• Journal of Neurocritical Care
• /
• v.11 no.2
• /
• pp.86-92
• /
• 2018

Background: A delay of transfer for patients with acute stroke needing emergent revascularization is a huge hurdle for efficacy of revascularization. The objective of this study was to investigate changes of transportation time calculated by image to door (ITD) time (from checking brain images at first contact hospital to arriving at our emergency center) before and after 2015. Methods: This study was performed in a retrospective manner from 2013 into 2017. Acute ischemic stroke (AIS) patients having intravenous thrombolysis and/or mechanical thrombectomy during the observation period were enrolled. Among them, those who had revascularization under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm were selected. Results: During the observation period, 225 patients were treated under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm. Twenty-three were excluded due the lack of detailed data. Among 202 patients, 73 and 129 were treated under Drip-and-Ship and Ship-and-Drip paradigms, respectively. In 2013, 35 patients from 18 hospitals (median distance, 25 km) were transferred to our regional stroke center and their median ITD time was 116 minutes. It was gradually decreased after 2015. In 2017, ITD time was significantly (P<0.01) shortened to 85 minutes without significant changes in transfer distance. The median onset to puncture time was also significantly (P=0.03) decreased from 365 minutes in 2013 to 270 minutes in 2017. Conclusion: Our results implicate that many hospitals in our stroke region might have recognized the importance of rapid transportation for AIS after 2015.

• Clinical and Experimental Pediatrics
• /
• v.64 no.4
• /
• pp.180-187
• /
• 2021

Background: Severe perinatal asphyxia results in multiple organ involvement, neonate hospitalization, and eventual death. Purpose: This study aimed to investigate the predictive factors of death in newborns with hypoxic-ischemic encephalopathy (HIE) receiving selective head cooling. Methods: This cross-sectional descriptive-retrospective study was conducted from 2013 to 2018 in Fatemieh Hospital of Hamadan and included 51 newborns who were admitted to the neonatal intensive care unit with a diagnosis of HIE. Selective head cooling for patients with moderate to severe HIE began within 6 hours of birth and continued for 72 hours. The required data for the predictive factors of death were extracted from the patients' medical files, recorded on a premade form, and analyzed using SPSS ver. 16. Results: Of the 51 neonates with moderate to severe HIE who were treated with selective head cooling, 16 (31%) died. There were significant relationships between death and the need for advanced neonatal resuscitation (P=0.002), need for mechanical ventilation (P=0.016), 1-minute Apgar score (P=0.040), and severely abnormal amplitude-integrated electroencephalography (a-EEG) (P=0.047). Multiple regression of variables or data showed that the need for advanced neonatal resuscitation was an independent predictive factor of death (P=0.0075) and severely abnormal a-EEG was an independent predictive factor of asphyxia severity (P=0.0001). Conclusion: All cases of neonatal death in our study were severe HIE (stage 3). Advanced neonatal resuscitation was an independent predictor of death, while a severely abnormal a-EEG was an independent predictor of asphyxia severity in infants with HIE.

