Objectives : This study was aimed at examining the effects of the application of EA (electroacupuncture) at GV20 and LI4 in the early cerebral ischemia on the size of cerebral infarction, COX-2 and IL-6. Methods : For this experiment, 21, six-week-old male S-D (Sprague - Dawley) rats weighting 160g to 200g were selected and randomly classified into 3 groups, seven rats in each group. Brain ischemia was simulated using a modified Koizumi method which was performed on each rat. In the GV20 group, the GV20 of the SD rats was stimulated for thirty minutes with acupunctural electrode low frequency stimulator five hours after inducement of ischemia. For the LI4 group, the LI4 was stimulated as above, while for the Ischemia group, no stimulation was applied. Twenty-four hours after the experiment, stained cerebral tissues were examined and an immuno-histological test was done to examine inflammatory reaction Results : Out of the three groups, the LI4 group showed the smallest size of cerebral infarction and the Ischemia group showed the highest COX-2 (cyclooxygenase-2) expression value in the cortex of the cerebrum. In addition, the LI4 group showed the lowest COX-2 expression value in unknown putamen out of the three groups. Conclusions : We infer that EA, applied at LI4 and GV20 in early ischemia, is effective in delaying the expression of IL-6 (interleukin-6) and COX-2, the inflammatory agents manifested from stroke. In addition, application at LI4, rather than GV20, can lower the expression value of the inflammatory agents. Further, EA can be an effective way to block early inflammatory reaction in stroke.
Background: Determination of inter-method differences between clinically available volumetry methods are essential for the clinical application of brain volumetry in a wider context. Purpose: The purpose of this study was to examine the inter-method reliability and differences between the Siemens morphometry (SM) software and the NeuroQuant (NQ) software. Materials and Methods: MR images of 86 subjects with subjective or objective cognitive impairment were included in this retrospective study. For this study, 3D T1 volume images were obtained in all subjects using a 3T MR scanner (Skyra 3T, Siemens). Volumetric analysis of the 3D T1 volume images was performed using SM and NQ. To analyze the inter-method difference, correlation, and reliability, we used the paired t-test, Bland-Altman plot, Pearson's correlation coefficient, intraclass correlation coefficient (ICC), and effect size (ES) using the MedCalc and SPSS software. Results: SM and NQ showed excellent reliability for cortical gray matter, cerebral white matter, and cerebrospinal fluid; and good reliability for intracranial volume, whole brain volume, both thalami, and both hippocampi. In contrast, poor reliability was observed for both basal ganglia including the caudate nucleus, putamen, and pallidum. Paired comparison revealed that while the mean volume of the right hippocampus was not different between the two software, the mean difference in the left hippocampus volume between the two methods was 0.17 ml (P < 0.001). The other brain regions showed significant differences in terms of measured volumes between the two software. Conclusion: SM and NQ provided good-to-excellent reliability in evaluating most brain structures, except for the basal ganglia in patients with cognitive impairment. Researchers and clinicians should be aware of the potential differences in the measured volumes when using these two different software interchangeably.
Objective: In this study, we used resting-state fMRI data to map differences in functional connectivity between a comprehensive set of 8 distinct cortical and subcortical brain regions in healthy controls and Internet addicts. We also investigated the relationship between resting state connectivity strength and the level of psychopathology (ex. score of internet addiction scale and score of Barratt impulsiveness scale). Background: There is a lot of evidence of relationship between Internet addiction and impaired inhibitory control. Clinical evidence suggests that Internet addicts have a high level of impulsivity as measured by behavioral task of response inhibition and a self report questionnaire. Method: 15 Internet addicts and 15 demographically similar non-addicts participated in the current resting-state fMRI experiment. For the connectivity analysis, regions of interests (ROIs) were defined based on the previous studies of addictions. Functional connectivity assessment for each subject was obtained by correlating time-series across the ROIs, resulting in $8{\times}8$ matrixs for each subject. Within-group, functional connectivity patterns were observed by entering the z maps of the ROIs of each subject into second-level one sample t test. Two sample t test was also performed to examine between group differences. Results: Between group, the analysis revealed that the connectivity in between the orbito frontal cortex and inferior parietal cortex, between orbito frontal cortex and putamen, between the orbito frontal cortex and anterior cingulate cortex, between the insula and anterior cingulate cortex, and between amydgala and insula was significantly stronger in control group than in the Internet addicts, while the connectivity in between the orbito frontal cortex and insula showed stronger negative correlation in the Internet addicts relative to control group (p < 0.001, uncorrected). No significant relationship between functional connectivity strength and current degree of Internet addiction and degree of impulsitivy was seen. Conclusion: This study found that Internet addicts had declined connectivity strength in the orbitofrontal cortex (OFC) and other regions (e.g., ACC, IPC, and insula) during resting-state. It may reflect deficits in the OFC function to process information from different area in the corticostriatal reward network. Application: The results might help to develop theoretical modeling of Internet addiction for Internet addiction discrimination.
