• Childhood Kidney Diseases
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• v.15 no.1
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• pp.22-28
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• 2011

Hypertension is one of the most common chronic diseases in childhood and adolescence. Untreated hypertension adversely affects many organs including heart, brain, kidney and peripheral arteries. We reviewed the complication of central nervous system caused by pediatric hypertension. Cerebral blood flows are maintained constantly in response to changes in blood pressure by cerebral autoregulation. Severe hypertension which destructs cerebral autoregulation results in acute hypertensive encephalopathy syndrome, ischemic or hemorrhagic stroke. Chronic pediatric hypertension induces learning disability and cognitive defect which are subclinical symptom prior to brain damage caused by severe hypertension. We should consider the effect of hypertension on pediatric brain because appropriate antihypertensive drugs could prevent these complications.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1063-1068
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• 2000

Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.

• The Journal of Internal Korean Medicine
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• v.31 no.2
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• pp.380-387
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• 2010

The ischemic penumbra represents part of the hypoperfused region associated with focal brain ischemia. A practical approach is to define this region as that portion of the ischemic territory that can potentially be salvaged by timely intervention. For the prevention and treatment of ischemic stroke, antithrombotic therapy is prescribed. But medication of antiplatelet agent is only validated as prevention effect. Cheonghyulgangki-tang has been used for cerebral apoplexy, hypertension, etc. In this case report, an acute ischemic stroke patient was treated with an antiplatelet agent named Plavix and Cheonghyulgangki-tang and remarkable reduction of ischemic portion in the brain CT was observed. The result of this case suggests that oriental medical therapy could be a safe and effective intervention in acute ischemic stroke.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.3
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• pp.551-557
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• 2011

The purpose of this study is to investigate the relation between brachial-ankle pulse wave velocity and the features of metabolic syndrome, and differences according to sex in patients diagnosed cerebral infarction. The study group comprised 61 patients over age 30 who were diagnosed cerebral infarction, accompanied with metabolic syndrome. The brachial-ankle pulse wave velocity, blood pressure, lipid profiles, fasting blood glucose, body mass index were measured. Also we checked past history of patients. Then we analyzed the association between brachial-ankle pulse wave velocity and the features of metabolic syndrome. Pearson correlation analysis reflected the variables affecting the brachial-ankle pulse wave velocity as follows : Age, SBP(systolic blood pressure), DBP(diastolic blood pressure), FBS(fasting blood glucose) were positively correlated. As a result of regression analysis, in patients with cerebral infarction accompanied with metabolic syndrome, the brachial-ankle pulse wave velocity is affected by age to men, SBP, FBS, DBP to women. The brachial-ankle pulse wave velocity is not affected by the components of metabolic syndrome, except blood pressure, FBS, in patients with ischemic stroke.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.718-723
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• 2008

Background: The advances in surgical techniques, anesthesia management, perfusion methodology and postoperative intensive care have markedly decreased the mortality and cardiac morbidity of patients who undergo heart surgery over the past 2 decades. Nevertheless, it is well recognized that cardiac surgery carries a substantial risk for central nervous system complications. This study was conducted to evaluate the prevalence of subclinical cerebrovascular lesions in the head and neck by performing magnetic resonance angiography (MRA), and we investigated the clinical course of patients who had abnormal lesion seen on head and neck MRA. Material and Method: The subjects were 107 patients (71 men and 36 women ranging in age from 21 to 83 years) who were scheduled for cardiac surgery under nonemergency conditions between October 2005 and June 2008. Informed consent was obtained before the MRA. The carotid arteries, intracranial arteries and brain parenchyme were examined for subclinical cerebrovascular lesions by performing MRA. We reviewed the patients' medical records and MR findings to evaluate the prevalence of neurologically high risk patients and their clinical course. Result: The overall prevalence of neurologically high risk patients was 15.7% (17 patients). Among these patients, 11 patients had ischemic heart disease and 6 patients had valvular heart disease. Only 2 patients had a history of cerebrovascular disease. The clinical courses of 14 patients (13.1%) were changed according to their MRI findings. Conclusion: The prevalence of subclinical cerebrovascular disease in patients who were scheduled for cardiac surgery was higher than was expected. MR angiography was of value to identify these patients.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.6
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• pp.293-301
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• 2006

Purpose: The aim of the study was to evaluate the hemodynamic changes after successful bypass surgery in patients with atherosclerotic stenosis in ICA using $^{99m}Tc-ECD$ SPECT. Materials and Methods: Fourteen patients (M:F=8:6, mean age; $60{\pm}9$ years) who underwent STA-MCA anastomosis for unilateral atherosclerotic cerebrovascular disease were enrolled. $^{99m}Tc-ECD$ basal/acetazolamide perfusion SPECT studies were performed before, 10 days and 6 months after bypass surgery. Perfusion reserve was defined as the % changes after acetazolamide over rest image. Regional cerebral blood flow and perfusion reserve were compared preoperative, early-postoperative and late-postoperative scans. Results: The mean resting perfusion and decrease in perfusion reserve in affected ICA territory on preoperative scan was $52.4{\pm}3.5\;and\;-7.9{\pm}4.7%$, respectively. The resting perfusion was significantly improved after surgery on early-postoperative scan (mean $53.7{\pm}2.7$) and late-postoperative scan (mean $53.3{\pm}2.5$) compared with preoperative images (p<0.05, respectively). Resting perfusion did not showed further improvement on late-postoperative scan compared with early-postoperative scan. The perfusion reserve was $-3.7{\pm}2.6%$ on early-postoperative scan, and $-1.6{\pm}2.3%$ on late-postoperative scan, which was significantly improved after surgery. Additionally, further improvement of perfusion reserved as observed on late-postoperative scan (p<0.05). While, in the unaffected ICA territory, no significant changes in the resting perfusion and perfusion reserve was observed. Conclusion: The improvement of resting perfusion and perfusion reserve in early-postoperative scan reflects the immediate restoration of the cerebral blood flow by bypass surgery. In contrasts, further improvement of perfusion reserve showing on late-postoperative scan may indicate a good collateral development after surgery, which may indicate good surgical outcome after surgery.

