• Herbal Formula Science
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• v.30 no.4
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• pp.293-304
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• 2022

Objectives : Sagunja-Tang is a famous prescription used in Korean medicine for the purpose of promoting vital energy, and there are few studies using Sagunja-Tang on cerebrovascular diseases yet. As previous studies confirmed that Sagunja-tang is highly likely to be used effectively for stroke, this study was intended to predict the mechanism through which Sagunja-tang would act effectively on stroke. Methods : In this study, a network pharmacology analysis method was used, and oral bioavailability (OB), drug likeness (DL), Caco-2 and BBB permeability were utilized to select compounds with potential activity. For the values of each variable used in this study, OB ≥ 30%, DL ≥ 0.18, Caco-2 ≥ 0, and BBB ≥ 0.3 were applied. Using the above variables, the relations between target genes and diseases that are presumed to be involved in the selected bioavailable compounds were constructed in a network format, and proteins thought to play a major role were identified. Results : Among the compounds included in Sagunja-Tang, 26 bioavailable compounds were selected and it was confirmed that these compounds can be effectively used in cerebrovascular diseases such as Alzheimer's disease and stroke. These compounds are considered to act on proteins related in cell death and growth. The most important mechanism of action was predicted to be apoptosis, and the protein that is thought to play the most key action in this mechanism was caspase-3. Conclusions : In our future study, Sagunja-Tang will be used in an ischemic stroke mouse model, and the mechanism of action will be explored focusing on apoptosis and cell proliferation.

• The Journal of Korean Medicine
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• v.43 no.3
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• pp.106-121
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• 2022

Objectives: The purpose of this study was to investigate the anti-inflammatory effect of Cornus Officinalis fruit extract(CE) and Cornus Officinalis Fruit Cheonghyeol Plus(CCP) in Human Umbilical Vein Endothelial Cell. Methods: We measured cell viability of CE, CCP and treated HUVEC with TNF-α. We measured the mRNA expression levels of KLF2, eNOS, MCP-1, ICAM-1, VCAM-1, the protein expression levels of KLF2, eNOS, MCP-1, ICAM-1, VCAM-1, and the protein phosphorylation level of ERK, JNK, p38 and the biomarker expression levels of MCP-1, ICAM-1, VCAM-1. Results: 1.CE incresed the mRNA, protein expression levels of KLF2, eNOS at concentrations of 100㎍/㎖ compared to the control group. CE decresed the mRNA, protein and biomarker expression levels of MCP-1,ICAM-1,VCAM-1 at concentrations of 100㎍/㎖ compared to the control group. CE decresed the protein phosphorylation level of p38 at concentrations of 100㎍/㎖ compared to the control group. 2. CCP incresed the mRNA, protein expression levels of KLF2, eNOS at concentrations of 100㎍/㎖ or more compared to the control group. CCP decresed the mRNA, protein and biomarker expression levels of MCP-1, ICAM-1, VCAM-1 at concentrations of 100㎍/㎖ or more compared to the control group. CCP decresed the protein phosphorylation level of ERK at concentrations of 100㎍/㎖ or more, p38 at concentrations of 200㎍/㎖ or more, and JNK at concentrations of 400㎍/㎖ compared to the control group. Conclusions: These results present that CE and CCP has anti-inflammatory effect in HUVEC. So, it could help treat or prevent inflammation in vein caused by dyslipidemia and contribute prevention of cardiovascular and cerebrovascular cerebrovascular diseases.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.8-16
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• 2008

Purpose: To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using $^{99m}Tc$-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). Materials and Methods: The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Results: Seventeen patients (M:F =12:5, mean age $53{\pm}2yr$) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p = 0.003) and decreased to the preoperative level at 3-6 months (p = 0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Conclusion: Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.2
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• pp.170-181
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• 1996

