• The Journal of Korean Medicine
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• v.24 no.1
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• pp.181-189
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• 2003

Background : Patient, family, society and country are badly damaged by stroke (CVA : cerebrovascular accident). To reduce sequelae and return rapidly to society, treatment in the acute stage is very important. In many studies on purgation therapy (下法) used in acute stages of stroke, the changes of blood pressure, pulse and so on before and after purgation therapy were reported. However, the changes in the human body according to the day elapsed after defecation were not reported, so study was needed to confirm such changes. Methods : Seventy-six patients were studied. We observed forty-three patients at acute stroke and thirty-three patients at convalescent stroke. To confirm the importance of regular defecation in stroke patients, we analyzed blood pressure according to the day elapsed after defecation. Results : The following result were obtained. 1. In stroke group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute stroke group. 2. Especially in stroke and acute stroke groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. 3. In the infarction group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute infarction group. 4. Especially, in the infarction and acute infarction groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. Conclusion : In stroke patients, regular defecation is important, so we think that purgation therapy (下法) is needed in stroke patients over the third day elapsed after defecation. We think that the bowel movement control in acute stroke patients is more important than in convalescent stroke patients.

• The Journal of Korean Medicine
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• v.15 no.2 s.28
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• pp.233-240
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• 1994

Cerebrovascular disease(CVD) is marked by loss of consciousness. facial palsy and hemiparesis. Although being treated properly in acute stage. CVD is accompanied by various sequelae. So treatment of sequelas is great importance as much as in acute stage. Man Geum Tang(MGT) and Bo Yang Whan O Tang(BYWOT) are representative general prescription for sequelae of CVD. This study is to clarify comparatively the efficiency of MGT and BYWOT. 110 Patients who were administrated with either MGT or BYWOT over 2 weeks for treatment of CVD divided into 2 groups:53 patients(27 males and 26 fomales. average $63.58{\pm}9.48$ years old) adminstated with MGT and 57 patients (32 males and 25 females. average $65.84{\pm}8.93$ years old) with BYWOT. In the patients administrated with MGT. 15 patients were with cerebral hemorrhage and 38 patients were with cerebral infarction. 57 BYWOT group consisted of 27 patients with cerebral hemorrhage and 30 patients with cerebral infarction. MGT with cerebral hemorrhage and 30 patients with cerebral infarction. MGT was administrated for $15.18{\pm}2.43$days and BYWOT for $14.24{\pm}1.24days$. Motor improved significantly(9〈0.005) from grade after administration in upper and lower extremities respectively. In view of comparative effeciency. the grade of motor disturbance after administration in upper extremities showed insignificant(p〉0.005) change to $1.19{\pm}1.18\;and\;0.89{\pm}1.13$ in MGT and BYWOT group respectively. In lower extremities. the grade changed insignificantly (p〉0.05) to $1.26{\pm}1.08\;and\;1.18{\pm}1.10$ respectively. In the patients group with cerebral infarction. the grade of motor disturbance in MGT and BYWOT administration groups respectively were $0.84{\pm}0.14\;and\;0.60{\pm}0.15$ in upper exemities and $0.89{\pm}0.14\;and\;0.90{\pm}0.17$ in lower extremities. The significant difference between two groups didn't appeared. In cerebral hemorrhage patients the grade of motor disturbance were in upper extremities $2.07{\pm}0.33$ in MGT group and $1.59{\pm}0.29$ in BOWOT group and $2.20{\pm}0.26\;and\;1.59{\pm}0.28$ in lower extremities respectively. The difference between two groups were insignificant(p〉0.05).

