• Laboraroty Animal Research
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• v.34 no.4
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• pp.195-202
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• 2018

Hyperglycemia is one of the major risk factors for stroke. Hyperglycemia can lead to a more extensive infarct volume, aggravate neuronal damage after cerebral ischemia. ${\alpha}$-Synuclein is especially abundant in neuronal tissue, where it underlies the etiopathology of several neurodegenerative diseases. This study investigated whether hyperglycemic conditions regulate the expression of ${\alpha}$-synuclein in middle cerebral artery occlusion (MCAO)-induced cerebral ischemic injury. Male Sprague-Dawley rats were treated with streptozotocin (40 mg/kg) via intraperitoneal injection to induce hyperglycemic conditions. MCAO were performed four weeks after streptozotocin injection to induce focal cerebral ischemia, and cerebral cortex tissues were obtained 24 hours after MCAO. We confirmed that MCAO induced neurological functional deficits and cerebral infarction, and these changes were more extensive in diabetic animals compared to non-diabetic animals. Moreover, we identified a decrease in ${\alpha}$-synuclein after MCAO injury. Diabetic animals showed a more serious decrease in ${\alpha}$-synuclein than non-diabetic animals. Western blot and reverse-transcription PCR analyses confirmed more extensive decreases in ${\alpha}$-synuclein expression in MCAO-injured animals with diabetic condition than these of non-diabetic animals. It is accepted that ${\alpha}$-synuclein modulates neuronal cell death and exerts a neuroprotective effect. Thus, the results of this study suggest that hyperglycemic conditions cause more serious brain damage in ischemic brain injuries by decreasing ${\alpha}$-synuclein expression.

• Physical Therapy Korea
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• v.28 no.1
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• Journal of Audiology & Otology
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• v.25 no.3
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• pp.163-170
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• 2021

Cortical deafness is a clinical rarity whereby a patient is unresponsive to all types of sounds despite the preserved integrity of the peripheral hearing organs. In this study, we present a patient who suddenly lost his hearing following ischaemic infarcts in both temporal lobes with no other neurological deficits. The CT confirmed damage to the primary auditory cortex (Heschl's gyrus) of both hemispheres. Initially, the patient was unresponsive to all sounds, however, he regained some of the auditory abilities during 10 months follow up. Pure tone threshold improvement from complete deafness to the level of moderate hearing loss in the right ear and severe in the left was observed in pure tone audiometry. Otoacoustic emissions, auditory brainstem responses, and acoustic reflex findings showed normal results. The middle and late latency potential results confirmed objectively the improvement of the patient's hearing, however, after 10 months still, they were somewhat compromised on both sides. In speech audiometry, there was no comprehension of spoken words neither at 3 nor at 10 months. The absent mismatch negativity confirmed above mentioned comprehension deficit. The extensive auditory electrophysiological testing presented in this study contributes to the understanding of the neural and functional changes in cortical deafness. It presents the evolution of changes after ischaemic cerebrovascular event expressed as auditory evoked potentials starting from short through middle and long latency and ending with event-related potentials and supported by neuroimaging.

• Korean Journal of Audiology
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• v.25 no.3
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• pp.163-170
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• 2021

Cortical deafness is a clinical rarity whereby a patient is unresponsive to all types of sounds despite the preserved integrity of the peripheral hearing organs. In this study, we present a patient who suddenly lost his hearing following ischaemic infarcts in both temporal lobes with no other neurological deficits. The CT confirmed damage to the primary auditory cortex (Heschl's gyrus) of both hemispheres. Initially, the patient was unresponsive to all sounds, however, he regained some of the auditory abilities during 10 months follow up. Pure tone threshold improvement from complete deafness to the level of moderate hearing loss in the right ear and severe in the left was observed in pure tone audiometry. Otoacoustic emissions, auditory brainstem responses, and acoustic reflex findings showed normal results. The middle and late latency potential results confirmed objectively the improvement of the patient's hearing, however, after 10 months still, they were somewhat compromised on both sides. In speech audiometry, there was no comprehension of spoken words neither at 3 nor at 10 months. The absent mismatch negativity confirmed above mentioned comprehension deficit. The extensive auditory electrophysiological testing presented in this study contributes to the understanding of the neural and functional changes in cortical deafness. It presents the evolution of changes after ischaemic cerebrovascular event expressed as auditory evoked potentials starting from short through middle and long latency and ending with event-related potentials and supported by neuroimaging.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.3
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• pp.47-53
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• 2023

