• 대한한의학회지
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• 제27권2호
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• pp.70-85
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• 2006

Objectives; This study examined the neuroprotective effect of Hyulbuchookautang (血府逐瘀湯, HBCAT)against neural damage following focal cerebral infarction. Methods : Sprague-Dawley Rats were induced with focal cerebral infarction by temporal middle cerebral artery occlusion (MCAO). The rats were divided into 2 groups. We treated extract of HBCAT to one group after operation (sample group), and the other group wasn't treated after operation (control group). We observed neurological scores and TIC-stained infarct area, total infarct volume in brain sections and Bax-positive neurons, HSP70- positive neurons in brain regions. Results : HBCAT treatment at 3 days after MCAO reduced neurological scores induced by MCAO. HBCAT treatment at 5 days after MCAO reduced TTC-stained infarct area in brain sections induced by MCAO. HBCAT treatment at 5 days after MCAO reduced total infarct volume in brain sections induced by MCAO. HBCAT treatment after MCAO reduced Bax-positive neurons in cortex infarct core and cortex infarct penumbra and caudo-putamen of brain regions induced by MCAO. HBCAT treatment after MCAO reduced HSP70- positive neurons in cortex infarct penumbra of brain regions induced by MCAO. Conclusions : These results suggest that HBCAT has a neuroprotective effect against focal cerebral ischemia.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.326-330
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• 2007

Objective : Stroke is the most prevalent disease involving the central nervous system. Since medical modalities are sometimes ineffective for the acute edema following massive infarction, surgical decompression may be an effective option when medical treatments fail. The present study was undertaken to assess the outcome and prognostic factors of decompressive surgery in life threatening acute, severe, brain infarction. Methods : We retrospectively analyzed twenty-six patients (17 males and 9 females; average age, 49.7yrs) who underwent decompressive surgery for severe cerebral or cerebellar infarction from January 2003 to December 2006. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : Of the 26 patients, 5 (19.2%) showed good recovery, 5 (19.2%) showed moderate disability, 2 (7.7%) severe disability, 6 (23.1%) persistent experienced vegetative state, and 8 (30.8%) death. In this study, the surgical decompression improved outcome for cerebellar infarction, but decompressive surgery did not show a good result for MCA infarction (30.8% overall mortality vs 100% mortality). The dominant-hemisphere infarcts showed worse prognosis, compared with nondominant-hemisphere infarcts (54.5% vs 70%). Poor prognostic factors were diabetes mellitus, dominant-hemisphere infarcts and low preoperative Glasgow Coma Scale (GCS) score. Conclusion : The patients who exhibit clinical deterioration despite aggressive medical management following severe cerebral infarction should be considered for decompressive surgery. For better outcome, prompt surgical treatment is mandatory. We recommend that patients with severe cerebral infarction should be referred to neurosurgical department primarily in emergency setting or as early as possible for such prompt surgical treatment.

• 대한방사선기술학회지:방사선기술과학
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• 제23권1호
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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.

• 대한핵의학회지
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• 제34권5호
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• pp.433-435
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• 2000

A 6000-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the ether represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.$^{1-4)}$ A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.$^{4)}$ Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.

• Journal of Chest Surgery
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• 제18권4호
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• pp.746-752
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• 1985

A retrospective clinical observation was made of 40 patients with postoperative cerebral dysfunction among 2634 patients who underwent open-heart operations in Severance Hospital. Yonsei University between 1962, the year the first successful open heart operation was done, and June 1985. Suspected causes of brain damage were reviewed. Brain CT findings were evaluated in 24 patients. There were 15 cerebral infarcts, 4 intracerebral bleedings, 3 ischemic brain damages, 1 infarction with intracerebral hemorrhage and 1 diffuse cortical atrophy from unknown cause. The most frequent site of cerebral infarction was the middle cerebral artery area with no predilection on the right of left.

• 대한한방내과학회지
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• 제21권5호
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• pp.729-738
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• 2000

Objective : We examined patients admitted to Dong Eui University Oriental Medical Hospital from 1st January to 31st December in 2000. We studied 110 cases of patients who were diagnosed as Brain stem(pons, mid brain, medullar) infarction with brain CT, MRI scan, MR Angiography. Methods : We analyzed patients into sex, age, onset time, invasion lesion, past and family history, risk factor, abnormal vital sign for early 2 weeks, prodromal symptoms, symptoms at entry, progress and incidental symptoms at acute stage, complications, the state of condition at discharge, demonstrations, herb medications, western and oriental medical cooperation and admission period. Results : Our study was similar to existing studies in the distribution of sex, age, past and family history and risk factors. But there was some differences in the prodromal symptoms, symptoms at entry progress and incidental symptoms at acute stage, and the state of condition at discharge. Conclusions : Our study shows the brain stem infarction patients differed from other cerebrovascular accident patients in the symptoms. We hoped that our study would be further studied in western and oriental medicine.

