• Title/Summary/Keyword: cerebral ischemia

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The Effect of Dodamtang(DDT) on Brain damage and Hypertension (도담탕(導痰湯)이 뇌손상(腦損傷) 및 고혈압(高血壓)에 미치는 영향(影響))

  • Lim, Seong-Min;An, Joung-Jo;Choi, Young;Kim, Yong-Jin;Yoo, Ho-Ryoung;Park, Yang-Chun;Seol, In-Chan;Hwang, Chi-Won;Cho, Hyun-Kyung
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.503-512
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    • 2001
  • Objective : This study was carried out to investigate the effects of DDT on the brain damage and hypertension. Methods : We observed the effect of Dodamtang(DDT) extract on KCN-induced coma, focal brain ischemia by MCA occlusion, cytotoxicity and protection of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35). To prove the effect of DDT as a blood pressure depressant, we measured aldosterone, renin activity, catecholamine, sodium and NO density using the seperated blood plasma. Results : DDT showed a protective effect on cytotoxicity of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35) in a dose dependent manner and proved the significant abridgement of brain ischemic area and edema induced by MCA occlusion, a critical decrease of neurologic deficitic grade in the fore-limbs. DDT didn't reduce the duration of KCN(1.87mg/kg iv.)-induced coma and prolonged the survival rate in the case of KCN(3.0mg/kg iv.)-induced coma by the ratio of 20%. While DDT increased the value of NO in SHR, it significantly decreased the blood pressure of SHR and the value of aldosterone& epinephrine in SHR. Conclusions : These results suggested that DDT might be usefully applied for treatment of hypertension, cerebral infarction, and brain damage.

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Significances and Outcomes of Mechanical Thrombectomy for Acute Infarction in Very Elderly Patients : A Single Center Experience

  • Kim, Dong Hun;Kim, Sang Uk;Sung, Jae Hoon;Lee, Dong Hoon;Yi, Ho Jun;Lee, Sang Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.654-660
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    • 2017
  • Objective : Mechanical thrombectomy is increasingly being used for the treatment of acute ischemic stroke. The population over 80 years of age is growing, and many of these patients have acute infarction; however, these patients are often excluded from clinical trials, so the aim of this study was to compare the functional outcomes and complication rates in very elderly patients (age ${\geq}80$ years) and aged patients (60-79 years) treated with mechanical thrombectomy. Methods : Between January 2010 and June 2015, we retrospectively reviewed 113 senior patients (over 60 years old) treated at our institution for acute ischemic stroke with mechanical thrombectomy. They were divided into a very elderly (${\geq}80$ years) and aged (60-79 years) group, with comparisons in recanalization rates, complications, death and disability on discharge be reported. Results : The mean age was 70.3 years in the aged group and 83.4 years in the very elderly group. Elderly patients had higher rates of mechanical thrombectomy failure than the younger group (40% vs. 14%; odds ratio [OR] 4.1; 95% confidence interval [CI] 1.4-11.9; p=0.012). Results from thrombolysis in cerebral ischemia and modified Rankin scale at discharge were worse in the older group (p=0.005 and 0.023 respectively). There were no differences in mortality rate or other complications, but infarction progression rates were significantly higher in the very elderly group. (15% vs. 2.2%; OR 8.0; 95% CI 1.2-51.7; p=0.038). The majority (92.3%) of the patients who failed in aged group were not successful after several trials. However, in half (4 of 8) of the very elderly group, the occlusion site could not be accessed. Conclusion : Patients older than 80 years of age undergoing mechanical thrombectomy for acute infarction were more difficult to recanalize due to inaccessible occlusion sites and had a higher rate of infarction progression, However, mortality and other complications were similar to those in younger patients.

A Review of Experimental study on Dementia in Oriental medicine;within Oriental medicine journal since 2000 (치매에 대한 최신 실험적 연구 동향;2000년 이후 한의학 학술지를 중심으로)

