• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.1
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• pp.274-282
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• 2014

This study aimed to investigate the general characteristics of patients with acute cerebral infarction, the characteristics of its treatment and its correlation with stroke rating scale and to analyze the factors that affect patient's quality of life. The subject of this study was 576 patients who survived more than a year after they were diagnosed with cerebral infarction that occurred within 7 days and discharged from a study center. Their quality of life was investigated through phone interview. The average age of subjects was $65.8{\pm}12.4$ years old and male subjects took up 62% among all subjects. The mean of quality of life showed $0.77{\pm}0.29$. There was statistically significant difference in factors such as gender, age, hypertension, atrial fibrillation, stroke history and smoking. The result of multiple regression analysis showed the quality of life was lower in females than in males and it was significantly low in older subjects or those with stroke history. Also high stroke scale was related to significantly low quality of life. As such, hospitalized patients due to stroke should receive appropriate intervention during the hospitalization and after their discharge and the development of program is required to prevent relapse.

• Journal of Life Science
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• v.29 no.11
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• pp.1258-1266
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• 2019

Yangkyuksanhwa-Tang (YKSH), consisting of nine different herbs, is commonly used in Soyangin-type individuals with stroke, based on the Sasang Constitution Theory in Korea. However, no evidence has yet confirmed a beneficial effect of YKSH in ischemic stroke treatment. In this study, we investigated the effects of YKSH on ischemic brain injury in a mouse model of cerebral ischemia. Focal cerebral ischemia in mice was induced by photothrombosis, and behavioral recovery was evaluated. Infarct volume, inflammation, and newly generated cells were evaluated by histology and immunochemistry. YKSH treatment resulted in a significant recovery from the motor impairments induced by focal cerebral ischemia, as determined with wire grip and rotarod tests. YKSH treatment also decreased the infarct volume and the number of cells positive for tumor necrosis factor-${\alpha}$ and myeloperoxidase when compared with a vehicle-treated control group. By contrast, YKSH treatment considerably increased the number of cells positive for glial fibrillary acidic protein and ionized calcium-binding adapter molecule 1, as well as the number of cells doubly positive for Ki67/doublecortin when compared with the vehicle-treated group. These results suggest that YKSH treatment attenuated the infarct size by anti-inflammatory action, astrocyte and microglia activation, and neuronal proliferation, thereby facilitating neurofunctional recovery from a cerebral ischemic assault. YKSH could therefore be a potential treatment for neurofunctional restoration of the injured brains of patients with stroke.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.115-117
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• 2013

Simultaneous subarachnoid hemorrhage and infarction is a quite rare presentation in a patient with a spontaneous dissecting aneurysm of the anterior cerebral artery. Identifying relevant radiographic features and serial angiographic surveillance as well as mode of clinical manifestation, either hemorrhage or infarction, could sufficiently determine appropriate treatment. Enlargement of ruptured aneurysm and progressing arterial stenosis around the aneurysm indicates impending risk of subsequent stroke. In this setting, prompt treatment with stent-assisted endovascular embolization can be a reliable alternative to direct surgery. When multiple arterial dissections are coexistent, management strategy often became complicated. However, satisfactory clinical results can be obtained by acknowledging responsible arterial site with careful radiographic inspection and antiplatelet medication.

• The Journal of Korean Medicine
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• v.21 no.3
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• pp.129-139
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• 2000

Clinical observation was made on 210 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyungwon University from January to December in 1998. Objective : To evaluate the current status of cerebrovascular disease in Korea, we performed observation on stroke patients. Methods : We performed a retrospective study on 210 cases of stroke who had been admitted to the Dept. of Internal Medicine, College of Oriental Medicine, Kyungwon University from Jan. 1, 1998 to Dec. 31, 1998. Results : The incidence was highest in the patients with the age of above fifty. The frequency of strokes was similar between male and female cases. Ischemic stroke(70.0%) was more common than hemorrhagic stroke(20.5%), with transient ischemic attacks(9.5%) occuring less frequently. Middle cerebra! arterial territory was the most commonly involved site in ischemic strokes. Among intracerebral hemorrhages, putaminal hemorrhages were found in 69.8%, and was followed by IVH(9.3%), IVH with ICH(7.0%), subcortical hemorrhages (4.7%) and pontine hemorrhages(4.7%). The most ordinary preceding disease was hypertension. The next was diabetes mellitus. Most cases were given simultaneous treatment in both western and oriental medical methods. Conclusions : Generally it is thought that CVA occurs frequently in winter. But our observations reveal no such relationship. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. I Patients whose condition of consciousness was bad at the time of admission tended to have a bad prognosis. This study suggests changing trends of stroke in Korea, and that a multicenter prospective study using stroke registry is required for confirmation.

