• Title/Summary/Keyword: Brain Stroke

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Change of Dialect after Stroke (뇌졸중 후에 나타난 방언의 변화)

  • Kwon, Mi-Seon;Kim, Jong-S
    • Proceedings of the KSPS conference
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    • 2005.11a
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    • pp.127-130
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    • 2005
  • Foreign Accent syndrome refers to segmental and suprasegmental changes of speech characteristics following brain lesion which is perceived by listeners as a foreign accent. Change in dialect after a stroke, however, have rarely been reported. We describe a patient who showed prominent change of accent from one to another Korean dialect and discuss about the alteration of prosodic patterns and the changes in segmental level of speech.

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Importance of CADASIL research in Jeju: a review and update on epidemiology, diagnosis, and clinical spectrum (제주도에서 CADASIL 연구의 중요성: 역학, 진단 및 임상양상에 대한 고찰)

  • Choi, Jay Chol;Lee, Jung Seok;Kim, Kitae
    • Journal of Medicine and Life Science
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    • v.17 no.3
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    • pp.65-73
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    • 2020
  • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a single-gene disease of the cerebral small blood vessels caused by mutations in the NOTCH3 gene on chromosome 19. Although CADASIL was known as a rare disease, recent research has suggested that the NOTCH variants could be found frequently even in the general population. The main clinical features included recurrent stroke, migraine, psychiatric symptoms, and progressive cognitive decline. On brain magnetic resonance imaging, patients with CADASIL showed multifocal white matter hyperintensity lesions, lacunar infarcts, microbleeds, and brain atrophy. Among them, lacunar infarcts and brain atrophy are important in predicting the clinical outcomes of patients with CADASIL. In the Jeju National University Hospital, we have diagnosed 213 CADASIL patients from 2004 to 2020. Most NOTCH3 mutations were located in exon 11 (94.4%), and p.Arg544Cys was the most common mutation. The mean age at diagnosis was 61.0±12.8 years. The most common presenting symptoms were ischemic stroke (24.4%), followed by cognitive impairment(15.0%), headache (8.9%), and dizziness(8.0%). Although the exact prevalence of CADASIL in Jeju is still unknown, the disease prevalence could be as high as 1% of the population considering the prevalence reported in Taiwan. Therefore, it is necessary to discover efficient biomarkers and genetic tests that can accurately screen and diagnose patients suspected of having CADASIL in this region. Ultimately, it is urgent to explore the exact pathogenesis of the disease to identify leading substances of treatment potential, and for this, multi-disciplinary research through active support from the Jeju provincial government as well as the national government is essential.

Translation and Content Validation of the Korean Version of the Falls Efficacy Scale for Stroke and Brain Injury Patients (뇌졸중 및 뇌손상 환자를 위한 한국판 넘어짐효능감척도(Korean Version-Falls Efficacy Scale) 번안과 내용타당도 연구)

  • Su-jin Kim;Jeong-Ah Kim;Su-jin Hwang
    • PNF and Movement
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    • v.21 no.3
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    • pp.387-401
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    • 2023
  • Purpose: The purpose of this study was to develop a Korean version of the Falls Efficacy Scale (K-FES), which is used to measure the fear of falling, that is conceptually equivalent to the original and culturally adaptable to the Korean population. Methods: A five-step translation and adaptation process was employed to create the K-FES, adhering to the established guidelines for cross-cultural rehabilitation outcome measures. The content validity was then evaluated by 22 rehabilitation professionals (15 males and 7 females) with an average clinical experience of 201 months at neurological rehabilitation centers. The content validity ratio and index were used as a basis for judgment. Results: The translation process identified inconsistencies with the terms "objects" and "telephone" in the original Falls Efficacy Scale, which were subsequently resolved in the final K-FES version. The content validity ratios for the original, second, and third versions of the K-FES ranged from -0.27-0.91, -0.27-0.91, and -0.27-0.91, respectively. Correspondingly, the content validity index values for the original, second, and third versions of the K-FES ranged from 0.77-1.00, 0.68-1.00, and 0.63-1.00, respectively. Conclusions: The K-FES was rigorously developed through translation, adaptation, and validation processes, making it a reliable tool for Korean stroke rehabilitation professionals. It is expected to be instrumental in clinical and research settings to assess postural stability and fall risk in patients with strokes and brain injuries.

