• The Journal of the Society of Stroke on Korean Medicine
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• v.18 no.1
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• pp.13-22
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• 2017

■ Objectives This case is to report the effect of Oryeong-san and acupuncture therapy on serum creatinine level of a cerebral infarction patient with diabetic nephropathy. ■ Methods A female Korean patient was treated with Oryeong-san, acupuncture for total 32 days. We observed renal function test, input/output balance, body weight, hand and foot circumferences, and other symptoms like edema, urination, and any adverse event. ■ Results After treatment, serum creatinine level was improved to 2.48mg/dL from 3.45mg/dL at admission, and foot circumference was decreased to 18.5~18.9cm from 22.0~22.5cm without any adverse event. However, we couldn't find any significant differences on input/output balance, body weight, or symptoms of urination. ■ Conclusion This case suggests that Oryeong-san and acupuncture therapy could be effective in improving serum creatinine clearance of cerebral infarction patient with diabetic nephropathy.

• Journal of Sasang Constitutional Medicine
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• v.12 no.1
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• pp.265-270
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• 2000

Occasionally, apoplexy is caused by functional or physiologic cardiopulmonary abnormality. In addition, theses may become the factor of aggravating apoplexy and involve complication. If patient has cardiopulmonary disease, progressing of apoplexy is commonly used to be accelerate and prognosis is deteriorative. There by the patient who has cardiopulmonary disease, should be particularly treated for cardiopulmonary disease. We got good result, during treat Soeumin cerebral vascular infarction patient who has pulmonary edema leaded from congestive heart failure, with Sasang Constitutional treatment. Therefore I reported them here. She was 68 years old, female patient. She visited our hospital for apoplexy with right side hemiparesis, dysphagia, dysphasia. After her admission into our hospital, we knew that she has congestive heart failure. The diagnosis is established. She presented with severe general edema and pulmonary edema. Although Soeumin edema usually classified as Taiyin Disease, we classified this as Shaoyin Disease, through diet, discharge, sleep, tongue and symptoms. We has prescribed Gungguichongsoyijung-tang(芎歸蔥蘇理中湯) in accordance with the principle of invigorating the Spleen and lower Yin(建碑而降陰). And her symptoms has improved.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.118-124
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• 2017

Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.553-559
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• 1998

Introduction: The most dramatic application of hypothermia in cardiac surgery is in deep hypothermic circulatory arrest(DHCA). Because man in natural circumstances is never exposed to this extreme hypothermic condition, one of the controversial aspects of clinical hypothermia is appropriate acid-base management($\alpha$-stat versus pH-stat). This study aims to compare $\alpha$-stat with pH-stat for: (1) brain cooling and re-warming speed during hypothermia induction and re-warming by cardiopulmonary bypass (CPB); (2) cerebral perfusion, metabolism, and their coupling; and (3) the extent of development of cerebral edema after circulatory arrest, in young pigs. Materials & Methods: Fourteen young pigs were assigned to one of two strategies of gas manipulation. Cerebral blood flow was measured with a cerebral venous outflow technique. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopHaryngeal temperature fell below $20^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below $20^{\circ}C$, the animals were subjected to DHCA for 40 mins. During cooling, acid-base balance was maintained according to either $\alpha$-STAT or pH-STAT strategies. After DHCA, the body was re-warmed to normal body temperature. The animals were then sacrificed, and their brains measured for edema. Cerebral perfusion and metabolism were measured before the onset of CPB, before cooling, before DHCA, 15 mins after re-warming, and upon completion of re-warming. Results & Conclusion: Cooling time was significantly shorter with $\alpha$-stat than with pH-stat strategy, while there were no significant differences in rewarming time between the two groups. Nosignificant differences were found in cerebral blood flow, metabolic rate, or flow/ metabolic rate ratio between two groups. Temperature-related differences were significant in cerebral blood flow, metabolic rate, and flow/metabolic rate ratio within each group. Brain water content showed no significant differences between two groups.

