• The Journal of Korean Physical Therapy
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• v.25 no.3
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• pp.126-131
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• 2013

This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1998.11a
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• pp.143-143
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• 1998

Antagonists acting at the glycine site of the NMDA receptor have been gaining safer alternatives for stroke therapy because they have few adverse effect competitive and noncompetitive NMDA antagonists. Therefore, the neuroprotect novel glycine site antagonist KC0244 were evaluated in a rat model of transient comparison with GV150526A in a developmental phase. Middle cerebral artery oc was produced by insertion of a silicone-coated 4-0 nylon monofilament to the o in male Sprague-Dawley rats under isoflurane anesthesia. After 90 or 120 min retracted and the ischemic tissue reperfused. In 90-min MCAO model, GV150526A was administered 30 min before MCAO or immediately after MCAO. In 120-min MC KC0244 or GV150526A (10 mg/kg, i.p.) was administered 1 hr before MCAO or imme MCAO. Infarct volume was measured 24 hr after MCAO using the 2,3,5-triphe chloride staining method. In 90-min MCAO model, treatments with GV1505 significantly reduce infarct volume although they tended to slightly reduce cor approximately 19% compared with the nontreated group. In 120-min MCAO model with GV150526A did not either significantly reduce infarct volume although the reduce total infarct volume by approximately 16% compared with the vehicle-tre However, 1-hr preischemic and immediate treatments with KC0244 reduced total i 39 and 30% (corrected total infarct volume by 44 and 32%), respectively, co vehicle-treated control group. The results suggest that KC0244 can provid against transient focal ischemic damage with greater in vivo potency than GV150

• Biomolecules & Therapeutics
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• v.15 no.3
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• pp.169-174
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• 2007

In the present study, we investigated the neuroprotective effects of standardized Ginkgo biloba extract (GBB) (total terpene trilactones, 13 ${\pm}$ 3%; biflavone, 4.5 ${\pm}$ 1.5%; flavonol glycoside, < 8%; proanthocyanidine, under detection limit) on ischemia-reperfusion-induced brain injury in the rats. Ischemia was induced by the intraluminal occlusion of the right middle cerebral artery for 2 h and reperfusion was continued for 22 h. GBB was orally administered, promptly prior to reperfusion and 2 h after. Total infarction volume in the ipsilateral hemispheres of ischemia-reperfusion rats were significantly reduced by treatment with GBB in a dose-dependent manner (P<0.05). The therapeutic time window of GBB was 3 h in this ischemia-reperfusion rat model. Furthermore, GBB also significantly inhibited increased neutrophil infiltration of ischemic brain tissue, as estimated by myeloperoxidase activity. These findings suggest that GBB plays a crucial protective role in ischemia-induced brain injury, in part, via inhibition of neutrophil infiltration, and suggest that this GBB could serve as a neuroprotective agent following transient focal ischemic brain injury.

• Therapeutic Science for Rehabilitation
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• v.6 no.1
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• pp.11-23
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• 2017

Spatial neglect is a neurological disorder following stroke, a lesion that usually affects the right hemisphere, fail to process or attention on the contralateral side of body and space. Functional neuroimaging studies report that spatial neglect is associated with lesions of large middle cerebral artery, perisylvian network and attention network. Spatial neglect is associated with a poor outcome. For optimal diagnosis and intervention, Types and theories of spatial neglect should be considered, in addition to clinical assessment with the conventional test and functional test. The treatment for spatial neglect could be consist of top-down approaches and bottom-up approaches. Recent trends in rehabilitation intervention for spatial neglect have reported prism adaptation.

• The Journal of Korean Medicine
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• v.24 no.3
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• pp.72-83
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• 2003

