• Title/Summary/Keyword: Oriental medicines

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Analysis of Case Studies of Treating Atopic Dermatitis - focusing on Korean Herbal Medicine Used in Cases - (아토피 피부염 증례 연구 분석 - 한약 처방을 중심으로 -)

  • Han, Chang-Yi;Park, Jung-Gun;Kang, Dong-Won;Park, So-Young;Kim, Bong-Hyun;Kim, Yoon-Bum;Kim, Kyu-Seok
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.3
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    • pp.151-163
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    • 2019
  • Objectives : The purpose of this study is to investigate the use of herbal medicine for the treatment of atopic dermatitis in cases and to find the general tendency of herbal medicine treatment and to establish the primary treatment direction of Atopic dermatitis. Methods : In the domestic databases, Oriental medicine Advanced Searching Integrated System(OASIS), Korean Traditional Knowledge Portal(KTKP), National Discovery for Science Leader(NDSL), Research Information Sharing Service(RISS), we selected among the papers published in the last 20 years using search terms related to "Atopic dermatitis & Cases". Reports based on Sasang constitutional medicine and Six meridian pattern identification were excluded and a total of 21 papers were finally selected. Results : 113 herbal medicines were retrieved from 21 papers. The most commonly used herbs are Scutellariae Radix(黃芩), Rehmanniae Radix(地黃), and Glycyrrhizae Radix et Rhizoma(甘草). Atractylodis Rhizoma(蒼朮), Akebiae Caulis(木通), Smilacis Rhizoma(土茯?), Paeoniae Radix(芍藥) used mostly when Oozing exists, Trichosanthis Radix (瓜蔞), Asparagi Radix(天門冬), Persicae Semen(桃仁), Carthami Flos(紅花) used mostly when Dryness, Lichenification, and Pigmentation exist. The average score of SCORAD index was improved after Herbal medicine treatment. Conclusion : Through this study, we could find out the tendency of herbal medicine to treat Atopic dermatitis along with Symptoms.

Discrimination and Authentication of Eclipta prostrata and E. alba Based on the Complete Chloroplast Genomes

  • Kim, Inseo;Park, Jee Young;Lee, Yun Sun;Lee, Hyun Oh;Park, Hyun-Seung;Jayakodi, Murukarthick;Waminal, Nomar Espinosa;Kang, Jung Hwa;Lee, Taek Joo;Sung, Sang Hyun;Kim, Kyu Yeob;Yang, Tae-Jin
    • Plant Breeding and Biotechnology
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    • v.5 no.4
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    • pp.334-343
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    • 2017
  • Eclipta prostrata and E. alba are annual herbal medicinal plants and have been used as Chinese medicinal tonics. Both species are widely distributed in tropical and subtropical regions as well as in Korea. Both species have similar morphological features but E. alba has smoother leaf blade margins compared with E. prostrata. Although both species are utilized as oriental medicines, E. prostrata is more widely used than E. alba. Morphological semblances have confounded identification of either species. Here, we report the complete chloroplast genomes of both species to provide an authentication system between the two species and understand their diversity. Both chloroplast genomes were 151,733-151,757 bp long and composed of a large single copy (83,285-83,300 bp), a small single copy (18,283-18,346 bp), and a pair of inverted repeats (25,075-25,063 bp). Gene annotation revealed 80 protein coding genes, 30 tRNA genes and four rRNA genes. A phylogenetic analysis revealed that the genus Eclipta is grouped with Heliantheae tribe species in the Asteraceae family. A comparative analysis verified 29 InDels and 58 SNPs between chloroplast genomes of E. prostrata and E. alba. The low chloroplast genome sequence diversity indicates that both species are really close to each other and are not completely diverged yet. We developed six DNA markers that distinguish E. prostrata and E. alba based on the polymorphisms of chloroplast genomes between E. prostrata and E. alba. The chloroplast genome sequences and the molecular markers generated in this study will be useful for further research of Eclipta species and accurate classification of medicinal herbs.

