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Recanalization Rate and Clinical Outcomes of Intravenous Tissue Plasminogen Activator Administration for Large Vessel Occlusion Stroke Patients

  • Min-Hyung Lee;Sang-Hyuk Im;Kwang Wook Jo;Do-Sung Yoo
    • Journal of Korean Neurosurgical Society
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    • v.66 no.2
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    • pp.144-154
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    • 2023
  • Objective : Stroke caused from large vessel occlusion (LVO) has emerged as the most common stroke subtype worldwide. Intravenous tissue plasminogen activator administration (IV-tPA) and additional intraarterial thrombectomy (IA-Tx) is regarded as standard treatment. In this study, the authors try to find the early recanalization rate of IV-tPA in LVO stroke patients. Methods : Total 300 patients undertook IA-Tx with confirmed anterior circulation LVO, were analyzed retrospectively. Brain computed tomography angiography (CTA) was the initial imaging study and acute stroke magnetic resonance angiography (MRA) followed after finished IV-tPA. Early recanalization rate was evaluated by acute stroke MRA within 2 hours after the IV-tPA. In 167 patients undertook IV-tPA only and 133 non-recanalized patients by IV-tPA, additional IA-Tx tried (IV-tPA + IA-Tx group). And 131 patients, non-recanalized by IV-tPA (IV-tPA group) additional IA-Tx recommend and tried according to the patient condition and compliance. Results : Early recanalization rate of LVO after IV-tPA was 12.0% (36/300). In recanalized patients, favorable outcome (modified Rankin Scale, 0-2) was 69.4% (25/36) while it was 32.1% (42/131, p<0.001) in non-recanalized patients. Among 133 patients, non-recanalized after intravenous recombinant tissue plasminogen activator and undertook additional IA-Tx, the clinical outcome was better than not undertaken additional IA-Tx (favorable outcome was 42.9% vs. 32.1%, p=0.046). Analysis according to the perfusion/diffusion (P/D)-mismatching or not, in patient with IV-tPA with IA-Tx (133 patients), favorable outcome was higher in P/D-mismatching patient (52/104; 50.0%) than P/D-matching patients (5/29; 17.2%; p=0.001). Which treatment tired, P/D-mismatching was favored in clinical outcome (iv-tPA only, p=0.008 and IV-tPA with IA-Tx, p=0.001). Conclusion : The P/D-mismatching influences on the recanalization and clinical outcomes of IV-tPA and IA-Tx. The authors would like to propose that we had better prepare IA-Tx when LVO is diagnosed on initial diagnostic imaging. Furthermore, if the patient shows P/D-mismatching on MRA after IV-tPA, additional IA-Tx improves treatment results and lessen the futile recanalization.

The Effects of Jodeungsan Pharmacopuncture at GB20 on Cognitive Impairment Induced by Focal Brain Injury in Rats (풍지(風池)(GB20) 조등산(釣藤散) 약침이 국소 뇌손상으로 유발된 흰쥐의 인지장애에 미치는 영향)

  • Hyun, Min Kyoung;Mo, Min Ju;Hwang, Doo Ree;Yang, Tae Jun;Lee, Jung Hun;Lee, Eun Ji;Yoon, Tae Kyung;Youn, Dae Hwan
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.49-63
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    • 2016
  • Objectives : This research was performed to investigate the effects of Jodeungsan pharmacopuncture(PA-J) of focal brain ischemia induced by middle cerebral artery occlusion(MCAO) in rats. Methods : The subjects were divided into 4 groups : control, acupuncture, pharmacopuncture PA-J1(11.43 mg / 250 g / $40{\mu}{\ell}$) and pharmacopuncture PA-J2(2.29 mg / 250 g / $40{\mu}{\ell}$). The focal brain ischemia was induced by intraluminal filament insertion into the middle cerebral artery. After 3 days of MCAO, Jodeungsan pharmacopuncture treatment was performed on the GB20, and the day after being treated with pharmacopuncture, the Morris water maze test was carried out on the assigned group. The series of processes were administered 6 times. Thereafter mGluR5, density of neuronal cell and ChAT were measured. Results : The results were as follows. 1. The distance to target significantly decreased in the 2nd trial of the Acu group on the water maze test for short-term memory. 2. The distance to target significantly decreased in the 4th trial of the PA-J2 group on the water maze test for long-term memory. 3. The intensity of mGluR5 significantly increased in the PA-J1 group compared with the control group. 4. The neuroprotective effect on the hippocampal CA1 significantly increased in the PA-J1 and PA-J2 groups compared with the control group. 5. The density of ChAT in the hippocampal CA1 significantly increased in the PA-J1 and PA-J2 groups compared with the control group. Conclusion : These results suggest that Jodeungsan pharmacopuncture may improve memory and cognitive impairment and also have neuroprotective effects on focal brain ischemia.

