• Korean Journal of Radiology
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• v.24 no.4
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• pp.338-348
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• 2023

Objective: Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine whether plaque enhancement can contribute to risk assessment for recurrent stroke compared with the Essen Stroke Risk Score (ESRS). Materials and Methods: This prospective study screened 151 patients with recent ischemic stroke and carotid atherosclerotic plaques at our hospital between August 2020 and December 2020. A total of 149 eligible patients underwent carotid CEUS, and 130 patients who were followed up for 15-27 months or until stroke recurrence were analyzed. Plaque enhancement on CEUS was investigated as a possible risk factor for stroke recurrence and as a possible adjunct to ESRS. Results: During follow-up, 25 patients (19.2%) experienced recurrent stroke. Patients with plaque enhancement on CEUS had an increased risk of stroke recurrence events (22/73, 30.1%) compared to those without plaque enhancement (3/57, 5.3%), with an adjusted hazard ratio (HR) of 38.264 (95% confidence interval [CI]:14.975-97.767; P < 0.001) according to a multivariable Cox proportional hazards model analysis, indicating that the presence of carotid plaque enhancement was a significant independent predictor of recurrent stroke. When plaque enhancement was added to the ESRS, the HR for stroke recurrence in the high-risk group compared to that in the low-risk group (2.188; 95% CI, 0.025-3.388) was greater than that of the ESRS alone (1.706; 95% CI, 0.810-9.014). A net of 32.0% of the recurrence group was reclassified upward appropriately by the addition of plaque enhancement to the ESRS. Conclusion: Carotid plaque enhancement was a significant and independent predictor of stroke recurrence in patients with ischemic stroke. Furthermore, the addition of plaque enhancement improved the risk stratification capability of the ESRS.

• Korean Journal of Radiology
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• v.24 no.5
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• pp.476-477
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• 2023

• Journal of Korean Neurosurgical Society
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• v.40 no.6
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• pp.463-466
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• 2006

A case of parasagittal meningioma en plaque with a peculiar clinical presentation is reported with a review of the literature. A 72-year-old woman presented with dysphasia and right hemiparesis. Computed tomography and magnetic resonance imaging demonstrated focal edema of left frontal lobe and a thick sheet-like parasagittal enhancing lesion with extension along the falx cerebri and adjacent sulcal enhancement. Differential diagnosis included idiopathic hypertrophic pachymeningitis, meningeal neurosarcoidosis, metastasis and meningioma en plaque. Cerebral angiography revealed occlusion of the anterior one-third of the superior sagittal sinus as well as a faint tumor blush supplied from the anterior branch of the middle meningeal artery. At surgery, the tumor invading the dura and skull was removed totally but the tumor invaded into the superior sagittal sinus was removed subtotally. The tumor was confirmed to be a transitional meningioma on pathological examination.

• Investigative Magnetic Resonance Imaging
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• v.13 no.1
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• pp.81-87
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• 2009

Purpose : We sought to evaluate enhancement of plaque with gadolinium-based contrast agent by magnetic resonance imaging (MRI) in comparison with histopathology, namely lipid-rich and macrophage-rich components that were two representative characteristics of plaque vulnerability using atherosclerotic rabbit aorta in order to determine which histopathologic component is relevant to the enhancement. Materials and Methods : New Zealand white rabbit (n=4, weight 3.0 to 3.5 kg, all male) was used for animal model of atherosclerosis. Atherosclerotic aortic lesions were induced by high-cholesterol diet and double balloon injury. T1-weight axial images were acquired before and after gadolinium-based contrast agent using a 3-T MRI. MR images and the matched histopathological sections (n=35) were divided into 4 quadrants or 3 (n=130). Enhancement ratio (ER, ER=SIpost/SIpre) on MRI was calculated for each quadrant and compared with histopathology in regard to lipid-rich and macrophage-rich areas. Results : Lipid-rich quadrants were 72 and fibrous quadrants were 58. The number of quadrants which had macrophage-rich areas was 105 and that of quadrants which did not have macrophage-rich areas was 25. ER was significantly higher in lipid-rich quadrants than in fibrous quadrants (mean ER 2.25c$\pm$0.41 vs. 2.72$\pm$0.65, p=0.013). ER poorly correlated with macrophage-rich areas when lipid-component was controlled (correlation coefficient -0.203, p=0.236). Conclusion : Lipid-rich plaques showed stronger enhancement than fibrous plaques using a standard gadolinium-based extracellular contrast agent. Macrophage infiltration did not correlate with degree of enhancement. Further study is warranted that account for optimal time of imaging after contrast injection using various plaque models from early to advanced stages and all possible parameters associated with contrast enhancement.

