효과를 나타냈다. 이와 같은 UDCA의 항산화효과는 $10\;{\mu}g/mL$ 전후에서 관찰되어 세포보호효과를 나타내는 농도$(7.5\;{\mu}g/mL)$와 큰 차이가 없는 것으로 사료되었고 따라서 UDCA의 농도범주는 일괄적 적용이 가능할 것으로 판단된다. 결론적으로 웅담활성성분인 UDCA는 일반적으로 사용하여온 간질환 및 소화계질환의 보조요법제의 개념을 벗어나 항염 및 항산화효과에 잠재능을 가지며 나아가 뇌신경세포를 보호하고 세포사를 차단하여 알츠하이머와 같은 퇴행성뇌질환 조절 후보물질로 적용이 가능할 것으로 판단되나 보다 심도 있는 in vivo 및 임상적 차원의 연구가 요구된다.

• 대한한의학원전학회지
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• 제4권
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• pp.101-126
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• 1990

At early Cheong (淸) dynasty, in medical aspect by dependent on practical studying attitude that must found a theory only by an evidence, there had been a tendancy that hoped direct research of sages' mind-eye by escaping the theory of individual classes since Geum-Won (金-元) dynasty. Yoo Chang (喩昌), born in Man-Ryeok (萬曆) 12th year of Myung (明) dynasty (A.D.1583) and dead in Gang-Hee (康熙) 3rd year of Cheong (淸) dynasty (A.D.1664). The results were as follows after studying his practical idea of medicine. 1. Yoo Chang, by recognizing the ${\ll}$Sang-Han-Ro${\gg}$ has lost its true meaning after commented by Wang Hee (王熙), Lim Eog (林億), Seong Moo-I (成無巳), etc. according to Bang Yoo-Jip's (方有執) Chak-Gan-Jung-Jeong (錯簡重訂) theory, he diversified the protocal of ${\ll}$Sang-Han-Ro${\gg}$ 397 method and arranged under Six Meridian part. (六經) 2. The theory of Sam-Gang-Jeong-Rip (三綱鼎立) can be summerized Gye-Ji (桂枝) syndrome which is the case of Wind (風) has injured Wi (衛) stage, Ma-hwang (麻黃) syndrome which is the case of Cold (寒) has injured Yeong (榮) stage, Dae-Cheong-Ryong (大靑龍) syndrome which is the case both of Wind-Cold (風寒) has injured Yeong-Wi (榮衛) stage, and there has been Sam-Gang-Jeong-Rip theory by anterior medical practitioners already but the person who formally used its Sam-Gang-Jeong-Rip term is Yoo Chang. 3. Yoo Chang seized the On Byeng (溫病) by dividing three category and in Byon-Jeung-Si-Chi (辨證施治) he influenced to many aspect of establishment of later Byon-Jeung system On-Byong (溫病의 辨證體系) pertaining to Triple-Warmer by O-Dang (吳瑭) introducing Triple-Wanner Theory. (三焦理論) 4. At Chu-Jo-Ron (秋燥論) of ${\ll}$EUi-Moon-Beop-Ryo${\gg}$, while ${\ll}$Nae-Gyeong${\gg}$ describing if humidity injury Lung, then occur a disorder in it, Yoo Chang recognized that of au tuam when dryness injure Lung there occure a disorder is it so he insisted that at this case, must use Cheong-Joe-Goo-Pye method (淸操救肺法) withherbs, pertaing to Gam-Yoo-Ja-Yoon(甘柔滋潤性) property and he invented Cheong-Joe-Goo-Pye-Tang. (淸操救肺湯) 5. Yoo Chang', so called, Dae-Gi (大氣) indicates Yang-Gi (陽氣) of chest, he insisted that man's creation and every physiological activity depends on maintainence of Dae-Gi, and it integrate Yeong-Gi (榮氣), Wea-Gi (衛氣), Jong-Gi (宗氣), Jang-Boo-Ji-Gi (臟腑之氣), Gyeong-Rak-Ji-Gi. (經絡之氣) 6. Yoo Chang's expression about partical function and character of stomach, not only bolster its theory of historical physician's expression, that is stomach is. foundatness of postnatal period, but also it has corresponding aspect with modern medicine and clinic. 7. Yoo Chang emphasized "if one cure a disease, be must understood the character of disease first and use drugs later" (先議病 後用藥) phrase about of drug usage, and his theory of Geup-Rew-Man-Joo method (急流挽舟) and three therapy of Simple Ascite (單腹腸) are all unique opinion based upon this phrase mentioned above. 8. Yoo Chang's practical idea of medicine greatly influenced to Jang Ro (張璐), Hwang Won-A (黃元御), Oh Eui-Rak (吳儀洛), Joo Yang-Joon (周揚俊), etc. and theory of Sam-Gang-Jeng-Rip (三綱鼎立), Triple Warmer Theory of On Byong (溫疫의 三焦論治), Chu-Jo-Ron (秋燥論), Dae-Gi-Ron (大氣論) etc. became important object to student of Sang-Han (傷寒) and On-Byeng. (溫病) 9. Yoo Chang's Writings has more practical meaning than other physician's, especially, later the idea of Sang-Han (傷寒) and On-Byong (溫病) greatly contributed to development of Sang-Han theory and formation of On-Byong theory.

