Leptin has a close correlation with obesity, which is known to be a major factor for stroke. This study was performed to determine whether serum leptin level would be an independent risk factor for stroke and whether it would change significantly early after stroke. Subjects were selected from those within I month after onset and non-stroke referents at Kyung Hee Oriental Medical Center in Seoul, Korea. We compared leptin and the other characteristics between stroke subjects and referents. Body mass index, hypertension history, presence of drinking and smoking, waist/hip ratio, total cholesterol and triglyceride were recorded. To assess odds ratio of leptin for stroke, we used logistic regression analysis. Leptin was rechecked 2 weeks later and compared with the former value in acute stroke subjects. In this study, serum leptin did not differ significantly between stroke subjects and referents, and its odds ratio was not significant in male (OR=0.52, 95％ Cl; 0.13-2.08) and female (OR=1.57, 95％ Cl; 0.53-4.67). In acute stroke subjects, leptin did not change significantly 2 weeks later. Hypertension had a significant odds ratio in male (OR=3.39, 95％ Cl; 1.02-11.24) and female (OR=12.37, 95％ Cl; 3.67-41.65). High waist/hip ratio was only in female (OR=6.70, 95％ Cl; 1.73-26.02). In conclusion, leptin was not an independent risk factor for stroke and its serum level did not change significantly early after stroke. Hypertension and waist/hip ratio had significant relative risks.

To investigate the relative risk of obesity factors for stroke imd their correlation, we assessed odds ratio of obesity factors for stroke by univariate and multivariate logistic regression analysis. Correlations among obese factors were estimated by Pearson's correlation test. Study subjects were selected stroke Subjects within 1 month after onset and non-stroke referents in Kyung Hoo Medical Center in Seoul. Body mass index, hypertension history, habits of drinking and smoking, waist/hip ratio, total cholesterol and triglyceride were checked once at baseline. In this study, there was no significant difference between referents and stroke subjects in general characteristics except. waist/hip ratio and hypertension. By logistic regression, high waist/hip ratio (OR=7.05; 95％ Cl, 1.70-29.1l) and hypertension (OR=12.90; 95％ Cl, 3.63-45.61) had significant odds ratio in females, as did hypertension (OR=3.36; 95％ Cl, 1.01-11.16) in males. Much more significant correlations among obesity factors were found in stroke subjects than referents. In conclusion, waist/hip ratio was an independent risk factor for stroke in females, and hypertension was a predictor of stroke in all lenders. Interaction of obesity factors could be an important condition for stroke.

Purpose : This study examined the effect of Tongbiyeum (TBY) on rats with fatty livers. Methods : After administration of TBY extracts to rats with fatty livers, body weight, liver weight, serum, cholesterol, TG, HDL-cholesterol were measured, and histopathological changes were observed. Results : In proportion to density, TBY decreased liver weight and serum TG levels and suppressed fat accumulation and liver cell death, but increased serum HDL levels in comparison with those of controls. Conclusion : TBY might be considered to be used to control fatty liver by inhibiting absorption and storage of TG.

Background and Purposes : Smoking is a well-known risk factor for ischemic stroke. It may contribute to s1Toke by inducing the aggregation of platelets and formation of atheroma, reducing cerebral blood flow, and increasing fibrinogen. However, the relative risk varies according to different ethnicity and area. Therefore, we performed this study to assess the risk of smoking for ischemic s1Toke in Korea. Methods : Cigarette smoking habit was studied in 308 patients with ischemic s1Toke and in 348 age- and sex-matched control subjects who had no history of stroke using case control methods. In multiple logistic regression analysis, smoking had a significant value of odds ratio adjusted for hypertension, diabetes mellitus, and hyperlipidemia. Results : The adjusted odds ratio (AOR) and 95％ confidence interval (CI) was significant in the medium smokers (AOR, 1.92; 95％ CI, 1.11 to 3.33: p< 0.05) and heavy smokers (AOR, 2.80; 95％ CI, 1.64 to 4.78: p< 0.05). Furthermore, the OR was higher in hypertensive subjects than in normotensive subjects compared to non-smokers (AOR, 1.98; 95％ CI, 1.01 to 3.85: p< 0.05). Conclusions : Our findings suggest that smoking is an independent risk factor for ischemic stroke in Korea.