Purpose: We investigated the difference in injury of the corticospinal tract (CST) and the spinothalamic tract (STT) in patients with putaminal hemorrhage, using diffusion tensor tractography (DTT). Methods: Thirty one consecutive patients with PH and 34 control subjects were recruited for this study. DTT scanning was performed at early stage of PH (7-63 days), and the CST and STT were reconstructed using the Functional Magnetic Resonance Imaging of Brain (FMRIB) Software Library program. Injury of the CST and STT was defined in terms of the configuration or abnormal DTT parameters was more than 2 standard deviations lower than that of normal control subjects. Results: Among 31 patients, all 31 patients (100%) had injury of the CTS, whereas 25 patients (80.6%) had injury of the STT: the incidence of CST injury was significantly higher than that of STT (p<0.05). In detail, 20 (64.5%) of 31 patients showed a discontinuation of the CST in the affected hemisphere; in contrast, 14 patients (45.2%) of 31 patients showed a discontinuation of the STT in the affected hemisphere. Regarding the FA value, 6 (19.4%) of 31 patients and 2 (6.4%) of 31 patients were found to have injury in the CST and STT, respectively. In terms of the fiber number, the same injury incidence was observed in 11 patients (35.5%) in both the CST and STT. Conclusion: The greater vulnerability of the CST appears to be ascribed to the anatomical characteristics; the CST is located anteriorly to the center of the putamen compared with the STT.
The caffeine intake cause a local or wide ranges of convulsion and it is associated with release of dopamine (DA) receptors into the brain striatum. However, the effect of caffeine addiction on expression of DA receptors gene in the rat caudate-putamen (CPu), nucleus accumbens (NAc), and olfactory tubercle (OTu) has not been elucidated. In this study, we examined the influence of caffeine addiction on DA D $_1$and D$_2$receptor mRNAs after the treatment of caffeine for four weeks. Using the specific antisense ribo-probes for DA D$_1$and D$_2$receptor cDNAs, in situ hybridization was performed on the CPu, NAc, and OTu of the adult male Sprague Dawely rats. In caffeine-treated group, DA D$_1$and D$_2$receptor mRNAs were highly increased in CPu, NAc, and OTu. The expression density of DA D$_1$receptor mRNAs were 2.52${\pm}$1.40 (CPu), 2.78${\pm}$1.69 (NAc), and 3.91${\pm}$1.28 (OTu) in control group and 7.76${\pm}$2.09 (CPu), 4.2 ${\pm}$1.85 (NAc), and 8.21${\pm}$1.72 (OTu) in caffeine-treated group. The expression density of DA D$_2$receptor mRNA was 2.32${\pm}$1.52 (CPu), 2.63${\pm}$2.11 (NAc), and 3.61${\pm}$1.43 (OTu) in control group, and 6.41${\pm}$1.82 (CPu), 6.89${\pm}$1.32 (NAc), and 6.82${\pm}$1.18 (OTu) in caffeine-treated group. DA D$_1$receptor mRNA was higher expressed than DA D$_2$ receptor mRNA in CPu and NAc. These results suggest that caffeine reacts as a upregulator of the expression of DA D$_1$and D$_2$receptor mRNA among the neurotransmitters.
Objectives : Spontaneous intracerebral hemorrhage(S-ICH) is generally considered to be a mon-ophasic event. But some patients with ICH continued to bleed even after hospitalization. In order to evaluate the rebleeding and growth factor of hematoma in small volume S-ICH, 125 cases of S-ICH were reviewed retrospectively. Methods : We assesed age, sex, initial mental state, location of hemorrhage, systolic and diastolic blood pressure, blood pressure patterns, hematologic profile, trauma and stroke history, alcohol consumption and smoking history. Two subgroups-rebleeding groups versus no rebleeding groups-were compared, in terms of data analysis, with student T-test and chi-square test. Results : Substantial growth in the volume of S-ICH occurred in 21 cases(16.8%)-putamen(7 cases), thalamus(6 cases), subcortex(5 cases), cerebellum(2 cases), pons(1 case)-of the 125 patients. There was no significant difference in any of the parameters except initial systolic blood pressure(p=0.037) when patients with and without rebleeding were compared. Conclusion : The rebleeding and growth of the small volume S-ICH was related to the markedly elevated initial systolic blood pressure(${\geq}180mmHg$) and labile pattern of blood pressure.
