• Investigative Magnetic Resonance Imaging
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• v.3 no.2
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• pp.146-153
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• 1999

Purpose : To evaluate the proton MR spectroscopy (MRS) findings of early and late ischemic infarcts and to compare these MRS findings with clinical symptoms. Materials and Methods : We obtained MRs spectra of 28 consecutive patients with early ischemic infarct (15 me, 13 women) between 2-10 (mean 6.2) days after stroke onset. Follow-up MRS was carried out between 20-32 (mean 25) days in 12 patients. The MRs spectra were acquired at 1.5T MR unit using single voxel technique with PRESS sequence, TR of 2000ms, TE of 288 (144)ms, and voxel size of 2cm x 2cm x 2cm in the three areas; an infarct lesion, the brain parenchyma adjacent to the lesion, and contralateral normal brain parenchyma. The NAA/creatine, choline/creatine, and lactate/creatine ratios were calculated in each spectrum. The spectra of MRS were compared with clinical symptoms. Results : In early infarct, decreased NAA/creatine ratio (n=22) and increased lactate/creatine ratio (n=25) were found in the infarct lesion. Choline/creastine ratio was within normal range (n=25). On follow-up MRS in late stage, NAA/creatine ratio in the infarct lesion decreased further (n=5), did not change (n=6), or increased (n=1). Lactate/creatine ratio became less elevated (n=10), or did not changed (n=2). Choline/creatine ratio had a trend for increase. The decreased NAA/creatine and increased lactate/creatine ratios were correlated well with the severity of symptoms, respectively. Conclusion : Decreased NAA/creatine and increased lactate/creatine ratios were common MRS findings characteristic in early ischemic infarct and correlated well with clinical severity. On follow-up MRS in late stage, NAA/creatine ratio decreased further or did not change, and lactate/creatine ratio became less elevated.

• Journal of Preventive Medicine and Public Health
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• v.43 no.2
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• pp.174-184
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• 2010

Objectives: This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. Methods: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. Results: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. Conclusions: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.190-194
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• 2015

Blunt cerebrovascular injury is defined as a vertebral or carotid arterial structural wall injury resulting from nonpenetrating trauma. Complete traumatic internal carotid artery occlusion is very rare condition accounting for 0.08~0.4 0f all trauma patients and believed to be associated with the greatest risk of ischemic stroke reported in 50~90% in a few small series. A 55-year-male was admitted with drowsy mentality and severe headache after a fall down accident. Brain computed tomography showed a subdural hematoma at the both frontal area with a fracture of the occipital skull bone. Two days after admission, he suddenly complained with a right side hemiparesis of motor grade 2. Brain magnetic resonance diffusion demonstrated multiple high flow signal changes from the left frontal and parietal lesion. Computed tomographic angiogram (CTA) revealed absence of the left ICA flow. Trans femoral cerebral angiography (TFCA) showed complete occlusion of the left internal carotid artery (ICA) at ophthalmic segment in the left ICA angiogram and flows on the left whole hemispheric lesions through the anterior communicating artery in the right ICA angiogram. We decided to conduct close observations as a treatment for the patient because of acute subdural hematoma and sufficient contralateral cerebral flow by perfusion SPECT scan. Two weeks after the accident, he was treated with heparin anticoagulation within INR 2~4 ranges. He recovered as the motor grade 4 without another neurologic deficit after 3 months.

• Korean Journal of Pharmacognosy
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• v.40 no.4
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• pp.400-407
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• 2009

The purpose of this study is to investigate hypotensive effect of BDR-29, new herbal preparation of Cassiae Semen, Prunellae Spica, Uncariae Ramulus et Uncus, and Tribuli Semen, in stroke-prone spontaneously hypertensive rats (SHR-SP). SHR-SP were treated with BDR-29 at a dose of 100, 200 mg/kg/day orally for 13 weeks. In the BDR-29 treat group, mean blood pressure and systolic blood pressure were significantly reduced (p<0.05). In phenylephrine-precontracted arota and carotid artery, BDR-29 induced endothelium-dependent vascular relaxation. Hematological findings and biochemical examination revealed no evidence of specific toxicity related to BDR-29. In addition, BDR-29 was markedly attenuated intima-media thickness of thoracic aorta with progression of atherosclerosis. SHR-SP were treated with BDR-29 were significantly increased eNOS expression in arota. These results indicated that BDR-29 improves blood pressure as well as initial atherosclerotic lesion.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.3
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• pp.370-374
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• 2018

Subclavian steal syndrome is a type of obstructive artery disease caused by severe stenosis and occlusion of a left proximal subclavian artery or brachiocephalic trunk. The resulting vertebro-basilar insufficiency symptoms are due to retrograde blood flow from the contralateral vertebral and basilar arteries into the low-pressure ipsilateral upper extremity vessels. For that reason, patients usually experience dizziness or arm ischemic symptoms. Neurointervention is an effective treatment for ischemic stroke, including the subclavian artery stenosis. This paper reports a patient with subclavian steal syndrome who had a vertebral artery Doppler waveform change in duplex sonography and a 12 mmHg difference in interarm systolic blood pressure. A stenotic lesion of the subclavian artery was treated effectively by inserting a precise stent. The follow up examination showed that the vertebral artery Doppler waveform change disappeared and recovered and that the 12 mmHg difference in interarm systolic blood pressure decreased to 5 mmHg after treatment.

• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.38-43
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• 2002

Background & Purpose : Dynamic susceptibility contrast MR imaging, one method of perfusion MRI, was developed to define cerebral hemodynamic status with good anatomical resolution. The authors investigated hemodynamic parameters using this imaging method, in an effort to identify hemodynamic changes on the remote crossed cerebellum of patients with a supratentorial infarct. Methods : Dynamic susceptibility contrast MR imaging was performed in 15 patients with only unilateral supratentorial infarcts. Imaging was obtained at the anatomic level of the cerebellum. rCBF, rCBV, MTT and TP were determined over both cerebellar hemispheres of interest. Results : The rCBF and rCBV values of the contralateral cerebellar hemisphere were significantly more decreased than those of the ipsilateral cerebellar hemisphere in 12 patients(p=0.028, 0.033). MTT and TP values of the contralateral and ipsilateral cerebellar hemispheres didn't reveal any differences(p=0.130, 0.121). Conclusions : The results of this work suggest that the region which are remote from the ischemic brain lesion shows no changes of MTT or TP but show decrease of rCBF and rCBV, mean to diaschisis, it also demonstrates that perfusion MRI is an easily available method to evaluate the hemodynamic status of the brain.

• The Journal of Korean Physical Therapy
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• v.23 no.2
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• pp.61-68
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• 2011

Purpose: The purpose of this study was to provide basic data for the effectiveness and the necessity of home visiting physical therapy through examining performance ability and functional changes in daily life activities by investigating the life of disabled persons living at home. Methods: After selecting 100 people with physical disabilities greater than level 3 and brain damage related disabilities living in Youngam-Gun, we conducted mobility tests according to a Modified Bathel Index (MBI), the Berg Balance Scale (BBS), and floor and bed movements? for Activities of Daily Living evaluation. We did this before the experiment and after doing home visiting physical therapy for 90 minutes at a time, once a week for 6 months Results: 1) Persons who live in a bed are higher than those who live in a floor. There was a significant difference between persons who live in a floor and those who live in a bed in the change in MBI and BBS scores after home visiting physical therapy. 2) Those with a musculoskeletal disorder had a significantly different change in MBI and BBS according to the type of disease and kind of disability. Those with neuropathy had a significantly different change in MBI. Those with physical disabilities showed a significant difference in MBI and BBS. Conclusion: A home visiting physical therapist can cause an improved performance ability and lead to the ability of disabled persons living at home to carry out activities of daily livingin a large part and the study for brain lesion disabilities except physical disabilities and stroke which occupy large proportion of disabled persons should be done.

• Therapeutic Science for Rehabilitation
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• v.6 no.1
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• pp.11-23
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• 2017

Spatial neglect is a neurological disorder following stroke, a lesion that usually affects the right hemisphere, fail to process or attention on the contralateral side of body and space. Functional neuroimaging studies report that spatial neglect is associated with lesions of large middle cerebral artery, perisylvian network and attention network. Spatial neglect is associated with a poor outcome. For optimal diagnosis and intervention, Types and theories of spatial neglect should be considered, in addition to clinical assessment with the conventional test and functional test. The treatment for spatial neglect could be consist of top-down approaches and bottom-up approaches. Recent trends in rehabilitation intervention for spatial neglect have reported prism adaptation.

• Journal of Gastric Cancer
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• v.10 no.3
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• pp.118-125
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• 2010

Purpose: Operative morbidity and mortality from gastric cancer have decreased in recent years, but many studies have demonstrated that its prevalence is still high. Therefore, we investigated the risk factors for morbidity and mortality considering the type of complication in patients with gastric cancer. Materials and Methods: A total of 259 gastrectomies between 2004 and 2008 were retrospectively reviewed. Results: Overall morbidity and mortality rates were 26.6% and 1.9%, respectively. A major risk factor for morbidity was combined resection (especially more than two organs) (P=0.005). The risk factors for major complications in which a re-operation or intervention were required were type of gastrectomy, upper location of lesion, combined resection, and respiratory comorbidity (P=0.042, P=0.002, P=0.031). Mortality was associated with preexisting neurologic disease such as cerebral stroke (P=0.016). In the analysis of differen complication's risk factors, a wound complication was not associated with any risk factor, but combined resection was associated with bleeding (P=0.007). Combined resection was an independent risk factor for a major complication, surgical complication, and anastomotic leakage (P=0.01, P=0.003, P=0.011, respectively). Palliative resection was an independent risk factor for major complications and a previous surgery for malignant disease was significantly related to anastomosis site leakage (P=0.033, P=0.007, respectively). Conclusions: The risk factors for gastrectomy complications of gastric cancer were combined resection, palliative resection, and a previous surgery for a malignant disease. To decrease post-gastrectomy complications, we should make an effort to minimize the range of combined resection, if a palliative gastrectomy is needed for advanced gastric cancer.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.531-534
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• 2007

Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.