• Korean Circulation Journal
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• v.52 no.11
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• pp.801-807
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• 2022

Percutaneous patent foramen ovale (PFO) closure in patients with a prior PFO-associated stroke showed a risk reduction of the stroke recurrence compared to the medical therapy alone in recent several studies. Nevertheless, optimal patient selection for PFO closure has not been clarified. In this paper, we discuss the characteristics of PFO-associated strokes and discuss the recently published evidence and patient selection for PFO closure in patients with ischemic stroke. The lesions characteristics of PFO-associated stroke are associated with multiple scattered lesion, small sized cerebral cortical lesion, or posterior circulation. Overcoming the failure of early studies in CLOSURE I, PC, and RESPECT trials, PFO closure showed a significant reduction in recurrent stroke in recently published REDUCE, CLOSE, DEFENSEPRO trials, and long-term follow-up data of RESPECT study. However, considering that PFO closure cannot completely prevent stroke recurrence and that complications including atrial fibrillation, we should be selectively performed in patients with high-risk PFO.

• Journal of Sasang Constitutional Medicine
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• v.27 no.3
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• pp.318-325
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• 2015

Objectives This study was to investigate the Sasang Constitutional classification in storke inpatients by using QSCC II and to evaluate the relevance of the results and Donguisusebowon contents. Methods QSCC II was conducted to 73 Stroke patients who were admitted from April 2014 to August 2014 in Dongseo oriental hospital. And the results were analyzed by contents of Donguisusebowon. Results The number of Soyangin and Taeumin was the most common and Soeumin was the lowest. There was no Taeyangin. The number of Soyangin and Taeumin was the most common in cerebral infarction patients, and the number of Soyangin was the most common in intracerebral hemorrhage patients. The patients who had both cerebral infarction and intracerebral hemorrhage were all Taeumin. Conclusions The incidence of stroke was higher in Soyangin and Taeumin. This results were relevant with the Sasang Constitutional Temperament of Donguisusebowon.

• Journal of Korean Neurosurgical Society
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• v.51 no.2
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• pp.75-80
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• 2012

Objective : To optimize the recanalization of acute cerebral stroke that were not effectively resolved by conventional intraarterial thrombolysis (IAT), we designed a double device technique to allow for rapid and effective reopening. In this article, we describe the feasibility and efficacy of this technique. Methods : From January 2008 to September 2009, twenty patients with acute cerebral arterial occlusion (middle cerebral artery : n=12; internal carotid artery terminus : n=5; basilar artery : n=3) were treated by the double device technique. This technique was applied when conventional thrombolytic methods using drug, microwires, microcatheters and balloons did not result in recanalization. In the double device technique, two devices are simultaneously placed at the lesion (for example, one microcatheter and one balloon or two microcatheters). Chemicomechanical or mechanicomechanical thrombolysis was performed simultaneously using various combinations of two devices. Recanalization rates, procedural time, complications, and clinical outcomes were analyzed. Results : The initial median National Institute of Health Stroke Scale (NIHSS) was 16 (range 5-26). The double device technique was applied after conventional IAT methods failed. Recanalization was achieved in 18 patients (90%). Among them, 55% (11 cases) were complete (thrombolysis in cerebral infarction 2B, 3). The median thrombolytic procedural time including the conventional technique was $135{\pm}83.7$ minutes (range 75-427). Major symptomatic hemorrhages (neurological deterioration ${\geq}4$ points in NIHSS) developed in two patients (10%). Good long term outcomes (modified Rankin Scale ${\leq}2$ at 90 days) occurred in 25% (n=5) of the cases. Mortality within 90 days developed in two cases (10%). Conclusion : The double device technique is a feasible and effective technical option for large vessel occlusion refractory to conventional thrombolysis.

