• The Journal of Pediatrics of Korean Medicine
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• v.18 no.2
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• pp.143-160
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• 2004

Objective: There were few reports on the treatment of Hypoxic ischemic encephalopathy. We treated a hypoxic ischemic encephalopathic patient after accident with Oriental medical approach, and get a significant result. this treatment shows the possibility of healing Hypoxic ischemic encephalopathy, So we are reporting that case. Method : The acupuncture, herb medication. rehabilitation therapy was applied for treting patient's chife symptom(involuntary movement, dystonia, aphasia, dysuria, constipation) Results : 1. Generally patients with Hypoxic ischemic encephalopathy show language impairment and cognition disorder for several weeks to months. After coma stage, first they recover consciousness but have various degree of confusional mentality, visual agnosia, extrapyramidal stiffness and motor disturbance. 2. Consciousness loss in acute stage of Hypoxic ischemic encephalopathy can be considered as Mental Confusion due to Phlegm(Dammisimgyu) in veiw point of Oriental medicine. 3. After oriental medical treatment, patient's chief symptoms were improved. Conclusion: We treated a hypoxic ischemic encephalopathic patient with Oriental medical approach and patient's chief symptoms were improved. this treatment shows the possibility of healing Hypoxic ischemic encephalopathy.

• The Journal of Pediatrics of Korean Medicine
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• v.19 no.2
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• pp.255-269
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• 2005

Objective : To evaluate the effect of Oriental Medical Treatment on a patient with Hypoxic Ischemic Encephalopathy followed by Cardiopulmonary Resuscitation Method : We applied various methodology of Oriental Medical Treatment including Acupuncture, Electroacupuncture, Physical treatment, Herbal Medicine, Moxibustion treatment and Western medication as well. Result: Herbal medicine was applied on the basis of the patient's history. We applied formular to remove phelgm as a pathogenic factor after Hypoxic Ischemic Encephalopathy. At the same time, considering the patient spent more than a month in ICU lacking appropriate nutrition, we used formuli on the basis of 'Deficiency of Spleen' focusing to vitalize the function of digestive system. As the condition of the patient changed, we also adapted formular accordingly. We prescribed Herbal medication to strengthen Yin and Yang equally as she got hospitalized for long time. Also we applied Acupuncture treatment and Moxibustion treatment to control Qi flow. The general condition of the patient got better with successful removal of Foley catheter and elevated Glasgow Coma scale. We used Electroacupuncture, Physical treatment and Western medication at the same to get maximized effect on relaxing the contracted muscle. According to the Modified Ashworth Scale (MAS), we have some changes in muscle spasticity but later, the effect was not that significant. Conclusion : We had a patient with Hypoxic Ischemic Encephalopathy followed by Cardiopulmonary Resuscitation. In the management of Hypoxic Ischemic Encephalopathy, Conservative treatments are the mainstream but there are not many alternatives. Therefore, We suggest that Oriental medical approach may contribute to the management of Hypoxic Ischemic Encephalopathy.

• Clinical and Experimental Pediatrics
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• v.64 no.12
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• pp.608-618
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• 2021

Hypoxic-ischemic encephalopathy (HIE) is the most common cause of neonatal encephalopathy with a global incidence of approximately 1 to 8 per 1,000 live births. Neonatal encephalopathy can cause neurodevelopmental and cognitive impairments in survivors of hypoxic-ischemic insults with and without functional motor deficits. Normal neurodevelopmental outcomes in early childhood do not preclude cognitive and behavioral difficulties in late childhood and adolescence because cognitive functions are not yet fully developed at this early age. Therapeutic hypothermia has been shown to significantly reduced death and severe disabilities in term newborns with HIE. However, children treated with hypothermia therapy remain at risk for cognitive impairments and follow-up is necessary throughout late childhood and adolescence. Novel adjunctive neuroprotective therapies combined with therapeutic hypothermia may enhance the survival and neurodevelopmental outcomes of infants with HIE. The extent and severity of brain injury on magnetic resonance imaging might predict neurodevelopmental outcomes and lead to targeted interven tions in children with a history of neonatal encephalopathy. We provide a summary of the long-term cognitive outcomes in late childhood and adolescence in children with a history of HIE and the association between pattern of brain injury and neurodevelopmental outcomes.