  • Choi, Sung-Youl;Kim, Dae-Hyun;Kim, Sang-Tae;Kim, Tae-Heon;Kang, Hyung-Won;Lyu, Yeong-Su
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.1
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    • pp.125-146
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    • 2008
  • Objectives : The purpose of this study is to suggest for the following experimental study of dementia by reviewing recent oriental medicine journals that have been published since 2000. Methods: We have investigated various types of studies in relation to dementia through 90 articles that have been published from 2000 to 2007 in recent oriental medicine journals were registered Korea research foundation. Results and Conclusions : 1. Since 2000, 88 articles in relation to dementia have been published and almost of them are herbal medicine-centered studies. Also they show a tendency to increase every year. The journal of oriental neuropsychiatry carries the highest number of studies in relation to dementia. 2. According to the experimental paper, there are 30 cases of using herb simplexes, 48 cases of herb-combined prescription, and 10 cases of other ways. Especially 7 cases of using herb-combined prescription relation to Sasang constitution are all for the Taeumin. 3. There are 85 cases of Animal and cellular experimental, 60 cases of using pathologic model induced cytotoxic activity, a case of using L-NAME, 3 cases of 192 saporin, 4 cases of ibotenic acid, 10 cases of focal cerebral ischemia, 3 cases of alcohol-administered, and one case of natural degradation. 4. Moms water maze, Radial arm maze Passive avoidance learning model were using for examining learning and memory of model animal 5. We propose that following studies of dementia are to he investigated of the applied method of using siRNA with tranceduced gene, sample preparation by water-soaking, oriental medical diagnosis, standardization of differentiating symptom and herb simplexes, building the database by classified prescriptions, and experiment model which are based on precise examining mechanism with cell line as like mouse H19-7 hippocampus, rat HT22 hippocampus, astrocyte, microglia, using the model of animals at APP, PS1, BACE, CT99/PS1, APOE4, Tau, APP/PSI/Tau

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Comparison of Intraoperative Somatosensory Evoked Potential(SSEP) Monitoring During Aneurysm Surgery : ACA Aneurysms vs MCA Aneurysms (전대뇌동맥과 중대뇌동맥 동맥류 수술시 체성감각유발전위의 모니터링의 비교, 분석)

  • Choi, Kwang Yeong;Kim, Gook Ki;Lim, Young Jin;Kim, Tae Sung;Leem, Won;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.281-288
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    • 2001
  • Objectives : The purpose of this study is to evaluate the usefulness of SSEP monitoring during intracranial aneurysm surgery and compare the characteristics of wave change in relation to neurologic changes between ACA aneurysms and MCA aneurysms. Methods : During recent three years(between January 1997 and November 1999), intraoperative SSEP monitoring had been done in 63 operations for intracranial aneurysms. We had monitored the median nerve SSEP during surgery for aneurysms of MCA and the posterior tibial nerve SSEP for aneurysms of ACoA or ACA. A more than 50% reduction of any cortical SEP response was considered to be a significant SEP change, compared to its baseline value before the start of surgery. Changes in the SEPs were categorized as follows : Type IA, no significant amplitude changes without temporary clipping ; Type IB, no significant amplitude changes with temporary clipping ; Type II, significant changes with temporary clipping and complete return to control amplitude ; Type III, significant changes with temporary clipping and incomplete return to control amplitude ; Type IV, significant changes with temporary clipping and more decreased amplitude changes. Results : Among the 63 intraoperative monitoring, there were 37 cases of ACA aneurysms(An), and 26 of MCA An. The temporary proximal arterial occlusion during surgery were performed in 31(83.8%)cases of ACA An, 22(84.6%) of MCA An. Seven of the 31 ACA An(22.6%) and ten of the 22 MCA An(45.5%) had significant changes. The type were as follows : 4 patients with type II and 3 with type III in the ACA An ; 3 patients with type II and 3 with type III and 4 with type IV in the MCA An. In both group type II changes had no new postoperative neurological deficit. All 6 patients with type III had new neurological deficits ; However, One case in the ACA An and two cases in the MCA An. had transient neurologic deficit and improved markedly over the next two months. All 4 type IV changes in the MCA An. had permanant neurologic deficits. Two out of 30 cases(6.7%) in the ACA An. and one out of 16 cases(6.3%) in the MCA An. without significant amplitude change had new neurologic deficit postoperatively. Conclusion : Based on this study, Intraoperative SSEP monitoring during aneurysm surgery would provide useful information for detecting cerebral ischemia. SSEP response during surgery for MCA An. is more sensitive than ACA An. Otherwise, there were no meaningful difference in rate of false negativity.

