• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.360-368
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• 2009

Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

• 대한한의학방제학회지
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• 제31권3호
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• pp.145-156
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• 2023

Objectives : This study aimed to select candidate herbal medicines to be used in preclinical studies of cerebral infarction using the network pharmacology research method. Methods : Oral bioavailability (OB), drug likeness (DL), Caco-2, and blood-brain barrier (BBB) permeability were employed in this study's network pharmacology analysis method to choose compounds with potential efficacy. The following formulas were utilized for the values of each variable used in this study: OB ≥ 20%, DL ≥ 0.18, Caco-2 ≥ 0, and BBB ≥ -0.3. The relationships between target proteins and diseases that are assumed to be involved in the chosen bioavailable chemicals were built in a network manner using the aforementioned factors, and proteins thought to play a significant role were identified. Results : Sudan III was obtained as a result of selecting compounds related to ischemic stroke in consideration of pharmacokinetic characteristics such as digestion and absorption and practicality using the TCMSP database. Medicinal herbs Gardeniae Fructus (GF) contains sudan III, and it was confirmed that compounds in GF were highly related to brain diseases, and the mechanism involved through the KEGG pathway was confirmed. GF, which has sudan III related to ischemic stroke and is also involved in other neurological diseases, is expected to be used for ischemic stroke treatment. Conclusions : GF has been predicted to have potential for ischemic stroke treatment, and can be used for future preclinical studies.

• The Journal of Korean Physical Therapy
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• 제12권3호
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• pp.293-310
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• 2000

This study was performed to investigate rehabilitation service patterns of stroke patients in metropolis of Korea. Seoul, Taegu. Taejon, Pusan and Kwangju from April-July. 2000. Authors developed questionnair, and distributed it to each physical therapist. Total number of distributed questionnaire was 800, and 622 questionnaire were collected and analysed. 1. The occurrence rate of ischemic stroke$(51.1\%)$ was higher than hemorrage stroke$(48.9\%)$. The highest incidence of the stroke was noted in the group or60 years and ratio of male to female 1.3:1 2. The several warning sign is motor deficit$(50.3\%)$, headache. dizziness. vomitting$(32.6\%)$ and difficulty speaking or understanding$(8.2\%)$. 3. The most important contributing factor of stroke was hypertension both hemorrage stroke$(50.7\%)$ and ischemic stroke$(47.2\%)$. 4. In the painful stroke patients$(53.4\%)$, the major problems were shoulder pain$(55.1\%)$ and shoulder-hand syndrome$(31.9\%)$. There is no clinical method for relieving the pain. 5. The seasonal preference was winter and autumn followed by summer and spring in regardless of diagnosis. 6. In the surgery, hemorrage stroke$(61.2\%)$ was higher than ischemic stroke$(13.5\%)$. 7. The major associated impairment were motor deficit$(99.0\%)$, hearing and speech deficit$(30.9\%)$.perception deficit$(15.9\%)$. psychological deficit$(14.1\%)$ and vision deficit$(10.6\%)$. We need more role of speech pathologist and psychotherapist. 8. The rehabilitation services for stroke patients were given only $15\%$ by onset. 9. Medical doctor did not checking everyday$(41\%)$. 10. Patents said that the physical therapist well understanding$(60.1\%)$ than medical doctor$(36.2\%)$ about their conditions.

• Investigative Magnetic Resonance Imaging
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• 제22권2호
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• pp.131-134
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• 2018

Susceptibility-weighted imaging (SWI) is well known for detecting the presence of hemorrhagic transformation, microbleeds and the susceptibility of vessel signs in acute ischemic stroke. But in some cases, it can provide the tissue perfusion state as well. We describe a case of a patient with hyperacute ischemic infarction that had a slightly hypodense, patchy lesion at the left thalamus on the initial SWI, with a left proximal posterior cerebral artery occlusion on a magnetic resonance (MR) angiography and delayed time-to-peak on an MR perfusion performed two hours after symptom onset. No obvious abnormal signals at any intensity were found on the initial diffusion-weighted imaging (DWI). On a follow-up MR image (MRI), an acute ischemic infarction was seen on DWI, which is the same location as the lesion on SWI. The hypointensity on the initial SWI reflects the susceptibility artifact caused by an increased deoxyhemoglobin in the affected tissue and vessels, which reflects the hypoperfusion state due to decreasing arterial flow. It precedes the signal change on DWI that reflects a cytotoxic edema. This case highlights that, in some hyperacute stages of ischemic stroke, hypointensity on an SWI may be a finding before the hyperintensity is seen on a DWI.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1063-1068
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• 2000

Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.

• 대한한의학회지
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• 제28권3호통권71호
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• pp.289-298
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• 2007

Objectives : Electrical acupoint stimulation (EAS) has been used to treat motor dysfunction of stroke patients with reportedly effective results. The purpose of this study was to evaluate the efficacy of EAS with different frequencies in treating motor dysfunction of ischemic stroke patients. Methods : The subjects of this study were sixty-two ischemic stroke patients with motor dysfunction at Kyunghee Oriental Medicine Hospital who were hospitalized for one week to one month from onset. They were treated with 2Hz or 120Hz EAS for two weeks, and motor evoked potentials (MEP) were measured before and after EAS treatment. To compare the effect of 2Hz EAS with 120Hz, we measured latency, central motor conduction time (CMCT) and amplitude of MEP before and after EAS treatment. Results : After two weeks of treatment, we compared MEP data of the affected side between the 2Hz group and the 120Hz group. The 2Hz group showed more significant improvement than the 120Hz group in latency, CMCT and amplitude (P=0.008, 0.002, 0.002). In case of the affected side MEP data divided by normal side MEP data, the 2Hz group also showed improvement on latency, CMCT and amplitude with significant differences (P=0.003, 0.000, 0.008). Conclusions : These results suggest that low frequency EAS activates the central motor conduction system better than high frequency EAS, and it means that EAS with low frequency is more helpful for motor recovery after ischemic stroke than that with high frequency.

