• Korean Journal of Acupuncture
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• 제22권4호
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• pp.67-81
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• 2005

Objectives : Cervus Elaphus(CE) has been used to medication for ischemic stroke in the Oriental Medicine. So this study was planned to investigate the effects of CE herbal acupuncture therapy(CE-HAT) on the focal ischemia-induced by intraluminal filament insertion in the rats. Materials and methods : The focal ischemia was induced by middle cerebral artery occlusion for 2hours. The groups divided into 6 groups, normal(intachess group), control(no theray group after ischemia-induced), CE-HAT1(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9 after ischemia-induced), CE-HAT2(Cervus Elaphus-herbal acupuncture therapy group at LU8, KI7 after ischemia-induced), CE-HAT3(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9, LU8, KI7 after ischemia-induced), CE-HAT4(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9, HT3, KI10 after ischemia-induced). CE-HAT was carried out during 3 weeks after focal ischemia-induced. Eight-arm radial maze was used for the behavioral task and neuropretective effect of CE-HAT was observed by Cresyl violet, AchE, ChAT-stain. Results : The error rate in the eight-arm radial maze task was significantly decreased in CE-HAT1, CE-HAT2, CE-HAT4 on 3days, CE-HAT4 on 4days, CE-HAT2, CE-HAT4 on 5days, CE-HAT3, CE-HAT4 on 6days. The rate of correct choice was significantly increased in CE-HAT4. The density of neurons in the hippocampal CA1 was significantly increased in CE-HAT1, CE-HAT2, CE-HAT3, CE-HAT4, compared to control group. The density of ChAT in the hippocampal CA1 was significantly increase in CE-HAT4. The density of ChAT in the hippocampal CA1 was significantly increased CE-HAT1. Conrlusions : These results suggest that the Cervus Elaphus-herbal acupuncture therapy could be used as a medication for controlling the stroke induced by deficiency.

• Investigative Magnetic Resonance Imaging
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• 제20권2호
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• pp.105-113
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• 2016

Purpose: Susceptibility vessel sign (SVS) on gradient echo image, which is caused by MR signal loss due to arterial thrombosis, has been reported in acute middle cerebral artery (MCA) infarction. However, the reported sensitivity and diagnostic accuracy of SVS have been variable. Susceptibility-weighted imaging (SWI) is a newly developed MR sequence. Recent studies have found that SWI may be useful in the field of cerebrovascular diseases, especially for detecting the presence of prominent veins, microbleeds and the SVS. The purpose of this study was to evaluate the diagnostic values of SWI for the detection of hyperacute MCA occlusion. Materials and Methods: Sixty-nine patients (37 males, 32 females; 46-89 years old [mean, 69.1]) with acute stroke involving the MCA territory underwent MR imaging within 6 hours after the symptom onset. MR examination included T2, FLAIR (fluid-attenuated inversion recovery), DWI, SWI, PWI (perfusion-weighted imaging), contrast-enhanced MR angiography (MRA) and contrast-enhanced T1. Of these patients, 28 patients also underwent digital subtraction angiography (DSA) within 2 hours after MR examination. Presence or absence of SVS on SWI was assessed without knowledge of clinical, DSA and other MR imaging findings. Results: On MRA or DSA, 34 patients (49.3%) showed MCA occlusion. Of these patients, SVS was detected in 30 (88.2%) on SWI. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of SWI were 88.2%, 97.1%, 96.8%, 89.5% and 92.8%, respectively. Conclusion: SWI was sensitive, specific and accurate for the detection of hyperacute MCA occlusion.

• 한국전문물리치료학회지
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• 제14권3호
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• pp.48-56
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• 2007

Environmental Enrichment (EE) alone is not capable of enhancing the fine digit and the forelimb functions. Therefore, we applied modified constraint-induced movement therapy (mCIMT) under the influence of EE to assess its effect on promoting improved forelimb sensorimotor functions. Focal ischemic brain injury was produced in Sprague-Dawley rats (60 rats, $250{\pm}50$ g) through middle cerebral artery occlusion (MCAO). Before MCAO induction, all rats were trained in modified limb placing tests and reaching tasks for 1 week. Then they were randomly divided into three groups: Group I: application of standard environment (SE) after MCAO induction (n=20), Group II: application of EE after MCAO induction (n=20), Group III: MCAO+EE, mCIMT and task-oriented training that was initiated at 10th day after MCAO induction (n=20). We also applied mCIMT (between 9 AM and 5 PM/daily) which included restraining the forelimb ipsilateral to the lesion using the 'Jones & Schallert' method. We assessed the change of modified limb placing, single pellet reaching test and the immunoreactivity of BDNF by immunohistochemistry (pre, 1st, 5th, 10th and 20th day). Group I showed no improved outcome, whereas group II and III significantly improved on the use of the forelimb and the immunoreactivity. The qualitative analysis of the skilled reaching test, of group III showed the greatest improvement in the fine digit and the forelimb function. These results suggest that EE combined with mCIMT is more functional in promoting enhanced fine digit and forelimb functional movements.

