• Journal of Cerebrovascular and Endovascular Neurosurgery
• /
• v.26 no.3
• /
• pp.274-283
• /
• 2024

Objective: The incidence of spontaneous intracerebral hemorrhage (ICH) in young people is relatively low; however, it leads to devastating lifelong neurologic deficits. We focused on spontaneous ICH occurring in young adults between 30 and 50 years of age. Methods: We retrospectively reviewed the records of 139 patients, aged 30-50 years, diagnosed with spontaneous ICH between 2011 and 2021. Cases of ICH attributable to discernible causative lesions were excluded. Demographic data, laboratory results, image findings, and clinical outcome were analyzed. Results: After exclusions, 73 patients were included in this study. Common characteristics among the study patients included male sex (83.6%), high body mass index (>25 kg/m², 45.8%), smoking history (47.2%), heavy alcohol consumption (30.6%), previously diagnosed hypertension (41.1%), high serum triglyceride level (>150 mg/dL, 33.3%), and microbleeds or white matter changes observed on magnetic resonance images (51.3%). In the multivariate analysis, previously diagnosed hypertension was the sole significant risk factor for cerebral small vessel (OR 7.769, P=0.031). Age, brain stem location, Glasgow Coma Scale score at admission, and hematoma volume were associated with poor outcomes. Conclusions: Hypertension, obesity, smoking, and cerebral small vessel disease were important factors associated with non-lesional spontaneous intracerebral hemorrhage in young patients. Radiologic changes corresponding to cerebral small vessel disease appeared in young patients (in their 30s) and they were associated with hypertension.

• The Journal of Korean Medicine
• /
• v.28 no.1 s.69
• /
• pp.224-236
• /
• 2007

Background : Chunghyul-dan is a combinatorial herbal medicine; previous studies reported it had therapeutic effects for microangiopathy, a major part in the progression of small vessel disease, as well as having anti-hypertensive, anti-hyperlipidemic, anti-apoptotic, anti-oxidative, and anti-inflammatory activities. Therefor, we examined the inhibitory effect of Chunghyul-dan on stroke recurrence in patients with small vessel disease. Methods : We prescribed Chunghyul-dan at 600 mg a day to patients with small vessel disease, and monitored stroke recurrence, drug compliances, and adverse effect for 1 year. We then performed follow-up brain MRI to find new vascular lesions after 1 year of Chunghyul-dan medication. For the subjects lost to follow-up, we assessed their prognosis after 1 year by telephone. Results : There were 73 subjects treated with Chunghyul-dan for 1 year; new vascular events were found in 3. Of the 85 subjects lost to follow-up, fifty four could be contacted, and eight of them had stroke recurrence. One year of Chunghyul-dan medication reduced the odds ratio of stroke recurrence by 75% compared to the subjects lost to follow-up and the rate increased to 88%, when adjusted for other relevant risk factors for stroke recurrence. These reductions were much higher than those of aspirin and other kinds of conventional anti-platelets. There was no adverse effect in any of the study subjects. Conclusions : We suggest Chunghyul-dan could be useful for inhibition of stroke recurrence. Further study with a randomized controlled trial is needed to confirm this suggestion.

• Journal of the Korean Society of Radiology
• /
• v.83 no.3
• /
• pp.486-507
• /
• 2022

Cerebral small vessel disease (CSVD) includes vascular lesions detected on brain MRI, such as white matter hyperintensities, lacunar infarctions, microbleeds, or enlarged perivascular spaces. There is accumulating evidence that vascular changes may play an important role in development of Alzheimer's disease (AD), and CSVD lesions detected on brain MRI were reported to be associated with β-amyloid and tau proteins accumulation. As the vascular contribution has therapeutic potential, it is important to understand the association of CSVD with AD and AD biomarkers. This review begins with a brief introduction of AD and AD biomarkers, explains the association between AD and vascular changes, and then details the pathogenesis and MR imaging findings of CSVD. Afterwards, we discuss the association of CSVD with AD and AD biomarkers.

