중풍 후 중추성 통증환자에 대한 봉독약침의 임상효과 -단일맹검 무작위배정 환자 대조군 비교연구-

곽자영,조승연,신애숙,이인환,김나희,김혜미,나병조,박성욱,정우상,문상관,박정미,고창남,조기호,김영석,배형섭 대한침구의학회 2009 대한침구의학회지 Vol.26 No.6

Objectives : This study was designed to evaluate objectively the efficacy of bee-venom acupuncture on Central post-stroke patients. Methods : After screening, 25 patients recruited with eligible criteria. Among them 1 dropped out in treatment group, 4 in control group. We applied bee-venom acupuncture 6 points of body(LI15, GB21, LI11, GB31, ST36, GB39) 2 times a week for 3 weeks for treatment group, and normal saline for control group in the same way. After 3 weeks treatment and 2 weeks follow up we measured VAS, categorial rating scale as a pain assessment also MBI, Modified Rankin Scale as a stroke recovery. Results : 1. Treatment group showed significant difference in VAS, categorial rating scale after treatment and 2 weeks follow up, compared with baseline. The control group showed significant difference between baseline and after treatment But the 2 weeks follow up, there is no significant difference compared with baseline. Also there’s no significant difference in categorial rating scale. 2. MBI showed significant difference in treatment group between baseline and after treatment, but the control group did not have any difference. There’s no significant difference in Modified Rankin Scale for treatment group and control group. 3. There’s no significant difference between control group and treatment group. This is because of the small sample size in the study, Thus it seems to reflect individual difference strongly. Conclusions : There are positive effect on CPSP patients in pain and stroke recovery treating with bee-venom acupuncture than control group.

증례 : 감염 ; 후천성 면역 결핍증 환자에서 발생한 진행성 다발성 백질뇌병증 7예

곽동명 ( Dong Myoung Kwak ),정현일 ( Hyun Il Jeong ),박상민 ( Sang Min Park ),차혁환 ( Hyuck Hwan Cha ),정자영 ( Ja Yong Jung ),방지환 ( Ji Hwan Bang ),신형식 ( Hyoung Shik Shin ) 대한내과학회 2010 대한내과학회지 Vol.78 No.6

AIDS 환자에서 2차적인 중추신경계 기회감염은 전체 기회감염의 1/3 정도를 차지한다. 고효능 항바이러스 치료(highly active antiretroviral therapy, HAART)가 본격적으로 사용된 이후에 이러한 기회감염은 현저히 줄어들고 있으나, JC바이러스(JCV)에 의한 진행성 다발성 백질뇌병증(progressive multifocal leukoencephalopathy, PML)의 발생률은 줄어들지 않고 있다. 저자들은 국립의료원 감염병센터에서 경험하였던 7예의 진행성 다발성 백질뇌병증의 임상상을 조사하였다. HAART 후 PML 진단된 1예를 제외하고는 6예에서 PML진단 당시 HAART를 시행하지 않은 상태였다. 조사대상자의 중간 연령은 39세였다. 남자 6예, 여자 1예였다. 7예의 CD4림프구 개수는 각각 58, 6, 18, 73, 90, 252, 94 cells/μL이었고, 중간 CD4 림프구 개수는 84 cells/μL이었다. 가장 흔한 임상증상은 편측마비였으며, 호발부위는 측두엽이었다. 2예에서 진단 후 25일, 52일에 사망하였다. 3예에서 질환의 진행없이 1년 이상 생존하였다. HIV 감염자에게서 신경학적 증상이 있는 경우 이에 대한 적극적인 병력청취와 신경학적 검사, 뇌 자기공명영상 촬영이 필요하다. Secondary opportunistic central nervous system infections occur in approximately one-third of patients with acquired immune deficiency syndrome. With the introduction of highly active antiretroviral therapy, the number of opportunistic infection cases has significantly decreased. However, the number of progressive multifocal leukoencephalopathy (PML) cases caused by opportunistic human JC polyomavirus has not decreased at a noticeable rate. In this report, seven patients with PML were evaluated at the infectious disease unit of the National Medical Center. Six of the 7 patients were not on antiretroviral therapy at the time of diagnosis. The mean patient age of the 6 men and 1 woman was 39 years. The individual CD4 cell counts were 58, 6, 18, 73, 90, 252, and 94 cells/μL. The mean CD4 cell count was 84 cells/μL. The most common clinical manifestation was focal weakness and the temporal lobe was mainly involved. Two of the patients died 52 days after the diagnosis was made. Three patients survived for more than 1 year without disease progression. We conclude that one must take a careful patient history, perform a neurological examination, and examine brain magnetic resonance images in patients with human immunodeficiency virus who show neurological symptoms. (Korean J Med 78:771-775, 2010)

