• Investigative Magnetic Resonance Imaging
• /
• v.25 no.4
• /
• pp.323-331
• /
• 2021

Purpose: To investigate the diagnostic criteria of T1-weighted imaging (T1W) and time-of-flight (TOF) imaging for detecting intraplaque hemorrhage (IPH) of a vertebrobasilar artery (VBA) compared with simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) imaging. Materials and Methods: Eighty-seven patients with VBA atherosclerosis who underwent high resolution MR imaging for evaluation of VBA plaque were reviewed. The presence and location of VBA plaque and IPH on SNAP were determined. The signal intensity (SI) of the VBA plaque on T1W and TOF imaging was manually measured and the SI ratio against adjacent muscles was calculated. The receiver-operating characteristic (ROC) curve was used to compare the diagnostic accuracy for detecting VBA IPH. Results: Of 87 patients, 67 had IPH and 20 had no IPH on SNAP. The SI ratio between VBA IPH and temporalis muscle on T1W was significantly higher than that in the no-IPH group (235.9 ± 16.8 vs. 120.0 ± 5.1, P < 0.001). The SI ratio between IPH and temporalis muscle on TOF was also significantly higher than that in the no-IPH group (236.8 ± 13.3 vs. 112.8 ± 7.4, P < 0.001). Diagnostic efficacies of SI ratios on TOF and TIW were excellent (AUC: 0.976 on TOF and 0.964 on T1W; cutoff value: 136.7% for TOF imaging and 135.1% for T1W imaging). Conclusion: Compared with SNAP, cutoff levels of the SI ratio between VBA plaque and temporalis muscle on T1W and TOF imaging for detecting IPH were approximately 1.35 times.

• The Journal of Internal Korean Medicine
• /
• v.14 no.2
• /
• pp.50-70
• /
• 1993

Clinical observation was done on 92 cases of Occlusive CVD, Cerebral hemorrhage (Subarachnoid hemorrhage) which were confirmed by Brain CT scan and observed for over 4 weeks, among the 121 cases which were more than 65 years of age. they admitted to the Dept. of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from July 1992 to June 1993. The result were as follows; 1. In this study, Occlusive CVD was 74 cases, Cerebral hemorrhage (Subarachnoid hemorrhage was 2 cases) was 18 cases. 2. The ratio of male to female was 1.09:1. The age distribution showed the large number in the 65-69 year group(52.2%), 7th decade was 44.5% over 8th decade was 3.3% in ratio. 3. The site of Occlusive CVD was most common at MCA. the site of Cb-hemorrhage was most common at Basal ganglia. 4. The most common preceding disease was hypertension(47.8%) and the next were diabetes mellitus(14.1%), heart desease(14.1%). 5. Recurrence rate was 33.7% and 2nd attack was 20.7%, 3rd attack was 8.7%, 4th attack was 4.3% 6. Predisposing factors in Occlusive CVD were initiated usually during resting and sleeping, and that in Cb-hemorrhage were represented chiefly exercising(66.6%). 7. The smoker was 52.2%, the drinker was 32.6% in whole group. the drinker was 61.1% by the Cb-hemorrhage. 8. The ratio of the season distribution was as follow, fall 35.8%, winter 29.3%, spring 19.6%, summer 15.3%, that of the month distribution was november 15.2%. 9. Duration from on set in Occlusive CVD, 60.8% was within 5 days, that in Cb-hemorrhage, 77.8% was within 5 days. 10. Level of consciousness on attack was clear 42.2%, lethargy and mental change(dull, stupid etc.) 41.3%. The common symptoms were motor disturbance(90.2%), verbal disturbance(65.2%), headache(43.5%). 11. The physical theraphy of Occlusive CVD has been performed 75.7% in whole group and the average beginning time was 6.4 days, and that of Cb-hemorrhage has been performed 61.1% in whole group and the average beginning time was 13 days. 12. Duration of hospitalization was noted 11-20 days was 31.5%, over 21 days was 46.8%, and the average admission was 22.7 day(Occlusive CVD), 32days (Cb-hemorrhage). 13. The main complication were observed in the studies; urinary tract infection and pneumonia were noted in 6.5%, bed sore in 5.4%. 14. The ratio of systolic blood pressures in admission and discharge decreased from 58.7% to 28.3% in over 160 mmHg, that of diastolic blood pressures in admission and discharge decreased from 72.8% to 51.1% in over 90 mmHg. In 31(33.7%) of the 92 cases it showed the glucose levels of more than normal. 15. The patients have done family history of hypertension and C.V.A were 32.6% of all 16. Occlusive CVD In 83.8% and Cb-hernorrhage in 72.2% were improved 17. The herb medications were various Sunghyanggeonggisan, Sopungtang, CHunmagudeungeum were used most frequently and Gamidaebotang, Boyangwhanotang, Gagamyunjotang, Mangeumtang etc. were used as discharge.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.4
• /
• pp.328-333
• /
• 2015