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.3
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• pp.275-287
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• 2023

Objective: Flow diverting stents (FDS) are a validated device in the treatment of intracranial aneurysms, allowing for minimally invasive intervention. However, after its approval for use in the United States in 2011, post-market surveillance of adverse events is limited. This study aims to address this critical knowledge gap by analyzing the FDA Manufacturer and User Facility Device Experience (MAUDE) database for patient and device related (PR and DR) reports of adverse events and malfunctions. Methods: Using post-market surveillance data from the MAUDE database, PR and DR reports from January 2012-December 2021 were extracted, compiled, and analyzed with R-Studio version 2021.09.2. PR and DR reports with insufficient information were excluded. Raw information was organized, and further author generated classifications were created for both PR and DR reports. Results: A total of 2203 PR and 4017 DR events were recorded. The most frequently reported PR adverse event categories were cerebrovascular (60%), death (11%), and neurological (8%). The most frequent PR adverse event reports were death (11%), thrombosis/thrombus (9%) cerebral infarction (8%), decreased therapeutic response (7%), stroke/cerebrovascular accident (6%), intracranial hemorrhage (5%), aneurysm (4%), occlusion (4%), headache (4%), neurological deficit/dysfunction (3%). The most frequent DR reports were activation/positioning/separation problems (52%), break (9%), device operates differently than expected (4%), difficult to open or close (4%), material deformation (3%), migration or expulsion of device (3%), detachment of device or device component (2%). Conclusions: Post-market surveillance is important to guide patient counselling and identify adverse events and device problems that were not identified in initial trials. We present frequent reports of several types of cerebrovascular and neurological adverse events as well as the most common device shortcomings that should be explored by manufacturers and future studies. Although inherent limitations to the MAUDE database are present, our results highlight important PR and DR complications that can help optimize patient counseling and device development.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.22-29
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• 2022

Objective : Despite many advancements in endovascular treatment, the benefits of mechanical thrombectomy (MT) in patients with large infarctions remain uncertain due to hemorrhagic complications. Therefore, we aimed to investigate the efficacy and safety of recanalization via MT within 6 hours after stroke in patients with large cerebral infarction volumes (>70 mL). Methods : We retrospectively reviewed the medical data of 30 patients with large lesions on initial diffusion-weighted imaging (>70 mL) who underwent MT at our institution within 6 hours after stroke onset. Baseline data, recanalization rate, and 3-month clinical outcomes were analyzed. Successful recanalization was defined as a modified treatment in cerebral ischemia score of 2b or 3. Results : The recanalization rate was 63.3%, and symptomatic intracerebral hemorrhage occurred in six patients (20%). The proportion of patients with modified Rankin Scale (mRS) scores of 0-3 was significantly higher in the recanalization group than in the non-recanalization group (47.4% vs. 9.1%, p=0.049). The mortality rate was higher in the non-recanalization group, this difference was not significant (15.8% vs. 36.4%, p=0.372). In the analysis of 3-month clinical outcomes, only successful recanalization was significantly associated with mRS scores of 0-3 (90% vs. 50%, p=0.049). The odds ratio of recanalization for favorable outcomes (mRS 0-3) was 9.00 (95% confidence interval, 0.95-84.90; p=0.055). Conclusion : Despite the risk of symptomatic intracerebral hemorrhage, successful recanalization via MT 6 hours after stroke may improve clinical outcomes in patients with large vessel occlusion.

• The Journal of Internal Korean Medicine
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• v.21 no.5
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• pp.729-738
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• 2000

Objective : We examined patients admitted to Dong Eui University Oriental Medical Hospital from 1st January to 31st December in 2000. We studied 110 cases of patients who were diagnosed as Brain stem(pons, mid brain, medullar) infarction with brain CT, MRI scan, MR Angiography. Methods : We analyzed patients into sex, age, onset time, invasion lesion, past and family history, risk factor, abnormal vital sign for early 2 weeks, prodromal symptoms, symptoms at entry, progress and incidental symptoms at acute stage, complications, the state of condition at discharge, demonstrations, herb medications, western and oriental medical cooperation and admission period. Results : Our study was similar to existing studies in the distribution of sex, age, past and family history and risk factors. But there was some differences in the prodromal symptoms, symptoms at entry progress and incidental symptoms at acute stage, and the state of condition at discharge. Conclusions : Our study shows the brain stem infarction patients differed from other cerebrovascular accident patients in the symptoms. We hoped that our study would be further studied in western and oriental medicine.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.850-862
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• 2007

