• PNF and Movement
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• v.22 no.1
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• pp.139-149
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• 2024

Purpose: This study aimed to investigate the effects of gradually increasing treadmill inclination on the electroencephalogram (EEG) of stroke patients during gait training. Methods: Three stroke patients who were diagnosed with stroke within six months and capable of walking on a treadmill were selected as subjects. EEG electrodes were attached at Fp1, Fp2, F3, F4, C3, C4, P3, and P4 positions of the cerebral hemispheres using the International 10-20 system. The intervention involved walking for 2 minutes each at 0 degrees, 15 degrees, and 30 degrees inclination on the treadmill while focusing on a target point located in front during the treadmill gait training. The EEG (Smartingmobi, Serbia) generated when the treadmill gradient gradually increased was measured. In addition, relative alpha and relative beta waves were visualized through the Brain mapping program in the TeleScan program to assess the changes in each brain region for the activity of the EEG. Results: The relative alpha wave value decreased as treadmill inclination increased, while the relative beta wave value increased. Conclusion: Gradually increasing the inclination during treadmill gait training appears to be a crucial parameter for increasing the brain activity levels of stroke patients.

• The Journal of Korean Medicine
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• v.24 no.2
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• pp.204-212
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• 2003

Current therapy for acute ischemic stroke is highly focused on neuroprotective agents, and many herbal medicines have been challenged for experimental models. The aim of this study is to investigate whether Angelicae gigantis Radix can protect nerve cells against ischemic neural damage of middle cerebral artery occlusion (MCAO) in rats' brains. Rats were treated with Angelicae gigantis Radix immediately after 2 hours of MCAO for 7 days. On the 7th day, the brains of the rats were sliced through the hippocampus and dyedby c-Fos immunohistochemistry stain and cresyl violet stain for microscopic examination. The number of viable neurons and c-Fos immunoreactive cells in CA1 regions was counted. MCAO caused significant decrease in density of neurons and c-Fos immunoreactive cells compared to those of sham-operated rats. Administration of Angelicae gigantis Radix significantly elevated MCAO-induced decrease in density of neurons and c-Fos immunoreactive cells. These results suggest that the neuroprotective effect of Angelicae gigantis Radix against focal cerebral ischemia is related to c-Fos gene expression. Thus, these findings indicate that Angelicae gigantis Radix can be used for treatment and prevention of cerebral ischemia.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.1
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• pp.113-119
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• 2012

The aim of this study was to investigate the differences in blood homocysteine levels and blood d-dimer levels of cerebral infarction patients categorized by Pattern Identification. We studied hospitalized patients within 4 weeks after the onset of stroke who were admitted to the Oriental Internal Medical Department at Semyung University Chungju Oriental Medical Hospital from May 2008 to September 2009. We analyzed risk factors and blood homocysteine levels and blood d-dimer levels accordings to Pattern Identification in Cerebral infarction patients. A total of 49 patients were included in the trial. No statistical significance was noted for any characteristics except body weight and body mass index. Body weight and body mass index were significantly higher Dampness-Phlegm pattern. On past history of patients, prevalence of DM was significantly higher in Fire-Heat pattern than that of other patterns. There was no significant difference of blood homocysteine levels and blood d-dimer levels among Pattern Identification. This study investigated the differences in blood homocysteine levels and blood d-dimer levels of cerebral infarction patients categorized by Pattern Identification. The correlation in homocysteine and d-dimer levels and Pattern Identification was not clarified.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.3
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• pp.741-747
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• 2007

This study evaluated neuroprotective effects of Yanggyuksanhwa-tang (YST), which have been known to be efficacy in the treatment of the stroke and diabetes. on focal cerebral ischemia of diabetic rats. On primary experiment, diabetic condition in rats was induced by streptozotocin injection, then, focal cerebral ischemia was induced by the middle cerebral artery occlusion (MCAO) under the diabetic condition. Then neuroprotective effect of YST was observed with changes of infarct size and volume, expressions of c-Fos, Bax, and hypoxia inducible factor (HIF)-1${\alpha}$ in the brain tissues by using 2% 2,3,5-triphenyltetrazolium chloride (TTC) staining and immunohistochemistry. YST treatment showed a significant decrease of infarct size and volume induced by MCAO in diabetic rats. YST treatment showed a significant decrease of c-Fos and Bax positive neurons in cortex penumbra. YST treatment showed a decrease of HIF-l${\alpha}$ positive neurons in cortex penumbra, but it was not significant statistically. These results suggest that YST has effects on neuroprotection against cerebral infarct under diabetic condition. And it is supposed that neuroprotective effect of YST reveals by anti-apoptosis mechanism.

• The Journal of Internal Korean Medicine
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• v.45 no.3
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• pp.488-496
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• 2024

Objectives: The purpose of this study was to address a case of cerebral infarction with dysesthesia and weakness. Methods: A patient diagnosed with cerebral infarction with dysesthesia and weakness was treated with Korean medicine therapies including herbal medication (Sunhyunagjunggi-san) for 8 days. To evaluate the therapeutic effect, we used the National Institute of Health Stroke Scale (NIHSS) and Numerical Rating Scale (NRS). Results: After the treatment, the NIHSS and NRS scores dramatically decreased, and the symptoms no longer disturbed the patient. Although the symptoms of dysesthesia did not disappear completely, fine therapeutic effects were noted. Conclusion: These results suggested that Korean medicine therapies with Sunghyuangjunggi-san have a beneficial effect on the dysesthesia and weakness of cerebral infarction.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.145-153
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• 2023

Objectives: Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume. Methods: From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression. Results: Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96). Conclusions: The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.

• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.157-167
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• 1998

Background and Purpose : Cerebrovascular reactivity(CVR) can be estimated by measuring the change of cerebral blood flow that occurs during vasostimulation. To estimate the cerebrovascular reactivity, we investigated the change of flow velocity of the middle cerebral artery(MCA) during hyperventilation and hypoventilation with the transcranial doppler. So we studied whether the CVR measured by this method could show a significant difference between the normal and the cerebral infarction subjects and whether the CVR may decrease with age in normal subjects. Methods : Using transcranial doppler, we measured the mean velocity(Vm), the pulsatility index(P.I.) at the resting state, the end of breath-holding and the end of hyperventilation in 36 normal and 10 cerebral infarction subjects, so we calculated the percentile change of mean velocity(%${\Delta}$Vm) and P.I.(%${\Delta}$P.I.) after the vasostimulation. We estimated the change of Vm, P.I., %${\Delta}$Vm and %${\Delta}$P.I. by the age group and compared those parameters between the age-matched normal control and cerebral infarction subjects. Results : The Vm in MCA significantly decreased with age(p<0.05), but there was no significant difference in Vm and P.I. between normal and cerebral infarction subjects. The %${\Delta}$Vm and %${\Delta}$P.I. in response to hyperventilation significantly decreased with age in MCA and there was significant difference in $%{\Delta}Vm$ of MCA after breath-holding between the normal and cerebral infarction subjects. Conclusion : The breath-holding and hyperventilation tests could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied in the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.115-119
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• 2001

Objective : The cause and clinical outcome of cerebral hemorrhage in patients on maintenance hemodialysis have been poorly studied in korea. The purpose of this paper is to clarify the clincal features and the outcome of cerebral hemorrhage in patients on maintenance hemodialysis. Method : We analyzed clincal features and the outcome of cerebral hemorrhage in 14 patients on maintenance hemodialysis. Hematomas were reviewed and evaluated for location, size, and intraventricular extension by the one of the authors without any prior informations. The axial slice of CT film that the hematoma was appeared in maximal dimension was chosen for evaluations. Result : Hypertension was found in 71.4%(10 cases) and motality rate was 78.5%(11 cases). Basal ganglia hemorrhage was found in 50%(7 cases), subcortex in 28.5%(4 cases), pons in 14.2%(2 cases). Size of hematoma in patients on maintenance hemodialysis was significantly larger than that of hypertensive cerebral hemorrhage patients(p=0.0061). The 4 cases of basal ganglia hemorrhage without intraventricular hemorrhage and subarachnoid hemorrhage were good mental state at the onset of stroke because of small mass effect relative to the size of hematoma. The duration of hemodialysis treatment prior to strokes ranged from 1 to 107 months. Strokes developed within 6 hours of the previous hemodialysis are 5 cases. Average serum albumin concentration was 3.4g/dl. The use of heparin is less responsible for the development of cerebral hemorrhage in patients on maintenance hemodialysis Conclusion : Cerebral hemorrhage in patients on maintenance hemodialysis is more severe in terms of hematoma size and clinical outcome. Therefore, the prevention and treatment of cerebral hemorrhage in patients on maintenance hemodialysis should be more aggressive.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.70-75
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• 1999

Trancranial Doppler(TCD) monitoring is a new application of ultrasonography which allows the nonivasive detection of blood flow velocity in the horizontal (M1) segment of the middle cerebral artery (MCA) and detects microembolic phenomena in the cerebral circulation. Recent studies emphasized the potential of using this technique in vascular surgery (carotid endarterectomy, cardiopulmonary bypass), interventional and intensive care setting. Although the disparity between CBF and blood flow velocity and number of microemboli could be used to prevent cerebral ischemic and embolism based on clinical studies. A reduction of more than 60% of MCA can reflex hemodynamic ischemic state and acoustic feedback of high intensity transient signals(HITS) from the TCD monitoring unit has a direct influence on surgical technique. TCD monitoring can immediately provide information about thromboembolism and hemodynamic changes, which may be a useful tool in the study and prevention of stroke.

• Anatomy and Cell Biology
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• v.57 no.2
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• pp.155-162
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• 2024

Cerebral ischemia is the important cause of worldwide disability and mortality, that is one of the obstruction of blood vessels supplying to the brain. In early stage, glutamate excitotoxicity and high level of intracellular calcium (Ca²⁺) are the major processes which can promote many downstream signaling involving in neuronal death and brain tissue damaging. Moreover, autophagy, the reusing of damaged cell organelles, is affected in early ischemia. Under ischemic conditions, autophagy plays an important role to maintain energy of the brain and its function. In the other hand, over intracellular Ca²⁺ accumulation triggers excessive autophagic process and lysosomal degradation leading to autophagic process impairment which finally induce neuronal death. This article reviews the association between intracellular Ca²⁺ and autophagic process in acute stage of ischemic stroke.