• Title/Summary/Keyword: Stroke

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Efficacy Assessment of Endovascular Stenting in Patients with Unilateral Middle Cerebral Artery Stenosis Using Statistical Probabilistic Anatomical Mapping Analysis of Basal/Acetazolamide Brain Perfusion SPECT (기저/아세타졸아미드 국소뇌혈류 SPECT의 확률 뇌지도 분석을 이용한 일측 중대뇌동맥 협착환자에서 시행한 스텐트 삽입술의 효용성 평가)

  • Kim, Hae-Won;Won, Kyoung-Sook;Zeon, Seok-Kil;Lee, Chang-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.280-286
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    • 2009
  • Purpose: The aim of this study was to evaluate the hemodynamic changes after endovascular stenting in patients with unilateral middle cerebral artery (MCA) stenosis using statistical probabilistic anatomical mapping (SPAM) analysis of basal/acetazolamide (ACZ) Tc-99m ECD brain perfusion SPECT. Materials and Methods: Eight patients (3 men and 5 women, 64.8$\pm$10.5 years) who underwent endovascular stenting for unilateral MCA stenosis were enrolled. Basal/ACZ Tc-99m ECD brain perfusion SPECT studies were performed by one-day protocol before and after stenting. Using SPAM analysis, we compared basal cerebral perfusion (BCP) counts and cerebrovascular reserve (CVR) index of the MCA territory before stenting with those after stenting. Results: After stenting, no patient had any complication nor additional stroke. In SPAM analysis, 7 out of the 8 patients had improved BCP counts of the MCA territory and 7 out of the 8 patients had improved CVR index of the MCA territory after stenting. Before stenting, the mean BCP counts and CVR index in the affected MCA territory were 47.1$\pm$2.2 ml/min/100 g and -2.1$\pm$2.9%, respectively. After stenting, the mean BCP counts and CVR index in the affected MCA territory were improved significantly (48.3$\pm$2.9 ml/min/100 g, p =0.025 and 0.1$\pm$1.3%, p =0.036). Conclusion: This study revealed that SPAM analysis of basal/ACZ brain perfusion SPEG would be helpful to evaluate hemodynamic efficacy of endovascular stenting in unilateral MCA stenosis.

Exonic SNP (rs7144, 3’-UTR) in CD46 Molecule and Complement Regulatory Protein (CD46) Gene Associated with Excess Syndrome to Categorize Korean Bronchial Asthma Patients (한국인 기관지 천식 허증(虛證), 실증(實證) 환자와 CD46 유전자 다형성과의 관계)

  • Lee, Mei;Baek, Hyun-jung;Park, Eui-keun;Kim, Kwan-il;Lee, Beom-joon;Kim, Su-kang;Chung, Joo-ho;Kim, Jin-ju;Kim, Mi-a;Jung, Hee-jae;Jung, Sung-ki
    • The Journal of Internal Korean Medicine
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    • v.36 no.4
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    • pp.547-561
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    • 2015
  • Objectives In this study, we divided Korean asthma patients into excess syndrome or deficiency syndrome groups according to clinical phenotype. Genetic analysis was conducted to investigate the association of exonic SNPs in the CD46 gene polymorphism with the clinical phenotype based on the differentiation syndrome of the bronchial asthma patients.Methods There were 95 healthy patients (control group) and 53 asthma patients. (The deficiency syndrome group included 24 and the excess syndrome group 29). We searched the exonic areas of the CD46 gene in the NCBI website SNPs with <0.01 minor allele frequency (MAF) and <0.01 heterozygosity. We finally selected two SNPs: rs138843816, Ser13Phe and rs7144, 3’-UTR. Hardy-Weinberg equilibrium was calculated using SNPStats.Results There were significant differences in the codominant 1 model and the dominant model between the healthy group and the asthma group. There were significant differences between deficiency syndrome group and the excess syndrome group in the genotype frequencies and in the codominant 1 model, the dominant model, and the log-additive model. The allele frequency of rs7144C showed a significant difference between the deficiency syndrome group and the excess syndrome group. Two-SNP haplotype analysis showed a significant difference in frequency in the deficiency syndrome group and in the excess syndrome group. There were significant differences between the healthy group and the excess syndrome group in the codominant 1 model, the dominant model, and the log-additive model. The frequency of the rs7144 C allele exhibited a significant difference in the demonstration. SNP haplotype analysis between the healthy group and the excess syndrome group showed a significant difference in the frequency of the CT haplotype and the CC haplotype.Conclusions The results indicate that two CD46 SNPs (rs138843816, Ser13Phe and rs7144, 3′–UTR) might be associated with the symptomatic excess syndrome in Korean asthma patients.

