• 대한한의학회지
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• 제18권2호
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• pp.316-325
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• 1997

In a 36-month period, 23 selected Patients with Acute Cerebral Infarction were studied utilizing Computerized Tomography, Barthel Index in an attempt to correlate Brain Computerized Tomography findings with 1week, 4weeks rehabilitation and evaluate the influences of the size and location of the lesion. The study suggested that the size of the lesion had impact on 4 weeks rehabilitation. There was significant different between the patients with Middle Cerebral Artery Pial Territory Infarction(I.P.B.M.C.A.) lesion and the patients with Lacunar Infarction(L.I.), Striatocapsular Infarction(S.C.I.), Internal Watershed Infarction(I.W.I.) lesion, but there was no significant difference between the patients with L.I. lesion and the patients with S.C.I. lesion and the patients with I.W.I. lesion. The size and location of the lesion should be considered together in predicting the functional outcomes of Acute Cerebral Infarction.

• Journal of Korean Neurosurgical Society
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• 제30권9호
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• pp.1072-1078
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• 2001

Objectives : There is continuing controversy about the benefits of decompressive craniectomy in massive cerebral edema following space occupying hemispheric cerebral infarction. The aims of this study are to determine the effectiveness and to confirm the life-saving nature of decompressive craniectomy with dural augmentation for massive cerebral infarction. Patients and Methods : We present twelve patients with medically uncontrollable hemispheric cerebral infarction. All were treated with extensive craniectomy and duroplasty without resection of necrotic tissue. We evaluated various characteristics(size of hemispheric infarction, Glasgow Coma Scale, volume of low density and midline shift in CT) at three different periods(preoperative, immediate postoperative and 3-4weeks after operation) and evaluated effectiveness of hemicraniectomy for massive cerebral edema after large hemispheric infarction. Results : All patients have survived from surgery. Nine patients with nondominant hemispheric infarction showed significant functional recovery with minimal assistance, and remaining two patients with dominant hemispheric infarction and one patient with nondominant hemispheric infarction have functionally dependent. The volume of low density and midline shift in CT were significantly reduced after decompressive craniectomy. Conclusions : Our results indicate that decompressive craniectomy with dural augmentation without resection of necrotic tissue for massive cerebral hemispheric infarction not only reduce the mortality and infarction size but also significantly improve the outcome, especially for nondominant hemispheric infarction.

• 대한핵의학회지
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• 제34권5호
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• pp.433-435
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• 2000

A 6000-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the ether represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.$^{1-4)}$ A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.$^{4)}$ Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.

• 대한한방내과학회지
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• 제30권4호
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• pp.674-684
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• 2009

Objectives : In conditions of brain infarction, irreversible axon damage occurs in the central nerve system (CNS), because gliosis becomes a physical and a mechanical barrier to axonal regeneration. Reactive gliosis induced by ischemic injury such as middle cerebral artery occlusion is involved with up-regulation of GFAP and CD81. This study was undertaken to examine the effect of the Gongjin-dan (GJD) on CD81 and GFAP expression and its pathway in the rat brain following middle cerebral artery occlusion (MCAO). Methods : In order to study ischemic injuries on the brain, infarction was induced by MCAO using insertion of a single nylon thread, through the internal carotid artery, into a middle cerebral artery. Cresyl violet staining, cerebral infarction size measurement, immunohistochemistry and microscopic examination were used to detect the expression of CD81 and GFAP and the effect on the infarct size and pyramidal cell death in the brain of the rat with cerebral infarction induced by MCAO. Also, c-Fos and ERK expression were measured to investigate the signaling pathway after GJD administration in MCAO rats. Results : Measuring the size of cerebral infarction induced by MCAO in the rat after injection of GJD showed the size had decreased. GJD administration showed pyramidal cell death protection in the hippocampus in the MCAO rat. GJD administration decreased GF AP expression in the MCAO rat. GJD administration decreased CD81 expression in the MCAO rat. GJD administration induced up-regulation of c-FOS expression compared with MCAO. GJD administration induced down-regulation of ERK expression compared with MCAO. Conclusion : We observed that GJD could suppress the reactive gliosis, which disturbs the axonal regeneration in the brain of a rat with cerebral infarction after MCAO by controlling the expression of CD81 and GFAP. The effect may be modulated by the regulation of c-Fos and ERK. These results suggest that GJD can be a candidate to regenerate CNS injury.