• The Journal of Korean Physical Therapy
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• v.18 no.3
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• pp.59-70
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• 2006

Purpose: This study is intended to examine the aquatic exercise on the improvement of muscle atrophy and motor function in an ischemic stroke model induced by middle cerebral artery occlusion. Methods: We used 60 Sprague-Dawely rats which were divided into 4 groups; the subjects were divided into group of 5 rats. Group I was a group of high dose aquatic exercise after inducing ischemic stroke; Group II was a group of low dose aquatic exercise after inducing ischemic stroke; Group III was a control group, Group IV was a sham group without ischemic stroke. Results: Muscle weight of gastrocnemius muscle was significantly difference in Group II compared to Group III on 8 weeks(p<0.05). For the changes in relative muscle weight of gastrocnemius muscle, there was significant increase in Group II compared to Group III on 8 weeks(p<0.05). For neurologic exercise behavior test, Group II generally had the highest score, compared to other groups. The results of behavior test that Group II improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group III. Conclusion: Based on these results, aquatic exercise may improve muscle atrophy and contribute to the improvement of motor function.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.61-70
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• 2013

■ Objectives The goal of this pilot study is to observe the change of gait pattern in a patient after peroneal nerve electrical stimulation(PNST). ■ Methods We analyzed the gait pattern of stroke patient using treadmill gait analysis system before and after PNST for seven weeks. The PNST was carried out for 20minutes every day except Sunday. In addition, the measurement was carried out every Saturday. At the fifth week, the PNST was not carried out to confirm whether the effect of PNST was disappeared immediately when PNST was not applied. ■ Results After PNST, while heel contact time and heel max force increased and forefoot and midfoot max force decreased, the gait parameters such as cadence, velocity, swing phase, stance phase, total double support, step length, stride length, step time, stride time and forefoot contact time, were not changed. ■ Conclusion Gait of a patient with cerebral stroke was changed positively after PNST.

• The Journal of Korean Medicine
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• v.29 no.4
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• pp.205-212
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• 2008

Background and purpose: So far it was reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. A previous study demonstrated a correlation between LI4-11 electro-acupuncture (EA) and rCBF increase in frontal lobe. However, there remained a need to study further using various controls in acupuncture research. Transcutaneous electrical nerve stimulation (TENS) has been used as a non-invasive control in acupuncture study. This study was to evaluate the effect of LI4-LI11 TENS on regional cerebral blood flow (rCBF) in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (9 males, 1 female, mean age 26.6$\pm$0.5 years; age range from 26 to 27 years). On the other day, 7 days after the resting examination, 15 minute TENS were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 TENS, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 TENS 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 = 0.001, uncorrected (extent threshold: k=100 voxels). Results: TENS applied at right LI4-LI11 increased rCBF in the left somatosensory association cortex (Brodmann area 5, 7). However there was no area where LI4-11 TENS decreased rCBF. Conclusion and suggestions: These results demonstrate that right LI4-LI11 TENS increased rCBF only in corresponding somatosensory association cortex, which was different from the previous results using LI4-11 EA. It is suggested that there be a different mechanism between TENS and EA.

