• Title/Summary/Keyword: Subacute infarction

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Milk Fat Globule-Epidermal Growth Factor VIII Ameliorates Brain Injury in the Subacute Phase of Cerebral Ischemia in an Animal Model

  • Choi, Jong-Il;Kang, Ho-Young;Han, Choongseong;Woo, Dong-Hun;Kim, Jong-Hoon;Park, Dong-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.163-170
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    • 2020
  • Objective : Milk fat globule-epidermal growth factor VIII (MFG-E8) may play a key role in inflammatory responses and has the potential to function as a neuroprotective agent for ameliorating brain injury in cerebral infarction. This study aimed to determine the role of MFG-E8 in brain injury in the subacute phase of cerebral ischemia in a rat model. Methods : Focal cerebral ischemia was induced in rats by occluding the middle cerebral artery with the modified intraluminal filament technique. Twenty-four hours after ischemia induction, rats were randomly assigned to two groups and treated with either recombinant human MFG-E8 or saline. Functional outcomes were assessed using the modified Neurological Severity Score (mNSS), and infarct volumes were evaluated using histology. Anti-inflammation, angiogenesis, and neurogenesis were assessed using immunohistochemistry with antibodies against ionized calcium-binding adapter molecule 1 (Iba-1), rat endothelial cell antigen-1 (RECA-1), and bromodeoxyuridine (BrdU)/doublecortin (DCX), respectively. Results : Our results showed that intravenous MFG-E8 treatment did not reduce the infarct volume; however, the mNSS test revealed that neurobehavioral deficits were significantly improved in the MFG-E8-treated group than in the vehicle group. Immunofluorescence staining revealed a significantly lower number of Iba-1-positive cells and higher number of RECA-1 in the periinfarcted brain region, and significantly higher numbers of BrdU- and DCX-positive cells in the subventricular zone in the MFG-E8-treated group than in the vehicle group. Conclusion : Our findings suggest that MFG-E8 improves neurological function by suppressing inflammation and enhancing angiogenesis and neuronal proliferation in the subacute phase of cerebral infarction.

Quantitative Analysis of MR Image in Cerebral Infarction Period (뇌경색 시기별 MR영상의 정량적 분석)

  • Park, Byeong-Rae;Ha, Kwang;Kim, Hak-Jin;Lee, Seok-Hong;Jeon, Gye-Rok
    • Journal of radiological science and technology
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    • v.23 no.1
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    • pp.39-47
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    • 2000
  • In this study, we showed a comparison and analysis making use of DWI(diffusion weighted image) using early diagnosis of cerebral Infarction and with the classified T2 weighted image, FLAIR images signal intensity for brain infarction period. period of cerebral infarction after the condition of a disease by ischemic stroke. To compare 3 types of image, we performed polynomial warping and affined transform for image matching. Using proposed algorithm, calculated signal intensity difference between T2WI, DWI, FLAIR and DWI. The quantification values between hand made and calculated data are almost the same. We quantified the each period and performed pseudo color mapping by comparing signal intensity each other according to previously obtained hand made data, and compared the result of this paper according to obtained quantified data to that of doctors decision. The examined mean and standard deviation for each brain infarction stage are as follows ; the means and standard deviations of signal intensity difference between DWI and T2WI for each period are $197.7{\pm}6.9$ in hyperacute, $110.2{\pm}5.4$ in acute, and $67.8{\pm}7.2$ in subacute. And the means and standard deviations of signal intensity difference between DWI and FLAIR for each period are $199.8{\pm}7.5$ in hyperacute, $115.3{\pm}8.0$ in acute, and $70.9{\pm}5.8$ in subacute. We can quantificate and decide cerebral infarction period objectively. According to this study, DWI is very exact for early diagnosis. We classified the period of infarction occurrence to analyze the region of disease and normal region in DW, T2WI, FLAIR images.

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Cerebral Postischemic Hyperperfusion in PET and SPECT (PET과 SPECT에서 나타나는 뇌허혈후 과관류)

  • Cho, Ihn-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.343-351
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    • 2001
  • Cerebral post-ischemic hyperperfusion has been observed at the acute and subacute periods of ischemic stroke. In the animal stroke model, early post-ischemic hyperperfusion is the mark of recanalization of the occluded artery with reperfusion. In the PET studios of both humans and experimental animals, early post-ischemic hyperperfusion is not a key factor in the development of tissue infarction and indicates the spontaneous reperfusion of the ischemic brain tissue without late infarction or with small infarction. But late post-ischemic hyperperfusion shows the worse prognosis with reperfusion injury associated with brain tissue necrosis. Early post-ischemic hyperperfusion defined by PET and SPECT may be useful in predicting the prognosis of ischemic stroke and the effect of thrombolytic therapy.

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Significant Reperfusion on $^{99m}Tc-HMPAO$ SPECT in a Case of Subacute MCA Infarction (한의학적 치료로 $^{99m}Tc-HMPAO$ SPECT상 현저한 재관류를 보인 아급성기 중대뇌동맥경색 환자 1례)

  • Park, Jung-Mi;Jung, Woo-Sang;Seo, Al-An
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.437-442
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    • 2001
  • For ischemic cerebrovascular disease, it is well known that early luxury perfusion is related to a good clinical outcome and single photon emission computed tomography(SPECT) has the potential for providing useful information about regional cerebral blood flow. We report one case of Rt. MCA infarction mainly treated by oriental medicine and revealed luxury perfusion without thrombolysis. In acute stage, neurological deficits of the patient were very severe. 99mTc-HMPAO SPECT images obtained 10days after the attack showed large perfusion defect in the Rt. MCA territory. We followed up 99mTc-HMPAO SPECT 40days after the ictus. Despite of the poor early perfusion, we found considerably improved perfusion and neurological improvement.

