• The Journal of Internal Korean Medicine
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• v.29 no.4
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• pp.979-987
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• 2008

Objectives : This study aimed to evaluate the characteristics of acute stroke patients between excess syndrome and deficiency syndrome groups. Method : We recruited stroke patients from the patients admitted to the Department of Internal Medicine of Kyunghee University Oriental Medical Center, Dongguk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center and Kyungwon University Incheon Oriental Medical Center from April 2007 to August 2008. We diagnosed acute stroke patients as either excess syndrome or deficiency syndrome and analyzed their characteristics for type of stroke, blood test result. Sasang constitution and lifestyle. Result : We found height, weight, BMI, W/H ratio, hypertension, diabetes, migraine, silent infarction, TG, total lipid, HDL-chol, RBC, Hb, hematocrit, alcohol, smoking and Sasang constitution (Tae-eum, So-yang) were more associated with the excess syndrome group. And we found sea food and Sasang constitution(So-eum) was more associated with the deficiency syndrome group. Conclusion : According to the analysis, we found that the excess syndrome group had more risk factors than the deficiency syndrome group. These results could be utilized in the future as a basis material for Oriental medicine therapy. Further studies will be needed to better understand the differences between excess syndrome and deficiency syndrome groups among acute stroke patients.

• The Journal of Korean Medicine
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• v.27 no.4
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• pp.135-141
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• 2006

We were to assess clinical effectiveness, safety and usefulness of Kyejibokryung-hwan (KBH), which has been used for Er-hyul similar with vascular or neurologic disorders causing sensory or motor abnormalities. This study is a retrospective single case series. Two hundred ninety five patients were treated with KBH for various neuropathies in our hospital. Of them, 120 cases were excluded because of insufficient medical records or failure to follow up; the remaining 175 were included in the analysis. There were 18 patients with sensory abnormalities and 28 with motor abnormalities after stroke. Of peripheral type, there were 14 with diabetic neuropathy, 12 with carpal tunnel syndrome, 41 with spinal radiculopathies, and 62 with idiopathic neuropathies, for which the effectiveness was assessed as 55.6%, 21.4%, 64.3%, 83.3%, 45.0%, and 56.5%, respectively. Adverse effects including indigestion or diarrhea were seen in 3.4% of the total patients. Taking the effectiveness and the safety together into consideration, the usefulness was assessed as 55.6%, 21.4%, 64.3%, 83.3%, 45.0%, and 54.8% for treating post-stroke sensory and motor abnormalities, diabetic neuropathy, carpal tunnel syndrome, spinal radiculopathies, and idiopathic neuropathies, respectively. In conclusion, we suggest that KBH is a useful herbal medicine for various neuropathies, especially of sensory type.

• Journal of Society of Preventive Korean Medicine
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• v.12 no.3
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• pp.59-65
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• 2008

Objective : This study was conducted to integrate the results of studies which show the relationship between risk factors(smoking, drinking, intaking coffee, exercise, BMI, family history, hypertension, DM, hyperlipidemia, heart disease, TIA) and the incidence of stroke in Korean adults. Methods : We surveyed 17 stroke-related articles, published between 1995 and 2007, and conduct meta-analysis. And we estimated common odds ratio(OR). Results : The overall OR of risk factors associated CVD were as follow : Smoking had a 2.488 OR, no regular exercise had a 1.942 OR, $BMI{\geq}25$ had a 1.848 OR, hypertension had a 6.053 OR, DM had a 2.931 OR, heart disease had a 5.455 OR, and TIA had a 5.238 OR. Conclusion : The result of this study suggest that smoking, no regular exercise, $BMI{\geq}25$, hypertension, DM, heart disease, and TIA are important risk factor of stroke.

• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.33-42
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• 2012

Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.708-718
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• 2009

Objectives : The aim of this study was to assess the relationship between risk factors, warning signs, tongue diagnosis, pulse pattern, pattern identification and National Institute of Health Stroke Scale in acute stroke patients. Methods : We studied patients hospitalized within 4 wks after their ictus who were admitted at the Internal Medical Department at Kyunghee Oriental Medical Center, Kyunghee University East-West Neo Medical Center, Kyungwon University Songpa Oriental Medical Center, Kyungwon University Incheon Oriental Medical Center, Dongguk University Ilsan Oriental Medical Center from April 2007 to August 2009. We analyzed the relationship between risk factors, warning signs, tongue diagnosis, pulse pattern, pattern identification and National Institute of Health Stroke Scale in acute stroke patients. Results : 1506 subjects were included into the final analysis. 1. In the risk factors, the NIHSS mean score of atrial fibrillation was significantly higher than non-atrial fibrillation. 2. In the warning signs, the NIHSS mean scores of weakness, loss of eyesight, dysarthria, and sensory loss were significantly higher than in the non-warning signs. 3. There were no significant differences in lifestyle, tongue fur color, pattern identification between groups. 4. In the tongue color, the NIHSS mean score of red was significantly higher than pale or pale red. 5. There were significant differences statistically between forceful/weak, fine/not fine, slippery/not slippery pulse and NIHSS score. Conclusion : The above results show the relationship between risk factors, warning signs, tongue diagnosis, pulse pattern, pattern identification and National Institute of Health Stroke Scale in acute stroke patients. These results can be utilized in the future as a basis material.

• The Journal of Korean Medicine
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• v.30 no.1
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• pp.109-119
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• 2009

Objectives: This study was aimed to clarity the relationship between the pattern of dampness-phlegm and metabolic syndrome in acute stroke patients. Methods: Three hundred fifty-nine subjects were recruited from the patients admitted to the Internal Medical Department at Kyunghee University Oriental Medical Center, Donggnk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center and Kyungwon University Incheon Oriental Medical Center from April 2007 to March 2008. We diagnosed dampness-phlegm by Oriental medical diagnosis and analyzed their characteristics with type of stroke, blood test result, Sasang constitution, lifestyle and metabolic syndrome. Results: I. On the demographic variables of the patients, the weight and body mass index, the rate of hypertension, diabetes mellitus, hyperlipidemia, silent infarction were significantly higher in dampness-phlegm group than in the control. 2. There was no significant difference of stroke type between the dampness-phlegm group and the control. 3. According to the blood test, the dampness-phlegm group showed higher total cholesterol, triglyceride, fasting blood sugar and lower high density lipoprotein cholesterol than the control group with statistical significance. 4. According to the Sasang constitution distribution, the rate of Tae-Eum was significantly higher in dampness-phlegm group than in the control. 5. According to lifestyle, smoking and drinking were significantly lower in the dampness-phlegm group than in the control. Otherwise, exercise and dietary habits showed no significant difference between the two groups. 6. There were much more patients diagnosed with metabolic syndrome in the dampness-phlegm group than in the control. 7. Metabolic syndrome, silent infarction and obesity showed close relationship with dampness-phlegm pattern in multivariate analysis. Conclusions: According to the analysis, the relationship between the patterns of dampness-phlegm and metabolic syndrome in acute stroke patients were clarified. These results can be utilized in the future as a basis material.

• Genomics & Informatics
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• v.6 no.3
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• pp.153-156
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• 2008

Complex diseases such as stroke and cancer have two or more genetic loci and are affected by environmental factors that contribute to the diseases. Due to the complex characteristics of these diseases, identifying candidate genes requires a system-level analysis of the following: gene ontology, pathway, and interactions. A database and user interface, termed StrokeBase, was developed; StrokeBase provides queries that search for pathways, candidate genes, candidate SNPs, and gene networks. The database was developed by using in silico data mining of HGNC, ENSEMBL, STRING, RefSeq, UCSC, GO, HPRD, KEGG, GAD, and OMIM. Forty candidate genes that are associated with cerebrovascular disease were selected by human experts and public databases. The networked cerebrovascular disease gene maps also were developed; these maps describe genegene interactions and biological pathways. We identified 1127 genes, related indirectly to cerebrovascular disease but directly to the etiology of cerebrovascular disease. We found that a protein-protein interaction (PPI) network that was associated with cerebrovascular disease follows the power-law degree distribution that is evident in other biological networks. Not only was in silico data mining utilized, but also 250K Affymetrix SNP chips were utilized in the 320 control/disease association study to generate associated markers that were pertinent to the cerebrovascular disease as a genome-wide search. The associated genes and the genes that were retrieved from the in silico data mining system were compared and analyzed. We developed a well-curated cerebrovascular disease-associated gene network and provided bioinformatic resources to cerebrovascular disease researchers. This cerebrovascular disease network can be used as a frame of systematic genomic research, applicable to other complex diseases. Therefore, the ongoing database efficiently supports medical and genetic research in order to overcome cerebrovascular disease.