대뇌반구의 병변과 동측에 반신마비 발생한 중풍 환자의 1례

조승연,곽자영,홍진우,나병조,박성욱,정우상,문상관,박정미,고창남,Cho, Seung-yeon,Gwak, Ja-young,Hong, Jin-woo,Na, Byong-jo,Park, seong-uk,Jung, Woo-sang,Moon, Sang-kwan,Park, Jung-mi,Ko, Chang-nam 대한중풍순환신경학회 2007 대한중풍.순환신경학회지 Vol.8 No.1

Stroke is a disease which results in impairment of body functions and affects everyday life. The ability of cerebral neurons to become reorganized and restore function after damage is called plasticity. Motor impairment typically appears contralateral to the affected cerebral hemisphere in patients with cerebral lesions. The authors report a case of a patient with hemiplegia ipsilateral to affected cerebral hemisphere, along with its conjectured mechanism.

급성기 중풍환자의 재발군과 초발군에 대한 단면조사연구 - 다기관 임상연구

이인환,곽자영,조승연,신애숙,김나희,김혜미,나병조,박성욱,정우상,문상관,박정미,고창남,조기호,임영석,배형섭,Lee, In-Whan,Gwak, Ja-Young,Cho, Seung-Yeon,Shin, Ae-Sook,Kim, Na-Hee,Kim, Hye-Mi,Na, Byung-Jo,Park, Seong-Uk,Jung, Woo-Sang,Moon, Sang-Kwan 대한한방내과학회 2009 大韓韓方內科學會誌 Vol.30 No.4

Objective : We designed this study to investigate differences between stroke reattack and stroke first attack group to establish fundamental data and prevent a secondary stroke. Methods : 826 subjects were recruited from the patients admitted to the department of internal medicine at Kyung Hee University Oriental Medical Center, Kyung Hee University East-West Neo Medical Center, Kyungwon University Incheon Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center and Dongguk University Ilsan Oriental Medical Center from 1 April 2007 to 31 August 2009. We compared general characteristics, classification of diagnosis, subtypes of cerebral infarction, risk factors, Sasang constitution, diagnostic classifications between stroke reattck and stroke first attack groups. Results : 1. In general characteristics, age differed significantly between the reattck and first attack groups. 2. Classification of diagnosis differed significantly between reattck and first attack groups. 3. In risk factors, hypertension, diabetes mellitus, alcohol drinking, and stress were significantly different between reattck and first attack groups. 4. Diagnostic classifications were significantly different between reattck and first attack groups. Conclusion : To prevent recurrence of stroke, education on stroke risk factors associated with recurrence is needed. In addition, those who are diagnosed as Dampness-Phlegm need to be well-controlled.

두침과 상하지 침자극이 뇌와 뇌의 체성감각피질에 미치는 영향에 대한 fMRI Study

박정미,곽자영,조승연,박성욱,정우상,문상관,고창남,조기호,김영석,배형섭,장건호,방재승 대한침구의학회 2008 대한침구의학회지 Vol.25 No.5