• Molecules and Cells
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• 제27권5호
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• pp.591-599
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• 2009

Nicotinic acetylcholine receptors (nAChRs) play important roles in nervous system functions and are involved in a variety of diseases. We previously demonstrated that ginsenosides, the active ingredients of Panax ginseng, inhibit subsets of nAChR channel currents, but not ${\alpha}7$, expressed in Xenopus laevis oocytes. Mutation of the highly conserved Leu247 to Thr247 in the transmembrane domain 2 (TM2) channel pore region of ${\alpha}7$ nAChR induces alterations in channel gating properties and converts ${\alpha}7$ nAChR antagonists into agonists. In the present study, we assessed how point mutations in the Leu247 residue leading to various amino acids affect 20(S)-ginsenoside $Rg_3$ ($Rg_3$) activity against the ${\alpha}7$ nAChR. Mutation of L247 to L247A, L247D, L247E, L247I, L247S, and L247T, but not L247K, rendered mutant receptors sensitive to $Rg_3$. We further characterized $Rg_3$ regulation of L247T receptors. We found that $Rg_3$ inhibition of mutant ${\alpha}7$ nAChR channel currents was reversible and concentration-dependent. $Rg_3$ inhibition was strongly voltage-dependent and noncompetitive manner. These results indicate that the interaction between $Rg_3$ and mutant receptors might differ from its interaction with the wild-type receptor. To identify differences in $Rg_3$ interactions between wild-type and L247T receptors, we utilized docked modeling. This modeling revealed that $Rg_3$ forms hydrogen bonds with amino acids, such as Ser240 of subunit I and Thr244 of subunit II and V at the channel pore, whereas $Rg_3$ localizes at the interface of the two wild-type receptor subunits. These results indicate that mutation of Leu247 to Thr247 induces conformational changes in the wild-type receptor and provides a binding pocket for $Rg_3$ at the channel pore.

• 동아시아식생활학회지
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• 제17권4호
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• pp.554-562
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• 2007

본 연구는 식이 습관병 예방을 위한 건강식품을 개발하기 위한 기초 연구로써 계획되어 선행 연구와 문헌상의 기록을 바탕으로 한 천마의 여러 기능 중 혈류 개선 효과에 중점을 두고 그 기능을 과학적으로 확인하여 보고자 하였다 즉, 쌀뜨물을 주로하여 소화 흡수 및 면역력의 증강을 기대할 수 있고 독성 성분을 제거할 수 있으며, 더불어 활혈(活血) 및 청열량혈(靑熱凉血)기능을 가지는 천궁과 이수(利水) 및 안신(安神)작용을 하는 복령을 포제에 함께 이용하여 뇌혈류와심혈관 기능을 증진시키고자 하였다. 따라서 흰쥐를 대상으로 Laser-Doppler flowmeter system(LDF)을 이용하여 천마가 국소 뇌혈류량과 혈압에 미치는 효과를 관찰한 결과는 다음과 같다. 1. 천마를 0.1mg/kg, 1.0mg/kg 및 10.0 mg/kg 농도로 주사 시 농도 의존적으로 국소 뇌혈류량이 증가되었다. 2. 천마가 국소 뇌혈류량을 증가시키는 기전을 확인하기 위해 propranolol, atropine, methylene blue, indomethacin으로 전처리한 후 천마를 주사했을 때는 국소뇌혈류량에 유의한 변화를 관찰할 수 없었으나, anti-nitric oxide synthetase를 전처리한 후 천마를 주사했을 때는 국소 뇌혈류량이 유의적으로 증가함을 관찰할 수 있었다. 3. 천마를 0.1 mg/kg, 1.0 mg/kg 및 10.0 mg/kg 농도로 주사 시 농도 의존적으로 혈압이 저하되었다. 4. 천마가 어떤 기전으로 혈압의 변화를 초래하는지를 확인하기 위해 propranolol, atropine, methylene blue, indomethacin으로 전처리한 후 천마를 주사했을 때는 혈압에 유의한 변화를 관찰할 수 없었으나 anti-nitric oxide synthetase로 전처리한 후 천마를 주사했을 때에는 혈압이 유의적으로 저하되는 변화가 나타났다. 이상의 결과에서 포제 천마는 뇌혈류량을 증가시키고 혈압을 강하시키는 작용이 있음을 확인하였고, 그 기전은 nitric oxide 생성과 관련되어 나타나는 결과로 판단된다. 따라서 혈관 질환을 포함한 식이 습관병과 관계된 질환의 예방 및 치료의 보조 식이물로써 활용이 가능하다고 판단되며, 향후 포제 천마를 이용한 건강식품을 개발하고 완제품에 대한 유효성에 대한 연구를 수행할 때 기초 자료가 될 수 있을 것으로 사료된다.

• 동서간호학연구지
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• 제1권1호
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• pp.22-39
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• 1997

Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.