• Biomedical Science Letters
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• v.10 no.3
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• pp.285-291
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• 2004

To determine the magnetic resonance (MR) imaging findings and natural history of cerebral fat embolism in a cat model, and to correlate the MR imaging and histologic fmdings. Intemel carotid artery of 11 cats was injected with 0.1 ml of triolein. T2-weighted, T1-weighted and Gd-enhanced T1-weighted images were obtained serially for 2 hours, 1 days, 4 days, 1 week, 2 weeks and 3 weeks after embolization. Any abnormal signal intensity was evaluated. After MR imaging at 3 weeks, brain tissue was obtained for light microscopic (LM) examination using hematoxylin-eosin (HE) and Luxol fast blue staining, and for electron microscopic examination. The LM examination with HE staining revealed normal histological findings in the greater part of an embolized lesion. Cystic change was observed in the gray matter of 8 cats, while in the gray and white matter of 3 cats. At LM examination, Luxol fast blue, staining demonstrated demyelination around the cystic change occurring in the white matter, and EM examination of the embolized cortex revealed sporadic intracapillary fat vacuoles (n=11) and disruption of the blood-brain barrier (n=4). Most lesions were normal, however, and perivascular interstitial edema and cellular swelling were mild compared with the control side. The greater part of an embolized lesion showed reversible findings at MR and histological examination. Irreversible focal necrosis was, however, observed in gray and white matter at weeks 3.

• The Journal of Internal Korean Medicine
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• v.30 no.3
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• pp.632-638
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• 2009

The patient was hospitalized for treatment of cerebral infarction (Lt. BG). He was a 61-year-old man who was diagnosed with membranous nephropathy (MN) in 2000. Before admission, he was admitted for treatment for cerebral infarction at another hospital. During that admission, his MN symptoms went from bad to worse, and medication for MN was started (steroid and cyclophosphamide therapy). In our hospital, we started herbal medicine and western medicine combination therapy as well as oriental rehabilitation therapy. Our main herbal medicine was Magsungsinyeom-bang(Moxingshenyanfang). After 5 months, levels of 24 hrs proteinuria, total cholesterol, LDL-cholesterol and triglyceride decreased, levels of serum albumin, total protein increased, and clinical symptoms (lower limb edema, general body weakness) improved.

• Journal of Haehwa Medicine
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• v.8 no.1
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• pp.425-449
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• 1999

For the evaluation of the effect on SWS, experiments were made on hyperlipidemia induced by hypercholesterol diet, inhibitory reaction to human platelet aggregation, Pulmonary thrombosis induced by collagen and epinephrine, global cerebral ischemia induced by KCN, brain ischemia induced by MCA occlusion, cytotoxicity of PC12 cells induced by amyloid ${\beta}$ protein(25-35), and NO production in RAW cells stimulated by lipopolysaccharide. The results were obtained as follows : 1. In the experiment on hyperlipidemia, the level of serum total cholesterol, phospholipid, and LDL-cholesterol were significantly decreased while the level of triglyceride, VLDL-cholesterol, and HDL-cholesterol had no significant change. 2. In the experiment on inhibitory reaction to platelet aggregation, SWS inhibited platelet aggregation induced by ADP(36.05%), by collagen(20.4%), and by thrombin(0.6%). 3. In the experiment on pulmonary thrombosis induced by collagen and epinephrine, the protective effect was found(37%). 4. In the experiment on global cerebral ischemia, coma duration induced by KCN changed insignificantly. 5. In the experiment on MCA occlusion, the change of neurologic grades on hind limb was significant only after the operation. Besides brain ischemic area and edema ratio were significantly decreased. 6. In the experiment on cytotoxicity of PC 12 cells induced by amyloid ${\beta}$ protein, the significant protective effect was found as concentration increases. 7. In the experiment on NO production in RAW cells stimulated by lipopolysaccharide, NO was significantly decreased. According to the results, it is expected that SWS might be effective on hyperlipidemia and brain damage.

