• Journal of Pharmacopuncture
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• v.27 no.2
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• pp.162-171
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• 2024

Objectives: Electroacupuncture (EA) has been demonstrated to aid stroke recovery. However, few investigations have focused on identifying the potent molecular targets of EA by comparing EA stimulation between naïve and disease models. Therefore, this study was undertaken to identify the potent molecular therapeutic mechanisms underlying EA stimulation in ischemic stroke through a comparison of mRNA sequencing data obtained from EA-treated naïve control and ischemic stroke mouse models. Methods: Using both naïve control and middle cerebral artery occlusion (MCAO) mouse models, EA stimulation was administered at two acupoints, Baihui (GV20) and Dazhui (GV14), at a frequency of 2 Hz. Comprehensive assessments were conducted, including behavioral evaluations, RNA sequencing to identify differentially expressed genes (DEGs), functional enrichment analysis, protein-protein interaction (PPI) network analysis, and quantitative real-time PCR. Results: EA stimulation ameliorated the ischemic insult-induced motor dysfunction in mice with ischemic stroke. Comparative analysis between control vs. MCAO, control vs. control + EA, and MCAO vs. MCAO + EA revealed 4,407, 101, and 82 DEGs, respectively. Of these, 30, 7, and 1 were common across the respective groups. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses revealed upregulated DEGs associated with the regulation of inflammatory immune response in the MCAO vs. MCAO + EA comparison. Conversely, downregulated DEGs in the control vs. control + EA comparison were linked to neuronal development. PPI analysis revealed major clustering related to the regulation of cytokines, such as Cxcl9, Pcp2, Ccl11, and Cxcl13, in the common DEGs of MCAO vs. MCAO + EA, with Esp8l1 identified as the only common downregulated DEG in both EA-treated naïve and ischemic models. Conclusion: These findings underscore the diverse potent mechanisms of EA stimulation between naïve and ischemic stroke mice, albeit with few overlaps. However, the potent mechanisms underlying EA treatment in ischemic stroke models were associated with the regulation of inflammatory processes involving cytokines.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.3
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• pp.260-266
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• 2023

Objective: Microvascular anastomosis, particularly side-to-side (STS) bypass, is a complex surgical procedure. While several suture techniques exist, none of them is superior to the others. We assessed the association between various STS bypass techniques and vessel twisting using chicken wing training models. Methods: Three suture techniques were compared over an anterior wall suture procedure. The unidirectional continuous suture (UCS) group used a downward "right-to-left" continuous suture. The reverse continuous suture (RCS) group used a downward "left-to-right" continuous suture. The interrupted suture (IS) group used the standard interrupted suture. The number of samples in each of the three groups was 30 (n=90). We compared the incidence of vessel twisting and rotation angles across groups. Results: Vessel twisting occurred in 96.7%, 56.7%, and 0% of the cases in the UCS, IS, and RCS groups, respectively. The incidence of vessel twisting differed significantly in all 3 groups (p<0.001), with an apparent trend (p=0.002). The mean rotation angles were 201°±90.6°, 102°±107.6°, and 0° in the UCS, IS, and RCS groups, respectively, which were significantly different (p<0.001). On excluding cases without twisting, the rotation angles of twisted vessels in the UCS and IS groups were 207.9°±83.7° and 180°±77.9°, respectively, which yielded a significant difference between these groups (p<0.001). Conclusions: We found that the incidence and trend of vessel twisting differed significantly across suture techniques. The RCS technique may aid in preventing vessel twisting in the STS bypass procedure.

• Journal of Life Science
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• v.19 no.11
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• pp.1658-1665
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• 2009