lridology, a form of complementary and alternative medicine (CAM), is the diagnosis of medical conditions through noting irregularities of the pigmentation in the iris. lridological constitution has a strong familial aggregation and is implicated in heredity. Apolipoprotein E (apoE) gene polymorphism is one of the most well studied genetic markers of vascular disease. I investigated the relationship between iridological constitution and apoE polymorphism. I classified 87 hypertensive patients with family history of cerebral infarction and 79 controls according to iris constitution, and determined apoE genotype. Neurogenic type in hypertensives was 32.2% compared with 16.5% in controls (P<0.001). No differences in the apoE genotypes frequencies were observed in patients compared with those in controls ($x^2=0.726$, df-=2, P=0.696). However, in a population with ${\varepsilon}3/{\varepsilon}4$ genotype, the frequency of neurogenic constitution was significantly higher in hypertensives than in controls (60% vs. 0%) ($x^2=5.265$, df=l, P=0.022). These results could imply that apoE ${\varepsilon}3/{\varepsilon}4$ genotype and neurogenic iris constitution are risk factors for hypertension.

This study was designed to investigate the modulation of the Corydalis tuber on glycine-activated ion current in rat periaqueductal gray (PAG) neurons. Aqueous extract from Corydalis tuber has been widely used for pain control such as dysmenorrhea, irregular menstruation or amenorrhea with abdominal cramping, neuralgia, headache and gastrointestinal spasm. The PAG region of the brain is known to be involved heavily with nociception. Modulation of the Corydalis tuber on glycine-induced ion current in rat periaqueductal gray (PAG) neurons was studied by a nystatin-perforated patch-clamp technique. High concentrations of Corydalis tuber elicited ion current, which was suppressed by strychnine application. Low concentrations of Corydalis tuber reduced glycine-induced ion currents in the PAG neurons. Inhibitory action of Corydalis tuber on glycine-activated ion current was reduced by treatment with naltrexone, a non- selective opioid antagonist. Application of N-methylmalemide (NEM), a sulfhydryl alkylating agent, also reduced the inhibitory action of Corydalis tuber on glycine-activated ion current in the PAG neurons. These results suggest that the inhibitory effect of Corydalis tuber on glycine-activated ion current in the PAG neurons is one of the analgesic mechanisms of the Corydalis tuber, which may activate descending pain control system in PAG neurons.

Drynariae Rhizorna (DR), an herbal medicine known for its effect to purify blood quality and improve circulation, frequently appears as the main ingredient in prescriptions for bone injuries. Currently, how pharmacologically it contributes to the reformation of bone is unclear. In the present study, the effect of the aqueous extract of DR on bone cells was investigated in vitro for the first time. The human osteoprecursor cells (OPC-I) were incubated in the medium with different concentrations of the aqueous extract of DR and the cell proliferation was studied. When the concentration of DR aqueous extract was $<120{\;}\mu\textrm{g}/ml$, the proliferation of OPC-I was enhanced. However, the proliferation of OPC-I was inhibited by DR extract with the concentrations $>250{\;}\mu\textrm{g}/ml$. Under most treatments, the cells presented very pale expression for cyclooxygenase-2 (Cox 2) protein; a slightly intensified band showed at the highest DR concentration, 1.0 mg/ml during the course of culture. From the results, it was concluded that the aqueous extract of DR was found to directly stimulate the proliferation, alkaline phosphatase (ALP) activity, protein secretion and particularly type I collagen synthesis of OPC-I at dose-dependent manner.

