• The Journal of Internal Korean Medicine
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• v.21 no.5
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• pp.883-887
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• 2000

A clinical study was carried out 1 case of ischemic cerebrovascular accident which occurred at puerperium in a 27 year-old woman followed by vaginal delivery The results were as follows: 1. In the clinical view, it was thought that the cause of this case is intracranial venous thrombus, because the symptom-headache, foaming at the mouse, acromyotonia, hemiparesis- occurred in the postpartum and functional outcome is good. 2. In this case, the patient's functional system of spleen-stomach is usually weak, and due to delivery the functional system of spleen-stomach is more insufficient. so it can not control damp-phlegm(濕痰). In addition, vital energy of liver stagnate.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1063-1068
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• 2000

Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.

• Korean Journal of Acupuncture
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• v.21 no.1
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• pp.15-27
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• 2004

Objectives : Acupuncture has been used to prevent and treat the cerebrovascular accident, such as a stroke, and many studies of acupuncture and moxibustion concerning to the stroke have been undertaken in the human and various animals. Also, herbal acupuncture, namely aqua acupuncture has been applied and developed to various diseases including the cerebrovascular accident. FOLIUM ARTEMISIAE ARGYI is the dry leaf of Artemisia argyi Levl. et Vant. collected in summer before the plant blooms and used to moxibustion and has been recommended for use as an analgesic and hemostatic. In this study, effects of FOLIUM ARTEMISIAE ARGYI (艾葉)' herbal acupuncture on the $LR_3$, namely Taechung on neuroprotection after the transient forebrain ischemia were investigated in Sprague-Dawely rats. Methods : Expressions of neuronal nitric oxide synthase (nNOS) protein in the hippocampus and cortex were observed at 2 hrs after transient forebrain ischemia by immunohistochemistry. Results : Expression of nNOS protein was increased in the hippocampus and cortex at 2 hrs after transient forebrain ischemia. However, pretreatment with FOLIUM ARTEMISIAE ARGYI' herbal acupuncture on $LR_3$ significantly decreased expression of nNOS protein protein compared to ischemia group. These features were observed in the motor cortex and the hippocampus. Conclusions : These results suggest that pretreatment with FOLIUM ARTEMISIAE ARGYI' herbal acupuncture on $LR_3$ inhibits the expression of nNOS protein induced by transient forebrain ischemia and may modulate excitatory toxicity of neuron related to neuronal cell death.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.4 no.1
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• pp.26-31
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• 2008

Cerebrovascular Accident(stroke) is that a sudden, nonconvulsive loss of neurologic function due to an ischemic or hemorrhagic intracranial vascular event. If stroke happens at the portion of trigeminal motor nucleus or its control part of cerebral cortex, masticatory muscles will be atrophy or paralyzed. So it is possible that dental occlusion changes after stroke. A 74-aged woman recurred mild stroke 2 month ago, who had experienced severe stroke 2 years ago. After recurrence, suddenly her upper full denture was dropped when lower denture contacted upper one. According to the her occlusion exam, her lower jaw moved back slightly compared with the occlusion of old denture. And her face had asymmetry and lower jaw dislocated to paralyzed side. A 50-aged man was treated because many cervical caries, which would occur because of an aftereffect of stroke, long-herm hospitalization and limits of self oral-care. 6 years ago he had cerebral hemorrhage and he claimed that he cannot bite exactly. Just two pairs of teeth was contact on biting, his lower jaw was located back, too. This two case suggests that dental occlusion can change after stroke.

• The Journal of Korean Medicine
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• v.21 no.3
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• pp.129-139
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• 2000

Clinical observation was made on 210 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyungwon University from January to December in 1998. Objective : To evaluate the current status of cerebrovascular disease in Korea, we performed observation on stroke patients. Methods : We performed a retrospective study on 210 cases of stroke who had been admitted to the Dept. of Internal Medicine, College of Oriental Medicine, Kyungwon University from Jan. 1, 1998 to Dec. 31, 1998. Results : The incidence was highest in the patients with the age of above fifty. The frequency of strokes was similar between male and female cases. Ischemic stroke(70.0%) was more common than hemorrhagic stroke(20.5%), with transient ischemic attacks(9.5%) occuring less frequently. Middle cerebra! arterial territory was the most commonly involved site in ischemic strokes. Among intracerebral hemorrhages, putaminal hemorrhages were found in 69.8%, and was followed by IVH(9.3%), IVH with ICH(7.0%), subcortical hemorrhages (4.7%) and pontine hemorrhages(4.7%). The most ordinary preceding disease was hypertension. The next was diabetes mellitus. Most cases were given simultaneous treatment in both western and oriental medical methods. Conclusions : Generally it is thought that CVA occurs frequently in winter. But our observations reveal no such relationship. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. I Patients whose condition of consciousness was bad at the time of admission tended to have a bad prognosis. This study suggests changing trends of stroke in Korea, and that a multicenter prospective study using stroke registry is required for confirmation.

