• Korean Journal of Oriental Medicine
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• v.2 no.1
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• pp.26-39
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• 1996

The literatual study on the therapy for clearing away heat with apoplexy therapy, the result were obstained as follows. 1. In apoplexy therapy, therapy for clearing away heat is used excessive heart - fire by overacting of the five emotions, liver fire, deficiency of kidney - fluid, wind - heat. 2. The fire of aetiology of apoplexy is used therapy for clearing away eat, in aspect of viscera and bowels, divied into heart - fire, liver - fire, deficiency fie of kidney yin, wetness - phlegm of spleen heat. The treatment is clear away heart - fire, clear away liver - fire, clear away spleen - heat and sthenic water. 3. Symptom of excessiveness symptom - complex is used therapy for clearing away heat that are fever, flushed face, halitosis, heart burn, easy anger, apoplestic stroke, unconsciouness, trismus, paralysis, constipation, red tongue with yellow coat, taut - smooth pulse or full - rapid pulse and symptom of insufficiency symptom - complex that are dizziness, tinitus, blurring of vision, deficiency sleeping, dreaminess, lassitude of the loins and legs, hemiplegia, red tongue with white coat or thin - yellow coat taut - thready - rapid pulse. 4. Therapy for norish vital essence - clearing away heat is availed in excessive fire caused by deficiency of yin of the liver and kidney, therapy for break through phlegm - clearing away heat in stagnant heat therapy for waking up a patient from unconsciousness - clearing away heat in yang type sthenia - syndrom of coma of apoplexy involving viscera and bowels. 5. Commonly used recipes of therapy for clearing away heat are Yang gyolksan(凉膈散), Bang pongtongseongsan(防風通聖散), Sotongseongsan(小通聖散), Jibodan(至寶丹), Supungsungisan(搜風順氣散), Woowhangchengshimwhan(牛黃淸心丸), Chengungsekgong(川芎石膏湯), Samwhatang(三化湯) etc in excessiveness symptom- complex, and are Yukmijiwhangweon(六味地黃元), Jiwhangtang(地黃湯), Palmiji whangtang(八味地黃湯), Samultanggagam(四物湯加減) etc in insufficiency symptom - complex.

• The Journal of Korean Medicine
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• v.25 no.3
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• pp.32-44
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• 2004

Objectives : This study was undertaken to prove the effect of GSHT on the glutamate receptor, free radical and brain damage in rats subjected to brain ischemia Methods : Levels of cultured cortical neuron death caused by toxic chemicals were measured by LDH release assay. Neuroprotective effects of GSHT on brain tissues were examined in vivo by ischemic model of middle cerebral artery (MCA) occlusion. Results : GSHT showed significant inhibitory effect on LDH release induced by NMDA-kinate-Fe/sup 2+/. GSHT remarkably decreased coma duration time in a nonfatal dose of KCN and showed higher survival rate in a fatal dose. GSHT remarkably decreased ischemic area and edema induced by the MCA blood flow block. GSHT showed high improvement of forelimb and hind limb test after MCA occlusion in neurological examination. GSHT showed no significant change after MCA occlusion in pathological observation of the normal group. Conclusions : These results indicate that GSHT can be used to treat the brain damage caused by brain ischemia. Further study will be needed about the functional mechanism, etc.

• Clinical and Experimental Pediatrics
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• v.54 no.6
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• pp.234-240
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• 2011

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system (CNS) that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI) are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS). Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.242-247
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• 2009