Assessment of Parameters Measured with Volumetric Pulmonary Artery Catheter as Predictors of Fluid Responsiveness in Patients with Coronary Artery Occlusive Disease (관상동맥 질환을 가진 환자에서 폐동맥카테터로 측정한 전부하 지표들은 수액부하 반응을 예상할 수 있는가?)

  • Lee, Ji-Yeon;Lee, Jong-Hwa;Shim, Jae-Kwang;Yoo, Kyung-Jong;Hong, Seung-Bum;Kwak, Young-Lan
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.41-48
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    • 2008
  • Background: Accurate assessment of the preload and the fluid responsiveness is of great importance for optimizing cardiac output, especially in those patients with coronary artery occlusive disease (CAOD). In this study, we evaluated the relationship between the parameters of preload with the changes in the stroke volume index (SVI) after fluid loading in patients who were undergoing coronary artery bypass grafting (CABG). The purpose of this study was to find the predictors of fluid responsiveness in order to assess the feasibility of using. certain parameters of preload as a guide to fluid therapy. Material and Method: We studied 96 patients who were undergoing CABG. After induction of anesthesia, the hemodynamic parameters were measured before (T1) and 10 min after volume replacement (T2) by an infusion of 6% hydroxyethyl starch 130/0.4 (10 mL/kg) over 20 min. Result: The right ventricular end-diastolic volume index (RVEDVI), as well as the central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP), failed to demonstrate significant correlation with the changes in the SVI (%). Only the right ventricular ejection fraction (RVEF) measured at T1 showed significant correlation. with the changes of the SVI by linear regression (r=0.272, p=0.017). However, when the area under the curve of receiver operating characteristics (ROC) was evaluated, none of the parameters were over 0.7. The volume-induced increase in the SVI was 10% or greater in 31 patients (responders) and under 10% in 65 patients (non-responders). None of the parameters of preload measured at T1 showed a significant difference between the responders and non-responders, except for the RVEF. Conclusion: The conventional parameters measured with a volumetric pulmonary artery catheter failed to predict the response of SVI following fluid administration in patients suffering with CAOD.

The Cross-sectional Mass Flux Observation at Yeomha Channel, Gyeonggi Bay at Spring Tide During Dry and Flood Season (단면 관측을 통한 경기만 염하수로의 대조기 평수시와 홍수시 유출입량 변화특성 조사)

  • Lee, Dong-Hwan;Yoon, Byung-Il;Kim, Jong-Wook;Gu, Bon-Ho;Woo, Seung-Buhm
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.24 no.1
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    • pp.16-25
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    • 2012
  • To calculate the total mass flux that change in dry and flood season in the Yeomha Channel of Gyeonggi Bay, the 13 hour bottom tracking observation was performed from the southern extremity. The value of the total mass flux(Lagrange flux) was calculated as the sum of the Eulerian flux value and stroke drift value and the tidal residual flow was harmonically analyzed through the least-squares method. Moreover, the average during the tidal cycle is essential to calculate the mass flux and the tidal residual flow and there is the need to equate the grid of repeatedly observed data. Nevertheless, due to the great differences in the studied region, the number of vertical grid tends to change according to time and since the horizontal grid differs according to the transport speed of the ship as a characteristic of the bottom tracking observation, differences occur in the horizontal and vertical grid for each hour. Hence, the present study has vertically and horizontally normalized(sigma coordinate) to equate the grid per each hour. When compared to the z-level coordinate system, the Sigma coordinate system was evaluated to have no irrationalities in data analysis with 5% of error. As a result of the analysis, the tidal residual flow displayed the flow pattern of sagging in the both ends in the main waterway direction of dry season. During flood season, it was confirmed that the tidal residual flow was vertical 2-layer flow. As a result of the total mass flux, the ebb properties of 359 cm/s and 261 cm/s were observed during dry and flood season, respectively. The total mass flux was moving the intertidal region between Youngjong-do and Ganghwa-do.