• Journal of Korean Biological Nursing Science
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• 제10권1호
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• pp.1-10
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• 2008

Purpose: The purpose of this study was to investigate the cerebral infarction size, antioxidant enzyme activities and lipid peroxidation changes after 6 weeks of dietary soybean protein intake in a rat focal brain ischemia model. Method: Weaning Sprague-Dawley rats were fed with either modified AIN-93G diet containing casein 20% (control), 20% soybean protein isolate-based diet (S20), or 40% of soybean protein isolate-based diet (S40) for 6 weeks. The animals were subject to right middle cerebral artery occlusion for 2 hr. After 24 hr of recirculation, the rats were sacrificed. Antioxidant enzymes activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) and thiobarbituric acid reactive substance (TBARS) level in the right brain were also measured. Result: There were no significant differences in the right cortical infarction volume, TBARS level, SOD and CAT activities among the three groups whereas the GPx activities of the S20 group were significantly higher than those of the control group (p=.02). Conclusion: Our results suggest that 20% of soybean protein may have a modulating effect on GPx and possibly have some protective effect against oxidative stress although it may enough to decrease cerebral infarction volume in rat focal brain ischemia model.

• 대한의용생체공학회:의공학회지
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• 제38권6호
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• pp.313-320
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• 2017

Myocardial infarction is a disease caused by stenosis of the coronary arteries. The high risk of sudden cardiac death due to myocardial infarction has triggered related researches that have been actively studied so far. However, these studies focused on the clinical results, which are mainly based on observations of symptoms due to infarction through electrocardiograms. Therefore, in this study, we tried to analyze the behavior of heart according to the position and volume of infarction lesion through the computer simulation study using three dimensional ventricular models. In order to implement infarction, commercial software was used to simulate cell necrosis due to blockage of a specific coronary. In addition, the conduction block due to infarction was mimicked by reducing the electrical conduction in the infarcted area, which was 100 times less than the electrical conduction of the whole ventricular lattice implemented by the finite element analysis method. Thus, this study classified the infarcted cases into the upper, middle, lower, and apex according to lattice data of eight different infraction areas. In other words, we assumed that myocardial infarction would have inherent electro-dynamic characteristics depending on the location and extent, and analyzed the ventricular electromechanical responses for infarction lesions using a three dimensional cardiac physiome model. The results showed that the volume of infarction did not directly affect the cardiac responses, but the location of the infarction lesions could influence the ventricular pumping efficiency. These suggest that the occlusion of specific coronary arteries may have a fatal effect on the decline in ventricular performance. In conclusion, although location of myocardial infarction lesions is considered to be an important variable to be considered clinically rather than lesion size, quantitative predictions should be made more in the future considering physiological factors such as lesion location and direction of myocardial fiber at that location.

• Journal of Korean Neurosurgical Society
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• 제38권4호
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• pp.293-298
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• 2005

Objective : The authors investigate the spatial characteristics of apoptotic genes expressed around the focal cerebral infarction, and attempted to explain the penumbra with them. Methods : A delayed focal cerebral infarction was created in twelve adult Sprague-Dawley rats. We performed the immunohistochemical staining for the apoptosis, bcl-2 and p53 proteins and measured the local cerebral blood flow [CBF] at the infarction core area and peri-infarct area pre- and intra-operatively. The peri-infarct area was divided into six sectors by distance from the infarction border. Results : The size [$mm^2$] of apoptosis, bcl-2, and p53 areas were $3.1{\pm}1.2$, $4.7{\pm}2.1$, and $6.8{\pm}2.4$, respectively. Apoptosis, bcl-2 or p53 positive cells were concentrated at the peri-infarct area adjacent to the infarction core. Their numbers reduced peripherally, which was inversely proportional to the local CBF. The p53 area seems to overlap with and larger than the ischemic penumbra. Conclusion : The p53 positive area provides a substitutive method defining the penumbra under the molecular base of knowledge.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.331-336
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• 2007