This study was carried out on thirty men to define the association of inflammatory markers with physiological factors on one-time aerobic exercise (for 15 min. Post-exercise interleukin-6 (IL-6), mean corpuscular hemoglobin concentration (MCHC), heart rate (HR), systolic blood pressure (SBP), and pulsatility and resistance index of middle cerebral artery (PI and RI, respectively) levels were elevated compared to those measured pre-exercise. Total leukocyte and platelet counts, high-sensitivity C-reactive protein (hs-CRP), free radical (FR), and low density lipoprotein cholesterol (LDL) levels tended to decrease after exercise. Pre-exercise IL-6 levels were positively correlated with pre-exercise SBP levels, while post-exercise IL-6 level was positively correlated with post-exercise PI and RI levels. Post-exercise, hs-CRP levels were negatively related to SBP and HR. Pre-exercise, FR levels were positively associated to SBP, DBP, and HR. Post-exercise FR levels were negatively related to the post-exercise blood flow velocity in middle cerebral artery. Pre-exercise erythrocyte indices (RBC, MCV, MCH, and MCHC levels) were in inverse proportion to pre-exercise IL-6 levels. Post-exercise FR levels were inversely related to post-exercise total leukocyte, lymphocyte, monocyte, and MCH levels. Pre-exercise $Mg^{++}$ levels were in inverse proportion to pre-exercise IL-6, hs-CRP, or FR levels. These findings suggest that one-time aerobic exercise offers a significant relationship between inflammatory markers and some biochemical markers or electrolytes. Further studies need to be carried out for investigation of differences between genders or age groups following one-time or regular aerobic exercise.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.705-710
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• 2001

Objective : Postoperative seizure is a well documented complication of aneurysm surgery. The purpose of the present study was to analyze risk factors for postoperative seizure. Methods : Between January 1990 and December 1996, we performed craniotomy for ruptured cerebral aneurysms in 321 patients. Among them 206 patients who could be followed up for more than 1 year(range, 1 to 4.6 years) were enrolled to present study. All patients were treated with anticonvulsants for 3 to 18 months postoperatively. We analyze the incidence of postoperative seizure in different sex and age groups, and risk factors associated with postoperative seizures following aneurysm rupture. For statistical processing chi-square test and Fisher's exact test were used. Results : In the follow-up period of 1 to 4.6 years(mean, 1.8 years) postoperative seizure appeared in 18 out of 206 patients(8.7%). Mean latency between the operation and the first seizure was 6 months(range, 3 weeks to 18 months). The age of the patients has significant influence on the risk of seizure, it occurred more often in younger patients(p =0.0014). Aneurysm location in the MCA was associated with a significantly a higher risk of seizure(p = 0.042). Eight patients(19%) out of 42 patients who suffered delayed ischemic neurologic deficit(DID) developed seizure. Delayed ischemic neurologic deficit was associated with significantly a higher risk of seizure(p =0.019). Infarct and hypertension were associated with significantly a higher risk of seizure(p <0.05). pre- or postoperative intracranial hematoma(intracerebral or epidural hematoma) was associated with significantly a higher risk of seizure(p <0.0001). H-H grade, Fisher grade, Glasgow Outcome Scale of patients and timing of operation after subarachnoid hemorrhage had no significant relation with the risk of seizure. Conclusion : Factors associated with the development of postoperative seizure were middle cerebral artery aneurysm, delayed ischemic neurologic deficit, infarct on late postoperative CT scan, hypertension, pre or postoperative intracranial hematoma(intracerebral or epidural hematoma). Identification of the risk factors may be help to focus the antiepileptic drug threapy in cases prone to develop seizures. Prospective evaluation is indicated.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.732-742
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• 2002

Purpose : In order to evaluate the hypoxia-ischemia(H-I) induced neurotoxicity and the protective effect of xanthine oxidase(XO) inhibitor(allopurinol), cell number, cell viability, lactate dehydrogenase(LDH), protein synthesis(PS) and protein kinase C(PKC) activity were measured in cerebral neurons and astrocytes. Methods : Cytotoxic effect was measured by in vitro assay at 12-72 hours after H-I on cerebral neurons and astrocytes derived from 7-day old neonatal rats which were subjected to unilateral common carotid artery occlusion and exposed to hypoxic condition for 3 hours. The protective effect of XO inhibitor was examined by the cell number, cell viability, LDH and PS on 14 days after H-I with allopurinol intraperitoneal injection 15 minutes prior to H-I. In addition, the effect of allopurinol on PKC activity in hypoxic conditions was examined in neurons. Results : 72 hours from H-I, the cell numbers and viability were decreased significantly in time-dependent manner on neurons and those of astrocytes also decreased slightly, compared with control. In neonatal rats treated with H-I, the cell number, cell viability, and PS in neurons were decreased, but LDH was increased significantly compared with control. In neonatal rats pretreated with allopurinol, the cell number and viability, and PS in neurons were increased and LDH was decreased significantly compared with H-I. PKC was increased remarkably after hypoxic condition. But PKC was decreased significantly against hypoxic condition after allopurinol pretreatment. Conclusion : From these results, it is suggested that H-I is more toxic in neurons than astrocytes and allopurinol is very protective with increasing of PS, and decreasing of LDH and PKC in neurons from hypoxic-ischemic condition.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.441-446
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• 2009

