• Title/Summary/Keyword: Ischemic cerebral disease

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Prospective Evaluation of the G-protein $\beta$3 Subunit (GNB3) Gene 825T Polymorphism is Associated With Cerebral Infarction in Korean Population (한국인의 G Protein $\beta$3 Subunit유전자의 다형성과 뇌혈관 질환과의 상관성에 대한 연구)

  • Choi Min Hee;Lee Jin Woo;Lee Kyung Jin;Lee Hyo Jung;Rho Sam Woong;Choi Hyun;Cho Ki Ho;Hong Moo Chang;Shin Min Kyu;Kim Young Suk;Bae Hyun Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.3
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    • pp.719-727
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    • 2003
  • Background and purpose: Hypertension and obesity has been implicated in the most important risk factors for stroke. The original finding that the G-protein beta3 subunit (GNB3) C825T allele associates with essential hypertension and obesity has been confirmed in several different populations. Hence, our objective was to determine whether the GNB3 C825T polymorphism predicts interindividual variation in stroke. Method: We recruited 361 stroke patients (cerebral infarction, n=278; intracerebral hemorrhage (ICH), n=83) and 199 healthy control subjects. Subjects were genotyped for GNB3 C825T mutation and findings were investigated for association with stroke. Result: The GNB3 T/T type was significantly associated with cerebral infarction prevalence (OR, 1.98; 95% Cl, 1.14-3.46; p=0.015). While, ICH was not found to be significantly associated with GNB3 T/T type (OR, 1.63; 95% ICH, 0.74-3.56; p=0.219). Similarly, no significant association was determined between GNB T/C type, and cerebral infarction (OR, 1.09; 95% Cl, 0.68-1.74; p=0.716), and ICH (OR, 1.14; 95% Cl, 0.59-2.21; p=0.697). Conclusion: In clinical characteristics, this study shows no differences among GNB3 genotypes, that are BMI, WH ratio. hypertension rate, and ischemic heart disease rate, total lipid level, triglycerides level, total cholesterol level, HDL cholesterol level, prothrombine time, with the exception of LDL cholesterol concentrations. However, our subjects showed an inverse relationship between LDL cholesterol level and the risk of cerebral infarction. We have shown that the GNB3 T/T genotype is strongly associated with cerebral infarction. (OR, 1.98; 95% Cl, 1.14-3.46; p=0.015).

Socioeconomic Differentials in Stroke and Cardiovascular Disease Mortality in Korea (소득계층에 따른 뇌심혈관질환 사망률 차이)

  • Im Jeong-Soo;Choi Dae-Kyung;Yim Jun;Hong Du-Ho;Kim Jong-Kyun;Park Sang-Hyun;Youn Sung-Tae
    • Korean Journal of Health Education and Promotion
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    • v.23 no.2
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    • pp.109-119
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    • 2006
  • Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA (모야모야병(moyamoya disease) 환자의 전신마취 하 치과 치료)

  • Sang, Eun Jung;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.108-113
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    • 2017
  • Moyamoya disease is a disorder in which certain arteries in the brain are constricted. Blood flow can be blocked by the constriction and blood clots. The patients frequently experience transient ischemic attacks (TIA), cerebral hemorrhage, or may not experience any symptoms at all. It is reported that they have a higher risk of recurrent stroke and a distinct underlying pathophysiology. A 3-year-8-month old boy with moyamoya disease experienced cerebral infarctions five times, and he underwent a cerebrovascular anastomosis surgery four years ago. He showed swallow disturbance, general delayed development, hemiplegia, and strabismus. Also he had hypocalcified teeth with or without multiple caries lesions in all dentitions. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation. Moyamoya disease is associated with various medical conditions requiring a thoughtful deliberation and a careful examination before and during dental treatment. Pain and anxiety control during dental treatment is important because hyperventilation induced by crying has been seen to trigger TIA. Both isoflurane and sevoflurane are commonly used in patients with MMD, but dynamic autoregulation is better preserved during sevoflurane than isoflurane anesthesia. So sevoflurance general anesthesia may be recommendable to manage dental patients having multiple caries with moyamoya disease.

Clinical study on the estimation of blood flow velocity using doppler ultrasound of the cerebral artery in stroke patients (도플러 초음파를 이용한 중풍환자(中風患者)의 뇌혈관(腦血管) 혈류측정(血流測定)에 관한 임상적(臨床的) 연구(硏究) (경동맥(頸動脈), 추골동맥(椎骨動脈) 및 기저동맥(基底動脈)을 중심으로))

  • Chang, In-Su;Sun, Jungn-Ki
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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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.

