• Journal of Trauma and Injury
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• v.28 no.3
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• pp.190-194
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• 2015

Blunt cerebrovascular injury is defined as a vertebral or carotid arterial structural wall injury resulting from nonpenetrating trauma. Complete traumatic internal carotid artery occlusion is very rare condition accounting for 0.08~0.4 0f all trauma patients and believed to be associated with the greatest risk of ischemic stroke reported in 50~90% in a few small series. A 55-year-male was admitted with drowsy mentality and severe headache after a fall down accident. Brain computed tomography showed a subdural hematoma at the both frontal area with a fracture of the occipital skull bone. Two days after admission, he suddenly complained with a right side hemiparesis of motor grade 2. Brain magnetic resonance diffusion demonstrated multiple high flow signal changes from the left frontal and parietal lesion. Computed tomographic angiogram (CTA) revealed absence of the left ICA flow. Trans femoral cerebral angiography (TFCA) showed complete occlusion of the left internal carotid artery (ICA) at ophthalmic segment in the left ICA angiogram and flows on the left whole hemispheric lesions through the anterior communicating artery in the right ICA angiogram. We decided to conduct close observations as a treatment for the patient because of acute subdural hematoma and sufficient contralateral cerebral flow by perfusion SPECT scan. Two weeks after the accident, he was treated with heparin anticoagulation within INR 2~4 ranges. He recovered as the motor grade 4 without another neurologic deficit after 3 months.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

• The Journal of Internal Korean Medicine
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• v.26 no.3
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• pp.692-698
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• 2005

Eczema is a general term for skin diseases showing itching, vessiculopapular eruption, and erythema when acute, or lichenification and scale if chronic. It is classified as irritant dermatitis, atopic dermatitis, seborrheic dermatitis, neurodermatitis, nummular eczema, statis dermatitis, infective dermatitis, xerotic eczema, and pompholyx by afflicted regions and symptoms. Therapy for eczema is allopathic, and includes application of ice- pack to erythema, and application of emollients and steroids to the affected parts during subacute or chronic stages. Eczema is understood as ulceration(瘡), tinea(癬), wind syndrome(風證), and dryness syndrome(燥證) in terms of oriental medicine. Xerotic eczema is understood in dryness syndrome. Nourishing blood(養血) therapy is used. This is a case study on which xerotic eczema occurred on a patient's afflicted left palm and fingers after stroke. The patient's xerotic eczema was attributed to dryness syndrome. Therefore, Samul-tang(四物湯) and Saenghyeoryunbu-eum(生血潤膚飮) were used for nourishing blood. This therapy was effective on eczema and accompanying symptoms such as dizziness and numbness of the left hand.

• Investigative Magnetic Resonance Imaging
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• v.15 no.2
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• pp.91-101
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• 2011

Perfusion magnetic resonance imaging (pMRI) is a special technique for evaluation of blood flow. Exogenous pMRI methods which are dynamic susceptibility contrast (DSC) and dynamic contrast-enhanced (DCE) use an intravenous bolus injection of paramagnetic contrast agent. In contrast, an endogenous pMRM method which is arterial spin labeling (ASL) use diffusible blood in body. In order to scan pMRI in human, technical optimizations are very important according to disease conditions. For examples, DSC is popularly used in patients with acute stroke due to its short scan time, while DSC or DCE provides the various perfusion indices for patients with tumor. ASL is useful for children, women who are expected to be pregnant, and in patients with kidney diseases which are problematic in nephrogenic systemic fibrosis (NSF). Perfusion MRI does not require any injection of radioisotopes. We expect that demand for perfusion MRI will be higher in evaluating drug efficacy and other treatment effects.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.2
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• pp.21-29
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• 2019

Background: The purpose of this study is to investigate the effect of the combined exercise program on the static balance ability of the lumbar instability of adults. Methods: The experimental group was divided into two groups and randomly. The experimental group 1 (Exp 1) applied the combined exercise program for the lumbar stabilization exercise and strengthening exercises and the experimental group 2 (Exp 2) applied the combined exercises program for the lumbar stabilization exercises and active stretching exercises. Each experiment group performed exercise program for 4 weeks, 3 times a week, 30 minutes a day. Static balance ability was measured using GOOD BALANCE system. Results: As the comparing results of static balance ability, normal standing eye open was Ant-Post and Med-Lat showed significant differences in Exp 1 (p<.05). One leg left eye open was velocity moment showed significant differences in Exp 1 (p<.05). and one leg right eye open was Med-Lat showed significant differences in Exp 1 (p<.05). Conclusion: These results show that thoracic self mobilization is immediate effective on balance and gait ability. Thus, thoracic self mobilization will help recovery of balance and gait ability in acute stroke patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.6
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• pp.1291-1296
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• 2002

Blood circulation of brain is divided into two major categories; anterior one from carotid artery and posterior one from vertebrobasilar artery. In stroke patients, it is important to diagnose which is involved, because there is many difference in the aspects of clinical menifestations and prognosis, especially in the acute stage. In some cases of vertebrobasilar infarction, such as Wallenberg's syndrome, charicteristic cranial nerve signs, eye movement disorders and cerebellar signs are appeared. And in Dejerine's syndrome, only pure motor or sensory defecits can be appeared without any brainstem signs. So It shoud be differenciated by Brain MRI from those of the cerebral hemisphere lesions. And in the cases that nausea, vomitting and dysphagia are the first menifestations, it is frequently misdiagnosed as internal medical disease, causing appropriate treatment delayed. In this case report, we are to describe the clinical menifestations and progresses of two cases of brainstem infarctions, review previously published case reports about them and compare them to our cases. The first is Dejerine's syndrome i.e. medial medullary infarction, the second is Wallenberg's syndrome i.e. lateral medullary infarction. Simultaneously we are to investigate the oriental medical approach in the bran stem infarctions.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.2
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• pp.186-194
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• 2014

