Journal of Physiology & Pathology in Korean Medicine
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v.20
no.4
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pp.1014-1020
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2006
This study was intended to examine the effects of electroacupuncture(EA) and therapeutic exercise on the improvement of exercise function, BNDF, and HSP70 protein expression in an ischemic stroke model induced by MCA occlusion. Experiments were conducted for 1, 3 days, 1, 8 weeks respectively. Group I was a group of EA and therapeutic exercise; Group II was a group of therapeutic exercise; Group III was a group of EA; Group IV was a sham group of EA; Group V was a control group; and Group VI was a sham group without ischemic stroke. In each group, neurologic motor behavior test, histologic observations, BDNF, and HSP70 expression were observed and analyzed. The following results were obtained. The results of behavior test suggest that 8 weeks after ischemic stroke was induced, Group I improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group VI. In immunohistochemical observations, Group I showed increase in BDNF and decrease in HSP70. Based on these results, EA and therapeutic exercise may improve muscle atrophy and change in BDNF and HSP70 expression of ischemic stroke rats and contribute to the improvement of exercise function.
Acute ischemic stroke(AIS) should be diagnosed within a few hours of onset of cerebral infarction symptoms using diagnostic radiology. In this study, we evaluated the clinical usefulness of SVD and the Bayesian algorithm to measure the volume of cerebral infarction using computed tomography perfusion(CTP) imaging and magnetic resonance diffusion-weighted imaging(MR DWI). We retrospectively included 50 patients (male : female = 33 : 17) who visited the emergency department with symptoms of AIS from September 2017 to September 2020. The cerebral infarct volume measured by SVD and the Bayesian algorithm was analyzed using the Wilcoxon signed rank test and expressed as a median value and an interquartile range of 25 - 75 %. The core volume measured by SVD and the Bayesian algorithm using was CTP imaging was 18.07 (7.76 - 33.98) cc and 47.3 (23.76 - 79.11) cc, respectively, while the penumbra volume was 140.24 (117.8 - 176.89) cc and 105.05 (72.52 - 141.98) cc, respectively. The mismatch ratio was 7.56 % (4.36 - 15.26 %) and 2.08 % (1.68 - 2.77 %) for SVD and the Bayesian algorithm, respectively, and all the measured values had statistically significant differences (p < 0.05). Spearman's correlation analysis showed that the correlation coefficient of the cerebral infarct volume measured by the Bayesian algorithm using CTP imaging and MR DWI was higher than that of the cerebral infarct volume measured by SVD using CTP imaging and MR DWI (r = 0.915 vs. r = 0.763 ; p < 0.01). Furthermore, the results of the Bland Altman plot analysis demonstrated that the slope of the scatter plot of the cerebral infarct volume measured by the Bayesian algorithm using CTP imaging and MR DWI was more steady than that of the cerebral infarct volume measured by SVD using CTP imaging and MR DWI (y = -0.065 vs. y = -0.749), indicating that the Bayesian algorithm was more reliable than SVD. In conclusion, the Bayesian algorithm is more accurate than SVD in measuring cerebral infarct volume. Therefore, it can be useful in clinical utility.
This study questionnaires 166 inpatients and outpatients with stroke in 8 hospitals, including Wonkwang University Gwangju Korean Hospital from July 2 to 31, 2001 in order to find out the influence of general nature, smoking, drinking, obesity, and perception of saltness of patients with stork on the outbreak of stroke and to examine important factors by dividing into hemorrhagic and ischemic stroke. Finally, collected data is analyzed statistically, using SPSS 7.5 statistics package. This study reaches a conclusion as follows. 1. For general nature, 86(51.8%) patients have hemorrhagic stroke and 80(48.2%), ischemic stroke in the rate of 1.59:1(male:female), suggesting that male's outbreak is more than female's. Outbreak age is ranged from 20 years to 90 years in order of 60's, 50's, and 40's. 50's-60's accounts for more than half percentage. 2. For smoking, 73(71.6%) of male patients has smoking experience and their 562% has ischemic stroke. Their cross-analysis for hemorrhagic and ischemic stroke shows significant difference with $x^2=3.90$(p<0.05). 48.6% of patients with smoking experience is ranged from 1 to 10 a day in smoking quantity. 3. For drinking, 90(88.2%) of male patients has drinking experience and their 53.3% has hemorrhagicstroke. Their cross-analysis for hemorrhagic and ischemic stroke shows no significant difference with x2=3.40(p<0.1). 59.3% of patients with drinking experience is classified as a overdrinking group. 4. For obesity, low weight is 8(4.8%): normal, 111(66.9%): excessive, 40(24.1%), and obesity, 7(4.2%). In patients with hemorrhagic stroke, excessive weight and obesity are somewhat high(33.7%). The cross-analysis for male's hemorrhagic and ischemic stork by dividing BMI into more and less than 25 shows no significant difference with x=3.52(p<0.1). 5. For perception of saltness, 21(12.7%) patients eat flat: 76(45.8%) normally, and 69(41.5%), saltily. Many patients with ischemic stroke are classified as a group who eat saltily. The cross-analysis for male's hemorrhagic and ischemic stroke shows signifiant difference with x2=10.99(p<0.05). As this study has small sample and selects inpatient and outpatient in certain local hospital, it is difficult to generalize. But the cross-analysis of male's hemorrhagic and ischemic stroke shows signifiant difference in smoking and perception of saltness. Drinking and obesity are more important factors in hemorrhagic stroke and smoking and perception of saltness in ischemic stroke.
