• Journal of Ginseng Research
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• v.46 no.4
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• pp.515-525
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• 2022

Background: The incidence of ischemic cerebrovascular disease is increasing in recent years and has been one of the leading causes of neurological dysfunction and death. Ginsenoside Rg1 has been found to protect against neuronal damage in many neurodegenerative diseases. However, the effect and mechanism by which Rg1 protects against cerebral ischemia-reperfusion injury (CIRI) are not fully understood. Here, we report the neuroprotective effects of Rg1 treatment on CIRI and its possible mechanisms in mice. Methods: A bilateral common carotid artery ligation was used to establish a chronic CIRI model in mice. HT22 cells were treated with Rg1 after OGD/R to study its effect on [Ca²⁺]_i. The open-field test and poleclimbing experiment were used to detect behavioral injury. The laser speckle blood flowmeter was used to measure brain blood flow. The Nissl and H&E staining were used to examine the neuronal damage. The Western blotting was used to examine MAP2, PSD95, Tau, p-Tau, NOX2, PLC, p-PLC, CN, NFAT1, and NLRP1 expression. Calcium imaging was used to test the level of [Ca²⁺]_i. Results: Rg1 treatment significantly improved cerebral blood flow, locomotion, and limb coordination, reduced ROS production, increased MAP2 and PSD95 expression, and decreased p-Tau, NOX2, p-PLC, CN, NFAT1, and NLRP1 expression. Calcium imaging results showed that Rg1 could inhibit calcium overload and resist the imbalance of calcium homeostasis after OGD/R in HT22 cells. Conclusion: Rg1 plays a neuroprotective role in attenuating CIRI by inhibiting oxidative stress, calcium overload, and neuroinflammation.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.12 no.1
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• pp.23-34
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• 2012

Purpose: Acute symptomatic seizures are caused by structural changes, inflammation or metabolic changes of brain, such as tumor, stroke, meningitis, encephalitis and metabolic disorders. Inherited metabolic disorders that can cause seizures are organic acidopathies, lysosomal storage disorders, peroxisomal disorders and mineral disorders. We have done this study to find out the importance of organic acidopathies causing seizure disorders in Korean childhood and adolescent patients. Method: Retrograde analysis for 1,306 patients with seizure disorders whose clinical informations are available and have done urine organic acid analysis for 5 years period, between Jan. 1st 2007 to Dec. 31th 2011. Statistical analysis was done with Student's t test using SPSS. Result: Out of 1,306 patients, 665 patients (51%) showed abnormalities on urine organic acid analysis. The most frequent disease was mitochondrial respiratory chain disorders (394, 30.1%), followed by mandelic aciduria (127, 9.7%), ketolytic defects (81, 6.2%), 3-hydroxyisobutyric aciduria (19, 1.4%), glutaric aciduria type II (10, 0.8%), ethylmalonic aciduria (4), propionic aciduria (4), methylmalonic aciduria (3), glutaric aciduria type I (3), pyruvate dehydrogenase deficiency (3), pyruvate carboxylase deficiency (3), isovaleric aciduria (2), HMG-CoA lyase deficiency (2), 3-methylcrotonylglycinuria (2), fatty acid oxidation disorders (2), fumaric aciduria (1), citrullinemia (1), CPS deficiency (1), MCAD deficiency (1). Conclusion: On neonatal period, mandelic aciduria due to infection was found relatively frequently. Mitochondrial disorders are most frequent etiologic disease on all age group, followed by ketolytic defects and various organic acidopathies. The number and diversities of organic acidopathies emphasize meticulous evaluation of basic routine laboratory examinations and organic acid analysis with initial sample on every seizure patient.