• YAKHAK HOEJI
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• v.43 no.5
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• pp.635-641
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• 1999

In this study, we investigated the immunopotent activities of lepidan, a water soluble proteoglycan from Lentinus lepideus. To examine whether lepidan may affect nonspecific immune responses, we determined the effect on the production of nitric oxide (NO). Lepidan effectively increased the NO production in IFN-${\gamma}$ and LPS triggered RAW 264.7 cells. To further demonstrate the evidence that lepidan activates various immune cells, we determined the alkaline phosphatase activity, plaque-forming cell number and secretion of interleukine-4 (IL-4) and granulocyte/macrophage-colony stimulating factor (GM-CSF) after lepidan treatment in murine splenocytes. The results showed that lepidan increased alkaline phosphatase activity and the number of plaque-forming cells, which indicates that lepidan can lead B lymphocytes to late stage of differentiation. Also, when the splenocytes were cultured with lepidan for 48 hr, the level of IL-4 and GM-CSF in the supernatant dramatically increased. Taken together, these data suggest that lepidan is a biological response modulator that is able to activate immune responses.

• Archives of Pharmacal Research
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• v.20 no.6
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• pp.545-549
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• 1997

Effects of swainsonine (SW;8${\alpha}$, ${\beta}$-indolizidine-${\alpha}$, $2{\alpha}$8-triol from Locoweed) on the humoral immune responses of lipopolysaccharide (LPS) wer studied in ICR mice. Mice were divided into 4 groups (10 mice/group), and LPS was given to each mouse 1 hr after i.p. injection with 3.7 mg/kg of swainsonine, by i.p. injection twice a week for 14 days at a dose of 2 mg/kg. Humoral immune responses were evaluated by hemagglutination (HA) titer and splenic plaque forming cells (PFC). The results of this study were summarized as follows: Mice administrated each of LPS and SW showed significant enhancement of the weight ratios of spleen to body, HA titer, 2-mercaptoethanol-resistant HA(MER-HA) titer and PFC compared with those in controls. However, the LPS plus SW treatment decreased HA titer, MER-HA titer and PFC corresponding to humoral immunity, as compared with those in the mice treated with LPS alone. These findings indicated that LPS significantly enhanced humoral immune responses, but their enhancement effects were lowered somewhat by SW.

• Archives of Pharmacal Research
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• v.28 no.11
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• pp.1293-1301
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• 2005

Flavonoids, a group of low molecular weight phenylbenzopyrones, have various pharmacological properties including antioxidant, anticancer, bactericidal, and anti-inflammatory. We carried out anti-herpetic assays on 18 flavonoids in five classes and a virus-induced cytopathic effect (CPE) inhibitory assay, plaque reduction assay, and yield reduction assay were performed. When flavonoids were applied at various concentrations to Vero cells infected by HSV-1 and 2, most of the f1avonoids showed inhibitory effects on virus-induced CPE. Among the flavonoids, EC, ECG (flavanols), genistein (isoflavone), naringenin (flavanone), and quercetin (flavonol) showed a high level of CPE inhibitory activity. The antiviral activity of flavonoids were also examined by a plaque reduction assay. EC, ECG, galangin, and kaempferol showed a strong antiviral activity, and catechin, EGC, EGCG, naringenin, chrysin, baicalin, fisetin, myricetin, quercetin, and genistein showed moderate inhibitory effects against HSV-1. In these experiments, flavanols and flavonols appeared to be more active than flavones. Furthermore, treatment of Vero cells with ECG and galangin (which previously showed strong antiviral activities) before virus adsorption led to a slight enhancement of inhibition as determined by a yield reduction assay, indicating that an intracellular effect may also be involved.

