• Korean Journal of Radiology
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• v.21 no.5
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• pp.582-587
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• 2020

Objective: Endovascular thrombectomy (EVT) fails in approximately 20% of anterior circulation large vessel occlusion (AC-LVO). Nonetheless, the factors that affect clinical outcomes of non-recanalized AC-LVO despite EVT are less studied. The purpose of this study was to identify the factors affecting clinical outcomes in non-recanalized AC-LVO patients despite EVT. Materials and Methods: This was a retrospective analysis of clinical and imaging data from 136 consecutive patients who demonstrated recanalization failure (modified thrombolysis in cerebral ischemia [mTICI], 0-2a) despite EVT for AC-LVO. Data were collected in prospectively maintained registries at 16 stroke centers. Collateral status was categorized into good or poor based on the CT angiogram, and the mTICI was categorized as 0-1 or 2a on the final angiogram. Patients with good (modified Rankin Scale [mRS], 0-2) and poor outcomes (mRS, 3-6) were compared in multivariate analysis to evaluate the factors associated with a good outcome. Results: Thirty-five patients (25.7%) had good outcomes. The good outcome group was younger (odds ratio [OR], 0.962; 95% confidence interval [CI], 0.932-0.992; p = 0.015), had a lower incidence of hypertension (OR, 0.380; 95% CI, 0.173-0.839; p = 0.017) and distal internal carotid artery involvement (OR, 0.149; 95% CI, 0.043-0.520; p = 0.003), lower initial National Institute of Health Stroke Scale (NIHSS) (OR, 0.789; 95% CI, 0.713-0.873; p < 0.001) and good collateral status (OR, 13.818; 95% CI, 3.971-48.090; p < 0.001). In multivariate analysis, the initial NIHSS (OR, 0.760; 95% CI, 0.638-0.905; p = 0.002), good collateral status (OR, 14.130; 95% CI, 2.264-88.212; p = 0.005) and mTICI 2a recanalization (OR, 5.636; 95% CI, 1.216-26.119; p = 0.027) remained as independent factors with good outcome in non-recanalized patients. Conclusion: Baseline NIHSS score, good collateral status, and mTICI 2a recanalization remained independently associated with clinical outcome in non-recanalized patients. mTICI 2a recanalization would benefit patients with good collaterals in non-recanalized AC-LVO patients despite EVT.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.806-812
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• 2009

Objective : The aim of this study was to provide basic background information on stroke by evaluation various etiological factors on the basis that the Tongue fur color of acute stroke patients. Method : We studied patients hospitalized within 4 weeks after their ictus who were admitted at Kyunghee University Oriental Medical Center, Dongguk University Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center, and Kyungwon University Incheon Oriental Medical Center from April 2008 to August 2009. We compared the general characteristics of acute stroke patients according to tongue fur color. Result : Tongue fur color showed significant difference for past history of hypertension, hyperlipidemia, stroke, HDL-chol, BUN, Hg, and pulse pattern. Conclusion : The above results show that the overall tendency of acute stage cerebral infarction patients varies according to their tongue fur color. Further studies will be needed to better understand the difference between yellow fur group and white fur among acute stroke patients.

• Journal of Sasang Constitutional Medicine
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• v.18 no.2
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• pp.125-132
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• 2006

1. Objectives The purpose of this study was to examine the regional cerebral blood-flow(r-CBF) difference between OMT(Oriental Music Therapy) group and control group using brain SPECT, to evaluate the effect of OMT in ischemic stroke patients Classified by Sasang Constitutional. 2. Methods We selected 10 ischemic storke patients, classified groups into OMT group or control group. r-CBF of two groups were examined by brain SPECT. in all group we applied SCM(Sasang constitutional medicine)treatment for 4-5 weaks, and additionally in OMT group We applied OMT for 4-5 weaks. after that all the r-CBF of two groups took brain SPECT again. r-CBF difference and change before and after SCM treatment and OMT were quantified and analyzed using SPM. 3. Results r-CBF of OMT groups were increased compared to control groups. 4. Conclusions This study demonstrated that Sasang Constitutional OMT increased regional cerebral blood perfusion to the corresponding brain areas in ischemic stroke patients.