• Journal of Life Science
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• v.30 no.11
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• pp.939-946
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• 2020

Stroke is one of the leading causes of neurological disability worldwide and stroke patients exhibit a range of motor, cognitive, and psychiatric impairments. GPR88 is an orphan G protein-coupled receptor (GPCR) that is highly expressed in striatal medium spiny neurons; its deletion results in poor motor coordination and motor learning. There are currently no studies on the involvement of GPR88 in stroke or in post-stroke brain function recovery. In this study, we found a decrease in GPR88 protein and mRNA expression levels in an ischemic mouse model using Western blot and real-time PCR, respectively. In addition, we observed that, among the three types of cells derived from the brain (brain microvascular endothelial cells, BV2 microglial cells, and HT22 hippocampal neuronal cells), the expression of GPR88 was highest in HT22 neuronal cells, and that GPR88 expression was downregulated in HT22 cells under oxygen-glucose deprivation (OGD) conditions. Moreover, pretreatment with RTI- 13951-33 (10 mg/kg), a brain-penetrant GPR88 agonist, ameliorated brain injury following ischemia, as evidenced by improvements in infarct volume, vestibular-motor function, and neurological score. Collectively, our results suggest that GPR88 could be a potential drug target for the treatment of central nervous system (CNS) diseases, including ischemic stroke.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.5
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• pp.1167-1171
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• 2009

Ischemic stroke has been the leading cause deaths and the critical disability. In addition, the clinical problem of ischemic stroke have the poor prognosis and high mortality rate. The study aim was to identify the incidence variation of ischemic stroke by days of the week and its relationship with residences in males. We analyzed 607 males patients with ischemic stroke diagnosed by magnetic resonance image or computerized tomography. They were admitted to the oriental hospital of Kyunghee, Daejeon, Wonkwang university. We analyzed the onset of ischemic stroke using a ${\chi}2$ test. The results showed significant weekly variation of ischemic stroke onset and the differences of weekly variation according to residences. A deeper knowlegde of the underlying weekly variation could be provide more effective insights for preventive approach.

• The Korean Journal of Nuclear Medicine
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• v.33 no.3
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• pp.247-261
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• 1999

Purpose: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO, Materials and Methods: Thirty four right-handed normal volunteers (20 males, 14 females, mean age $40.3{\pm}24.9$ years, range 4 to 82 years) were underwent rost/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in (rental, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Results: Mean values of right to left ratios range from 1.004 to 1.018, rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was $29.9{\pm}12.9%$. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Conclusion: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.

• Journal of Oriental Neuropsychiatry
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• v.18 no.1
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• pp.185-196
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• 2007

Objective : This experimental Study was designed to investigate the effects of FOENICULI FRUCTUS(FF) on the change of inhibition lactate dehydrogenase(LDH) activity in neuronal cells and cytokines production in serum of cerebral ischemic rats. Method : FOENICULI FRUCTUS(FF)freeze dry powder and FF on the LDH activity in neuronal cells. Changes of FF on the physiological parameters(PaO2, PaCO2, MABP and HR) in crerbral ischemic rats. Effects of FF on the IL-1beta production, $TNF-{\alpha}$ production, $TGF-{\beta}$ production, and IL-10 in serum of cerebral ischemic rats. MCAO :. cytokines production of serum by drawing from femoral arterial blood after MCAO 1 hr. Reperfusion : cytokines production of serum by drawing from femoral arterial blood after reperfusion 1 hr. Results and Conclusion : 1. FF did not inhibit lactate dehydrogenase(LDH) activity in neuronal cells. 2. In serum by drawing from femoral arterial blood after middle cerebral arterial occlusion(MCAO) 1 hr and reperfusion 1 hr, sample group was significantly decreased $IL-l{\beta}$ production compared with control group 3. In serum by drawing from femoral arterial blood after MCAO 1 hr and reperfusion 1 hr, sample group was significantly decreased $TNF-{\alpha}$ production compared with control group. 4. In serum by drawing from femoral arterial blood after MCAO 1 hr and reperfusion 1 hr, sample group was significantly increased $TGF-{\beta}$ production compared with control group. 5. In serum by drawing from femoral arterial blood after reperfusion 1 hr, sample group was significantly increased IL-10 production compared with control group. This results were suggested that FF had inhibitive effect on the brain damage by inhibited LDH activity, $IL-l{\beta}$ and $TNF-{\alpha}$production, but accelerated $TGF-{\beta}$ production and IL-10 production.