• 대한한의학회지
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• 제24권4호
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• pp.1-5
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• 2003

Leptin has a close correlation with obesity, which is known to be a major factor for stroke. This study was performed to determine whether serum leptin level would be an independent risk factor for stroke and whether it would change significantly early after stroke. Subjects were selected from those within I month after onset and non-stroke referents at Kyung Hee Oriental Medical Center in Seoul, Korea. We compared leptin and the other characteristics between stroke subjects and referents. Body mass index, hypertension history, presence of drinking and smoking, waist/hip ratio, total cholesterol and triglyceride were recorded. To assess odds ratio of leptin for stroke, we used logistic regression analysis. Leptin was rechecked 2 weeks later and compared with the former value in acute stroke subjects. In this study, serum leptin did not differ significantly between stroke subjects and referents, and its odds ratio was not significant in male (OR=0.52, 95％ Cl; 0.13-2.08) and female (OR=1.57, 95％ Cl; 0.53-4.67). In acute stroke subjects, leptin did not change significantly 2 weeks later. Hypertension had a significant odds ratio in male (OR=3.39, 95％ Cl; 1.02-11.24) and female (OR=12.37, 95％ Cl; 3.67-41.65). High waist/hip ratio was only in female (OR=6.70, 95％ Cl; 1.73-26.02). In conclusion, leptin was not an independent risk factor for stroke and its serum level did not change significantly early after stroke. Hypertension and waist/hip ratio had significant relative risks.

• 대한한방내과학회지
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• 제40권6호
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• pp.1225-1236
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• 2019

Objective: This is a case report on the effect of Korean traditional medicine on deep stupor to semi-coma with intracerebral and intraventricular hemorrhage. Methods: The patient was treated by Korean traditional medicine such as acupuncture, moxibustion, and herbal medicine. The change of mental state was evaluated by the Glasgow Coma Scale (GCS). We used the Modified Medical Research Council Scale (MRC scale) and the Modified Barthel Index (MBI) to evaluate the effectiveness of the treatment. Results: After treatment, the physical function and ability to perform activities of daily living were improved. The Modified Barthel Index increased from 0 to 40 after treatment with Korean medicine. Conclusions: According to this study, Korean traditional medicine can be effective for the treatment of quadriparesis in patients with deep stupor to semi-coma in intracerebral and intraventricular hemorrhage.

• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.523-527
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• 2012

Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.

• 대한한방내과학회지
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• 제38권5호
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• pp.658-667
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• 2017

Objectives: This is a case report regarding the effect of Korean traditional medicine on vision disorder and quadriplegia in a patient with neuromyelitis optica. Methods: We treated a patient who was diagnosed with neuromyelitis optica with Korean traditional medicine, including acupuncture, moxibustion, and herbal medicine (Gigugyanghyeol-tang gamibang) for 106 days. We evaluated the patient with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), Modified Barthel Index (MBI), Modified Ashworth Scale (MAS) Grade, and Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient's symptoms were improved. The ISNCSCI scores increased from 42 to 66 in motor score, from 152 to 196 in sensory score, and from A to D in the ASIA impairment scale; the MBI score increased from 9 to 33, while the score of the MAS Grade decreased from I+ to I, and the NRS-11 scores of vision disorder, spasticity, and tingling decreased from 10 to 7, 3, and 2-3, respectively. Conclusions: Korean traditional medicine may be effective for treatment of vision disorder and quadriplegia in patients with neuromyelitis optica.

• 대한영양사협회학술지
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• 제10권4호
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• pp.442-451
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• 2004

Protein-calories malnutrition is common among patients in the hospital. In particular, elderly patients with neurologic disorders has more risk of nutritional deficiency due to swallowing difficulty. Enteral tube feeding is more economical, physiological and immunological than parenteral nutrition for patients who have adequate gastrointestinal function. This study was conducted patients with neurologic disorders who received enteral nutrition at Asan Medical Center from February 1 to October 10, 2002. The control group (48 patients) were given traditional feeding methods 4 times a day while the treatment group (45 patients) were given improved feeding methods 3 times a day. We assessed nutritional status of patients and compared to both groups. We investigated body weight, serum albumin, hemoglobin, total lymphocyte count by means of nutrition markers. The objectives of this study is to reduce the time needed for nutritional requirement of patients without an increase in gastrointestinal intolerances. The results of this study are as follows: 1. Nutritional status of many patients in both groups were either malnourished or at risk for malnutrition. 2. The time to arrive to the nutritional requirements were 6.21 $\pm$ 0.35 days for the control group and 4.24 $\pm$ 0.52 days for the treatment group. The treatment group showed a significantly shorter amount of time. 3. The changes of the nutritional marker in the control group showed a significant drop in body weight, serum albumin and serum hemoglobin while the treatment group experienced a significant increase in body weight, serum albumin and total lymphocyte count. 4. Feeding intolerane such as diarrhea, high residual volume, ileus, nausea and vomiting were investigated. Diarrhea found in 25.1% (12 patients) of the control group and 22.2% (10 patients) of the treatment group and these findings are not significant.

