• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.1
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• pp.224-229
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• 2005

Ginseng radix, the root of Panax ginseng C.A.Meyer (Araliaceae), has traditionally been used for the treatment of various disorders including cerebrovascular accident (CVA). In the present study, the effect of Ginseng radix on c-Fos expression and apoptosis in the hippocampal CA1 region of gerbils following transient global ischemia was investigated via immunohistochemistry for c-Fos and caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Enhanced c-Fos-, TUNEL-, and caspase-3-positivities were detected in the hippocampal CA1 region in ischemic gerbils. Administration of the aqueous extract of Ginseng radix suppressed this ischemia-induced increment in the numbers of c-Fos-, TUNEL-, and caspase-3-positive cells. These results suggest that Ginseng radix has an inhibitive effect on the induction of c-Fos expression and apoptosis seen following transient global ischemia.

• The Journal of Korean Medicine
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• v.39 no.4
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• pp.1-15
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• 2018

Objectives: Cerebral ischemia results from a variety of causes that cerebral blood flow is reduced due to a transient or permanent occlusion of cerebral arteries. Reactive astrocytes and microglial activation plays an important role in the neuronal cell death during ischemic insult. Acupunctural treatment is effective for symptom improvement in cerebrovascular accident, including cerebral ischemia. Methods: In the present study, the effects of acupuncture at the ST40 acupoint on short-term memory and apoptosis in the hippocampal CA1 region following transient global cerebral ischemia were investigated using gerbils. Transient global ischemia was induced by occlusion of both common carotid arteries with aneurysm clips for 5 min. Acupuncture stimulation was conducted once daily for 7 consecutive days, starting one day after surgery. Results: In the present results, ischemia induction deteriorated short term memory, increased apoptosis, and induced reactive astrocyte and microglial activation. Acupuncture at ST40 acupoint ameliorated ischemia-induced short-term memory impairment by suppressing apoptosis in the hippocampus through down-regulation of reactive astrocytes and microglial activation. Conclusion: The present study suggests that acupuncture at the ST40 acupoint can be used for treatment of patients with cerebral stroke.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.190-194
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• 2015

Blunt cerebrovascular injury is defined as a vertebral or carotid arterial structural wall injury resulting from nonpenetrating trauma. Complete traumatic internal carotid artery occlusion is very rare condition accounting for 0.08~0.4 0f all trauma patients and believed to be associated with the greatest risk of ischemic stroke reported in 50~90% in a few small series. A 55-year-male was admitted with drowsy mentality and severe headache after a fall down accident. Brain computed tomography showed a subdural hematoma at the both frontal area with a fracture of the occipital skull bone. Two days after admission, he suddenly complained with a right side hemiparesis of motor grade 2. Brain magnetic resonance diffusion demonstrated multiple high flow signal changes from the left frontal and parietal lesion. Computed tomographic angiogram (CTA) revealed absence of the left ICA flow. Trans femoral cerebral angiography (TFCA) showed complete occlusion of the left internal carotid artery (ICA) at ophthalmic segment in the left ICA angiogram and flows on the left whole hemispheric lesions through the anterior communicating artery in the right ICA angiogram. We decided to conduct close observations as a treatment for the patient because of acute subdural hematoma and sufficient contralateral cerebral flow by perfusion SPECT scan. Two weeks after the accident, he was treated with heparin anticoagulation within INR 2~4 ranges. He recovered as the motor grade 4 without another neurologic deficit after 3 months.

• The Journal of Korean Medicine
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• v.18 no.2
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• pp.223-244
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• 1997

Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

• The Journal of Korean Medicine
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• v.24 no.2
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• pp.66-80
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• 2003

Objectives : Recently, herbal acupuncture has been developed in the Korea since the earlier 1960' applied to various diseases including the cerebrovascular accident. The main characteristics of herbal acupuncture are a combination the merit 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. Ramulus Uncariae Cum Uncis (釣鉤藤) has been claimed to possess sedative, anti-spasmodic actions, and treat childhood epilepsy in oriental medical preparation. Also, it has been stated that Ramulus Uncariae Cum Uncis was antioxidatvie effect and neuroprotection against glutamateinduced neuronal death. Methods : In this study, effects of Ramulus Uncariae Cum Uncis' herbal acupuncture on the $GV_{20}{\;}or{\;}LR_3$, named Baek-hue or Tae-chung, 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 immunohistochemistry 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 Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ 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. Especially, cFos expression was more increased at the herbal acupuncture on $GV_{20}{\;}than{\;}LR_3$, but FosB expression was more decreased in $LR_3$ group than $GV_{20}$ group. Also, pretreatment with Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ significantly increased the expression of BDNF protein in the hippocampus ($254.88{\pm}12{\;}pg/ml{\;}in{\;}GV_{20}$ group, $245.93{\pm}44.4{\;}pg/ml{\;}in{\;}LR_3$ group) and the cortex ($85.81{\pm}3.45{\;}pg/ml{\;}in{\;}GV_{20}$ group, $111.51{\pm}15.79{\;}pg/ml{\;}in{\;}LR_3$, group) compared to the hippocampus ($134.07{\pm}2.96{\;}pg/ml$) and the cortex ($61.16{\pm}4.11{\;}pg/ml$) in control group at 48 hrs after transient forebrain ischemia. Conclusion : These results suggest that pretreatment with Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ has neuroprotective effect on transient forebrain ischemia and the herbal acupunture on $GV_{20}{\;}or{\;}LR_3$ may be related to antioxidative effect and calcium channel block of Ramulus Uncariae Cum Uncis. Also, it could be mentioned there is specificity of acupoints treating ischemic injury through the difference between the herbal acupuncture of $GV_{20}{\;}and{\;}LR_3$.

