• Title/Summary/Keyword: ischemic brain

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A Study on the Mitigation of the Exposure Dose Applying Bolus Tracking in Brain Perfusion CT Scan (뇌 관류 CT검사에서 BolusTracking기법을 적용한 피폭선량 저감화에 관한 연구)

  • Kim, Ki-Jeong;Jung, Hong-Ryang;Lim, Cheong-Hwan;Hong, Dong-Hee;Shim, Jae-Goo;You, In-Gyu
    • Journal of Digital Convergence
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    • v.12 no.3
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    • pp.353-358
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    • 2014
  • This study was conducted to analyze the patient's exposed dose targeting the patients who had acute ischemic stroke symptoms and CT brain perfusion scan, by comparing fixed time technique and bolus tracking technique which was provided by the manufacturer and to identify the Time graph to implement the usability of contrast medium's tracking technique the best contrast enhancement intervals. $CTDI_{VOL}$ of PCT in patient appeared to be 431.72mGy in fixed scan delay protocol, whereas 323.61mGy in Bolus tracking technique. The value of DLP appeared to be $1243.47mGy{\cdot}cm$ in fixed scan delay protocol, whereas $932mGy{\cdot}cm$ in Bolus tracking technique. Time graph appeared to be various in fixed scan delay protocol, whereas the optimal time graph could be obtained in Bolus tracking. The exposure dose could be reduced by 25% applying Bolus tracking technique when taking brain perfusion CT scan.

A Study on Usefulness of Diffusion Tensor Imaging (DTI6D) in Brain Ischemic Disease (뇌 허혈성 질환 확산텐서영상(DTI6D)의 임상적 유용성에 관한 연구)

  • Goo, Eunhoe
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.1
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    • pp.223-228
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    • 2013
  • We evaluated the usefulness of $DTI_{6D}$ which was acquiring six direction diffusion data through compared to $DWI_{3D}$. Mean SNR and CNR were on $DWI_{3D}$ and $DTI_{6D}$ $44.01{\pm}13.36$, $37.15{\pm}11.44$ (p=0.029) and $18.47{\pm}9.66$, $19.88{\pm}9.20$(p=0.017). The number of lesions were $311{\pm}26.87$, $224.5{\pm}26.16$(p=0.041) on $DTI_{6D}$ and $DWI_{3D}$. Twenty patients were the more detected brain infarction lesion on $DTI_{6D}$. But there is no one the more detected on $DWI_{3D}$. And the more three direction diffusion data could get more information. However, we need to consider about the time consumption compared to DWI.

Protective effects of Tat-NQO1 against oxidative stress-induced HT-22 cell damage, and ischemic injury in animals

  • Jo, Hyo Sang;Kim, Duk-Soo;Ahn, Eun Hee;Kim, Dae Won;Shin, Min Jea;Cho, Su Bin;Park, Jung Hwan;Lee, Chi Hern;Yeo, Eun Ji;Choi, Yeon Joo;Yeo, Hyeon Ji;Chung, Christine Seok Young;Cho, Sung-Woo;Han, Kyu Hyung;Park, Jinseu;Eum, Won Sik;Choi, Soo Young
    • BMB Reports
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    • v.49 no.11
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    • pp.617-622
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    • 2016
  • Oxidative stress is closely associated with various diseases and is considered to be a major factor in ischemia. NAD(P)H: quinone oxidoreductase 1 (NQO1) protein is a known antioxidant protein that plays a protective role in various cells against oxidative stress. We therefore investigated the effects of cell permeable Tat-NQO1 protein on hippocampal HT-22 cells, and in an animal ischemia model. The Tat-NQO1 protein transduced into HT-22 cells, and significantly inhibited against hydrogen peroxide ($H_2O_2$)-induced cell death and cellular toxicities. Tat-NQO1 protein inhibited the Akt and mitogen activated protein kinases (MAPK) activation as well as caspase-3 expression levels, in $H_2O_2$ exposed HT-22 cells. Moreover, Tat-NQO1 protein transduced into the CA1 region of the hippocampus of the animal brain and drastically protected against ischemic injury. Our results indicate that Tat-NQO1 protein exerts protection against neuronal cell death induced by oxidative stress, suggesting that Tat-NQO1 protein may potentially provide a therapeutic agent for neuronal diseases.

