• Journal of Korean Medicine Rehabilitation
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• v.18 no.2
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• pp.33-43
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• 2008

Objectives : Sunghyangjungki-san(Xingxiangzhengqi-san) is a herb decoction prescribed frequently for stroke patients. The present study investigated neuroprotective effects of Sunghyangjungki-san(Xingxiangzhengqi-san) against the ischemic damage of the rat brain. Neuronal cell death under the cerebral ischemia is distinguished with the delayed cell death through apoptosis. Consequently, the effects of Sunghyangjungki-san(Xingxiangzhengqi-san) was evaluated with Bax and Bcl-2 expressions as apoptosis related factors in the brain tissues. Methods : The ischemic damage was induced by the middle cerebral artery occlusion(MCAO) method in Sprague-Dawley rats. Water extract of Sunghyangjungki-san(Xingxiangzhengqi-san) was treated for 5 days after the MCAO. Neurological scores and infarct size with TTC were measured. Bax and Bcl-2 expressions in the brain tissues were observed with immunohistochemistry. Results : Sunghyangjungki-san(Xingxiangzhengqi-san) treatment improved neurological score significantly at 5 days after the MCAO. Sunghyangjungki-san(Xingxiangzhengqi-san) treatment decreased infarct size by the MCAO, but it was not significant statistically. Sunghyangjungki-san(Xingxiangzhengqi-san) treatment attenuated Bax positive neurons significantly in the cerebral penumbra and the caudate putamen. Bcl-2 positive neurons were increased, but not significant. Sunghyangjungki-san(Xingxiangzhengqi-san) treatment increased Bcl-2/Bax expression ratios significantly in the cerebral penumbra and the caudate putamen. Conclusions : These results suggest that Sunghyangjungki-san(Xingxiangzhengqi-san) has a neuroprotective effect on the stroke with modulation of apoptosis related factors.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.842-848
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• 2001

Objectives : The mortality rate of subarachnoid hemorrhage(SAH) has been reduced recently due to refinement of microsurgical technique and improved perioperative management. Also, many survivors of SAH show excellent neurological recoveries. However, we found that a high proportion of the survivors do not fully regain their premorbid status in cognitive and memory function. Object of this study is to evaluate which factors might influence on cognitive and memory impairment in ruptured aneurysmal SAH patients. Methods : In this prospective study, a series of 66 patients with aneurysmal subarachnoid hemorrhage(SAH) from 1996 to 1998, most of whom had a "good" or "fair" neurological outcome, were assessed with various tests of cognition and memory function. All patients underwent clipping operation by pterional approach. Right side approach was performed in 16 case and left 21 cases. K-WAIS(Korean-Wechsler Adult Intelligence Scale) was used as method of cognition and memory function test. The time interval between SAH and assessment varied between 4 months and 8 months, averaging 6.2 months. Statistical analyses were carried out for each test score to see whether aneurysm site(A-com : non A-com), route of approach, age and sex, vasospasm, Hunt-Hess grade and Fisher CT group at admission, Glasgow Outcome Scale(GOS) at discharge affect cognitive and memory function. Results : Aneurysm site was not shown to be associated with performance on any test, and the initial grade (Hunt-Hess grade, Fisher CT group) of SAH and vasospasm had only minimal predictive values. The grade at discharge( GOS) was proved to be the best predictor of impairment of cognition and memory function within 1 year after operation. Conclusion : The authors conclude that the diffuse effects of SAH are more important than focal neuropathology in relation to cognitive impairment in this group of patients.

• Journal of Korean Neurosurgical Society
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• v.55 no.3
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• pp.142-147
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• 2014

Objective : A thoracolumbar burst fracture is usually unstable and can cause neurological deficits and angular deformity. Patients with unstable thoracolumbar burst fracture usually need surgery for decompression of the spinal canal, correction of the angular deformity, and stabilization of the spinal column. We compared two struts, titanium mesh cages (TMCs) and expandable cages. Methods : 33 patients, who underwent anterior thoracolumbar reconstruction using either TMCs (n=16) or expandable cages (n=17) between June 2000 and September 2011 were included in this study. Clinical outcome was measured by visual analogue scale (VAS), American Spinal Injury Association (ASIA) scale and Low Back Outcome Score (LBOS) for functional neurological evaluation. The Cobb angle, body height of the fractured vertebra, the operation time and amount of intra-operative bleeding were measured in both groups. Results : In the expandable cage group, operation time and amount of intraoperative blood loss were lower than that in the TMC group. The mean VAS scores and LBOS in both groups were improved, but no significant difference. Cobb angle was corrected higher than that in expandable cage group from postoperative to the last follow-up. The change in Cobb angles between preoperative, postoperative, and the last follow-up did not show any significant difference. There was no difference in the subsidence of anterior body height between both groups. Conclusion : There was no significant difference in the change in Cobb angles with an inter-group comparison, the expandable cage group showed better results in loss of kyphosis correction, operation time, and amount of intraoperative blood loss.