PURPOSE: A visual feedback method was proposed to induce brain stimulation in a stroke patient, and among them, there was a treatment using a mirror. On the other hand, mirror therapy focuses only on the functional changes in body movements, and analysis of neurophysiological mechanisms of brain activity is lacking. In addition, studies on evaluating the activity and response generated in specific brain regions during visual feedback training using mirrors are insufficient. METHODS: Fifteen healthy adults (male: 10, female: 5, Years: 23.33 ± 1.23), who were right-handed were recruited. By attaching the C3, Cz, and C4 channels in the sensorimotor cortex using an electroencephalogram, training was performed under the conditions without mirror-based visual feedback (No-condition) and with visual feedback (Tasks-condition). At this time, the immediate activity of the mu-rhythm in response to training was separated and evaluated. RESULTS: The tasks-condition of C3, Cz, and C4 channels activated the relative mu-rhythm rather than the no-condition, and all showed significant differences (p < .05). In addition, in all channels at the start time, the tasks-condition was more active than the no-condition (p < .05). The activity of the cortical response was higher in the tasks-condition than in the no-condition (p < .05). CONCLUSION: The mu-rhythm activity can be evaluated objectively when visual feedback using a mirror is applied to healthy subjects, and a basic analysis protocol is proposed.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.207-213
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• 2023

Objective: The purpose of this study was to understand the complex anatomical structure and function of the midbrain to better understand the patient's symptoms and plan effective treatment including pharmacological and rehabilitation interventions. Design: A single case study Methods: A 17-year-old girl presented with acute onset of drowsiness, gait disturbance, mutism, and ptosis. Physical examination revealed postural instability, rigidity of all limbs, and limitations in extraocular movement. The brain MRI revealed an isolated acute infarction in the bilateral midbrain. Considering the location of the infarction, the presenting symptoms were the result of an impairment of the dopaminergic pathway in addition to lesions in the nuclei of the oculomotor nerve. Levodopa/carbidopa was prescribed. And the intensive and comprehensive rehabilitation program was done. Results: As a result of the study, through comprehensive intervention, which encompassed assessments such as the manual muscle test, Korean Modified Barthel Index score, and Trail-making test, significant enhancements in the patient's condition were observed. These findings provide evidence supporting the effectiveness of the intervention in promoting the patient's physical functioning and overall well-being. Conclusions: The results of this case highlight the significance of comprehending the intricate anatomical structure and functional aspects of the midbrain, which led us to approach appropriate pharmacological and rehabilitation interventions. Through active communication among the medical team, we were able to establish a therapeutic plan, which demonstrated that effective treatment can be achieved.

• Korean Journal of Radiology
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• v.21 no.4
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• pp.450-461
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• 2020

Objective: We performed a meta-analysis to evaluate the agreement of cardiac computed tomography (CT) with cardiac magnetic resonance imaging (CMRI) in the assessment of right ventricle (RV) volume and functional parameters. Materials and Methods: PubMed, EMBASE, and Cochrane library were systematically searched for studies that compared CT with CMRI as the reference standard for measurement of the following RV parameters: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), or ejection fraction (EF). Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient (r) between CT and CMRI. Heterogeneity was also assessed. Subgroup analyses were performed based on the probable factors affecting measurement of RV volume: CT contrast protocol, number of CT slices, CT reconstruction interval, CT volumetry, and segmentation methods. Results: A total of 766 patients from 20 studies were included. Pooled bias and LOA were 3.1 mL (-5.7 to 11.8 mL), 3.6 mL (-4.0 to 11.2 mL), -0.4 mL (5.7 to 5.0 mL), and -1.8% (-5.7 to 2.2%) for EDV, ESV, SV, and EF, respectively. Pooled correlation coefficients were very strong for the RV parameters (r = 0.87-0.93). Heterogeneity was observed in the studies (I² > 50%, p < 0.1). In the subgroup analysis, an RV-dedicated contrast protocol, ≥ 64 CT slices, CT volumetry with the Simpson's method, and inclusion of the papillary muscle and trabeculation had a lower pooled bias and narrower LOA. Conclusion: Cardiac CT accurately measures RV volume and function, with an acceptable range of bias and LOA and strong correlation with CMRI findings. The RV-dedicated CT contrast protocol, ≥ 64 CT slices, and use of the same CT volumetry method as CMRI can improve agreement with CMRI.

• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.14-21
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• 2024

Objective : The primary treatment goal of current endovascular thrombectomy (EVT) for emergent large-vessel occlusion (ELVO) is complete recanalization after a single maneuver, referred to as the 'first-pass effect' (FPE). Hence, we aimed to identify the predictive factors of FPE and assess its effect on clinical outcomes in patients with ELVO of the anterior circulation. Methods : Among the 129 patients who participated, 110 eligible patients with proximal ELVO (intracranial internal carotid artery and proximal middle cerebral artery) who achieved successful recanalization after EVT were retrospectively reviewed. A comparative analysis between patients who achieved FPE and all others (defined as a non-FPE group) was performed regarding baseline characteristics, clinical variables, and clinical outcomes. Multivariate logistic regression analyses were subsequently conducted for potential predictive factors with p<0.10 in the univariate analysis to determine the independent predictive factors of FPE. Results : FPE was achieved in 31 of the 110 patients (28.2%). The FPE group had a significantly higher level of functional independence at 90 days than did the non-FPE group (80.6% vs. 50.6%, p=0.002). Pretreatment intravenous thrombolysis (IVT) (odds ratio [OR], 3.179; 95% confidence interval [CI], 1.025-9.861; p=0.045), door-to-puncture (DTP) interval (OR, 0.959; 95% CI, 0.932-0.987; p=0.004), and the use of balloon guiding catheter (BGC) (OR, 3.591; 95% CI, 1.231-10.469; p=0.019) were independent predictive factors of FPE. Conclusion : In conclusion, pretreatment IVT, use of BGC, and a shorter DTP interval were positively associated with FPE, increasing the chance of acquiring better clinical outcomes.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.6
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• pp.929-933
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• 2012

This study was done to examine the prognosis according to onset and duration of treatment in acute ischemic cerebral infarction patients. We analysed NIHSS(National Institutes of Health Stroke Scale) score of acute ischemic cerebral infarction patients who visited department of Internal Korean Medicine, one medical center in Busan from January to December 2009. We divided patients into two groups by the initial time of treatment. Group A is admitted within 7 days, Group B is admitted from 7 to 14 days. We used NIHSS for functional recovery after 3 weeks later from admission day, and analyzed prognostic factor by analysis of covariance. All patients showed statistically significant improvement after 1week, 2weeks, 3weeks from admission, and between 1st week and 2nd week. However, there was no significant difference between 2nd week and 3rd week. NIHSS recovery score after 3weeks were analysed according to the timing of treatment. There was a statistically significant difference between two groups. The percentage of aggravated patients showed no statistically significant difference between the two groups. This study suggests that earlier admission care has an effect on functional recovery of patients with acute ischemic cerebral infarction. Further research on the large scale and long-term follow up is required.

• The Journal of Korean Physical Therapy
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• v.10 no.2
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• pp.41-55
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• 1998

An analysis of 87 stroke Patients who were enrolled in 7 hospitals in cities of Pusan, Taegu, Kumi, and Andong from January 1 to May 31, 1998 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals : Initial assessment, one month after initial, at discharge, and ore month after discharge. The mean BI score of patients initial assessment was 26.32. and that of PS was 17.34. There were statistically significant between initial score and one month after initial (16.61 : p<0.001), at discharge(33.51 : p<0,001), one month after discharge(43,56 : p<0.001). PS scores were also improved significantly(-2.1, -3. 94, and -5.52(p<0.001), and BI score between discharge and one month after discharge wag significant improvement(10.06 : p <0.001) and in PS score(-1,57 : p<0.001). Age and BI scone were significantly associated with the improved in BI score between initial and discharge (T3-T1)(p<0.05). Below age forty and the lower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial BI score, BI score at discharge, and religion were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, the high. BI score at discharge, and the religious showed significantly higher improvement(T4-T1)(p<0.05). BI score at discharge and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3)(p<0.05). The lower BI score at discharge, the religious showed significantly higher improvement(T4-T3)(p<0.05) Initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score showed significantly hier improvement(T3-T1)(p<0.05). Initial PS score, Bi score at discharge, and patient's attitude for physical therapy after discharge were significantly associated with the improvement of PS score between initial and one month after discharge(T4- T1)(p <0.05). The higher initial PS scorer the lower PS score at discharge, patient's positive attitude for physical therapy after discharge showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, Patient's attitude for Physical therapy after discharge were significantly associated with the improvement of PS score between discharge and one month after discharge(T4-T3)(p<0.05). The higher PS score at discharge, patient's positive attitude for physical therapy after discharge showed significantly higher improvement(T4-T3)(p<0.05). In conclusion, Initial BI score, BI score at discharge, age, and religion were significantly associated with BI score improvement. initial PS score, BI score discharge, and patient's attitude for physical therapy after discharge were significantly associated with PS score improvement in stroke patients.