Objectives : This study aimed to elucidate the effects of TBE on hyperlipidemia. Methods : We studied the effects of TBE on hyperlipidemia through gene expressions related with lipid metabolism and serum triglyceride as well as total and HDL-cholesterol levels, and perceived histological changes. Results : The present studies demonstrate that TBE can reduce the rise in plasma cholesterol and TG levels induced by a high-cholesterol diet and also reverse pre-established hypercholesterolemia and hypertriglycemia. In the TBE group total cholesterol levels decreased, TG levels decreased, but HDL-cholesterol levels also decreased. In the analysis of absolute and relative liver weight, TBE inhibited the weight gain induced by a high-cholesterol diet. In the histological observations, lipid droplet and apoptotic change in the TBE treated group were less compared with the control group. In the serum biochemical analysis, a difference of serum AST and ALT changes among groups was not shown, but TG and total cholesterol levels were less and HDL level decreased compared with the control group. In the gene expression related with TG and cholesterol metabolism, DGAT decreased slightly but ACAT decreased more as compared with control and Lipidil groups. Conclusion : From this study, we can infer that TBE possesses a hypolipidemic effect by inhibiting the intestinal absorption and storage of exogenous and endogenous cholesterol.

Background and Purpose : Allergic rhinitis is a well-known, relatively controllable chronic disease. Although a number of methods for treating allergic rhinitis have been tried, many patients have not been satisfied with their treatment. Therefore, this study tried to evaluate the effect of a cooperative system of Oriental and Western medicine and to develop a new diagnosis protocol for treatment of allergic rhinitis. Methods : We measured improvement rate and acoustic rhinometry after the allergeninduction test and performed a filter paper test as a nonspecific hypersensitivity test with 60 patients who are allergic to house dust mite. Patients were divided into two groups, one treated with Western medicine only and one treated with both Western and Oriental herbal medicine. For the group with Western medicine only, antihistamine for one week and local steroid medicine for two weeks were prescribed. For the group with combined medicine, Oriental herbal medicine was prescribed according to the patient s constitution, along with Western medicine. After all treatments, the above tests were re-performed and the improvement rate was compared. Results and Conclusion : We observed better results in the group treated with both Western and Oriental herbal medicines, comparing improvement rate and the alteration of total nasal volume through acoustic rhinometry after the allergen induction test. In the filter paper test, there was no significant difference between the two groups. In conclusion, we showed the additive effect of Oriental herbal medicine without any severe side effects compared with treatment with Western medicine only. In this study, we set only two patient groups, but further study is required to create various experimental groups and compare among them. We suggest that it might enhance understanding of the improved effect of Oriental herbal medicine in the therapy of allergic rhinitis.

So-Hap-Hyang-Won, a traditional oriental medicine used in the treatment of stroke patients, was examined for its ability to reverse the cell damage caused by lipid peroxidation products and oxidative stress in bovine aortic endothelial cells (BAEC). The effects of herbal medicine on cell proliferation and recovery of oxidative damaged situation were studied in BAEC, which was considered an appropriate in vitro model for stroke resulting from various vascular diseases prevalent in advanced age. In a clinical study of stroke patients, So-Hap-Hyang-Won appeared to improve considerably arm and leg movements as well as consciousness disturbance condition, compared with other traditional medicines used for stroke. When BAEC were treated with extracts of the lyophilized herbal medicines, only that of So-Hap-Hyang-Won stimulated cell proliferation and showed no toxicity even at high concentrations. In studies of BAEC treated with extracts of the lyophilized material of the 14 components of So-Hap-Hyang-Won, only the extract of Foeniculi Fructus stimulated cell growth at all concentrations tested. Moreover, when cells were treated with Foeniculi Fructus (10 and 100 mg/ml) extract after prior exposure to t-BHP ($l0\mu\textrm{M}$) or HNE ($0.2\mu\textrm{M}$), lipid peroxidation products which are known to be involved in aging and vascular diseases, or after the exposure to SIN-l ($500\mu\textrm{M}$), which generates nitric oxide (NO) and other reactive oxygen species, there was substantial recovery from the oxidative damage, presumably due to the radical-scavenging effect of Foeniculi Fructus extract. Foeniculi Fructus not only showed stimulatory effects on cell growth and cell damage repair in BAEC, but also appeared to show the most anti-aging activity among all the herbal components of So-Hap-Hyang-Won.

