• Journal of Korean Neurosurgical Society
• /
• v.30 no.sup1
• /
• pp.91-98
• /
• 2001

Objective : The purpose of this study was to investigate the prognostic factors in patients who suffered an intracerebral hemorrhage(ICH) due to a ruptured middle cerebral artery(MCA) aneurysm. Methods : Among 148 case of ruptured MCA aneurysm, ruptured MCA aneurysm with ICH was compared with ruptured MCA aneurysm alone. According to factors, the prognosis in these two groups was analyzed. Prognosis was evaluated postoperatively by applying Glasgow Outcome Scale(GOS) at discharge. Prognostic factors were evaluated with Chi square test, Mann-Whitney test and ANOVA test with differences being considered significant for value less than 0.05. Results : Ruptured MCA aneurysm alone revealed better consciousness on admission and final outcome than those combined with ICH. Ruptured MCA aneurysm alone showed 74% in H-H grade I, II and 82% in GOS I, II. But ruptured MCA aneurysm with ICH showed 63% in H-H grade IV, V and 52% in GOS IV, V. Age, sex, lesion site, aneurysmal size, temoporary clipping time, interval to operation, operative approach were statistically not significant in prognosis(p>0.05). But H-H grade on admission(p<0.05), complication(esp. cerebral infarction)(p<0.05), preoperative ICH volume and site(p<0.01), preoperative midline shifting(p<0.01), remained ICH volume(p<0.05) showed significance statistically. Conclusion : Prognostic factors are helpful to neurosurgeon to estimate clinical and neurological outcome postoperatively. We suggest that the good prognostic factors in ruptured MCA aneurysm with ICH were good H-H grade on admission, cerebral infarction(-), preoperative ICH volume <25cc, temporal and intrasylvian ICH, preoperative midline shifting <5mm, remained ICH volume <10cc.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.25 no.5
• /
• pp.799-806
• /
• 2011

This study was performed in order to evaluate the neuroprotective effect of Boyanghwano-tang (BYT) water extract on intracerebral hemorrhage (ICH). ICH was induced by the stereotaxic intrastriatal injection of bacterial collagenase type IV in Sprague-Dawley rats. BYT was orally given once a day for 3 days after ICH. Hematoma volume and percentage edema were examined. As imflammatory markers, myeloperoxidase (MPO)-positive neutrophils infiltration and iNOS expression in the peri-ICH regions were examined using immunohistochemistry. As cellular damage markers, c-Fos, Bax, and HSP72 positive cells in the peri-ICH regions were measured also. BYT significantly reduced the hematoma volume and percentage edema of the ICH-induced rat brain. In the peri-hematoma regions, BYT significantly reduced MPO-positive neutrophil infiltration and iNOS expression of the ICH-induced rat brain. Additionally, BYT significantly reduced c-Fos, Bax, and HSP72 positive cells in the peri-hematoma regions of the ICH-induced rat brain. These results suggest that BYT plays a neuroprotective role against ICH through suppression of inflammatory responses, apoptosis and cellular damage.

• Investigative Magnetic Resonance Imaging
• /
• v.24 no.3
• /
• pp.154-161
• /
• 2020

Purpose: A CT angiography spot sign (CTA-spot) is a significant predictor of the early expansion of an intracerebral hemorrhage (ICH-Ex). Dynamic-susceptibility-contrast magnetic resonance imaging (DSC-MRI) can track the real-time leaking of contrast agents. It may be able to indicate active bleeding, like a CTA-spot. Materials and Methods: From September 2014 to February 2017, we did non-contrast CT, CTA, and DSC-MRI examinations of seven patients with acute ICH. We investigated the time from symptom onset to the first contrast-enhanced imaging. We evaluated the time course of the contrast leak within the ICH at the source image of the DSC-MRI and the volume change of ICH between non-contrast CT and DSC-MRI. We compared the number of slices showing CTA-spots and DSC-MRI leaks. Results: The CTA-spot and DSC-MRI leak-sign were present in four patients, and two patients among those showed ICH-Ex. The time from the symptom onset to CTA or DSC-MRI was shorter for those with a DSC-MRI leak or CTA-spot than for three patients without either (70-130 minutes vs. 135-270 minutes). The leak-sign began earlier, lasted longer, and spread to more slices in the patients with ICH-Ex than in those without ICH-Ex. The number of slices of the DSC-MRI leak and the number of the CTA-spot were well correlated. Conclusion: DSC-MRI can demonstrate the leakage of GBCA within hyperacute ICH, showing the good contrast between hematoma and contrast. The DSC-MRI leakage sign could be related to the hematoma expansion in patients with ICH.