• Journal of Veterinary Science
• /
• v.23 no.6
• /
• pp.84.1-84.15
• /
• 2022

Background: Stroke is caused by disruption of blood supply and results in permanent disabilities as well as death. Chlorogenic acid is a phenolic compound found in various fruits and coffee and exerts antioxidant, anti-inflammatory, and anti-apoptotic effects. Objectives: The purpose of this study was to investigate whether chlorogenic acid regulates the PI3K-Akt-Bad signaling pathway in middle cerebral artery occlusion (MCAO)-induced damage. Methods: Chlorogenic acid (30 mg/kg) or vehicle was administered peritoneally to adult male rats 2 h after MCAO surgery, and animals were sacrificed 24 h after MCAO surgery. Neurobehavioral tests were performed, and brain tissues were isolated. The cerebral cortex was collected for Western blot and immunoprecipitation analyses. Results: MCAO damage caused severe neurobehavioral disorders and chlorogenic acid improved the neurological disorders. Chlorogenic acid alleviated the MCAO-induced histopathological changes and decreased the number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells. Furthermore, MCAO-induced damage reduced the expression of phospho-PDK1, phospho-Akt, and phospho-Bad, which was alleviated with administration of chlorogenic acid. The interaction between phospho-Bad and 14-3-3 levels was reduced in MCAO animals, which was attenuated by chlorogenic acid treatment. In addition, chlorogenic acid alleviated the increase of cytochrome c and caspase-3 expression caused by MCAO damage. Conclusions: The results of the present study showed that chlorogenic acid activates phospho-Akt and phospho-Bad and promotes the interaction between phospho-Bad and 14-3-3 during MCAO damage. In conclusion, chlorogenic acid exerts neuroprotective effects by activating the Akt-Bad signaling pathway and maintaining the interaction between phospho-Bad and 14-3-3 in ischemic stroke model.

• Proceedings of the Korean Society of Applied Pharmacology
• /
• 2003.11a
• /
• pp.62-62
• /
• 2003

It is now convincing that free radical generation is involved in the pathophy siological mechanisms of ischemic stroke, particularly in ischemia-reperfusion injury. The present study, therefore, examined neuroprotective effect of aloesin isolated from Aloe vera, which was known to have antioxidative activity, in a rat model of transient focal cerebral ischemia. Transient focal cerebral ischemia was induced by occlusion of middle cerebral artery for 2 hr with a silicone-coated 4-0 nylon monofilament in male Sprague-Dawley rats under isoflurane anesthesia Aloesin (1, 3, 10, 30 and 50 mg/kg/injection) was administered intravenously 3 times at 0.5, 2 and 4 hr after onset of ischemia. Neurological score was measured 24 hr after onset of ischemia immediately before sacrifice. Seven serial coronal slices of the brain were stained with 2,3,5-triphenyltetrazolium chloride and infarct size was measured using a computerized image analyzer. Treatment with the close of 1 or 50 mg/kg did not significantly reduce infarct volume compared with the saline vehicle-treated control group. However, treatments with the closes of 3 and 10 mg/kg significantly reduced both infarct volume and edema by approximately 47% compared with the control group, producing remarkable behavioral recovery effect. Treatment with the close of 30 mg/kg also significantly reduced infarct volume to a lesser extent by approximately 33% compared with the control group, but produced similar degree of behavioral recovery effect. In addition, general pharmacological studies showed that aloesin was a quite safe compound. The results suggest that aloesin can serve as a lead chemical for the development of neuroprotective agents by providing neuroprotection against focal ischemic neuronal injury.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.7 no.1
• /
• pp.59-64
• /
• 2006

Objective : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : Three-hundred sixty three acute stroke patients were recuited in the oriental medical hospitals of 3 universities located in metropolitan region from October in 2005 to October in 2006. We evaluated their stroke type with brain MRI, their waring signs, and general characteristics such as age, sex, past history, risk factor, etc. Result : Of the 363 patient, 138(38%) patients were experience of warning signs. The frequency of Stress were found more in experience of warning signs than none of them. Warning signs were more common in Large Artery Atherosclerosis than in the other etiology. Conclusion : Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which their patients appeal. For the further investigation, it seems to be necessary to construct fundamental databases for stroke by increasing the number of patients and by examination into the etiology and location.

