• 대한본초학회지
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• 제25권2호
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• pp.71-79
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• 2010

Objectives : In this study, the neuroprotective effects of modified Boyanghwano-Tang (mBHT) and the major medicinal plants, Astragali Radix(AR) and Salviae Miltiorrhizae Radix(SMR) were investigated in transient middle cerebral artery occlusion (tMCAO)-induced ischemic stroke of rats. Methods : mBHT(400 mg/kg) and AR(154 mg/kg) or SMR(62 mg/kg) water extract orally injected in rats after 90 min occlusion of MCA and then allow reperfusion to 24 h. Brain infarction was measured by TTC staining and the expressions of NOS isoforms and apoptotic molecules were determined in ischemic brain by Western blot. Results : The results showed that mBHT has stronger neuropreotective property through inhibitions of the PARP cleaved and caspase-3 activation in ischemic rats, and could reduced infarction volumes comparison of those of AR or SMR, respectively. While, AR extract has an angiogenic property through increasing the expressions of eNOS and VEGF, and SMR extract has a strong anti-inflammatory effects through inhibition of iNOS expression in ischemic brains. Conclusions : These results suggest that mBHT has multifactorial therapeutic advantages through anti-apoptosis, anti-inflammation and angiogenesis for ischemic stroke based on a synergistic combination of ingradients rather than monotherapy.

• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.152-156
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• 2014

We report on a patient who showed visual recovery following bilateral occipital lobe infarct, as evaluated by follow up functional magnetic resonance imaging (fMRI) and diffusion tensor tractography (DTT). A 56-year-old female patient exhibited severe visual impairment since onset of the cerebral infarct in the bilateral occipital lobes. The patient complained that she could not see anything, although the central part of the visual field remained dimly at 1 week after onset. However, her visual function has shown improvement with time. As a result, at 5 weeks after onset, she notified that her visual field and visual acuity had improved. fMRI and DTT were acquired at 1 week and 4 weeks after onset, using a 1.5-T Philips Gyroscan Intera. The fiber number of left optic radiation (OR) increased from 257 (1-week) to 353 (4-week), although the fiber numbers for right OR were similar. No activation in the occipital lobe was observed on 1-week fMRI. By contrast, activation of the visual cortex, including the bilateral primary visual cortex, was observed on 4-week fMRI. We demonstrated visual recovery in this patient in terms of the changes observed on DTT and fMRI. It appears that the recovery of the left OR was attributed more to resolution of local factors, such as peri-infarct edema, than brain plasticity.

• 대한본초학회지
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• 제27권2호
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• pp.77-83
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• 2012

Objectives : This work was designed to investigate the effect of The root of Achyranthes japonica Nakai (AJN) water extract on serum deprivation reperfusion-induced apoptosis in PC-12 cells and transient middle cerebral artery occlusion (tMCAO)-induced ischemic brains of rats. Methods : Apoptosis in PC12 cells was induced by serum deprivation and reperfusion. The cells were treated with AJN water extract at doses of 0.5 and 1.0 mg/ml for 24 hr after inducing the apoptosis. Cell viability was determined by WST-1 assay. The expression of caspase-3 protein was determined by Western blot. Ischemic brains were prepared from tMCAO-induced ischemic rats after oral administration with AJN at dose of 50 and 100 mg/kg, and then brain infarction was measured by TTC staining. Results : AJN significantly increased the cell viability in apoptocic-induced PC-12 cells, and also decreased the expression of caspase-3 protein. Furthermore, the administration of AJN significantly inhibited tMCAO-induced brain infarction in rats. Conclusions : Our results suggest that AJN extract has a neuroprotective property via suppressing the apoptosis in PC12 cells and the infarction of ischemic brains.

• 대한핵의학회지
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• 제26권1호
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• pp.14-25
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• 1992