• The Journal of Internal Korean Medicine
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• v.19 no.2
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• pp.50-59
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• 1998

Background : Vascular dementia occurs mainly due to cerebral vascular disease. So we performed this clinical study to investigate the incidence and characteristics of vascular dementia in stroke patients. Methods : This study was performed on the patients hospitalized from April 1, 1998 to August 31, 1998 at the department of circulatory internal medicine, hospital of Oriental medicine, Kyung-Hee University, and diagnosed cerebral infarction or hemorrhage by Brain CT or MRI. we devided the patients into two groups; vascular dementia group and non dementia group according to MMSE-K(Mini Mental State Examination Korean version), Hasegawa dementia scale. Patients were diagnosed dementia using DSM-IV. We compared general characteristics, stoke types and laboratory findings between the two groups and investigated the correlationship between MMSE-K and Hasegawa dementia scale. Results : Results showed that the incidence of vascular dementia was about 27.8% in stroke patients. The greater number of subjects with dementia were women in the lower educational classes and had lower MBI(Moderfied Bathel Index) scores. Vascular dementia were more common in patients with large brain lesion size($>20cm^3$). There was a positive correlationship between Hasegawa scores and MMSE-K.

• Journal of Korean Neurosurgical Society
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• v.63 no.4
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• pp.470-476
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• 2020

Objective : The objective of this study was to develop a score to predict patients with acute ischemic stroke (AIS) who will not benefit from endovascular treatment (EVT) using computed tomographic angiography (CTA) parameters. Methods : The CTA-ABC score was developed from 3 scales previously described in the literature: the Alberta Stroke Program Early CT Score (0-5 points, 3; 6-10 points, 0), the clot burden score (0-3 points, 1; 4-10 points, 0), and the leptomeningeal Collateral score (0-1 points, 2; 2-3 points, 0). We evaluated the predictive value of CTA parameters associated with symptomatic intracranial hemorrhage (sICH) or malignant middle cerebral artery infarction (MMCAI) after EVT and developed the score using logistic regression coefficients. The score was then validated. Performance of the score was tested with an area under the receiver operating characteristic curve (AUC-ROC). Results : The derivation cohort consisted of 115 and the validation cohort consisted of 40 AIS patients. The AUC-ROC was 0.97 (95% confidence interval [CI], 0.94-0.99; p<0.001) in the derivation cohort. The proportions of patients with sICH and/or MMCAI in the derivation cohort were 96%, 73%, 6%, and 0% for scores of 6, 5, 1, and 0 points, respectively. In the validation group, the proportions were similar (90%, 100%, 0%, and 0%, respectively) with an AUC-ROC of 0.96 (95% CI, 0.90-1.00; p<0.001). Conclusion : Our CTA-ABC score reliably assessed risk for sICH and/or MMCAI in patients with AIS who underwent EVT. It can support clinical decision-making, especially when the need for EVT is uncertain.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.226-231
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• 2009

Objective : We describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with a review of the literature. The types of thromboembolic complications were divided and the treatment modalities for each type were described. Methods : Between August 2004 and March 2009 we performed endovascular embolization with Guglielmi detachable coils for 173 patients with 189 cerebral aneurysms, including ruptured and unruptured aneurysms at our hospital. Sixty-eight patients were males and 105 patients were females. The age of patients ranged from 22-82 years (average, 58.8 years). We retrospectively evaluated this group with regard to complication rates and outcomes. The types of thromboembolic complications were classified into the following three categories: mechanical obstruction, distal embolic stroke, and stent-induced complications, which corresponded to types I, II, and III, respectively. A comparison of the clinical results was made for each type of complication. Results : Only eight patients had a thromboembolic complication during or after a procedure (4.6%). Of the eight patients, two had a mechanical obstruction as the causative factor; the other three patients had distal embolic stroke as the causative factor. The remaining three patients had stent-induced complications. In cases of mechanical obstruction, recanalization occurred due to the use of intra-arterial thrombolytic agents in one of two patients. Nevertheless, a poor prognosis was seen. In the cases of stent-induced complications, in one of three patients in whom a thrombus developed following stent insertion, a middle cerebral artery territory infarct developed with a poor prognosis despite the use of wiring and an intra-arterial thrombolytic agent. In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. Conclusion : Treatment for thromboemboic complications due to mechanical obstruction and stent-induced complications include antiplatelet and intra-arterial thrombolytic agents; however, this cannot guarantee a sufficient extent of effectiveness. Therefore, active treatments, such as balloon angioplasty, stent insertion, and clot extraction, are helpful.