Objective : To examine the inhibition of 5-Hydroxytryptamine(5-HT) induced vasocontraction of the water extract of Acanthopanax senticosus Harms roots (ASR) on rat thoracic Aorta and mesenteric artery with and without endothelium. Methods : Segments of thoracic aorta and mesenteric artery obtained from rats immediately after delivery were mounted in organ baths superfused on a polygraph. Results : We found that the thoracic aorta segments responded to the water extract of ASR with a dose-dependent and concentration-dependent vasorelaxation. 5-HT produced a concentration-dependent contraction of the thoracic aorta and mesenteric artery. At high concentrations of ASR, the inhibition responses were 93.7% (Jang-su), 93.5% (Heok-ryong-kang-sung), 92.8% (Mt. Back-doo), and 83.5% (Yeon-byun) of the maximum 5-HT induced contraction. At high concentrations of ASR, the relaxational response at thoracic aorta and mesenteric artery wi1h endothelium were 95.2% and 94.6%; without endothelium were 93.5% and 92.5% of 1he maximum 5-HT induced contraction. Conclusions : In conclusion, the effect of water extract of ASR had potent inhibition at 5-HT and the effect of ASR in isolated thoracic aorta and mesenteric artery showed dose-dependent inhibition but endothelium-independent response.

Objectives: To examine the relaxational response to the water extract of Rheum palmatum L. and Rheum undulatum L. on rat thoracic aorta and abdominal aorta. Methods: Segments of thoracic aorta and abdominal aorta obtained from rats immediately after delivery were mounted in organ baths superfused on a polygraph. Results : We found that the thoracic aorta segments responded to the water extract of genus Rheum with a dose-dependent vasorelaxation. At $10^{-4}$ M 5-HT, the maximal contraction force was 93.5% of the maximum KCI-response. The 5-HT induced contractions at $10^{-4}$ M were inhibited by 86.4% and 62.1 % after addition of the high concentrations of R. palmatum root (RPR) and leaf (RPL) and R. undulatum root (RUR) and leaf (RUL). At 10 mg/ml RPR and RUR, the relaxational response at thoracic aorta and abdominal aorta with and without endothelium were 86.4%, 83.2%, 85.8%, and 62.1% of the maximum 5-HT induced contraction. Conclusion: Our result showed that RPL and RUL induced dose-dependent vasorelaxation on rat thoracic aorta and abdominal aorta, and that RPL and RUL roots have more potent effects than the leaves.

Background ＆ Aims : The aim of this study was to investigate the change of dominant power with observation of gastric myoelectrical activity and its parameter linkage in electrogastrography. Methods : Electrogastrography was performed on a total of 123 subjects (113 patients with functional dyspepsia, 10 healthy controls) for 30 min in fasting state and 50 min in postprandial state. Average myoelectrical activity per frequency and accumulated electrical activity of 5 min duration in each bradygastria, normogastria, and tachygastria were measured at the moment of frequency switchover of slow wave. Assumed parameter linkages were also investigated among dominant frequency, ％ of normal regularity, and dominant power (or power ratio). Results : Average myoelectrical activity per frequency was highest in bradygastria (mean 1.10-1.47 Volt/s), next highest in normogastria (mean 0.50-0.82 Volt/s), and lowest in tachygastria (mean 0.44-0.47 Volt/s). Average accumulated myoelectrical activity was highest in normogastria (mean 114.90-126.29 Volt/ss), next highest in tachygastria (mean 71.02-90.00 Volt/ss), and lowest in bradygastria (mean 12.93-51.94 Volt/ss). Significance of parameter linkages were noted in dominant frequency (p< 0.01) and in ％ of normal regularity (p< 0.01), but not in dominant power in case of frequency shift from bradygastria to normogastria (p=0.376). Conclusion : Dominant power is not a parameter that reflects the gastric myoelectrical activity related with only gastric contraction. Bradygastric dominant power does not follow the inter-parameter linkage of electrogastrography for gastric motility assessment.