Thallium-201 $(^{201}T1)$ SPECT studies were performed on a normal volunteer and 12 patients with intracerebral lesions: 3 patients with gliomas, 3 patients with meningiomas, 1 patient each with metastatic tumor, brain abscess, and cerebral infarction, and 3 postirradiation patients. (2 with metastatic tumors, 1 with lymphoma). A $^{201}T1$ index, based on the ratio of $^{201}T1$ uptake in the brain lesion versus the homologous contralateral brain, was calculated and compared with tumor histology and CT/MRI findings. The SPECT $^{201}T1$ scan showed minimal uptake of tracer in a normal brain. There was substantial uptake of $^{201}T1$ in high-grade gliomas (index>1.5) with little uptake in low-grade lesions. A previously irradiated patient with recurrent astrocytoma, in whom MRI study was unable to distinguish tumor recurrence from necrosis, showed the lesions with high $^{201}T1$ indices in both hemispheric regions (2.50/1.93), suggesting tumor recurrence. Two meningiomas and a metastatic tumor showed varying degrees of $^{201}T1$ uptake (index $1.71\sim8.15$), revealing that $^{201}T1$ uptake is not exclusive to high-grade gliomas. In 2 postirradiation patients with metastatic tumors, no abnormal $^{201}T1$ uptake was found in the cerebral lesions, shortly after the initiation of radiation therapy or despite the persistence of enhancing lesions-though improved-on MR images, suggesting that $^{201}T1$ uptake may reflect the metabolic and possibly clonogenic activities of tumors and the brain $^{201}T1$ SPECT imaging might be valuable for the evaluation of tumor responsiveness to the therapy and for early detection of tumor recurrence. A patient with brain abscess on antibiotic treatment, showig increased uptake of $^{201}T1$ in the resolving lesions (index 2.87/1.52) is discussed. In a patient with cerebral infarction, there was no abnormal uptake of $^{201}T1$ in infarcted tissue. When using a threshold index of 1.5, correlation rate between $^{201}T1$ uptake and contrast enhancement of the cerebral lesions on CT/MRI was 73% (8/11). In conclusion, the brain $^{201}T1$ SPECT imaging may be useful for assessment of tumor response to the therapy and to predict low-or high-grade lesions.

• 동의생리병리학회지
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• 제16권4호
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• pp.724-728
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• 2002

Angiotensin-converting enzyme (ACE) gene polymorphism, which consists of presence (insertion, I) or absence (deletion, D) of a 250-bp fragment, is associated with ischemic heart disease, renovascular disease, systemic lupus erythematosus. Subjects with the DD genotype have higher levels of circulating ACE than subjects with the II genotype and show an increased tendency towards vascular wall thickness and contribute to the development of vascular disease. But the association between I/D polymorphism of the ACE gene and cerebrovascular disease is still controversial. The aim of this study was to determine whether the DNA polymorphism of the ACE are associated with cerebrovascular disease in Korean population. The study group comprised 377 Korean patients admitted to Kyunghee Oriental Medical Center in the year of 2000 for the treatment of brain infarction or brain hemorrhage. Magnetic resonance imaging(MRI) was performed for each patient to determine the stroke phenotype, infarction or hemorrhage. The 183 subjects without evidence of brain infarction or brain hemorrhage were selected from the some ethnical population(control group). Venous blood samples were drawn from each subject for the extraction of DNA. Genotypes of ACE were determined by polymerase chain reaction amplification of the genomic DNA. Case and control genotype frequencies were compared by chi-square testing. Both the patients and the controls were classified respectively into 4 groups: age less than forty years, age forty one to fifty, age fifty one to sixty, age greater than sixty years. There were no significant differences in the distributions of ACE genotypes among the patients with infarction, with hemorrhage and controls (Infarction: D/D 15.8%, I/D 46.7%, I/I 37.5%, Hemorrhage: D/D 15.1%, I/D 46.5%, I/I 38.4%, Control: D/D 18.6%, I/D 50.3%, I/I 31.2%). There was a significant difference in the distribution of ACE genotypes between the age greater than sixty year subgroup of patient with brain hemorrhage and the control (Hemorrhage: D/D 0%, I/D 55.6%, I/I 44.4%, Control: D/D 13.0%, I/D 63.0%, I/I 23.9%; Pearson Chi-Square value 5.956, P<0.05). Furthermore, the frequency of the ACE D/D type declined with increasing age both in the patient and control group (Patient group: age < 50 D/D 21.5%, age > 50 D/D 14.42%; Control group: age < 50 D/D 21.0%, age > 50 D/D 14.2%). In conclusion there is no clear association between ACE polymorphism and cerebrovascular disease in Korean population. Although, there was a tendency for the frequency of the ACE D/D type declined with increasing age in both patients and controls.