• Radiation Oncology Journal
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• 제38권1호
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• pp.26-34
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• 2020

Purpose: Intensity-modulated radiotherapy (IMRT) allows for more precise treatment, reducing unwanted radiation to nearby structures. We investigated the safety and feasibility of IMRT for anaplastic ependymoma patients below 3 years of age. Materials and Methods: A total of 9 anaplastic ependymoma patients below 3 years of age, who received IMRT between October 2011 and December 2017 were retrospectively reviewed. The median equivalent dose in 2 Gy fractions was 52.0 Gy (range, 48.0 to 60.0 Gy). Treatment outcomes and neurologic morbidities were reviewed in detail. Results: The median patient age was 20.9 months (range, 12.1 to 31.2 months). All patients underwent surgery. The rates of 5-year overall survival, freedom from local recurrence, and progression-free survival were 40.6%, 53.3%, and 26.7%, respectively. Of the 9 patients, 5 experienced recurrences (3 had local recurrence, 1 had both local recurrence and cerebrospinal fluid [CSF] seeding, and 1 had CSF seeding alone). Five patients died because of disease progression. Assessment of neurologic morbidity revealed motor dysfunction in 3 patients, all of whom presented with hydrocephalus at initial diagnosis because of the location of the tumor and already had neurologic deficits before radiotherapy (RT). Conclusion: Neurologic morbidity is not caused by RT alone but may result from mass effects of the tumor and surgical sequelae. Administration of IMRT to anaplastic ependymoma patients below 3 years of age yielded encouraging local control and tolerable morbidities. High-precision modern RT such as IMRT can be considered for very young patients with anaplastic ependymoma.

• 대한한의학회지
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• 제29권5호
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• pp.52-66
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• 2008

Objectives :Ginkgo-Chunghyul-dan (GCHD) is newly developed herbal medicine to prevent and treat stroke. In this study, we investigated whether the GCHD had antioxidant activity and anti-platelet aggregation effect in vitro and hypolipidemic activities in vivo. Methods :Anti-oxidant activity of GCHD was measured using the Blois method, anti-platelet effect of GCHD was assessed by the Born method, and hypolipidemic activities of GCHD were evaluated in corn oil- or Triton WR-1339-induced and cholesterol-fed rats. Results :GCHD showed anti-oxidant activity in the study inhibiting the formation of 1-diphenyl-2-picrylhydrazyl radicals and xanthine oxidase activity. GCHD had anti-platelet aggregation activity. GCHD significantly lowered total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) in high cholesterol diet and Triton WR-1339 induced model TG in corn oil-induced model. GCHD had no acute toxicity at a single dosage. Conclusion : These results suggest that GCHD has the potential to treat hyperlipidemia and stroke.

• 대한한방내과학회지
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• 제24권2호
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• pp.283-289
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• 2003

Background and Purpose : Hemiplegic upper extremity is a problem frequently encountered in the rehabilitation of patients with stroke. In Korean traditional medicine, moxibustion has been used clinically in treatment of stroke patients with hemiplegia. So far, its efficacy has not been proven clinically. The purpose of this study was to evaluate the efficacy of the moxibustion in treating hemiplegic upper extremity in stroke patients. Design : Randomized Control Trial. Subjects and Methods : Forty hemiplegic stroke patients admitted to Kyunghee oriental medicine hospital were randomized into the treatment with standard physiotheraphy combined with Moxibustion-group or Control-group with standard physiotherapy alone. It took them 2-5 weeks from the onset to start this study. Moxibustion was applied at LI4(合谷), LI11(曲池), TE3(中渚), TE5(外關) in hemiplegic hand, once a day for 2weeks. The effect of treatment on hemiplegic upper extremity was assessed using Fugl-Myer motor scale, Motricity Index and Modified Barthel Index(drinking/feeding, dressing upper body, grooming) Results : These 2 groups had comparable clinical characteristics; sex, age, plegic side (Rt., Lt.), pretreatment impairment. After two weeks, patients in the moxibustion group perfomed better on Fugl-Myer test and Motricity index test. The differences were significant.(P=0.038, 0.002) But Results on the Modified Barthel Index revealed no effect.(P=0.348) Conclusion : This results suggest that moxibustion is an effective treatment for improvement of motor function of hemiplegic upper extremity.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.534-539
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• 2017

Objective : Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. Methods : From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. Results : The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). Conclusion : Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.

• 대한한방내과학회지
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• 제42권5호
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• pp.727-737
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• 2021

Objectives: This study investigated the effect of Korean medicine on an elderly patient with posterior circulation cerebral infarction, chronic kidney disease (CKD), and early neurological deterioration (END). Methods: The patient, who already had CKD, was treated with Korean medicine, comprising herbal medicine, acupuncture, moxa, and cupping combined with Western medicine (antiplatelet, diabetes) and physical therapy. A manual muscle test (MMT) and a modified Barthel index (MBI) were used to observe the treatment effects, and blood tests were performed to check estimated glomerular filtration rate (eGFR), creatinine and blood urea nitrogen (BUN), which represent renal function. Results: After the treatment, MMT, MBI, and renal function scores had increased. Conclusions: This study suggests that Korean medicine can effectively treat posterior circulation cerebral infarction with END in CKD, but further studies should be conducted.