• Proceedings of the Plant Resources Society of Korea Conference
• /
• 2021.04a
• /
• pp.57-57
• /
• 2021

Oxygen glucose deprivation/re-oxygenation (OGD/R) induces neuronal injury via mechanisms that are believed to mimic the pathways associated with brain ischemia. Stachys sieboldii Miq. (Chinese artichoke), which has been extensively used in oriental traditional medicine to treat of ischemic stroke; however, the role of S. sieboldii Miq. (SSM) in OGD/R induced neuronal injury is not yet fully understood. The present research is aimed to investigate the protective effect and possible mechanisms of SSM extract treatment in an in vitro model of OGD/R to simulate ischemia/reperfusion Injury. Pretreatment of these cells with SSM significantly attenuated OGD/R-induced production of reactive oxygen species (ROS) by increasing GPx, SOD, and decreasing MDA. SSM decreased mitochondrial damage caused by OGD/R injury and inhibited the release of cyt-c from mitochondrion to cytoplasm in SH-SY5Y cells. Furthermore, neuronal cell apoptosis caused by OGD/R injury was inhibited by SSM, and SSM could decrease apoptosis by increasing ratio of Bcl-2/Bax and inhibiting caspase signaling pathway in SH-SY5Y cells. SSM demonstrated a neuroprotective effect on the simulated cerebral ischemia in vitro model, and this effect was the inhibition of mitochondria-mediated apoptosis pathway by scavenging of ROS generation. Therefore, SSM may be a promising neuroprotective strategy against ischemic stroke.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.6
• /
• pp.467-476
• /
• 2013

Objective : This study aimed to evaluate the hypotheses that administration routes [intra-arterial (IA) vs. intravenous (IV)] affect the early stage migration of transplanted human bone marrow-derived mesenchymal stem cells (hBM-MSCs) in acute brain infarction. Methods : Male Sprague-Dawley rats (n=40) were subjected to photothrombotic infarction. Three days after photothrombotic infarction, rats were randomly allocated to one of four experimental groups [IA group : n=12, IV group : n=12, superparamagnetic iron oxide (SPIO) group : n=8, control group : n=8]. All groups were subdivided into 1, 6, 24, and 48 hours groups according to time point of sacrifice. Magnetic resonance imaging (MRI) consisting of T2 weighted image (T2WI), $T2^*$ weighted image ($T2^*WI$), susceptibility weighted image (SWI), and diffusion weighted image of rat brain were obtained prior to and at 1, 6, 24, and 48 hours post-implantation. After final MRI, rats were sacrificed and grafted cells were analyzed in brain and lung specimen using Prussian blue and immunohistochemical staining. Results : Grafted cells appeared as dark signal intensity regions at the peri-lesional zone. In IA group, dark signals in peri-lesional zone were more prominent compared with IV group. SWI showed largest dark signal followed by $T2^*WI$ and T2WI in both IA and IV groups. On Prussian blue staining, IA administration showed substantially increased migration and a large number of transplanted hBM-MSCs in the target brain than IV administration. The Prussian blue-positive cells were not detected in SPIO and control groups. Conclusion : In a rat photothrombotic model of ischemic stroke, selective IA administration of human mesenchymal stem cells is more effective than IV administration. MRI and histological analyses revealed the time course of cell migration, and the numbers and distribution of hBM-MSCs delivered into the brain.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.9
• /
• pp.1233-1237
• /
• 2000

Objectives : In order to evaluate the metabolic changes associated with pericontusional edematous area in mild head injury, proton magnetic resonance spectroscopy(1H-MRS) was performed in mild head injury patients (initial GCS score 13-15) with focal brain contusion. Methods : Seven head injury patients with initial GCS 13-15(3 males and 4 females : age range 15-65 years, mean age 33 years) have underwent 1H-MRS evaluations. The patients were examined within 7 days after injury(n=7) and 2 months after injury(n=5). The region of interest(ROI) was selected in the edematous area adjacent to traumatic brain contusion upon T2-weighted MR images and a corresponding region of the contralateral hemisphere (ROC, region of contralateral corresponding hemisphere) was examined as well. The metabolic ratios of NAA/Cr and lactate/Cr were compared between ROIs, ROCs and control values. Results : In initial NAA/Cr ratios, the values of ROIs were significantly lower than those of the controls(p=0.009), but there was no difference either between ROIs and ROCs(p=0.410) or between ROCs of patients and the control (p=0.199). In lactate/Cr ratios, the ROIs in all seven patients and the ROCs in two showed increased lactate signals. The lactate/Cr ratios of the ROIs were significantly elevated as compared to those of the ROCs(p=0.02) and the control(p=0.015). In two months follow-up, lactate signals were absent or significantly reduced(p=0.015). In no patients, clinical or radiological deterioration has been observed. Conclusion : Our 1H-MRS results demonstrate that there are significant ischemic changes in pericontusional edematous areas as indicated by elevated lactate signals in the patients with mild head injury. But there were no consistent neural loss or dysfunction in these area. There findings suggest that pericontusional edematous areas can be vulnerable to secondary brain insults even in the patients with mild head injury.