• Korean Journal of Biological Psychiatry
• /
• v.12 no.2
• /
• pp.98-106
• /
• 2005

Objectives:Donepezil is a widely used drug for the treatment of patients with Alzheimer's disease(AD). The aim of the present study was to clarify the efficacy and the characteristics of responders to donepezil. Methods:Patients with probable AD(n=80;75.7 years) and small vessel dementia(SVD)(n=18;77.8 years) who received donepezil were retrospectively analyzed using Alzheimer's registry, and three questions were asked:1) Does donepezil therapy improves cognitive symptoms in patients with dementia? 2) If donepezil improves cognitive symptoms, which items of the K-MMSE are improved? 3) What are the characteristics of responder to donepezil medication? Results:1) After donepezil medication, cognitive function measured by the K-MMSE was significantly improved in both types of dementia(AD and SVD), However, statistical differences were not found between these groups. 2) In a clinical trial of donepezil, the patients performed better than before mediation on K-MMSE items assessing orientation, recall, construction, concentration, calculation. 3) In AD, the K-MMSE score before medication was closely related with response of donepezil. Conclusion:This study suggests that donepezil improves various cognitive functions in both types of dementia, and the responsive group had significantly lower K-MMSE scores than the non-responsive group before medication.

• Journal of Chest Surgery
• /
• v.37 no.3
• /
• pp.220-227
• /
• 2004

The number of patients with coronary artery disease and peripheral vascular disease are increasing, and the need of small diameter vessel is also increasing. We developed small diameter artificial vessel and experimented in vivo. We got allogenic valve from mongrel dogs, and removed all cells from the allogenic valve. Then, we seeded autologous bone marrow cells onto the decellularized scaffold. After implantation of artificial vessel into the canine carotid artery, we performed angiography regularly. In case of vessel occlusion or at 8 weeks after operation, we euthanized dogs, and retrieved the implanted artificial vessels. Control vessels were all occluded except one (which developed aneurysmal dilatation). But autologous cell seeded vascular graft were patent by 4 weeks in one, by 6 in one and by 8 weeks in two. Histologic examination of patent vessel revealed similar structure to native artery. Tissue-engineered vascular graft manufactured with decellularized allogenic matrix and autologous bone marrow cells showed that tissue engineered graft had similar structure to native artery.

• Journal of Korean Neurosurgical Society
• /
• v.63 no.4
• /
• pp.463-469
• /
• 2020

Objective : This study aimed to investigate the changes and significance of microRNA155 levels in serum of patients with cerebral small vessel disease (CSVD). Methods : Thirty patients with CSVD who met the inclusion criteria were selected and divided into eight patients with lacunar infarction (LI) group and 22 patients with multiple lacunar infarction (MLI) combined with white matter lesions (WML) group according to the results of head magnetic resonance imaging (MRI). Thirty samples from healthy volunteers without abnormalities after head MRI examination were selected as the control group. The levels of serum microRNA155 in each group were determined by real-time polymerase chain reaction, and the correlation between microRNA155 in the serum of patients with CSVD and the increase of imaging lesions was analyzed by Spearman correlation analysis. Results : Compared with the control group, the serum microRNA155 level in the LI group, MLI combined with WML group increased, the difference was statistically significant (p<0.05); serum microRNA155 level was positively correlated with the increase of imaging lesions (p<0.05). Conclusion : The change of serum microRNA155 level in patients with CSVD may be one of its self-protection mechanisms, and the intensity of this self-protection mechanism is positively correlated with the number of CSVD lesions.

• The Journal of Internal Korean Medicine
• /
• v.30 no.4
• /
• pp.761-771
• /
• 2009

Objectives : The aim of this study was to assess the relationship between metabolic syndrome and erythrocyte deform ability in acute stroke patients. Methods : Among 88 of the recruited patients, 52 were diagnosed as metabolic syndrome. We assessed their general characteristics, risk factors. We compared the assessed variables between metabolic syndrome and control group. We analyzed the relationship between metabolic syndrome and erythrocyte deform ability. We analyzed relationship between cardiovascular risk factors and erythrocyte deformability. Results : The general characteristics waist and hip circumference, waist/hip ratio were higher in metabolic syndrome group. The metabolic syndrome group was also diagnosed with hypertension, DM, and hyperlipidemia more often than the control group. The blood test metabolic syndrome group showed higher triglycerides, total lipids, fasting blood sugar, and 2 hours postprandial plasma glucose level and lower HDL-cholesterol than the control group. There were more patients diagnosed with Dampness-Phlegm in the metabolic syndrome group. There were more patients showing lower erythrocyte deform ability in the metabolic syndrome group. The plasma homocysteine level was negatively correlated with erythrocyte deform ability. Conclusion : The results reconfirmed that the risk factors are more in metabolic syndrome group. The results indicated that metabolic syndrome lead to a lower erythrocyte deform ability in small vessel disease stroke patients. The Plasma homocysteine level was negatively correlated with erythrocyte deform ability.

