• Journal of Korean Neurosurgical Society
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• v.60 no.4
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• pp.391-396
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• 2017

Objective : To investigate the neuroprotective effects of Ginkgolide B (GB) against ischemic stroke-induced injury in vivo and in vitro, and further explore the possible mechanisms concerned. Methods : Transient middle cerebral artery occlusion (tMCAO) mice and oxygen-glucose deprivation/reoxygenation (OGD/R)-treated N2a cells were used to explore the neuroprotective effects of GB. The expression of brain-derived neurotrophic factor (BDNF) was detected via Western blot and qRT-PCR. Results : GB treatment (4 mg/kg, i. p., bid) significantly reduced neurological deficits, water content, and cerebral infarct volume in tMCAO mice. GB also significantly increased Bcl-2/Bax ratio, reduced the expression of caspase-3, and protected against OGD/R-induced neuronal apoptosis. Meanwhile, GB caused the up-regulation of BDNF protein in vivo and in vitro. Conclusion : Our data suggest that GB might protect the brain against ischemic insult partly via modulating BDNF expression.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.1
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• pp.15-21
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• 2010

Previously standardization study for identifying 5 types of pattern identification of stroke patients has been performed and the Korean standard of pattern identification (II) was developed. In the present study we investigated the interactions between total indices designated by the Korean standard of pattern identification(KSPI II) and indices for PI of Cold-Heat and Deficiency-Excess. Indicators for Cold-Heat and Deficiency-Excess are isolated from 58 indices through the survey of oriental medicine doctors and their relationship with KSPI-II indices was analyzed by corresponding analysis method using data of 1581 stroke patients. Means and standard deviations indicated that 2 Cold indices, 14 Heat indices, 12 Deficiency indices, and 5 Excess indices were included for Cold-Heat and Deficiency-Excess pattern identification. The results of corresponding analysis shows the relationship of 57 indices and 4 types of pattern identification (excluding 1 index and 1 pattern among 58 indices and 5 patterns) using the cross-tabulation which was obtained from the clinical data. Most of Cold and Heat index were divided to dimension 1(inertia 51.9%) obtained from the result of corresponding analysis. Deficiency and Excess index were partially associated with dimension 2(inertia 31.7%). These data suggest that pattern identification of Cold-Heat plays an role in the standardization of pattern identification in stroke, although further studies are required by various trials such as analysis of surveys and clinical data.

• KIPS Transactions on Software and Data Engineering
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• v.5 no.2
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• pp.69-78
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• 2016

Ischemic stroke is a disease that the brain tissues cannot function by reducing blood flow due to thrombosis or embolisms. Due to the nature of the disease, it is most important to identify the status of cerebral vessel and the medical images are necessarily used for its diagnosis. Among many indicators, brain MRI is most widely utilized because experts can effectively obtain the semantic information such as cerebral anatomy aiding the diagnosis with it. However, in case of emergency diseases like ischemic stroke, even though a intelligent system is required for supporting the prompt diagnosis and treatment, the current systems have some difficulties to provide the information of medical images intuitively. In other words, as the current systems have managed the medical images based on the basic meta-data such as image name, ID and so on, they cannot consider semantic information inherent in medical images. Therefore, in this paper, to provide core information like cerebral anatomy contained in brain MRI, we suggest a template-driven medical images mapping method. The key idea of the method is defining the mapping characteristics between anatomic feature and representative images by using template images that can be representative of the whole brain MRI image set and revealing the semantic relations that only medical experts can check between images. With our method, it will be possible to manage the medical images based on semantic.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.300-302
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• 2006

"Stunning" represents prolonged contractile depression of any muscular component after alleviation of severe ischemia, as shown in reperfusion following acute myocardial ischemia or ischemic stroke. Clinically, it presents with no or delayed recovery past to thrombolytic therapy but its pathogenic mechanism is not fully uncovered yet. We describe a unique case of a 63-year-old woman, who was undertaken endovascular coiling for the aneurysms, deteriorated several hours later without known cause, and showed delayed clinical improvement over the next 3 days following thrombolysis. Immediate post-thrombolysis magnetic resonance imaging scan showed no apparent abnormality except for high signal intensity within the corresponding hemisphere. Reversible but delayed nature of " brain stunning" can be explained by these images and it seems to be caused by a certain type of reperfusion injury.