Clinical Observation was made on 37 cases of Endotracheal intubation patients in the ICU of Oriental Medical Hosptal of Tae- Jon University from January in 1992 to June in 1995. 1. There were many cases of Endotracheal intubation in ischemic attack hemorragic in order. 2. Cerebral embolism mostly occured in the MCA territory and cerebral thrombosis, ICH, in the pons, generally. 3. On admission the consciousness of the most patients was 3 to 7 point by GCS. 4. The ordinary preceeding disease was hypertension. 5. Most patients were discharged from ICU after 2 days. 5. Most patients were discharged from ICU after 2 days. 6. Endotracheal intubation was done most frequently from 1 p.m. to 3 p.m. and intubated time was less than 2 hours. 7. Endotracheal intubation was done in case of heart arrest than dyspnea cases. 8. The main complication of patients of C.V.A. in ICU were urinary tract infection, pneumonia in order. 9. There were no side effects after and by Endotracheal intubation.
This study examined whether the difference in the middle cerebral artery (MCA) velocities can predict the prognosis of stroke and whether the prognostic impact differs among stroke subtypes. Transient ischemic attack (TIA) or acute ischemic stroke patients, who underwent a routine evaluation and transcranial Doppler (TCD), were included in this study. The MCA asymmetry index was calculated using the relative percentage difference in the mean flow velocity (MFV) between the left and right MCA: (|RMCA MFV-LMCA MFV|/mean MCA MFV)${\times}100$. The stroke subtypes were determined using the TOAST classification. Poor functional outcomes were defined as a mRS score ${\geq}3$ at 3 months after the onset of stroke. A total of 988 patients were included, of whom 157 (15.9%) had a poor functional outcome. Multivariable analysis showed that only the MCA asymmetry index was independently associated with a poor functional outcome. ROC curve analysis showed that adding the MCA asymmetry index to the prediction model improved the discrimination of a poor functional outcome from acute ischemic stroke (from 88.6% [95% CI, 85.2~91.9] to 89.2% [95% CI, 85.9~92.5]). The MCA asymmetry index has an independent prognostic value for predicting a poor short-term functional outcome after an acute cerebral infarction. Therefore, TCD may be useful for predicting a poor functional outcome in patients with acute ischemic stroke.
Objectives : We compared with the effects of different parts (root head, root body and hairy root) of Angelica gigas Nakai (Angelicae Gigantis Radix, AG) with on middle cerebral artery occlusion(MCAO)-induced ischemic rats, and on LPS-induced inflammatory response in BV2 microglia. Methods : The 30% ethanol and water extracts of different parts of AG were prepared. Each extract (50 and 100 mg/kg) was administrated intraperitoneally once in MCAO-induced ischemic rats. We measured infarction volumes by TTC staining, and investigated the expression of iNOS, Bax, Bcl-2 and caspase-3 by Western blot. BV2 cells were treated with each extract for 30 min, and then stimulated with LPS. The levels of NO was measured by Griess assay. The expression of iNOS, Cox-2 and proinflammatory cytokines ($TNF-{\alpha}$, $IL-1{\beta}$, and IL-6) were determined RT-PCR and Western blot. The phosphorylation of ERK1/2 and JNK MAPK was determined by Western blot. Results : Among different parts of AG, the 30% ethanol and water extracts of hairy root significantly decreased infarction volume in ischemic brains and inhibited the expression of iNOS, bax and caspase-3. The extracts of hairy root significantly inhibited LPS-induced production of NO, $TNF-{\alpha}$ and IL-6 in BV2 cells, and suppressed the expression of iNOS and COX-2. The hairy root extracts attenuated LPS-induced phosphorylation of ERK1/2 and JNK MAPK in BV2 cells. Conclusions : Our results indicate that the root hairy of AG has a good neuroprotective and anti-inflammatory effects in ischemic stroke compared to other parts.
Journal of the Korean Society of Physical Medicine
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v.5
no.4
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pp.559-567
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2010
Purpose : The purpose of this study is to investigate the effects of motor function recovery and change of the heart function factors(ECG & Troponin I) with ischemic stroke patients by different amounts(times) exercise. Methods : Forty-six consecutive chronic hemiparetic patients with cerebral infarct were randomly assigned to two groups: Group 1 (exercise time 60 minutes/day) and Group 2 (exercise time 120 minutes/day). Types of exercise included static bicycle, isokinetic exercise, and standing or gait exercise on a treadmill. Outcome measures included the level of motor recovery (Fugl-Meyer Scale, FMS) and heart function (ECG and Troponin I), and measurements were performed three times: pre-test, 8 weeks and 12 weeks. Results : There was a significantly different change of motor function recovery and ECG between two groups during treatment period. Especially there were significantly change period of pre-test to 8 weeks on ECG and pre-test to 12 weeks on motor function recovery. But Troponin I has no significantly different change between two groups during treatment period. Also there was no significantly different change of motor function recovery and ECG and Troponin I with between two groups during treatment period. Conclusion : The exercise program improved motor function and change ECG without Troponin I in two groups. The result of this study shows that no matter how different amounts of exercise to effect of motor function recovery and heart function test in chronic patients with cerebral infarct.
