• Title/Summary/Keyword: Stroke, Acute

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Safety Evaluation of LB10522, a New Cephalosporin Antibiotic

  • Kim, Seong-Il;Raffi Mikaelian;Kwak, Jin-Hwan;Kim, In-Chull;Lee, Chang-Ho
    • Biomolecules & Therapeutics
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    • v.3 no.4
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    • pp.316-321
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    • 1995
  • All the pharmacological studies of LB17522 described here were carried out with high doses (fifteen to sixty times of the therapeutic dose) to determine an indication of potential side effects in clinical use in terms of the acute clinical signs, cardiovascular and central nervous system. LB10522 does not produce any observable clinical signs except for the symptoms such as moist eye, skin rash, slight salivation, vomitting, and slightly reduced activity. The effects of LB10522 on the hemodynamics and cardiac function of anesthetized beagle dogs are as follows; heart rates and mean arterial blood pressure had a tendency to increase mildly, which is a normal finding in anesthetized dogs. All the animals except for one showed relatively stable respiratory rates throughout the observation period. Each animal treated with LB10522 showed slight increase in the left cardiac work and left ventricular stroke work which are mainly related to corresponding increases in cardiac output. Femoral blood flow were shown to be increased in some animals treated with LB10522. The epileptogenic activities of various cephalosporins were assessed by a direct intracerebral injection of appropriate concentration of test articles. The CD$_{50}$ values (nmol) obtained from the analysis of the dose-response data are as follows; 78.2, 175.3, 156.3, and 53.5 for cefazolin, cephaloridine, ceftazidime, and LB 10522, respectively. LB10522 seems to be equipotent with cefazolin or to be three times more potent than cephaloridine and ceftazidime in causing adverse CNS stimulation. Taken into consideration all the information obtained, LB10522 is not supposed to induce much changes in the functions examined in these studies in man at therapeutic doses.s.

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Initial Troponin Level as a Predictor of Prognosis in Patients with Intracerebral Hemorrhage

  • Chung, Pil-Wook;Won, Yu-Sam;Kwon, Young-Joon;Choi, Chun-Sik;Kim, Byung-Moon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.355-359
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    • 2009
  • Objective : It has been suggested that elevated cardiac troponin T (cTnT) level is a marker of increased risk of mortality in acute ischemic stroke and subarachnoid hemorrhage (SAH). However, the association of serum cTnT level and prognosis of intracerebral hemorrhage (ICH) has been sparsely investigated. The aim of this study was to identify the relationship between cTnT level and the outcome in patients with spontaneous ICH. Methods : We retrospectively investigated 253 patients identified by a database search from records of patients admitted in our department for ICH between January 1, 2003 and December 31, 2007. The patients were divided into 2 groups; the patients in group 1 (n=225) with serum cTnT values of 0.01 ng/mL or less, and those in group 2 (n=28) with serum cTnT values greater than 0.01 ng/mL. Results : The serum cTnT level was elevated in 28 patients. There were significant differences in sex, hypertension, creatine kinase-myocardial band, midline shift, side of hematoma, and presence of intraventricular hemorrhage between the 2 groups. Logistic regression analysis identified the level of consciousness on admission, cTnT and midline shift as independent predictors of hospital mortality. Conclusion : Theses results suggest that increased serum cTnT level at admission is associated with in-hospital mortality and the addition of a serum cTnT assay to routine admission testing should be considered in patients with ICH.

Analysis of the Occurrence of Diseases Following Gastrectomy for Early Gastric Cancer: a Nationwide Claims Study

  • Seo, Ho Seok;Na, Yewon;Jung, Jaehun
    • Journal of Gastric Cancer
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    • v.21 no.3
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    • pp.279-297
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    • 2021
  • Purpose: Various changes in nutrition, metabolism, immunity, and psychological status occur through multiple mechanisms after gastrectomy. The purpose of this study was to predict disease status after gastrectomy by analyzing diseases pattern that occur or change after gastrectomy. Materials and Methods: A retrospective cohort study was conducted using nationwide claims data. Patients with gastric cancer who underwent gastrectomy or endoscopic resection were included in the study. Eighteen target diseases were selected and categorized based on their underlying mechanism. The incidence of each target disease was compared by dividing the study sample into those who underwent gastrectomy (cases) and those who underwent endoscopic resection for early gastric cancer (controls). The cases were matched with controls using propensity score matching. Thereafter, Cox proportional hazard models were used to evaluate intergroup differences in disease incidence after gastrectomy. Results: A total of 97,634 patients who underwent gastrectomy (84,830) or endoscopic resection (12,804) were included. The incidence of cholecystitis (P<0.0001), pancreatitis (P=0.034), acute kidney injury (P=0.0083), anemia (P<0.0001), and inguinal hernia (P=0.0007) were higher after gastrectomy, while incidence of dyslipidemia (P<0.0001), vascular diseases (ischemic heart disease, stroke, and atherosclerosis; P<0.0001, P<0.0001, and P=0.0005), and Parkinson's disease (P=0.0093) were lower after gastrectomy. Conclusions: This study identifies diseases that may occur after gastrectomy in patients with gastric cancer.