Effect of Rhei Rhizoma on Brain Edema Induced by MCAO in Rats (대황(大黃)이 뇌허혈 손상에 의한 뇌부종에 미치는 영향)

  • Kang, Kyung-Hwa;Sohn, Nak-Won;Kim, Bum-Hoi
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.4
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    • pp.866-871
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    • 2009
  • Brain edema is a major importance in the pathophysiology of CNS injuries including stroke. Ischemic brain edema results from both cytotoxic edema, which is severe in astrocytes at early stage, and vasogenic edema caused by excessive blood-brain barrier (BBB) permeability. The present study was performed to determine the effect of Rhei Rhizoma on brain edema induced by middle cerebral artery occlusion (MCAO) in the rats. The neurological symptom, total infarct volume and edema index caused by MCAO were measured. The changes of Matrix Metalloproteinase-9 (MMP-9) and inducible nitric oxide synthase (iNOS) immunoreactivities were also observed. We found that Rhei Rhizoma extract improved the neurological symptom and attenuated the total infarct volume and brain edema caused by ischemic insult. Rhei Rhizoma extract also attenuated the expression of MMP-9 and iNOS. This results suggest that Rhei Rhizoma has a protective effect on the brain edema caused by ischemic insult.

Blood-Brain Barrier Interfaces and Brain Tumors

  • Lee Sae-Won;Kim Woo-Jean;Park Jeong-Ae;Choi Yoon-Kyung;Kwon Yoo-Wook;Kim Kyu-Won
    • Archives of Pharmacal Research
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    • v.29 no.4
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    • pp.265-275
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    • 2006
  • In the developing brain, capillaries are differentiated and matured into the blood-brain barrier (BBB), which is composed of cerebral endothelial cells, astrocyte end-feet, and pericytes. Since the BBB regulates the homeostasis of central nervous system (CNS), the maintenance of the BBB is important for CNS function. The disruption of the BBB may result in many brain disorders including brain tumors. However, the molecular mechanism of BBB formation and maintenance is poorly understood. Here, we summarize recent advances in the role of oxygen tension and growth factors on BBB development and maintenance, and in BBB dysfunction related with brain tumors.

Methanol Extract of Cassia mimosoides var. nomame and Its Ethyl Acetate Fraction Attenuate Brain Damage by Inhibition of Apoptosis in a Rat Model of Ischemia-Reperfusion

  • Kim, Ki-Hong;Lee, Jong-Won
    • Preventive Nutrition and Food Science
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    • v.15 no.4
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    • pp.255-261
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    • 2010
  • Ischemic stroke, a major cause of death and disability worldwide, is caused by occlusion of cerebral arteries that, coupled with or without reperfusion, results in prolonged ischemia (hypoxia and hypoglycemia) and, ultimately, brain damage. In this study, we examined whether methanol extract of the whole plant of Cassia mimosoides var. nomame Makino that grows naturally in Korea, as well as Japan and China, and some of its fractions obtained by partitioning with organic solvents could protect human hepatocellular carcinoma cells (HepG2) under hypoxic condition by inhibiting apoptosis. We also investigated if these extracts could attenuate brain damage in a rat model of 2 hr of ischemia, generated by middle cerebral artery occlusion, and 22 hr of reperfusion. The whole extract ($100{\mu}g$/mL) maintained the cell number at more than half of that initially plated, even after 24 hr of cell culture under hypoxic condition (3% $O_2$). In the absence of the whole extract, almost all of the cells were dead by this time point. This improvement of cell viability came from a delay of apoptosis, which was confirmed by observing the timing of the formation of a DNA ladder when assessed by gel electrophoresis. Of fractions soluble in hexane, ethyl acetate (EA), butanol and water, EA extracts were selected for the animal experiments, as they improved cell viability at the lowest concentration ($10{\mu}g$/mL). The whole extract (200 mg/kg) and EA extract (10 and 20 mg/kg) significantly reduced infarct size, a measure of brain damage, by 34.7, 33.8 and 45.2.0%, respectively, when assessed by 2,3,5-triphenyl tetrazolium chloride staining. The results suggest that intake of Cassia mimosoides var. nomame Makino might be beneficial for preventing ischemic stroke through inhibition of brain cell apoptosis.

