• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.49-57
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• 1992

혈관확장제 투여에 의한 약물부하 심근스캔시는 운동부하 심근스캔시와 비교하여 심박출량과 관상 동백 혈류의 증가정도가 달라서 심근내 T1-201의 농도가 달라진다. 그러므로 부하 심근관류스캔의 정량적 판독시에 각각의 부하에 특이적인 Normal file을 사용하지 않으면 이러한 심근내 T1-201 농도의 차이로 인하여 관류 결손의 크기가 다르게 나타날 수 있으리라 추측할 수 있다. 본 연구는 좌전하행지의 유의한 협착이 있는 34명의 단일 혈관 관상동맥 환자에서 이러한 가정이 실제적으로 어떻게 나타나는가를 조사하였다. 환자들은 adenosine 140ug/kg/min을 정맥주사하고 T1-201 SPECT를 실시하였다. 관류결손의 크기는 답차운동부하 T1-201 스캔을 실시한 정상인에서 구한 Normal File (File-ex)과 adenosine T1-201 스캔의 Normal File (File-ad)을 각각 이용하여 만든 극성지도에서 구한 adenosine 심근스캔의 관류결손의 범위지수(extent score)와 중증도지수(severity score)로 표시하였고, 이들의 값을 비교하여 아래의 결과를 얻었다. File-ex로 구한 관류결손의 범위지수는 $19{\pm}13%$였고 File-ad로 구한 범위는 $11{\pm}10%$였다(차이 $8.1{\pm}1.6%$, p=0.0001), 중증도지수는 File-ex를 사용하였을 때 $582{\pm}479$였고 File-ad를 사용하였을때는 $310{\pm}309$였다(차이 $272{\pm}49$, p<0.0001). $50\sim70%$의 중등도의 내경 협착이 있었던 20명의 환자에서는 범위지수는 File-ex와 File-ad에서 각각 $17{\pm}10$과 $7{\pm}7%$(p=0.001)였고, 70% 이상의 내경 협착이 있었던 14명에서의 범위 지수는 각각 $24{\pm}16$과 $18{\pm}10%$ (p=0.03)로 모두에서 File-ex를 사용하였을때의 값이 컸다. 이와 같은 성적으로 보아 T1-201 스핀에서 관류결손의 정도를 정량적으로 첨가할 시에는 부하에 특이적인 Normal File을 사용하여야 관류 결손의 정도를 정확하게 추출할 수 있다는 사실을 알 수가 있다. 즉 dipyridamole이나 adenosine부하경사에서 운동부하의 Normal File을 사용하면 관류결손의 정도가 과대평가 된다는 것이다.

• Biomolecules & Therapeutics
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• v.15 no.1
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• pp.16-26
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• 2007

Tissue plasminogen activator (tPA) is a serine protease catalyzing the proteolytic conversion of plasminogen into plasmin, which is involved in thrombolysis. During last two decades, the role of tPA in brain physiology and pathology has been extensively investigated. tPA is expressed in brain regions such as cortex, hippocampus, amygdala and cerebellum, and major neural cell types such as neuron, astrocyte, microglia and endothelial cells express tPA in basal status. After strong neural stimulation such as seizure, tPA behaves as an immediate early gene increasing the expression level within an hour. Neural activity and/or postsynaptic stimulation increased the release of tPA from axonal terminal and presumably from dendritic compartment. Neuronal tPA regulates plastic changes in neuronal function and structure mediating key neurologic processes such as visual cortex plasticity, seizure spreading, cerebellar motor learning, long term potentiation and addictive or withdrawal behavior after morphine discontinuance. In addition to these physiological roles, tPA mediates excitotoxicity leading to the neurodegeneration in several pathological conditions including ischemic stroke. Increasing amount of evidence also suggest the role of tPA in neurodegenerative diseases such as Alzheimer's disease and multiple sclerosis even though beneficial effects was also reported in case of Alzheimer's disease based on the observation of tPA-induced degradation of $A{\beta}$ aggregates. Target proteins of tPA action include extracellular matrix protein laminin, proteoglycans and NMDA receptor. In addition, several receptors (or binding partners) for tPA has been reported such as low-density lipoprotein receptor-related protein (LRP) and annexin II, even though intracellular signaling mechanism underlying tPA action is not clear yet. Interestingly, the action of tPA comprises both proteolytic and non-proteolytic mechanism. In case of microglial activation, tPA showed non-proteolytic cytokine-like function. The search for exact target proteins and receptor molecules for tPA along with the identification of the mechanism regulating tPA expression and release in the nervous system will enable us to better understand several key neurological processes like teaming and memory as well as to obtain therapeutic tools against neurodegenerative diseases.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.473-486
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• 1995