• Journal of Sasang Constitutional Medicine
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• v.16 no.1
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• pp.120-129
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• 2004

Yangkyuk-Sanhwa-Tang(YST) has been widely used as a formula for the Soyangin cerebral infarction (CI) patients according to Sasang constitutional philosophy. Brain cells produce cytokines and chemokines during the inflammatory process after stroke both in animal models and in patients. Previously, regulation of serum cytokine levels by YSThas been observed in individuals at the acute stage of CI disease, but there have not been other scientific investigations on YST. The author investigated the effect of YST on theproduction of various cytokines using peripheral blood mononuclear cells (PBMCs)from the Soyangin (CI) patients, and Soyangin normal group. The cytokine production was analyzed using enzyme-linked immunosorbent assay (ELISA). The amount of interleukin (IL)-1, IL-1, IL-6, IL-8, and tumor necrosis factor (TNF)- in culture supernatant significantly increased in the LPS-treated cells compared with unstimulated-cells (P < 0.05). However, in LPS-stimulated PBMCs, cytokines level in CI patients group was higher than that of normal group. YST (1 mg/ml) significantly inhibited IL-1, IL-1, and IL-8 production in PBMCs stimulated with LPS (about 85% for IL-1, 87% for IL-1, and 53% for IL-8, P < 0.05), but did not significantly inhibit IL-6 and TNF- production in the CI patients group. We also show that YST significantly increased LPS-induced IL-1, IL-6, and TNF- production in the normal group. Thesedata suggest that YST has a regulatoryeffect on the cytokine production, which might explain its beneficial effect in the treatment of CI.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.790-798
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• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.5-24
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• 1997

Clinical observation was made on 226 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1995. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in spring and summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through vestern medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission. the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 6.4 days and with cerebral hemorrhage 9.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.441-446
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• 2009

Background: Side clamping of ascending aorta during proximal graft anastomosis in coronary bypassing surgery in-creases the risk of direct aortic injury as well as embolization of intimal atheroma. Heartstring proximal sealing system (Guidant Corporation, Santa Clara, Calif), developed to avoid aortic side clamping, may minimize risks of such complications. The aim of the current study is to compare the surgical outcomes of the two proximal anastomosis techniquesi.e., Heartstring system versus aortic side clamping in off pump coronary bypassing' surgery (OPCAB). Material and Method: From January 2003 to August 2008, 499 patients underwent OPCAB. Of them, proximal graft anastomosis was performed using Heartstring system in 182 patients (Group I) and conventional manual anastomosis in 317 patients (Group II). The two groups were compared for postoperative major complications and mortality. Result: Two groups showed similar characteristics in terms of preoperative demographic data, left ventricular ejection fraction, renal function and history of diabetes, hypertension and smoking. Although there was no inter-group difference in the history of cerebral ischemia (p=0.48), preoperative brain magnetic resonance angiography revealed greater incidence of severe carotid artery stenosis (>75% of lumen) in the Group I than in the. Group II (44.5% in the Group I and 30.0% in the Group II, p=0.003). There were no inter-group differences in postoperative mortality (p=0.40) and complications (p=0.47) including neurologic events (3 in the Group land 2 in the Group II, p=0.258). Whereas neurologic events all comprised transient ischemic attacks in the Group I, they comprised multiple embolic strokes in the Group II. One patient in the Group II experienced aortic dissection during proximal anastomosis which resulted in ascending aortic replacement. Conclusion: Although proximal anastomosis using Heartstring system did not show statistically significant benefit over aortic side clamping, the. absence of embolic stroke maybe a definite benefit which may be better defined through further studies over a larger cohort.

• The Journal of Korean Medical History
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• v.24 no.1
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• pp.43-56
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• 2011

