• The Journal of Korean Medicine
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• v.27 no.3 s.67
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• pp.187-200
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• 2006

Objectives: Acupuncture has been applied in Asia for thousands of years, especially to rehabilitation after stroke. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells shown by using brain imaging techniques. This study was to evaluate the effect of GB 34-GB 39 electro-acupuncture (EA) on regional cerebral blood flow (rCBF) in stroke patients and normal volunteers using single photon emission computed tomography (SPECT). Methods: The study procedure was divided into two parts: patients and volunteers studies. For the patients study, ten ischemic stroke patients (3 males, 7 females, mean age $68.5{\pm}8.9$ years old) were selected. Baseline brain SPECT was done with triple head gamma camera (MultiSPECT3, Siemens, USA) after intravenous administration of 1,110 MBq of $^{99m}Tc-ECD$. Fifteen-minute EA at GB 34 and GB 39 were applied on the affected limb. The same dose of $^{99m}Tc-ECD$ was injected during the EA, and the second set of SPECT images wasobtained. Using the computer software (ICON 7.1, Siemens, USA), 3 SPECT slices (upper, middle, lower) surrounding the brain lesion were selected and each slice was divided into 10-16 brain regions. Asymmetry indexes (AI) were analyzed in each brain region. We regarded over 10% changes of AI between before and after EA as significance. For the volunteers study, 10 healthy human volunteers (5 males, 5 females, mean age $28.1{\pm}6$ years old) were selected. In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed. On the 7th day after the resting examination, 15 minute EA was applied at GB 34 and GB 39 on the right side of the subjects. Immediately after EA, the second SPECT images were obtained inthe same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: In stroke patients, six of the eight (75%) had significantly increased perfusion in post-acupuncture scans compared to their baseline state. In normal volunteers, GB 34-GB GB EA increased rCBF in both hemispheres including right ventral posterior cingulate (Brodmann area (BA) 23), left superior temporal, anterior transverse temporal (BA 22, 41), left parastriate, peristriate (BA 18, 19), right occipitotemporal, angular (BA 37, 39), left rostral postcentral, caudal postcentral and preparietal (BA 2, 3, 5). However GB 34-GB 39 EA decreased rCBF in the right hemisphere including triangular and middle frontal lobes. Conclusions: The results demonstrated that OB 34-GB 39 EA increased cerebral perfusion in ischemic stroke patients and increased rCBF grossly in temporal lobes of normal volunteers. It is also suggested that there may be a correlation between the GB meridian and the territory of the middle cerebral artery.

• Neonatal Medicine
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• v.16 no.2
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• pp.221-233
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• 2009

Purpose: Erythropoietin (EPO) has neuroprotective effects in many animal models of brain injury, including hypoxic-ischemic (HI) encephalopathy, trauma, and excitotoxicity. Current studies have demonstrated the neuroprotective effects of EPO, but limited data are available for the neonatal periods. Here in we investigated whether recombinant human EPO (rHuEPO) can protect the developing rat brain from HI injury via modulation of NMDA receptors. Methods: In an in vitro model, embryonic cortical neuronal cell cultures from Sprague-Dawley (SD) rats at 19-days gestation were established. The cultured cells were divided into five groups: normoxia (N), hypoxia (H), and 1, 10, and 100 IU/mL rHuEPO-treated (H+E1, H+ E10, and H+E100) groups. To estimate cell viability and growth, a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay was done. In an in vivo model, left carotid artery ligation was performed on 7-day-old SD rat pups. The animals were divided into six groups; normoxia control (NC), normoxia Sham-operated (NS), hypoxia-ischemia only (H), hypoxia-ischemia+vehicle (HV), hypoxia-ischemia+rHuEPO before a HI injury (HE-B), and hypoxia-ischemia+rHuEPO after a HI injury (HE-A). The morphologic changes following brain injuries were noted using hematoxylin and eosin (H/E) staining. Real-time PCR using primers of subunits of NMDA receptors (NR1, NR2A, NR2B, NR2C and NR2D) mRNA were performed. Results: Cell viability in the H group was decreased to less than 60% of that in the N group. In the H+E1 and H+E10 groups, cell viability was increased to >80% of the N group, but cell viability in the H+E100 group did not recover. The percentage of the left hemisphere area compared the to the right hemisphere area were 98.9% in the NC group, 99.1% in the NS group, 57.1% in the H group, 57.0% in the HV group, 87.6% in the HE-B group, and 91.6% in the HE-A group. Real-time PCR analysis of the expressions of subunits of NMDA receptors mRNAs in the in vitro and in vivo neonatal HI brain injuries generally revealed that the expression in the H group was decreased compared to the N group and the expressions in the rHuEPO-treated groups was increased compared to the H group. Conclusion: rHuEPO has neuroprotective property in perinatal HI brain injury via modulation of N-methyl-D-aspartate receptors.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.337-342
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• 2013