• 동의생리병리학회지
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• 제22권4호
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• pp.968-974
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• 2008

This study was aimed to investigate the electrolytes and its relationship with acute stroke patients in each stroke type by case-control study. 217 patients with first-ever acute stroke within 2 weeks as the case group(Cases), 146 people without four major risk factors(hypertension, diabetes mellitus, hyperlipidema and ischemic heart disease) as the healthy control group(Normals), and 160 people as the general control group(Controls) were recruited at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital from july 2005 to march 2007 for this case-control study. We analyzed the odds ratio of electrolytes in binary logistic analysis and evaluated each stroke type and general characteristics such as age, sex etc. The level of sodium(Na+) and potassium(K+) were significantly lower in LAA, SVO type of ischemic stroke and hemorrhagic stroke. But the level of chloride(Cl-) had no significant relation with stroke occurance. In this study we demonstrated that low sodium(Na+) and potassium(K+) have an influence on stoke occurance than chloride(Cl-). And we think that the electrolytes must be considered in risk factors of ischemic stroke in Korean and more prospective studies are needed.

• 대한한방내과학회지
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• 제30권2호
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• pp.422-430
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• 2009

Background : Stroke is the second leading cause of death in Korea, following cancer. Stroke consists of ischemic and hemorrhagic stroke, and ischemic stroke can be largely classified as atherothrombotic stroke or embolic stroke. Carotid intima-media thickness (IMT) is an indicator of atherosclerosis used commonly as a screening test for abnormalities of the coronary artery. 24-hour ambulatory ECG is widely used to screen for underlying diseases that causes syncope, palpitation, arrhythmia, etc. Objectives : Since both carotid IMT and 24-hour ambulatory ECG are used to screen for cardiac problems, we endeavored to explore the correlation between carotid IMT and 24-hour ambulatory ECG of stroke patients. Methods : The records of ischemic stroke patients who were admitted to Kyunghee Medical Center Oriental Hospital ward from March 2006 to May 2009 were reviewed. 28 patients who had both carotid Doppler US and 24-hour ambulatory ECG test undertaken during their admission were analyzed. The relationship of abnormal ambulatory results and common carotid artery(CCA) IMT were statistically analyzed using Fisher's exact test and t-test. Results : The mean age of the abnormal ambulatory group was older than the normal group (74${\pm}$ 8.0 vs. 61${\pm}$12.1, p=0.0098). Although insignificant, the abnormal ambulatory group showed much thicker CCA-IMT than normal ambulatory group (2.l7${\pm}$ 1.16 vs. 1.51${\pm}$0.97. p=0.l389). Conclusion: No significant correlation was observed between abnormal ambulatory results and CCA-IMT. However, the difference in CCA-IMT between the two groups was too big to be ignored and further investigation with larger and better controlled trials are warranted.

• 대한한의학회지
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• 제17권1호
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• pp.345-360
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• 1996

Background and Purpose: To evaluate the blood flow velocity using doppler ultrasound of the carotid artery, vertebral artery, and basilar artery in stroke patients Material and Methods: To evaluate the blood flow, I measured the peak systolic velocity and mean velocity of the common carotid artery(CCA), internal carotid artery(ICA), external carotid artery (ECA). vertebral artery(VA), and basilar artery(BA) in 44 stroke patients and 15 healthy adults. To investigate the difference between ischemic stroke patients and normal healthy adults, I selected 44 ischemic stroke patients diagnosed by brain CT and brain MRI, and 15 healthy adults who did not have any symptoms of stroke, hypertension, heart disease, and diabetes melitus. Results: Peak velocity in normal adults was 50.6${\pm}$1.6cm/sec in the CCA, 67.2${\pm}$1.7cm/sec in the ICA, 62.5${\pm}$2.4cm/see in the ECA, 45.5${\pm}$1.9cm/sec VA. and 50.5${\pm}$3.5cm/sec in the BA. Mean velocity in normal adults was 26.9${\pm}$1.1cm/sec in the CCA, 43.7${\pm}$1.4cm/sec in the ICA, 26.7${\pm}$1.3cm/sec in the ECA. 31.6${\pm}$1.9cm/sec in the VA and 33.0${\pm}$2.6cm/sec in the BA. In this study, there was a significant increase in the velocity of ICA, ECA, and VA of ischemic stroke patients in comparison with normal healthy adults. And the blood flow velocity of this study in the CCA and ECA was different from other reported foreign values and the other known values in my country. Conclusion: There was a significant difference in the blood flow velocity between ischemic stroke patients and normal healthy adults. And the blood flow velocity of this study was different from other reported foreign values and the other known values in my country. Therefore, it needs more detailed studies about old aged Korean and ischemic stroke patients than previous studies.

• 대한신경과학회지
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• 제36권4호
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• pp.333-336
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• 2018

Carotid free-floating thrombus (FFT) is a rare cause of stroke. The FFT is commonly associated with an atherosclerotic plaque rupture, but other causes need to be examined in young patients. We report a case of 31-year-old male patient with recurrent ischemic stroke caused by carotid FFT. Although initial laboratory test was unremarkable, recurrent stroke events led us to perform additional study and antiphospholipid syndrome (APLS) was diagnosed. Repetitive testing for APLS seems considerable when young patients present with recurrent stroke.