Objectives : To evaluate the effects of Head Acupuncture versus Upper and Lower Limbs Acupuncture on signal activation of Blood Oxygen Level Dependent (BOLD) fMRI on the Brain and Somatosensory Cortex. Subjects and Methods : 10 healthy normal right-handed female volunteer were recruited. The average age of the 10 subjects was 30 years old. The BOLD functional MRI(fMRI) signal characteristics were determined during tactile stimulation was conducted by rubbing 4 acu-points in the right upper and lower limbs(LI1, LI10, LV3, ST36). After stimulation of Head Acupuncture in Sishencong(HN1), GB18, GB9, TH20 of Left versus Upper and Lower Limbs Acupuncture(LI1, LI10, LV3, ST36 of Right) and took off needles. Then the BOLD fMRI signal characteristics were determined at the same manner. Results : 1. When touched with cotton buds(sensory stimulation), left Parietal Lobe, Post-central Gyrus, primary somatosensory cortex(BA 1, 2, 3), and primary motor cortex(BA 4) were mainly activated. When ST36 was stimulated, Frontal Lobe, Parietal Lobe, Cerebellum, and Posterior Lobe as well as Inter- Hemispheric displaying a variety of regions. 2. In signal activation before and after Head Acupuncture reaction, it showed signal activation after removing the acupuncture needle and right Somatosensory Association Cortex, Postcentral Gyrus, and Parietal Lobe were more activated. 3. In reactions of before and after Upper and Lower Limb Acupuncture, it also showed signal activation after removing the acupuncture needle and bilateral Occipital Lobe, Lingual Gyrus, visual association cortex, and Cerebellum were activated. 4. After acupuncture stimulation, In Upper and Lower Limb Acupuncture Group, left frontal Lobe, Precentral Gyrus and Bilateral parietal lobe, Postcentral Gyrus and Primary Somatosensory Cortex(BA 2) were activated. In Head Acupuncture Group, which has most similar activation regions, but especially right Pre-Post central Gyrus, Primary Somatosensory Cortex(BA 3), Primary Motor Cortex, frontal Lobe and Parietal Lobe were activated. Conclusions : When sensory stimulation was done with cotton buds on four acup-points(LI1, LI10, LV3, ST36), while bilaterally activated, contralateral sense was more dominant. It showed consistency with cerebral cortex function. When ST36 was stimulated Frontal Lobe, Parietal Lobe, Cerebellum, Posterior Lobe as well as Inter-Hemispheric were stimulated. In Head Acupuncture, it showed more contralateral activation after acupuncture. In Upper and Lower Limb Acupuncture, it showed typically contralateral activation and deactivation of limbic system after acupuncture stimulation. Therefore, there were different fMRI BOLD signal activation reaction before and after Head Acupuncture vs Upper and Lower Limb Acupuncture which might be thought to be caused by acu-points’ sensitivity and different sensory receptor to response acupuncture stimulation.

화열과 음허로 진단된 급성기 뇌질환 환자의 특성 비교 연구

김혜미,곽자영,조승연,신애숙,이인환,김나희,나병조,박성욱,정우상,문상관,박정미,고창남,조기호,김영석,배형섭,Kim, Hye-mi,Gwak, Ja-young,Cho, Seung-yeon,Shin, Ae-sook,Lee, In-whan,Kim, Na-hee,Na, Byung-Jo,Park, Seong-Uk,Jung, Woo-sang,Mun, Sang-gwan 대한중풍순환신경학회 2009 대한중풍.순환신경학회지 Vol.10 No.1

Objects : This study propose to compare on general characteristics of acute stroke patients between Fire-Heat group and Deficiency of Yin group. Method : We recruited acute stroke patient within 4 weeks after stroke admitted to Department of Internal Medicine of Kyunghee University Oriental Medicial Center, Dongguk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Centar and Kyungwon University Incheon Oriental Medical Center from April 2007 to August 2009. We investigate age, sex, type of stroke, past history, general characteristics, smoking, drinking alcohol, marriage sasang constitution, etc. Result : It was significant different in sex, smoking, dringking alcohol and marriage between Fire-Heat group and Deficiency Yin group. We need more cases for another result that could associate with diagnosis of stroke. Conclusion : We found that Fire heat group was more associated with lifestyle than deficiency yin group. Further study will be needed to analysis for the diagnosis and the treatments of stroke.

급성기 중풍환자의 설진(舌診)과 National Institute of Health Stroke Scale과의 상관성 연구 - 다기관 임상연구

이인환,신애숙,곽자영,조승연,박성욱,박정미,고창남,조기호,배형섭,Lee, In-Whan,Shin, Ae-Sook,Gwak, Ja-Young,Cho, Seung-Yeon,Park, Seong-Uk,Park, Jung-Mi,Ko, Chang-Nam,Cho, Ki-Ho,Bae, Hyung-Sup 대한중풍순환신경학회 2008 대한중풍.순환신경학회지 Vol.9 No.1

