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1. Effects of Oxiracetam and Physical Activity in Preventing Post-Stroke Cognitive Decline: A Randomized Controlled Trial

Author

Jae-Sung Lim, Dong-Eog Kim, Jae-Kwan Cha, Tai Hwan Park, Jae-Hyeok Heo, Kyung Bok Lee, Jong-Moo Park, Kyusik Kang, Mi-Sun Oh, Byung-Chul Lee, Eung-Gyu Kim, Dae-Il Chang, Sung Hyuk Heo, Man-Seok Park, Hyun-Young Park, Sang Hak Yi, Yeong Bae Lee, Kwang-Yeol Park, Soo Joo Lee, Jae Guk Kim, Jun Lee, Kyung-Hee Cho, Joung-Ho Rha, Yeong-In Kim, Jun Hong Lee, Jaychol Choi, Kyung-Mi Oh, Jee-Hyun Kwon, Chulho Kim, Jong-Ho Park, Keun-Hwa Jung, Sang Min Sung, Jong-Won Chung, Yong-Seok Lee, Hahn Young Kim, Jeong-Wook Park, Won-Jin Moon, Hyuntae Park, Seongryu Bae, Yeonwook Kang, Juneyoung Lee, and Hee-Joon Bae

Subjects
Specialties of internal medicine, RC581-951, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Introduction: This trial, conducted according to the request of the Korean Ministry of Food and Drug Safety, investigated the potential of oxiracetam in mitigating post-stroke cognitive decline, and whether physical activity could augment its efficacy. The mechanisms behind these effects were explored using functional neuroimaging. Methods: In this multicenter, randomized, double-blind, placebo-controlled trial, we enrolled patients reporting subjective cognitive decline more than three months post-stroke and at a high risk of dementia. Participants were randomly assigned to a 36-week regimen of either 800 mg oxiracetam or a placebo, administered twice daily, in conjunction with recommended physical activity. Physical activity levels were monitored using wrist actigraphy. Cognitive function was assessed using a mini-mental state examination (MMSE) and clinical dementia rating sum of boxes (CDR-SB) at baseline and 36 weeks. Other assessments included the 60-minute protocol of Vascular Cognitive Impairment Harmonization Standards, Euro QoL, patient's global assessment, and resting-state functional MRI-derived neural network attributes. Results: Of the 500 participants (mean age 68.9 years, male 76.1%, median interval between stroke and randomization 32 months), 457 were analyzed. Both groups have equally adhered to the exercise guidelines (moderate-to-vigorous physical activity per day; 23.7±26.1 vs. 24.1±28.7 minutes; p=0.75). No significant difference was observed in changes to MMSE and CDR-SB scores between the two groups (MMSE, 0.13±2.27 vs. 0.27±2.09, p=0.49; CDR-SB -0.14±0.70 vs. -0.08±0.80, p=0.38). Although increased baseline exercise time correlated with better MMSE scores, the correlation was weak (R= 0.11, p=0.02). Verbal memory, phonemic fluency, language, NPI-Q, and geriatric depression scale also improved significantly within each group. However, only the intervention group showed significant improvements in CDR-SB and EuroQoL scores. A predetermined multivariate analysis showed a significant change in the normalized clustering coefficient for the secondary efficacy endpoint (r=0.09, SE=0.04, p=0.03). Discussion: This study failed to confirm the efficacy of oxiracetam in preventing post-stroke cognitive decline. Nonetheless, adherence to the exercise guidelines appeared to help participants maintain their cognitive functions, despite being a chronic stage post-stroke and having a high dementia risk.

Published
2024
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2. Apixaban for Secondary Stroke Prevention: Coexistant Cerebral Atherosclerosis May Increase Recurrent Strokes

Author

Jong S. Kim, Jaseong Koo, Dong-Ick Shin, Byung-Su Kim, Jei Kim, Eung-Gyu Kim, Keun-Sik Hong, and Hyeju Yi

Subjects
apixaban, stroke, magnetic resonance imaging, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background and Purpose Oral anticoagulants are needed in stroke patients with atrial fibrillation (AF) for the prevention of recurrent stroke. However, the risk of major events or bleeding may be greater in stroke patients than in those without, because the presence of cerebral atherosclerosis or small vessel disease may increase these risks. This study aimed to investigate the outcomes of apixaban-treated stroke patients with AF and assess whether these factors are associated with the outcome. Methods This was a sub-analysis of stroke patients with AF enrolled in a prospective, open-label, multicenter, post-marketing surveillance study in South Korea, who were treated with apixaban and underwent magnetic resonance imaging (MRI) (Clinical trial registration: NCT01885598). Results A total of 651 patients (mean age, 72.5±8.7 years) received apixaban for a mean duration of 82.7±37.4 weeks. Fifty-three bleeding events occurred in 39 patients (6.0%), and 10 (1.5%) experienced major bleeding. Seventeen patients (2.6%) had major events (stroke, n=15, 2.3%; all ischemic), systemic embolism (n=1, 0.2%), and death (n=3, 0.5%). MRI data showed no significant association between white matter ischemic changes and microbleeds, and major events or bleeding. Patients with cerebral atherosclerotic lesions had a higher rate of major events than those without (4.6% [n=10/219] vs. 1.7% [n=7/409], P=0.0357), which partly explains the increased prevalence of major outcomes in this group versus patients without stroke (0.7%, P=0.0002). Conclusions Apixaban is generally safe for patients with ischemic stroke. Increased primary outcomes in stroke patients may in part be attributed to the presence of cerebral atherosclerotic lesions, suggesting that further studies are needed to establish therapeutic strategies in this population.