Performance Trial for Developing High - Yielding and Early Maturing Hairy Vetch (Vicia villosa Roth) Cultivar under Double Cropping System (2모작 작부체계 적응 다수성 및 조숙성 헤어리베치 품종 선발을 위한 생산력 검정)

  • Shin, Chung-Nam;Ko, Ki-Hwan
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.31 no.3
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    • pp.243-250
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    • 2011
  • This experiment was conducted to evaluate agronomic characteristics, forage quality and dry matter (DM) yield of early-maturing hairy vetch 'Cold green', 'Haymaker plus', 'Cappello' and medium-late maturing cultivar 'Cheong pa', 'Challenger', 'Hungvillosa' and 'Latigo' at Seongju in the Kyeongbuk from 2009 to 2011. The experiment was arranged in randomized complete block design with three replications. Hairy vetchs were seeded on Sep. 26 and Oct. 11 in 2009 and 2010. Vetch plants were harvested on 30 Apr. in 2010 and 2011. Cold tolerance for Haymaker plus and Cappello were a little lower than other cultivars. Fifty percent-flowering dates of Cold green had earlier than others and Haymaker plus and Cappello were earlier than Cheong pa, Challenger, Hungvillosa and Latigo. Cheong pa and Challenger were ealirer than Hungvillosa and Latigo. The DM yield of Cold green was the highest (p<0.05) of the cultivar except Haymaker plus. Haymaker plus was higher (p<0.05) than others and Cappello, Cheong pa, Challenger were higher (p<0.05) than Hungvillosa and Latigo in 2010. In 2011, the DM yield of Cold green was the highest (p<0.05) of the cultivar and Haymaker plus was higher (p<0.05) than others. Cappello was higher (p<0.05) than Hungvillosa and Latigo. Cheong pa and Challenger were higher (p<0.05) than Latigo. Vetch cultivar was high in crude protein (CP) and low in Acid detergent fiber (ADF). According to the results obtained from this study, it is suggested that early-maturing cultivar would be recommendable for fall sown vetch for DM production.

Effects of Phytic Acid on Viability of Vibrio vulnificus and on Septicemia-Induced Mice (피틴산이 비브리오균의 생존과 마우스의 패혈증에 미치는 영향)