Background: Side clamping of ascending aorta during proximal graft anastomosis in coronary bypassing surgery in-creases the risk of direct aortic injury as well as embolization of intimal atheroma. Heartstring proximal sealing system (Guidant Corporation, Santa Clara, Calif), developed to avoid aortic side clamping, may minimize risks of such complications. The aim of the current study is to compare the surgical outcomes of the two proximal anastomosis techniquesi.e., Heartstring system versus aortic side clamping in off pump coronary bypassing' surgery (OPCAB). Material and Method: From January 2003 to August 2008, 499 patients underwent OPCAB. Of them, proximal graft anastomosis was performed using Heartstring system in 182 patients (Group I) and conventional manual anastomosis in 317 patients (Group II). The two groups were compared for postoperative major complications and mortality. Result: Two groups showed similar characteristics in terms of preoperative demographic data, left ventricular ejection fraction, renal function and history of diabetes, hypertension and smoking. Although there was no inter-group difference in the history of cerebral ischemia (p=0.48), preoperative brain magnetic resonance angiography revealed greater incidence of severe carotid artery stenosis (>75% of lumen) in the Group I than in the. Group II (44.5% in the Group I and 30.0% in the Group II, p=0.003). There were no inter-group differences in postoperative mortality (p=0.40) and complications (p=0.47) including neurologic events (3 in the Group land 2 in the Group II, p=0.258). Whereas neurologic events all comprised transient ischemic attacks in the Group I, they comprised multiple embolic strokes in the Group II. One patient in the Group II experienced aortic dissection during proximal anastomosis which resulted in ascending aortic replacement. Conclusion: Although proximal anastomosis using Heartstring system did not show statistically significant benefit over aortic side clamping, the. absence of embolic stroke maybe a definite benefit which may be better defined through further studies over a larger cohort.

• Progress in Medical Physics
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• v.16 no.4
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• pp.207-213
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• 2005

The severity of carotid Intima-media thickness (IMT) is an Independent predictor of atherosclerosis which causes transient cerebral ischemia, stroke, and coronary events such as myocardial Infarction. The IMT consists of Intima thickness (IT) and media thickness (MT). However, the Individual clinical significance of IT and MT has not been well studied. We devised a method of measuring IT, MT, and IMT using B-mode ultrasound Image processing technique for the diagnosis of atherosclerosis. To inspect the clinical significance of IT, MT, and IMT, one hundred forty-four consecutive patients (mean age; 57 years old, 72 males) were underwent common carotid artery scanning using high-resolution ultrasound. Results showed that, the IT (p<0.05), MT (p<0.05) as well as IMT (p<0.01) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hyperiension showed significantly thicker IT (p<0.01), MT (p<0.001), and IMT (p<0.001). However, only IT was thicker in patients with smoking (p<0.01). The IT (r=0.374, p=0.001), MT (r=0.433, p=0.000), and IMT (r=0.479, p=0.000) showed positive correlation with age. The coefficients of determination ($r^2$) were estimated to be $92.4\%$ for IMT and MT, $49.1\%$ for IMT and IT, and $27.4\%$ for IT and MT. This result suggests that the Intima layer of the carotid artery has a different physiology with the media layer.

• Physical Therapy Korea
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• v.15 no.4
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• pp.50-58
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• 2008