Neuroprotective mechanisms of dieckol against glutamate toxicity through reactive oxygen species scavenging and nuclear factor-like 2/heme oxygenase-1 pathway

  • Cui, Yanji;Amarsanaa, Khulan;Lee, Ji Hyung;Rhim, Jong-Kook;Kwon, Jung Mi;Kim, Seong-Ho;Park, Joo Min;Jung, Sung-Cherl;Eun, Su-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • v.23 no.2
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    • pp.121-130
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    • 2019
  • Glutamate toxicity-mediated mitochondrial dysfunction and neuronal cell death are involved in the pathogenesis of several neurodegenerative diseases as well as acute brain ischemia/stroke. In this study, we investigated the neuroprotective mechanism of dieckol (DEK), one of the phlorotannins isolated from the marine brown alga Ecklonia cava, against glutamate toxicity. Primary cortical neurons ($100{\mu}M$, 24 h) and HT22 neurons (5 mM, 12 h) were stimulated with glutamate to induce glutamate toxic condition. The results demonstrated that DEK treatment significantly increased cell viability in a dose-dependent manner ($1-50{\mu}M$) and recovered morphological deterioration in glutamate-stimulated neurons. In addition, DEK strongly attenuated intracellular reactive oxygen species (ROS) levels, mitochondrial overload of $Ca^{2+}$ and ROS, mitochondrial membrane potential (${\Delta}{\Psi}_m$) disruption, adenine triphosphate depletion. DEK showed free radical scavenging activity in the cell-free system. Furthermore, DEK enhanced protein expression of heme oxygenase-1 (HO-1), an important anti-oxidant enzyme, via the nuclear translocation of nuclear factor-like 2 (Nrf2). Taken together, we conclude that DEK exerts neuroprotective activities against glutamate toxicity through its direct free radical scavenging property and the Nrf-2/HO-1 pathway activation.

The Effect of Virtual Reality-based Physical Activity Therapy Program on Physical Fitness Factors in Adult - Systematic Reviews - (가상현실 기반 신체활동 치유 프로그램이 성인의 체력요인에 미치는 효과 - 체계적 고찰 -)

  • Park, Sang-Kyun;Tomita, Sigeru;Kim, Dae-Sik;Lee, Wang-Lok
    • Journal of Korean Society of Rural Planning
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    • v.28 no.2
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    • pp.33-40
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    • 2022
  • The purpose of this study is to review the effect of previous research data with virtual reality-based Physical Activity Therapy Programs(PATPs) in adult on the physical fitness factors. Research articles were retrieved from 2008 to 2021 with the Research Information Sharing Service(RISS) and Pubmed database. The main search terms were 'care', 'therapy', 'healing', 'exercise' or 'physical activity', and 'virtual reality'. The criteria for selecting articles of this study were the originality, duplication, Randomized controlled trial(RCT) experiment and subject. Finally, 18 papers were selected among 318 articles, which were excluded if any of the criteria was not satisfied. Most of papers(15) were conducted in the last 5 years, because of the high interest due to the development of virtual reality implementation technology and COVID-19 pandemic. The participants were mainly patients(8), and the types of diseases were stroke(2). The physical fitness factors were mostly balance ability(7), muscle strength(7), and range of motion(6). All the physical fitness factors were significantly improved after PATPs. However, 11 studies were conducted for less than 4 weeks, including 6 studies were performed a bout of acute exercise. Also, 14 studies did not clearly present the intensity of PATPs. In addition, there were 9 studies, that simply applied games without specialized programs. In conclusion, it seems that virtual reality-based PATPs have a positive effect on physical fitness factors. However, VR-based PATPs should be specialized and developed in order to verify their effectiveness for the further research.

Discussion on the Relationship between Well Points in the Fingers and EX-UE11 Points (수지부 정혈과 십선혈의 관계에 대한 고찰)

  • Da-Eun Yoon;Yeonhee Ryu;In-Seon Lee;Younbyoung Chae
    • Korean Journal of Acupuncture
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    • v.40 no.1
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    • pp.13-17
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    • 2023
  • Objectives : Our goals were to examine how the well points in the fingers came to be and how their placements have changed, as well as to determine how they relate to the EX-UE11 points. Methods : We reviewed the classic textbooks to understand the origin and the changes of locations of the well points in the fingers. We also compared the location and indications between well points in the fingers and EX-UE11 points. Results : At first, the tips of the fingers, which are now thought to be the locations of EX-UE11 points, were once described as containing well points. Currently, well points are positioned 0.1 F cun distal-medial (or lateral) to the medial (or lateral) corner of the nail. In addition to the locational commonality, we found similarities between the well points in the fingers and the EX-UE11 points in terms of their indications; for example, bloodletting at these places is frequently utilized to treat emergencies, including acute stroke and fever. Conclusions : We suggest that it is highly likely that well points in the fingers and EX-UE11 points were initially the same acupuncture point and later classified into two different acupuncture points, given their identical locations and indications. If the clinical relevance between the change process of the well points' locations in the fingers and the EX-UE11 is studied in the historical literature, it is anticipated that the significance and clinical application of well points can be expanded.

