• The Journal of Internal Korean Medicine
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• v.23 no.1
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• pp.1-4
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• 2002

Objective : Hyperhomocysteinemia has been proven to be an independent risk factor for stroke. The genetic mutation of methylenetetrahydrofolate reductase(MTHFR) elevates serum homocysteine level, but it still remains controversial whether the MTHFR gene mutation could be a predictor of ischemic stroke. Therefore, we studied if this genetic defect could cause ischemic stroke independently. Methods : We gathered ischemic stroke subjects and age, sex-matched controls. Age, gender, past medical history, smoking habit, serum homocysteine level, and the MTHFR genotype were recorded. General characteristics of ischemic stroke subjects were compared to the controls. We classified the stroke according to the related vessels(small and large artery infarction) and single lesion and multiple infraction. Relevant risk of the MTHFR genotype was evaluated in each stroke subtype with multiple logistic regression analysis. Results : When the controls were compared to the whole ischemic stroke, there was no specific difference except some medical histories. However, further analysis based on stroke subtypes showed important results. The small artery infarction group, multiple infraction group had significant odds ratio of the MTHFR TT genotype adjusted for age, gender, medical history and smoking habit. Conclusions : The MTHFR TT genotype is an independent risk factor for certain types of ischemic stroke, small artery infarction and multiple infarction.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.896-901
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• 2007

Objectives : This study aimed to evaluate the characteristics of patients with single infarction and multiple infarctions. Method : We studied inpatients who were admitted from 2005/10/1 to 2007/3/30 at the KyungHee University Oriental Medical Center (KOMC) Department of Cardiovascular & Neurology (stroke center). We sorted small vessel occlusion patients and evaluated general characteristics of the patients along with the characteristics of single and multiple infarction patients. Result : We evaluated 262 inpatients, and did not find any significant difference in age, hypertension, diabetes, hyperlipidemia, diet, exercise, homocysteine, or Sasang constitution between single infarction and multiple infarction. However, there were more significant associations with patients' smoking and stress with multiple infarctions than single infarction. Conclusion : From this study we could roughly grasp the characteristics of Small Vessel Occlusion patients and evaluated the characteristics of patients with multiple infarction. However, due to the special circumstance of the KOMC inpatients it is difficult to generalize our results; further multiple center research with a larger study group is needed.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.115-117
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• 2013

Simultaneous subarachnoid hemorrhage and infarction is a quite rare presentation in a patient with a spontaneous dissecting aneurysm of the anterior cerebral artery. Identifying relevant radiographic features and serial angiographic surveillance as well as mode of clinical manifestation, either hemorrhage or infarction, could sufficiently determine appropriate treatment. Enlargement of ruptured aneurysm and progressing arterial stenosis around the aneurysm indicates impending risk of subsequent stroke. In this setting, prompt treatment with stent-assisted endovascular embolization can be a reliable alternative to direct surgery. When multiple arterial dissections are coexistent, management strategy often became complicated. However, satisfactory clinical results can be obtained by acknowledging responsible arterial site with careful radiographic inspection and antiplatelet medication.

• Journal of Chest Surgery
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• v.30 no.9
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• pp.941-944
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• 1997

Pulmonary infarction is rarely diagnosed with certainty except at postmortem examination. Part of this uncertainty is because of the inability to distinguish between hemorrhage, congestive a electasis, and necrosis clinically and radiographically. The pathogenesis of pulmonary infarction is poorly understood. It is dif%cult to induce pulmonary infarction in animals by ligation of the arterial supply to the lung. Many factors seem to be important in its pathogenesis, in addition to congestive heart failure, malignant tumor, thrombophlebitis, chronic obstructive lung disease, nephrotic syndrome, and postopeiative state. However, pulmonary infarction have not been reported in association with chest trauma. We report a case of pulmonary infarction associated with fractures of right clavicle and multiple ribs. A 45-year-old male had admitted due to right chest pain and dyspnea, which developed after right chest trauma occurred at about 3 weeks ago. He was treated at local clinics under the diagnosis of fractures of right clavicle and ribs until the admission. Chest CT disclosed a huge mass with central low density in right upper lobe, and small masses were also seen on both l ng fields. Open lung biopsy resulted in negativity for the malignancy. Clinical symptoms and radiological findings were not improved by conservative treatment. Right upper lobectomy was done eventually. The final diagnosis was pulmonary infarction. And, the patient has been well after operation.

• Biomedical Science Letters
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• v.19 no.3
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• pp.233-238
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• 2013

Aspirin is still the mainstay of antiplatelet therapy in the cardiovascular and cerebrovascular disease. However, some patients are not responsive to the antithrombotic action of aspirin. The aim of this study was to assess the prevalence and clinical characteristics of aspirin resistance in patients with cerebral infarction. We tested platelet function in 557 patients who had been treated with aspirin in J general hospital. Platelet function was tested using the multiple electrode platelet aggregometry (MEA). Platelet reactivity was expressed as area under the aggregation curve (AUC, U) and >30 AUC was defined as aspirin resistance. Aspirin resistance was detected in 16.2% patients. There was not any significant differences in age, gender between aspirin resistance and aspirin sensitive patients. WBC was significantly higher in patients with aspirin resistance (P < .05). HDL-cholesterol was significantly higher in patients with aspirin sensitive (P < .05). Aspirin resistance was positive correlation with platelet count (r =.314, P =.003). The prevalence of aspirin resistance in cerebral infarction was 16.2%, and platelet count were related with aspirin resistance.