• Journal of Acupuncture Research
• /
• v.17 no.3
• /
• pp.125-139
• /
• 2000

Study of the fourteen meridians that include name of P'ung(風) point. The results were summarized as follows. 1. Pyongp'ung(秉風) is located middle of the supraspinatous fossa(Small intestine Meridian, 手太陽小腸經). we can cute the local area disease and also use to cure the pathway of the Arm greater yang small intestine which is attacked by P'ung(風) disease. 2. Yep'ung(翳風) is located behind the lobule of the auricle, in the depression between the mastoid process and the mandible(Triple Energizer Meridian, 手少陽三焦經). we can cure the local area disease especially hyper yang disease and also use to cure the pathway of the Arm lesser yang triple energizer which is attacked by P'ung(風) and Yo'l(熱) disease. 3. P'ungmun(風門) is located 1.5 chon beside the lower end of the spine of the second thoracic vertebra(Bladder Meridian, 足太陽膀胱經). we can cure the local area disease and also use to cure the pathway of the Leg greater yang bladder which is attacked by P'ung(風) disease. 4. P'ungbu(風府) is located 1 chon above the middle of natural line of the hair at the back of the head, in the depression below the occiptal protuberance(Governor meridian, 督脈). It connects (Liver meridian, 足厥陰肝經) and Yin Link Vessel(陽維脈). we can cure the rigidity and pain in head and nape which is related Yin Link Vessel(陽維脈). 5. P'ungshi(風市) is located on the lateral part of the thigh, 7 hon above the patella(From the greater trochanter to the knee joint is 19 chon, Gallbladder Meridian (足少陽膽經). we can cure the local area disease(leg, knee, etc). 6. P'ungji(風池) is located Below the occipital bone, in the depression on the outer part of the trapezius muscle(Gallbladder Meridian, 足少陽膽經) on a level with P'ungbu(風府) (Governor vessel, 督脈). we can cure the local area disease and also use to cure the pathway of the Leg lesser yang gall bladder which is attacked by P'ung(風) disease.

• Journal of Korean Foot and Ankle Society
• /
• v.6 no.1
• /
• pp.80-85
• /
• 2002

Purpose: This study is to assess the involvement of vessels in lower extremity in diabetics, using color doppler ultrasonogram. Materials and Methods: Arteries of both lower extremities were divided into 3 groups-large vessel (above-knee arteries), popliteal vessel, and small vessel(below-knee arteries) -, and evaluated using color doppler ultrasonogram in 60 diabetics. In color doppler ultrasonogram, the wave forms of all vessels were divided into 5 grades; grade I was triphasic wave form, grade II was spectral broadening form, grade III was monophasic wave form, grade IV was pulsus tardus et parvus form, grade V was absence of wave. Grade III, IV, V were grouped into vessel obstruction. We reviewed the correlationships among the degree of the peripheral vascular involvement, duration of dibetes, existence of bilaterality, types of dibetes. Results: Bilateral involvement was high in both lower extremity. Luminal stenosis, vascular calcification and vessel obstruction were high incidence in the patients over ten years of diabetic duration. Prevalence of vascular calcification and vessel obstruction were high in the small vessel of ankle level. But, insulin injection was not related to the incidence of vascular abnormality. Conclusion: Color doppler ultrasonogram seems to be useful for evaluation of peripheral vascular status, decision making for necessity of additional test, periodic follow -up tool in diabetes patients.

• The Korean journal of internal medicine
• /
• v.39 no.3
• /
• pp.524-536
• /
• 2024

Background/Aims: This study applied the 2022 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) criteria for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) to patients with systemic sclerosis (SSc) and investigated the frequency of overlap syndrome of SSc and AAV (SSc-AAV-OS). Methods: Among the 232 patients diagnosed with SSc, 105 with signs suggestive of small- or medium-vessel vasculitis, which were defined as the present of interstitial lung disease (ILD), peripheral neuropathy, or suspected renal vasculitis, were included in this study and analyzed. Results: Among the 105 SSc patients, the detection rate of ANCA was 19.0%. When the 2022 ACR/EULAR criteria were applied, the frequency of SSc-AAV-OS was 20.0%, which was much higher than 1.7% reported with previous criteria for AAV. ANCA positivity contributed to the reclassification of SSc-AAV-OS more than ANCA negativity in SSc patients with signs suggestive of small- or medium-vessel vasculitis. Conclusions: The frequency of SSc-AAV-OS in SSc patients with signs suggestive of small- or medium-vessel vasculitis at diagnosis was 20.0%. Therefore, we suggest that physicians should perform ANCA tests in SSc patients exhibiting signs suggestive of small- or medium-vessel vasculitis and apply the new criteria for AAV.