• Physical Therapy Korea
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• v.14 no.1
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• pp.1-10
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• 2007

This study was designed to examine the effects of electroacupuncture and treadmill exercise on the improvement of muscle atrophy and Brain-Derived Neurotrophic Factor (BDNF) expression in an ischemic stroke model induced by middle cerebral artery occlusion. This study selected 120 Sprangue-Dawley rats, divided them into six groups, and assigned 5 rats to each group. Experiments were conducted for 1, 3 days and 1, 8 weeks, respectively. In each group, changes in weight of muscle and relative muscle of tibialis anterior muscle, histologic observations, and BDNF expression were observed and analyzed. For the changes in muscle weight of unaffected and affected sides of tibialis anterior, muscle atrophy was expressed in an affected side 3 days after ischemic stroke was induced. There was a statistically significant difference in Group VI 1 and 8 weeks after ischemic stroke was induced, compared to Group II (p<.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 I, while there was a statistically significant increase in Group VI 1 week after ischemic stroke was induced, compared to Group II (p<.05). For neurologic exercise behavior test, Group VI generally had the highest score, compared to other groups. The results of the behavior test suggests that 8 weeks after ischemic stroke was induced, Group VI improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, thus indicating a similar state of muscle fiber and brain tissue in Group I. In immunohistochemical observations, Group 1 week showed increase in BDNF. Based on these results, electroacupuncture and treadmill exercise may improve muscle atrophy and change in BDNF expression of ischemic stroke rats and contribute to the improvement of exercise function.

• The Journal of Korea CHUNA Manual Medicine
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• v.3 no.1
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• pp.97-109
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• 2002

Objectives : Electroacupuncture(EA) has been suggested as a treatment for stroke rehabilitation. But whether, how much, by what mechanism and when it is effective has not been answered satisfactorily. Therefore it is important to critically review clinical trials and laboratory researches about EA for stroke rehabilitation. Subjectives : We researched various recent sources of EA for stroke rehabilitation such as medical journals and especially tried to review methodologically best randomized controlled trials(RCTs). Results and Conclusions : 1) EA increases brain plasticity, activity, blood flow and secretion of neuropeptides in CNS. 2) EA is significantly effective at the case that more than half of the neural motor pathway is reserved. 3) The acupoints, frequncy and intensity of EA should be determined by patient-specific symptoms of stroke. 4) More studies is needed for merdian functions for stroke rehabilitation.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.3
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• pp.117-124
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• 2013

Objectives The aims of this study was to observe the effectiveness of East-West Integrative Medicine (EWIM) by analysing between EWIM estimated group and Non-EWIM eastimated group with Brain Rehabilitation Registry. Methods We divided hospitals into two groups, one is EWIM estimated group hospital (Kyeonghee university, Wonkwang university, Dongguk university) and the other is non-EWIM estimated group (Jeonnam university, Gyeongbuk university, Catholic university). Then we analysed the effectiveness of treatments retrospectively using the database of Brain Rehabilitation Registry (http://www.kbrr.or.kr/, version 1.0). Totally 293 patients were included, EWIM estimated group was 175 and non-EWIM estimated group was 118. The main outcome measurements were National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI) and Mini Mental State Examination-Korea (MMSE-K). Results Changes of NIHSS was not significant in both total patient and patient who treated over 3 weeks. MMSE-K showed positively significant difference (p=0.044) in EWIM estimated group patients who treated over 3 weeks. In case of MBI, EWIM estimated group showed more effective result and also statistically significant in both total patients and patients who treated over 3 weeks. Conclusions We patially argued that EWIM estimated group was more effective than non-EWIM estimated group in stroke patients' functional recovery. We suggested base data of EWIM in stroke patiens through this study and this could be applied future researches of developing modified EWIM system.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.423-427
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• 2012