Neuroprotective Effects of Scrophulariae Radix on Cerebral Ischemia in Mongolian Gerbils (Mongolian gerbil의 뇌허혈에 대한 현삼의 신경보호효과)

  • Lee, Jun-Hwan;Song, Mi-Yeon;Lee, Jong-Soo;Kim, Sung-Su;Shin, Hyun-Dae;Chung, Seok-Hee
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.4
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    • pp.1-11
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    • 2008
  • Objectives : Cerebral ischemia resulting from transient or permanent occlusion of cerebral arteries leads to neuronal cell death and eventually causes neurological impairments. Scrophulariae radix is the roots of Scrophularia buergeria. In the present study, we investigated the effects of the aqueous extract of Scrophulariae radix on apoptotic cell death in the hippocampal dentate gyrus following transient global ischemia in gerbils. Methods : For this study, step-down avoidance task, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, and immunohistochemistry for caspase-3 were performed. Results : The present results showed that apoptotic cell death in the hippocampal dentate gyrus was significantly increased following transient global ischemia in gerbils. Treatment with the aqueous extract of Scrophulariae radix suppressed the ischemia-induced apoptosis in the dentate gyrus and thus facilitated the recovery of short-term memory impairment induced by ischemic cerebral injury. Conclusions : Here in this study, we have shown that Scrophulariae radix has a positive effect on-and possesses protective qualities against ischemia-induced apoptotic neuronal cell death, and it can be used for the treatment of ischemic brain diseases.

The Effect of Sosokmyung-tang extract on Global cerebral ischemia·Cerebral Infarction by MCA occlusion in vivo (소속명탕(小續命湯) 추출물(抽出物)이 전뇌허혈(全腦虛血)및 국소뇌허혈(局所腦虛血)에 미치는 영향(影響))

  • Lee, Kyung-Ae;Shin, Gil-Cho;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.1
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    • pp.107-116
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    • 1999
  • The effects of Sosokmyung-tang(小續命湯) on global cerebral ischemia and cerebral in farction by MCA(middle cerebral artery) occlusion were evaluated in this study. This study was performed to investigate that Sosokmyung-tang would be useful for cerebrovascular diseases. In the case of global cerebral ischemia, ICR mice were used and divided into three group at random. Control group was treated after oral administration of normal saline, experimental group was treated after oral administration of 10.4mg/20g/day of Sosokmyung-tang extract. The multiple parameter of global cerebral ischemia included the duration of coma of KCN(potassium cyanide)-injected(1.2mg/kg, i.v) group and the survival time of KCN-injected(3.0mg/kg, i.v) group. In the case of cerebral infarction by MCA occlusion, Sprague-Dawley rats were used and divided into three group at random. Control group was given nothing before MCA occlusion, experimental group was given 157.2mg/250g/day of Sosokrnyung-tang extract before MCA occlusion. We investigated edema and ischemic ratio in 8 slices of rats' brain after MCA occlusion. The results were obtained as follows : 1. Sosokrnyung-tang significantly shortened the duration of coma of KCN-injected(1.2mg/kg,i.v) group and lengthened the survival time of KCN-injected(3.0mg/kg, i.v) group. 2. Sosokmyung-tang significantly decreased cerebral edema and ischemic ratio in rats after MCA occlusion. From the above results, it was concluded that Sosokmyung-tang can be effectively applied to cerebrovascular diseases.

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Angiogenic Effect of Cardiac Ankyrin Repeat Protein Overexpression in Vascular Endo-thelial Cell (Cardiac Ankyrin Repeat Protein의 과량발현이 혈관내피세포에서 갖는 혈관신생 촉진 효과)