Purpose: Trauma is an important cause of death in children. In particular, the liver is the second most commonly organ injured by blunt abdominal trauma. Treatment of patients with liver injury is has changed, and non-operative treatment is the major treatment method at present. In this study, we reviewed traumatic liver injury in pediatric patients. Methods: Seventy-seven patients younger than 16 years of age with traumatic liver injury were assessed for 10 years from July 1999 to June 2009 at Wonju Christian hospital. Records of the patients were reviewed retrospectively. Demographic and clinical data were analyzed. Results: The median age was 6 years, and the male-to-female ratio was 1.2 : 1. The most common injury grade was grade I. The majority of injuries were caused by was traffic accidents, and the second most common cause of injuries was falls. Twenty-four patients had liver injuries alone, and the most common accopaning injury was a lung injury. The average hospital stay was 20.7 days, and the average ICU stay was 4.8 days. Four patients died (5.2%). There were 6 patients with under 10 points on the Glasgow coma scale (GCS). Among these patients, three died. All mortality cases had over 16 points on the Injury Severity Score (ISS). Two patients were treated surgically, one of whom died. Of the 75 patients with non-operative management, three died due to associated injuries. Conclusion: Most pediatric patients with liver injury have good results with non-operative management. Associated injuries and hemodynamic instability are predictive of patient outcome, and those with isolated liver injuries can be successfully managed non-operatively.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.134-141
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• 2009

Purpose: Patients with traumatic brain injury (TBI) were referred from other hospitals for further management. In addition, patients routinely underwent computed tomography examinations of the head (HCT) in the referral hospitals. The purpose of this study was to evaluate retrospectively the utility of routine HCT scans according to the severity of TBI. Methods: Patients with TBI referred to our hospital between December 2005 and July 2008 were included in this study. We investigated HCT findings, indications for repeat HCT examinations (routine versus a neurological change), and neurosurgical interventions. The head injury severity was divided into three categories according to the Glasgow Coma Scale (GCS) score, including mild, moderate, and severe TBI. The use of neurosurgical interventions between patients who underwent routine HCT scans and patients who underwent HCT scans for a neurological change were compared according to the severity of TBI. Results: A total of 81 patients met the entry criteria for this study. Among these patients, 67%(n=54) of the patients underwent HCT scans on a routine basis, whereas 33%(n=27) of the patients underwent HCT scans for a neurological change. A total of 21 patients showed signs of a worsening condition on the HCT scans. Neurosurgical intervention was required for 23(28.4%) patients. For patients who underwent routine HCT examinations, no patient with mild TBI underwent a neurosurgical intervention. However, one patient with moderate TBI and three(13%) patients with severe TBI underwent neurosurgical interventions. The kappa index, the level of agreement for HCT indications of intervention and referral reasons for intervention, was 0.65 for high hierarchy hospitals and 0.06 for low hierarchy hospitals. Conclusion: Routine serial HCT examinations in the referred hospitals would be useful for patients with severe head injury and for patients from low hierarchy hospitals where no emergency physicians or neurosurgeons are available.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.154-160
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• 2009

Purpose: This study aimed to determine new criteria for detecting independent factors with high sensitivity in cases of cervical spine injury. We compared the sensitivity, the specificity, and the false negative predictive value (NPV) of plain radiographs with those of computed tomography for cervical spine injury in patients with minor head injury. Methods: We retrospectively reviewed the cases of 357 patients who underwent both cervical plain radiographs and computer tomography from January 2006, to September 2008. Patients were divided into two groups: the cervical spine injury group and the no cervical spine injury group. New criteria were organized based on variables that had significant differences in the logistic regression test. Results: Among the 357 patients, 78 patients had cervical spine injuries. The average age was $43.9{\pm}15.2$ yrs old, and the male-to-female ratio was 1.90. The most common mechanism of injury was motor vehicle accidents. There was a significant difference in loss of consciousness, Glasgow Coma Scale (GCS)=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs between the two groups on the logistic regression test. New criteria included the above five variables. If a patient has at least variable, the area under the ROC curve of the new criteria was 0.850, and the sensitivity and the false NPV were 87.2% and 5.2%, respectively. Conclusion: New criteria included loss of consciousness, GCS=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs. If the patient had at least 1 variable, he or she could have a of cervical spine injury with a sensitivity of 87.2% and a false NPV of 5.2%.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.4
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• pp.702-706
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• 2010

The clinical manifestation of Hepatic encephalopathy is personality change, vacant behavior, lethargy, flapping tremor, muscle twitching, noisy, abusive, violent, coma. The purpose of this clinical study was done to report the improvement of hepatic encephalopathy after oriental medical treatment (herb-med, acupuncture, moxibustion). We applied Ukieum-ja and Sopungsungi-won to patient who had liver cirrhosis and hepatic encephalopathy. We examined the Change of CBC, LFT and Clinical Manifestation to evaluate the effectiveness of oriental medical treatment. We observed that oriental medical complex treatment decreased symtoms and improved general condition of a patient. So we report this clinical study to be helpful in treating patients of hepatic encephalopathy.