The object of this study was to obtain acute toxicity information (single-dose oral toxicity) of Woohwangchungshim-won (WHCSW), a pill type herbal medicine used in Korean Medicine (KM) for treating stroke. In order to obtain the 50% lethal dose (LD50), approximate lethal dosage (ALD) and target organs, WHCSW powders were once orally administered to female and male ICR mice at dose levels of 2,000, 1,000, 500 and 0 (control) mg/kg (body weight.) according to the recommendation of Korea Food and Drug Administration (KFDA) Guidelines (Notification No. 2009-116). The mortality and changes in the body weight, clinical signs and gross observation were monitored for 14 days after single-dose oral administration of WHCSW according to KFDA Guidelines with organ weights and histopathological changes were observed in 12 principle organs. After single-dose oral administration of WHCSW, we could not find any mortality and toxicological evidences up to 2,000 mg/kg-administered group, except for some accidental findings and dose-independent increases of body weight gains in female 1,000 and 500 mg/kg-administered female mice. The results obtained in this study suggest that the LD50 and ALD of WHCSW in both female and male mice after single-dose oral administration were considered as over 2,000 mg/kg because no mortalities were detected up to 2,000 mg/kg that was the highest dose recommended by KFDA and Organization for Economic Co-Operation and Development (OECD), and can be safely used in clinics.

• Journal of the Korea Convergence Society
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• v.6 no.5
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• pp.287-294
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• 2015

The purpose of this study, was Let's examine the exposure dose at the time of cerebral blood flow CT scan of acute ischemic stroke patients. In particular, long-term high doses of radiation sensitive organs and we Measured using phantom and a glass dosimeter. Apply the existing protocol suggested by the manufacturer (fixed time delay technique) and the proposed new convergence protocol (bolus tracking technique), reporting to measure the dose, dose reduction was to prepare the way. Results up to 39.8% as compared to the existing protocols in a new suggested convergence protocol, a minimum of 5.8% was long-term dose is reduced. Test dose of $CDTI_{vol}$ and DLP values decreased 25%, respectively, were measured at less than recommended dose. Try checking the protocol set out in the existing based on the analysis result of the above, by applying the proposed new convergence protocol by reducing the dose would have to contribute to improved public health. It is believed to be research continues to find the optimum protocol in the other tests.

• Reproductive and Developmental Biology
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• v.35 no.2
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• pp.167-174
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• 2011

Acute ischemic stroke results from sudden decrease or loss of blood supply to an area of the brain, resulting in a coinciding loss of neurological function. The antioxidant action of melatonin is an important mechanism among its known effects to protective activity during ischemic/reperfusion injury. The focus of this research, therapeutic efficacy of melatonin on recovery of neurological function following long term treatment in ischemic brain injured rats. Male Sprague-Dawley rats (n=40; 8 weeks old) were divided into the control group, and MCAo groups (Vehicle, MT7 : MCAo+ melatonin injection at 7:00, MT19 : MCAo+melatonin injection at 19:00, and MT7,19 : MCAo+melatonin injection at 7:00 and 19:00). Rat body weight and neurological function were measured every week for 8 weeks. After 8 weeks, the rats were anesthetized with a mixture of zoletil (40 mg/kg) and xylazine (10 mg/kg) and sacrificed for further analysis. Tissues were then collected for RNA isolation from brain tissue. Also, brain tissues were analyzed by histological procedures. We elucidated that melatonin was not toxic in vital organs. MT7,19 was the most rapidly got back to mild symptom on test of neurological parameter. Also, exogenous melatonin induces both the down-regulation of detrimental genes, such as NOSs and the up-regulation of beneficial gene, including BDNF during long term administration after focal cerebral ischemia. Melatonin treatment reduced the loss of primary motor cortex. Therefore, we suggest that melatonin could be act as prophylactic as well as therapeutic agent for neurorehabilitative intervention.

• Korean Journal of Pharmacognosy
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• v.42 no.2
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• pp.175-181
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• 2011

Oxidative stress or accumulation of reactive oxygen species (ROS) leads neuronal cellular death and dysfunction, and it contributes to neuronal degenerative disease such as Alzheimer's disease, Parkinson's disease and stroke. Glutamate is one of the major excitatory neurotransmitter in the central nervous system (CNS). Glutamate contributes to fast synaptic transmission, neuronal plasticity, outgrowth and survival, behavior, learning and memory. In spite of these physiological functions, high concentration of glutamate causes neuronal cell damage, acute insults and chronic neuronal neurodegenerative diseases. Heme oxygenase-1 (HO-1) enzyme plays an important role of cellular antioxidant system against oxidant injury. NNMBS020, the water-insoluble fraction of the 70% EtOH extract of root barks of Dictamnus dasycarpus, showed dominant neuroprotective effects on glutamate-induced neurotoxicity in mouse hippocampal HT22 cells by induced the expression of HO-1 and increased HO activity. In mouse hippocampal HT22 cells, NNMBS020 makes the nuclear accumulation of Nrf2 and stimulates extracellular signal-regulated kinase (ERK) pathway. The ERK MAPK pathway inhibitor significantly reduced NNMBS020-induced HO-1 expression, whereas the JNK and p38 inhibitors did not. In conclusion, the water-insoluble fraction of the 70% EtOH extract of root barks of D. dasycarpus (NNMBS020) significantly protect glutamate-induced oxidative damage by induction of HO-1 via Nrf2 and ERK pathway in mouse hippocampal HT22 cells.