Objective : The goal of the present study was to investigate the protective effect of Gamiheechum-tang (Jiaweixiqian-tang; GHCT) on brain tissue damage from chemical or ischemic insults. Methods : Levels of cultured cortical neuron death caused by toxic chemicals were measured by LDH release assay. Neuroprotective effects of GHCT on brain tissues were examined in vivo by ischemic model of middle cerebral artery (MCA) occlusion. Results : Animal groups treated with GBCT showed significantly decreased hypertension, and reduced levels of aldosterone, dopamine, and epinephrine in the plasma. GHCT treatments ($l0-200\mu\textrm{g}/ml$) significantly decreased cultured cortical neuron death mediated by AMPA, kainate, BSO, or Fe2+ when measured by LDH release assay. Yet, cell death mediated by NMDA was effectively protected by GHCT at the highest concentration examined ($200\mu\textrm{g}/ml$). In the in vivo experiment examining brain damage by MCA occlusion, affected brain areas by ischemic damage and edema were significantly less in animal groups administered with GHCT compared to the non-treated control group. Neurological examinations of forelimbs and hindlimbs showed that GHCT treatment improved animals' recovery from ischemic injury. Moreover, the extent of injury in cortical and hippocampal pyramidal neurons in ischemic rats was much reduced by GHCT, whose morphological features were similarly observed in non-ischemic animals. Conclusion : The present data suggest that GBCT may play an important role in protecting brain tissues from chemical or ischemic injuries.

• PNF and Movement
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• v.16 no.1
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• pp.7-17
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• 2018

Purpose: The aim of this study was to investigate the effects of coordinative locomotor training in a chronic stroke patient. Methods: A left hemiplegic patient diagnosed with a right middle cerebral artery stroke participated in this research. The patient's functional conditions were assessed, and a coordinative locomotor training program was initiated to resolve the problems identified. A set of movements deemed difficult based on the brief International Classification of Functioning, Disability and Health core set for stroke and d4501 (long-distance walking) were agreed as improvement targets. The program comprised warm up, main, cool-down, and home exercises. Repeated measurements were obtained, as follows: five times at baseline (A), 10 times during the intervention (B), and five times after the intervention (A). The study period was 7 weeks, and the intervention period was 1 h per day, twice a week for 5 weeks. Various tools, including the community walking test (CWT), 10-m walking test (10 MWT), 6-min walking test (6 MWT), and timed up and go (TUG) test, were conducted to assess the patient's walking ability. Changes in functional domains before and after the ICF Qualifier were compared. The mean values of the descriptive statistics were calculated, and a visual analysis using graphs was used to compare the rates of change. Results: The results showed that the CWT, 10 MWT, 6 MWT, and TUG test scores during the intervention period improved and that this improvement remained, even during the baseline period. In addition, the ICF Qualifier before and after the comparison decreased from moderate to mild. Conclusion: Based on the results, we propose that coordinative locomotor training can have positive effects on community ambulation of chronic stroke patients.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.137-152
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• 1998

Acute complications of diabetes mellitus were diminished after Banting and Best discovered insulin. But chronic complications of diabetes mellitus have been increased. The main complications of diabetes mellitus are diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, diabetic foot lesion and macrovascular complication. These complications can result in renal failure, loss of sight, cerebral infarction and myocardial infarction. So it is very difficult to treat the complications of diabetes mellitus. In oriental medicine, the transformations(傳變症) of Sogal(消渴) are edema, carbuncle, loss of sight and so on. The comparative study between the trcmsformations(傳變症) of SogaI(消渴) and the complications of diabetes mellitus has come to the following conclusions. 1. In oriental medicine, diabetic retinopathy was expessed as loss of sight and the treament of diabetic retinopathy should be started at an early stage, to prevent vitreous hemorrhage and traction retinal detachment. 2. In oriental medicine. diabetic nephropathy was expressed as edema and the treatment should be started at an early stage of renal injury when the protein comes from urine.3. Symmetrical distal polyneuropathy is the main part of diabetic neuropathy and it was expressed as weakness of the lower limbs and pain of joints in the symptoms of Haso(下消). In Oriental medicine, acupuncture and herb medicine which effect is SopungHwalHyul can treat polyneuropathy. 4. Chief macrovascular complications are coronary artery disease and cerebrovascular disease, The cause of macrovascular complication is atherosclerosis. So the method of treating atherosclerosis should be studied in oriental medicine. 5. Diabetic foot were expressed as carbuncle and its main causes are decreasing perfusion of fool, diabetic neuropathy and infection. So these causes should be studied in oriental medicine. 6. The complications of diabetes mellitus afe very similar to the transfonnatiuns of Sogal(消渴).The control of blood glucose is indispensable to prevent and delay the complication of diabetes mellitus.

