• The Journal of Korean Physical Therapy
• /
• v.21 no.4
• /
• pp.111-115
• /
• 2009

Purpose: The aim of this study was to present fundamental information regarding clinical prognosis and clinical criteria for therapeutic intervention in stroke patients with focal pons infarction. Methods: Four stroke patients (male: 2, female: 2) who were diagnosed with pons infarction were recruited. All subjects had motor functions evaluated using methods such as the Motricity Index (MI), the Modified Brunnstrom Classification (MBC), Functional Ambulatory Category (FAC), and the Bathel Index (BI). Evaluations were done at least 4 times over a period that was approximately 8~11 months from stroke onset. We compared the final evaluation with the first evaluation. Results: All patients with focal pons infarction showed improvement with time in motor function. The physical strength of all patients was improved to normal or good grades from zero or trace grades in the Motricity Index test. Also, other motor functions such as ambulatory capacity and activities of daily living (ADL) improved with time. Conclusion: Aspects of functional recovery and clinical prognosis are clearly predictable for specific patients with focal pons infarction. In addition, adequate therapeutic interventions can be provided clinical criterion to patients, according to aspect of functional recovery. Accordingly, patients with pons infarction change for the better over time.

• Journal of Chest Surgery
• /
• v.44 no.2
• /
• pp.186-188
• /
• 2011

Ventricular septal rupture (VSR) is a rare but lethal complication of myocardial infarction. The event occurs 2~8 days after an infarction and often precipitates cardiogenic shock. Post myocardial infarction VSR is known for difficult to repair. Especially, Transmural myocardial infarction involved in the posterior VSD area, exposure of the affected site is difficult and postoperative mortality rate is high. We have experienced a case of a 75-year-old female patient who suffered posterior VSD due to acute myocardial infarction, and attained good result by approaching the lesion through right atrial incision and repaired the defect by using patch closure technique.

• The Korean Journal of Physiology and Pharmacology
• /
• v.27 no.2
• /
• pp.177-185
• /
• 2023

The excessive inflammatory response induced by myocardial infarction exacerbates heart injury and leads to the development of heart failure. Recent studies have confirmed the involvement of multiple transcription factors in the modulation of cardiovascular disease processes. However, the role of KLF9 in the inflammatory response induced by cardiovascular diseases including myocardial infarction remains unclear. Here, we found that the expression of KLF9 significantly increased during myocardial infarction. Besides, we also detected high expression of KLF9 in infiltrated macrophages after myocardial infarction. Our functional studies revealed that KLF9 deficiency prevented cardiac function and adverse cardiac remodeling. Furthermore, the downregulation of KLF9 inhibited the activation of NF-κB and MAPK signaling, leading to the suppression of inflammatory responses of macrophages triggered by myocardial infarction. Mechanistically, KLF9 was directly bound to the TLR2 promoter to enhance its expression, subsequently promoting the activation of inflammation-related signaling pathways. Our results suggested that KLF9 is a pro-inflammatory transcription factor in macrophages and targeting KLF9 may be a novel therapeutic strategy for ischemic heart disease.

• The Journal of Korean Physical Therapy
• /
• v.22 no.1
• /
• pp.75-81
• /
• 2010

Purpose: The purpose of this study was to apply association rule mining to explore the labyrinthine network of cerebral infarction comorbidity and basic data supply to develop cutting-edge physical therapy protocols for cerebral infarction with comorbidity Methods: From clinic records of enrollees of A Hospital in D city, patients over 18 years of age with cerebral infarction and cerebral infarction comorbidity were recruited as a case group. All diagnoses of that hospital were categorized according to the "International Classification of Disease (ICD)" diagnosis system. We extracted code I63 from the "Korea Classification of Disease (KCD)-4". Associated rule mining was done with a priori modeling and Web nodes to examine the strengths of associations among those diagnoses. The support and confidence values of associated rule mining results were examined. Results: The subjects of this study were 2,267 cerebral infarction patients. E11 (Non-insulin-dependent diabetes mellitus), E78 (Disorders of lipoprotein metabolism and other lipidaemias), G81 (Hemiplegia), I10 (Essential hypertension), and K29 (Gastritis and duodenitis) were high frequency diagnoses, being found in 10% or more of total diagnoses of cerebral infarction from frequency analysis results. The highest frequency diagnosis was 1,042 (46.0%) for I10. The second most frequent diagnosis was for E11(21.5%) while the third most frequent diagnosis was E78 (20.2%). Results from a priori modeling and Web nodes indicated that cerebral infarction has a strong association withessential hypertension, non-insulin-dependent diabetes mellitus, disorders of lipoprotein metabolism and other lipidaemias. Conclusion: Cerebral infarction is associated with hypertension, diabetes mellitus, and disorders of lipoprotein metabolism and other lipidaemias. The result of this study will be helpful to clinicians treating patients with cerebral infarction.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.4
• /
• pp.536-542
• /
• 2000