• The Korean Journal of Physiology and Pharmacology
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• v.27 no.2
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• pp.177-185
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• 2023

The excessive inflammatory response induced by myocardial infarction exacerbates heart injury and leads to the development of heart failure. Recent studies have confirmed the involvement of multiple transcription factors in the modulation of cardiovascular disease processes. However, the role of KLF9 in the inflammatory response induced by cardiovascular diseases including myocardial infarction remains unclear. Here, we found that the expression of KLF9 significantly increased during myocardial infarction. Besides, we also detected high expression of KLF9 in infiltrated macrophages after myocardial infarction. Our functional studies revealed that KLF9 deficiency prevented cardiac function and adverse cardiac remodeling. Furthermore, the downregulation of KLF9 inhibited the activation of NF-κB and MAPK signaling, leading to the suppression of inflammatory responses of macrophages triggered by myocardial infarction. Mechanistically, KLF9 was directly bound to the TLR2 promoter to enhance its expression, subsequently promoting the activation of inflammation-related signaling pathways. Our results suggested that KLF9 is a pro-inflammatory transcription factor in macrophages and targeting KLF9 may be a novel therapeutic strategy for ischemic heart disease.

• Journal of Korean Neurosurgical Society
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• v.45 no.6
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• pp.394-396
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• 2009

Cerebral embolic infarction is the most common neurologic complication of cardiac myxoma (CM). Development of cerebral aneurysms in CM is very rare. We present a 64-year-old woman with acute cerebral infarction and multiple cerebral aneurysms complicated by CM. The aneurysms were multiple, fusiform-shaped, and located in distal branch of major cerebral arteries. The serum interleukin (IL)-6 was highly elevated, which was normalized after surgical resection of CM. There was no regression of aneurysms on follow-up neuroimaging. Multiple cerebral aneurysms in CM are rare condition. Highly elevated serum IL-6 may be associated with increased risk of cerebral aneurysmal formation.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.239-242
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• 2013

Spontaneous bilateral cerebellar infarction in the territory of the superior cerebellar arteries is extremely rare. Occasionally there have been reports of bilateral cerebellar infarction due to vertebrobasilar atherosclerotic occlusion or stenosis, whereas no report of bilateral cerebellar infarction due to complicated hemodynamic changes. In this report, we present a patient with bilateral cerebral infarctions related to stenoses of bilateral internal carotid arteries, in whom vertebrobasilar system was supplied by multiple collaterals from both posterior communicating arteries and right external carotid artery. We performed stent-angioplasty of bilateral internal cerebral arterial stenosis, and then acute infarction developed on bilateral superior cerebellar artery territories. The authors assumed that the infarction occurred due to hemodynamic change between internal carotid artery and external carotid artery after stent-angioplasty for stenosis of right internal carotid artery.

• Health Policy and Management
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• v.21 no.4
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• pp.541-564
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• 2011

This study aimed to investigate health outcome of acute myocardial infarction (AMI) patients such as mortality and length of stay in hospital and to identify factors associated with the health outcome according to the comorbidity index. Nation-wide representative samples of 3,748 adult inpatients aged between 20-85 years with acute myocardial infarction were derived from the Korea National Hospital Discharge Injury Survey, 2005-2008. Comorbidity index was measured using the Charlson Comorbidity Index (CCI). The data were analyzed using t-test, ANOVA, multiple regression, logistic regression analysis in order to investigate the effect of comorbidity on health outcome. According to the study results, the factors associated with length of hospital stay of acute myocardial infarction patients were gender, insurance type, residential area scale, admission route, PCI perform, CABG perform, and CCI. The factors associated with mortality of acute myocardial infarction patients were age, admission route, PCI perform, and CCI. CCI with a higher length of hospital stay and mortality also increased significantly. This study demonstrated comorbidity risk adjustment for health outcome and presented important data for health care policy. In the future study, more detailed and adequate comorbidity measurement tool should be developed, so patients' severity can be adjusted accurately.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.951-959
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• 2022

Objectives: The aim of this study is to describe the effects of treatment with traditional Korean medicine on a patient with multiple cerebral infarction caused by posterior cerebral artery occlusion. Methods: The patient was treated with herbal medicine (Yikgeebohyul-tang) and acupuncture. The effects of these treatments were evaluated using the Manual Muscle Test, the Korean version of the Modified Barthel Index, the Modified Rankin scale, and a subjective percentage of sensation in the left lower extremity and face. Results: After treatment, the Modified Rankin Scale score, subjective percentage of sensation in the left lower extremity, and gait disturbance improved. Conclusion: The results suggest that traditional Korean medicine may be effective for treating the symptoms of multiple cerebral infarction caused by posterior cerebral artery occlusion.