Objectives : We questioned whether the tongue diagnosis is effective for judging seriousness of cerebrovascular accidents. This study is about the relationship between tongue diagnosis and National Institute of Health Stroke Scale(NIHSS) in acute stroke patients. Methods : 738 subjects were recruited from the patients admitted to the department of internal medicine at Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center from April 2007 to August 2008. We looked at the tongue as in three dimensions of tongue color, tongue fur color and tongue body. And, we calculated NIHSS means according to the subtypes of three dimensions. Results : 1. In the Tongue color, from the most commom to least common colors were pale red, red, pale, bluish purple, and ect. The NIHSS mean score of red is significantly higher than pale and pale red. 2. In the Tongue fur color, white fur was the most common, and then yellow fur, etc. There is no significant difference among three subtypes in the NIHSS mean score. 3. In the Tongue body, etc. is the most common, followed by teeth-marked tongue, enlarged tongue, blood patchy tongue, and mirror tongue. The NIHSS mean score of teeth-marked tongue is significantly lower than blood patchy tongue and mirror tongue. Conclusions : The tongue color and the tongue body are useful indexes for judging seriousness of cerebrovascular accidents presented by NIHSS. But in our study, the tongue fur color was not useful. Further study is necessary on the tongue fur.

A Dunnione Compound MB12662 Improves Cisplatin-Induced Tissue Injury and Emesis

박동선,조인근,장자영,곽태환,유상구,전정희,최흔경,주성수,김옥진,김윤배 한국응용약물학회 2015 Biomolecules & Therapeutics(구 응용약물학회지) Vol.23 No.5

The present study was aimed to investigate the effects of MB12662, a synthetic dunnione compound, on cisplatin-induced vomiting reflexes and intestinal, renal, immune system, and hematopoietic toxicities in ferrets and mice, respectively. Male ICR mice were orally administered MB12662 (5, 10, 25 or 50 mg/kg) for 10 days, during which intraperitoneally challenged with cisplatin (3.5 mg/kg) from day 4 to 7, and sacrificed on day 10 for the pathological examination. Male ferrets were orally administered MB12662 (25, 50 or 100 mg/kg) for 7 days, subcutaneously challenged with cisplatin (5 mg/kg), and monitored for vomiting reflexes and survival of the animals. Four-day injection of cisplatin (3.5 mg/kg) to mice caused body weight loss and degeneration and atrophy of intestinal villi, reducing villi/crypt ratio to a half level of control animals. Cisplatin also induced renal and hepatic toxicities, and depletion of splenocytes and bone marrow progenitor cells. The systemic toxicities including decreased villi/crypt ratio, immune system atrophy, splenocyte depletion, and decreased cellularity in bone marrow were improved by MB12662. Cisplatin (5 mg/kg) induced retching and emetic responses of ferrets, which were remarkably attenuated by MB12662 in a dose-dependent manner. All the ferrets pretreated with MB12662 survived the challenge of cisplatin, in comparison with 40% mortality in vehicle-treated animals, and blood parameters of nephrotoxicity and hepatotoxicity were markedly recovered. It is expected that MB12662 could be a candidate for the body protection against burden, including emesis, of chemotherapeutic agents.

급성기 중풍 환자들의 위험요인 및 중풍유형과 변증분형의 관련성 연구

신애숙,이인환,곽자영,조승연,박성욱,박정미,고창남,조기호,배형섭,Shin, Ae-Sook,Lee, In-Whan,Gwak, Ja-Young,Cho, Seung-Yeon,Park, Seong-Uk,Park, Jung-Mi,Ko, Chang-Nam,Cho, Ki-Ho,Bae, Hyung-Sup 대한중풍순환신경학회 2008 대한중풍.순환신경학회지 Vol.9 No.1

Objectives : This study was conducted as part of the national project to standardize stroke diagnosis in Korean medicine. In this study, we assessed what categories of stroke diagnosis these three most common risk factors of cerebro-vascular attack(CVA), hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) fall into. Also we looked into stroke subtypes and its diagnosis in Korean medicine. Methods : 806 patients with acute stroke from 5 universities(Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center) across the country were involved from April, 2007 til August, 2008. We had data of 482 patients to be analyzed and diagnosed by a Korean medicine training doctor and a professor. Results : All three major stroke risk factors were diagnosed as being dampness-phlegm pattern, but no significant difference was observed except in hyperlipidemia patients. Stroke subtypes such as hemorrhage and infarction showed no significant difference in this study. Conclusions : This study provides evidence that hyperlipidemia can be diagnosed as dampness-phlegm by Korean medicine. Further studies with various subtypes of stroke patients are required to prove solid evidence with other stroke risk factors.