PURPOSE: The Unilateral neglect is characterized by difficulty shifting attention to the side of space opposite the brain lesion and frequently reducing use of contralesional extremities. This study was to identify whether the visual deprivation was responsible for head position on unilateral neglect patient after stroke. METHODS: A patient with left middle cerebral artery infarction participated in the study. We assessed neglect using line bisection and star cancellation test. Patient was instructed to maintain correct alignment of trunk and head in a sit position. We evaluated degree of head lateral tilting and rotation. Then, patient was blocked visual input. Also, we evaluated head position in the same way. RESULTS: He scored 3 points in the line bisection test and 9 points star cancellation test. In postural evaluation, he had deviated posture such as lateral head tilting and rotation. After visual cue deprivation, patient showed different head position which was decreased degree of head tilting and rotation. CONCLUSION: For vertical body orientation, it was used multiple sensory references including the vestibular, somatosensory, and visual system. This finding suggested that abnormal posture of neglect patient could be related to the visual input. It has important clinical implications in terms of understanding the neglect.

• Parasites, Hosts and Diseases
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• v.55 no.4
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• pp.429-431
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• 2017

Hydatid cyst is usually located in the liver and lungs, rare cases showing localization in other organs or tissues. In the unusual location, echinococcosis is an excluding diagnosis that is established only after microscopic evaluation. Our first case occurred in a 67-year-old female previously diagnosed with pulmonary tuberculosis and hospitalized with persistent pain in the hip joint. The clinical diagnosis was tuberculosis of the joint, but the presence of the specific acellular membrane indicated a hydatid cyst of the synovial membrane, without bone involvement. Fewer than 25 cases of joint hydatidosis have been reported in literature to date. In the second case, the intramural hydatid cyst was incidentally discovered at autopsy, in the left heart ventricle of a 52-year-old male hospitalized for a fatal brain hemorrhage, as a result of rupture of an anterior communicating artery aneurysm. The conclusion of our paper is that echinococcosis should be taken into account for the differential diagnosis of cystic lesions, independently from their location.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.423-425
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• 1996

Tic convulsif is a syndrome restricted to paroxysmal dysfunction of the fifth and seventh cranial nerves. It occurs predominantly in women over the age of 50 years and is usually associated with an ectatic vertebrobasilar artery - less frequently an arteriovenous malformation or cholesteatoma - which compresses the trigeminal and facial nerve roots in the postetior fossa. In rare instances this syndrome may be caused by brain tumor. Because of the high incidence of posterior fossa lesions in painful tic convulsif, a complete neurological evaluation including computerised transaxial tomography should be performed in every case. We experienced a case of trigeminal neuralgia(mandibular division)and contralateral hemifacial spasm.

• Journal of Pharmaceutical Investigation
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• v.29 no.1
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• pp.47-53
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• 1999

Gastrodia elata (GE) is an oriental medicinal herb which has been used traditionally for the treatment of various brain diseases including convulsion and epilepsy. The purpose of this study was to determine pharmacokinetic parameters of 4-hydroxy-3-methoxybenzaldehyde (HMBA) and p-hydroxybenzaldehyde (PHBA), constituents of GE, in rats. Male rats were cannulated in the femoral vein, femoral artery, bile duct and ureter. They received a single i.v. bolus dose of either HMBA or PHBA through the femoral vein. The concentration of HMBA or PHBA in plasma, bile and urine samples were analyzed by reversed-phase HPLC. HMBA and PHBA have very short half-lives, i.e. 4.03 and 2.26 minutes respectively. Most of HMBA and PHBA were thought to be eliminated through metabolism as the metabolized fraction approaches unity. Derivatives of HMBA or PHBA with longer biological half-lives should be designed to develop better anticonvulsants and more complete qualitative and quantitative understanding of the overall pharmacokinetic fate of these compounds awaits further investigation.