• The Journal of Korean Medicine
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• v.15 no.2 s.28
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• pp.46-91
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• 1994

l. Backgrounds of Studies Cerebrovascular accident. one of the three major causes of death among audults with cardiopathy and malignancy, has been on the increase in korea while it is on the decrease in European countries and Japan. Types of stroke undergo changes caused by prolongment of life expectancy. and social and economic variety. More patients of ischemic stroke show a tendency to increase now than those of hemorrhagic stroke in the past. Many clinical studies on medical cerebrovascular and oriental stroke of paralysis have been published. but few clinical studies on therapeutics of integrated oriental and western medicine are to be found. So I have made an attempt to study clinical observations and therapeutic responses of ischemic stroke under integrated oriental and western medicine. 2.Methods. Among the patients admitted into the clinic of Joong-Poong, Woo-Suk University Hospital from May 1. 1993 until April 30. 1994 those 56 patients who were diagnosed as ischemic stroke on Computed Tomography(CT) and showed no dubious symptom after examination of coagulation and bleeding time were classified into the following six steps and treated: l)diagnosis 2)emergency treatment 3)basic treatment 4)treatment of risk and provoking factors. and preceeding disease 5)complications and conservative therapy 6)rehabilitation. For a period of basic treatment both herb medication and urokinase therapy were applied at the same time. Intravenous injection has been given at a unit of 300.000 dosage a day as urokinase therapy during basic treatment. If they showed any dubious symptom in glucose tolerance test. fructose 500ml and urokinase 300.000 dosage were mixed and injected. In case of no symptom 5% DW 500ml was mixed with urokinase 300.000 unit. and injected at a speed of 15gtt per minute. 3. Results and Conclusions 1) The level of ambulation has been improved from 42.9% when admitted to 73.2% when discharged in the degree of recovery. The level of severe function disorder has been remarkably decreased from 55.4% when admitted to 19.6% when discharged. 2) The treatment effect on the basis of therapeutic response of clinical and subjective symptom shows as follows: 7.1% Excellent. 35.7% Good. 37.5% Effective. 10.7% Stationary. and 8.9% Aggravated. The total recovery above effective shows 80.3%. Judging from the above results I think it proper to develop the model of better preventing and treating ischemic stroke through effective therapeutic and clinical studies of integrated oriental and western medicine.

• Physical Therapy Korea
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• v.12 no.2
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• pp.98-104
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• 2005

This study was done to research the general information, causes of stroke, risk factors, complications during admission of geriatric CVA inpatients. We retrospectively studied 208 above 65 years old geriatric CVA inpatients treated in Ajou university hospital from 1994 to 2003 by medical record. These were divided into two groups by following years. We were gathered information about sex, onset age, cause of stroke, number of stroke, complications, housing, family, insurance, smoking, alcohol. Most of incidence of the stroke was noted in the group of young old age (65~74 years old) and old age (75~84 years old). The occurrence rate of male stroke (38.5%) was less than of female stroke (61.5%) and the ratio of male to female was 1:1.6. The occurrence rate of ischemic stroke (72.6%) was higher than of hemorrhagic stroke. The occurrence rate of ischemic stroke increased more and more at the late stage. The most common risk factors for stroke was hypertension and complications during hospitalization were neurogenic bowl and bladder. These results of epidemiologic study may help above 65 years old geriatric CVA early treatment and prevention, rehabilitation and use basic data for multiple prospective study using stroke registry.

• Speech Sciences
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• v.8 no.1
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• pp.115-122
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• 2001

This paper explored the effectiveness of a hierarchical Treatment of Aphasic Perseveration (TAP) program on an aphasic in two regards: decrease in the frequency of perseveration and improvement in naming ability. The subject was a 54-year-old female with Transcortical Sensory (TCS) aphasia following a left ischemic Cerebrovascular Accident (CVA). It was concluded that the hierarchical TAP program was more effective and efficient in terms of decreasing perseveration and increasing correct naming performance. Within the data of the hierarchical TAP program, however, a substantial decrease in the frequency of occurrence of perseverative behaviors did not necessarily result in proportionate improvement of naming ability. The probable causes and reasons were discussed.