• Biomedical Science Letters
• /
• v.24 no.4
• /
• pp.405-410
• /
• 2018

Stroke is a leading cause of death in the Korean population and remains a major health burden worldwide. The two main pathologic types of stroke are ischemic stroke and intracranial hemorrhage (ICH), but comparisons of risk factors for these have been limited. We under took a nationwide population-based study to analyze the relationship between these risk factor sand ischemic stroke and ICH. From January 2003 to December 2013, a total of 37,561 patients with newly diagnosed ischemic stroke or ICH were identified using the National Health Insurance Service data base as the study population. Multivariable logistic regression analysis was used to determine the association between baseline risk factors and presentation with ICH versus ischemic stroke. The incidence of ischemic stroke showed an increasing rend every year, while there was no significant change in the incidence of ICH. Of the several risk factors associated with stroke, old age (OR 2.35, 95% CI 2.12~2.49, P < 0.001) was more closely associated with ischemic stroke than ICH, whereas renal disease (OR 0.74, 95% CI 0.55~0.99, P = 0.04) and carotid disease (OR 0.25, 95% CI 0.17~0.35, P < 0.001) were more strongly associated with ICH. In addition, diabetes mellitus, dyslipidemia, hypertension, ischemic heart disease and male sex was associated with an increased risk of ischemic stroke. Old age was more strongly associated with ischemic stroke than ICH, while carotid stenosis and renal impairment were more closely associated with ICH risk. Classic risk factors for stroke have considerably different associations with the two main pathologic types of stroke.

• Proceedings of the Korean Society of Applied Pharmacology
• /
• 1997.11a
• /
• pp.57-74
• /
• 1997

To make a proposal for the revision of KGCP, ICH Harmonized Tripartite Guideline for Good Clinical Practice, which is on the stage of worldwide implementation, was compared with current GCPs of tripartite countries of ICH, namely USA, Europe and Japan as well as Korea. On the basis of the classification in ICH GCP, comprehensive comparisons among the corresponding articles of 4 regions or countries were made in the order of IRB / IEC, Investigator, Sponsor and Clinical Trial Protocol. Based on the comparisons of the contents in ICH-GCP with those in current GCPs, major suggestions for the revision of current KGCP can be made as follows. Firstly, the function of IRB / IEC needs to be strengthened for the initiation and continuation of clinical trial. Current 2-step approval system of IRB / IEC and Health Authorities requires to be converted into the system similar to that of developed countries. Secondly, sponsor's obligation needs to be tightened to control and assure the quality of clinical trial. Inspection of regulatory authorities should be made to perform during and / or after clinical trial, when it is necessary. In other words, sponsor should be made to establish written Standard Operating Procedures (SOPs) for all aspects of clinical trial including monitoring to ensure that trials are conducted and data are generated, documented, and reported in compliance with the protocol, GCP, and the applicable regulatory requirement (s). Besides, the provision of ‘Quality Control and Quality Assurance’ should be added to the protocol to establish the credibility of the result of the clinical trial.