• Herbal Formula Science
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• v.15 no.2
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• pp.89-98
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• 2007

Kyungisan (KGS) has been used in oriental medicine for many centuries as a therapeutic agent for treatment of stroke caused by deficiency of qi(氣虛). This study was performed to evaluate effects of KGS extract on the regional cerebral blood flow(rCBF) and mean arterial blood pressure(MABP) in rats. The result of this study were as follow ; 1. KGS significantly increased rCBF irrelevant to MABP in normal rats, 2. To prescribe KGS after pretreatment with indomethacin(IDN) decreased rCBF as compared with control group to administered only KGS in normal rats. But the change of MABP is not significantly as compared with control group. 3. To prescribe KGS after pretreatment with methylen blue( MTB) decreased MABP and rCBF as compared with control group to administered only KGS in normal rats. Especially, it significantly decreased rCBF. These results suggest that KGS increase rCBF by enlargement diameter of pial artery in brain. The active mechanism of KGS is related with prostaglandin activated by cyclooxygenase. So, I suggest that KGS has an anti-ischemic effect through the improvement of cerebral blood flow and can be used for stroke.

• Journal of Korean Neurosurgical Society
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• v.41 no.1
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• pp.30-38
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• 2007

Objective : To elucidate the role of aquaporin-4[AQP4] in cerebral edema formation, we studied the expression and subcellular localization of AQP4 in astrocytes after focal cerebral ischemia. Methods : Cerebral ischemia were induced by permanent middle cerebral artery[MCA] occlusion in rats and estimated by the discoloration after triphenyltetrazolium chloride[TTC] immersion. Change of AQP4 expression were evaluated using western blot. Localization of AQP4 was assessed by confocal microscopy and its interaction with ${\alpha}-syntrophin$ was analyzed by immunoprecipitation. Results : After right MCA occlusion, the size of infarct and number of apoptotic cells increased with time. The ratio of GluR1/GluR2 expression also increased during ischemia. The polarized localization of AQP4 in the endfeet of astrocytes contacting with ventricles, vessels and pia mater was changed into the diffuse distribution in cytoplasm. The interactions of AQP4 and Kir with ${\alpha}-syntrophin$, an adaptor of dystrophin complex, were disrupted by cerebral ischemia. Conclusion : The deranged spatial buffering function of astrocytes due to mislocalized AQP4/Kir4.1 channel as well as increased assembly of $Ca^{2+}$ permeable AMPA receptors might contribute to the development of edema formation and the excitotoxic neuronal cell death during ischemia.

• The Korean Journal of Physiology and Pharmacology
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• v.8 no.4
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• pp.187-194
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• 2004

Middle cerebral artery occlusion (MCAO) results in cell death by activation of complex signal pathways for cell death and survival. Hypothermia is a robust neuroprotectant, and its effect has often been attributed to various mechanisms, but it is not yet clear. Upstream from the cell death promoters and executioners are several enzymes that may activate several transcription factors involved in cell death and survival. In this study, we immunohistochemically examined the phosphorylation of mitogen-activated protein kinase, extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK) and p38 kinase during early period of the ischemic injury, following 2 hours (h) of transient MCAO. Increased phosphorylation of ERK and p38 was observed in the vessels at 3 h, neuron-like cells at 6 and 12 h and glia-like cells at 12 h. Activation of JNK was not remarkable, and a few cells showed active JNK following ischemia. Phosphorylation of Elk-1, a transcription factor, was reduced by ischemic insult. Hypothermia attenuated the activation of ERK, p38 and JNK, and inhibited reduction of Elk-1. These data suggest that signals via different MAPK family members converge on the cell damage process and hypothermia protects the brain by interfering with these pathways.