• Investigative Magnetic Resonance Imaging
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• 제6권1호
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• pp.55-63
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• 2002

목적 급성 허혈성 뇌졸중에서 관류 MR영상으로 측정한 상대적 뇌혈용적과 단광자방출전산화단층촬영으로 측정한 상대적 뇌혈류량이 나중에 발생할 뇌경색을 예측할 수 있는지 알아보고자 하였다. 대상 및 방법 급성 일측성 중대뇌동맥 폐색 환자에서 증상 발생 6시간 이내에 관류 MR영상과 99mTc-HMPAO 단광자방출전산화단층촬영을 모두 시행한 13명을 대상으로 하였다. 동맥 폐색에 의한 허혈 부위와 반대측 정상 부위에서 각 관류 변수를 측정하여 그 비(허혈 부위 관류변수 값 / 정상 부위 관류 변수 값)를 구한 후, 나중에 경색으로 이행할 부위와 그렇지 않을 부위를 판별할 수 있는 관류변수 비의 절단값을 계산하였다. 결과 : 경색으로 이행한 부위와 그렇지 않은 부위에서 상대적 뇌혈용적 비의 평균값은 각각 $0.58{\pm}0.27{\;}and{\;}0.99{\pm}0.17$ (p<0.001)이었고, 상대적 뇌혈류량 비의 평균 값은 $0.41{\pm}0.22{\;}and{\;}0.71{\pm}0.14$ (p<0.001)이었다. 경색으로 이행할 부위와 그렇지 않을 부위를 판별하는 절단값은 상대적 뇌혈용적 비가 0.80, 상대적 뇌혈류량 비가 0.56이었다. 각 절단값의 민감도, 특이도, 능률은 뇌혈용적 비가 80.6, 87.5, 82.7%이었고 상대적 뇌혈류량 비가 72.2, 75.0, 73.0%이었다. (두 관류변수 사이에서 p>0.05). 결론 : 급성 허혈성 뇌졸중에서 상대적 뇌혈용적과 상대적 뇌혈류량의 측정은 뇌경색의 발생을 예측하는 데에 유용한 것으로 사료된다.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1997년도 춘계학술대회
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• pp.103-103
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• 1997

일시적인 국소 뇌허혈 rat model에서 중대뇌동맥의 폐쇄시간에 따른 뇌조직의 손상정도를 비교 조사하였다. 웅성 Wistar rats를 isoflurane 홉입마취하에서 우측 내경동맥내로 17 mm의 silicone-coated 4-0 nylon monofilament를 삽입하여, 중대뇌동맥의 기저부를 30분, 60분 또는 90분동안 폐쇄한 후 이 monofilament를 다시 밖으로 뽑아내므로써 23 시간동안 recirculation 시키는 일시적 국소 뇌허혈 rat model을 사용한 결과, 수술 후 거의 모든 rats에서 left hemiparesis 또는 좌측으로의 circling과 같은 신경학적 결손이 나타나므로써 높은 성공률을 가지고서 비교적 용이하게 뇌허혈을 유발시킬 수 있었으며, 2 mm 두께의 fresh brain coronal slices에 대하여 2,3,5-triphenyltetrazolium chloride (TTC) 염색법을 시행하여 slice surface의 사진을 찍고 computerized 영상분석법을 이용하여 필요한 면적을 측정하므로써, coronal slice의 infarction size (%)는 총 면적에 대한 infarction 면적의 %로서, 부종율 (%)은 대조측 대뇌반구 면적의 2배에 대한 동측 대뇌반구와 대조측 대뇌반구 면적 차이의 %로서 산정되어졌다. 30분 허혈군에서는 본 염색법으로는 infarction이 거의 확인되지 않았으나 60분 허혈군 (n=13)에서는 우측 somatosensory frontoparietal cortex와 striatum 양자 모두 또는 일부 rats에서는 striatum에만 국한된 ulfarction이 확인되어졌으며 90분 허혈군 (n=12)에서는 거의 대부분의 rats에서 위 두 지역 모두에서 infarction이 확인되어졌다. Infarction size (%)는 60분과 90분 허혈군 각각에서, frontal pole로부터 5 mm되는 slice에서는 11.9$\pm$1.2 (평균치$\pm$표준오차), 13.7$\pm$1.9이었으며 7 mm되는 slice에서는 19.1$\pm$1.8, 21.9$\pm$2.1이었으며 9 mm되는 slice에서는 14.7$\pm$2.4, 19.7$\pm$2.2이었다. 또한 부종율 (%)은 60분과 90분 허혈군 각각에서, frontal pole로부터 5 mm되는 slice에서는 3.1$\pm$0.6, 3.8$\pm$0.7이었으며 7 mm되는 slice에서는 3.5$\pm$0.3, 5.7$\pm$1.0이었으며 9 $\pm$되는 slice에서는 3.4$\pm$0.5, 5.7$\pm$0.9이었다. 한편 90분 동안의 중대뇌동맥 폐쇄에 따른 뇌조직 손상을 cresyl violet 염색법, NADPH-diaphorase histochemistry, GFAP immunohistochemistry를 사용하여 일부 측정한 결과, 위의 손상지역에서는 뇌신경세포체들의 shrinkage 내지는 소실됨을 확인할 수 있었으며, NADPH-diaphorase-positive neuron들도 대부분 dendrite와 axon같은 cell process들의 fragmentation, shrinkage 내지는 소실되므로써 intensity의 감소현상이 나타났으며, reactive gliosis로 말미암아 GFAP immunoreactive intensity의 증가현상이 나타났다.