A hospital-based, matched case-control study was carried out to evaluate the relation ship of various suspected risk factors including snoring and serum level of cholesterol to cerebrovascular disease in Korea. A total of 127 incident cases of cerebrovascular disease(74 cases of cerebral infarction and 53 cases of intracerebral hemorrhage) admitted to. the department of neurology in a university hospital from December, 1993 to March, 1995 were compared with 127 matched controls admitted to same hospital in same period. A multivariate analysis suggested that ECG abnormality(left ventricular hypertrophy and atrial fibrillation), family history of cerebrovascular disease, fundoscopic abnormality, previous history of transient ischemic attack and hypercholesterolemia were risk factors of cerebrovascular disease, ECG abnormality, fundoscopic abnormality, smoking and hypercholesterolemia were also suggested as risk factors of cerebral infarction.

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.691-702
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• 2001

Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

• 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.

• The Journal of Internal Korean Medicine
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• v.31 no.3
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• pp.578-585
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• 2010

Objectives : Coldness of hands and feet has been regarded to be associated with blood circulation. This study was performed to assess the correlation between erythrocyte deformability and coldness of hands and feet. Methods : 145 patients who had taken an erythrocyte deformability test were selected for this study among hospitalized patients within 4 weeks after their cerebral infarction at the Internal Medical Department at Kyunghee Oriental Medical Center from August 2008 to August 2009. We divided the selected patients into two groups, with and without of coldness of hands and feet groups. The two groups were compared on risk factors for atherosclerosis and examined for variables including erythrocyte deformability. Results : 1. On demographic variables of the patients, only body mass index was significantly lower in the coldness of hands and feet group than the control group. There was no significant difference of the rate of hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, smoking, drinking and carotid artery stenosis between the two groups. 2. According to blood test, the coldness of hands and feet group showed significantly lower erythrocyte deformability index than the control group. 3. Body mass index and erythrocyte deformability index showed a close relationship with coldness of hands and feet in multivariate analysis. Conclusions : The correlation between the erythrocyte deformability and coldness of hands and feet in cerebral infarction patients were decreased erythrocyte deformability participated in the mechanism of coldness of hands and feet.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.751-757
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• 2007

Objectives : The aim of this study was to provide basic background information on stroke by evaluating various etiological factors on the basis that the onset time of cerebral infarction varies according to its cause. Methods : We studied hospitalized patients within 4 weeks after their ictus who were admitted at Kyunghee OMC, Kyungwon OMC, or Donguk Ilsan OMC from [month] $1^{st}$, 2005 to June $30^{th}$, 2007. We compared the general characteristics of acute stroke patients according to onset time. Results : Regardless of the onset time, the distribution of cerebral infarction patterns showed high SVO. The onset time did not show significant difference for average age, height, weight, BMI, waist measurement, hip measurement, or waist/hip ratio between onset during sleep and awakening. Patients whose stroke occurred while awake were more likely to have a past history of HTN, DM, ischemic heart disease, or atrial fibrillation but did not show significant difference according to their onset time. Conclusions : The above results show that the overall tendency of acute stage cerebral infarction patients varies according to their onset time. This study was carried out on the basis of previous findings that cerebral infarctions that occurred during sleep were more likely to have been caused by cerebral thrombosis, and strokes that occurred while awake were more likely to have been caused by cerebral embolism. However, there were no statistically relevant results, so a larger study group is needed to research the tendency of stroke patients.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.816-829
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• 2007

Objectives : This study investigated warning signs and stroke presymptoms and their relationship with acute stroke patients in each stroke type. Methods : 217 patients with first-ever acute stroke within 2 weeks as the case group, 146 people without four major risk factors (hypertension, diabetes mellitus, hyperlipidemia and ischemic heart disease) as the healthy control group (Normals), and 160 people as the general control group (Controls) were recruited at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital from July 2005 to March 2007 for this case-control study. We analyzed the odds ratio of each warning sign or presymptom by multivariate logistic analysis and evaluated each stroke type, as well as general characteristics such as age, sex, etc. Results : Paralysis or weakness of the face and limbs, visual field disorder or loss of vision or blurred and double vision in eyes or both eyes, and sudden difficulty in speaking or dysarthria showed significant increase respectively in each stroke type. In contrast, numbness or tingling sensation or lowering sensation of the face and limbs, numbness or dead sensation of 1st and 2nd fingers, tension at cervical lesion, blepharospasm, facial spasm, etc. had no significant relation with stroke occurrence. Conclusions : In this study we demonstrated that each presymptom have an influence on each stroke type and have different odds ratio for stroke. We believe this may contribute to interpreting the importance of warning signs or presymptoms for each type of stroke, and more prospective studies are needed.

