• Korean Journal of Veterinary Research
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• v.32 no.1
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• pp.99-109
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• 1992

Pathological studies by light and electron microscope were carried out on the twenty piglets naturally affected by encephalomyocarditis virus infection. Gross findings included pale or yellow, small necrotic foci on myocardium, together with pulmonary edema and liver congestion in some cases. On light microscopy, nonsuppurative interstitial endocarcitis, epicarditis and myocarditis, myocardial infarction, and dystrophic calcification or fibtosis were observed in heart. Perivascular cuffings, gliosis and nonsuppurative meningitis were appeared in brain. Focal or diffuse necrosis with mononuclear cell infiltration in lacrimal gland and multifocal necrosis in liver were observed in some cases. Congestion and edema of lung, hyperemia, hemorrhage and deletion of lymphocytes of lymph nodes and spleen were recognized. On electron microscopy, severe swelling and vacuolization of mitochondria and sarcoplasmic reticulum, large intracellular vacuolation and edema, separation and fragmentation of myofibrils were observed. Virus particles were seen in the sarcoplasm of degenerated cardiac muscle cell.

• The Journal of the Society of Stroke on Korean Medicine
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• v.18 no.1
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• pp.55-65
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• 2017

■ Objectives Atrial fibrillation is the most common cause of cardioembolic stroke. Of the 44 ischemic stroke patients with atrial fibrillation who were hospitalized in hospital of Korean Medicine from July 1, 2014 to June 30, 2017, we selected 39 patients who have had Magnetic Resonance Angiography. We divided them into Atrial Fibrillation group with no stenosis or less than 50% stenosis in the ipsilateral artery of the lesion and Artery to Artery Embolism group with more than 50% stenosis or occlusion in the ipsilateral artery of the lesion. ■ Methods Clinical characteristics, examination and evaluation tools were collected from the patient's electronic medical records. CHADS2, Initial National Institutes of Health Stroke Scale, 8-item Stroke Scale and Improved 8-item Stroke Scale Number were checked. ■ Results & Atrial Fibrillation group showed differences in age, brain lesion location, vascular lesion, Conclusion initial National Institutes of Health Stroke Scale, initial 8-item Stroke Scale and progress compared to Artery to Artery Embolism group.

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.124-131
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• 2003

Purpose : To reveal clinical usefulness of functional MRI (fMRI) using sensorymotor and language stimuli for demonstrating anatomic relationship between sensorimotor or language cortices and lesions in the planning of brain tumor surgery. Materials and Methods : This study included 12 right-handed patients with brain tumors in or around sensorimotor or language cortices. Eleven patients were evaluated with primary motor and sensory stimuli. Of these patients, six patients were also evaluated with language stimuli. One patient was evaluated with language stimuli only. For fMR imaging, a 1.5T scanner was used and the EPI BOLD technique was employed. For postprocessing image, the SPM99 program and a program made by our department was utilized. We evaluated whether sensorimotor and language stimuli activate sensorimotor and language cortices. And also, clinical efficacy of revealing anatomic relationship between cerebral cortices and lesions for planning neurosurgical operation were evaluated. Finally, we compared post-operative neurologic function with pre-operative neurologic function in same patients. Results : The fMRI examination was successful in identifying the functional cortices and depicting anatomic relationship between functional cortices and lesions in all patients. In nine patients of 11 patients with identified sensorimotor cortices, postoperative grade of manual motor test was not changed, compared with preoperative grade. Whereas postoperative improved than preoperative grade in one patient of remaining two patients, postoperative aggravated than preoperative grade in the other. This result was due to atherosclerotic lacunar infarction, regardless of tumor resection. Postoperative deficit of language function was not found in seven patients with identified language cortices. Conclusion : fMRI could be a helpful method for determining the best approach to neurosurgical treatment in patients with brain tumors in or around sensorimotor or language cortices.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.99-103
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• 2011