East Asian Herbal Medicine (EAHM) Alone for the Treatment of Women with Diminished Ovarian Reserve (DOR): A Systematic Review and Meta-analysis (난소예비력 저하 여성에 대한 한약 단독 치료의 임신 관련 지표 개선 효과에 관한 체계적 문헌 고찰 및 메타분석)

  • Lee, Ju Hyun;Choi, Su-Ji;Noh, Eun-Ji;Min, Sang-Yeon;Kim, Dong-Il
    • The Journal of Korean Medicine
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    • v.43 no.1
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    • pp.136-153
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    • 2022
  • Objectives: The aim of this study was to find out whether east asian herbal medicine (EAHM) treatment alone is effective in improving pregnancy-related indicators compared to conventional medicine in women with Diminished Ovarian Reserve (DOR). Methods: We searched eligible studies from PubMed, Cochrane Library, EMBASE, Chinese National Knowledge Infrastructure Database, CiNii, Korean Medical Database, Korean Studies Information Service System, Oriental Medicine Advanced Searching Integrated System, ScienceOn. GRADE pro was used to evaluate the current evidence of the study. Result: A total of 5 studies, 325 women with DOR were included. EAHM showed a significant effect on improvement of pregnancy rate (n=270, RR 2.13 [95% CI 1.44 to 3.15], Z=3.78, p=0.0002, I2=0%) and Anti-Mullerian Hormone (AMH) level (n=211, SMD 0.82 [95% CI 0.40 to 1.25], Z=3.80, p=0.0001) compared to conventional medicine. In ovulation rate (n=156, RR 0.86 [95% CI 0.70 to 1.06], Z=1.43, p=0.15, I2=0%), Antral Follicle Count (n=245, SMD 0.27 [95% CI -0.25 to 0.79], Z=1.01, p=0.31), and follicle stimulating hormone (n=245, SMD 0.29 [95% CI -0.13 to 0.70], Z=1.36, p=0.17) level, EAHM showed similar effects to conventional medicine. In this study, the most frequently used herbal medicines were Cuscutae Semen, Dipsaci Radix, and Angelicae Gigantis Radix. Conclusion: This meta-analysis showed that EAHM could improve pregnancy rates and AMH levels in women with DOR. However, more well-designed RCTs will have to be performed further in the future.

Antithrombosis, Antidiabetes, and Antioxidant Activities of Houttuynia cordata (어성초의 항혈전, 항당뇨 및 항산화 활성)

  • Yun-Jin, Lee;Deok-Gyeong, Kang;Jong Sik, Kim;Man-Hyo, Lee;Ho-Yong, Sohn
    • Journal of Life Science
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    • v.33 no.1
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    • pp.43-49
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    • 2023
  • Houttuynia cordata belongs to the Saururacease family and its leaves, stems, and roots have been used as oriental medicines to treat pneumonia, acute or chronic bronchitis, enteritis, and abscesses and to remove extravasated blood. Recently, the antioxidant, anti-inflammation, antibacterial, and anti-proliferation activities and protection abilities of H. cordata against liver and neuron cell damage have been reported. In this study, ethanol extract and its solvent fractions (fractions of hexane, ethyl acetate, butanol, and water residue) were prepared, and their antithrombosis, antidiabetes, antioxidant, and hemolysis activities were evaluated. The ethyl-acetate fraction of H. cordata (EF-HC) showed the highest polyphenol and flavonoids contents among the fractions and exhibited strong antithrombosis and antioxidant activities. The EF-HC at 5 mg/ml showed 2.09-folds of thrombin time, 2.19-folds of prothrombin time, and 1.69-folds of activated partial thromboplastin time compared to the their solvent control and 30.9, 19.9, and 49.6 ㎍/ml of RC50 against DPPH, ABTS, and nitrite radicals, respectively. Furthermore, the EF-HC did not show any hemolytic activity up to 1 mg/ml, whereas the hexane fraction of H. cordata showed 55% hemolysis at 1 mg/ml. This is the first report of the antithrombosis activity of H. cordata. Our results suggest that quercitirin, hyperoside, orientin, and isoquercitrin in EF-HC are related to its antithrombosis and antioxidant activities and that the EF-HC could be developed as a promising antithrombosis agent.