Kim, Gi-Do;Kim, Eun-Jung;Choi, Ki-Bok;Yoo, Young-Dae;Kim, Gye-Yeop
The Journal of Korean Physical Therapy
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v.18
no.3
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pp.59-70
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2006
Purpose: This study is intended to examine the aquatic exercise on the improvement of muscle atrophy and motor function in an ischemic stroke model induced by middle cerebral artery occlusion. Methods: We used 60 Sprague-Dawely rats which were divided into 4 groups; the subjects were divided into group of 5 rats. Group I was a group of high dose aquatic exercise after inducing ischemic stroke; Group II was a group of low dose aquatic exercise after inducing ischemic stroke; Group III was a control group, Group IV was a sham group without ischemic stroke. Results: Muscle weight of gastrocnemius muscle was significantly difference in Group II compared to Group III on 8 weeks(p<0.05). For the changes in relative muscle weight of gastrocnemius muscle, there was significant increase in Group II compared to Group III on 8 weeks(p<0.05). For neurologic exercise behavior test, Group II generally had the highest score, compared to other groups. The results of behavior test that Group II improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group III. Conclusion: Based on these results, aquatic exercise may improve muscle atrophy and contribute to the improvement of motor function.
Purpose: This study was intended to examine the effects of electroacupuncture and therapeutic exercise on muscle atrophy and exercise function in an ischemic stroke model induced by middle cerebral artery occlusion. Methods: This study selected 120 Sprangue-Dawley rats, 8-week of age, divided them into six groups, and assigned 5 rats to each group. Experiments were conducted for 1, 3 days, 1, and 8 weeks, respectively. Group I was a group of electroacupuncture and therapeutic exercise after inducing ischemic stroke; Group II was a group of therapeutic exercise after inducing ischemic stroke; Group III was a group of electroacupuncture after inducing ischemic stroke; Group IV was a sham group of electroacupuncture after inducing ischemic stroke; Group V was a control group and Group VI was a sham group without ischemic stroke. In each group, changes in weight of muscle and relative muscle of TA muscle, neurologic motor behavior test, histologic observations were observed and analyzed. Results: For the changes in muscle weight of unaffected and affected sides of TA muscle, muscle atrophy was seen in an affected side 3 days after ischemic stroke was induced. There was statistically significant difference in Group I 1 week and 8 weeks after ischemic stroke was induced, compared to Group V (p<0.05). For the changes in relative muscle weight of unaffected and affected sides of tibial anterior muscle, there was significant decrease in each group 3 days after ischemic stroke was induced, compared to Group IV, while there was statistically significant increase in Group I 1 week after ischemic stroke was induced, compared to Group V (p<0.05). For neuologic exercise behavior test, Group I generally had the highest score, compared to other groups. Conclusion: electroacupuncture and therapeutic exercise may improve muscle atrophy and change in histologic observations expression of ischemic stroke rats and contribute to the improvement of exercise function.
Journal of the Korean Society of Physical Medicine
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v.7
no.1
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pp.11-20
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2012
Purpose : This study is intended to examine the repetitive transcranial magnetic stimulation on cognitive function in the focal ischemic stroke rat model. Methods : This study selected 30 Sprague-Dawley rats of 8 weeks. The groups were divided into two groups and assigned 15 rats to each group. Control group: Non-treatment after injured by focal ischemic stroke; Experimental group: application of repetitive transcranial magnetic stimulation(0.1 Tesla, 25 Hz, 20 min/time, 2 times/day, 5 days/2 week) after injured by focal ischemic stroke. To assess the effect of rTMS, the passive avoidance test, spatial learning and memory ability test were analyzed at the pre, 1 day, $7^{th}$ day, $14^{th}$ day and immunohistochemistric response of BDNF were analyzed in the hippocampal dentate gyrus at $7^{th}$ day, $14^{th}$ day. Results : In passive avoidance test, the outcome of experimental group was different significantly than the control group at the $7^{th}$ day, $14^{th}$ day. In spatial learning and memory ability test, the outcome of experimental group was different significantly than the control group at the $7^{th}$ day, $14^{th}$ day. In immunohistochemistric response of BDNF in the hippocampal dentate gyrus, experimental groups was more increased than control group. Conclusion : These result suggest that improved cognitive function by repetitive transcranial magnetic stimulation after focal ischemic stroke is associated with dynamically altered expression of BDNF in hippocampal dentate gyrus and that is related with synaptic plasticity.
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