Purpose: Head movement during brain perfusion SPECT (Diamox) scan is a one of important issues which decreases image quality. It also causes repeated scans. This study was designed to evaluate variable factors causing scan failures. Materials and Methods: 676 patients (359 men, 317 women, age average $54.5{\pm}18.4$) for brain perfusion SPECT (Diamox) scan from March, 2010 to Feb. 2011 were used as a subject. Age data and the kind of disease(Moyamoya disease (MMD), None moyamoya disease (NMMD), Cerebral infarction (CI)), test performance outcome (success,failure) were collected. The head movement factors(gender, disease, age, head fixation device) were evaluated by chi-square test and logistic regression analysis Results: The result showed that men had higher scan failure rate than women. Seniors in seventies(men 3.4%, women 1.5%) showed the most highest failure rate. Using head fixation device increased scan success rate up to 94.4~97.7%. The scan success rate is dependent upon gender, head fixation device by chi-square test(${\chi}^2$=3.8 (df=1, p<0.05), ${\chi}^2$=10.4 (df=1, p<0.001)) Gender, disease(CI), head fixation device showed very effective result in logistic regression analysis.(Wald=3.3 (p<0.07), Wald=3.7 (p<0.05), Wald=9.3 (p<0.05) Conclusion: It is demonstrated that gender, disease, using head fixation device is statistically very useful factors. Especially, head fixation device is a main key minimizing repeated scan.

• The Journal of Internal Korean Medicine
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• v.21 no.3
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• pp.467-475
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• 2000

The water extracts of Jagamcho-tang has been used for treatment of arrhythmia and palpitation in oriental traditional medicine. Brain is provided with blood flow by heart. Jagamcho-tang has been studied on ischemia and infarction in heart. However, little is known about the mechanism by which the water extracts of Jagamcho-tang rescues brain cells from ischemic damages. To elucidate the protective mechanism on ischemic induced cytotoxicity, the effects of Jagamcho-tang on ischemia induced cytotoxicity and generation of nitric oxide(NO) are investigated in C6 glioma cells. Jagamcho-tang induce NO in a dose dependent manner up to 2.5mg/ml in C6 glioma cells. The pretreatment of Jagamcho-tang protect sodium nitroprusside(SNP) (2mM) induced cytotoxicity. This effect of Jagamcho-tang is mimicked by treatment by pretreatment of SNP($100{\mu}M$), an exogenous NO donor. NG-monomethyl-L-arginine($N^{G}MMA$), a specific inhibitor of nitric oxide synthase (NOS), significantly blocks the protective effects of Jagamcho-tang on cell toxicity by ischemia. In addition, lipopolysaccharide(LPS) and phorhol 12 myristate 13-acetate(PMA) treatment for 72h in C6 glial cells markedly induce NO, but treatment of the cells with the water extracts of Jagamcho-tang decrease nitrite formation in a dose dependent manner. In addition, LPS and PMA treatment for 72h induce severe cell death and LDH release into medium in C6 glial cells. However treatment of the cells with the water extracts of Jagamcho-tang dose not induce significant changes compare to control cells. Furthermore, the protective effects of the water extracts of Jagamcho-tang is mimicked by treatment of $N^{G}MMA$. Taken together, I suggest that the protective effects of the water extracts of Jagamcho-tang against ischemic brain damages may be mediated by regulation of iNOS during ischemic condition.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.22-30
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• 1994

Encephalo-duro-arterio-synangiosis (EDAS) is a relatively new surgical procedure for treatment of childhood moyamoya disease. We assessed regional cerebral perfusion in moyamoya patients before (1.3 mo) and after (6.8 mo) EDAS with $^{99m}Tc$-HMPAO brain SPECT. A total of 21 EDAS operations in 17 moyamoya patients was included. Preoperative CT or MRI showed cerebral infarction in 14 patients and carotid angiography showed Suzuki grade I to V stenosis in 6%, 9%, 62%, 12% and 12% of the hemispheres respectively. Preoperative SPECT showed regional hypoperfusion in all patients, bilateral frontal and temporal lobes being the most frequently involved site. $4{\times}4$ pixel sized ROIs were applied on the frontotemporal cortex in 3 slice averaged transverse tomographic images. An index of regional perfusion was measured as: PI (%)=average F-T activity/average cerebellar activity${\times}100$ Pre-EDAS ipsilateral PI ranged from 23.7 to 98.4% (mean: $74.3{\pm}17%$) and increased significantly after operation ($81.4{\pm}17%$, p<0.001). Individual post-EDAS PI improved in 15/21 cases, showed no significant change in 5 and was slightly aggravated in 1. The amount of clinical improvement (${\Delta}CI$) was graded with a scale of 0 to 4 based on frequency and severity of TIA attacks. When patients were grouped according to pre-EDAS PI, group II (PI 70-89) showed a significantly higher ${\Delta}CI$ (3.3) compared to group I (PI< 70, 1.57) or group III (PI >90, 0.5) (P< 0.001). The amount of perfusion improvement (${\Delta}PI$) showed significant correlation with ${\Delta}CI$ (r=0.42, p=0.04). ${\Delta}PI$ did not, however, correlate with the amount of neovascularization assessed angiographically in 8 patients. Serial HMPAO SPECT is an useful noninvasive study for assessing perfusion improvement after EDAS in childhood moyamoya patients.