• The Journal of the Society of Stroke on Korean Medicine
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• v.20 no.1
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• pp.17-24
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• 2019

■ Objectives The purpose of this case report is to show the effect of Bojungiki-tang on a patient complaining dysuria and urinary pain caused by repeated urinary tract infection(UTI) occurred after onset of cerebral infarction. ■ Methods A cerebral infarction patient with repeated UTI was treated with herbal medication, Bojungiki-tang. Then we evaluated the improvement with amount of total urine output, nelaton catheterization urine output and self voiding urine output. ■ Results Increase in amount of total and self voiding urine output and decrease in amount of nelaton urine output were observed after taking Bojungiki-tang. ■ Conclusion This case showed the effect of Bojungiki-tang on dysuria and urinary pain caused by repeated UTI.

• Journal of Veterinary Science
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• v.23 no.6
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• pp.84.1-84.15
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• 2022

Background: Stroke is caused by disruption of blood supply and results in permanent disabilities as well as death. Chlorogenic acid is a phenolic compound found in various fruits and coffee and exerts antioxidant, anti-inflammatory, and anti-apoptotic effects. Objectives: The purpose of this study was to investigate whether chlorogenic acid regulates the PI3K-Akt-Bad signaling pathway in middle cerebral artery occlusion (MCAO)-induced damage. Methods: Chlorogenic acid (30 mg/kg) or vehicle was administered peritoneally to adult male rats 2 h after MCAO surgery, and animals were sacrificed 24 h after MCAO surgery. Neurobehavioral tests were performed, and brain tissues were isolated. The cerebral cortex was collected for Western blot and immunoprecipitation analyses. Results: MCAO damage caused severe neurobehavioral disorders and chlorogenic acid improved the neurological disorders. Chlorogenic acid alleviated the MCAO-induced histopathological changes and decreased the number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells. Furthermore, MCAO-induced damage reduced the expression of phospho-PDK1, phospho-Akt, and phospho-Bad, which was alleviated with administration of chlorogenic acid. The interaction between phospho-Bad and 14-3-3 levels was reduced in MCAO animals, which was attenuated by chlorogenic acid treatment. In addition, chlorogenic acid alleviated the increase of cytochrome c and caspase-3 expression caused by MCAO damage. Conclusions: The results of the present study showed that chlorogenic acid activates phospho-Akt and phospho-Bad and promotes the interaction between phospho-Bad and 14-3-3 during MCAO damage. In conclusion, chlorogenic acid exerts neuroprotective effects by activating the Akt-Bad signaling pathway and maintaining the interaction between phospho-Bad and 14-3-3 in ischemic stroke model.

• The Journal of Korean Physical Therapy
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• v.35 no.5
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• pp.145-150
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• 2023

Purpose: This study examined the effects of ankle control training using neuromuscular electrical stimulation (NMES), leg muscle activation, and balance in stroke patients. Methods: Thirty-one stroke patients diagnosed with cerebral infarction and cerebral hemorrhage were selected for the study. The experimental group underwent ankle control training using NMES, while the control group applied NMES to the paretic tibialis anterior muscle for 30 minutes per session, five times a week for four weeks. The muscle activity changes were measured using surface electromyography, and balance parameters were evaluated using a functional reach test (FRT). Results: The intra-group comparison of the concentric muscle activity revealed improvements in the experimental group, including paretic tibialis anterior (TA) muscle (p<0.05), medial gastrocnemius muscle (MG) (p<0.01), and lateral gastrocnemius muscle (LG) (p<0.05), as well as MG (p<0.05), LG (p<0.05), soleus muscle (p<0.05) of the non-paretic side, and soleus muscle symmetry index (p<0.05). The intra-group comparison of the eccentric muscle activity showed improvements in the experimental group, including MG (p<0.01) and LG (p<0.01) of the paretic side, as well as MG (p<0.01), LG (p<0.01) of the non-paretic side, and LG symmetry index (p<0.01). The intra-group comparison of the functional reach test revealed significant differences in the test results in the experimental and control groups (p<0.05). Conclusion: Ankle control training using NMES had a positive effect on the changes in muscle activation and improved balance in patients with stroke.

• Journal of Yeungnam Medical Science
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• v.20 no.1
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• pp.1-12
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• 2003

Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.