• Journal of Acupuncture Research
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• v.24 no.2
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• pp.125-140
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• 2007

Objectives: This study was performed to investigate the effects of acupuncture therapy(AT, AT-9), electro-acupuncture therapy(EAT) and low level laser acupuncture therapy(LAT) at LRJ on the focal ischemia-induced by intraluminal filament insertion in rats. Methods : In the present syudy, the focal ischemia was induced by Intraluminal filament insertion into left middle cerebral artery. The subjects were divided into five groups after focal brain ischemia. (n=15, in each group) : Control with no treatment, AT with acupuncture at $LR_3$, AT-9 with acupuncture at $LR_3$ and rotating 9 times in a clockwise direction, EAT with electro-acupuncture at $LR_3$ and LAT with invasive laser acupuncture at $LR_3$. Anti-apoptotic and neuroprotective effects of acupuncture were observed by mGluR5 mRNA, Bax mRNA, Bcl-2 mRNA, Cytochrome C protein, Cresyl violet-stain and Choline acetyltransferase (ChAT)-stain in the hippocampus. Results: 1. In LAT, mGluR5, Cresyl violet-stain and ChAT-stain were increased. 2. In LAT, Cytochrome C protein was decreased. 3. In AT-9, Bax, Cytochrome C protein and the Bax/Bcl-2 ratio were decreased. 4. In AT-9, Bcl-2, Cresyl violet-stain and ChAT-stain were increased. 5. In EAT, Bcl-2 and Cresyl violet-stain were increased. Conclusions: These results suggests that LAT and AT-9 show anti-apoptotic and neuro-protective effects and that LAT and AT-9 may be useful for managing stroke by focal brain ischemia.

• Biomedical Science Letters
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• v.15 no.1
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• pp.17-23
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• 2009

The prevalence of patent foramen ovale (PFO) in healthy persons was estimated as about $10{\sim}25%$ and was up to 40% in patients with stroke. Transesophageal echocardiography (TEE) was considered to be the most sensitive method to detect PFO and was used as the gold standard. Transcranial doppler sonography (TCD) of the middle cerebral artery (MCA) during a contrast (saline bubble) injection has recently been proposed as an alternative detecting method for PFO. In this study, we would like to know the difference between TCD value and TEE value in subjects with cryptogenic ischemic stroke. We performed TCD and TEE tests to detect PFO on 64 patients (30 women and 34 men, mean age was 59.4 years) with cryptogenic ischemic stroke. PFO prevalence through TCD was 45.3% (29 of 64 patients) and the prevalence through TEE was 34.4% (22 of 64 patients). There was no statistical significance between PFO test and TCD test (P=0.206). But TCD had a sensitivity of 90.9% (20 of 22 patients), specificity of 78.6% (33 of 42 patients), positive predictive value of 69.0% (20 of 29 patients), and negative predictive value of 94.3% (33 of 35 patients). We concluded that TCD was a highly sensitive method for detecting a right-left shunt. Therefore, the non-invasive TCD test is a method more effective than the anti-invasive TEE test in the cost and evaluation of the existence or nonexistence of right to left shunt in addition to the screening method of the cerebrovascular disorder. Considering these points, TCD test could be recommended for patients with cryptogenic ischemic stroke as a useful and convenient method for screening of the existence or nonexistence of a right to left shunt caused by PFO.

• The Korean Journal of Physiology and Pharmacology
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• v.12 no.5
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• pp.275-280
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• 2008

A brief ischemic insult induces significant protection against subsequent massive ischemic events. The molecular mechanisms known as preconditioning (PC)-induced ischemic tolerance are not completely understood. We investigated whether kinetic changes of cyclooxygenase (COX)-2 during reperfusion time-periods after PC were related to ischemic tolerance. Rats were given PC by occlusion of middle cerebral artery (MCAO) for 10 min and sacrificed after the indicated time-periods of reperfusion (1, 2, 4, 8, 12, 18 or 24 h). In PC-treated rats, focal ischemia was induced by occlusion of MCA for 24 h and brain infarct volume was then studied to determine whether different reperfusion time influenced the damage. We report that the most significant protection against focal ischemia was obtained in rats with 8 h reperfusion after PC. Administration of indomethacin (10 mg/kg, oral) or rofecoxib (5 mg/kg, oral) 48 h prior to PC counteracted the effect of PC. Immunohistochemical analysis showed that COX-2 and HO-l protein were induced in PC-treated rat brain, which was significantly inhibited by rofecoxib. Taken together, we concluded that the kinetic changes of COX-2 expression during the reperfusion period after PC might be partly responsible for ischemic tolerance.