• Physical Therapy Korea
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• v.14 no.1
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• pp.1-10
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• 2007

This study was designed to examine the effects of electroacupuncture and treadmill exercise on the improvement of muscle atrophy and Brain-Derived Neurotrophic Factor (BDNF) expression in an ischemic stroke model induced by middle cerebral artery occlusion. This study selected 120 Sprangue-Dawley rats, divided them into six groups, and assigned 5 rats to each group. Experiments were conducted for 1, 3 days and 1, 8 weeks, respectively. In each group, changes in weight of muscle and relative muscle of tibialis anterior muscle, histologic observations, and BDNF expression were observed and analyzed. For the changes in muscle weight of unaffected and affected sides of tibialis anterior, muscle atrophy was expressed in an affected side 3 days after ischemic stroke was induced. There was a statistically significant difference in Group VI 1 and 8 weeks after ischemic stroke was induced, compared to Group II (p<.05). For the changes in relative muscle weight of unaffected and affected sides of tibial anterior muscle, there was significant decrease in each group 3 days after ischemic stroke was induced, compared to Group I, while there was a statistically significant increase in Group VI 1 week after ischemic stroke was induced, compared to Group II (p<.05). For neurologic exercise behavior test, Group VI generally had the highest score, compared to other groups. The results of the behavior test suggests that 8 weeks after ischemic stroke was induced, Group VI improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, thus indicating a similar state of muscle fiber and brain tissue in Group I. In immunohistochemical observations, Group 1 week showed increase in BDNF. Based on these results, electroacupuncture and treadmill exercise may improve muscle atrophy and change in BDNF expression of ischemic stroke rats and contribute to the improvement of exercise function.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.119-125
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• 2008

Background: Cerebral blood vessels are innervated by sympathetic nerves from the superior cervical ganglia (SCG), and these nerves may influence the cerebral blood flow. The purpose of the present study was to evaluate the neuroprotective effect of superior cervical sympathetic ganglion block in rats that were subjected to focal cerebral ischemia/reperfusion injury. Methods: Eighty male Sprague-Dawley rats (270-320 g) were randomly assigned to one of two groups (the ropivacaine group and a control group). In all the animals, brain injury was induced by middle cerebral artery (MCA) reperfusion that followed MCA occlusion for 2 hours. The animals of the ropivacaine group received $30{\mu}l$ of 0.75% ropivacaine, and their SCG. Neurologic score was assessed at 1, 3, 7 and 14 days after brain injury. Brain tissue samples were then collected. The infarct ratio was measured by 2.3.5-triphenyltetrazolium chloride staining. The terminal deoxynucleotidyl transferase mediated dUTP-biotin nick-end labeled (TUNEL) reactive cells and the cells showing caspase-3 activity were counted as markers of apoptosis at the caudoputamen and frontoparietal cortex. Results: The death rate, the neurologic score and the infarction ratio were significantly less in the ropivacaine group 24 hr after ischemia/reperfusion injury. The number of TUNEL positive cells in the ropivacaine group was significantly lower than those values of the control group in the frontoparietal cortex at 3 days after injury, but the caspase-3 activity was higher in the ropivacaine group than that in the control group at 1 day after injury. Conclusions: The study data indicated that a superior cervical sympathetic ganglion block may reduce the neuronal injury caused by focal cerebral ischemia/reperfusion, but it may not prevent the delayed damage.