• Journal of the Korean Society of Radiology
• /
• v.10 no.4
• /
• pp.279-284
• /
• 2016

Single-shot echo planar imaging(SS-EPI) is well established as high sensitivity for ischemic stroke. However, it is prone to susceptibility artifact in brain stem that diminish the image quality. single-shot turbo spin echo(SS-TSE) is a new DWI technique that can reduce susceptibility artifact. Thus, this research was conducted so as to reduce geometric distortion in brain stem by using single-shot turbo spin echo technique. Thirty patients without brain disease underwent diffusion MR on a 3T scanner with SS-EPI and SS-TSE. Obtained images with both sequences were analyzed for geometric distortion and error percentage as well. Image quality in terms of geometric distortion of SS-TSE were found to be significantly better than those for SS-EPI. And error percentage was considerably reduced for 2.4% of b0 image(from 11.1% to 8.7%), 1.2% of b1000 image(from 11.4% to 10.1%), respectively. In summary, diffusion MR using SS-TSE significantly reduce geometric distortion compared to SS-EPI in brain stem and may provide improved diagnostic performance.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.18 no.6
• /
• pp.1714-1721
• /
• 2004

This experimental study was designed to investigate the mechanism of Palmul-Tang(PMT) on the changes of cerebral hemodynamics in rats. The changes of cerebral hemodynamics in normal rats were as follows ; The PMT-induced increase in regional cerebral blood flow was significantly inhibited by pretreatment with indomethacin(1㎎/㎏, i.p.), an inhibitor of cyclooxygenase, and was inhibited by methylene blue(10㎍/㎏, i.p.), an inhibitor of guanylate cyclase. The PMT-induced dilation in pial arterial diameter was significantly inhibited by pretreatment with indomethacin and methylene blue. The PMT-induced increase in mean arterial blood pressure was significantly inhibited by pretreatment with indomethacin but was increased by methylene blue. This results were suggested that the mechanism of PMT was mediated by cyclooxygenase. The changes of cytokine production in cerebral ischemic rats were as follows ; In cytokine production of serum by drawing from femoral arterial blood after middle cerebral arterial occlusion 1hr, sample group was decreased IL-1β and TNF-α production compared with control group, IL-10 production of sample group was similar to that of control group, but sample group was significantly increased TGF-β production compared with control group. In cytokine production of serum by drawing from femoral arterial blood after reperfusion 1hr, sample group was significantly decreased IL-1β production compared with control group and decreased TNF-α production compared with control group. IL-10 production of sample group was similar to that of control group, but sample group was significantly increased TGF-β production compared with control group. In cytokine production of serum by drawing from femoral arterial blood after reperfusion 4 hrs, sample group was significantly decreased IL-1β production compared with control group, but IL-10 production of sample group was similar to that of control group. sample group was increased TNF-α and TGF-β production compared with control group. These results suggested that PMT had inhibitive effect on the brain damage by inhibiting IL-1β and TNF-α production, but by accelerating TGF-β production. The present author thought that PMT had an anti-ischemic effect through the improvement of cerebral hemodynamics and inhibitive effect on the brain damage.