Objective : The goal of this study was to assess the effect of high-dose simvastatin on cerebral vasospasm and its clinical outcome after aneurysmal subarachnoid hemorrhage (SAH) in Korean patients. Methods : This study was designed as a prospective observational cohort study. Its subjects were aneurysmal SAH patients who had undergone aneurysm clipping or coiling. They were assigned to 1 of 3 groups : the 20 mg, 40 mg, and 80 mg simvastatin groups. The primary end-point was the occurrence of symptomatic vasospasm. The clinical outcome was assessed with the modified Rankin Scale (mRS) score after 1 month and 3 months. The risk factors of the development of vasospasm were assessed by logistic regression analysis. Results : Ninety nine patients with aneurysmal SAH were treated and screened. They were sequentially assigned to the 20 mg (n=22), 40 mg (n=34), and 80 mg (n=31) simvastatin groups. Symptomatic vasospasm occurred in 36.4% of the 20 mg group, 8.8% of the 40 mg group, and 3.2% of the 80 mg group (p=0.003). The multiple logistic regression analysis showed that poor Hunt-Hess grades (OR=5.4 and 95% CI=1.09-26.62) and high-dose (80 mg) simvastatin (OR=0.09 and 95% CI=0.1-0.85) were independent factors of symptomatic vasospasm. The clinical outcomes did not show a significant difference among the three groups. Conclusion : This study demonstrated that 80 mg simvastatin treatment was effective in preventing cerebral vasospasm after aneurysmal SAH, but did not improve the clinical outcome in Korean patients.

• Journal of Life Science
• /
• v.19 no.7
• /
• pp.878-885
• /
• 2009

Serum ferritin levels are elevated in subjects with acute lung injury (ALI), and abnormalities in plasma and lung iron chemistry have also been demonstrated in ALI and acute respiratory distress syndrome (ARDS). Stress-inducible heme oxygenase-1 (HO-1), as well as ferritin, had shown anti-inflammatory actions. Biomarkers for early detection in patients who are likely to develop ARDS would give several therapeutic chances to the patients. In order to verify the predictability in severe hemorrhage-induced ALI in rats, we measured serum ferritin and HO-1 concentrations before and after hemorrhage. Severe hemorrhages significantly increased the number of leukocytes in bronchoalveolar lavage (BAL) fluid and lung tissue myeloperoxidase activity. Both serum ferritin and HO-1 levels increased following hemorrhage, but ferritin levels were elevated earlier than HO-1. In BAL cell immunohistochemical studies, ferritin and HO-1 expressions increased after hemorrhage and localized in the cytoplasm of leukocytes. These findings suggest that inflammatory leukocytes in BAL fluid can secrete ferritin and HO-1, and serum ferritin levels might be more valid factor in predicting ARDS than HO-1 levels in hemorrhage-induced ALI.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.6
• /
• pp.503-516
• /
• 2001