  • Kong, Hoon-Young;Byun, Jong-Hoe
    • Korean Journal of Microbiology
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    • v.44 no.4
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    • pp.282-288
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    • 2008
  • Tissue ischemia resulting from the constriction or obstruction of blood vessels leads to an illness that may affect many organs including the heart, brain, and legs. In recent years, considerable progress has been made in the field of therapeutic angiogenesis and the new approaches are expected to cure those "no-option patients" who are unsuited to conventional therapies. Although single angiogenic growth factor may be successful in inducing angiogenesis, combination of multiple growth factors is increasingly sought these days to augment the therapeutic responses. This trend is proper in light of the fact that blood vessel formation is a complex and multi-step process that requires the actions of many different factors. To meet the growing need for functionally significant blood flow recovery in the ischemic tissues, a novel strategy that can provide concerted actions of multiple factors is required. One way to achieve such a goal is to use a transcription factor that can orchestrate the expression of multiple target genes in the ischemic region and thus induce significant level of angiogenesis. Here, a putative transcription factor, cardiac ankyrin repeat protein (CARP), was evaluated in adenoviral vector context for angiogenic activity in human umbilical vein endothelial cells. The results indicated significant increase in proliferation, capillary-like structure formation, and induction of vascular endothelial growth factor, a typical angiogenic gene. Taken together, these results suggest that CARP represents itself as a novel target for therapeutic angiogenesis and warrants further investigation.

Initial Experience of ACE68 Reperfusion Catheter in Patients with Acute Ischemic Stroke Related to Internal Carotid Artery Occlusion

  • Jang, Hyoung-Gyu;Park, Jung-Soo;Lee, Jong-Myong;Kwak, Hyo-Sung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.545-550
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    • 2019
  • Objective : Penumbra ACE68 reperfusion catheter is a new large bore aspiration catheter used for reperfusion of large vessel occlusion. The objective of this study was to investigate the efficacy of this catheter in comparison to that of previous Penumbra catheters in patients with acute ischemic stroke related to internal carotid artery (ICA) occlusion. Methods : Data of all eligible patients who received endovascular treatment (EVT) for ICA occlusion using Penumbra aspiration catheters between January 2015 and December 2018 were retrospectively reviewed. After dividing into two groups according to use of penumbra ACE68, baseline characteristics of patients, successful recanalization rate, puncture to recanalization time, and switch to stent base technique rate were assessed. Successful recanalization was defined by a thrombolysis in cerebral infarction (TICI) score ${\geq}2b$ and favorable functional outcome was defined according to modified Rankin scale (score, 0-2). Results : ACE68 reperfusion catheter was used in 29 of 75 eligible patients (39%). The puncture to recanalization time was significantly shorter ($26{\pm}18.2$ minutes vs. $40{\pm}24.9$ minutes, p=0.011) and the rate of switch to stent-based retrieval was significantly lower (3% vs. 20%, p=0.046) in ACE68 catheter group. Moreover, although not statistically significant, the successful recanalization rate was higher (83% vs. 76%, p=0.492) in ACE68 catheter group. Favorable functional outcome was observed in 48% of patients treated with ACE68 reperfusion catheter and in 30% of patients treated using other Penumbra systems (p=0.120). Baseline Alberta Stroke Program Early CT Scores ${\geq}8$ (odds ratio [OR], 9.74; 95% confidence interval [CI], 1.72-54.99; p=0.010) and successful recanalization (OR, 10.20; 95% CI, 1.13-92.46; p=0.039) were independent predictors of favorable outcome. Conclusion : EVT using ACE68 reperfusion catheter can be considered a first-line therapy in patients with acute ICA occlusion as it can achieve rapid recanalization and reduce the frequency of conversion to stent-retrieve therapy.

DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA: CASE REPORT (모야모야병(moyamoya disease) 환자의 전신마취 하 치과치료: 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.40-44
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    • 2019
  • Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disease of unknown etiology characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. The clinical presentations of MMD include transient ischemic attacks (TIA), ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. MMD is the most important cause of stroke or TIA in children in East Asian countries. A 5-year-3-month old boy with MMD experienced cerebral infarctions five times. Cerebrovascular anastomosis surgery was performed on him four years ago. He had dysphagia, developmental delay, hemiplegia, and strabismus. Besides, a number of dental caries in primary dentition were identified during clinical oral examination. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation and underlying systemic disease. MMD is associated with various medical diseases requiring thoughtful consideration during dental treatment. Crying and hyperventilation in MMD patients may cause hypocapnia and have a cerebral vasoconstrictive effect. If dental treatment is required, control of pain and anxiety is very important. General anesthesia may be considered for dental treatment in uncooperative or very young patients with MMD.