'Clinical Observation for the 226 Cases of CVA' (뇌졸중환자(腦卒中患者) 226예(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee, Seong-Hun;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.5-24
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    • 1997
  • Clinical observation was made on 226 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1995. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in spring and summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through vestern medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission. the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 6.4 days and with cerebral hemorrhage 9.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

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Induction of Midbrain Dopaminergic Phenotype in Nurr 1-Over expressing Human Neural Stem Cells (사람 신경 간세포에서 도파민 신경세포 분화유도에 대한 Nurr 1 유전자의 역할 규명)

  • Kim, Han-Jip;Lee, Haksup;Kim, Hyon-Chang;Min, Churl-Ki;Lee, Myung-Ae;Kim, Seung-Up;Han, Jin;Youm, Jae-Boum;Kim, Nari;Park, Won, Sun;Kim, Taeho;Kim, Euiyong;Han, Il-Yong
    • KSBB Journal
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    • v.20 no.5 s.94
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    • pp.363-370
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    • 2005
  • Neural stem cells (NSCs) of the central nervous system (CNS) have raised a great interest not only for their importance in basic neural development but also for their therapeutic potentials in neurologically degenerative diseases such as Parkinson's, Alzheimer and stroke. During the CNS development, two molecular cascades determine specification of midbrain dopamine system. In one pathway, FGF-8, sonic hedgehog and transcription factor Nurr1 specify dopamine neurotransmitter phenotype. In the other, transcription factors $Lm{\times}lb\;and\;Pt{\times}3$ are required for induction of dopaminergic neurons. In Nurr1 knockout mouse, tyrosine hydroxylase (TH) positive cells fail to appear in substantia nigra, indicating that Nurr1 is essential in specification of dopaminergic cell phenotype. In this study, we used the immortalized human NSCs retrovirally transduced with Nurr1 gene to probe the Nurr1 mediated mechanism to induce dopamine phenotype. While Nurr1 over-expression alone did not generate dopamine phenotype in NSCs, applications of retinoid and forskolin induced expression of TH and AADC mRNAs. In addition, co-cultures of Nurr1 expressing NSCs with human astrocytes induced a marked increase of TH expression. In this co-culture system, the addition of retinoid and forskolin dramatically increased expression of TH. These results indicate that the immortalized human NSCs with Nurr1 gene could have a clinical utility for cell replacement for the Parkinson patients.

Snoring Clinic Visitors' Knowledge of Obstructive Sleep Apnea Syndrome (코골이 클리닉을 방문한 환자들의 폐쇄성 수면무호흡증 인식도)