Comparative Study of the Neuroprotective Effect of Sihogyeji-tang, Sihosogan-tang, and Sihocheonggan-tang on an MPTP-Induced Parkinson's Disease Mouse Model (MPTP로 유도된 파킨슨병 생쥐 모델에 대한 시호계지탕, 시호소간탕, 시호청간탕의 신경세포 보호 효과 비교 연구)

  • Ji Eun Seo;Hanul Lee;Chang-Hwan Bae;Dong Hak Yoon;Hee-Young Kim;Seungtae Kim
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.90-98
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    • 2023
  • Objectives : Parkinson's disease (PD) is the second most common neurodegenerative disorder worldwide and is characterized by the loss of the dopaminergic neurons in the substantia nigra (SN). In a previous in vitro study, we demonstrated that Sihogyeji-tang (SG), Sihosogan-tang (SS), and Sihocheonggan-tang (SC) have the potential to be candidate medicines for PD. This study aimed to compare the neuroprotective effect of SG, SS, and SC using 1-methyl-4-phenyl-1,2,3,6-tetrahydrophridine (MPTP)-induced PD mouse model. Methods : Eight-week-old male C57BL/6 mice were intraperitoneally administered with 30 mg/kg of MPTP for 5 days and orally administered SG, SS and SC for 12 days from the first MPTP injection. Motor function was assessed using the pole test and the rotarod test. Dopaminergic neuronal survival in the SN and striatum was evaluated through tyrosine-hydroxylase immunohistochemistry. Results : MPTP administration resulted in behavioral impairment and dopaminergic neuronal death in the SN and striatum. In the pole test, treatment with SG, SS, and SC alleviated the MPTP-induced motor dysfunction on day 5 and 12. In the rotarod test, SS and SG alleviated the MPTP-induced motor dysfunction on day 5, while only SS showed improvement on day 12. SS and SG significantly protected dopaminergic neurons in the SN from MPTP toxicity, and all three compounds (SG, SS, and SC) showed significant protection in the striatum. Notably, SS demonstrated superior efficacy in suppressing MPTP-induced motor dysfunction and dopaminergic neuronal death compared to SG and SC. Conclusions : These findings suggest that SS is the most effective formula among SG, SS, and SC for PD, indicating its potential role in the treatment of PD.

Synergistic Inhibition of Aronia melanocarpa and Moringa oleifera Seed Extract on Experimental Atopic Dermatitis (아로니아 및 모링가 종자 복합물의 항아토피 상승효과)

  • Ki, Hyeon-Hui;Lee, Ji-Hyun;Moon, Kwang-Hyun;Lee, Jeong-Ho;Kim, Dae-Geun;Jeong, Kyung-Ok;Im, So-Yeon;Lee, Young-Mi;Kim, Dae-Ki
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.3
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    • pp.298-305
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    • 2017
  • Atopic dermatitis is a chronic, relapsing inflammatory skin disease. This study aimed to investigate the therapeutic benefits of Aronia melanocarpa (AM) and Moringa oleifera seed extract (MO) on experimental atopic dermatitis. We examined the effects of AM or MO and their combination on 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis in BALB/c mice as well as tumor necrosis factor $(TNF)-{\alpha}$ and interferon $(IFN)-{\gamma}-stimulated$ HaCaT keratinocytes. Mice were orally treated with extract during repeated application of DNCB to shaved dorsal skin. Our results show that treatment with AM and MO in combination reduced histological manifestations such as epidermal hyperplasia and inflammatory cell infiltration. Furthermore, it significantly decreased skin thickness and serum immunoglobulin E (IgE) level compared to the AM or MO alone treated group. Combined extract of AM and MO suppressed expression of $TNF-{\alpha}/IFN-{\gamma}-induced$ T helper 2 (Th2) chemokines such as thymus and activation-regulated chemokine and macrophage-derived chemokine. To sum up, combination of AM and MO suppressed the inflammatory response and serum IgE as an indicator of several allergic diseases in DNCB-induced experimental atopic dermatitis and Th2 chemokine expression in HaCaT cells. This result suggests that combination of AM and MO could be a valuable strategy to improve atopic dermatitis.