Early Restoration of Hypoperfusion Confirmed by Perfusion Magnetic Resonance Image after Emergency Superficial Temporal Artery to Middle Cerebral Artery Anastomosis

  • Eun, Jin;Park, Ik Seong
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.816-824
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    • 2022
  • Objective : Emergency superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis in patients with large vessel occlusion who fails mechanical thrombectomy or does not become an indication due to over the time window can be done as an alternative for blood flow restoration. The authors planned this study to quantitatively measure the degree of improvement in cerebral perfusion flow using perfusion magnetic resonance imaging (MRI) after bypass surgery and to find out what factors are related to the outcome of the bypass surgery. Methods : For a total of 107 patients who underwent emergent STA-MCA bypass surgery with large vessel occlusion, the National Institute of Health stroke scale (NIHSS), modified Rankin score (mRS), infarction volume, and hypoperfusion area volume was calculated, the duration between symptom onset and reperfusion time, occlusion site and infarction type were analyzed. After emergency STA-MCA bypass, hypoperfusion area volume at post-operative 7 days was calculated and analyzed compared with pre-operative hypoperfusion area volume. The factors affecting the improvement of mRS were analyzed. The clinical status of patients who underwent emergency bypass was investigated by mRS and NIHSS before and after surgery, and changes in infarct volume, extent, degree of collateral circulation, and hypoperfusion area volume were measured using MRI and digital subtraction angiography (DSA). Results : The preoperative infarction volume was median 10 mL and the hypoperfusion area volume was median 101 mL. NIHSS was a median of 8 points, and the last normal to operation time was a median of 60.7 hours. STA patency was fair in 97.1% of patients at 6 months follow-up DSA and recanalization of the occluded vessel was confirmed at 26.5% of patients. Infarction volume significantly influenced the improvement of mRS (p=0.010) but preoperative hypoperfusion volume was not significantly influenced (p=0.192), and the infarction type showed marginal significance (p=0.0508). Preoperative NIHSS, initial mRS, occlusion vessel type, and last normal to operation time did not influence the improvement of mRS (p=0.272, 0.941, 0.354, and 0.391). Conclusion : In a patient who had an acute cerebral infarction due to large vessel occlusion with large ischemic penumbra but was unable to perform mechanical thrombectomy, STA-MCA bypass could be performed. By using time-to-peak images of perfusion MRI, it is possible to quickly and easily confirm that the brain tissue at risk is preserved and that the ischemic penumbra is recovered to a normal blood flow state.

Change of Peroxiredoxin-5 Expression by Curcumin Treatment in Cerebral Ischemia (허혈성 대뇌손상시 curcumin 투여에 의한 peroxiredoxin-5 발현의 변화)

  • Gim, Sang-Ah;Koh, Phil-Ok
    • Journal of agriculture & life science
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    • v.50 no.3
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    • pp.129-139
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    • 2016
  • Curcumin plays a protective role in brain injury through its anti-oxidant and anti-inflammatory activities. Moreover, peroxiredoxin-5 exerts a protective effect against oxidative stress. The aim of this study was to investigate whether curcumin modulated the peroxiredoxin-5 expression in focal cerebral ischemic animal model. Middle cerebral artery occlusion(MCAO) was performed to induce cerebral ischemic injury in rats. Adult male rats were injected intraperitoneally with vehicle or curcumin(50mg/kg B.W.) 1 h after MCAO and cerebral cortex tissues were collected 24 h after MCAO. Photographs of hematoxylin and eosin staining showed that MCAO induced necrotic changes with scalloped shrunken form and apoptotic changes with nuclear chromatin condensations. However, curcumin treatment attenuated MCAO-induced histopathological changes. Moreover, this study clearly showed that peroxiredoxin-5 expression was decreased in MCAO operated animal with vehicle using a proteomics approach. However, this decrease in peroxiredoxin-5 expression was attenuated by curcumin treatment. Reverse-transcription PCR and Western blot analyses confirmed that curcumin treatment alleviated the MCAO injury-induced decrease in peroxiredoxin-5 expression(p<0.05). These results demonstrated that curcumin regulates peroxiredoxin-5 expression in MCAO animal model. In conclusion, our findings suggest that curcumin exerts a neuroprotective effect in cerebral ischemia by attenuating the MCAO-induced decrease in peroxiredoxin-5 expression.