  • Lee, So-Jin;Lee, Jin-Seong;Shin, Hong-Beum;Cho, Sang-Yong;Rhee, Chae-Seo;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.18 no.2
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    • pp.87-94
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    • 2011
  • Objective: OSAS (obstructive sleep apnea syndrome) is a common disorder and its consequences are often serious. It is important to detect the disorder early in the course for proper treatment. This study is to grasp the snoring clinic visitors' knowledge level of OSAS. Method: One hundred and seventy-nine visitors at the of snoring clinic of Seoul National University Hospital were surveyed by questionnaire about reasons of visit and knowledge of treatment methods of snoring and OSAS, diagnostic method, OSAS-related symptoms, and complications. Results: Most of the respondents (89.4%) "have already heard about OSAS" and the major sources of information was the mass media (58.1%) such as television and radio. More than half (60.3%) were aware that snoring is closely related to OSAS. More than half (59.8%) recognized that a nocturnal polysomnograpy was necessary for proper diagnosis. Two thirds (67%) of the respondents noted surgery as a treatment for snoring. More than half (55.9%) answered that they would follow the doctor's advice on the treatment choice. Only 12.3% of respondents "have heard about nCPAP". No one chose nCPAP (nasal continuous positive airway pressure) as a treatment for either snoring or OSAS. About one third (34.6%) of the respondents were aware that OSAS is related to hypertension. Only 12.8% noted that OSAS is related to diabetes mellitus. Conclusion: Visitors at the snoring clinic were found to have substantially limited knowledge of health risks and proper treatments of OSAS. We suggest that it is crucially important to educate patients and offer easy-to-understand information on snoring and OSAS. We predict that provision of educaiton and information to patients and general public will faciliate the diagnosis and treatment of snoring and OSAS and reduce the related disorders such as hypertension, stroke, and diabetes mellitus.

Effect of NMDA Receptor Antagonist on Local Cerebral Glucose Metabolic Rate in Focal Cerebral Ischemia (국소뇌허혈에서 NMDA 수용체 길항제가 국소 뇌포도당 대사율에 미치는 영향)

  • Kim, Sang-Eun;Hong, Seung-Bong;Yoon, Byung-Woo;Bae, Sang-Kyun;Choi, Chang-Woon;Lee, Dong-Soo;Chung, June-Key;Roh, Jae-Kyu;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.3
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    • pp.294-306
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    • 1995
  • There has recently been increasing interest in the use of NMDA receptor antagonists as potential neuroprotective agents for the treatment of ischemic stroke. To evaluate the neuroprotective effect of the selective non-competitive NMDA receptor antagonist MK-801 in focal cerebral ischemia, local cerebral glucose utilization (ICGU) was examined in 15 neuroanatomically discrete regions of the conscious rat brain using the 2-deoxy-D[$^{14}C$] glucose quantitative autoradiographic technique 24 hr after left middle cerebral artery occlusion (MCAO). Animals received MK-801 (5 mg/kg i.v.) or saline vehicle before (20-30 min) or after (30 min) MCAO. Both pretreatment and posttreatment of MK-801 increased occluded/non-occluded ICGU ratio in 7 and 5 of the 15 regions measured, respectively (most notably in cortical structures). Following MK-801 pretreatment, there was evidence of widespread increases in ICGU not only in the non-occluded hemisphere (12 of the 15 areas studied) but also in the occluded hemisphere (13 of the 15 areas studied), while MK-801 postreatment did not significantly increase ICGU both in the normal and occluded hemispheres. These data indicate that MK-801 has a neuroprotective effect in focal cerebral ischemia and demonstrate that MK-801 provides widespread alterations of glucose utilization in conscious animals.

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Oral Health and Self-Rated Health among the Elderly in Busan (부산지역 65세 이상 노인의 구강건강과 자가건강평가수준(SRH))

