• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.60-68
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• 2021

Objective : Until recently, the transfemoral approach (TFA) was used as the primary method of arterial approach in acute ischemic stroke (AIS). However, TFA resulted in longer reperfusion times and worse outcomes in the mechanical thrombectomy (MT) of patients with complex aortic arches and significant carotid tortuosity. We found that the transradial approach (TRA) is a more favorable alternative approach for MT in such cases. Methods : We performed a retrospective review of our institutional database to identify 202 patients who underwent MT for AIS between February 2015 and December 2019. Patient characteristics, cause of TFA failure, procedure time, intra-procedural complications, and outcomes were recorded. Results : Eleven (5.4%) of 202 patients, who underwent MT for AIS, crossed over to TRA for recanalization, and eight (72%) of 11 achieved successful recanalization (≥modified Treatment in Cerebral Infarction 2b). The mean age (mean±standard deviation [median]) was 82.3±6.6 (76) years, and five of the 11 patients were male. The last seen normal to puncture time was 467.9±264.72 (264) minutes; baseline National Institutes of Health Stroke Scale score was 28.9±14.5 (16). Six (55%) of the 11 patients had right vertebrobasilar occlusions, and the remaining five (45%) had anterior circulation occlusive disease. The time from groin puncture to final recanalization time (overall procedural time) was 78.0±20.1 (62) minutes. The mean crossover time from TFA to TRA was 45.2±10.5 (41) minutes. The mean time from radial puncture to final recanalization was 33.8±10.5 (28) minutes. Distal thrombus migration events in previously unaffected territories occurred in 3/8 patients (37%). At 90 days, three patients (28%) had a favorable clinical outcome. Conclusion : Although rare, failure of TFA has been known to occur during MT for AIS. Our results demonstrate that TRA may be an alternative option for AIS intervention for select patients with subsequent timely revascularization. However, the incidence of distal thrombus migration was high, and the first puncture to reperfusion time was prolonged because of the time taken for the crossover to TRA after failure of TFA. This study provides some evidence that the TRA may be a viable alternative option to the TFA for MT of AIS.

• The Journal of the Korea Contents Association
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• v.9 no.4
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• pp.355-363
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• 2009

Increased oxidative stress by abnormal mitochondrial function can damage cell signal transduction and gene expression, and induce insulin resistance or diabetes. Autophagy, however, improve insulin resistance by clearance of malfunctioning mitochondria. Exercise also recovers the muscle dysfunction and degeneration by activating mitochondrial biogenesis. As it seems that exercise and autophagy might act as an orchestrated network to induce mitochondrial biogenesis, we investigated whether autophagy is involved in AMPK signal pathway stimulated by exercise or AICAR to increase mitochondrial biogenesis. And it showed that PGC-1 and mtTFA, but not autophagy marker LC3 mRNA expression were significantly increased by 6 hr of acute exercise. On the other hand, PGC-1 and mtTFA mRNA expression were upregulated by AICAR treatment to C2C12 myotube. However these genes were not inhibited by LC3 siRNA transfection. These results provide the evidence that autopahgy affects on mitochondrial biogenesis through different signal pathway from AMPK signal transduction.

• Journal of Life Science
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• v.21 no.7
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• pp.997-1003
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• 2011

Menopause and obesity are associated with metabolism. The purpose of this study was to examine the changes of PPAR${\gamma}$, PGC-1(${\alpha},\;{\beta}$), NRf-1 and TFAM mRNA and mitochondria biogenesis in adipocytes and investigate the effect of swimming exercise for 6weeks on ovariectomized rats. Rats were randomly assigned to 3 groups: (1) ovariectomized rats fed with a control diet (C, n=4), (2) ovariectomized rats fed with high fat diet (H, n=4), and (3) ovariectomized rats trained to exercise and fed with high fat diet (H+EX, n=4). Exercise was performed by swimming for 5 days/wk, with a progressive increase in exercise over the course of 6 weeks. Results showed that the fat tissue weight in the H group was markedly increased (p<0.01) compared to other groups, however, regular exercise significantly decreased fat weight. The PPAR-${\gamma}$ (p<0.05), PGC-$1{\alpha}$ (p<0.01), -$1{\beta}$ (p<0.05), NRf-1 (p<0.01) and TFAM (p<0.05) mRNA expression in the adipocytes of H+EX were higher than in the H group. These results suggest that regular exercise for 6 weeks might exert positive effects by increasing PPAR-${\gamma}$, PGC-1 (${\alpha},\;{\beta}$), NRf-1 and TFAM mRNA expression and mitochondria in adipocytes. Thus, regular exercise may be helpful in the improvement of mitochondria biogenesis function in obese, ovariectomized rats.