• 동의생리병리학회지
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• 제23권6호
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• pp.1491-1496
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• 2009

Stroke is usually associated with the cerebral blood flow of the central nervous system. However, studies concerning the effects of neurologic sysmptoms induced from stroke on the peripheral blood flow has not taken place sufficiently. To ascertain the feasibility of a blood flow meter adopting to use doppler ultrasonogrphy, under the prospect that hemiparesis induced from stroke may have effect on the peripheral blood flow, the peripheral blood flow velocity was observed. The control group made up of healthy people without any factors capable of effecting the peripheral blood flow velocity, and patient group which consist of hemiparetic people induced from stroke, were recruited. Volumes of recruitment are 21 persons in the patient group, and 29 persons in the control group, but the final numbers of people are 17 and 21 respectively because of the inconsistancy in the method of the test. The non-invasive method of Doppler effect of Ultrasound was used to measure the blood flow velocity. The blood flow velocity in the peripheral part of left and right fourth fingers:dorsal branches of proper palmar digital artery to dorsum of distal phalanges, was measured in the control group and patient group through Doppler Ultrasound. In comparison of the control group and the patient group, the systolic blood flow velocity from the peripheral part of the upper extremity was lower in the patient group than that of the control group. According to such results, it is concluded that hemiparesis induces the reduction of the peripheral blood flow velocity in the systolic phase.

• 동의신경정신과학회지
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• 제22권4호
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• pp.201-218
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• 2011

Objectives : The aim of this study was to investigate the effects of Guibi-Tang(GBT) on focal brain ischemic injury induced by intraluminal filament insertion in rats. Methods : The ischemia was induced by intraluminal filament insertion into middle cerebral artery. Sprague-Dawley rats were divided into five groups, normal group(n=8); control group was ischemia induced and no treatment(n=8); GBT 1X group was ischemia induced and administrated 42.2 mg/ml/kg of Guibi-Tang orally(n=8); GBT 3X group was ischemia induced and administrated 126.6 mg/ml/kg of Guibi-Tang orally(n=8); GBT 6X group was ischemia induced and administrated 253.2 mg/ml/kg of Guibi-Tang orally(n=8) for 21 days. mGluR5, Bax, Bcl-2 and cytochrome C were investigated to observe the effects of Guibi-Tang on apoptosis. The effects of Guibi-Tang on neuroprotective/apoptotic agents in cresyl violet, choline acetyltranferase(ChAT) with ischemic injury were investigated. Results : The intensity of mGluR5 mRNA in the hippocampal CA1 was increased in normal and GBT(Guibi-Tang) 1X groups compared with the control group. The intensity of Bax mRNA in the hippocampal CA1 was decreased in normal and GBT 1X groups compared with the control group. However it was increased unexpectedly in GBT 3X group. The intensity of Bcl-2 mRNA in the hippocampal CA1 was increased in normal and GBT 1X groups compared with the control group. The intensity of Bax/Bcl-2 ratio in the hippocampal CA1 was decreased in normal and GBT 1X groups compared with the control group. The intensity of cytochrome C protein in the hippocampal CA1 was decreased in normal, GBT 1X and GBT 6X groups compared with the control group. The density of neurons stained by cresyl violet and ChAT was increased in normal and GBT 1X groups compared with the control group. Conclusions : These results suggest that Guibi-Tang may have protective effect on vascular dementia.

• 대한한방내과학회지
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• 제42권5호
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• pp.1035-1044
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• 2021

Objective: This study investigated two cases of Korean medical treatment for visual field impairment after stroke: Case 1, a 56-year-old male with a posterior cerebral artery infarction and right homonymous hemianopsia, and Case 2, a 46-year-old male with an intracerebral hemorrhage in the left parietal lobe and right homonymous hemianopsia. Methods: Case 1 was treated with acupuncture, electroacupuncture, and herbal medicine (Mangeum-tang) for two months, and Case 2 was treated with acupuncture, electroacupuncture, and herbal medicine (Oryeong-san) for 40 days. Results: Following treatment, for Case 1, the Humphrey visual field test showed improvement. The visual field indexes (VFIs) for the left and right eyes improved from 44% to 55% and 49% to 64% respectively, and the mean deviations (MDs) for the left and right eyes improved from -21.11 dB to -19.91 dB and -17.45 dB to -13.89 dB, respectively. The mean visual sensitivities (MVSs) of the left and right eyes also improved from 8.67 dB to 11.33 dB and 1.67 dB to 9.67 dB, respectively, with no side effects. For Case 2, the VFI for the left eye improved from 36% to 64% and that for the right eye remained unchanged. The MDs for the left and right eyes also improved from -22.02 dB to -14.47dB and -22.11 dB to -21.34 dB, respectively, with no side effects. Conclusions: This study suggests that Korean medical treatment may improve visual impairment after stroke, but further research is needed.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.732-739
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• 2021