• Progress in Medical Physics
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• v.18 no.3
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• pp.149-160
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• 2007

Recent advent of 64-multidetctor (MD) CT enables more coverage of Z-axis in the perfusion imaging. The purpose of this study was to evaluate the clinical usefulness of perfusion CT by using 64-MD CT in detecting the lesion in patients with acute stroke. The perfusion CT was performed by using 64-MD CT in 62 consecutive patients who were initially suspected to have subacute ischemic stroke symptoms during the period of recent 9 months. These patients had subacute stroke (n=62). CT scanning was conducted with Jog Mode which provided 16 imaging slices with 5 mm of slice thickness, and 8 cm of coverage in Z-axis. Scan interval was 1 seconds for each imaging slice and total 15 scans were repeated. After CT scanning, perfusion maps (CBV, CBF, MTT and TTP) were created at Extended Brilliance Workstation. The CBV and CBF maps showed that lesions were smaller images. While on the MTT and TTP map lesions were seen to be larger fifty-one were large than they appeared on these images. Two slices of perfusion maps obtained at the level of the basal ganglia were chosen to simulate conventional older perfusion CT with 8 cm of coverage in Z-axis. TTP and MTT maps may be clinically useful for evaluation of the penumbral zone in cases of aubacute cerebral ischemic stroke. The perfusion CT is useful in the assessment of acute stroke as an initial imaging modality.

• Journal of Korean Neurosurgical Society
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• v.67 no.3
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• pp.333-344
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• 2024

Objective : Markers of neuroinflammation during ischemic stroke are well characterized, but additional markers of neural damage are lacking. The study identified associations of behavioral disorders after stroke with histologic neural damage and molecular biological change. Methods : Eight-week-old, 25 g male mice of the C57BL/6J strain were subjected to middle cerebral artery occlusion (MCAO) to induce ischemic stroke. The control group was a healthy wild type (WT), and the experimental group were designed as a low severity MCAO1 and a high severity MCAO2 based on post-stroke neurological scoring. All groups underwent behavioral tests, realtime polymerase chain reaction, triphenyltetrazolium chloride (TTC) staining and Hematoxylin and Eosin staining. One-way analysis of variance was used to analyze statistical significance between groups. Results : In TTC staining, MCAO1 showed 29.02% and MCAO2 showed 38.94% infarct volume (p<0.0001). The pro-inflammatory cytokine interleukin (IL)-1β was most highly expressed in MCAO2 (WT 0.44 vs. MCAO1 2.69 vs. MCAO2 5.02, p<0.0001). From the distance to target in the Barnes maze test, WT had a distance of 178 cm, MCAO1 had a distance of 276 cm, and MCAO2 had a distance of 1051 (p=0.0015). The latency to target was 13.3 seconds for WT, 27.9 seconds for MCAO1, and 87.9 seconds for MCAO2 (p=0.0007). Prospero homeobox 1 (Prox1) was most highly expressed in MCAO2 (p=0.0004). Doublecortin (Dcx) was most highly expressed in MCAO2 (p<0.0001). Conclusion : The study demonstrated that histological damage to neural cells and changes in brain mRNA expression were associated with behavioral impairment after ischemic stroke. Prox1 and Dcx may be biomarkers of neural damage associated with long-term cognitive decline, and increased expression at the mRNA level was consistent with neural damage and long-term cognitive dysfunction.

• Biomolecules & Therapeutics
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• v.17 no.3
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• pp.270-275
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• 2009

Polyethylene glycol-conjugated hemoglobin (PEG-Hb) has been proposed as a blood substitute for transfusion due to their plasma expansion and oxygen transport capabilities. The protective effect of PEG-Hb on cerebral hypoxic-ischemic injury was investigated in neonatal hypoxia model and adult rat focal cerebral ischemia model. As intravenously administered 30 min before the onset of hypoxia, PEG-Hb markedly protected cerebral hypoxic injury in a neonatal rat hypoxia model. A similar treatment of PEG-Hb largely reduced the ischemic injury ensuing after 2-h middle cerebral artery occlusion followed by 22-h reperfusion. Consistently, neurological disorder was significantly improved by PEG-Hb. The results indicate that the pharmacological blockade of cerebral ischemic injury by using PEG-Hb may provide a useful strategy for the treatment of cerebral stroke.