• Title/Summary/Keyword: ischemic

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Fluoxetine and Sertraline Attenuate Postischemic Brain Injury in Mice

  • Shin, Tae-Kyeong;Kang, Mi-Sun;Lee, Ho-Youn;Seo, Moo-Sang;Kim, Si-Geun;Kim, Chi-Dae;Lee, Won-Suk
    • The Korean Journal of Physiology and Pharmacology
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    • v.13 no.3
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    • pp.257-263
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    • 2009
  • This study aimed to investigate whether selective serotonin reuptake inhibitors (SSRIs) attenuate brain injury and facilitate recovery following photothrombotic cortical ischemia in mice. Male ICR mice were anesthetized and systemically administered Rose Bengal. Permanent focal ischemia was induced in the medial frontal and somatosensory cortices by irradiating the skull with cold light laser. The animals were treated with fluoxetine or sertraline once a day for 14 d starting 1 h after ischemic insult. Treatment with fluoxetine and sertraline significantly reduced the infarct size. The Evans blue extravasation indices of the fluoxetine- and sertraline-treated groups were significantly lower than that of the vehicle group. Treatment with fluoxetine and sertraline shifted the lower limit of the mean arterial blood pressure for cerebral blood flow autoregulation toward normal, and significantly increased the expression of heme oxygenase-1 (HO-1) and hypoxia-inducible factor-1 ${\alpha}$ (HIF-1 ${\alpha}$) proteins in the ischemic region. These results suggest that SSRIs, such as fluoxetine and sertraline, facilitate recovery following photothrombotic cortical ischemia via enhancement of HO-1 and HIF-1 ${\alpha}$ proteins expression, thereby providing a benefit in therapy of cerebral ischemia.

The Case-control Study of Ischemic Stroke according to Sasang Constitution (사상체질에 따른 허혈성 뇌졸중 환자-대조군 연구)

  • Hwang Min-Woo;Lee Tae-Gyu;Lee Soo-Kyung;Song Il-Byung;Choe Bong-Geun;Koh Byung-Hee
    • The Journal of Korean Medicine
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    • v.27 no.1 s.65
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    • pp.118-129
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    • 2006
  • Objectives : A human being is classified into 4 constitutions(Taeyangin, Soyangin, Taeumin, and Souemin) and each constitution has the different incidence, treatment and prevention of disease in Sasang Constutional Medicine[SCM], The purpose of this study is to find relative risk(RR)s of each risk factors including Sasang Constitution[SC] for incidence of ischemic stroke. Methods : In 344-case patients with ischemic stroke and 1446 healthy control subjects without ischemic stroke, we evaluated sex, age. height, weight, BMI, ECG abnormality, hypertension, diabetes mellitus, blood lipid level and SC. These data were statistically analysed to investigate the relations between risk factors and the incidence of ischemic stroke by chi-square test. And then significant factors were analysed to get each adjusted odds ratio[OR] by binary logistic regression analysis. Results : ECG abnormality, hypertension, diabetes mellitus, HDL(high density lipoprotein) cholesterol, and SC were significantly related to the incidence of ischemic stroke, while age, sex and BMI were adjusted in a binary logistic regression analysis. Especially in SC, the incidence of ischemic stoke in Tae-eumin and Soyangin were higher than that in Soeumin (Tae-eumin OR=11.68[95% CI: 6.26-21.80], Soyangin OR=4.64[95% CI: 2.66-8.10]). Conclusions : These results suggested that SC may be one of important risk factors for ischemic stroke and it should be a useful data for prediction of incidence of ischemic stroke.

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Treatment for Patients with Acute Ischemic Stroke Presenting beyond Six Hours of Ischemic Symptom Onset : Effectiveness of Intravenous Direct Thrombin Inhibitor, Argatroban

  • Park, Jung-Soo;Park, Seung-Soo;Koh, Eun-Jeong;Eun, Jong-Pil;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.258-264
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    • 2010
  • Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

A Case Report of dcrease of hypodense region on CT images in ischemic cerebrovascular disease patient treated with Antiplatelet agent and Cheonghyulgangki-tang (항혈소판제제와 청혈강기탕(淸血降氣湯)을 병용 투여하여 CT영상에서 저음영부위의 감소를 보인 허혈성 뇌혈관질환 환자의 증례 보고)

  • Shin, Woo-Jae;Cha, Ji-Hye;Kim, Tae-Yeon;Park, Yu-Jin;Ko, Heung;Kim, Gi-Tae;Sin, Sun-Mi
    • The Journal of Internal Korean Medicine
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    • v.31 no.2
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    • pp.380-387
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    • 2010
  • The ischemic penumbra represents part of the hypoperfused region associated with focal brain ischemia. A practical approach is to define this region as that portion of the ischemic territory that can potentially be salvaged by timely intervention. For the prevention and treatment of ischemic stroke, antithrombotic therapy is prescribed. But medication of antiplatelet agent is only validated as prevention effect. Cheonghyulgangki-tang has been used for cerebral apoplexy, hypertension, etc. In this case report, an acute ischemic stroke patient was treated with an antiplatelet agent named Plavix and Cheonghyulgangki-tang and remarkable reduction of ischemic portion in the brain CT was observed. The result of this case suggests that oriental medical therapy could be a safe and effective intervention in acute ischemic stroke.