Objectives : Dodam-tang has been reported to have a control effect against the hyperlipidemia and thrombosis. Based upon these previous reports, this study investigates the effects of Dodam-tang on the cerebral ischemic damage of the hyperlipidemic rats. Methods : Hyperlipidemia was induced by the beef tallow 30% diet for 14 days on Sprague-Dawley rats. Ischemic damage was induced by the middle cerebral artery occlusion (MCAO) for 2 hours with the intraluminal thread method. Then water extract of Dodam-tang was administered daily for 5 days. The effect of Dodam-tang was evaluated with the serum lipids, infarct volume and edema percentage, and immunohistochemical expressions of iNOS, MMP-9, and GFAP in the brain tissue. Results : The obtained results were as follows; Dodam-tang reduced significantly the infarct size in a TTC-stained 5th brain section of the hyperlipidemic MCAO rats. Dodam-tang suppressed the infarct volume of the hyperlipidemic MCAO rats, but not significant statistically. Dodam-tang suppressed the edema percentage of the hyperlipidemic MCAO rats significantly in the brain tissue. Dodam-tang suppressed significantly the iNOS expression in the cerebral penumbra and caudate putamen of the hyperlipidemic MCAO rats. Dodam-tang suppressed significantly the MMP-9 expression in the cerebral penumbra of the hyperlipidemic MCAO rats. Dodam-tang suppressed significantly the GFAP-expressed atrocytes in the cerebral penumbra of the hyperlipidemic MCAO rats. Conclusions : These results suggest that Dodam-tang suppresses the brain edema formation through the suppression of the iNOS, MMP-9 and GFAP, but the neuroprotective effect against the cerebral infarct are not distinct.
Objectives : This study was performed in order to evaluate the effects of Salviae Miltiorrhizae Radix (SMR) water extract against the cerebral hemorrhage and the blood-brain barrier (BBB) impairment in the intracerebral hemorrhage (ICH). Method : ICH was induced by the stereotaxic intrastriatal injection of bacterial collagenase type IV in Sprague-Dawley rats. SMR was orally given three times every 20 hours during 3 days after the ICH induction. Hematoma volume, water content of brain tissue and volume of evans blue leakage were examined. Myeloperoxidase (MPO) positive neutrophils and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) were observed with immunofluorescence labeling and confocal microscope. Results : SMR significantly reduced the hematoma volume of the ICH-induced rat brain. SMR significantly reduced the water content of brain tissue of the ICH-induced rat brain. SMR reduced the percentage of the evans blue leakage around the hematoma on the caudate putamen compared to the ICH group, especially on the cerebral cortex. SMR significantly reduced the volume of the evans blue leakage level in the peri-hematoma regions of the ICH-induced rat brain. SMR significantly reduced MPO positive neutrophils in the peri-hematoma regions of the ICH-induced rat brain. SMR reduced the TNF-${\alpha}$ expression in peri-hematoma regions of the ICH-induced rat brain. TNF-${\alpha}$ immuno-labeled cells were coincided with MPO immuno-labeled neutrophils in peri-hematoma regions of the ICH-induced rat brain. Conclusion : These results suggest that SMR plays a protective role against the blood-brain barrier impairment in the ICH through suppression of inflammation in the rat brain tissues.
Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 169 patients who were admitted to Dept. of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2003 to Dec. 31, 2003. Results : Ischemic stroke(include TIA, 85.2%) was more common than hemorrhagic stroke(14.8%). The incidence in male was 46.7%, in female was 53.3% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in MCA territory and lacunar-inf., hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus. The rate of recurrence was 30.18%. Cerebral infarction and cerebral hemorrhage was much occurred in acting. The most patients visited the hospital after 5 days. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly urinary tract infection. Physical treatment from onset, in cerebral infarction was 9.14 days and in cerebral hemorrhage was 18.33 days. Conclusions : Our study on CVA patients was similar to previous studies from 1994 to 2002. In most cases, western and oriental treatment and medicine were given synthetically.
Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 75 patients who were admitted to Department of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2005 to Dec. 31, 2005. Results : Ischemic stroke(include TIA, 93.3%) was more common than hemorrhagic stroke(6.7%). The incidence in male was 36.0%, in female was 64.0% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in MCA-infarction and hemorrhage in putamen & thalamus. Hypertention, the most preceding diseases, followed by diabetes mellitus and CVA. The rate of recurrence was 21.3%. Cerebral infarction and cerebral hemorrhage was much occurred after rising. The most patients visited the hospital within 24 Hours. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly urinary tract inflamation. Conclusions : Our study on CVA patients was similar to previous studies from 1994 to 2004. In most cases, western and oriental treatment and medicine were given synthetically.
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