• Childhood Kidney Diseases
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• v.26 no.2
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• pp.101-106
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• 2022

Nephrotic syndrome (NS) is a hypercoagulable state in which children are at risk of venous thromboembolism. A higher risk has been reported in children with steroid-resistant NS than in those with steroid-sensitive NS. The mortality rate of cerebral venous sinus thrombosis (CVST) is approximately 10% and generally results from cerebral herniation in the acute phase and an underlying disorder in the chronic phase. Our patient initially manifested as a child with massive proteinuria and generalized edema. He was treated with albumin replacement and diuretics, angiotensin-converting enzyme inhibitor, and deflazacort. Non-contrast computed tomography showed areas of hyperattenuation in the superior sagittal sinus when he complained of severe headache and vomiting. Subsequent magnetic resonance imaging revealed empty delta signs in the superior sagittal, lateral transverse, and sigmoid sinuses, suggesting acute CVST. Immediate anticoagulation therapy was started with unfractionated heparin, antithrombin III replacement, and continuous antiproteinuric treatment. The current report describes a life-threatening CVST in a child with steroid-dependent NS, initially diagnosed by contrast non-enhanced computed tomography and subsequently confirmed by contrast-enhanced magnetic resonance imaging, followed by magnetic resonance venography for recanalization, addressing successful treatment.

• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.203-209
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• 2010

Objective : The purpose of study was to evaluate the feasibility of brain magnetic resonance (MR) images of the rat obtained using a 1.5T MR machine in several blood-brain barrier (BBB) experiments. Methods : Male Sprague-Dawley rats were used. MR images were obtained using a clinical 1.5T MR machine. A microcatheter was introduced via the femoral artery to the carotid artery. Normal saline (group 1, n = 4), clotted autologous blood (group 2, n = 4), triolein emulsion (group 3, n = 4), and oleic acid emulsion (group 4, n = 4) were infused into the carotid artery through a microcatheter. Conventional and diffusion-weighted images, the apparent coefficient map, perfusion-weighted images, and contrast-enhanced MR images were obtained. Brain tissue was obtained and triphenyltetrazolium chloride (TTC) staining was performed in group 2. Fluorescein isothiocyanate (FITC)-labeled dextran images and endothelial barrier antigen (EBA) studies were performed in group 4. Results : The MR images in group 1 were of good quality. The MR images in group 2 revealed typical findings of acute cerebral infarction. Perfusion defects were noted on the perfusion-weighted images. The MR images in group 3 showed vasogenic edema and contrast enhancement, representing vascular damage. The rats in group 4 had vasogenic edema on the MR images and leakage of dextran on the FITC-labeled dextran image, representing increased vascular permeability. The immune reaction was decreased on the EBA study. Conclusion : Clinical 1.5T MR images using a rat depicted many informative results in the present study. These results can be used in further researches of the BBB using combined clinical MR machines and immunohistochemical examinations.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.8-15
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• 2006

Purpose : To describe MR imaging features of hypoxic brain damage in relation to time elapse and prognosis of patients. Materials and methods : We reviewed 19 MR studies of 18 patients with hypoxic brain damage. MR imaging studies were performed between 1 to 20 days after the hypoxic insults (mean 8.6 days). MR images were analyzed with regard to the locations of abnormal signal intensities, the presence of brain edema. And imaging findings were correlated with the time elapse after the insults and the prognosis of patients. Results : On 19 cases of MR studies, abnormal high intensities on T2-weighted images were found in the basal ganglia (15, 78.9%), cerebral cortex (13, 68.4%), white matter (9, 47.4%), thalamus (6, 31.6%), cerebellum (4, 21.1%) and brainstem (1, 5.3%), respectively. Cerebral cortical involvement was typically bilateral and diffuse, but sometimes limited to the parieto-occipital area. The brainstem and cerebellar involvement was rare and in all cases, cerebral cortical lesions accompanied. Most of the white matter lesions were accompanied with cortical and deep gray matter lesions and found in subacute period(>6 days). The cortical high signal intensity lesions on T1-weighted image were found mostly in subacute stage, but in some cases involvement was also found in acute stage ($\leq$ 6 days). The cortical edema is found on 11 cases in acute and subacute stages. In cases of recovered consciousness, cortical involvement and edema on MR were rare. Conclusion : MR findings of hypoxic brain damage were various, but diffuse bilateral involvement of cortex and/or deep gray matter was found in most of the cases. White matter involvement was rarely found in acute stage and usually found in subacute stage. In cases of good pronosis, cortical involvement and edema were rare.