Everyone once in a life experience headaches as symptoms are very common. According to a study in a country of more than a week and as many as those who have experienced a headache amounts to 69.4%. In addition, the high reported prevalence of migraine in 30s for 80% of all migraine sufferers daily life interfere with work or was affected. In Western medicine, the cause of headaches is traction or deformation of pain induced tissue like scalp, subcutaneous tissue, muscle, fascia, extracranial arteriovenous, nerves, periosteum. But it turns out there are not cause why pain induced tissue is being tracted or deformated. Therefore, most of the western-therapy is mainly conducted with regimen for a temporary symptom reduction. Therefore, I examined how it has been developed in Chinese Ming Dynasty, the perception of headache, change in disease stage and an etiological cause. Oriental medicine in the treatment of headache is a more fundamental way to have an excellent treatment. The recognition of head in "素問($s{\grave{u}}$ $w{\grave{e}}n$)" and "靈樞($l{\acute{i}}ng$ $sh{\bar{u}}$)" began to appear in 'Soul-神($sh{\acute{e}}n$) dwelling place' and 'where to gather all the Yang-'諸陽之會($zh{\bar{u}}$ $y{\acute{a}}ng$ $zh{\bar{i}}$ $hu{\grave{i}}$)'. Also, head was recognized as '六腑($li{\grave{u}}f{\check{u}}$) 淸陽之氣($q{\bar{i}}ng$ $y{\acute{a}}ng$ $zh{\bar{i}}$ $q{\grave{i}}$) and 五臟($w{\check{u}}$ $z{\grave{a}}ng$) 精血($j{\bar{i}}ng$ $xu{\grave{e}}$) gathering place'. More specific structures such as the brain is considered a sea of marrow(髓海-$su{\check{i}}$ $h{\check{a}}i$) in "內經($n{\grave{e}}i$ $j{\bar{i}}ng$)" and came to recognized place where a stroke occurs. Accompanying development of the recognition about head, there had been changed about the perception of headache and the recognition of the cause and mechanism of headache. And the recognition of headache began to be completed in Ming Dynasty through Jin, Yuan Dynasty. Chinese Ming Dynasty, specially 樓英($l{\acute{o}}u$ $y{\bar{i}}ng$), in "醫學綱目($y{\bar{i}}xu{\acute{e}}$ $g{\bar{a}}ngm{\grave{u}}$)", first enumerated prescription in detail by separating postpartum headache. and proposed treatment of headache especially due to postpartum sepsis(敗血-$b{\grave{a}}i$ $xu{\grave{e}}$). 許浚($x{\check{u}}$ $j{\grave{u}}n$) accepted a variety of views without impartial opinion in explaining one kind of headache in "東醫寶鑑($d{\bar{o}}ng-y{\bar{i}}$ $b{\check{a}}oji{\grave{a}}n)$" 張景岳($zh{\bar{a}}ng$ $j{\check{i}}ng$ $yu{\grave{e}}$), in "景岳全書($j{\check{i}}ng$ $yu{\grave{e}}$ $qu{\acute{a}}nsh{\bar{u}}$)", established his own unique classification system-新舊表裏($x{\bar{i}}nji{\grave{u}}$ $bi{\check{a}}ol{\check{i}}$)-, and offered a clear way even in treatment. Acupuncture treatment of headache in the choice of meridian has been developed as a single acupuncture point. Using the classification of headache to come for future generation as a way of locating acupoints were developed. Chinese Ming Dynasty, there are special treatments like 導引按蹻法($d{\check{a}}o$ y ${\check{i}}n$ ${\grave{a}}n$ $ji{\check{a}}o$ $f{\check{a}}$), 搐鼻法($ch{\grave{u}}$ $b{\acute{i}}$ $f{\check{a}})$, 吐法($t{\check{u}}$ $f{\check{a}}$), 外貼法($w{\grave{a}}i$ $ti{\bar{e}}$ $f{\check{a}}$), 熨法($y{\grave{u}}n$ $f{\check{a}}$), 點眼法($di{\check{a}}n$ $y{\check{a}}n$ $f{\check{a}}$), 熏蒸法($x{\bar{u}}nzh{\bar{e}}ng$ $f{\check{a}}$), 香氣療法($xi{\bar{a}}ngq{\grave{i}}$ $li{\acute{a}}of{\check{a}}$). Most of this therapy in the treatment of headache, it is not used here, but if you use a good fit for today's environment can make a difference.