• Korean Journal of Radiology
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• v.23 no.3
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• pp.333-342
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• 2022

Objective: Intracranial atherosclerotic stroke occurs through various mechanisms, mainly by artery-to-artery embolism (AA) or branch occlusive disease (BOD). This study evaluated the spatial relationship between middle cerebral artery (MCA) plaques and perforating arteries among different MCA territory infarction types using vessel wall magnetic resonance imaging (VW-MRI). Materials and Methods: We retrospectively enrolled patients with acute MCA infarction who underwent VW-MRI. Thirty-four patients were divided into three groups according to infarction pattern: 1) BOD, 2) both BOD and AA (BOD-AA), and 3) AA. To determine the factors related to BOD, the BOD and BOD-AA groups were combined into one group (with striatocapsular infarction [BOD+]) and compared with the AA group. To determine the factors related to AA, the BOD-AA and AA groups were combined into another group (with cortical infarction [AA+]) and compared with the BOD group. Plaque morphology and the spatial relationship between the perforating artery orifice and plaque were evaluated both quantitatively and qualitatively. Results: The plaque margin in the BOD+ group was closer to the perforating artery orifice than that in the AA group (p = 0.011), with less enhancing plaque (p = 0.030). In the BOD group, plaques were mainly located on the dorsal (41.2%) and superior (41.2%) sides where the perforating arteries mainly arose. No patient in the AA group had overlapping plaques with perforating arteries at the cross-section where the perforator arose. Perforating arteries associated with culprit plaques were most frequently located in the middle two-thirds of the M1 segment (41.4%). The AA+ group had more stenosis (%) than the BOD group (39.73 ± 24.52 vs. 14.42 ± 20.96; p = 0.003). Conclusion: The spatial relationship between the perforating artery orifice and plaque varied among different types of MCA territory infarctions. In patients with BOD, the plaque margin was closer and blocked the perforating artery orifice, and stenosis degree and enhancement were less than those in patients with AA.

• Journal of Korean Academy of Nursing
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• v.41 no.5
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• pp.684-693
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• 2011

Purpose: To investigate the effects of oral care education on knowledge, attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes. Methods: In this quasi-experimental study, the intervention group (n=27) of residents received oral care from intervention group caregivers (n=28) who had received 6 weeks of oral care education. The control group (n=27) of residents received usual oral care from control group caregivers (n=26). Data on knowledge, attitude, and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected. Data were analyzed using SPSS WIN 16.0. Results: 1) Scores on caregivers' knowledge (p<.001) and behavior (p<.001) for oral care were higher in the intervention group 6 and 12 weeks. The caregivers' attitude (p<.001) score for oral care was higher in the intervention group 12 weeks. 2) The plaque index (p=.004) and halitosis (p=.002) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks. Conclusion: Oral care education programs for caregivers are effective in improving the oral hygiene of elderly residents in nursing homes through enhancement of caregivers' knowledge, attitude, and behavioral change.

• YAKHAK HOEJI
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• v.49 no.2
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• pp.147-150
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• 2005

Macrophage scavenger receptors (MSRs) induce microglial interaction with ${\beta}$-amyloid fibrils (fA${\beta}$) that are associated with Alzheimer's disease (AD). Although microglia are know n to have a dual effect on formation of plaque and clearance of fA${\beta}$ in the AD brain, receptor-mediated phagocytosis is a very important tool for preventing amyloid plaque via activated microglia in the early stage of AD. In the study, we examined whether ginsonoside Rg3 enhances the microglial Phagocytosis of A${\beta}$1-42 through Phagocytosis assay, gene expression (RT-PCR) and protein assay (western blots) for the cell responsiveness presented between Rg3-treated and non-treated groups. Fluro-labeled Ac-LDL and E.coli particles were used as control proteins for phagocytosis. In previous studies, this was a particularly interesting property of Rg3 in the stimulation and phagocytosis of macrophages in the periphery. We report here that ginsenoside Rg3 increased the expression of type-A MSR (MSR-A) in microglia and thus accelerated the phagocytosis with an effective degradation of engulfed fA${\beta}$. This result suggests that Rg3 may play an important role in removing fA${\beta}$ by enhancing the receptor-mediated phagocytosis. In addition, Rg3 could be a potential candidate for balancing the rate of production of fA${\beta}$ in AD brain.