  • Chung, Young-Ho;Park, Woo-Woung;Lee, Sang-Yong;Lee, Sun-Woo;Lim, Chi-Hwan;Yoon, Min-Ho
    • Applied Biological Chemistry
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    • v.49 no.1
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    • pp.15-20
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    • 2006
  • EDTA is known to have bacteriocidal effect on Vibrio vulnificus, pathogen of septicemia by osmotic shock in seafoods. Attempts were made to elucidate the bacteriocidal effect of phytic acid (PA) as a substitute for EDTA against V. vulnificus and its inhibition effect on the septicemia, which induces liver damage of the mice by the pathogen. Viable cells of V. vulnificus with the initial titre of $1.7{\times}10^6$ c.f.u. $ml^{-1}$ decreased by 90.6% after 1 min and 99.6% after 5 min in distilled water. The titre decreased by 65.9% and 94.5% in 2 mM solution of $Mg^{2+}$. In 0.1 mM solution of PA, the rate of decrease in titre was 97.4% after 1 min of incubation and 99.8% after 5 min, compared to 95.7% and 99.8% in 0.1 mM solution of EDTA. The bacteriocidal effect of PA solution at a concentration of 1 mM was marked: the rate of decrease in titre was 99.9% after 1 min. In relation to the bacteriocidal effect, PA was evaluated as a potential therapeutic agent for V. vulnificus septicemia in mouse. When the survival periods of mice were investigated by PA and EDTA treatment after the pathogen injection, the group of mice which infected by a low concentration of the strain survived longer than that inoculated at high concentration; also, the ratio of survival was 1.3 times higher in PA than in EDTA, showing that the fatal rate depended on the inoculation concentration. Although survival periods of mice induced with liver damage by carbon tetrachloride and then inoculated with the strain showed a similar trend, the fatal rate of mice was 2 times faster than those inoculated with only pathogen into normal liver, These results indicate that the infection by V. vulnificus was more fatal to those with liver disease. Also, symptoms of hemorrhage and inflammation on the mice with induced liver damage were reduced in case there was phytic acid treatment at each concentration.

Comparison of Disk Tension Infiltrometer and van Genuchten-Mualem Model on Estimation of Unsaturated Hydraulic Conductivity (장력 침투계(Disk Tension Infiltrometer)와 van Genuchten-Mualem 모형 적용에 따른 불포화수리 전도도의 비교 해석)

  • Hur, Seung-Oh;Jung, Kang-Ho;Park, Chan-Won;Ha, Sang-Keun;Kim, Geong-Gyu
    • Korean Journal of Soil Science and Fertilizer
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    • v.39 no.5
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    • pp.259-267
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    • 2006
  • Hydraulic conductivity is the rate of water flux on hydraulic gradient. The van Genuchten Mualem (VGM) model is frequently used for describing unsaturated state of soils, that is composed with the function of soil water potential and soil water content and requests various parameters. This study is to get the value of VGM parameters used Rosetta computer program based on neural network analysis method and to calculate VGM parameters. VGM parameters included Ko(effective saturated hydraulic conductivity), ${\theta}r$(residual soil water content), ${\theta}s$(saturated soil water content), L, n and m. The unsaturated hydraulic conductivity at 10 kPa was calculated by using Rosetta program. Unsaturated hydraulic conductivities of 17 soil series at 1, 3, 5, 7 kPa were also obtained by applying saturated hydraulic conductivity by disk tension infiltrometer based on Gardner and Wooding's equation. Water flow at the water potential of 3 kPa was very low except Namgye, Hagog, Baegsan, Sangju, Seogcheon, Yesan soil series. Unsaturated hydraulic conductivity at 1 kPa showed the highest value for Samgag soil series and was in order of Yesan, Hwabong, Hagog and Baegsan soil series. Those of Gacheon, Seocheon and Ugog soil series were very low. When the value by VGM was compared with the value by disc tension infiltrometer, there was a tendency with exponential function to soils without gravel but there was no tendency to soils including gravel. Conclusively, it would be limited that VGM model for unsaturated hydraulic conductivity analysis applies to Korean agricultural land including gravel and having steep slope, shallow soil depth.

Effect of Irrigation Starting Point of Soil on Chlorophyll Fluorescence, Stem Sap Flux Relative Rate and Leaf Temperature of Cucumber in Greenhouse (시설 토양 오이재배에서 관수개시점 처리가 광합성 형광반응, 줄기수액흐름 및 엽온에 미치는 영향)