Comparative Study about Academic Thoughts of Xu Lingtai and Yoshimasu Todo (I) - Focus on their Major Books - (서영태(徐靈胎)와 길익동동(吉益東洞)의 학술사상 비교 연구 (I) - 각자의 주요 저서를 중심으로 -)

  • Yoon, Cheol-Ho;Huang, Huang
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.792-812
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    • 2010
  • In the 18th century, Xu Lingtai (徐靈胎) and Yoshimasu Todo (吉益東洞) were famous doctors advocating ancient medicine, though they lived in different countries, China and Japan. We compared their major books, analyzed their academic thoughts and then took conclusions as below. 1. The first, for instance "Classified Prescriptions of Treatise on Cold Damage Diseases, 傷寒論類方" and "Classified Assemblage of Prescriptions, 類聚方". Based on essential thought that a prescription and a syndrome should correspond, these books arranged and classified the Zhang Zhongjing (張仲景)'s texts."Classified Prescriptions of Treatise on Cold Damage Diseases", based on the thought that principles, methods, formulas and medicinals (理法方藥) were integrated in prescriptions, tried to find out the implicit treatment rules in prescriptions and syndromes through analyzing "Treatise on Cold Damage Diseases, 傷寒論". On the other hand, because Classified Assemblage of Prescriptions focused on the syndromes of ancient prescriptions (古方), it classified and collected the related texts of Treatise on Cold Damage Diseases and "Synopsis of Prescriptions of the Golden Chamber, 금궤요략", and then suggested only simple instructions on how to prescribe medicine. So in this book, the trend of experience was clear. 2. The second, there is "100 Kinds Records from Shennong's Classic of Materia Medica, 神農本草經百種錄" and "Description work of herbal pharmacology comprised of excerpts from Shanhanlun and medical experiences, 藥徵". Though both of these books are professional oriental pharmacology publications that advocate reactionism, there were remarkable differences in writing style between them. "Description work of herbal pharmacology comprised of excerpts from Shanhanlun and medical experiences" was based on "Treat on Cold Damage Diseases" and "Synopsis of Prescriptions of the Golden Chamber", just explained the effects of medications and discussed 'matter of course (所當然)', but not discussed 'the reason why (所以然)'. In explaining style of syndromes, it confirmed through research, and emphasized the inductive method. On the other hand, "100 Kinds Records from Shennong's Classic of Materia Medica based on "Shennong's Classic of Materia Medica, 神農本草經", explained the nature of medications and discussed 'the reason why (所以然)'. In explaining style of syndromes, it annotated and explained, and emphasized the process of reasoning. 3. The third, there is "Discuss the Headwaters of Medicine, 醫學源流論" and Severance of Medical evils, 醫斷". Aiming the then medical theories fallen in confused state, these books brought order out of chaos, clarified the categories of medical research, and emphasized the scientific method that could put theories into practice and verify them. The difference is that "Severance of Medical Evils" researched only macroscopic viewable clinical phenomena, and even denied the existence of names of diseases and etiological causes. Thus, it emphasized the accumulation of experiences, laid emphasis on "watching and realizing (目認)", and "understand and taking in (解悟)". Discuss the Headwaters of Medicine extremely emphasized the research of 'something not occuring (未然)', that is to say, induced notions of a disease from observing clinical phenomena, furthermore based on these, predicted the 'something not occuring (未然)' and emphasized researching 'the reason why (所以然)'. As regards how they deal with the traditional theories and post-Zhang Zhongjing's medicines, "Severance of Medical evils" took completely denying attitudes. In case of "Discuss the Headwaters of Medicine", it could be used reasonably through specific situation and detailed analysis. Collectively speaking, there were some differences between medical theories of Xu Lingtai and Yoshimasu Todo. Actually, these differences were whether he tried to research the essence of disease, whether he tried to consider it rationally, and how he treated various opinions occurring in the theories of traditional medicine and clinical experience.