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A Hospital-based Case-control Study on the Risk Factors of Cerebrovascular Disease (뇌혈관질환의 위험요인에 대한 환자 - 대조군 연구)

  • Kim, Jang-Rak;Hong, Dae-Yong;Park, Sung-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.473-486
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    • 1995
  • A hospital-based, matched case-control study was carried out to evaluate the relation ship of various suspected risk factors including snoring and serum level of cholesterol to cerebrovascular disease in Korea. A total of 127 incident cases of cerebrovascular disease(74 cases of cerebral infarction and 53 cases of intracerebral hemorrhage) admitted to. the department of neurology in a university hospital from December, 1993 to March, 1995 were compared with 127 matched controls admitted to same hospital in same period. A multivariate analysis suggested that ECG abnormality(left ventricular hypertrophy and atrial fibrillation), family history of cerebrovascular disease, fundoscopic abnormality, previous history of transient ischemic attack and hypercholesterolemia were risk factors of cerebrovascular disease, ECG abnormality, fundoscopic abnormality, smoking and hypercholesterolemia were also suggested as risk factors of cerebral infarction.

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Study on the Correlation between Homocysteine and Serum Lipids in Cerebral Infarction Patients (뇌경색 환자의 Homocysteine 농도와 혈중 지질농도와의 상관성 연구)

  • Nam, Sang-Kyu;Ko, Mi-Mi;Lee, Jung-Sup;Shin, Yoang-Jin;Jeon, Ji-Young;Seol, Jae-Gyun;Ko, Seok-Jae;Lee, Seon-A;Seong, Ki-Ho;Lee, In;Shin, Sun-Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.219-224
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    • 2009
  • This study was aimed at investigating the correlation between Homocysteine and Serum Lipids in Cerebral Infarction Patients. This study was done with 69 cases of cerebral infarction patients who admitted to department of the internal medicine Jeonju Oriental Medical hospital, Wonkwang University from June in 2007 to May in 2008 and with 46 people without 6 major risk factors (hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, past history of CVA and TIA) as control group recruited at department of the internal medicine Iksan Oriental Medical hospital, Wonkwang University from March in 2008 to March in 2008. The general characteristics along with blood homocysteine and serum lipids are recorded and analyzed according to blood homocysteine levels. A total of 69 patients and 46 control groups were included in the trial. In cerebral infarction patients, total cholesterol, LDL-cholesterol, triglyceride were increased according to concentration of homocysteine, but no statistical significance was noted in this study. The Correlation between Homocysteine and Serum Lipids was not proven. Further research on the subject is needed.

Effects of Folium Perillae on cytokine productions in ischemic rats (소엽(蘇葉) 추출물이 뇌허혈이 유발된 백서의 cytokine분비에 미치는 영향)

  • Yang, Gi-Ho;Kim, Hyung-Woo;Cho, Su-Jin;Kim, Sang-Dae;Yoon, Kwan-Hee;Kim, Bu-Yeo;Jeong, Hyun-Woo;Cho, Su-In
    • The Korea Journal of Herbology
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    • v.22 no.3
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    • pp.93-99
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    • 2007
  • Objective : The present study was carried out to investigate the effects of Folium Perillae (FP) on several cytokine production such as IL-1$\beta$, TNF-$\alpha$, IL-10 and TGF-$\beta$ to determine related mechanisma in Rats. Methods: So, we investigated the effects of FP on levels of several cytokines such as IL-l$\beta$, TNF-$\alpha$, IL-10 and TGF-$\beta$ in ischemic rats. Results: In this experiment, IL-10, an immune-modulatory cytckine, level was elevated by treatment with FP, but another regulatory cytokine, TGF-$\beta$1 level was not affected. On the other hand, levels of IL-l$\beta$ and TNF-$\alpha$, an inflammatory cytokines, were lowered by treatment with FP effectively. Conclusion : In conclusion, these results suggest that FP is useful to treat patient with disease related to cerebral ischemia, because FP can elevate IL-10 level, lower IL-l$\beta$ and TNF-$\alpha$ levels.

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The Neuroprotective Activities of the Sam-Hwang-Sa-Shim-Tang in the Transient Ischemic Model in Rats.

  • Kim, Min-Sun;Hwang, Young-Sun;Ryu, Jong-Hoon
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 2001.11a
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    • pp.85-85
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    • 2001
  • Sam-Hwang-Sa-Shim-Tang(SHSST), a traditional Chinese medicine, composed of Rhei rhizoma, Scutellaria radix, and Coptidis rhizoma were used in the several disease including hypertension, constipation, and hemorrhage. In the present study, we investigated the neuroprotective effects of SHSST and its ingredients on the ischemia/ reperfusion-induced brain injury was evaluated in the rat brain. Ischemia was induced by intraluminal occlusion of the right middle cerebral artery for 120 min and reperfusion was continued for 22 h. SHSST (450 mg/kg), Rhei rhii oma (100 mg/kg), Coptidis rhizoma (100 mg/kg), and Scutellaria radik (100 mg/kg) were orally administered twice, promptly prior to reperfusion and 2 h after the repefusion. Total infarction volume in the ipsilateral hemisphere of ischemia/ reperfusion rats was significantly lowed by the treatments of SHSST (39.2%) and Scutellaria radix (66.5%). However, Coptidis rhizoma did not show any significant effects on the total infarct volume. The inhibiting effect of Scutellaria radix on the total infarct volume was more potent than that of SHSST. In addition, Scutellaria radix significantly inhibited myeloperoxidase (MPO) activity, an index of neutrophil infiltration in ischemic brain tissue. However, there was marked mismatch between total infarct volume and MPO activity in the Scutellaria radix-treated rats. Our findings suggest that Scutellaria radix as an ingredient of SHSST plays a protective role in ischemia-induced brain injury by inhibiting neutrophil infiltration. The effects of Rhei rhizoma on transient brain ischemia-induced neuronal injury are under study.

