Objectives : The purpose is to discuss the clinical applications of Orungsan(Goreisan: 五苓散) as an alternative management for increased intracranial pressure in the field of neurosurgery in Japan. Methods and Results : Attention has focused on Kampo medicine(traditional Japanese medicine) for some cerebral disease including chronic subdural hematoma(CSDH) and cerebral infarction in Japan. Orungsan and one of its classes, Sirungtang(Saireto: 柴苓湯) are well known their effects on brain edema. After some studies of Orungsan has the anti-edemic effects by the inhibition of aquaporin, this herbal medicine has been used widely in the neurosurgery field in Japan. It is high time to think about where we are and we go ahead for the progress and the integration in medicine. We have reviewed the studies using Orungsan or Sirungtang, that was reported at the 20th annual meeting of 'the Japan society for Kampo medicine and neurological surgery' was held on November 5, 2011 in Tokyo. Fifteen studies related with Orungsan or Sirungtang were reported among all 32 studies at the meeting. Orungsan in ten, and Sirungtang in five among 14 studies contained specific clinical case. In the aspects of disease, thirteen papers were related with SDH, including CSDH(11), SSDH(1), aneurism clipping for SDH prevention(1), and one was acute cerebral infarction and one was multiple metastatic brain tumor. In the report style, case control study was 7(mostly retrospective), and the case report was 8. Conclusions : Orungsan may be plausible to be an alternative method to reduce brain edema after SDH and other brain injury in the field of neurosurgery.

Objectives : The aim of this study was to examine the Differences of symptom improvement depending on correspondance of Herb medicine with Oriental Medical Diagnosis in Acute Stroke Patient. Methods : We studied hospitalized patients within 10days after their ictus who were admitted at Kyunghee University Oriental Medical Center from May 2011 to October 2011. We compared the improvement of MI and SSS score between Correspondance group(n=9) and Non-correspondance group(n=13). Results : The patients who had corresponding herb medicine with Oriental Medical Diagnosis show much improvement of MI score, but there is no significant difference. There is no significant difference on improvement of SSS score, between Correspondance and Non-correspondance. Conclusion : This study provides evidence that correspondance of herb medicine with Oriental Medical Diagnosis is important to improve the symptoms of acute stroke.

Object : The purpose of this study is to observe the changes of symptoms and signs diagnosised by differentiation of the pattern identification in stroke patients. Methods : Seventy subjects were recruited from patients with stroke within ten days of onset. We chose twenty-nine subjects diagnosised as same differentiation of the pattern identification, and who had at least on follow up session. We had investigated change of symptoms and signs diagnosised by differentiation of the pattern identification. Results : There were five symptoms and signs (thick fur, dry fur, difficult defecation, heat vexation and aversion to heat, normal pulse) and ten (heavy-headedness, frequency of defecation, hard defecation, feel heavy, slippery pulsem, dry mouth, bitter taste in the mouth, feel lazy, look lazy) symptoms and signs that were statistically significant improved in fire-heat patterns and dampness-phlegm pattern, respectively. Conclusions : This study provides evidence that collaborative treatment is effective in improving some symptoms and signs in acute ischemic stroke patients diagnosised by fire-heat pattern and dampness-phlegm pattern. Further studies with larger scale, longer observation period would be required.

Objective : Fire and heat related symptoms and signs are considered common in acute stage of diseases. The purpose of this study is to evaluate the occurrences and changes of fire and heat related symptoms and signs in acute cerebral infarction patients. Method & subjects : 40 acute cerebral infarction patients hospitalized in Oriental medicine hospital, Kyung-Hee University, who had examined and diagnosed 2 or 3 times based on oriental medical diagnosis were selected. We chose 23 as fire and heat related symptoms and signs from 94 diagnostic articles, and we added all those scores together of each patient. We analysed the scores of fire and heat related symptoms and signs as the time passed, and depending on oriental medical diagnosis. Result : In acute cerebral infarction patients of this study, 4 of fire and heat related symptoms and signs were took 1st, 2nd, 4th and 8th places in most changeable 10 articles of total 94 articles. The mean score of fire and heat related symptoms and signs of all patients were decreased significantly over the 3 times of measurements. The 8 patients diagnosed as fire and heat diagnosis at visit1 were samely diagnosed as fire and heat diagnosis at visit2, and at visit3 5 patients of them except for 3 patients excluded between visit2 and visit3, were still diagnosed as fire and heat diagnosis. At all of 3 measuring times, the scores of fire and heat related symptoms and signs of fire and heat diagnosis group were higher than non-fire and heat diagnosis group. Conclusion : This study indicated that fire and heat related symptoms and signs were very changeable phenomenon in acute cerebral infarction patients. And they decreased as time goes on.