• The Journal of Korean Physical Therapy
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• v.4 no.1
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• pp.43-57
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• 1992

This study was conducted from August, 1980 to March, 9991 to the 40 subjects who were admitted to Kosin Medical Center and received rehabilitation treatment and discharged under the impression of stroke. The objectives are to evaluate the function of the activites of daily living and comprehensive function and find the status of rehabilitation treatment by Modified Barthel Index and PULSES Profile when first requested or rehabilitation treatment(T1), at 2 weeks after rehabilitation treatment(T2), at discharge(T3) and at the time of ambulatory treatment after 2 weeks(T4). The study materials were clinical charts and functional evaluation sheets, and the results are as follows : 21 subject$(52.5\%)$ were male, 19 subjects$(47.5\%)$ were female, and the age distribution was from 19 to 70 in age, the average age was 52.7. By the classification of diagnosis, 21 subjects$(52.5\%)$ were cerebral hemorrhage, 8 subjects$(20.2\%)$ were cerebral thrombosis, 6 subjects$(15.0\%)$ were cerebral embolism, and 5 subjects$(12.5\%)$ were cerebral infarction. The Barthel Index scores were 35.7, 54.5, 71.8, 88.7 on the average at T1, T2, T3, T4 respectively. The PULSES scores were 16.4, 13.7, 11.4, 8.7 on the average at T1, T2, T3, T4 respectively. Regarding the Pearson's correlation coefficient between the Barthel Index scores and the PULSES scores, it was -0.7991(P>0.001) at T1 and -0.8986(P>0.001) at T3, then beth of correlations were very high.

• Molecules and Cells
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• v.39 no.4
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• pp.337-344
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• 2016

Intravenous administration of mesenchymal stem cells (IV-MSC) protects the ischemic rat brain in a stroke model, but the molecular mechanism underlying its therapeutic effect is unclear. We compared genomic profiles using the mRNA microarray technique in a rodent stroke model. Rats were treated with $1{\times}10^6$ IV-MSC or saline (sham group) 2 h after transient middle cerebral artery occlusion (MCAo). mRNA microarray was conducted 72 h after MCAo using brain tissue from normal rats (normal group) and the sham and MSC groups. Predicted pathway analysis was performed in differentially expressed genes (DEGs), and functional tests and immunohistochemistry for inflammation-related proteins were performed. We identified 857 DEGs between the sham and normal groups, with the majority of them (88.7%) upregulated in sham group. Predicted pathway analysis revealed that cerebral ischemia activated 10 signaling pathways mainly related to inflammation and cell cycle. IV-MSC attenuated the numbers of dysregulated genes in cerebral ischemia (118 DEGs between the MSC and normal groups). In addition, a total of 218 transcripts were differentially expressed between the MSC and sham groups, and most of them (175/218 DEGs, 80.2%) were downregulated in the MSC group. IV-MSC reduced the number of Iba-$1^+$ cells in the peri-infarct area, reduced the overall infarct size, and improved functional deficits in MCAo rats. In conclusion, transcriptome analysis revealed that IV-MSC attenuated postischemic genomic alterations in the ischemic brain. Amelioration of dysregulated inflammation- and cell cycle-related gene expression in the host brain is one of the molecular mechanisms of IV-MSC therapy for cerebral ischemia.

• The Journal of the Society of Stroke on Korean Medicine
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• v.18 no.1
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• pp.47-53
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• 2017

■ Objectives The purpose of this clinical study is to evaluate the effect of Low-frequency Electroacupuncture on a patient with spasticity due to cerebral infarction. ■ Methods A patient with spasticity with cerebral infarction was treated with herbal medication, acupuncture, electroacupuncture. Then we evaluated the improvement by modified Ashworth scale(MAS). ■ Results Decrease of MAS was observed after low-frequency electroacupuncture for 3 weeks. ■ Conclusion This study proved the effect of Low-frequency electroacupuncture on spasticity due to cerebral infarction.

• Journal of Acupuncture Research
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• v.21 no.3
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• pp.83-97
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• 2004

Objective : This study was performed to evaluate the effect acupuncture on cerebral blood flow by Transcranial Doppler Ultrasonography(TCD). Methods : Monitoring of TCD was examined in stroke patients before and after acupuncture on seven points of CVA. Mean Velocity, pulsatility index, systolic velocity, diastolic velocity values are analyzed from TCD at middle cerebral artery. Results : The results showed a insignificant(p>0.05: Paired T-test) decrease in mean velocity, pulsatility index, systolic velocity, diastolic velocity, which was measured at normal middle cerebral artery. The results showed a significant($p{\leq}0.05$: Paired T-test) decrease in mean velocity, pulsatility index, systolic velocity, which was measured at injuried middle cerebral artery, except diastolic velocity. Conclusion : These results suggest that acupuncture could have a specific effect on injuried cerebral artery.

• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.134-143
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• 1998

Background : The purpose of this study was to investigate the prodromal of cerebral infarction in attacked patients and to prove the traditional hypothesis that some symptoms were to be prodromes of cerebral infarction in the oriental medicine. Methods : The questionnaire which was based on symptoms of traditional hypothesis was distributed cerebral infarction patients who were confirmed by Brain CT or MRI.. Results : Fifty-six patients(93.3%) felt some symptoms within three years before onset. Most common prodromal symptoms was dizziness(50%), failure of memory(45%), numbness of arm(45%). Conclusion : This results suggest that the prodromal symptoms before cerebral infarction can be regarded as predicting sign. and we think that these research may contributed to preventing stroke and relapse.

• Annals of Clinical Neurophysiology
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• v.1 no.2
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• pp.99-105
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• 1999

Background and Objectives : The Motor evoked potentials (MEP) study may be useful in the evaluation of the degree of impairment in the motor nervous system and in the determination of the prognosis. The purpose of this study is to evaluate the status of central nervous system in acute and subacute state of cerebral ischemia by comparing the changes of MEP in the initial and follow-up study. Methods : Twenty patients with hemiparesis caused by ischemic stroke were recruited for this study. We tested MEP within 7 days and followed-up after 14 days after symptom onset. The cerebral motor cortex area, cervical area for upper extremity and lumbar area for lower extremity were stimulated by transmagnetic stimulator. The central motor conduction time(CMCT) was measured with the difference in MEP caused by stimulating the vertical area and spinal area. The CMCT of hemiparetic patients were classified into three groups-normal, delayed, and no evoked MEP groups. Results : The CMCT in hemiparetic side of acute ischemic stroke patients were singnificantly delayed (P < 0.05) compared with the control group. The CMCT of hemiparetic side in the follow-up study showed no sinificantly difference in comparison to the control group. The prognosis of motor improvement was better in the groups of delayed MEP than the groups of no evoked MEP. Conclusion : The CMCT of hemiparetic and contralateral sides were delayed in acute ischemic stroke, compared with control group and were returned to normal boundaries in subacute state. But in the most cases with no MEP response in the initial study, also showed no MEP response in the follow-up study. The recovery occurred in the subacute state in cases with mild hemiparesis, whereas recovery did not occur in the subacute stage in case with severe hemiparesis.

• Journal of Korean Neurosurgical Society
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• v.62 no.2
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• pp.201-208
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• 2019

Objective : In patients with internal carotid artery (ICA) occlusion, collateral middle cerebral artery (MCA) flow has a protective role against ischemia. However, some of these patients may experience initial major neurological deficits and major worsening on following days. Thus, we investigated the safety and efficacy of endovascular treatment (EVT) for ICA occlusion with collateral MCA flow by comparing clinical outcomes of medical treatment versus EVT. Methods : The inclusion criteria were as follows : 1) acute ischemic stroke with ICA occlusion and presence of collateral MCA flow on transfemoral cerebral angiography (TFCA) and 2) hospital arrival within 12 hours from symptom onset. The treatment strategy was made by the attending physician based on the patient's clinical status and results of TFCA. Results : Eighty-one patients were included (30 medical treatment, 51 EVT). The EVT group revealed a high incidence of intracranial ICA occlusion, longer ipsilesional MCA contrast filling time, and a similar rate of favorable clinical outcome despite a higher mean baseline the National Institutes of Health Stroke Scale (NIHSS) score. By binary logistic regression analysis, intravenous recombinant tissue plasminogen activator and EVT were independent predictors of favorable clinical outcome. In subgroup analysis based on stroke etiology, the non-atherosclerotic group showed a higher baseline NIHSS score, higher incidence of EVT, and a higher rate of distal embolization during EVT in comparison with the atherosclerotic group. Conclusion : In patients with ICA occlusion and collateral MCA flow, decisions regarding treatment strategy based on TFCA can help achieve favorable clinical outcomes. EVT strategy with respect to etiology of ICA occlusion might help achieve better angiographic outcomes.