Objective : The aim of this study was to analyze the treatment results and prognostic factors in patients with massive cerebral infarction who underwent decompressive craniectomy. Methods : From January 2000 to December 2005, we performed decompressive craniectomy in 24 patients with massive cerebral infarction. We retrospectively reviewed the medical records, radiological findings, initial clinical assessment using the Glasgow Coma Scale, serial computerized tomography (CT) with measurement of midline and septum pellucidum shift, and cerebral infarction territories. Patients were evaluated based on the following factors : the pre- and post-operative midline shifting on CT scan, infarction area or its dominancy, consciousness level, pupillary light reflex and Glasgow Outcome Scale. Results : All 24 patients (11 men, 13 women; mean age, 63 years; right middle cerebral artery (MCA) territory, 17 patients; left MCA territory, 7 patients) were treated with large decompressive craniectomy and duroplasty. The average time interval between the onset of symptoms and surgical decompression was 2.5 days. The mean Glasgow Coma Scale was 12.4 on admission and 8.3 preoperatively. Of the 24 surgically treated patients, the good outcome group (Group 2 : GOS 4-5) comprised 9 cases and the poor outcome group (Group1 : GOS 1-3) comprised 15 cases. Conclusion : We consider decompressive craniectomy for large hemispheric infarction as a life-saving procedure. Good preoperative GCS, late clinical deterioration, small size of the infarction area, absence of anisocoria, and preoperative midline shift less than 11mm were considered to be positive predictors of good outcome. Careful patient selection based on the above-mentioned factors and early operation may improve the functional outcome of surgical management for large hemispheric infarction.

• The Korean Journal of Physiology and Pharmacology
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• 제26권2호
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• pp.87-94
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• 2022

Myocardial infarction promotes cardiac remodeling and myocardial fibrosis, thus leading to cardiac dysfunction or heart failure. Peiminine has been regarded as a traditional anti-fibrotic Chinese medicine in pulmonary fibrosis. However, the role of peiminine in myocardial infarction-induced myocardial injury and fibrosis remained elusive. Firstly, rat model of myocardial infarction was established using ligation of the left coronary artery, which were then intraperitoneally injected with 2 or 5 mg/kg peiminine once a day for 4 weeks. Echocardiography and haemodynamic evaluation results showed that peiminine treatment reduced left ventricular end-diastolic pressure, and enhanced maximum rate of increase/decrease of left ventricle pressure (± dP/dt max) and left ventricular systolic pressure, which ameliorate the cardiac function. Secondly, myocardial infarction-induced myocardial injury and infarct size were also attenuated by peiminine. Moreover, peiminine inhibited myocardial infarction-induced increase of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α production, as well as the myocardial cell apoptosis, in the rats. Thirdly, peiminine also decreased the myocardial fibrosis related protein expression including collagen I and collagen III. Lastly, peiminine reduced the expression of p38 and phosphorylation of extracellular signal-regulated kinase 1/2 in rat model of myocardial infarction. In conclusion, peiminine has a cardioprotective effect against myocardial infarction-induced myocardial injury and fibrosis, which can be attributed to the inactivation of mitogen-activated protein kinase pathway.

• Journal of Korean Biological Nursing Science
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• 제3권1호
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• pp.41-52
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• 2001

This study was undertaken to investigate the effects of n-6(corn oil) & n-3(fish oil) fatty acids on infarction size and the cerebral activities of antioxidant enzyme in rat focal brain ischemia model. Weaning Sprague-Dawley rats were fed with either corn oil supplemented diet(COD, 14% corn oil) or fish oil supplemented diet(FOD, 14% menhaden oil) for 6 weeks. The right middle cerebral artery was occluded for 2 hours with a silicon rubber coated nylon surgical thread. After 24 hours of recirculation, the rats were sacrificed and brain sections were photographed using CCD camera after staining with 2, 3, 5-triphenyltetrazolium chloride for 60 minutes in room temperature. The infarcted area was measured and the volume of infarction was calculated. Catalase(CAT), superoxide dismutase(SOD) activities, and fatty acid composition in the brain were also measured. The total and corrected infarction volumes were not significantly different between FOD and COD group. The docosagexaenoic acid(DHA) and DHA content/arachidonic acid(AA) ratio of the cerebral cortex, an index of defense against lipid oxidation, were significantly increased in FOD group compared to those of COD group(p<0.05). In the left cortex(non-infarction side) as well as the right cortex(infarction side) of FOD group, CAT and Cu/Zn SOD activities were higher than those of the COD group(p<0.05). However, CAT and Cu/Zn SOD activities were not significantly different between the left cortex(non-infarction side) and the right cortex(infarction side) of both FOD and COD group. GPx activities were also not significantly different between two groups. Our results demonstrate that the brain infarction size in FOD and COD were not significantly different. However, cerebral lipid composition and antioxidant enzyme activities in FOD and COD group were different. Fish oil, a source of n-3 polyunsaturated fatty acid(PUFA) and corn oil, that of n-6(PUFA) may have a protective effect against oxidative stress induced via different mechanisms.