  • An, Jin Hee;Jeon, Sang Ho;Choi, Eun Yong;Kang, Ho Min;Na, Jong Kuk;Choi, Ki Young
    • Journal of Bio-Environment Control
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    • v.30 no.1
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    • pp.46-55
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    • 2021
  • This experiment was conducted to investigate the effect on chlorophyll fluorescence, stem sap flux relative rate (SFRR) and leaf temperature of cucumber when irrigation is controlled using a soil moisture tensiometer. Cucumber (Cucumis sativus L.) 'Chungchun' was irrigated of 10-10-20 kPa and 20-10-10 kPa by soil starting point of irrigation at each growth stage. At the 66 days after treatment (DAT) of 736 to 854 W·m-2 and above 32℃, chlorophyll fluorescence variables (Fo, Fm, Fv/Fm) values showed significantly different between treatments. The Fo and Fv/Fm value in the daytime (10:30 am to 6:00 pm) at 66 DAT was higher in 20-10-10 kPa treatment than in 10-10-20 kPa treatment. The Fv/Fm value decreased when the leaf temperature was increased. There was no difference in leaf growth (length, width and area) at 28 and 66 DAT, but the chlorophyll content (SPAD value) was significantly higher in 20-10-10kPa treatment. SFRR and leaf temperature increased with light intensity and temperature increased. In both treatments, the SFRR started to increase sharply between 8 am and 9 am when the solar radiation is 170 W·m-2 or higher. The soil temperature of the treatments decreased after irrigation, that showed 31.0℃ at 10-10-20kPa and 28.5℃ at 20-10-10kPa on July 5 (820W·m-2 at 1 pm). However, there was no difference in SFRR, leaf temperature, temperature difference (leaf temperature - air temperature) and VPD between treatments. SFRR was significantly positive correlate with the leaf temperature (p < 0.01, r = 0.770). The SFRR and leaf temperature showed positive significant correlation with solar radiation, temperature, soil temperature, soil moisture content and VPD. There was a negative significant correlation with relative humidity and temperature difference.

The Changes in Carbon Stocks and Emissions Assessment of Harvested Wood Products in Korea (우리나라의 수확된 목제품 탄소축적 변화량 및 배출량 평가)

  • Choi, Soo Im;Kang, Hag Mo
    • Journal of Korean Society of Forest Science
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    • v.96 no.6
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    • pp.644-651
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    • 2007
  • This study compared and estimated the changes in carbon stocks and emissions of harvested wood products (HWP) by applying FAO statistics and domestic statistics for Korean HWP production, import, and export volume, which is almost always supposed to be included in the carbon emissions and removals inventory by country in negotiations since the 2nd commitment period (2013~2017) of the Kyoto Protocol, for assessing the changes in carbon stocks and emissions of HWP. As a result, when applying FAO statistics to the changes in carbon stocks of HWP as of 2005, stock-change approach (SCA) was estimated at 1.434 Tg C, atmospheric-flow approach (AFA) -1.330 Tg C, and production approach (PA) 0.597 Tg C. When applying Korean statistics, SCA was estimated at 1.246 Tg C, AFA -11.520 Tg C, and PA 0.444 Tg C. When applying FAO statistics to $CO_2$ emissions and removals from HWP, SCA showed a decrease of $-5,258Gg\;CO_2$ (removals), AFA showed an increase of $4,877Gg\;CO_2$ (emissions), and PA showed a decrease of $-2,189Gg\;CO_2$ (removals). When applying Korean statistics, SCA showed a decrease of $-4,569Gg\;CO_2$ (removals), AFA showed an increase of $5,573Gg\;CO_2$ (emissions), and PA showed a decrease of $-1,628Gg\;CO_2$, (removals). Therefore, the application of FAO statistics was shown to be more beneficial for the estimation of both the changes in carbon stocks and emissions of HWP by all methods other than that of Korean statistics.

A Study of Hydrodenitrogenation of Quinoline Catalyzed by Sulfided $Ni-Mo/\gamma - Al_2O_3$ (황화 $Ni-Mo/\gamma - Al_2O_3$ 촉매상에서 Quinoline의 수소첨가탈질반응에 관한 연구)

  • 최응수;이원묵;김경림
    • Journal of Korean Society for Atmospheric Environment
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    • v.5 no.1
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    • pp.52-61
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    • 1989
  • The hydrodenitrogenation of quinoline dissolved in n-heptane was studied over sulfided Ni-Mo/$\gamma-Al_2O_3$ catalyst at the range of the temperature between 553 K and 673 and the total pressure between $20 \times 10^5$ Pa and $60 \times 10^5$ Pa in a fixed bed flow reactor. Quinoline conversion was very high at relatively low temperature and total pressure, and decreased with quinoline partial pressure. The thermodynamic equilibrium between quinoline and Py-THQ existed in wide ranges of experimental conditions and shifted in favor of quinoline at higher temperature. At the range of the temperature betwwen 553 K and 673 K and at the total pressure $60 \times 10^5$ Pa, the quinoline reaction rate was 1st order with respect to the concentr4ation of quinoline and its apparent activation energy was 7.15 Kcal/mole.

