• The Korean Journal of Nuclear Medicine
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• v.38 no.3
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• pp.268-271
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• 2004

A 43-year-old man was presented with persistent headache for two weeks. 72 weighted MR imaging showed high signal intensity with surrounding edema in the left frontal lobe. These findings were considered with intracranial tumor such as glioma or metastasis. Tc-99m tetrofosmin SPECT showed focal radiotracer accumulation in the left frontal lobe. The operative specimen contained cerebral infarction with organizing leptomeningeal hematoma by pathologist. Another 73-year-old man was hospitalized for chronic headache. Initial CT showed ill-defined hypodensity with mass effect in the right parietal lobe. Tc-99m tetrofosmin SPECT showed focal radiotracer uptake in the right parietal lobe. These findings were considered with low-grade glioma or infarction. Follow-up CT after 5 months showed slightly decreased in size of low density in the right parietal lobe, and cerebral infarction is more likely than others. Tc-99m tetrofosmin has been proposed as a cardiotracer of myocardial perfusion imaging and an oncotropic radiotracer. Tc-99m tetrofosmin SPECT image provides a better attractive alternative agent than T1-201 as a tumor-imaging agent, with characteristics such as high-energy flux, short half-life, favorable biodistribution, dosimetry and lower background radioactivity. We have keep in mind on the analysis of Tc-99m tetrofomin imaging when cerebral infarction is being differentiated from brain tumor.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3425-3428
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• 2014

Objective: To explore the value of computed tomography (CT) in the differential diagnosis of glioma stroke and simple cerebral hemorrhage. Materials and Methods: A total of 45 patients with glioma stroke and stroke as the initial symptom in our hospital from Jun., 2009 to Oct., 2013 were selected along with 50 individuals with simple cerebral hemorrhage in the same period randomly collected as a control group. The CT results in both groups were analyzed and compared. Results: In the observation group, there were 25 patients with astrocytoma (55.6%), 11 with oligodendroglioma (24.4%), 8 with ependymoma (17.2%) and 1 with glioblastoma multiforma (GBM, 2.22%). Additionally, the major CT manifestation was coexistence of hemorrhage and tumor signs. By comparison, it could be found that the proportions of patients respectively with peripheral edema and space-occupying effect in the observation group were significantly higher than in the control group (P<0.01). Conclusions: Application of CT examination combined with medical history in patients has very important clinical value in the differential diagnosis of glioma stroke and simple cerebral hemorrhage.

• Korean Journal of Medicinal Crop Science
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• v.19 no.1
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• pp.31-37
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• 2011

Previous work demonstrated that an ethanol extract (HS0608) of a mixture of three medicinal plants of Curcuma longae radix, Phellinus linteus, and Scutellariae radix markedly inhibits $A{\beta}$ (25-35)-induced neurotoxicity. The present study was performed to further verify the neuroprotective effect of HS0608 on oxidative and ischemic cerebral injury using cultured rat cortical neurons and rats. Exposure of cultured cortical neurons to $100\;{\mu}M$ hydrogen peroxide ($H_2O_2$) induced neuronal apoptotic death. At $10-100{\mu}g/ml$, HS0608 inhibited neuronal death, elevation of intracellular calcium concentration ($[Ca^{2+}]_i$), and generation of reactive oxygen species (ROS) induced by $H_2O_2$ in primary cultures of rat cortical neurons. In vivo, HS0608 prevented cerebral ischemic injury induced by 2-h middle cerebral artery occlusion (MCAO) and 24-h reperfusion. The ischemic infarct and edema were significantly reduced in rats that received HS0608 (200 mg/kg). These results suggest that the anti-oxidative properties of HS0608 may be responsible for its neuroprotective effect against focal cerebral ischemic injury and that HS0608 may have a therapeutic role in neurodegenerative diseases such as stroke.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.652-664
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• 2022

The Kernohan-Woltman notch phenomenon (KWNP) refers to an intracranial lesion causing massive side-to-side mass effect which leads to compression of the contralateral cerebral peduncle against the free edge of the cerebellar tentorium. Diagnosis is based on "paradoxical" motor deficit ipsilateral to the lesion associated with radiologic evidence of damage to the contralateral cerebral peduncle. To date, there is scarce evidence regarding KWNP associated neuroimaging patterns and motor function prognostic factors. A systematic review was conducted on Medline database from inception to July 2021 looking for English-language articles concerning KWNP, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research yielded 45 articles for a total of 51 patients. The mean age was 40.7 years-old and the male/female sex ratio was 2/1. 63% of the patients (32/51) suffered from head trauma with a majority of acute subdural hematomas (57%, 29/51). 57% (29/51) of the patients were in the coma upon admission and 47% (24/51) presented pupil anomalies. KWNP presented the neuroimaging features of compression ischemic stroke located in the contralateral cerebral peduncle, with edema in the surrounding structures and sometimes compression stroke of the cerebral arteries passing nearby. 45% of the patients (23/51) presented a good motor functional outcome; nevertheless, no predisposing factor was identified. A Glasgow coma scale (GCS) of more than 3 showed a trend (p=0.1065) toward a better motor functional outcome. The KWNP is a regional compression syndrome oftentimes caused by sudden and massive uncal herniation and leading to contralateral cerebral peduncle ischemia. Even though patients suffering from KWNP usually present a good overall recovery, patients with a GCS of 3 may present a worse motor functional outcome. In order to better understand this syndrome, future studies will have to focus on more personalized criteria such as individual variation of tentorial notch width.