Objective : This study was tried to investigate the specific relationships among cognitve function, neurbehavioral symptoms, and daily living functions, as well as provide the guidline of more proper clinical approches for patients with subcortical cerebrovascular disease. Objects and Methods Subjects were 85 patients whose diagnosis was confirmed by brain CT or MRI and controls were 195 normal persons matched by educational level with the subjects. The cognitive functions were evaluated by BNA(Benton neuropsychiatric assessment), subjective neurobehavioral symptoms by SCL-90-R(Sympton Check List-90-Revised), objective neurobehavioral symptoms by NRS(Neurobehavioral Rating Scale), and daily living function symptoms by NRS(Neurobehavioral Rating Scale), and daily living function by GERRI(Geriatric Evaluation by Relative's Rating Instrument) and IADL(Instrumental Activities of Daily Living Scale). Results: 1) Subjects showed significantly lower cognitive functions than controls in all tests of BNA except Lt-Rt Orientation Test(p=0.09) and facial Recognition Test(p=0.186). 2) In subjective neurobehavioral symptoms, subjects showed significantly lower scores in all symptoms except anxiety(p=0.059), hostility(p=0.159), and phobic anxiety(p=0.849). But in objects neurobehavioral symptoms, subjects showed significantly higher in scores in psychoticism (p=0.000) and neuroticism(p=0.025) of NRS. 3) The score of social functioning of GERRI(p=0.000) and that of IADL(p=0.000) were significantly higher in subjects than in controls. 4) for correlation between cognitive and daily living functions, there were significant correlations between the scores of all items on BNA and the score of cognitive or social function of GERRI and the socre of MDL in corntrols, whereas in subjects, there were significant correlations only between the scores of BNA and the score of IADL. 5) for correlation between neuroehavioral symptoms and daily living functions, there were significant correlatons between the socre of subjective neurobehavioral symptoms and the scores of all subscales of GERRI and the score of MDL in controls. On the contrary, in subjects, there were significant correlations between the score of social function of GERRI and the score of objective neurobehavioral symptoms such as psychoticism, agitiation-hostility, and decrease d motivation-emotional withdrawl. Conclusion : Above results suggest that disturbances in specific function of brain may play a role as a predictor of impairments with specific daily living functions and also suggest that specific correlations among various functions may be useful as clinical parameters for setting of the treatment goal and for assessing the ongoing process in the treatment and rehavilitation of the patients with subcortical cerebrovascular disease.

• Journal of the Korean Society of Radiology
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• v.11 no.6
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• pp.493-500
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• 2017

In this study, data analysis has been conducted by INFINITT program to analyze the effect of signal to noise ratio(SNR) and contrast to noise ratio(CNR) of flow related enhancement(FRE) and computed tomography Angiography(CTA) on cerebrovascular diseases for qualitative evaluations. Based on the cerebrovascular image results achieved from 63 patients (January to April, 2017, at C University Hospital), we have selected 19 patients that performed both FRE-MRA and CTA. From the 19 patients, 2 were excluded due to artifacts from movements in the cerebrovascular image results. For the analysis conditions, we have set the 5 part (anterior cerebral artery, right and left Middle cerebral artery, right and left Posterior cerebral artery) as the interest area to evaluate the SNR and CNR, and the results were validated through Independence t Test. As a result, by averaging the SNR, and CNR values, the corresponding FRE-MRA achieved were: anterior cerebral artery ($1500.73{\pm}12.23/970.43{\pm}14.55$), right middle cerebral artery ($1470.16{\pm}11.46/919.44{\pm}13.29$), left middle cerebral artery ($1457.48{\pm}17.11/903.96{\pm}14.53$), right posterior cerebral artery ($1385.83{\pm}16.52/852.11{\pm}14.58$), left posterior cerebral artery ($1318.52{\pm}13.49/756.21{\pm}10.88$). by averaging the SNR, and CNR values, the corresponding CTA achieved were: anterior cerebral artery ($159.95{\pm}12.23/123.36{\pm}11.78$), right middle cerebral artery ($236.66{\pm}17.52/202.37{\pm}15.20$), left middle cerebral artery ($224.85{\pm}13.45/193.14{\pm}11.88$), right posterior cerebral artery ($183.65{\pm}13.47/151.44{\pm}11.48$), left posterior cerebral artery ($177.7{\pm}16.72/144.71{\pm}11.43$) (p < 0.05). In conclusion, MRA had high SNR and CNR value regardless of the cerebral infarction or cerebral hemorrhage observed in the 5 part of the brain. Although FRE-MRA consumed longer time, it proved to have less side effect of contrast media when compared to the CTA.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.183-198
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• 2000

Purpose: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TBI) and normal brain MRI findings. Materials and Methods: Thirty TBI patients and 19 healthy volunteers underwent rest/acetazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM'97) Results: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities. In patients with lower performance scale scores, CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a part of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal lobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. Conclusion: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.68-78
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• 1996

Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.