• Korean Journal of Pharmacognosy
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• v.36 no.1 s.140
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• pp.56-59
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• 2005

Urease plays an important role in the urea metabolism and the effect of urease activity on human and environment is enormous. For instance, urease acts as a virulence factor of the urinary and gastrointestinal tracts infections in human and animal, being involved in kidney stone formation, catheter encrusatation, pyelonephritis, ammonia encephalopathy, hepatic coma, and urinary tract infections. Widespread urease activity in soil induces a plant damage due to ammonia toxicity and pH increase. Therefore, urease activity regulation through urease inhibitors would lead to an enhanced efficiency of urea nitrogen uptake in plants and to the improved therapeutic strategies for ureolytic bacterial infections. To search for new inhibitory compounds on urease activity from herbs, MeOH extracts of herbs were screened. Among of them, the MeOH extracts of Areca catechu exhibited an excellent inhibitory effect on urease activity. Two compounds were isolated from the ethyl acetate fraction by the activity guided fractionation. Their chemical structures were identified as (+)-catechin(compound I) and allantoin(compound II) by spectroscopic evidence, respectively. Compound I showed a stronger inhibitory effect on urease activity than compound II.

• Korean Journal of Pharmacognosy
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• v.31 no.3
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• pp.310-319
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• 2000

WooHwangChungSimWon is a traditional prescription formula for treating with hypertension, arteriosclerosis, coma, and stroke in China, Korea, and Japan. In the new prescription of WooHwangChungSimWon, the civet is substituted for the musk, the major component of WooHwangChungSimwon, because of the prohibition law (CITES) on the commercial use of musk. We have made a comparative study of the effects on the hypertension and contractile force of heart between the musk-containing and civet-containing WooHwangChungSimWon. The SHR rats were used for investigating the effects on the hypertension and the rabbits were used for investigating effects on the contractile force of isolated heart. The blood pressure which was recorded during the adminstration period showed that all the samples except the low dose of musk-containing WooHwangChungSimWon decreased the blood pressure, and the effects on the heart works of all the samples were higher than control group, which resulted from the examination of isolated heart. These results suggest that all the musk-containing and civet-containing WooHwangChungSimWon formula have similar protective effects on hypertension and palpitation.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.235-243
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• 1992

Patterns of abnormality in regional cerebral perfusion and its relation to clinical severity was evaluated with 32 head injury patients using $^{99m}Tc-HMPAO$ single photon emission tomography (SPECT). The findings were compared with computed tomography (CT) done within 48 hours of each SPECT study. The initial SPECT study was done within 7 days of injury in 16 cases, between 1 week and 2 months in 12, and after over 2 months in 4. Nineteen of the patients underwent followup SPECT and CT after a mean interval of 1 to 2 months. The initial SPECT showed abnormalities in 96% (31/32) of the patients while CT showed abnormal findings in only 81% (26/32). There were a total of 54 supratentorial SPECT lesions in all. Ninity percent (49/54) of these were of regional hypoperfusion, while 5 lesions showed focal hyperperfusion. The lesions were most often localized in the frontal and temporal lobes. Fifty five percent (30/54) were areas not detected as a lesion on CT. Cerebellar diaschisis was observed in 50% (16/32) of the patients. The degree of perfusion abnormality was quantified by the product of differential activity and a size factor. Correlation between the degree of perfusion abnormality and the clinical severity (Glasgow coma scale) failed to show statistical significance (p=0.053). The amount of change in the degree of perfusion abnormality on follow up SPECT was compared to the amount of change in clinical severity. Perfusion abnormality showed a tendancy to improve in most patients, and the degree of improvement showed significant correlation with the amount of clinical improvement (p < 0.01).