The homozygous deletion allele of the angiotensin converting enzyme gene (ACF/DD), homozygous threonine allele of the angiotensinogen gene (AGN/TT), and the 4 allele of the apolipoprotein E gene (apoE/4) are reported to be associated with ischemic heart disease. Ischemic cerebrovascular disease (ICVD) is another atherosclerotic disease, and the effects of these polymorphisms on ICVD have been confusing. In this study, I investigated whether ACF/DD, AGN/TT, and apoE/4 genotypes are associated with ICVD and whether genetic risk is enhanced by the effect of one upon another. I ascertained these genotypes in patients with ICVD (n=121) diagnosed by brain computed tomography. Control subjects for the ICVD were randomly selected from subjects matched for age, gender, and history of hypertension with patients. Frequency of ACF/DD genotype was somewhat higher in the patients with ICVD than in the controls (18％ vs. 15％). Incidence of ICVD was higher in subjects with the apoE/4/4 genotype than in the other genotypes (50％ vs. 27-29％). Incidence of ICVD was much higher in subjects with the AGN/TT genotype than in AGN/MM genotype (36％ vs. 17％). Furthermore, the AGN/TT genotype greatly increased the relative risk for ICVD in the subjects with ACF/DD genotype (80.0％ vs. 20.0％, P=0.089). Finally, incidence of ICVD was much higher in the subjects with both apoE/2/4 and AGN/TT genotype than in the other genotypes (83.3％ vs. 16.7％, P=O.095). These results suggest that AGN/TT enhances the risk for ICVD associated with ACF/DD and apoE/2/4.

The association between apolipoprotein E (apo E) gene polymorphism and ischemic cerebrovascular disease (ICVD) has been controversial. These controversies may be due to inaccurate classification of patients and ethnic differences. We investigated the association between apo E genotypes and ICVD patients by case-control study in a Korean population. The association between apo E polymorphism and ICVD was examined in 121 patients with ICVD and 132 controls without ICVD. The E3/E4 phenotype was more frequent in control subjects (23.8％) than in patients (13.0％) (p<0.05). The E2/E3 phenotype was more frequent in patients (14.8％) than in control subjects (10.8％), but the difference was not statistically significant (p>0.05). These results suggest that the E4 allele may be a protective factor against early vascular morbidity, and the E2 allele may be a risk factor for cerebrovascular morbidity.

Object : This study was done to evaluate the inhibitory effect of Samul-tang (Siwu-tang) on collagen production by cultured murine hepatic non-parenchymal cells. Methods : Hepatic non-parenchymal cells were cultured from normal Sprague-Dawley rats and established in a primary cell culture on uncoated plastic culture plates. The Samul-tang (Siwu-tang) was treated into the cell culture media for 72 hours and the cells were harvested for analysis. Analyses were done on cell proliferation, [3H]thymidine incorporation assay and procollagen type IC-peptide. Results : The cultured cells resembled fibroblasts in shape and produced procollagen which is consistent to fibrogenesis in vivo. Proliferation of the non-parenchymal cells was inhibited slightly and the [3H]thymidine incorporation assay showed a dose-dependent decrease by Samul-tang (Siwu-tang) treatment. Production of procollagen type I C-peptide was decreased by low-concentration treatment of the Samul-tang (Siwu-tang), but increased by high-concentration treatment. Conclusion : It seemed that the cells were responding to the Samul-tang (Siwu-tang) in low-concentration, thus producing less collagen. However, when the drug was administered with high enough concentration to cause excessive stimulation of cells, it seemed that the activated cells might overly produce procollagen, the precursor of collagen, thus aggravating fibrosis of the liver. So, it is considered that the proper concentration of Samul-tang (Siwu-tang) is important when treating patients with liver cirrhosis based on the patients' status.