Background : The present study was carried out in association with neutrophilic respiratory burst in the lung in order to clarify the pathogenesis of acute respiratory distress syndrome(ARDS) following acute severe hemorrhage. Because oxidative stress has been suggested as one of the principal factors causing tissue injury, the role of free radicals from neutrophils was assessed in acute hemorrhage-induced lung injury. Method : In Sprague-Dawley rats, hemorrhagic shock was induced by withdrawing blood(20 ml/kg of B.W) for 5 min and the hypotensive state was sustained for 60 min. To determine the mechanism and role of oxidative stress associated with phospholipase A2(PLA2) by neutrophils, the level of lung leakage, pulmonary myeloperoxidase(MPO), and the pulmonary PLA2 were measured. In addition, the production of free radicals was assessed in isolated neutrophils by cytochemical electron microscopy in the lung. Results : In hypotensive shock-induced acute lung injury, the pulmonary MPO, the level of lung leakage and the production of free radicals were higher. The inhibition of PLA2 with mepacrine decreased the pulmonary MPO, level of lung leakage and the production of free radicals from neutrophils. Conclusion : A. neutrophilic respiratory burst is responsible for the oxidative stress causing acute lung injury followed by acute, severe hemorrhage. PLA2 activation is the principal cause of this oxidative stress.

• Journal of Korean Neurosurgical Society
• /
• v.49 no.5
• /
• pp.287-289
• /
• 2011

Thalamoperforating artery aneurysms are rarely reported in the literature. We report an extremely rare case of ruptured distal anterior thalamoperforating artery aneurysm which was treated by endovascular obliteration in a patient with occlusion of both the internal carotid arteries (ICAs) : A 72-year-old woman presented with severe headache and loss of consciousness. Initial level of consciousness at the time of admission was drowsy and the Glasgow Coma Scale score was 14. Brain computed tomography (CT) scan was performed which revealed intracerebral hemorrhage in right basal ganglia, subarachnoid hemorrhage, and intraventricular hemorrhage. The location of the aneurysm was identified as within the globus pallidus on CT angiogram. Conventional cerebral angiogram demonstrated occlusion of both the ICAs just distal to the fetal type of posterior communicating artery and the aneurysm was arising from right anterior thalamoperforating artery (ATPA). A microcatheter was navigated into ATPA and the ATPA proximal to aneurysm was embolized with 20% glue. Post-procedural ICA angiogram demonstrated no contrast filling of the aneurysm sac. The patient was discharged without any neurologic deficit. Endovascular treatment of ATPA aneurysm is probably a more feasible and safe treatment modality than surgical clipping because of the deep seated location of aneurysm and the possibility of brain retraction injury during surgical operation.

• Journal of Pharmacopuncture
• /
• v.16 no.2
• /
• pp.46-54
• /
• 2013

Objective: This study was undertaken to isolate a fibrin(ogen)olytic enzyme from the snake venom of Gloydius blomhoffii siniticus and to investigate the enzymatic characteristics and hemorrhagic activity of the isolated enzyme as a potential pharmacopuncture agent. Methods: The fibrinolytic enzyme was isolated by using chromatography, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and fibrin plate assay. The characteristics of the enzyme were determined by using fibrin plate assay, protein hydrolysis analysis, and hemorrhage assay. Its amino acid composition was determined. Results: The fibrin(ogen)olytic enzyme with the molecular weight of 27 kDa (FE-27kDa) isolated from G. b. siniticus venom consisted of two heterogenous disulfide bond-linked polypeptides with the molecular weights of 15 kDa and 18 kDa. When more than $20{\mu}g$ of FE-27kDa was applied on the fibrin plate, fibrinolysis zone was formed as indicating its fibrinolytic activity. The fibrinolytic activity was inhibited completely by phenylmethanesulfonylfluoride (PMSF) and ethylenediaminetetraacetic acid (EDTA) and partially by thiothreitol and cysteine. Metal ions such as $Hg^{2+}$ and $Fe^{2+}$ inhibited the fibrinolytic activity completely, but $Mn^{2+}$ did not. FE-27kDa preferentially hydrolyzed ${\alpha}$-chain of fibrinogen and slowly hydrolyzed ${\beta}$-chain, but did not hydrolyze ${\gamma}$-chain. High-molecular-weight polypeptides of gelatin were hydrolyzed partially into polypeptides with molecular weights of more than 45 kDa. A dosage of more than $10{\mu}g$ of FE-27kDa per mouse was required to induce hemorrhage beneath the skin. Conclusion: FE-27kDa was a serine proteinase consisting of two heterogeneous polypeptides, hydrolyzed fibrin, fibrinogen, and gelatin, and caused hemorrhage beneath the skin of mouse. This study suggests that the potential of FE-27kDa as pharmacopuncture agent should be limited due to low fibrinolytic activity and a possible side effect of hemorrhage.