Purpose: The cerebellum is a region of brain structure that plays an important role in calibrating two different information of neural signal from descending motor commands and from ascending sensory inputs. Damage of the cerebellum shows a variety of classic motor symptoms such as postural and locomotor dysfunctions. Therefore, we tried to investigate motor function and skill in stroke patients with cerebellar lesions in sub-acute stage, and compare with these functions of patients with non-cerebellar lesions. Methods: Total twelve stroke patients with cerebellar lesion and 130 stroke patients with non-cerebellar lesions were retrospectively recruited in this study. For evaluation of motor strength, Motricity index (MI) for upper and lower limbs was tested. For measurement of motor skill function, the modified Brunnstrom classification (MBC), Manual function test (MFT), functional ambulatory category (FAC), and Barthel index were adopted. Results: In comparison of motor strength and motor skill function between two groups, statistical differences between the two groups were significantly observed only in upper MI and FAC. Although no significant differences were found in other variables, stroke patients with cerebellar lesion had higher scores in lower and total MI, MBC, and MFT, whereas they had lower scores in FAC and Barthel index. Conclusion: Our results showed that stroke patients with cerebellar lesion had greater impact on movement functions related to hand motor and walking ability in activities of daily life, compared with patients with non-cerebellar lesion, in spite of similar degree of motor function and skill between the two different lesioned-groups.

• Annals of Clinical Neurophysiology
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• v.16 no.2
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• pp.62-69
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• 2014

Background: Neuromodulation therapy has been used to an adjunctive treatment promoting motor recovery in stroke patients. The objective of the study was to determine the effect of repetitive transcranial magnetic stimulation (rTMS) on neurobehavioral recovery and evoked potentials in rats with middle cerebral artery occlusion. Methods: Seventy Sprague-Daley rats were induced permanent middle cerebral artery occlusion (MCAO) stroke model and successful stroke rats (n=56) assigned to the rTMS (n=28) and sham (n=28) group. The 10 Hz, high frequency rTMS gave on ipsilesional forepaw motor cortex during 2 weeks in rTMS group. The somatosensory evoked potential (SSEP) and motor evoked potential (MEP) were used to evaluate the electrophysiological changes. Behavioral function of the stroke rat was evaluated by the Rota rod and Garcia test. Results: Forty rats ($N_{rTMS}=20;\;N_{sham}=20$) completed all experimental course. The rTMS group showed better performance than sham group in Rota rod test and Garcia test at day 11 (p<0.05) but not day 18 (p>0.05). The amplitude of MEP and SSEP in rTMS group was larger than sham group at day 18 (p<0.05). Conclusions: These data confirm that the high frequency rTMS on ipsilesional cerebral motor cortex can help the early recovery of motor performance in permanent middle cerebral artery stroke model and it may simultaneously associate with changes in neurophysiological activity in brain.

• The Korea Journal of Herbology
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• v.25 no.2
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• pp.71-79
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• 2010

Objectives : In this study, the neuroprotective effects of modified Boyanghwano-Tang (mBHT) and the major medicinal plants, Astragali Radix(AR) and Salviae Miltiorrhizae Radix(SMR) were investigated in transient middle cerebral artery occlusion (tMCAO)-induced ischemic stroke of rats. Methods : mBHT(400 mg/kg) and AR(154 mg/kg) or SMR(62 mg/kg) water extract orally injected in rats after 90 min occlusion of MCA and then allow reperfusion to 24 h. Brain infarction was measured by TTC staining and the expressions of NOS isoforms and apoptotic molecules were determined in ischemic brain by Western blot. Results : The results showed that mBHT has stronger neuropreotective property through inhibitions of the PARP cleaved and caspase-3 activation in ischemic rats, and could reduced infarction volumes comparison of those of AR or SMR, respectively. While, AR extract has an angiogenic property through increasing the expressions of eNOS and VEGF, and SMR extract has a strong anti-inflammatory effects through inhibition of iNOS expression in ischemic brains. Conclusions : These results suggest that mBHT has multifactorial therapeutic advantages through anti-apoptosis, anti-inflammation and angiogenesis for ischemic stroke based on a synergistic combination of ingradients rather than monotherapy.