• The Journal of Korean Medicine
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• v.24 no.2
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• pp.81-93
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• 2003

Objectives : Recently, the new therapeutic tool, that is herbal acupuncture, has been developed 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. The objective was to determine the effect of folium artemisiae argyi (艾葉) herbal acupuncture on the trasient forebrain ischemic injured rat. Methods : In this study, the effects of folium artemisiae argyi (艾葉) herbal acupuncture on the $LR_3$ named Taechung, 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 immunohistochemistry 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' herbal acupuncture on $LR_3$ significantly increased expression of cFos protein and significantly decreased expression of FosB protein compared to control group. These features were observed in the retrosplenial granular cortex as well as the hippocampus. Also, pretreatment with folium artemisiae argyi' herbal acupuncture on $LR_3$ significantly increased the expression of BDNF protein in the hippocampus ($263.26{\pm}44.56{\;}pg/ml$ extracted by water, $275.35{\pm}51.47{\;}pg/ml$ extracted by moxa tar)and the cortex ($102.33{\pm}13.65{\;}pg/ml$ extracted by water, $109.54{\pm}9.37{\;}pg/ml$ extracted by moxa tar) compared to the hippocampus ($134.07{\pm}2.96{\;}pg/ml$) and the cortex ($61.16{\pm}4.11{\;}pg/ml$) in control group at 48 hrs after transient forebrain ischemia. Conclusions : These results suggest that pretreatment with folium artemisiae argyi' herbal acupuncture on $LR_3$ has neuroprotective effect on transient forebrain ischemia and the herbal acupunture on $LR_3$ may be related to antioxidative function of folium artemisiae argyi.

• Korean Journal of Acupuncture
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• v.22 no.3
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• pp.63-81
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• 2005

Herbal 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. 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. In this study, neuroprotective effects of folium artemisiae argyi (艾葉)' herbal acupuncture on the $LR_3$ (Taechung) on 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 immunohistochemistry and ELISA technique. 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' herbal acupuncture on $LR_3$ significantly increased expression of cFos protein and significantly decreased expression of FosB protein compared to control group. These features were observed in the motor cortex and retrosplenial granular cortex as well as the hippocampus. Also, pretreatment with folium artemisiae argyi' herbal acupuncture on $LR_3$ significantly increased the expression of BDNF protein in the hippocampus ($263.26{\pm}44.56pg/ml$ extracted by water, $275.35{\pm}51.47pg/ml$ extracted by moxa tar)and the cortex ($102.33{\pm}13.65pg/ml$ extracted by water, $109.54{\pm}9.37pg/ml$ extracted by moxa tar) compared to the hippocampus $(134.07{\pm}2.96pg/ml)$ and the cortex $(61.16{\pm}4.11pg/ml)$ in control group at 48 hrs after transient forebrain ischemia. These results suggest that pretreatment with folium artemisiae argyi'herbal acupuncture on $LR_3$ has neuroprotective effect on transient forebrain ischemia and the herbal acupunture on $LR_3$ may be related to antioxidative function of folium artemisiae argyi.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.195-199
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• 1997

From Dec. 1992 to Dec. 1995, 20 patients with atherosclerotic occlusive disease in the lower extremities underwent arter al bypass surgery. The age of the patients ranged between 46 and 77 years(mean .60.8 years) and the most prevalent incidence was in the 7th decades. The mean follow up period was 18.8 months ranging from 4 to 36 months. Associated diseases were diabetus mellitus(25%), hypertension (35%), cerebrovascular accident(25%), and acute myocardial infarction(5%). Disabling intermittent claudifcation(35%), resting pain(20%) or ischemic gangrene(or ulceration)(45%) were operative indications. Aorto-bifemoral bypass in 4 cases, aorto-single femoral bypass in 2 cases, Aorto-bifemoral bypass and femoropopliteal bypass in 3 cases, aorto-single femoral bypass and femoropopliteal bypass in 1 case, femoropopliteal bypass in 4 cases, femorotibial bypass in 1 case, popliteotibial bypass 4 cases and femorofemoral bypass in 1 case were the surgical approches. Early thrombosis(2 cases) and wound infection(2 case) were main complication. Postoperative complication rate was 20% . Postoperative patency rates re 92.6% at 6 months, 84.2% at 1 year, 75.4% at 2 years and 69.4% at 3 years.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.790-798
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• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1049-1055
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• 1998

Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.