• 대한의생명과학회지
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• 제18권4호
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• pp.399-405
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• 2012

The brain is the body's most organized and controlled organ, and it governs various psychological and mental functions. A brain abnormality could greatly affect one's physical and mental abilities, and consequently one's social life. Brain disorders can be broadly categorized into three main afflictions: stroke, brain tumor, and dementia. Among these, stroke is a common disease that occurs owing to a disorder in blood flow, and it is accompanied by a sudden loss of consciousness and motor paralysis. The main types of strokes are infarction and hemorrhage. The exact diagnosis and early treatment of an infarction are very important for the patient's prognosis and for the determination of the treatment direction. In this study, texture features were analyzed in order to develop a prototype auto-diagnostic system for infarction using computer auto-diagnostic software. The analysis results indicate that of the six parameters measured, the average brightness, average contrast, flatness, and uniformity show a high cognition rate whereas the degree of skewness and entropy show a low cognition rate. On the basis of these results, it was suggested that a digital CT image obtained using the computer auto-diagnostic software can be used to provide valuable information for general CT image auto-detection and diagnosis for pre-reading. This system is highly advantageous because it can achieve early diagnosis of the disease and it can be used as supplementary data in image reading. Further, it is expected to enable accurate medical image detection and reduced diagnostic time in final-reading.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.252-255
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• 2011

Authors report a case of a painless acute dissecting aneurysm of the descending aorta in a patient who presented with unexplained hypotension followed by simultaneous paraplegia and right arm monoparesis. To our knowledge, case like this has not been reported previously. Magnetic resonance imaging of the brain and spine revealed hemodynamic cerebral infarction and extensive cord ischemia, respectively. Computerized tomography angiography confirmed a dissecting aneurysm of the descending aorta. The cause of the brain infarction may not have been embolic, but hemodynamic one. Dissection-induced hypotension may have elicited cerebral perfusion insufficiency. The cause of cord ischemia may be embolic or hemodynamic. The dissected aorta was successfully replaced into an artificial patch graft. The arm monoparesis was improved, but the paraplegia was not improved. In rare cases of brain and/or spinal cord infarction caused by painless acute dissecting aneurysm of the aorta, accurate diagnosis is critical because careless thrombolytic therapy can result in life-threatening bleeding.

• 대한디지털의료영상학회논문지
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• 제13권2호
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• pp.55-58
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• 2011

It is important to study using experimental animals for research about stroke. Magnetic Resonance Imaging(MRI) is avaluable diagnosticmethods for stroke diagnosis. The purpose of this research is to know the Magnetic Resonance Imaging(MRI) and histopathological characteristics findings after induction of photothrombotic cerebral infarction in rat brain. Male Sprague-Dawley rats were anesthetized, Rose Bengal dye(20 mg/kg) was intravenously injected. The right sensonrimotor cortex of rat brain was exposed to cold light of 7 mm diameter at a position of 1 mm anterior and 3.5 mm lateral to bregma for 20 min. The post-infarction effects were monitored by T1 weighted and T2 weighted images of brain MRI. Histopathological changes were observed after Hematoxylin & Eosin staining. The lesion appeared clearly high signal intensity area on T2 weighted images(the major axis $7.04{\pm}0.11$ mm, the minor axis $3.08{\pm}0.04$ mm) and also H&E staining was same result. In conclusion, MRI was avaluable diagnostic methods for diagnosis and serial changes of stroke.

• 한국의학물리학회지:의학물리
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• 제21권4호
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• pp.348-353
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• 2010

임상적용 전 단계에서 마우스와 같은 작은 설치류를 이용한 신경학적 실험의 필요성이 높아지면서 임상용 3T MRI를 이용한 마우스 뇌 영상의 요구가 높아지고 있다. 본 연구에서는 임상용 3T MRI를 이용한 마우스 뇌 영상의 가능성과 기술적인 적용과 최적화에 대해 알아보고자 하였다. 20~25g 체중 마우스 3마리에서 임상용 3T MRI를 이용하여 T1 강조영상(T1WI), T2 강조영상(T2WI), FLAIR (Fluid Attenuated Inversion Recovery) 영상, 가돌리늄 조영 T1 강조영상(Gd-T1WI), 확산 강조영상(DWI)을 시행하였다. 대상이 되었던 마우스 1마리는 뇌 경색을 유발시키지 않았으며 2마리는 우측 중대뇌동맥을 결찰하여 일측 뇌경색을 유발하고 1시간, 24시간, 72시간에 각각의 MRI 영상을 시행하였으며 각 영상에서 마우스 뇌의 striatum, 뇌실, 대뇌 피질의 해부학적 구별, 뇌 경색 부위의 진단 가능성 등을 분석하였다. T2WI에서 마우스 뇌의 striatum, 뇌실, 대뇌 피질의 해부학적 구별이 모두 가능하였고 T1WI, FLAIR, DWI 영상에서는 위의 해부학적 경계부위의 해상도는 감소하였다. 뇌경색 부위는 경색 후 1시간, 24시간, 72시간 영상 모두에서 발견되었고 T2WI, FLAIR에서는 24시간, 72시간에서만 구분되었다. 임상용 3T MRI를 이용한 마우스 뇌 영상에서 해부학적 부위의 구별이 가능하였고 특히 DWI를 이용하여 급성기 뇌 경색의 진단이 가능하였다. 앞으로 기술적인 적용과 최적화를 위한 노력이 계속 진행된다면 임상 실험에 큰 도움을 줄 수 있을 것이라 생각된다.