A Case Report on Right Hemiparesis after Left Thalamus Infarction Treated with Boyanghwanoh-tang-gagam and Complex Korean Medicine Treatment (보양환오탕가감방 및 복합한의치료로 호전된 시상 부위 뇌경색 후 우측 편마비 환자 치험 1례)

  • Eun-soo Park;Hyun-seo Park;Seong-hyun Jeon;Jin-won Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.823-829
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    • 2023
  • Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment. Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (Boyanghwanoh-tang-gagam) three times a day. Jowiseunggi-tang extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient's clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency . Results: The patient's MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication. Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.

Minimally Invasive Procedure versus Conventional Redo Sternotomy for Mitral Valve Surgery in Patients with Previous Cardiac Surgery: A Systematic Review and Meta-Analysis

  • Muhammad Ali Tariq;Minhail Khalid Malik;Qazi Shurjeel Uddin;Zahabia Altaf;Mariam Zafar
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.374-386
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    • 2023
  • Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population. Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model. Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05). Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.

A Case Report of Pontine Infarction as an Initial Manifestation of Systemic Lupus Erythematosus: Diagnostic Clues from MRI and Digital Subtraction Angiography (전신성 홍반성 루푸스의 초기 증상으로 나타난 교뇌경색의 증례 보고: 자기공명영상 및 디지털감산 혈관조영술에서의 진단 단서)

  • Mi Sun Chung;Jun Soo Byun;Younghee Yim
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1281-1286
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    • 2021
  • Brainstem infarction due to vertebrobasilar insufficiency is a rare initial presentation of systemic lupus erythematosus (SLE) patients and small-vessel dissection as the direct cause of infarction has not been reported. We report the case of a 20-year-old female with acute infarction on the right side of the pons due to a small artery (pontine perforator) dissection, identified on digital subtraction angiography and high-resolution vessel wall MRI (vwMRI). She was diagnosed with SLE based on the presence of neurologic disorders and relevant laboratory findings. The pontine perforator-dissecting aneurysm had occluded and the right distal vertebral artery had resolved on subsequent vwMRI. She had a modified Rankin Scale (mRS) score of 1 at discharge with mild symptom improvement, and exhibited no further aggravation of symptoms at 3 or 12 months, maintaining an mRS score of 1.

Predictive Factors of First-Pass Effect in Patients Who Underwent Successful Endovascular Thrombectomy for Emergent Large Vessel Occlusion

  • In-Hyoung Lee;Jong-Il Choi;Sung-Kon Ha;Dong-Jun Lim
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.14-21
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    • 2024
  • Objective : The primary treatment goal of current endovascular thrombectomy (EVT) for emergent large-vessel occlusion (ELVO) is complete recanalization after a single maneuver, referred to as the 'first-pass effect' (FPE). Hence, we aimed to identify the predictive factors of FPE and assess its effect on clinical outcomes in patients with ELVO of the anterior circulation. Methods : Among the 129 patients who participated, 110 eligible patients with proximal ELVO (intracranial internal carotid artery and proximal middle cerebral artery) who achieved successful recanalization after EVT were retrospectively reviewed. A comparative analysis between patients who achieved FPE and all others (defined as a non-FPE group) was performed regarding baseline characteristics, clinical variables, and clinical outcomes. Multivariate logistic regression analyses were subsequently conducted for potential predictive factors with p<0.10 in the univariate analysis to determine the independent predictive factors of FPE. Results : FPE was achieved in 31 of the 110 patients (28.2%). The FPE group had a significantly higher level of functional independence at 90 days than did the non-FPE group (80.6% vs. 50.6%, p=0.002). Pretreatment intravenous thrombolysis (IVT) (odds ratio [OR], 3.179; 95% confidence interval [CI], 1.025-9.861; p=0.045), door-to-puncture (DTP) interval (OR, 0.959; 95% CI, 0.932-0.987; p=0.004), and the use of balloon guiding catheter (BGC) (OR, 3.591; 95% CI, 1.231-10.469; p=0.019) were independent predictive factors of FPE. Conclusion : In conclusion, pretreatment IVT, use of BGC, and a shorter DTP interval were positively associated with FPE, increasing the chance of acquiring better clinical outcomes.