Published
2022
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3. Changes in High-Density Lipoprotein Cholesterol and Risks of Cardiovascular Events: A from the PICASSO Trial

Author

Eun-Jae Lee, Sun U. Kwon, Jong-Ho Park, Yong-Jae Kim, Keun-Sik Hong, Sungwook Yu, Yang-Ha Hwang, Ji Sung Lee, Juneyoung Lee, Joung-Ho Rha, Sung Hyuk Heo, Sung Hwan Ahn, Woo-Keun Seo, Jong-Moo Park, Ju-Hun Lee, Jee-Hyun Kwon, Sung-Il Sohn, Jin-Man Jung, Hahn Young Kim, Eung-Gyu Kim, Sung Hun Kim, Jae-Kwan Cha, Man-Seok Park, Hyo Suk Nam, and Dong-Wha Kang

Subjects
cholesterol, hdl, secondary prevention, cilostazol, probucol, cholesterol ester transfer proteins, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background and purpose Whether pharmacologically altered high-density lipoprotein cholesterol (HDL-C) affects the risk of cardiovascular events is unknown. Recently, we have reported the Prevention of Cardiovascular Events in Asian Patients with Ischaemic Stroke at High Risk of Cerebral Haemorrhage (PICASSO) trial that demonstrated the non-inferiority of cilostazol to aspirin and superiority of probucol to non-probucol for cardiovascular prevention in ischemic stroke patients (clinicaltrials.gov: NCT01013532). We aimed to determine whether on-treatment HDL-C changes by cilostazol and probucol influence the treatment effect of each study medication during the PICASSO study. Methods Of the 1,534 randomized patients, 1,373 (89.5%) with baseline cholesterol parameters were analyzed. Efficacy endpoint was the composite of stroke, myocardial infarction, and cardiovascular death. Cox proportional hazards regression analysis examined an interaction between the treatment effect and changes in HDL-C levels from randomization to 1 month for each study arm. Results One-month post-randomization mean HDL-C level was significantly higher in the cilostazol group than in the aspirin group (1.08 mmol/L vs. 1.00 mmol/L, P

Published
2020
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4. Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society

Author

Jun Yup Kim, Kyusik Kang, Jihoon Kang, Jaseong Koo, Dae-Hyun Kim, Beom Joon Kim, Wook-Joo Kim, Eung-Gyu Kim, Jae Guk Kim, Jeong-Min Kim, Joon-Tae Kim, Chulho Kim, Hyun-Wook Nah, Kwang-Yeol Park, Moo-Seok Park, Jong-Moo Park, Jong-Ho Park, Tai Hwan Park, Hong-Kyun Park, Woo-Keun Seo, Jung Hwa Seo, Tae-Jin Song, Seong Hwan Ahn, Mi-Sun Oh, Hyung Geun Oh, Sungwook Yu, Keon-Joo Lee, Kyung Bok Lee, Kijeong Lee, Sang-Hwa Lee, Soo Joo Lee, Min Uk Jang, Jong-Won Chung, Yong-Jin Cho, Kang-Ho Choi, Jay Chol Choi, Keun-Sik Hong, Yang-Ha Hwang, Seong-Eun Kim, Ji Sung Lee, Jimi Choi, Min Sun Kim, Ye Jin Kim, Jinmi Seok, Sujung Jang, Seokwan Han, Hee Won Han, Jin Hyuk Hong, Hyori Yun, Juneyoung Lee, and Hee-Joon Bae