• Journal of Ginseng Research
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• v.46 no.2
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• pp.275-282
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• 2022

Background: Stroke is a neurological disorder characterized by brain tissue damage following a decrease in oxygen supply to brain due to blocked blood vessels. Reportedly, 80% of all stroke cases are classified as cerebral infarction, and the incidence rate of this condition increases with age. Herein, we compared the efficacies of Korean White ginseng (WG) and Korean Red Ginseng (RG) extracts (WGex and RGex, respectively) in an ischemic stroke mouse model and confirmed the underlying mechanisms of action. Methods: Mice were orally administered WGex or RGex 1 h before middle cerebral artery occlusion (MCAO), for 2 h; the size of the infarct area was measured 24 h after MCAO induction. Then, the neurological deficit score was evaluated and the efficacies of the two extracts were compared. Finally, their mechanisms of action were confirmed with tissue staining and protein quantification. Results: In the MCAO-induced ischemic stroke mouse model, WGex and RGex showed neuroprotective effects in the cortical region, with RGex demonstrating superior efficacy than WGex. Ginsenoside Rg1, a representative indicator substance, was not involved in mediating the effects of WGex and RGex. Conclusion: WGex and RGex could alleviate the brain injury caused by ischemia/reperfusion, with RGex showing a more potent effect. At 1,000 mg/kg body weight, only RGex reduced cerebral infarction and edema, and both anti-inflammatory and anti-apoptotic pathways were involved in mediating these effects.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.738-746
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• 2020

Objectives : The purpose of this study was to evaluate surgical outcomes and complications of spinal deformity associated with neurofibromatosis type-1 (NF-1). Methods : From 2012 to 2018, patients suffering from spinal deformity associated with NF-1 who underwent surgical correction were identified. Demographic data and radiographic measures were retrospectively reviewed. Pre- and postoperative whole spine radiograph images were used to determine both coronal and sagittal Cobb angles. All of patients underwent 3-dimentional computed tomographic scan and magnetic resonance imaging scan to confirm dystrophic features. For evaluation of clinical outcomes, we surveyed the pre- and postoperative scoliosis research society-22r (SRS-22r) score. Results : Seven patients with spinal deformity associated with NF-1 were enrolled in this study. The mean age of patients was 29.5±1.2 years old. The mean follow-up period was 2.8±1.4 years. The apex of the deformity was located in cervicothoracic (n=1), thoracic (n=4), and lumbar region (n=2). Most patients have poor bone quality and decreased bone mineral density with average T-score of -3.5±1.0. All patients underwent surgical correction via posterior approach. The pre- and postoperative mean coronal and sagittal Cobb angle was 61.6±22.6° and 34.6±38.1°, 56.8±18.5° and 40.2±9.1°, respectively. Mean correction rate of coronal and sagittal angle was 44.7% and 23.1%. Ultimate follow-up SRS-22r score (average score, 3.9±0.4) improved comparing to preoperative score (average score, 3.3±0.9). Only one patient received revision surgery due to rod fracture. No serious complication occurred, such as neurological deficit, and viscerovascular injury. Conclusion : The surgical correction of patients having spinal deformity associated with NF-1 is challenging, however the radiographic and clinical outcomes are satisfactory. The all posterior approach can be a safe and effective surgical option for patients having dystrophic curves associated with NF-1.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1200-1209
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• 2020

Aphasia is a language disorder that results from brain damage and typically occurs after a stroke. The purpose of this case report was to describe the effects of Korean medical treatment on anomic aphasia after a putaminal hemorrhage. We used Korean medical treatment, including head acupuncture and herbal medicine (Hyungbangsabaek-san) therapy, on a patient who was admitted to the hospital for 19 days. The clinical symptoms were assessed with the Korean version of the Western Aphasia Battery (K-WAB), and quality of life was evaluated with Korean version of Stroke and Aphasia Quality of Life Scale-39 (K-SAQOL-39). After 19 days of treatment, the K-WAB scores were increased from 17 to 19 in the spontaneous speech score, from 7.55 to 9.85 in the comprehension score, from 9 to 9.4 in the speaking score, and from 5.8 to 9.7 in the naming score. The AQ score was increased from 78.7 to 95.9, and the K-SAQOL-3 score was increased from 2.64 to 3.26. In conclusion, the study findings suggested that Korean medical treatment could be an effective option for treating symptoms and improving quality of life in patients with aphasia after stroke.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.98-104
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• 2012

Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.287-296
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• 2022