• Korean Journal of Acupuncture
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• v.20 no.3
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• pp.61-80
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• 2003

Objectives : Acupuncture and herbal medicine have been used to prevent and treat the cerebrovascular accident, such as a stroke, and many studies of acupuncture and moxibustion concerning to the stroke have been undertaken in the human and various animals. Recently, the new therapeutic tool, that is herbal acupuncture, has been developed since the 1950' and applied to various diseases including the cerebrovascular accident. The main characteristics of herbal acupuncture are a combination of acupuncture and herbal medicine. It was not well known the therapeutic effect and the mechanism of herbal acupuncture on transient forebrain ischemic injury, although it has been used frequently in clinics. Methods : In this study, effects of folium Artemisiae Argyi and moxa tar' herbal acupuncture on the $GV_{20}$, named Baek-Hue, on neuroprotection after the transient forebrain ischemia were investigated in Sprague-Dawely rats. Expressions of cFos, FosB and BDNF protein in the hippocampus and cortex were observed at 2 hrs and 48 hrs after transient forebrain ischemia by immunohis- tochemistry and ELISA technique. Results : Expression of cFos protein was increased slightly in the hippocampus and cortex at 2 hrs after transient forebrain ischemia, but FosB protein was increased highly comparing to cFos protein. However, pretreatment with folium Artemisiae Argyi or moxa tar' herbal acupuncture on $GV_{20}$ significantly increased expression of cFos protein and significantly decreased expression of FosB protein compared to control group, respectively. These features were observed in the motor cortex and retrosplenial granular cortex as well as the hippocampus. Also, pretreatment with folium Artemisiae Argyi and moxa tar' herbal acupuncture on$GV_{20}$ significantly increased the expression of BDNF protein in the hippocampus and the cortex compared to control group at 48 hrs after transient forebrain ischemia, respectively. Conclusions : These results suggest that pretreatment with folium Artemisiae Argyi or moxa tar' herbal acupuncture on $GV_{20}$ has neuroprotective effect on transient forebrain ischemia and theherbal acupuncture on $GV_{20}$ may be related to antioxidative function.

• The Journal of the Korean life insurance medical association
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• v.29 no.2
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• pp.29-32
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• 2010

Moyamoya disease (MMD) is a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. MMD is one of cerebrovacular accident,which is treated with sugical maeuver in pediatic neurosurgery. Moyamoya (ie, Japanese for "puff of smoke") characterizes the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but unilateral involvement does not exclude the diagnosis. The exact etiology of moyamoya disease is unknown. Some genetic predisposition is apparent because it is familial 10% of the time. The disease may be hereditary and multifactorial. It may occur by itself in a previously healthy individual. However, many disease states have been reported in association with moyamoya disease, including the following: 1) Immunological - Graves disease/thyrotoxicosis 2) Infections - Leptospirosis and tuberculosis 3) Hematologic disorders - Aplastic anemia, Fanconi anemia, sickle cell anemia, and lupus 4) Congenital syndromes - Apert syndrome, Down syndrome, Marfan syndrome, tuberous sclerosis, Turner syndrome, von Recklinghausen disease, and Hirschsprung disease 5) Vascular diseases - Atherosclerotic disease, coarctation of the aorta and fibromuscular dysplasia, 6)cranial trauma, radiation injury, parasellar tumors, and hypertension etc. These associations may not necessarily be causative but do warrant consideration due to impact on treatment.(Mainly neurosurgical operation.) The incidence of moyamoya disease is highest in Japan. The prevalence of MMD is 1 person per 100,000 population. The prevalence and incidence of moyamoya disease in Japan has been reported to be 3.16 cases and 0.35 case per 100,000 people, respectively. With regard to sex, the female-to-male ratio is 1.4:1. A bimodal peak of incidence is noted, with symptoms occurring either in the first decade(5-10yr) or in the third and fourth decades (30-40yr)of life. Mortality rates of moyamoya disease are approximately 10% in adults and 4.3% in children. Death is usually from hemorrhage. In aspect of life insurance, MR is 1700%, EDR is 16 per 1000 persons. Children and adults with moyamoya disease (MMD) may have different clinical presentations. The symptoms and clinical course vary widely from asymptomatic to transient events to severe neurologic deficits. Adults experience hemorrhage more commonly; cerebral ischemic events are more common in children. Children may have hemiparesis, monoparesis, sensory impairment, involuntary movements, headaches, dizziness, or seizures. Mental retardation or persistent neurologic deficits may be present. Adults may have symptoms and signs similar to those in children, but intraventricular, subarachnoid, or intracerebral hemorrhage of sudden onset is more common in adults. Recently increasing diagnosis of MMD with MRI, followed by surgical operation is noted. MMD needs to be considered as the "CI" state now in life insurance fields.