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Repair of Postinfarct Subacute Left Ventricular Free Wall Rupture Using Fibrin Glue (급성심근경색 후 발생한 아급성형 좌심실파열에서 Fibrin Glue를 이용한 치료)

  • Lee, Jae-Hoon;Noh, Dong-Sub;Kim, Jae-Bum;Park, Nam-Hee;Keum, Dong-Yoon;Choi, Sae-Young
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.448-450
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    • 2007
  • The mortality of left ventricular free wall rupture after acute myocardial infarction is high; however, subactue myocardial rupture can be diagnosed by echocardiogram and the use of the intraaortic balloon pump reduces the incidence of re-rupture. Bleeding from subacute myocardial rupture can be managed by employing fibrin glue and several patches. We report here on a case of successfully managed case of subactue left ventricular free wall rupture after acute myocardial infarction with using the sutureless technique and fibrin glue.

Yearly Report on CVA patients (IV) (뇌졸중환자(腦卒中患者)에 대한 연례보고(年例報告)(IV))

  • Shim, Mun-Ki;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.59-74
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    • 1998
  • Clinical observation was done on 272 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1997. 1. The cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage. and transient ischemic attack. The most case of them was the cerebral infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension. and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 7. The common symptoms were motor disability and verbal disturbance. 8 The average time to start physical therapy was 1l.3rd day after stroke in cerebral infarction and it was 15.2th day after stroke in cerebral hemorrhage. 9. The common complications were urinary tract infection, pneumonia, myocardial infarction. 10. Hypercholesterolemia and hypertriglyceridemia are usually found more frequently in cerebral infarction than in hemorrhage. 11. In acute or subacute stage, the methods of smoothening the flow of ki(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. and in recovering stage, the methods of replenishing ki(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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The Effect of Korean Medicine Treatment on Left Basal Ganglia Infarction with Hemiplegia Symptoms: Case Report (기저핵 뇌경색 환자의 편마비 한방치료 1례)

  • Kim, Hong Kyoung;Kim, Jae Ik;Jung, So Youn;Kim, Jung Ho;Kim, Young Il
    • Journal of Haehwa Medicine
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    • v.27 no.2
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    • pp.21-29
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    • 2018
  • Objectives : The purpose of this study was to report the effect of Korean medical treatment on left basal ganglia infarction. Methods : We performed acupuncture and administered herbal medicine to one patient to alleviate symptoms of hemiplegia such as motor disorder, facial palsy, and dysarthria. Manual Muscle Test(MMT), Hand Grip Test(HGT), Gait Level(GL), and Dysarthria grade were used to evaluate status of the patient. Results & Conclusions : The results of this research showed that overall symptoms of hemiplegia in the patient were improved. According to the results, the Korean medical treatment is considered to be effective on patients of left basal ganglia infarction to treat symptoms of hemiplegia. Further studies with larger sample sizes are needed to examine this issue.

Systematic Review of Occupational Therapy Programs for Upper Extremity Functions in Subacute Stroke Patients (아급성기 뇌졸중 환자의 팔 기능을 위한 작업치료프로그램에 대한 체계적 고찰)

  • Yo-Soon Bang;Eun-Sol Ju
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.4
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    • pp.105-114
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    • 2023
  • Purpose : This study systematically reviewed occupational therapy programs for upper extremity functions in subacute patients implemented over the last decade at home and abroad to utilize the findings as the basis for intervention protocols. Methods : This study was conducted with domestic and foreign randomized controlled experimental studies published from January 2013 to May 2023. Acute or subacute, CVA or stroke, upper extremity function, and program or therapy were used as search keywords in the search databases Scopus, PubMed, Riss, and DBpia. A total of 3,723 documents were retrieved, and 1,007 duplicate papers were excluded. In addition, 2,640 papers that did not meet the inclusion and exclusion criteria were excluded by the researcher examining the titles and abstracts. Thereafter, the full texts were checked. Consequently, 67 documents were excluded, and nine documents were finally used for analysis. Results : Due to the evaluation of the quality of the documents of nine studies, five items were rated "low," and two items were rated "unclear" in many studies. Males predominated the genders, and infarction predominated the types. The average age was over 50 but under 60 years, and the number of days after onset was predominantly fewer than one month. Occupational therapy programs were classified into mental programs, mirror therapy, music programs, and virtual reality programs, and virtual reality programs were frequently used. The intervention periods were predominantly 15-30 sessions for less than 30 minutes, and the Fugl-Meyer assessment-upper extremity was predominantly applied as an evaluation tool. Conclusion : This study is significant because it attempted to present the direction of intervention protocols for upper extremity functions in subacute stroke patients in clinical settings. Studies should be conducted with an expanded scope for a literature review.

Brain SPECT Using $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD in Subacute Cerebral Infarction: Case Report (아급성 뇌경색 환자에서 $^{99m}Tc$-HMPAO 및 $^{99m}Tc$-ECD 뇌 SPECT: 증례보고)

  • Ahn, Byeong-Cheol;Lee, Dong-Soo;Yoon, Byung-Woo;So, Young;Jung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.570-575
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    • 1996
  • For brain perfusion SPECT imaging, $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD are commonly used. Although these two tracers usually show similar distribution, it is well known that discrepant finding might be noted between $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD imaging in some conditions. Luxury perfusion(perfusion/metabolism mismatch) is one of the examples and could be observed in subacute cerebral infarction. We report a case of subacute cerebral infarction that revealed luxury perfusion. Increased perfusion was found in $^{99m}Tc$-HMPAO SPECT and perfusion defect was found in $^{99m}Tc$-ECD SPECT. We found large area of mismatch with a consecutive acquisition-subtraction method. Crossed cerebellar diaschisis was observed in both SPECT images.

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