• Title/Summary/Keyword: Ischemic Cerebrovascular Diseases

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Surgical Complication and Its Management in Ischemic Stroke (허혈성뇌졸중의 수술치료시 동반되는 합병증과 관리)

  • Kim, Dal Soo;Yoo, Do Sung;Huh, Pil Woo;Cho, Kyoung Suok;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1107-1112
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    • 2000
  • Recently various operative procedures including microsurgery or endovascular surgery have been increasing for the management of ischemic cerebrovascular diseases. Carotid endarterectomy(CEA), extracranial-intracranial(EC-IC) arterial bypass, embolectomy, decompressive craniectomy, arterial transposition, intravascular thrombolysis, and percutaneous transarterial angioplasty and stenting (PTAS) are available surgical modalities for ischemic stroke. This article focuses the complications and perioperative management of patients treated with CEA and carotid PTAS among various surgical managements for ischemic stroke.

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Imaging Hypoxic Myocardium (심근 저산소증 영상)

  • Bae, Sang-Kyun
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.141-145
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    • 2005
  • Hypoxia (decreased tissue oxygen tension) is a component of many diseases such as tumors, cerebrovascular diseases and ischemic heart diseases. Although hypoxia can be secondary to a low inspired $pO_2$ or a variety of lung disorders, the most common cause is ischemia due to an oxygen demand greater than the local oxygen supply. In the heart tissue, hypoxia is often observed in persistent low-flow states, such as hibernating myocardium. Direct "hot spot" imaging of myocardial tissue hypoxia is potentially of great clinical importance because it may provide a means of identifying dysfunctional chronically ischemic but viable hibernating myocardium. A series of radiopharmaceuticals that incorporate nitroimidazole moieties have been synthesized to detect decreased local tissue pO2. In contrast to agents that localize in proportion to perfusion, these agents concentrate in hypoxic tissue. However, the ideal agents are not developed yet and the progress is very slow. Furthermore, the research focus is on tumor hypoxia nowadays. This review introduces the myocardial hypoxia imaging with summarizing the development of radiopharmaceuticals.

Municipal Disease Burden Attributable to Heat Wave (기초자치단체의 폭염으로 인한 온열 및 심뇌혈관질환 부담)

  • Lee, Suehyung;Shin, Hosung
    • Korean Journal of Health Education and Promotion
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    • v.31 no.4
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    • pp.51-62
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    • 2014
  • Objectives: The objective of study was to calculate the municipal level environmental burden of disease (EBD) due to heat wave. Methods: The data used were Korea National Health Insurance 2011 claim data and 2011 death registry. Heatwave related diseases included hypertensive heart diseases, ischemic heart diseases, cerebrovascular disease, and heat related illness. According to the method that WHO proposed, the study computed population-attributable fraction with relative risk which come from previous study and proportion of exposure which the study calculated with historical meteorology data. Results: The Average of 251 municipal EBD was 2.11 per thousand persons. The value of years lost due to disability was 11 times higher than that of years of life lost. On average EBD of county and southern geographical areas tended to be higher than those of District or city areas. The relationship between municipal deprivation index (composite deprivation index) and EBD showed the positive association, which means that the worse deprived municipal is, the higher EBD takes. Conclusions: Climate change is getting one of the major risk factors of cardio-cerebrovascular disease, which is the second leading cause of death. The study results suggested the urgent policy planning and reaction of climate change adaptation.

Physiological approach of CADASIL animal model and its predictable implication (CADASIL 동물모델의 생리학적 접근 및 연구적 가치의 예측)

  • Jung, Sung-Cherl;Ko, Eun-A
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.55-59
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    • 2019
  • Cerebral vessels are functionally and structurally specialized to provide adequate blood flow to brain which shows high metabolic rates. Cerebral hemorrhage or ischemic infarction due to cerebrovascular injury or occlusion can cause the immediate brain damage, and if not treated rapidly, can lead to serious or permanent brain damages, and sometimes life-threatening. Unlike these popular cerebrovascular diseases, there are diseases caused by genetic problems. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is one of them. CADASIL does not show the high incidence, but it is considered to be significantly affected by regional obstructiveness such as islands and therefore, to be an important genetic disease in Jeju. This paper aims to summarize the possibility of animal model research that can provide preclinical data for CADASIL disease research and to evaluate its applicability in future research plans.

One Case of Stroke in Childhood (소아중풍(小兒中風) 환자(患者)에 대한 치험(治驗) 1례(例))

  • Park, Eun-Jung;Lee, Hai-Ja;Na, Won-Kyeung;Jang, Sung-Jin;Ahn, Jai-Sun;Han, Kyeung-Hoon
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.2
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    • pp.21-30
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    • 2004
  • Objectives : The purpose of this study is case report of stroke in childhood. The childhood cerebrovascular diseases are interesting than those seen in adulthood, because the etiology and prognosis of the disease in children are quite different from those of adults. Cerebrovascular diseases in children is more common than once recognized. However, relatively little attention has been paid to the epidemiology of childhood stroke. Methods : We experienced one case of ischemic stroke in childhood whose symptoms are similar to that of adults. There is no evidence of cerebrovascular malformation at MRI, MRA film. The cause of stroke is undetermined and just we can see the little infarction lesion on Lt. pons. We treated the patient with herb medicine, acupuncture-Tx, negative-Tx, moxa-Tx and physical treatment. Results : After the treatment of oriental medicine, the patient recovered from the stroke symptoms. Conclusion : we thought that the more follow-up is needed. So we repoert one case of cerebral infarction in children that recovered from stroke symptoms after the treatment of oriental medicine.