• 대한한의학회지
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• 제17권1호
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• pp.171-189
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• 1996

Background and Purpose: The greater part of patients to visit Hospital of Oriental Medicine suffer from cerebrovascular accident(CVA). There is transcranial Doppler(TCD) in the diagnostic method to confirm cerebrovascular accident(CVA). Transcranial Doppler(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral vessels and have been generally used to prevent symptomatic vasospasm and confirm cerebral infarction. So we studied, in the crebrovascular accident(CVA), to estimate whether transcranial Doppler(TCD) is useful to. Methods: Using transcranial doppler(Multigon Model 500M Transcranial Doppler System), we measured the mean and peak velocity and the direction of blood flow in 10 cerebrovascular accident(CVA)'s subjects who had been examined by Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). Results : As an anticipation, in cerebrovascular accident(CVA)'s subject with Cb-infarction, the mean and peak velocity of blood flow fell down remarkably and the direction of blood flow was change or irritable. But didn't find out any signal in lacunar infarction. Also, in case with spontaneous hemorrhage, the velocity and direction of blood flow was change but this signal was short of diagnosis for Cb-hemorrhage. Besides, we found signals about embolism, stenosis, thrombosis and occlusion in cerebrovascular accident(CVA)'s subjects. Conclusion: In Cb-infarction, the result of TCD was equal to diagnosis with Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). But about lacunar infarction or spontaneous hemorrhage, signals of TCD couldn't be found out or was insufficient more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). In cerebrovascular accident(CVA)'s subject with embolism, stenosis, thrombosis or occlusion, signals of TCD were found out more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). Therefore transcranial doppler(TCD) is necessary method which makes a diagnosis of cerebrovascular accident(CVA), with Computed Tomography(CT) or Magnetic Resonance Imaging(MRI).

• 대한한방내과학회지
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• 제24권2_4호
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• pp.1014-1022
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• 2003

Aphasia is speech disorder caused by injuries on the speech nerve center. It usually occur due to a disease in the right cerebral cortex and is divided into the various aphasia such as Global aphasia, Broca's aphasia, Wernicke's aphasia, conduction aphasia, Anomic aphasia, etc. Jihwangumja is used the cerebral infarction with Aphasia due to deficiency syndrome of kidneys. The purpose of this study is to examine the efficacy of oriental treatment for cerebral infarction with aphasia by Jihwangumsa. In the hospital, the patient showed the symptoms of mental disorder, Rt. hemiparesis G3/G4, aphasia, chest discomfort, obstipation, frequent urination, etc. The case showed that acute infarction on Lt. fronto-temporo-parietal lobe in Brain-CT. We identified the patient's clinical conditions and treated accordingly. As a result of treatment, symptoms were markedly improved and he was discharged. Further elaboration of oriental diagnostic classification could possibly lead to the fundamental treatment.

• 동의생리병리학회지
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• 제22권1호
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• pp.222-225
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• 2008

Hiccup is one of common symptoms that remains poorly understood. The hiccups coordinating center is located in the brain-stem reticular formation. Hiccups may be derived from 400 medical origins. Stroke is an infrequent cause of intractable hiccups. Intractable hiccups in pontine infarction remain poorly understood. As for treatments of hiccups, physical stimulating methods, pharmacological therapies and surgery are occidental conventional methods. In Pharmacological therapies, antidepressants, gastric motility stimulants, antispastic drugs are commonly used. Oriental medicines and acupuncture are also used frequently to treat hiccups. We have treated a case of intractable hiccup induced by pontine infarction with herbal medication; Gwakhyangjeonggi-san gami, acupuncture and moxibustion, and successfully improved. This case showed oriental medicine therapy is effective in intractable hiccup induced by pontine infarction.