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Initial Experience of ACE68 Reperfusion Catheter in Patients with Acute Ischemic Stroke Related to Internal Carotid Artery Occlusion

  • Jang, Hyoung-Gyu;Park, Jung-Soo;Lee, Jong-Myong;Kwak, Hyo-Sung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.545-550
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    • 2019
  • Objective : Penumbra ACE68 reperfusion catheter is a new large bore aspiration catheter used for reperfusion of large vessel occlusion. The objective of this study was to investigate the efficacy of this catheter in comparison to that of previous Penumbra catheters in patients with acute ischemic stroke related to internal carotid artery (ICA) occlusion. Methods : Data of all eligible patients who received endovascular treatment (EVT) for ICA occlusion using Penumbra aspiration catheters between January 2015 and December 2018 were retrospectively reviewed. After dividing into two groups according to use of penumbra ACE68, baseline characteristics of patients, successful recanalization rate, puncture to recanalization time, and switch to stent base technique rate were assessed. Successful recanalization was defined by a thrombolysis in cerebral infarction (TICI) score ${\geq}2b$ and favorable functional outcome was defined according to modified Rankin scale (score, 0-2). Results : ACE68 reperfusion catheter was used in 29 of 75 eligible patients (39%). The puncture to recanalization time was significantly shorter ($26{\pm}18.2$ minutes vs. $40{\pm}24.9$ minutes, p=0.011) and the rate of switch to stent-based retrieval was significantly lower (3% vs. 20%, p=0.046) in ACE68 catheter group. Moreover, although not statistically significant, the successful recanalization rate was higher (83% vs. 76%, p=0.492) in ACE68 catheter group. Favorable functional outcome was observed in 48% of patients treated with ACE68 reperfusion catheter and in 30% of patients treated using other Penumbra systems (p=0.120). Baseline Alberta Stroke Program Early CT Scores ${\geq}8$ (odds ratio [OR], 9.74; 95% confidence interval [CI], 1.72-54.99; p=0.010) and successful recanalization (OR, 10.20; 95% CI, 1.13-92.46; p=0.039) were independent predictors of favorable outcome. Conclusion : EVT using ACE68 reperfusion catheter can be considered a first-line therapy in patients with acute ICA occlusion as it can achieve rapid recanalization and reduce the frequency of conversion to stent-retrieve therapy.

Efficacy of Combining Proximal Balloon Guiding Catheter and Distal Access Catheter in Thrombectomy with Stent Retriever for Anterior Circulation Ischemic Stroke

  • Kim, Sang Hwa;Choi, Jae Hyung;Kang, Myung Jin;Cha, Jae Kwan;Kim, Dae Hyun;Nah, Hyun Wook;Park, Hyun Seok;Kim, Sang Hyun;Huh, Jae Taeck
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.405-413
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    • 2019
  • Objective : We evaluated efficacy of combining proximal balloon guiding catheter (antegrade flow arrest) and distal access catheter (aspiration at the site of occlusion) in thrombectomy for anterior circulation ischemic stroke. Methods : We retrospectively analyzed 116 patients who underwent mechanical thrombectomy with stent retriever. The patients were divided by the techniques adopted, the combined technique (proximal balloon guiding catheter and large bore distal access catheter) group (n=57, 49.1%) and the conventional (guiding catheter with stent retriever) technique group (n=59, 50.9%). We evaluated baseline characteristics (epidemiologic data, clinical and imaging characteristics) and procedure details (the number of retrieval attempts, procedure time), as well as angiographic (thrombolysis in cerebral infarction (TICI) score, distal thrombus migration) and clinical outcome (National Institutes of Health Stroke Scale at discharge, modified Rankin Scale [mRS] at 3 months) of them. Results : The number of retrieval attempts was lower (p=0.002) and the first-pass successful reperfusion rate was higher (56.1% vs. 28.8%; p=0.003) in the combined technique group. And the rate of final result of TICI score 3 was higher (68.4% vs. 28.8%; p<0.01) and distal thrombus migration rate was also lower (15.8% vs. 40.7%; p=0.021) in the combined technique group. Early strong neurologic improvement (improvement of National Institutes of Health Stroke Scale ${\geq}11$ or National Institutes of Health Stroke Scale ${\leq}1$ at discharge) rate (57.9% vs. 36.2%; p=0.02) and favorable clinical outcome (mRS at 3 months ${\leq}2$) rate (59.6% vs. 33.9%; p=0.005) were also better in the combined technique group. Conclusion : The combined technique needs lesser attempts, decreases distal migration, increases TICI 3 reperfusion and achieves better clinical outcomes.