Antithrombotic Therapy for Ischemic Stroke (허혈성 뇌졸중에서의 항혈전 치료)

  • Hah, Jung-Sang;Lee, Jun
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.1-12
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    • 2003
  • Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.

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A Clinical Study on the Functional Outcome in Stroke (중풍 환자의 기능 회복에 관한 임상적 고찰)

  • Kwon, Jung-Nam;Kim, Young-Kyun;Cho, Eun-Hee
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.647-657
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    • 2001
  • In the oriental medicine field, researches have been in progress regarding oriental medical factors. I also carried out a clinical study on stroke, from which I discovered meaningful results about important factors that impact on the prognosis of stroke. We studied 132 patients after diagnosis of stroke through a Brain-CT scan and MRI sea, to the oriental internal medicine department at the Hospital affiliated to Oriental Medical College, Dongeui University. All the patients showed meaningful improvement in the examination of their symptoms after four weeks, compared with the first week. Between strokes involving meridian system and strokes involving internal organs, the symptom of paralysis caused by strokes involving meridian system, which patients were in favorable initial condition, had improved significantly and that by strokes involving internal organs had not. The group whose initial bowel movement since the stroke was delayed, whose coating on the tongue was thick or the tongue was dry, whose pulse was tachycardiac, or who had a history of hypertension or diabetics showed a significantly worse symptom after 4 weeks than that of groups in the opposite cases.

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Motor Recovery in Stroke Patients (뇌졸중의 운동신경기능 회복)

  • Jang, Sung-Ho;Kwon, Yong-Hyun
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.119-130
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    • 2005
  • Stroke is a leading cause of chronic physical disability. The recent randomized controlled trials have that motor function of chronic stroke survivors could be improved through physical or pharmacologic intervention in the stroke rehabilitation setting. In addition, several functional neuroimaging techniques have recently developed, it is available to study the functional topography of sensorimotor area of the brain. However, the mechanisms involved in motor recovery after stroke, are still poorly understood. Four motor recovery mechanisms have been suggested, such as reorganization into areas adjacent to the injured primary motor cortex (M1), unmasking of the motor pathway from the unaffected motor cortex to the affected hand, attribution of secondary motor areas, and recovery of the damaged contralateral corticospinal tract. Understanding the motor recovery mechanisms would provide neurorehabilitation specialists with more information to allow for precise prognosis and therapeutic strategies based on the scientific evidence; this may help promote recovery of motor function. This review introduces several methodologies for neuroimaging techniques and discusses theoretical issues that impact interpretation of functional imaging studies of motor recovery after stroke. Perspectives, for future research are presented.

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Effect of Combination Electroacupuncture and Tenuigenin on the Migration and Differentiation of Mesenchymal Stem Cells following Ischemic Stroke

  • Jae Ho Lee;Byung Tae Choi;Hwa Kyoung Shin
    • Journal of Pharmacopuncture
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    • v.26 no.4
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    • pp.357-365
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    • 2023
  • Objectives: Since stroke is a serious health issue, novel therapeutic strategies are required. In a mouse model of ischemic stroke, this study analyzed the potential of electroacupuncture (EA) and tenuigenin (TE) to improve the efficacy of human mesenchymal stem cell (hMSC) transplantation. Methods: Middle cerebral artery occlusion (MCAO) with reperfusion was used to generate ischemic stroke. Forty-eight male C57BL/6 mice were randomly divided into five groups: control, MCAO-operated, MCAO-EA, MCAO-TE, or MCAO + EA + TE. Subsequently, hMSCs were transplanted into the ischemic region and EA, TE, or the combination was administered. Behavior assessments and immunohistochemistry were conducted to evaluate motor and cognitive recovery and hMSCs survival, migration, and differentiation. Results: The combined treatment of EA and TE exhibited enhanced hMSCs survival, migration and differentiation into neural cell lineages while suppressing astrocyte formation. Immunohistochemistry demonstrated increased neurogenesis through hMSCs transplantation in the ischemic brain. Immediate behavioral improvements were not significantly different between groups, but there was a gradual recovery in motor and cognitive function over time. Conclusion: These findings highlight the potential of EA and TE co-treatment as a therapeutic strategy for ischemic stroke, opening avenues for further research to optimize treatment protocols and elucidate underlying mechanisms.