Objectives : Intracerebral hemorrhage (ICH) is one of the most devastating types of stroke. The effect of acupuncture on the intrastriatal hemorrhage-induced neuronal cell death and cell proliferation in rats is examined. Methods : Cell death and cell proliferation in rats was investigated via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay and immunohistochemistry for caspase-3 and 5-bromo-2'-deoxyuridine (BrdU). Results : Results showed that apoptotic cell death in the striatum and cell proliferation in the hippocampal dentate gyrus significantly increased following intrastriatal hemorrhage in rats, and that acupunctural treatment at the Zusanli acupoint suppressed the hemorrhage-induced increase in apoptosis in the striatum and cell proliferation in the dentate gyrus. Conclusions : It is suggested that acupunctural treatment, especially at the Zusanli acupoint, may aid recovery following central nervous system sequelae following ICH.

Purpose : A clinical case of diabetic foot-wound repair using Hirudo medicinalis therapy and its application is reported and discussed. Methods : The subject was a sixty-six-year-old woman diagnosed with a non-healing wound indicating the amputation of her right diabetic foot. Instead, Hirudo medicinalis therapy was performed twelve times over forty days, twice a week. The transition of wound closure was observed with the naked eye, and the plethysmogram was measured at the beginning and end of the treatment period. Results : The wound contracted with decreased exudate, collagen-like connective tissue sprouted, and then the wound gradually closed. The initial value (-0.08) of the dicrotic elastic index rose to -0.03. Conclusion : Hirudo medicinalis therapy had a positive effect on the wound repair, without a negative effect on the circulation, allowing the foot to be saved. It is necessary to investigate its wound repair mechanism for the further development of the Sahyul method.

Objectives : Polyneuropathies are diseases of multiple peripheral nerves. They are usually characterized by symmetrical, bilateral distal motor and sensory impairment with a graded increase in severity distally. It is generally regarded that the natural courses are poor, so we wanted to study the effects of Oriental medical treatment on a patient with polyneuropathy. Methods : We treated by conservative Oriental medical treatment a woman of 68 years who was diagnosed as a polyneuropathy and was hospitalized at Seoul Oriental Hospital, Kyungwon University, from 12th Mar. to 31st May, 2003. Changes of functional disability were checked by Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS), muscle atrophy was checked by measuring circumference of the thighs, calves, arms, and sensory impairment was checked by a sensory test. Results : 1. Functional disability caused by motor impairment was reduced after the Oriental medical treatment 2. Muscle atrophy was reduced after the Oriental medical treatment 3. Sensory impairment was reduced after the Oriental medical treatment Conclusion : We treated a patient who was diagnosed with polyneuropathy for over 80 days and recorded good effects of Oriental medical treatment on polyneuropathy.

Objective : Moxibustion is one of the primary remedies in traditional oriental medicine. We successfully treated a one patient who complained of oculomotor nerve palsy related to diabetes mellitus with moxibustion. Methods : We performed moxibustion treatment on the protuberances surrounding the Mok-chang acupoint and adjacent frontal scalp of the patient's head at the same time every day and observed the recovery of eye movement and changes of ptosis. Results : After about I week of moxibustion treatment, there were some changes of ptosis and eyeball movement. The patient felt better opening his eyes than before and seemed to reduce his paralytic condition. After 14 days, ptosis was remarkably improved, although slight diplopia remained, and eye movement had recovered to almost normal. Furthermore, his blood glucose was on the decrease and revealed an average 120 mg/dl. Conclusions : Moxibustion treatment performed on the Mok-chang acupoint remarkably improved ptosis and limited eye movement arising from oculomotor nerve palsy related to diabetes mellitus. We hope moxibustion is used for treating nerve palsies and similar diseases in the future.