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Brain Hypoxia Imaging (뇌 저산소증 영상)

  • Song, Ho-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.91-96
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    • 2007
  • The measurement of pathologically low levels of tissue $pO_2$ is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowaday have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. $^{18}F-MISO$ PET and $^{99}mTc-EC-metronidazole$ SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using $^{123}I-IAZA$ in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.

Prediction of cerebral infarction suppression mechanism of the Sagunja-Tang through network pharmacology analysis (네트워크 약리학 분석을 통한 사군자탕(四君子湯)의 뇌경색 억제 기전 예측)

  • Lim, Chiyeon;Lee, Byoungho;Cho, Suin
    • Herbal Formula Science
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    • v.30 no.4
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    • pp.293-304
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    • 2022
  • Objectives : Sagunja-Tang is a famous prescription used in Korean medicine for the purpose of promoting vital energy, and there are few studies using Sagunja-Tang on cerebrovascular diseases yet. As previous studies confirmed that Sagunja-tang is highly likely to be used effectively for stroke, this study was intended to predict the mechanism through which Sagunja-tang would act effectively on stroke. Methods : In this study, a network pharmacology analysis method was used, and oral bioavailability (OB), drug likeness (DL), Caco-2 and BBB permeability were utilized to select compounds with potential activity. For the values of each variable used in this study, OB ≥ 30%, DL ≥ 0.18, Caco-2 ≥ 0, and BBB ≥ 0.3 were applied. Using the above variables, the relations between target genes and diseases that are presumed to be involved in the selected bioavailable compounds were constructed in a network format, and proteins thought to play a major role were identified. Results : Among the compounds included in Sagunja-Tang, 26 bioavailable compounds were selected and it was confirmed that these compounds can be effectively used in cerebrovascular diseases such as Alzheimer's disease and stroke. These compounds are considered to act on proteins related in cell death and growth. The most important mechanism of action was predicted to be apoptosis, and the protein that is thought to play the most key action in this mechanism was caspase-3. Conclusions : In our future study, Sagunja-Tang will be used in an ischemic stroke mouse model, and the mechanism of action will be explored focusing on apoptosis and cell proliferation.

Effect of Bambusae Caulis in Liquamen(Jukryuk) on Ischemic Damage to 4 Vessel Occlusion and Middle Cerebral Artery Occlusion in Mice (죽력(竹瀝)이 흰쥐의 중대뇌동맥(中大腦動脈) 및 전뇌허혈(全腦虛血) 폐쇄 허혈모델에 미치는 영향)

  • Kim, Jae-Hong;Hong, Jin-Woo;Na, Byung-Jo;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Cham-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.629-640
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    • 2008
  • Objective : The purpose of this study was to investigate the neuroprotective effect of Jukryuk on 4-vessel occlusion(4-VO) and middle cerebral artery (MCA) ischemia. Method : After administration of Jukryuk, we compared the Jukryuk-treated group, the control, and the sham groups, in view of several points as follows 1) We evaluated the damage characterized by coagulative cell change of pyramidal neurons and pronounced gliosis in each group 2) We counted the number of normal pyramidal shapes after ischemia in each group 3) Immunohistochemistry (cyclooxygenase-2) 4) In focal ischemic injury model, we measured the volume of ischemic area Results : In this experiment, the effect of Jukryuk was determined to be protecting neuron cell shape, reducing the number of neuron cells damaged by ischemia and the volume of the ischemic area. In immunohistochemistry, Jukryuk reduced cyclooxygenase-2 expression Conclusions : According to this study, Jukryuk can protect neuron cells from injury by cerebrovascular ischemia.

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Age-period-cohort Analysis of Cardiovascular Disease Mortality in Japan, 1995-2018

  • Okui, Tasuku
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.3
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    • pp.198-204
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    • 2020
  • Objectives: This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis. Methods: We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases' mortality rates into age, period, and cohort effects. Results: The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later. Conclusions: The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.

A Study on the Management of Non-Communicable Disease in Fiji (피지에서의 만성병 관리)

  • Kim, Daeseon;Romakin, Pablo;Rafai, Eric;Lee, Chulwoo
    • Journal of Appropriate Technology
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    • v.6 no.2
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    • pp.163-173
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    • 2020
  • For the successful execution of an ODA project, it is necessary to know what areas are weak and necessary to the country of demand exactly. The health sector is also a top priority in most of developing countries. This study was carried out to introduce non-communicable disease (NCD) in Fiji for ODA projects planning. The major causes of death in Fiji in 2016 are diabetes, ischemic heart disease, cerebrovascular disease, chronic kidney disease, lower respiratory infect, asthma in ranking. The major causes of death in Korea in same year are cancer, ischemic heart diseases, cerebrovascular diseases, pneumonia, suicide, diabetes in the order of ranking. The chronic disease as non-communicable disease (NCD) has been increasing continuously due to changes in lifestyle and consumption patterns and population aging in prevalence rate. This global trend is also apparent in Fiji and Korea, reflected in increasing mortality and personal costs for the treatment and management of NCD. The need for a sustained comprehensive treatment tailored for individual patients has suggested from many studies and the development of a systematic program to manage NCD patients to provide such care have been recommended. The Fiji government developed Non-communicable Diseases Strategic Plan 2015-2019 and has tried to reduce the prevalence rate of non-communicable diseases by factors. The WHO global action plan guiding national-level NCD policies requires an NCD prevention and control model at the community level, presenting strategic goals and detailed options for the introduction and application of the approach to communities. It is necessary to develop an NCD prevention and control model, consisting of a strategy of community intervention, education for students and NCD patients, and the legal enactment of NCD that adequately meets the needs of community members.