• The Journal of Pediatrics of Korean Medicine
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• v.19 no.2
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• pp.127-136
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• 2005

Objective: There were few reports on the treatment of Wolff-Parkinson-White syndrome with Hypoxic ischemic encephalopathy. We treated a Wolff-Parkinson-White syndrome with Hypoxic ischemic encephalopathic patient with Oriental medical approach, and got a significant result. This treatment shows the possibility of healing Wolff-Parkinson-White syndrome with Hypoxic ischemic encephalopathy. So we are reporting this case. Method : Acupuncture treatment, herb medication, rehabilitation therapy were applied for treating patient's chief symptom.(involuntary movement, dystonia, aphasia, fever, perspiration) Results : Consciousness loss in acute stage of Hypoxic ischemic encephalopathy can be considered as Mental Confusion due to Phlegm(Dammisimgyu) in veiw point of Oriental medicine. Wolff-Parkinson-White syndrome can be considered as Sudden Palpitation(Gyounggye) in veiw point of Oriental medicine. After oriental medical treatment, patient's chief symptoms were improved. Conclusion: More study about oriental medical treatment on Wolff-Parkinson-White syndrome with Hypoxic ischemic encephalopathy is needed.

• Annals of Clinical Neurophysiology
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• v.15 no.2
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• pp.42-47
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• 2013

Background: Diffusion-weighted image (DWI) might be useful to predict the prognosis of acute hypoxic encephalopathy. The aim of our study was to test whether the early change and extent of DWI abnormalities can be an indicator of the clinical outcome of hypoxic encephalopathy. Methods: Forty-four patients who were diagnosed as hypoxic encephalopathy due to the cardiorespiratory arrest were retrospectively identified. Clinical variables were determined, and the DWI abnormalities were counted by four areas: cortex, subcortical white matter, cerebellum and deep grey matter, and were divided into three groups by the extent of lesions. Prognosis was classified as 'poor' (Glasgow coma scale (GSC) at 30 days after arrest <9 or death) and 'good' (GSC at 30 days after arrest ${\geq}9$). Results: GCS at day 3 (p<0.001), presence of seizure (p=0.01), and presence of lesion (p<0.001) were significantly different in prognosis, but statistically there is no association with the extent of lesions and prognosis (p=0.26). Conclusions: Presence of early DWI changes could predict the clinical outcome of hypoxic encephalopathy after cardiorespiratory arrest.

• Proceedings of the PSK Conference
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• 2003.10a
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• pp.104-105
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• 2003

Hypoxic-ischemic (H-I) encephalopathy in the prenatal and perinatal period is a major cause of morbidity and mortality and often results in cognitive impairment, seizures, and motor impairment (cerebral palsy). Many studies of neonatal H-I brain injury have utilized the well characterized Levine model in which unilateral carotid ligation is followed by exposure to hypoxia. (omitted)

• Clinical and Experimental Pediatrics
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• v.64 no.4
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• pp.169-171
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• 2021

• Clinical and Experimental Pediatrics
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• v.63 no.8
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• pp.329-334
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• 2020

Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney. Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzyme-linked immunosorbent assay of a cord blood sample collected within 30 minutes after birth. Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001). Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.2
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• pp.91-96
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• 2007

The measurement of pathologically low levels of tissue $pO_2$ is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowaday have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. $^{18}F-MISO$ PET and $^{99}mTc-EC-metronidazole$ SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using $^{123}I-IAZA$ in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.

• Clinical and Experimental Pediatrics
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• v.64 no.12
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• pp.628-629
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• 2021