• The Korean Journal of Rehabilitation Nursing
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• v.4 no.1
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• pp.94-104
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• 2001

The purpose of this study was to analysis of nursing interventions performed by the ICU nurses to the patients with cerebrovascular disorder practically from one university hospital in Seoul. The data were collected from 15 nurses with 86 cerebrovascular disorder cases from one ICU with the questionaire to write frequency of nursing care done by the surveyee from May, 2, 2000 to July, 3, 2000 and the list of 66 nursing interventions selected out of 433 NIC(Nursing Interventions Classification) of Iowa University which were translated into Korean (44 items) and core nursing interventions by ICU nurses (22 items; KIm, Su-Jin, 1997). The data were analysed with SPSS program. The results are as follow : 1. The most frequently used nursing interventions were vital sign monitoring, fall prevention, cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care, communication enhancement, technology management, bed rest care, respiratory monitoring in rank. 2. The most frequently used nursing intervention domains were 'Physiological : Complex', 'Physiological : basic', 'Behavior', 'Safty', 'Health system' in rank. In the domain of physiological : basic, the most frequently used nursing interventions were bed rest care, urinary elimination management, tube care : urinary, physical restraints in rank. In the domain of physiological : complex, the most frequently used nursing interventions were cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care in rank. In the domain of behavior, the most frequently used nursing interventions were communication enhancement, touch, active listening in rank. In the domain of safty, the most frequently used nursing interventions were vital sign monitoring, fall prevention in rank. In the domain of health system, the most frequently used nursing interventions were technology management, specimen management in rank. 3. some difference of the frequency practicing the nursing interventions according to the shift of duties was found. For example, medication administration was common at day duty, touch was practiced at evening duty, temperature regulation was performed.

• Journal of Korean Neurosurgical Society
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• v.37 no.5
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• pp.370-374
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• 2005

Objective: We investigated the morphologic changes within 24 hours after a single ${\gamma}$-irradiation in the rat brain. Methods: Forty Sprague-Dawley rats were used. After a burr hole trephination on right parietal area, cerebral hemisphere was irradiated with 2Gy and 5Gy using iridium-192($^{192}Ir$), respectively. The effect was assessed at 4, 8, 12 and 24 hours after irradiation. The histological changes were scored following the detection of edema or disarray severity. TUNEL-positive cells exhibiting apoptotic morphology were counted in irradiated region. Results: Cortical edema and disarray were initially showed at 4 or 8 hour and almost all defined at 24 hour after irradiation. And the injury was wedge shape. TUNEL-positive cells were minimal at 8 hour after irradiation as the number of positive cells were $2.6{\pm}5.27$(n=5) after 2Gy, and $0.8{\pm}0.84$(n=5) after 5Gy. But, the number of apoptotic cells were increased markedly to $60{\pm}6.24$ at 12 hour after 2Gy and to $104{\pm}19.7$ at 24 hour after 5Gy. Conclusion: There were prominent morphologic changes immediately after ${\gamma}$-irradiation. And, apoptosis was increased according to the time period. These findings implicate that brain irradiation induces rapid apoptotic change, which may play an important role in the pathogenesis of radiation-induced pathologic conditions.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.167-179
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• 2000

Objective : We studied to clarify the effective time zone of mild hypothermic neural protection during ischemia and/or reperfusion after middle cerebral artery occlusion. Methods : In a reversible cerebral infarct model which maintained reperfusion of blood flow after middle cerebral artery occlusion for two hours, the size of cerebral infarction, cerebral edema and the extent of neurological deficit were observed and analyzed for comparison between the control and the experimental groups under hypothermia($33.5^{\circ}C$). The temporalis muscle temperature was reduced to $33.5^{\circ}C$ by surface cooling for two hours during middle cerebral artery occlusion for study group I. The following groups applied hypothermia for two-hour periods after reperfusion : group II(0-2 hours), group III(2-4 hours), and group IV(4-6 hours). They were rewarmed to $36.5^{\circ}C$ until sacrified at 2, 4, 6, 12, and 24 hours after reperfusion. Control group was maintained at normothermia without hypothermia. Results : In the experimental groups with hypothermia, the average value of the size of cerebral infarction($mean{\pm}SD$) was $1.97{\pm}1.65%$, which was a remarkable reduction over that of the control, $4.93{\pm}3.79%$. In the control, a progressive increase was shown in the size of infarction from point of reperfusion to 6 hours after reperfusion without further changes in size afterward. Intra-ischemic hypothermia(group I) prevented ischemic injury but did not prevent reperfusion injury. Group II examplified the most neural protective effect in comparison to the control group and group IV(p<0.05). The cortex was more vulnerable to reperfusion injury than the subcortex. Mild hypothermia showed more neural protective effects on the cortex than subcortex. Conclusion : The most appropriate time zone for application of mild hypothermia was defined to be within four hours following reperfusion.