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The Effect of Woohwangcheongsim-won on Circulatory Disturbance in Diabetes (우황청심원이 당뇨병 Rat의 혈액순환장애에 미치는 영향)

  • 황성록;정승현;신길조;이원철
    • The Journal of Korean Medicine
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    • v.23 no.2
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    • pp.164-179
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    • 2002
  • Object: Death rate due to hypertension, atherosclerosis, ischemic heart disease and cerebral infarction induced by Westernized diet and increased average life span is on the rise. Decrease in blood circulation, activation of thrombus generation and intravascular lipid accumulation, cited as the principal causes of the above mentioned diseases in recent studies, result in circulatory disturbance and blood vessel obstruction leading to ischemic cell death of heart, brain and peripheral vessels. Method: We investigated the biochemical changes in microvascular permeability, aggregation of platelet and the intravascular lipid accumulation in induced-diabetic rat using Streptozotocin. We also studied the effects of Woohwangcheongsirn-won after oral administration on blood circulation, platelet function and lipid metabolism. The results are as follows: I. Woohwangcheongsim-won increased blood circulation in microvessels. 2. Woohwangcheongsim-won increased the reduced erythrocyte deformability in diabetes. 3. Woohwangcheongsim-won induced the reduction of contents of 2, 3-DPG, but failed to affect the reduced contents of ATP in erythrocyte in diabetes. 4. Woohwangcheongsim-won reduced the activity of Ca/sup 2+/-ATPase in the membrane of erythrocyte. 5. Woohwangcheongsim-won reduced the platelet aggregation evoked by platelet agglutinin factor. 6. Woohwangcheongsim-won reduced the production of platelet-derived granules. 7. Woohwangcheongsim-won reduced the production of metabolites of arachidonic acid in diabetes, and also reduced the production of increased thromboxane B2. 8. Woohwangcheongsim-won reduced the synthesis of oxidized LDL-cholesterol. In conclusion, Woohwangcheongsim-won enhanced blood circulation in microvesseles, erythrocyte deformability and inhibited the increased platelet aggregation and the synthesis of oxidized LDL-cholesterol in diabetes. Therefore Woohwangcheongsim-won is believed to positively affect blood circulation (J Korean Oriental Med 2002;23(2):164-179)

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Can Transradial Mechanical Thrombectomy Be an Alternative in Case of Impossible Transfemoral Approach for Mechanical Thrombectomy? A Single Center's Experience

  • Cho, Hyun Wook;Jun, Hyo Sub
    • Journal of Korean Neurosurgical Society
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    • v.64 no.1
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    • pp.60-68
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    • 2021
  • Objective : Until recently, the transfemoral approach (TFA) was used as the primary method of arterial approach in acute ischemic stroke (AIS). However, TFA resulted in longer reperfusion times and worse outcomes in the mechanical thrombectomy (MT) of patients with complex aortic arches and significant carotid tortuosity. We found that the transradial approach (TRA) is a more favorable alternative approach for MT in such cases. Methods : We performed a retrospective review of our institutional database to identify 202 patients who underwent MT for AIS between February 2015 and December 2019. Patient characteristics, cause of TFA failure, procedure time, intra-procedural complications, and outcomes were recorded. Results : Eleven (5.4%) of 202 patients, who underwent MT for AIS, crossed over to TRA for recanalization, and eight (72%) of 11 achieved successful recanalization (≥modified Treatment in Cerebral Infarction 2b). The mean age (mean±standard deviation [median]) was 82.3±6.6 (76) years, and five of the 11 patients were male. The last seen normal to puncture time was 467.9±264.72 (264) minutes; baseline National Institutes of Health Stroke Scale score was 28.9±14.5 (16). Six (55%) of the 11 patients had right vertebrobasilar occlusions, and the remaining five (45%) had anterior circulation occlusive disease. The time from groin puncture to final recanalization time (overall procedural time) was 78.0±20.1 (62) minutes. The mean crossover time from TFA to TRA was 45.2±10.5 (41) minutes. The mean time from radial puncture to final recanalization was 33.8±10.5 (28) minutes. Distal thrombus migration events in previously unaffected territories occurred in 3/8 patients (37%). At 90 days, three patients (28%) had a favorable clinical outcome. Conclusion : Although rare, failure of TFA has been known to occur during MT for AIS. Our results demonstrate that TRA may be an alternative option for AIS intervention for select patients with subsequent timely revascularization. However, the incidence of distal thrombus migration was high, and the first puncture to reperfusion time was prolonged because of the time taken for the crossover to TRA after failure of TFA. This study provides some evidence that the TRA may be a viable alternative option to the TFA for MT of AIS.