Subjects
stroke, statistics, epidemiology, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Despite the great socioeconomic burden of stroke, there have been few reports of stroke statistics in Korea. In this scenario, the Epidemiologic Research Council of the Korean Stroke Society launched the “Stroke Statistics in Korea” project, aimed at writing a contemporary, comprehensive, and representative report on stroke epidemiology in Korea. This report contains general statistics of stroke, prevalence of behavioral and vascular risk factors, stroke characteristics, pre-hospital system of care, hospital management, quality of stroke care, and outcomes. In this report, we analyzed the most up-to-date and nationally representative databases, rather than performing a systematic review of existing evidence. In summary, one in 40 adults are patients with stroke and 232 subjects per 100,000 experience a stroke event every year. Among the 100 patients with stroke in 2014, 76 had ischemic stroke, 15 had intracerebral hemorrhage, and nine had subarachnoid hemorrhage. Stroke mortality is gradually declining, but it remains as high as 30 deaths per 100,000 individuals, with regional disparities. As for stroke risk factors, the prevalence of smoking is decreasing in men but not in women, and the prevalence of alcohol drinking is increasing in women but not in men. Population-attributable risk factors vary with age. Smoking plays a role in young-aged individuals, hypertension and diabetes in middle-aged individuals, and atrial fibrillation in the elderly. About four out of 10 hospitalized patients with stroke are visiting an emergency room within 3 hours of symptom onset, and only half use an ambulance. Regarding acute management, the proportion of patients with ischemic stroke receiving intravenous thrombolysis and endovascular treatment was 10.7% and 3.6%, respectively. Decompressive surgery was performed in 1.4% of patients with ischemic stroke and in 28.1% of those with intracerebral hemorrhage. The cumulative incidence of bleeding and fracture at 1 year after stroke was 8.9% and 4.7%, respectively. The direct costs of stroke were about ₩1.68 trillion (KRW), of which ₩1.11 trillion were for ischemic stroke and ₩540 billion for hemorrhagic stroke. The great burden of stroke in Korea can be reduced through more concentrated efforts to control major attributable risk factors for age and sex, reorganize emergency medical service systems to give patients with stroke more opportunities for reperfusion therapy, disseminate stroke unit care, and reduce regional disparities. We hope that this report can contribute to achieving these tasks.

Published
2019
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5. Low- versus Standard-Dose Intravenous Alteplase in the Context of Bridging Therapy for Acute Ischemic Stroke: A Korean ENCHANTED Study

Author

Jong S. Kim, Yeon-Jung Kim, Kyung Bok Lee, Jae Kwan Cha, Jong-Moo Park, Yangha Hwang, Eung-Gyu Kim, Joung-Ho Rha, Jaseong Koo, Jei Kim, Yong-Jae Kim, Woo-Keun Seo, Dong-Eog Kim, Thompson G. Robinson, Richard I. Lindley, Xia Wang, John Chalmers, and Craig S. Anderson

Subjects
cerebral infarction, thrombectomy, intracranial hemorrhages, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background and Purpose Following the positive results from recent trials on endovascular therapy (EVT), bridging therapy (intravenous alteplase plus EVT) is increasingly being used for the treatment of acute ischemic stroke. However, the optimal dose of intravenous alteplase remains unknown in centers where bridging therapy is actively performed. The optimal dose for eventual recanalization and positive clinical outcomes in patients receiving bridging therapy also remains unknown. Methods In this prospective Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) sub-study, we explored the outcomes following treatment with two different doses (low- [0.6 mg/kg] or standard-dose [0.9 mg/kg]) of intravenous alteplase across 12 Korean centers where EVT is actively performed. The primary endpoint was a favorable outcome at 90 days (modified Rankin Scale scores 0 to 1). Secondary endpoints included symptomatic intracerebral hemorrhage (ICH) in all patients, and the recanalization rate and favorable outcome in patients who underwent cerebral angiography for EVT (ClinicalTrials.gov, number NCT01422616). Results Of 351 patients, the primary outcome occurred in 46% of patients in both the standard-(80/173) and low-dose (81/178) groups (odds ratio [OR], 1.14; 95% confidence interval [CI], 0.72 to 1.81; P=0.582), although ICHs tended to occur more frequently in the standard-dose group (8% vs. 3%, P=0.056). Of the 67 patients who underwent cerebral angiography, there was no significant difference in favorable functional outcome between the standard- and low-dose groups (39% vs. 21%; OR, 2.39; 95% CI, 0.73 to 7.78; P=0.149). Conclusions There was no difference in functional outcome between the patients receiving different doses of alteplase in centers actively performing bridging therapy.

Published
2018
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7. Magnetic resonance imaging diagnosis of metastatic lymph nodes in a rabbit model: efficacy of PJY10, a new ultrasmall superparamagnetic iron oxide agent, with monodisperse iron oxide core and multiple-interaction ligands.