  • Yoon, Hyun-Seo;Chun, Jin-Ho;Lee, Jung-Hwa
    • Journal of dental hygiene science
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    • v.12 no.3
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    • pp.197-207
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    • 2012
  • The purpose of this study was to examine the impact of the oral health status and health care of elderly people on their self-rated health(SRH). The subjects on this study were 479 senior citizens who were at the age of 65 and up and resided in the city of Busan. They got a dental checkup, and a survey was conducted by having an one-on-one interview. After the collected data were analyzed, the following findings were given: The senior citizens were diagnosed with a mean of 1.43 systemic diseases, and hypertension(51.8%) was the most prevalent disease among them, followed by diabetes(25.1%), arthritis(41.8%), oral diseases(75.6%), stroke(9.0%) and heart diseases(15.9%). Their self-rated health was better when they were male, when they were aged between 65 and 69, when there was someone with whom they lived, when they were better educated and when they owned their own houses. But their self-rated health was poorer when they felt more oral symptoms, when they had more missing teeth and when they needed both of maxillary and mandibular dentures. Their self-rated health was more positively affected when they were better educated($\beta$=0.894), when they owned their own houses($\beta$=4.220), when they got a dental checkup on a regular basis($\beta$=2.997) and when the rate of their functional tooth was larger($\beta$=0.081). And that was more negatively influenced when they had a denture($\beta$=-1.110), when they had more oral symptoms($\beta$=-1.590) and when they had more systemic diseases($\beta$=3.363). There is a close relationship between the oral health and self-rated health of elderly people. Therefore how to promote their oral health should carefully be considered.

A Study on the Change of Materials and Fabrication Techniques of Stone Figures in Royal Tombs of the Joseon Period - Focusing on Shindobi, Pyo-Seok, and Sang-Seok - (조선시대 왕릉 석물의 재료와 제작 방법 변화에 관한 연구 - 신도비와 표석, 상석을 중심으로 -)

  • Cha, Moonsung
    • Korean Journal of Heritage: History & Science
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    • v.52 no.4
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    • pp.56-77
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    • 2019
  • Bi-Seok is a treasure trove of funeral rites and an important cultural asset that can shed light on the historical and social history of calligraphy, but research of the topic is still insignificant. In particular, research on the production method of Bi-Seok remains an unproven field. The production of Bi-Seok can be roughly divided into ma-jeong (refining stone), sculpture, and the Buk-chil (process of engraving letters) process. This article reveals some facts: First, performing ma-jeong to the Sang-Seok, Honyu-Seok, Bi-seok, which are known to be God's things. This process is needed because of the change in the perception of the Honyu-Seok due to the settlement and propagation of Confucian ceremonial rituals in the times of hardship in 1592 and 1636. As the crafting process of ma-jeong did not remain concrete, it was only possible to examine the manufacturing process of Bi-Seok through its materials and tools. Second, the rapid proliferation of Oh-Seok and Sa-jeo-chwi-yong (purchase of things made by private citizens) in the Yeongjo era has great importance in social and cultural history. When the Gang-Hwa-Seok of the commodity were exhausted, the Oh-Seok that was used by Sadebu (upper civil class) were used in the tomb of Jangneung, which made Oh-Seok popular among people. In particular, the use of Oh-Seok and the Ma-Jeong process could minimize chemical and physical damage. Third, the writing method of the Bi-seok is Buk-chil. After Buk-Chil of Song Si-Yeol was used on King Hyojong's tomb, the Buk-Chil process ( printing the letters on the back of the stone and rubbing them to make letters) became the most popular method in Korea and among other East Asian countries, and the fact that it was institutionalized to this scale was quite impressive. Buk-Chil became more sophisticated by using red ink rather than black ink due to the black color that results from Oh-Seok. Fourth, the writing method changes in the late Joseon Dynasty. Until the time of Yeongjo's regime, when inscribing, the depth of the angle was based on the thickness of the stroke, thus representing the shade. This technique, of course, did not occur at every Pyo-Seok or Shindobi, but was maintained by outstanding artisans belonging to government agencies. Therefore, in order to manufacture Bi-Seok, Suk-seok, YeonJeong, Ma-jeong, Jeong-Gan, ChodoSeoIp, Jung-Cho, Ip-gak, Gyo-Jeong, and Jang-Hwang, a process was needed to make one final product. Although all of these methods serve the same purpose of paying respects and propagandizing the great work of deceased persons, through this analysis, it was possible to see the whole process of Pyo-Seok based upon the division of techniques and the collaboration of the craftsmen.