• Journal of Korean Society of Steel Construction
• /
• v.19 no.1
• /
• pp.53-65
• /
• 2007

Column tests were performed for a new type of column, the internally confined hollow concrete filled tube column (ICH CFT column), to evaluate its seismic performance. The seismic performances for two types of ICH CFT columns and a general solid RC column were evaluated and compared by quasi-static tests. The displacements and the lateral loads of column specimens were measured during tests. Ductilities, absorbed energy, equivalent damping ratios, damage indices were calculated from recorded data. From the test results, the ICH CFT column shows superior seismic performances with double moment capacity and larger energy absorbing capacity over that of a solid RC column.

• Korean Journal of Heritage: History & Science
• /
• v.44 no.4
• /
• pp.18-41
• /
• 2011

The Safeguarding of Intangible Cultural Heritage in Korea has begun since1962 when the Cultural Properties Protection Act was established. Korean ICH Safeguarding system is initially derived from Cultural Properties Protection Act in Japan. Japan has started Important ICH Designation System in 1954 to concede the skills and artistic talents holders, thus it could implement the multilateral system management for adopting different ICH protection systems such as Important Intangible Folklore Properties, Selection and Preservation Techniques, and Documenting Records. However, Korea has solely adopted Important ICH Designation System since Cultural Properties Protection Act was introduced. Korean ICH Safeguarding System represented by the Certification System of ICH Skill Holders is to ensure skills and artistic holders who perform the elements of Intangible Cultural Heritage, and manage the safeguarding of intangible cultural heritage in order to let the skills and artistic holders instruct inheritors. As a result, it could build up the internal foundation for the diffusion of inheritors and established the related organizations. However, the inheritor-centered protection system has caused many problems as it is being lasted for more than fifty years. Fragmented designation measures, the cultural power of skill holders, and the research and evaluation methods have pointed out the difficulties of safeguarding and preservation measures of ICH. Moreover,the legitimacy of safeguarding system related in the authenticity of transmission in ICH has emerged to review the safeguarding system of ICH with diverse viewpoints. Therefore, this paper will review the implementation process and achievement of ICH safeguarding system to examine the problem and causes of the safeguarding system. The conference records of Cultural Property Association and articles of cultural properties policies directors, Cultural Property Association members, and professional experts are being used for the initial materials of this paper, and it is examined for the contents of designation system of Important Cultural Heritage, rather than overall cases. Thus such problems the limitation of expansion in ICH lists as inheritor-centered designation system, hierarchical and exclusive transmission system, inappropriate concept of archetype as the principle of ICH transmission are derived from the root of Important ICH designation system. Thus this paper demonstrates that this system must be revised for the expansion of ICH safeguarding system in Korea and points out multilateral protection system should be established as well as Certification System of Important ICH skill holders.

• Journal of Korean Neurosurgical Society
• /
• v.61 no.1
• /
• pp.42-50
• /
• 2018

Objective : Massive intracerebral hemorrhage (ICH) and major infarction (MI) are devastating cerebral vascular diseases. Decompression craniectomy (DC) is a common treatment approach for these diseases and acceptable clinical results have been reported. Author experienced the postoperative intracranaial pressure (ICP) trend is somewhat different between the ICH and MI patients. In this study, we compare the ICP trend following DC and evaluate the clinical significance. Methods : One hundred forty-three patients who underwent DC following massive ICH (81 cases) or MI (62 cases) were analyzed retrospectively. The mean age was $56.3{\pm}14.3$ (median=57, male : female=89 : 54). DC was applied using consistent criteria in both diseases patients; Glasgow coma scale (GCS) score less than 8 and a midline shift more than 6 mm on brain computed tomography. In all patients, ventricular puncture was done before the DC and ICP trends were monitored during and after the surgery. Outcome comparisons included the ictus to operation time (OP-time), postoperative ICP trend, favorable outcomes and mortality. Results : Initial GCS (p=0.364) and initial ventricular ICP (p=0.783) were similar among the ICH and MI patients. The postoperative ICP of ICH patients were drop rapidly and maintained within physiological range if greater than 80% of the hematoma was removed. While in MI patients, the postoperative ICP were not drop rapidly and maintained above the physiologic range (MI=18.8 vs. ICH=13.6 mmHg, p=0.000). The OP-times were faster in ICH patients (ICH=7.3 vs. MI=40.9 hours, p=0.000) and the mortality rate was higher in MI patients (MI=37.1% vs. ICH=17.3%, p=0.007). Conclusion : The results of this study suggest that if greater than 80% of the hematoma was removed in ICH patients, the postoperative ICP rarely over the physiologic range. But in MI patients, the postoperative ICP was above the physiologic range for several days after the DC. Authors propose that DC is no need for the massive ICH patient if a significant portion of their hematoma is removed. But DC might be essential to improve the MI patients' outcome and timely treatment decision.