The Study On The ${\ulcorner}Dongyi{\;}Sasang{\;}Shinpyun{\lrcorner}$ ("동의사상신편(東醫四象新編)" 에 대한 연구(硏究))

  • Park, Seong-Sik;Youn, Bo-Hyun
    • Journal of Sasang Constitutional Medicine
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    • v.13 no.2
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    • pp.28-48
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    • 2001
  • 1. Background and Purpose Since ${\ulcorner}$Dongri Sasang Shinpyun${\lrcorner}$ was published in 1929, it had great effects on the publications related to Sasang Constitutional Medicine. However there had been no practical research or its applications about ${\ulcorner}$Dongyi Sasang Shinpyun${\lrcorner}$ at all in spite of its importance. So through the study on the ${\ulcorner}$Dongyi Sasang Shinpyun${\lrcorner}$ we highly intend to utilize the book. 2. Methods In this dissertation, you'll find our research of ${\ulcorner}$Dongyi Sasang Shinpyun${\lrcorner}$ regarding the author, the people who were involved in the publishing, the formations and the contents, our another research of ${\ulcorner}$Dongyi Sasang Shinpyun Chebang${\lrcorner}$(東醫四象新編劑方) to make its medical characteristics and meaning clear. 3. Results and Conclusion 1) Won Chi Sang was Chang Bong Young's granduncle's son-in-law. Nam Dae-hee is suspected of Nam Tae-hee who lived in YeoJu Bam Gol at that time though, it's not certain. 2) ${\ulcorner}$Dongyi Sasang Shinpyun${\lrcorner}$ is consisted of two pans. ${\ulcorner}$The Internal part${\lrcorner}$ is the basic explanation and ${\ulcorner}$The External part${\lrcorner}$, is the prescriptions depending on the symptoms. ${\ulcorner}$Sasang Byunron${\lrcorner}$,(四象辯論) is mostly that's for the explanations about analysis of Sasang Constitution. ${\ulcorner}$Sasang Kyunghum${\lrcorner}$(四象經驗) is mainly it's for the prescriptions depends on Sasangin's symptoms. ${\ulcorner}$Sasang Kukyul${\lrcorner}$(四象口訣), ${\ulcorner}$Tong Sasang Changbu Sochaedo${\lrcorner}$(通四象臟腑所在圖), ${\ulcorner}$Tong Sasang Chunche Sosokdo${\lrcorner}$(通四象全體所屬圖) are about the analysis of Sasangin's characteristics from metaphysical concepts to Changbustic concepts. In ${\ulcorner}$Sasangin oyak${\lrcorner}$(四象人要藥), among them, 10 types of medicines were categorized separately by constitutional difference in ${\ulcorner}$Dongui Sasang Shinpyun${\lrcorner}$ and ${\ulcorner}$Dongmu Youg${\lrcorner}$(東武遺槁). The unique style of ${\ulcorner}$Dongyi Sasang Yongyak Huebun${\lrcorner}$(東醫四象用藥索分) is originated from ${\ulcorner}$Bangyak Happyun${\lrcorner}$ ${\ulcorner}$Euibang Whaltu${\lrcorner}$(${\ulcorner}$方藥合編${\lrcorner}$${\ulcorner}$醫方活套${\lrcorner}$), ${\ulcorner}$Whaltu Chimsun${\lrcorner}$,(${\ulcorner}$方藥合編${\lrcorner}$ ${\ulcorner}$活套鎭線${\lrcorner}$). 3) There are 293 prescriptions in ${\ulcorner}$Dongyi Sasang Shinpyun Chebang${\lrcorner}$. 36 out of 44 prescriptions in ${\ulcorner}$Gapont${\lrcorner}$(甲午本) are quoted in ${\ulcorner}$kyunghumbang${\lrcorner}$. Therefore it could be very possible that those unknown prescriptions in ${\ulcorner}$Kyunghumbang${\lrcorner}$ can be from lee Je Ma. 4) We are assumed that ${\ulcorner}$Dongyi Sasang Shinpyun${\lrcorner}$ was made by some other doctors not from one single person, based on Lee Je Ma's prescriptions, after Lee Je Ma died. ${\ulcorner}$Dongyi Sasang Shinpyun${\lrcorner}$ is very different from ${\ulcorner}$Dongeyi Suse Bowon${\lrcorner}$, ${\ulcorner}$Dongmu Yougo${\lrcorner}$(東武遺稿). ${\ulcorner}$Chobonkwun${\lrcorner}$(草本卷) by lee Je Ma since it was published for utilizing Sasang Constitutional Medicine and medical practice not for the basic principles of Sasang Constitution by Lee Je Ma. Therefore it could be highly possible to look over the spirit of Sasang Constitution by lee Je-ma.