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A Study on the Usefulness of Styrofoam Wedge for Wrist True PA and Lateral examination (WRIST TRUE PA와 LATERAL 검사 시 경사보조도구의 유용성 분석)

  • Jeon, Sang-Hyun;Kim, Gab-Jung;Kim, Nak-Sang;Seo, Sun-Youl;Choi, Seon-Wook;Jeon, Min-Cheol
    • Journal of the Korea Convergence Society
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    • v.11 no.2
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    • pp.53-60
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    • 2020
  • The purpose of this paper is to evaluate the image of the Styrofoam Wedge that can minimize the position change by supporting the wrist during the True PA and lateral examination of the wrist. In 50 people, the gap between the distal radius joint facet and the wrist bone was measured after the wrist True PA and lateral images were obtained using a general examination(vertical), tube angle(vertical:10°, lateral:20°) and Styrofoam Wedge(vertical). When joint spacing was measured in the True PA and lateral images of the wrist, general examination(5.54mm, 9.42mm), tube angle(2.05mm, 5.07mm) and Styrofoam Wedge(1.79mm, 5.46mm) were shown to be small. The smaller the joint spacing, the easier it is to observe that is open. Therefore, True PA and lateral imaging of the wrist Styrofoam Wedge can reduce the distortion of the image and thus acquire images of high diagnostic value. In addition, it may be possible to reduce the deviation caused by the change of patient's position during re-projection.

Comparison of Two Methods of Recruiting the Acutely Injured Lung (급성 폐손상에서 폐를 Recruit시키는 방법간의 비교 연구)

  • Suh, Gee-Young;Kang, Kyeong-Woo;Park, Sang-Joon;Kim, Ho-Choel;Young, Lim-Si;Chung, Man-Pyo;Han, Jeong-Ho;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.500-512
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    • 2000
  • Background : To evaluate the efficacy of two methods of obtaining lung recruitment to reduce ventilator-induced lung injury(VILI). Methods : Fifteen New-Zealand white rabbits were ventilated in the pressure-controlled mode while maintaining constant tidal volume(10 ml/kg) and fixed respiration rate. Lung injury was induced by repeated saline lavage (PaO2<100 mmHg), and the pressure-volume curve was drawn to obtain Pflex. The animals were then randomly assigned to three groups and ventilated for 4 hours. In the control group(n=5), positive end-expiratory pressure(PEEP) less than that of Pflex by 3 mmHg was applied throughout the study. In the recruitment maneuver(RM) group(n=5), RM(CPAP of 22.5 mmHg, for 45 seconds) was performed every 15 minutes in addition to PEEP level less than Pflex by 3 mmHg This phrase is unclear. In the Pflex group, PEEP of Pflex was given without RM. Gas exchange, lung mechanics, and hemodynamics parameters as well as pathology were examined. Results : 1) Both the control and RM groups showed decreasing tendency in PaO2 with time. There was significantly decreased PaO2 at 4 hr compared to Ihr(p<0.05). But in the Pflex group, PaO2 did not decrease with time(p<0.05 vs other groups at 3, 4 hr). PaCO2 did not show significant difference among the three groups. 2) There was no significant difference in static compliance and plateau pressure. Mean blood pressure and heart rate also did not show any significant difference among the three groups. 3) The pathologic exam showed significantly less neutrophil infiltration in the Pflex group than in the control group(p<0.05). There was borderline significant difference in hyaline membrane score among the groups (p= 0.0532). Conclusion : Although recruitment maneuver of the injured lung may be important in decreasing VILI, it alone may not be sufficient to minimize VILI.

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