• The Journal of Internal Korean Medicine
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• v.22 no.2
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• pp.161-174
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• 2001

Objectives : The purpose of this investigation is to evaluate the effect of Chungpesagan-Tang Extracts on reversible forebrain ischemia in Sprague-Dawley rats. Methods : the volume of cerebral infarction and edema, the pathohistological change of neurons, the number of survived neurons, neurotransmitters through immunohistochemical methods, proteins connected with neurotransmitters through immunohistochemical methods and the pathohistological change of neurons through electro-microscopy were investigated. From these reseach data, the protection of neurons and the activity of brain cells were examined. Results : 1. The infaction volume of the control group was 23.9%, and that of the sample group was 16%. 2. The brain edema volume of the control group increased by 17% compared to the normal group and that of the sample group increased by 10%. 3. The light microscopy revealed that the neurons in the ischemia-induced area and CA1 area of hippocampus were most heavily damaged and that the sample group was less damaged compared with the control group. Most pyramidal neurons died in 7 days when brain ischemia was induced. 4. The number of survived pyramidal neurons in the CA1 area of the hippocampus were studied. The normal group had 93 neurons/mm, survived the control group(after 3 days) had 21/mm, the control group(after 7 days) had 3/mm and the sample group 33/mm. 5. The immunohistochemical methods revealed that: (1) In the control group, the sensitivity of GABA, NOS, DBH were increased, and those of Synapsin, eEF-$1{\alpha}$ decreased. NOS and DBH had positive reactions in the control group, but negative in the normal group. (2) In thd sample group, the sensitivity of GABA, NOS, DBH were attenuated, and those of NPY, Synapsin, CaMKII, eEF-$1{\alpha}$ increased when compared to the control group. 6. The electro-microscopy revealed that most neurons died by necrosis and some neurons died by apoptosis. Several imflammation cells appeared in the injured area of neurons. The number of neurons in the sample group that died by ischemia decreased. But, the number that died by apoptosis did not significantly change. Conclusions : The data shows that the effect of Chungpesagan-Tang Extracts on reversible forebrain ischemia in Sprague-Dawley rats is significant.

• Investigative Magnetic Resonance Imaging
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• v.23 no.3
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• pp.210-219
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• 2019

Purpose: The purpose of this study was to investigate if double inversion recovery (DIR) imaging can have a role in the evaluation of brain ischemia, compared with diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) imaging. Materials and Methods: Sixty-seven patients within 48 hours of onset, underwent MRI scans with FLAIR, DWI with b-value of 0 (B0) and $1000s/mm^2$, and DIR sequences. Patients were categorized into four groups: within three hours, three to six hours, six to 24 hours, and 24 to 48 hours after onset. Lesion-to-normal ratio (LNR) value was calculated and compared among all sequences within each group, by the Friedman test and conducted among all groups, for each sequence by the Kruskal-Wallis test. In qualitative assessment, signal intensity changes of DIR, B0, and FLAIR based on similarity with DWI and image quality of each sequence, were graded on a 3-point scale, respectively. Scores for detectability of lesions were compared by the McNemar's test. Results: LNR values from DWI were higher than DIR, but not statistically significant in all groups (P > 0.05). LNR values of DIR were significantly higher than FLAIR within 24 hours of onset (P < 0.05). LNR values were significantly different between, before, and after six hours onset time for DIR (P = 0.016), B0 (P = 0.008), and FLAIR (P = 0.018) but not for DWI (P = 0.051). Qualitative analysis demonstrated that detectability of DIR was higher, compared to that of FLAIR within 4.5 hours and six hours of onset (P < 0.05). Also, the DWI quality score was lower than that of DIR, particularly relative to infratentorial lesions. Conclusion: DIR provides higher detectability of hyperacute brain ischemia than B0 and FLAIR, and does not suffer from susceptibility artifact, unlike DWI. So, DIR can be used to replace evaluation of the FLAIR-DWI mismatch.