• The Journal of Internal Korean Medicine
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• v.29 no.4
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• pp.970-978
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• 2008

Objectives : This study aimed to clarify the relationship between the Oriental medical diagnosis and arteriosclerosis by measuring carotid-ankle vascular index(CAVI) in acute cerebral infarction patients. Method : One hundred thirty-one subjects were recruited from the patients admitted to the Internal Medical Department at Kyunghee University Oriental Medical Center from April 2007 to August 2008. We sorted cerebral infarction patients and assessed one hundred fourteen patients' CAVI data. We diagnosed dampness-phlegm by Oriental medical diagnosis and evaluated stroke type by single or multiple infarctions. then, we analyzed their characteristics with type of stroke, risk factor, lifestyle, metabolic syndrome and dampness-phlegm diagnosis. Result : 1. On the demographic variables of the patients, age, hypertension, hyperlipidemia, multiple infarction group and metabolic syndrome and dampness-phlegm group were significantly higher in the high CAVI score group than in the control. 2. According to the significant difference in the dampness-phlegm group, we analyzed dampness-phlegm related index for pattern identifications by CAVI score. As a result, dark circles, insomnia, headache, white coating tongue. slippery pulse, and rough pulse were significantly higher in the high CAVI score group then in the control. 3. In multivariate analysis, age, hypertension, multiple infarction and dampness-phlegm groups showed a close relationship with the high CAVI score group. Conclusions : According to the analysis, significance between dampness-phlegm diagnosed patients group and high CAVI score were clarified. Moreover, multiple location infarctions also have a relationship with high CAVI score in cerebral infarction patients. These results can be utilized in the future as a basis material.

• The Journal of Internal Korean Medicine
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• v.31 no.3
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• pp.578-585
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• 2010

Objectives : Coldness of hands and feet has been regarded to be associated with blood circulation. This study was performed to assess the correlation between erythrocyte deformability and coldness of hands and feet. Methods : 145 patients who had taken an erythrocyte deformability test were selected for this study among hospitalized patients within 4 weeks after their cerebral infarction at the Internal Medical Department at Kyunghee Oriental Medical Center from August 2008 to August 2009. We divided the selected patients into two groups, with and without of coldness of hands and feet groups. The two groups were compared on risk factors for atherosclerosis and examined for variables including erythrocyte deformability. Results : 1. On demographic variables of the patients, only body mass index was significantly lower in the coldness of hands and feet group than the control group. There was no significant difference of the rate of hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, smoking, drinking and carotid artery stenosis between the two groups. 2. According to blood test, the coldness of hands and feet group showed significantly lower erythrocyte deformability index than the control group. 3. Body mass index and erythrocyte deformability index showed a close relationship with coldness of hands and feet in multivariate analysis. Conclusions : The correlation between the erythrocyte deformability and coldness of hands and feet in cerebral infarction patients were decreased erythrocyte deformability participated in the mechanism of coldness of hands and feet.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.5
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• pp.964-968
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• 2009

The purpose of this study is to select the major pulse indicators and evaluate their significance in discriminating the subtypes of Pattern Identifications (PI) from stroke patients. Decision tree analysis was carried out using clinical data collected from 835 stroke patients with the same subtypes diagnosed identically by two experts with more than 3 year clinical experiences. Among the 10 pulse indicators, 6 major pulse indicators (slow, rapid, strong, weak, slippery, and fine pulse) were selected by decision tree analysis. The accumulated distributions of six pulse indicators in each PI showed that strong was major pulse indicator in Fire-Heat pattern, slippery in Dampness Phlegm pattern, weak in Qi Deficiency pattern. But there were two major combinations in Yin deficiency pattern, weak or fine with rapid pulse and weak or fine without rapid pulse. Therefore, it is suggested that 6 pulse indicators can be used for discrimination of PI in stroke patients, though the combination studies between these pulse indicators and the other PI indicators are left for further study.