• Journal of Chest Surgery
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• v.34 no.3
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• pp.203-211
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• 2001

배경: AT$_1$수용체의 길항제가 세포 수준에서 심근을 재관류 손사으로부터 보호할수 있다는 것으로 알려져 있지만, 생체내에서의 효과나 그 기전은 아직 명확히 밝혀지지 않았다. 본 연구에서는 백서 심근 허혈 모델을 이용하여, AT$_1$ 수용체의 길항제들 중 하나인 irbesartan이 심근이 재관휴 손상에 미치는 효과를 알아보고, 재관류 손상을 매개하는 한 각지 기전으로서 세포자멸의 기여에 대하여 연구하고자 하였다. 대상 및 방법: Sprague-Dawley 백서에서 무작용 부형약(10% gum arabic: 1군, 개체수=14관) irbesartan(50mg/kg/day :II 군, 개체수=12)을 각각 3일 동안 24시간마다 경구로 투여하였다. 실험동물의 좌 관상 동맥을 45분간 결찰하였다가, 그 후 2시간 동안 재관류시킨 다음 심장을 적출 하였다. TTC(triphenyltetrazolium chloride) 염색법을 이용하여, 허혈 노출 부위에 대한 심근 경색 부위의 비율을 측정하였다. Agarose gel 전기영동상의 DNa 분절 양상과 TUNEL(TdT-mediated dUCP nick end labeling) 염색을 관찰하여 세포자멸이 일어난 정도를 평가하였다. 세포자멸을 조절하는데 관여하는 것으로 알려진 Bcl-2(B-cell lymphoma 2 gene), Bad 등의 단백과 ERK (extracellular signal-regulated kinase), p-38 등 신호전달체계에 작용하는 MAPKs(mitogen-activated protein kinases)의 발현을 측정하기 위하여 Western blot을 시행하였다. 결과: 허혈 노출부위에 대한 심근 경색부위의 비율은 II군(42$\pm$2.7%)이 I군( 64.1$\pm$4.65)에 비해 유의하게 작았다.(p< 0.05), Agarose gel 전기영동상의 DNA laddering 양상은 I군에서 보다 높게 발현되었다. Bad와 ERK2의 발현은 두 군간에 유의한 차이가 없었다. 결론: AT$_1$수용체 길항제인 irbesartan은 생체에서 심근의 재관류 손상을 줄이는 효과가 있었다. 이 효과는 적어도 부분적으로 나만 심근세포의 세포자멸이 감소한 것에 기인한 것으로 설명할 수 있으며, 이 항-세포 자멸 효과는 Bcl-2의 발현증가와 관련이 있는 것으로 추정되었다.

• Microbiology and Biotechnology Letters
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• v.39 no.4
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• pp.364-373
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• 2011

Human embryonic stem cells have been highlighted as a valuable cellular source in the regenerative medicine field, due to their pluripotency. However, there is the challenge of the establishment of specific functional cell type forms of undifferentiated human embryonic stem cells (hESC). To establish and purify functional cell types from hESCs, we differentiated undifferentiated hESCs into vascular lineage cells and sorted the specific cell population from the whole cell population, depending on their cell volume, and compared them with the non-sorted cell population. We observed that about 10% of the PECAM positive population existed in the VEGF induced differentiating human embryoid body (hEB), and differentiated hEBs were made into single cells for cell transplantation. After making single cells, we performed cell sorting using a fluorescence-activated cell sorter (FACs), according to their cell volume on the basis of FSC region gating, and compared their therapeutic capacity with the non-sorted cell population through cell transplantation into hindlimb ischemic disease model mice. 4 Weeks after cell transplantation, the recovery rate of blood perfusion reached 54% and 17% in the FSC regions of sorted cells- and non-sorted cells, respectively. This result suggests that derivation of a functional cell population from hESCs can be performed through cell sorting on the basis of cell volume after preliminary differentiation induction. This approach may then greatly contribute to overcoming the limitations of marker sorting.