• The Journal of Korean Medicine
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• v.32 no.5
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• pp.100-113
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• 2011

Objectives: Brain edema is brain swelling that occurs due to the accumulation of excess water in the brain parenchyma. AQP4 and AQP9 are water-channel proteins expressed strongly in the brain and control water fluxes into and out of the brain parenchyma. This study was conducted to evaluate effect of Hwangnyeonhaedok-tang on brain edema and intracerebral hemorrhage. Methods: Intracerebral hemorrhage was induced by intrastriatal injection of type IV collagenase(0.23 U/${\mu}l$, 0.1 ${\mu}l$/min) into Sprague-Dawley rat brains. Hwangnyeonhaedok-tang water extract(1,000 mg/kg) was administered orally three times every 20 hours from 4 hours after ICH operation. Then hematoma volume, brain edema percentage, and water content of brain tissue were measured. Immuno-histochemistry was performed for AQP4 and AQP9 expressions in the brain sections and area % of immuno-labeling was analyzed with image analyzing system. Results: 1. Water extract of Hwangnyeonhaedok-tang reduced hematoma volume of ICH induced rat. 2. Water extract of Hwangnyeonhaedok-tang reduced MPO positive neutrophils in the perihematoma of the ICH induced rat. 3. Water extract of Hwangnyeonhaedok-tang reduced brain edema percentage and water content of brain tissue of ICH induced rat. 4. Water extract of Hwangnyeonhaedok-tang reduced AQP4 immuno-positive cells in the perihematoma of the ICH induced rat. 5. Water extract of Hwangnyeonhaedok-tang reduced AQP9 immuno-positive cells in the perihematoma of the ICH induced rat. Conclusions: These results suggest that Hwangnyeonhaedok-tang decreases intracerebral hemorrhage and brain edema by means of downregulating AQP4 and AQP9 expressions in the brain.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.1
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• pp.265-273
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• 2004

KBPTS is the fortified prescription of Bang-pung-tong-sung-san (BPTS) by adding Spatholobi Clulis and Salviae Miltiorrzae Radix. BPTS prescription has been used in Qriental medicine for the treatments of vascular diseases including hypertension, stroke, and arteriosclerosis, and nervous system diseases. Yet, the overall mechanism underlying its activity at the cellular levels remains unknown. To investigate the protective role of KBPTS on brain functions, noxious stimulations were applied to neurons in vitro and in vivo. KBPTS pretreatment in cultured cortical neurons of albino ICR mice rescued death caused by AMPA, NMDA, and kainate as well as by buthionine sulfoximine (BSO) and ferrous chloride (Fe/sup 2+/) treatments. Furthermore, KBPTS promoted animal's recovery from coma induced by a sublethal dose of KCN and improved survival by a lethal dose of KCN. To examine its physiological effects on the nervous system, we induced ischemia in the Sprague-Dawley rat's brain by middle cerebral artery (MCA) occlusion. Neurological examination showed that KBPTS reduced the time which is required for the animal after MCA occlusion to respond in terms of forelimb and hindlimb movement$. Histological examination revealed that KBPTS reduced ischemic area and edema rate and also protected neurons in the cerebral cortex and hippocampus from ischemic damage. Thus, the present data suggest that KBPTS may play an important role in protecting neuronal cells from external noxious stimulations.

• The Journal of Korean Medicine
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• v.21 no.2
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• pp.25-36
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• 2000

Objectives : This study demonstrates the effects of Daejo-hwan on learning and memory impairment induced by L-NAME (75 mg/kg) treatment and on cerebral ischemic damage induced by middle cerebral artery (MCA) occlusion in rats. Methods : Daejo-hwan emulsion (73.3 mg/100 g/l ml) was administered to rats along a timed study schedule. The Moms water maze was used for learning and memory test of the rats. The MCA was occluded by using the intraluminal thread method. The brain slices were stained by 2 % triphenyl tetrazolium chloride (TTC) and 1 % cresyl violet solution. Infarct size, neuron cell number and size in penumbra was measured by using computer image analysis system. Results : 1. The escape latency of the Daejo-hwan treated group decreased significantly with respect to the control group. 2.The memory score of the Daejo-hwan treated group showed increase tendency, And the swimming distance was not different between the normal, the control, and the Daejo-hwan treated group. 3. The infarct size of the Daejo-hwan treated group decreased significantly with respect to the control group. 4. The total infarct volume of the Daejo-hwan treated group showed decrease tendency. And the brain edema index of the Daejo-hwan treated group decreased significantly with respect to the control group. 5. The neuron cell number and cell size in penumbra of the Daejo-hwan treated group increased significantly with respect to the control group. Conclusions : According to the above results, it is supposed that Daejo-hwan is clinically applicable to the vascular dementia.