Neuroimaging Findings of First-Visit Headache Patients (두통 초진 환자에서 신경영상검사 소견)

  • Kim, Byung-Su;Kim, Soo-Kyoung;Kim, Jae-Moon;Moon, Heui-Soo;Park, Kwang-Yeol;Park, Jeong Wook;Sohn, Jong-Hee;Song, Tae-Jin;Chu, Min Kyung;Cha, Myoung-Jin;Kim, Byung-Kun;Cho, Soo-Jin
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.294-301
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    • 2018
  • Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

Identification and confirmation of 14-3-3 ζ as a novel target of ginsenosides in brain tissues

  • Chen, Feiyan;Chen, Lin;Liang, Weifeng;Zhang, Zhengguang;Li, Jiao;Zheng, Wan;Zhu, Zhu;Zhu, Jiapeng;Zhao, Yunan
    • Journal of Ginseng Research
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    • v.45 no.4
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    • pp.465-472
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    • 2021
  • Background: Ginseng can help regulate brain excitability, promote learning and memory, and resist cerebral ischemia in the central nervous system. Ginsenosides are the major effective compounds of Ginseng, but their protein targets in the brain have not been determined. Methods: We screened proteins that interact with the main components of ginseng (ginsenosides) by affinity chromatography and identified the 14-3-3 ζ protein as a potential target of ginsenosides in brain tissues. Results: Biolayer interferometry (BLI) analysis showed that 20(S)-protopanaxadiol (PPD), a ginseng saponin metabolite, exhibited the highest direct interaction to the 14-3-3 ζ protein. Subsequently, BLI kinetics analysis and isothermal titration calorimetry (ITC) assay showed that PPD specifically bound to the 14-3-3 ζ protein. The cocrystal structure of the 14-3-3 ζ protein-PPD complex showed that the main interactions occurred between the residues R56, R127, and Y128 of the 14-3-3 ζ protein and a portion of PPD. Moreover, mutating any of the above residues resulted in a significant decrease of affinity between PPD and the 14-3-3 ζ protein. Conclusion: Our results indicate the 14-3-3 ζ protein is the target of PPD, a ginsenoside metabolite. Crystallographic and mutagenesis studies suggest a direct interaction between PPD and the 14-3-3 ζ protein. This finding can help in the development of small-molecular compounds that bind to the 14-3-3 ζ protein on the basis of the structure of dammarane-type triterpenoid.

Long-Term Outcomes of Preoperative Atrial Fibrillation in Cardiac Surgery

  • Kim, Hyo-Hyun;Kim, Ji-Hong;Lee, Sak;Joo, Hyun-Chel;Youn, Young-Nam;Yoo, Kyung-Jong;Lee, Seung Hyun
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.378-387
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    • 2022
  • Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

Butyric acid and prospects for creation of new medicines based on its derivatives: a literature review

  • Lyudmila K. Gerunova;Taras V. Gerunov;Lydia G. P'yanova;Alexander V. Lavrenov;Anna V. Sedanova;Maria S. Delyagina;Yuri N. Fedorov;Natalia V. Kornienko;Yana O. Kryuchek;Anna A. Tarasenko
    • Journal of Veterinary Science
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    • v.25 no.2
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    • pp.23.1-23.15
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    • 2024
  • The widespread use of antimicrobials causes antibiotic resistance in bacteria. The use of butyric acid and its derivatives is an alternative tactic. This review summarizes the literature on the role of butyric acid in the body and provides further prospects for the clinical use of its derivatives and delivery methods to the animal body. Thus far, there is evidence confirming the vital role of butyric acid in the body and the effectiveness of its derivatives when used as animal medicines and growth stimulants. Butyric acid salts stimulate immunomodulatory activity by reducing microbial colonization of the intestine and suppressing inflammation. Extraintestinal effects occur against the background of hemoglobinopathy, hypercholesterolemia, insulin resistance, and cerebral ischemia. Butyric acid derivatives inhibit histone deacetylase. Aberrant histone deacetylase activity is associated with the development of certain types of cancer in humans. Feed additives containing butyric acid salts or tributyrin are used widely in animal husbandry. They improve the functional status of the intestine and accelerate animal growth and development. On the other hand, high concentrations of butyric acid stimulate the apoptosis of epithelial cells and disrupt the intestinal barrier function. This review highlights the biological activity and the mechanism of action of butyric acid, its salts, and esters, revealing their role in the treatment of various animal and human diseases. This paper also discussed the possibility of using butyric acid and its derivatives as surface modifiers of enterosorbents to obtain new drugs with bifunctional action.