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The Comparative Understanding between Red Ginseng and White Ginsengs, Processed Ginsengs (Panax ginseng C. A. Meyer) (홍삼과 백삼의 비교 고찰)

  • Nam, Ki-Yeul
    • Journal of Ginseng Research
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    • v.29 no.1
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    • pp.1-18
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    • 2005
  • Ginseng Radix, the root of Panax ginseng C. A. Meyer has been used in Eastern Asia for 2000 years as a tonic and restorative, promoting health and longevity. Two varieties are commercially available: white ginseng(Ginseng Radix Alba) is produced by air-drying the root, while red ginseng(Ginseng Radix Rubra) is produced by steaming the root followed by drying. These two varieties of different processing have somewhat differences by heat processing between them. During the heat processing for preparing red ginseng, it has been found to exhibit inactivation of catabolic enzymes, thereby preventing deterioration of ginseng quality and the increased antioxidant-like substances which inhibit lipid peroxide formation, and also good gastro-intestinal absorption by gelatinization of starch. Moreover, studies of changes in ginsenosides composition due to different processing of ginseng roots have been undertaken. The results obtained showed that red ginseng differ from white ginseng due to the lack of acidic malonyl-ginsenosides. The heating procedure in red ginseng was proved to degrade the thermally unstable malonyl-ginsenoside into corresponding netural ginsenosides. Also the steaming process of red ginseng causes degradation or transformation of neutral ginsenosides. Ginsenosides $Rh_2,\;Rh_4,\;Rs_3,\;Rs_4\;and\;Rg_5$, found only in red ginseng, have been known to be hydrolyzed products derived from original saponin by heat processing, responsible for inhibitory effects on the growth of cancer cells through the induction of apoptosis. 20(S)-ginsenoside $Rg_3$ was also formed in red ginseng and was shown to exhibit vasorelaxation properties, antimetastatic activities, and anti-platelet aggregation activity. Recently, steamed red ginseng at high temperature was shown to provide enhance the yield of ginsenosides $Rg_3\;and\;Rg_5$ characteristic of red ginseng Additionally, one of non-saponin constituents, panaxytriol, was found to be structually transformed from polyacetylenic alcohol(panaxydol) showing cytotoxicity during the preparation of red ginseng and also maltol, antioxidant maillard product, from maltose and arginyl-fructosyl-glucose, amino acid derivative, from arginine and maltose. In regard to the in vitro and in vivo comparative biological activities, red ginseng was reported to show more potent activities on the antioxidant effect, anticarcinogenic effect and ameliorative effect on blood circulation than those of white ginseng. In oriental medicine, the ability of red ginseng to supplement the vacancy(허) was known to be relatively stronger than that of white ginseng, but very few are known on its comparative clinical studies. Further investigation on the preclinical and clinical experiments are needed to show the differences of indications and efficacies between red and white ginsengs on the basis of oriental medicines.

A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder (견관절부 외상후 발생된 Shoulder-Hand Syndrome)

  • Jeon, Jae-Soo;Lee, Sung-Keun;Song, Hoo-Bin;Kim, Sun-Jong;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.155-166
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    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

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