• The Journal of Internal Korean Medicine
• /
• v.30 no.3
• /
• pp.594-603
• /
• 2009

Objectives : ICH breaks down blood vessels within the brain parenchyma, which finally leads to neuronal loss, drugs to treat ICH have not yet been established. In this experiment, we measured the effect of Woowhangchongshim-won (WWCSW) on intracerebral hemorrhage (ICH) in rat using microarray technology. Methods : We measured the effect of WWCSW on ICH in rat using microarray technology. ICH was induced by injection of collagenase type IV, and total RNA was isolated. Image files of microarray were measured using a ScanArray scanner, and the criteria of the threshold for up- and down-regulation was 2 fold. Hierarchical clustering was implemented using CLUSTER and TREEVIEW program, and for Ontology analysis. GOSTAT program was applied in which p-value was calculated by Chi square or Fisher's exact test based on the total array element. Results : WWCSW-treatment restored the gene expression altered by ICH-induction in brain to the levels of 76.0% and 70.1% for up- and down-regulated genes, respectively. Conclusion : Co-regulated genes by ICH model of rat could be used as molecular targets for therapeutic effects of drug including WWCSW. That is, the presence of co-regulated genes may represent the importance of these genes in ICH in the brain and the change of expression level of these co-regulated genes would also indicate the functional change of brain tissue.

• Journal of Korean Neurosurgical Society
• /
• v.41 no.4
• /
• pp.230-235
• /
• 2007

Objective : We investigated the incidence of the vascular abnormalities associated with spontaneous intracerebral hemorrhage [ICH] using three-dimensional computed tomographic angiography [3D-CTA]. Methods : We prospectively assessed consecutive 76 patients with spontaneous intracerebral hemorrhage [ICH] who underwent 3D-CTA between June 2003 and May 2005. The patients with a recent history of trauma or mainly subarachnoid hemorrhage were excluded. We investigated relationship between vascular abnormality and ICH location. The findings of 3D-CTA were classified as one of three patterns with ICH; type A [without evidence of vascular abnormality], type B [with no vascular abnormality as the source of hemorrhage, but with incidental vascular abnormality], and type C [presence of a vascular abnormality as the source of hemorrhage]. Results : Sites of ICH were lobar 26, basal ganglia 23, thalamus 17, posterior fossa 6 and dominant intraventricular hemorrhage [IVH] 4. Among 76 patients, sixteen [21.1%] vascular abnormalities were noted excluding 13 cases of stenoocclusive disease. Sixteen cases included 6 cases of cerebral aneurysms [7.9%], 5 moyamoya diseases [6.6%], 4 arteriovenous malformations [5.3%] and 1 dural sinus thrombosis [1.3%]. Lobar ICH [30.8%] had a higher vascular abnormalities than other types, and younger age [<40] group had a higher incidence of vascular abnormalities than old age group. The patterns of 3D-CTA include sixty cases [79.0%] of type A, 6 cases [7.8%] of type Band 10 cases [13.2%] of type C. The vascular abnormalities were found in 8 [13.5%] of 59 hypertensive patients and 8 [47.0%] of 17 non-hypertensive patients [p=0.006]. Conclusion : 3D-CT angiography is considered a useful screening tool for ICH patients with suspected cerebrovascular abnormalities and should be considered in such clinical settings, especially in lobar type and in non-hypertensive younger patients.