Preventive effects of ginseng against atherosclerosis and subsequent ischemic stroke: A randomized controlled trial (PEGASUS trial)

  • Kwon, Boseong;Song, Yunsun;Kim, Joong-Goo;Lee, Dongwhane;Lee, Sang-hun;Cho, Young-Keol;Kim, Jong S.;Suh, Dae Chul
    • Journal of Ginseng Research
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    • v.46 no.4
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    • pp.585-591
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    • 2022
  • Background: Korean Red Ginseng (KRG) extract has been shown to have beneficial effects in patients with atherosclerosis, suggesting that KRG extract may be effective in preventing subsequent ischemic stroke in patients with severe atherosclerosis. Methods: This double-blind, placebo-controlled trial randomized patients with severe atherosclerosis in major intracranial arteries or extracranial carotid artery, to ginseng group and placebo group. They were given two 500-mg KRG tablets or identical placebo tablets twice daily for 12 months according to randomization. The primary endpoint was the composite of cerebral ischemic stroke and transient ischemic attack during 12 months after randomization. The secondary endpoints were change in volumetric blood flow of the intracranial vessels and the incidence of newly developed asymptomatic ischemic lesions. Any adverse events were monitored. Results: Fifty-eight patients were randomized from June 2016 to June 2017, 29 to ginseng and 29 to placebo, and 52 (28 and 24, respectively) completed the study. One patient in the placebo group, but none in the ginseng group, experienced ischemic symptoms (p = 0.46). Changes in volumetric blood flow and the presence of ischemic brain lesions did not differ significantly in the two groups, and none of these patients experienced adverse drug reactions. Conclusion: Ginseng was well tolerated by patients with severe atherosclerosis, with these patients showing good compliance with ginseng dosing. Ginseng did not show significant effects compared with placebo, although none of the ginseng-treated patients experienced ischemic events. Long-term studies in larger patient populations are required to test the effect of ginseng.

Study on the Ischemic penumbra concept in stroke patient by case study (허혈경계부의 감소를 보인 뇌졸중 환자에 대한 증례보고)

  • Ko, Seong-Gyu
    • The Journal of Internal Korean Medicine
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    • v.21 no.2
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    • pp.341-348
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    • 2000
  • I have treated one ischemic stroke patient in acute stage with Seonghyangjeonggi-san, and observed remarkable reduction of the size ischemic portion in brain CT, notable improved motor power of patient. So I report this case of stroke patint. The ischemic penumbra, simply stated, is the part of the brain that is sandwiched brain regions committed to die and those that receive enough blood to communicate. Therefore, it is ischemic brain tissue that has just enough to communicte and function. The life expectancy of the penumbrais short. Although the penumbra is an elegant concept, in practice, it has been a difficult one to exploit. Up to now, a lot of research worker have tried to develop the method to make a accurate diagnosis. and then we know that PET and Xenon CT is available for the diagnosis for the ischemic penumbra. But those are not perfect to diagnose of penumbra. The case in my case report was confirmed as ischemic penumbra with CT. I know that CT is not prefect to diagnose penumbra, but I just want to raise the interest in penumbra of oriental medicine researcher and my report will be benificial to the penumbra researcher.

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Effects of Samul-tang-gamibang against Focal Cerebral Ischemic Damage by Middle Cerebral Artery Occulusion of Rats (사물탕가미방이 백서의 좌우 중대뇌 동맥 폐쇄에 의한 뇌허혈 손상의 회복에 미치는 효과)

  • 서창훈;김영균;권정남
    • The Journal of Korean Medicine
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    • v.25 no.1
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    • pp.117-128
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    • 2004
  • Objectives : This research was performed to investigate effect of Samul-tang-gamibang against focal cerebral ischemic damage after middle cerebral artery occlusion(MCAO). Methods : This research was used rats which were against focal cerebral ischemic damage by MCAO. It was used Zea Longa's theory and Belayev's methods to give rise to focal cerebral ischemic damage by MCAO. After 7days later, we drew out the brain and then had frozen and dyeing it and we had taken a picture to measure of the damaged area in each brain section. We determined the Neurological Index and tested the Foot-fault test and Roatated test to appraise the fall of motion ability result from cerebral ischemic damage. Results : The results of the experiment are as follows. 1. Samul-tang-gamibang reduced infarct size of sample group compared to control group at 7 day after MCAO. 2. Samul-tang-gamibang reduced infarct volume of sample group compared to control group at 7 day after MCAO. 3. Samul-tang-gamibang reduced foot-fault index of sample group compared to control group at 5,7 day after MCAO. Conclusions : Samul-tang-gamibang has protective effects against ischemic brain damage and had significant reduced infarct size and infarct volume of Rt-MCAO.