Objective : Early successful reperfusion is associated with favorable outcomes in acute ischemic stroke (AIS). The purpose of this study was to achieve successful recanalization by a combined mechanical thrombectomy technique, the Aspiration-Retriever Technique for Stroke (ARTS), which is composed of a flexible large lumen distal access catheter and a retrievable stent as the first-line strategy of mechanical thrombectomy. Methods : We retrospectively reviewed 62 patients with AIS who underwent mechanical thrombectomy from 2018 to 2019 at our institute by a senior neurointerventionalist. Among them, patients who were treated using the ARTS technique with the soft torqueable catheter optimized for intracranial access (SOFIA^®; MicroVention-Terumo, Tustin, CA, USA) as the first-line treatment were included. Patients who had tandem occlusions or underlying intracranial artery stenosis were excluded. The angiographic and clinical outcomes were evaluated. The angiographic outcome was analyzed by the rate of successful recanalization, defined as a Thrombolysis in Cerebral Infarction score of 2b or 3 at the end of all procedures and the rate of successfully achieving the first pass effect (FPE), defined as complete recanalization with a single pass of the device. The clinical outcomes included the National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS), and mortality. Results : A total of 27 patients (mean age, 59.3 years) fulfilled the inclusion criteria. The successful recanalization rate was 96% (n=26) while the FPE rate was 41% (n=11). The mean post-procedural NIHSS change was -3.0. Thirteen patients (48%) showed good clinical outcomes after thrombectomy with the ARTS technique (mRS at 90 days ≤2). Postoperative complications occurred in seven of 25 patients : hemorrhagic transformation in six patients (22%) and distal embolization in one patient (4%). Mortality was 15% (n=4). Conclusion : Although the clinical outcomes using the ARTS technique with a flexible large lumen distal access catheter performed as the frontline thrombectomy in patients with AIS were not significantly superior than those of other studies, this study showed a high rate of successful endovascular recanalization which was comparable to that of other studies. Therefore, ARTS using the SOFIA^® catheter can be considered as the first choice of treatment for AIS due to large vessel occlusion.

• 생명과학회지
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• 제32권7호
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• pp.567-577
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• 2022

최근 인구 고령화로 인해 허혈성 심장질환, 허혈성 뇌졸중, 말초 동맥 질환 등의 허혈성 혈관질환의 유병률이 지속적으로 증가하고 있다. 허혈성 질환에 대한 현재 표준화된 치료법은 약물 요법 및 수술을 통한 재관류요법이다. 재관류요법은 손상된 동맥의 기능을 회복시킬 수 있지만 허혈로 인해 손상된 주변 조직의 기능 회복에 있어 효율적이지 않다. 그러므로 허혈 질병을 안전하고 효과적으로 치료하고 주변 조직의 기능을 회복시킬 수 있는 새로운 치료전략의 개발이 필요하다. 이러한 한계를 극복하기 위해 손상된 부위를 재생하는 줄기세포 기반 치료가 허혈성 혈관질환의 유망한 전략으로 연구되어 왔다. 다양한 조직에서 분리할 수 있는 중간엽줄기세포(MSC)는 면역 조절, 혈관 신생 촉진 및 다양한 관련 인자의 분비를 통해 손상된 조직을 재생함으로써 허혈성 질환의 치료에 유망한 것으로 나타났다. 또한, 줄기세포 치료 효과를 높이기 위해 3D 배양법을 이용하거나 세포 프라이밍(Cell Priming)과 같은 MSC 기능을 강화하여 이식 효율을 높이는 새로운 접근법이 연구되고 있다. 이 논문에서는 MSC를 허혈성 질환 치료에 사용하는 다양한 전략을 제공하고 허혈성 부위에서 MSC의 분화(Differentiation), 증식(Proliferation) 및 생착(Engraftment)과 같은 이식의 문제에 대해 논의한다.

• Journal of Chest Surgery
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• 제55권5호
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• pp.378-387
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• 2022

Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

• 대한임상검사과학회지
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• 제54권4호
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• pp.256-264
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• 2022

허혈성 뇌졸중은 뇌동맥의 혈전이나 색전에 의해 폐색되어 산소가 포함된 혈액이 뇌에 도달하는 것을 방지하고, 신경 세포의 괴사를 유발하는 것이다. 본 연구의 목적은 지금까지 연구된 허혈성 뇌졸중의 조기 진단을 가능하게 하는 심혈관 질환 및 심방세동 질환과 관련된 혈청 후보 마커를 정리하고, 각 마커의 OR을 비교 분석하는 것이다. 본 연구에서는 메타분석 기법을 이용하여 혈청 후보 마커의 효과 크기를 분석하고자 하였다. '심혈관질환', '심방세동', '허혈성 뇌졸중', '혈청 표지자'를 키워드로 포함하는 논문에 대한 학술 Database 검색에서 추출된 데이터는 모두 허혈성 뇌졸중 환자에 대한 결과로 제한하였다. 이 연구에서 가장 많이 검색된 마커는 NT-proBNP, D-dimer, CRP 및 GFAP 등으로 나타났다. 결론적으로, NT-proBNP는 허혈성 뇌졸중의 조기 진단에 매우 유용한 것으로 보이며, 특히 심방세동(AF)의 표지자로 알려져 있으며, 앞으로 더 많은 심방세동 표지자가 발굴되어 연구되어야 할 것이다.