Background : Cerebrovascular disease is a major cause of death and disability in adults. Silent cerebral infarction (SCI) portends more severe cerebral infarction or may lead to insidious progressive brain damage resulting in vascular dementia. Known cardiovascular risk factors, such as arterial hypertension, diabetes mellitus, smoking, hyperlipidemia and ischemic heart disease may increase the risk of SCI. This study was designed to evaluate the risk factors of SCI in an apparently normal adult population. Methods : We divided 340 neurologically normal adults (mean age=59.90$\pm$8.30, men:women = 146:194) who underwent brain computed tomography (CT) or magnetic resonance imaging (MRI) at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital in two groups, Silent inf. and Controls,and analyzed risk factors of SCI by interview, physical examination and blood test. Risk factors of SCI were assessed by interview, physical examination and blood test. We performed Pearson's chi-square test and two-sample t-test for univariate analysis and multiple logistic regressions for multivariate analysis to evaluate risk factors of SCI. Results : Old age, diabetes mellitus, and high lactate dehydrogenase (LDH) levels were associated with SCI on univariate analysis. Diabetes mellitus was demonstrated to be an independent risk factor for SCI on multivariate analysis. Conclusions : Advanced age, diabetes mellitus, and LDH levels are associated with SCI.

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.45-49
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• 2018

Group B streptococcus (GBS) is the leading cause of neonatal morbidity and mortality. Late-onset GBS disease commonly manifests as occult bacteremia or meningitis. Approximately 50% of survivors of late-onset meningitis have long-term neurologic sequelae. Cerebrovascular complications are often associated with unfavorable clinical outcomes of GBS meningitis. There have been a few reports of cerebral infarction accompanied by GBS meningitis. We report a 29-day-old girl with severe, widespread cerebral infarction due to late-onset GBS meningitis. Isolated GBS strain from this patient was serotype III, ST-19. Currently, she has cortical blindness and significant developmental delay.

• The Korean Journal of Nuclear Medicine
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• v.22 no.1
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• pp.15-19
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• 1988

SPECT of regional cerebral blood flow was performed using $^{99m}Tc-HMPAO$ in 28 patients with cerebrovascular disease and quantitative analysis was done. Cerebral asymmetry index and percent index of asymmetry of cerebellar hemisphere of patients with cerebral infarction or ischemia were $0.764{\pm}0.576$ and $-5.6{\pm}7.1%$ and those of intracranial hemorrhage was $0.416{\pm}0.251$ and $-2.5{\pm}4.1%$ respectively. According to PIA of cerebellar hemisphere, 12 patients showed crossed cerebellar diaschisis. $^{99m}Tc-HMPAO$ SPECT seemed to be a useful tool for the evaluation of regional cerebral blood flow.

• Clinical and Experimental Pediatrics
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• v.55 no.11
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• pp.408-413
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• 2012

Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.

• Herbal Formula Science
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• v.13 no.2
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• pp.153-168
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• 2005

This study was investigated to make sure the range of Lindera Radix' treatment, the nature of disease, the chief virtue of medicine, the pathology and the usage quantity of it in Donguibogam The results were as follows; 1. The Lindera Radix is used in 15 fields which contain the Cerebrovascular Accident chapter. 2. The Lindera Radix is used in 31 pathologies of the cerebral infarction, intracranial hemorrhage, etc. 3. The Lindera Radix is used in a range of the pathology of the C.V.A, eliminating phlegm, stagnated blood, etc. 4. The Lindera Radix is used in a range of $2.4g{\sim}40g$ in herbal-prescription. The main using dosage is 4g. 5. The Lindera Radix is used with various crude herbs in accordance with the pathogeny. The Lindera Radix has been used to reduce the C.V.A, eliminate phlegm and any blocking substances with dampness, to promote sober by sending qi and reduce pain, etc. According to the results, I suggest to use the Lindera Radix in a various pathogenic fields. The Lindera Radix is able to remove not only pathogenic cerebral infarction or intracranial hemorrhage, but also pathogenic phlegm and sputm, etc.