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Combined Influence of Obesity and Metabolic Syndrome on Ischemic Heart Disease in Korean middle aged and older adults (허혈성심질환 발생에 대한 대사증후군과 비만의 개별효과와 결합효과)

  • Ra, Jin Suk;Kim, Hye Sun
    • Journal of Korean Public Health Nursing
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    • v.29 no.3
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    • pp.540-550
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    • 2015
  • Purpose: The purpose of this study was to examine a combined influence of obesity and metabolic syndrome on ischemic heart disease in Korean middle aged and older adults. Methods: This study used secondary data from the 2013 Korea National Health and Nutrition Examination Survey. A total of 3,726 adults over age 40 were included. Logistic regression was used for analysis of complex samples. Gender, age, educational level, family income, family history of ischemic heart disease, physical activity, smoking, and heavy alcohol consumption were analyzed as covariates. Results: Ischemic heart disease was more prevalent among adults with metabolic syndrome regardless of obesity (non-obesity: Adjusted Odds Ratio [AOR]: 3.044, 95% Confidence Interval [CI]: 1.163-7.967, overweight: AOR: 2.805, 95% CI: 1.246-6.316, obese: AOR: 3.137, 95% CI: 1.548-6.358) compared to the reference group, defined as adults with non-obesity and non-metabolic syndrome. Odds of ischemic heart disease were not significant in the group with obesity and non-metabolic syndrome compared to the reference group. Conclusion: The results of this study show that the population with metabolic syndrome is an at-risk group for ischemic heart disease. Thus, management of metabolic syndrome is required for prevention of ischemic heart disease.

Neuroprotective effect of modified Boyanghwano-Tang and the major medicinal plants, Astragali Radix and Salviae Miltiorrhizae Radix on ischemic stroke in rats (허혈성뇌졸중 흰쥐모델에서 가미보양환오탕(加味補陽還五湯)와 주요 구성약재인 황기(黃芪), 단삼(丹蔘)의 뇌신경보호효과에 대한 연구)

  • Son, Hye-Young;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.25 no.2
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    • pp.71-79
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    • 2010
  • Objectives : In this study, the neuroprotective effects of modified Boyanghwano-Tang (mBHT) and the major medicinal plants, Astragali Radix(AR) and Salviae Miltiorrhizae Radix(SMR) were investigated in transient middle cerebral artery occlusion (tMCAO)-induced ischemic stroke of rats. Methods : mBHT(400 mg/kg) and AR(154 mg/kg) or SMR(62 mg/kg) water extract orally injected in rats after 90 min occlusion of MCA and then allow reperfusion to 24 h. Brain infarction was measured by TTC staining and the expressions of NOS isoforms and apoptotic molecules were determined in ischemic brain by Western blot. Results : The results showed that mBHT has stronger neuropreotective property through inhibitions of the PARP cleaved and caspase-3 activation in ischemic rats, and could reduced infarction volumes comparison of those of AR or SMR, respectively. While, AR extract has an angiogenic property through increasing the expressions of eNOS and VEGF, and SMR extract has a strong anti-inflammatory effects through inhibition of iNOS expression in ischemic brains. Conclusions : These results suggest that mBHT has multifactorial therapeutic advantages through anti-apoptosis, anti-inflammation and angiogenesis for ischemic stroke based on a synergistic combination of ingradients rather than monotherapy.

Time-dependent Modulation of Cerebral Ischemic Injury by Activated Macrophages/microglia after Lipopolysaccharide Microinjection into Rat Corpus Callosum

  • Lee, Jae-Chul;Kim, Won-Ki
    • Proceedings of the PSK Conference
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    • 2003.10a
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    • pp.106-107
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    • 2003
  • tIn brain ischemic insult, inflammatory cells such as macrophages and lymphocytes are chemo-attracted into the brain lesion and release cytokines, resulting in an activation of microglia that are functionally equivalent to peripheral macrophages in the central nervous system. In cerebral ischemic insults, activated inflammatory cells such as microglia and macrophages may be implicated in the pattern and degree of ischemic injury by producing various bioactive mediators. (omitted)

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