• Journal of Sensor Science and Technology
• /
• v.26 no.3
• /
• pp.160-167
• /
• 2017

Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body composition in paretic and non-paretic regions. In this study, the body fluid alteration in the paretic and non-paretic regions of stroke patients with hemiplegia caused by cerebral hemorrhage and cerebral infarction was analyzed using bioelectrical impedance analysis (BIA). Alterations in body fluids were investigated to assess the physical status of the paretic and non-paretic regions of 20 stroke patients with hemiplegia caused by cerebral hemorrhage (7 patients) and cerebral infarction (13 patients). Extracellular water (ECW), intracellular water (ICW), ICW/ECW, total body water (TBW), ECW/TBW, and TBW/fat-free mass were utilized to evaluate the functional status of the paretic and non-paretic regions. Compared with the non-paretic region, the paretic region had high ECW and low ICW. Due to the loss of motor function and nutritional imbalance caused by the stroke, the amount of fat increased while the muscle quantity and quality significantly decreased in the paretic region. Thus, BIA can be a useful tool for quantitatively assessing paretic and non-paretic regions in stroke patients with hemiplegia.

• Journal of Acupuncture Research
• /
• v.20 no.4
• /
• pp.237-244
• /
• 2003

Objective : Hemophilia, a genetically determined disorder, is characterized by abnormality of the coagulation mechanism due to functional deficiency of a specific factor, namely VIII or IX. In this study, the effect of Dong-Si acupuncture therapy on the cerebral hemorrhage patient with hemophilia was evaluated. Methods : We treated him with acupuncture by stimulating Dong-Si acupuncture point(Yuk Wan) and assessed the effect by using manual dynamic evaluation of MRC(Medical Research Council) and Modified Barthel Index. Results : After treatment, the bleeding tendency was grossly reduced and bleeding lesion was absorbed gradually. And manual dynamic evaluation of the upper extremity increased from 4 grade to 5 grade. Conclusions : This result suggest that Dong-Si acupuncture therapy on the cerebral hemorrhage patient with hemophilia was effective. And futher studies are required to concretely prove the effectiveness of Dong-Si acupuncture therapy for treating hemorrhagic diseases.

• Korean Journal of Adult Nursing
• /
• v.20 no.4
• /
• pp.600-612
• /
• 2008

Purpose: This study was conducted to compare the recovery state of 6 month between s-ICH and s-SAH patients. The patients' recovery state was measured with 2 dimensions: functional and cognitive. Methods: Non-experimental prospective design was adopted by including 108 hemorrhagic stroke patients(s-ICH: 52 vs s-SAH: 56) admitted to Intensive Care Unit of one university hospital. Results: The study results showed that overall functional recovery state of s-SAH patients was better than that of s-ICH patients, and s-SAH patients also showed better recovery states in all of the sub-dimensions of functional recovery, such as feeding, grooming, and toileting, than those of s-ICH in 6 month. On the contrary, the study results showed that overall cognitive recovery states of 6 month between two groups were not significantly different. However, according to the results comparing the sub-dimensions of cognitive recovery, s-SAH patients' recovery states on attention, communication and memory were significantly better than those of s-ICH patients, while recovery states on problem solving, safety behavior, and social behavior between 2 groups were not significantly different. Conclusion: From the study results, it was noted that s-SAH patients showed better recovery states in cognitive dimension as well as in functional dimension compared with s-ICH patients.