Objective : The aim of this study was to examine Differences of overall characteristics depending on Symptom Severity in Acute Stroke Patient Method : We studied hospitalized patients within 10days after their ictus who were admitted at Kyunghee University Oriental Medical Center from May 2011 to October 2011. We compared the general characteristics of acute stroke patient according to Scandinavian Stroke Scale score Result : The patient who had mild severity show significant difference for FBS, PP2, Homocysteine, Exercise, Tongue color, Mouth dryness, Chest discomfort, Constipation, Stool hardness. Conclusion : The above result contribute to predict severity of stroke symtoms according to risk factor and general condition of patients. Also, After occurrence of stroke, We will can block worsening of symptoms progression. Further studies will be needed to observation of follow up studies about progression of stroke among acute stroke patients with a serious disability.

Objective : Stroke is the most common disabling neurological disease of adult life. And some part of the clinical symptoms and signs are correlated to the post stroke complication. This study was to analyze the therapeutic effect of the East-West collaborative treatment, especially on the motor power and the clinical symptoms and signs improvement of ischemic stroke patients. Method : For 2 weeks as possible, we observed the patients with acute ischemic stroke receiving East-West collaborative treatment. We assessed the patients using Motricity Index (MI) and the changes of clinical symptoms and signs three times at seven-day intervals. At the end of the study, we compared the results. Result : Motricity Index of patients changed from 71.55 to 76.03 (upper limb) and 73.05 to 79.42 (lower limb), respectively. Some items of clinical symptoms and signs showed the statistically significant result. Especially, the urination and defecation symptoms improved obviously. Conclusion : The East-West collaborative treatment has an effect on motor power and clinical symptoms and signs improvement of acute ischemic stroke patients.

Objectives : This study was aimed to clarify the relationship between the dampness-phlegm diagnosis and internal carotid artery stenosis by measuring carotid artery sonography in cerebral infarction patients. Methods : One hundred eighty subjects were recruited from the patients admitted to the Department of Internal Medicine at Kyunghee university oriental medical center from September 2008 to July 2010. We assessed one hundred eighty patients' carotid artery sonography data and diagnosed dampness-phlegm by oriental medical diagnosis. then, analyzed their characteristics, risk factor, lifestyle, metabolic syndrome, body mass index, Waist/Hip ratio(W/H ratio) and dampness-phlegm diagnosis. Results : On the demographic variables of the patients, age, smoking, W/H ratio and dampness-phlegm group were significantly higher in severe internal carotid artery(ICA) stenosis group than in the control group. According to the significant difference in dampness-phlegm group, we analyzed dampness-phlegm related index for pattern identifications by ICA stenosis. As a result, sputum, bowel sound, chest discomfort, slippery pulse were significantly higher in the severe ICA stenosis group than in the control group. In multivariate analysis, dampness-phlegm group showed close relationship with severe ICA stenosis group. Conclusion : According to the analysis, significance between dampness-phlegm diagnosed patients group and severe ICA stenosis were clarified. These results can be utilized in the future as a basis material.

Background : Prevalence of spasticity because of stroke are 40% patients after 12 month. Spasticity caused decrease of range of motor, motor function, and active daily living. Electroacupuncture widely used stroke. But it is been studied by systematic review between spasticity and electroacupuncture. This study is aimed to efficacy of electroacupuncture for spasticity because of stroke. Methods : We had used pubmed(www.pubmed.com) and cochrane library(www.thecochranelibrary.com) database. Limits are'human','randomized controlled trial'and'all adult 19+ years'in pubmed. The period was until 15, september, 2011. We used MeSH(Medical Subject Headings terms. The search words were'stroke'[mesh],'muscle spasticity'[mesh and 'electroacupuncture'[mesh]. In cochrane library, we used spasticity and electroacupuncture in cochrane library. We found 19 studies. But only 3 studies were included for inclusion criteria. Results : The appropriate 3 studies were different from subject, acupoint, duration of treatment, endpoint and etc. But these studies were effective for spasticity because of stroke. Conclusion : These studies were not meta analysis because of heterogeneity. But the above results might explain the electroacupuncture were effective for spasticity and further study needed to verify and standard electroacupuncture study for spasticity.

본 증례에서는 경항통에 대해 음양균형장치를 포함한 침치료, 한약치료를 통해 양호한 치료효과를 관찰했다.