Objective : Although radiotherapy (RT) is recommended for multiple myeloma (MM) involving spine, the treatment of choice between reconstructive surgery with RT and RT alone for pathologic vertebral fractures (PVFs) associated with structural instability or neurologic compromises remains controversial. The purpose of this study was to evaluate the clinical efficacies of reconstructive surgery with adjuvant RT for treatment of MM with PVFs by comparing with matched cohorts treated with RT alone. Methods : Twenty-eight patients underwent reconstructive surgery followed by RT between 2008 and 2015 in a single institution, for management of PVFs associated with structural instability of the spine and/or neurologic compromises (group I). Twenty-eight patients were treated with RT alone (group II) after propensity score matching in a 1-to-1 format based on instability of the spine, as well as age and performance. Clinical outcomes including the overall survival rates, duration of independent ambulation, neurological status, and numeric rating scale (NRS) for back pain were compared. Results : Clinical and radiological features before treatment were similar in both groups. The median survival period was similar between the two groups. However, the mean duration of independent ambulation was significantly longer in group I (88.8 months; 95% confidence interval [CI], 66.0-111.5) than in group II (39.4 months; 95% CI, 25.2-53.6) (log rank test; p=0.022). Deterioration of Frankel grade (21.4% vs. 60.7%, p=0.024) and NRS for back pain (2.7±2.2 vs. 5.0±2.7, p=0.000) at the last follow-up were higher in the group II. Treatment-related complications were similar in both groups. Conclusion : In patients with unstable PVFs due to MM, reconstructive surgery may yield superior clinical outcomes compared with RT alone in maintaining independent ambulation and neurological status, as well as pain control despite similar median survival and complications.

• The Journal of Internal Korean Medicine
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• v.23 no.1
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• pp.47-56
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• 2002

Objectives: We identified the effects of Jingansikpung-tang, (JGSPT), derived from therapy on closed head trama(CHT)-induced brain edema and neurologial disturbance symptom in rats. Methods : We used a drop device and induced CHT. We divided the animals into 3 groups. They were JGSPT 1 group (Administered JGSPT 96.5mg/kr through anal far one hour after using CHT) and JGSPT 2 group(Administered JGSPT 386mg/kg through anal for one hour after using CHT) Then, we tested neurological severity score(NSS), water content of brain and haematological changes. Result : aNSS increased significantly in JGSPT 1 and JGSPT 2 as compared to the controlled group, and the change of water content which was pulled out of the right hemisphere from the left hemisphere decreased in JGSPT 1 and JGSPT 2 as compared to the controlled group. The lactate level in serum decreased in JGSPT 1 and JGSPT 2 as compared to the controlled group, which showed no efficacy. Glucose level in serum increased in JGSPT 1 and JGSPT 2 as compared to the controlled group, only JGSPT 2 showed no efficacy. Conclusions : JGSPT, caused by Anal Therapy and effect on CHT-induced brain edema and neurological symptom.

• Molecules and Cells
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• v.40 no.2
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• pp.133-142
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• 2017

Previous studies have shown that bone marrow mesenchymal stromal cell (MSC) transplantation significantly improves the recovery of neurological function in a rat model of intracerebral hemorrhage. Potential repair mechanisms involve anti-inflammation, anti-apoptosis and angiogenesis. However, few studies have focused on the effects of MSCs on inducible nitric oxide synthase (iNOS) expression and subsequent peroxynitrite formation after hypertensive intracerebral hemorrhage (HICH). In this study, MSCs were transplanted intracerebrally into rats 6 hours after HICH. The modified neurological severity score and the modified limb placing test were used to measure behavioral outcomes. Blood-brain barrier disruption and neuronal loss were measured by zonula occludens-1 (ZO-1) and neuronal nucleus (NeuN) expression, respectively. Concomitant edema formation was evaluated by H&E staining and brain water content. The effect of MSCs treatment on neuroinflammation was analyzed by immunohistochemical analysis or polymerase chain reaction of CD68, Iba1, iNOS expression and subsequent peroxynitrite formation, and by an enzyme-linked immunosorbent assay of pro-inflammatory factors (IL-$1{\beta}$ and TNF-${\alpha}$). The MSCs-treated HICH group showed better performance on behavioral scores and lower brain water content compared to controls. Moreover, the MSC injection increased NeuN and ZO-1 expression measured by immunochemistry/immunofluorescence. Furthermore, MSCs reduced not only levels of CD68, Iba1 and pro-inflammatory factors, but it also inhibited iNOS expression and peroxynitrite formation in perihematomal regions. The results suggest that intracerebral administration of MSCs accelerates neurological function recovery in HICH rats. This may result from the ability of MSCs to suppress inflammation, at least in part, by inhibiting iNOS expression and subsequent peroxynitrite formation.