Objective : This study was performed to evaluate the relationships among intracranial pressure(ICP), cerebral perfusion pressure(CPP), and cerebral arteriovenous oxygen difference($AVDO_2$) which were used as parameters of adequacy of cerebral blood flow to support cerebral metabolism after severe head injury and also to examine the association between delayed cerebral infarction and outcome. Material and Method : The authors studied the ICP, CPP and $AVDO_2$ before and after treatment on 34 head-injured patients from June 1996 to December 1997 and examined the association with the change of an ICP, CPP and $AVDO_2$ following treatment and the development of delayed cerebral infarction. Sixteen patients underwent craniotomy for hematoma evacuation and eighteen patients received mannitol to decrease ICP. Results : The development of delayed cerebral infarction was demonstrated in 3(42.9%) out of 7 patients in no improvement group and 13(48.1%) out of 27 patients in improvement group with an increased ICP following treatment. Also, the development of delayed cerebral infarction was demonstrated in 8(50%) out of 16 patients in no improvement group and 8(44.4%) out of 18 patients in improvement group with a decreased CPP following treatment. The association with changes of ICP and CPP following treatment and development of delayed cerebral infarction was not statistically significant(p>0.01). However, 11(78.6%) out of 14 patients who demonstrated an increase in $AVDO_2$ and 5(25%) out of 20 patients who demonstrated a decrease in $AVDO_2$ following treatment developed delayed cerebral infarction. No improvement(reduction) in $AVDO_2$ following treatment was significantly associated with the development of delayed cerebral infarction(p<0.01). All of 16 patients with delayed cerebral infarction showed poor prognosis. Conlcusion : The change of $AVDO_2$ rather than those of ICP and CPP was considered more important factor for the development of the delayed cerebral infarction and poor outcome.

• BMB Reports
• /
• v.42 no.4
• /
• pp.200-205
• /
• 2009

Thromboxane A2 (TBXA2) is a potent vasoconstrictor in cerebral circulation and is a known contributor to the pathogenesis of cerebral infarction. Thromboxane A2 synthase 1 (TBXAS1) and thromboxane A2 receptors (TBXA2R) are key components in TBXA2 function. We examined whether genetic variants in TBXA2R and TBXAS1 are risk factors for cerebral infarction by genotyping 453 Korean patients with noncardiogenic cerebral infarction and 260 controls. A few, specific polymorphisms in the TBXA2R (-3372G>C, +4710T>C and 4839T>C) and TBXAS1 (+16184G>T, +141931A>T and +177729G>A) genes were chosen and investigated. Logistic regression showed the frequencies of TBXAS1+16184G>T and TBXAS1-ht3 were significantly more frequent in cerebral infarction (P = 0.002, OR = 2.75 and P = 0.01, OR = 1.57, respectively), specifically in small-artery occlusion (SAO) type of cerebral infarction (P = 0.0003 and 0.005, respectively). These results suggest specific TBXAS1 gene polymorphisms may be a useful marker for development of cerebral infarction, especially SAO type in Korean population.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.22 no.4
• /
• pp.993-999
• /
• 2008

Ischemic brain injury such as cerebral infarction is characterized by acute local inflammatory response mediated by cytokines. The mechanism of cytokines involved in cerebral infarction progression are uncompletely revealed yet. We investigated to find out the relationship between single nucleotide polymorphism (SNP) of interleukin 4 receptor(IL4R) and Oriental Medicine therapy efficacy in patients with cerebral infarction for 2 weeks. Oriental Korean Medicine therapies (herbal medicine and acupuncture) were applied daily and motor functions of patients were assessed using the modified cerebral vascular accident (MCVA) scores. Genotyping for IL4R polymorphism was done by pyrosequencing analysis. In IL4R genotypes and the frequency of alleles, there was no significant difference between cerebral infarction patients (n=124) and controls group (n=175). And there was also no significant difference among good and bad responders in cerebral infarction patients. In this study the IL4R genotype might not be the risk factor or a good predictive genetic marker for good and bad responders in cerebral infarction patients in Korean. Further studies including different cytokine genes will be necessary for the exact genetic markers.

• Journal of Chest Surgery
• /
• v.30 no.9
• /
• pp.941-944
• /
• 1997

Pulmonary infarction is rarely diagnosed with certainty except at postmortem examination. Part of this uncertainty is because of the inability to distinguish between hemorrhage, congestive a electasis, and necrosis clinically and radiographically. The pathogenesis of pulmonary infarction is poorly understood. It is dif%cult to induce pulmonary infarction in animals by ligation of the arterial supply to the lung. Many factors seem to be important in its pathogenesis, in addition to congestive heart failure, malignant tumor, thrombophlebitis, chronic obstructive lung disease, nephrotic syndrome, and postopeiative state. However, pulmonary infarction have not been reported in association with chest trauma. We report a case of pulmonary infarction associated with fractures of right clavicle and multiple ribs. A 45-year-old male had admitted due to right chest pain and dyspnea, which developed after right chest trauma occurred at about 3 weeks ago. He was treated at local clinics under the diagnosis of fractures of right clavicle and ribs until the admission. Chest CT disclosed a huge mass with central low density in right upper lobe, and small masses were also seen on both l ng fields. Open lung biopsy resulted in negativity for the malignancy. Clinical symptoms and radiological findings were not improved by conservative treatment. Right upper lobectomy was done eventually. The final diagnosis was pulmonary infarction. And, the patient has been well after operation.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.4
• /
• pp.326-330
• /
• 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.

• Journal of radiological science and technology
• /
• v.23 no.1
• /
• pp.39-47
• /
• 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.