• Journal of the Institute of Electronics and Information Engineers
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• v.51 no.12
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• pp.180-188
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• 2014

It is very important accurate diagnosis and quick treatment in cerebrovascular disease, i.e. stenosis or occlusion that could be caused by risk factors such as poor dietary habits, insufficient exercise, and obesity. Time-of-flight magnetic resonance angiography (TOF-MRA), it is well known as diagnostic method without using contrast agent for cerebrovascular disease, is the most representative and reliable technique. Nevertheless, it still has measurement errors (also known as overestimation) for length of stenosis and area of occlusion in celebral infarction that is built by accumulation and rupture of plaques generated by hemodynamic turbulence. The purpose of this study is to show clinical trial feasibility for 3D-SPACE T2, which is improved by using signal attenuation effects of fluid velocity, in diagnosis of cerebrovascular disease. To model angiostenosis, strictures of different proportions (40%, 50%, 60%, and 70%) and virtual blood stream (normal saline) of different velocities (0.19 ml/sec, 1.5 ml/sec, 2.1 ml/sec, and 2.6 ml/sec) by using dialysis were made. Cross-examinations were performed for 3D-SPACE T2 and TOF-MRA (16 times each). The accuracy of measurement for length of stenosis was compared in all experimental conditions. 3D-SPACE 2T has superiority in terms of accuracy for measurements of the length of stenosis, compared with TOF-MRA. Also, it is robust in fast blood stream and large stenosis than TOF-MRA. 3D-SPACE 2T will be promising technique to increase diagnosis accuracy in narrow complex lesions as like two cerebral small vessels with stenosis, created by hemodynamic turbulence.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.352-361
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• 1999

Purpose: Carotid endarterectomy nay benefit patients with bilateral carotid stenosis by improving cerebro-vascular hemodynamics of ipsilateral as well as contralateral cerebral hemispheres. We investigated cerebro-vascular hemodynamics after carotid endarterectomy in patients with contralateral carotid occlusion by acetazolamide stress brain SPECT. Materials and Methods: Subjects were 14 symptomatic patients (all men, mean age 66 yrs) with carotid stenosis (>50%) with contralateral carotid occlusion. Acetazolamide stress Tc-99m ECD brain SPECTs were performed within 2 weeks before and after carotid endarterectomy using one day protocol. Cerebral blood flow (CBF) and cerebrovascular reserve (CVR) were assessed visually. In 12 patients, correlation between the patency of proximal anterior cerebral or anterior communicating arteries (A1/A-comm) and the improvement of CBF or CVR after endarterectomy was assessed. Results: Preoperative SPECT showed reduced CBF in 2 ipsilateral and 10 contralateral hemispheres. CVR was reduced in 4 ipsilateral and 9 contralateral hemispheres. Of 12 hemispheres with reduced CBF, 2 hemispheres (16.7%) showed improvement of CBF after endarterectomy. However, reduced CVR was improved in all 4 ipsilateral and 7 of 9 (78%) of contralateral hemispheres after endarterectomy. Three of4 with stenotic Al/A-comm and 4 of 8 with patent A1/A-comm had reduced contralateral CVR. Reduced contralateral CVR improved in all 3 patients with stenotic A1/A-comm and 3 of 4 with patent A1/A-comm. Conclusion: Acetazolamide stress brain SPECT demonstrated improvement of compromised cerebrovascular reserve in not only ipsilateral but also contralateral hemispheres of patients with contralateral carotid occlusion after carotid endarterectomy, and may, therefore, be useful for evaluating cerebral blood flow and cerebrovascular reserve after carotid endarterectomy.

• Journal of Korean Academy of Nursing
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• v.33 no.2
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• pp.246-255
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• 2003

Purpose: This study was designed to compare direct cost and indirect cost between home care and hospital care according to subject's characteristics. Method: The subjects of this study were patients with cerebrovascular disease. They were 50 patients in six university hospitals and 49 in four home care centers. Data were collected by using two type of questionnaires and reviewing medical records, home care service records and medical-fee claims from April 4th to September 13th, 2001. Result: The results were as follows; First, there was a statistically significant difference of direct cost between home care and hospital care, however, there was not a statistically significant difference of indirect cost. Second, according to subject's characteristics, six variables had statistically significant differences; sex, age, marital status, economy, job and diagnosis. Conclusion: It was found that cost-saving effect of home care was affected by subject's characteristic factors. More study needs to be done to develop a more detailed selection criteria for home care subjects.