The purpose of this study was to investigate the effects of the task-oriented training according to the application time with the change of motor and cognition function. Focal ischemic brain injury was produced in Sprague-Dawley rats (20 rats, $250{\pm}50$ g) through middle cerebral artery occlusion (MCAo). Before MCAo induction, all rats were trained in treadmill training and Morris water maze training for 1 week. Then they were randomly divided into groups: Group I : MCAo induction ($n_1$=5), Grop II: the application for simple treadmill task training after. MCAo induction ($n_2$=5). Group III: the application for Morris water maze cognitive task training after MCAo induction ($n_3$=5). Group IV: the application for progressive treadmill task training and Morris water maze cognitive task training after MCAo induction ($n_4$=5). Modified limb placing tests (MLPTs) and motor tests (MTs) were performed to test motor function and then Morris water maze acquisition test (MWMAT) and Morris water maze retention test (MWMRT) were performed to test cognitive function. For MTs, there were significant interactions among the groups with the time (p<.001). Group IV showed the steeper increasing pattern than those in other Groups on the 7th and 14th day. For MLPTs, there were significant interactions among the groups with the time (p<.001). The scores in Group III. IV had showed the more decreasing pattern than those in Group I, II since the 7th day and 14th day. For MWMAT, there were significant interactions among the groups with the time (p<.001). Group II found the Quadrant circular platform showed the steeper decreasing pattern than that in Group I on the 9th, 10th, 11th and 12th day. Group III. IV found the quadrant circular platform showed the slower decreasing pattern than that in Group I, II, For MWMRT, there were significant differences among the four groups (p<.001). The time to dwell on quadrant circular platform in Group IV on the 13th day was the longest compared with other groups. These results suggested that the combined task training was very effective to improve the motor and cognition function for the rats affected on their focal ischemic brain injury.

• Investigative Magnetic Resonance Imaging
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• v.21 no.2
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• pp.65-70
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• 2017

Purpose: To optimize the saturation time and maximizing the pH-weighted difference between the normal and ischemic brain regions, on 3-tesla amide proton transfer (APT) imaging using an in vivo rat model. Materials and Methods: Three male Wistar rats underwent middle cerebral artery occlusion, and were examined in a 3-tesla magnetic resonance imaging (MRI) scanner. APT imaging acquisition was performed with 3-dimensional turbo spin-echo imaging, using a 32-channel head coil and 2-channel parallel radiofrequency transmission. An off-resonance radiofrequency pulse was applied with a Sinc-Gauss pulse at a $B_{1,rms}$ amplitude of $1.2{\mu}T$ using a 2-channel parallel transmission. Saturation times of 3, 4, or 5 s were tested. The APT effect was quantified using the magnetization-transfer-ratio asymmetry at 3.5 ppm with respect to the water resonance (APT-weighted signal), and compared with the normal and ischemic regions. The result was then applied to an acute stroke patient to evaluate feasibility. Results: Visual detection of ischemic regions was achieved with the 3-, 4-, and 5-s protocols. Among the different saturation times at $1.2{\mu}T$ power, 4 s showed the maximum difference between the ischemic and normal regions (-0.95%, P = 0.029). The APTw signal difference for 3 and 5 s was -0.9% and -0.7%, respectively. The 4-s saturation time protocol also successfully depicted the pH-weighted differences in an acute stroke patient. Conclusion: For 3-tesla turbo spin-echo APT imaging, the maximal pH-weighted difference achieved when using the $1.2{\mu}T$ power, was with the 4 s saturation time. This protocol will be helpful to depict pH-weighted difference in stroke patients in clinical settings.

• Journal of Oriental Neuropsychiatry
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• v.18 no.1
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• pp.153-171
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• 2007

Objective : The aim of this study was to investigate effects of Gagambosim-Tang(GBT) of focal brain ischemic injury induced by intraluminal filament insertion in the rats. Method : The ischemia was induced by intraluminal filament insertion into middle cerebral artery Eight-arm radial maze was designed for the behavioral task. Gagambosim-Tang was orally administrated in SD rats for 21 days. The task was started on the 4th week after focal brain injury, and performed two trials per day for 6days. The effects of Gagambosim-Tang on neuroprotective agents in cresyl violet, choline acetyltranferase(ChAT), nerve growth factor (NGF)-stain and c-Fos with ischemic injury were investigated. Results : The errors in the eight-arm radial maze task were significantly decreased in normal group compared with control group on 2-6days, GBT lX(42.2 mg/ml)orally administrated group on 1days, GBT 6X(253.2 mg/ml) on 3, 5, 6days. The rate of correct choice was increased in normal and GBT 6X groups. The neuroprotective effect in the hippocampal CA1 was increased in normal and GBT 1X, GBT 6X groups compared with control group. The density of ChAT in the hippocampal CA1 was increased in normal and GBT6X groups compared with control group. The density of NGF in the hippocampal CA1 was increased normal and GBT6X groups compared with control group. The number of c-Fos-positive neurons in the hippocampal CA1 was increased in normal and GBT 6X groups compared with control group. Conclusion : These results suggest that Gagambosim-Tang may have protective effect on dementia.