Author

Roh-Eul Yoo, Seung Hong Choi, Hye Rim Cho, Bong-Sik Jeon, Eunbyul Kwon, Eung-Gyu Kim, Juyoung Park, Wan-Jae Myeong, Jae-Kyung Won, Yun-Sang Lee, Ji-Hoon Kim, Sun-Won Park, and Chul-Ho Sohn

Subjects
Medicine, Science
Abstract

Accurate diagnosis of lymph node metastasis is crucial in treatment planning for cancer patients. Despite the use of various parameters, making correct diagnosis of a small metastatic or a hyperplastic benign node is still a challenge. In this study, we evaluated the feasibility of detecting lymph node metastasis using a new ultrasmall superparamagnetic iron oxide particle, PJY10, in a rabbit model.To make metastatic and benign lymph nodes, either VX2 carcinoma or fecal material suspension was inoculated into thighs of 56 rabbits three weeks or three days before magnetic resonance (MR) imaging, respectively. T2*-weighted 3T MR imaging was performed before and 24 hours after PJY10 injection (5.2 [n = 15], 7.8 [n = 17], and 10.4 [n = 24] mg Fe/kg). MR images were correlated with pathologic results to calculate sensitivity and specificity. Quantitative analysis of the signal intensity (SI)--number of voxels[low] (the fraction of the number of voxels with the normalized SI on the postcontrast image lower than that on the precontrast image) and mean SI ratio--was also performed for each lymph node.Sensitivities were 100% at all three dosages, whereas specificity increased with increasing dosage (89% at 10.4 mg Fe/kg). The benign nodes had a significantly higher number of voxels[low] and a lower mean SI ratio than the metastatic nodes at the dosage of 10.4 mg Fe/kg (P

Published
2014
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8. Intracranial Hemorrhage in the TST Trial

Author

Pierre Amarenco, Jong S. Kim, Julien Labreuche, Hugo Charles, Maurice Giroud, Philippa C. Lavallée, Byung-Chul Lee, Marie-Hélène Mahagne, Elena Meseguer, Norbert Nighoghossian, Philippe Gabriel Steg, Éric Vicaut, Eric Bruckert, Pierre-Jean Touboul, Didier Leys, Yannick Béjot, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, YunJeong In, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-BègueMarsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul- Wermester, Frédéric Philippeau, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, null Hamon, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal- Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, null Emilie, Mathieu Zuber, Marie Bruandet, Claire Join- Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, null Alnajar-Carpentier, Michèle Levasseur, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, null Stantescu, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jong Sung Kim, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Keun Seo, Jongwon Chung, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Asan Medical Center [Seoul, South Korea] (AMC), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Equipe Avenir. University of Burgundy, Hallym University Sacred Heart Hospital [Anyang, South Korea] (HUS2H), Hôpital Pasteur [Nice] (CHU), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris Diderot - Paris 7 (UPD7), Université Sorbonne Paris Cité (USPC), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, Treat Stroke to Target Investigators*: Pierre-Jean Touboul, Didier Leys, Yannick Béjot, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Pierre-Jean Touboul, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, YunJeong In, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Bertrand Lapergue, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Fernando Pico, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Gurkan Mutlu, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Candice Sabben, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Marion Yger, Yannick Béjot, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-BègueMarsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Hamon, Emmanuel Touzé, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, Emilie, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, Alnajar-Carpentier, Michèle Levasseur, Pierre Louchart, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, Stantescu, Marc Bataillard, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jong Sung Kim, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-Kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Keun Seo, Jongwon Chung, and CarMeN, laboratoire

Subjects
Adult, Male, [SDV]Life Sciences [q-bio], Coronary Artery Disease, LDL, Young Adult, Predictive Value of Tests, Risk Factors, Secondary Prevention, Humans, cardiovascular diseases, Aged, Ischemic Stroke, Advanced and Specialized Nursing, Aged, 80 and over, Anticholesteremic Agents, Incidence, cholesterol, Anticoagulants, Cholesterol, LDL, Middle Aged, Ezetimibe, Intracranial Arteriosclerosis, [SDV] Life Sciences [q-bio], Ischemic Attack, Transient, Hypertension, Female, Neurology (clinical), atherosclerosis, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, Intracranial Hemorrhages
Abstract

Background and Purpose: Although statins are effective in secondary prevention of ischemic stroke, they are also associated with an increase risk of intracranial hemorrhage (ICH) in certain conditions. In the TST trial (Treat Stroke to Target), we prespecified an exploration of the predictors of incident ICH. Methods: Patients with ischemic stroke in the previous 3 months or transient ischemic attack within the previous 15 days and evidence of cerebrovascular or coronary artery atherosclerosis were randomly assigned in a 1:1 ratio to a target LDL (low-density lipoprotein) cholesterol of Results: Among 2860 patients enrolled, 31 incident ICH occurred over a median follow-up of 3 years (18 and 13 in the lower and higher target group, 3.21/1000 patient-years [95% CI, 2.38–4.04] and 2.32/1000 patient-years [95% CI, 1.61–3.03], respectively). While there were no baseline predictors of ICH, uncontrolled hypertension (HR, 2.51 [95% CI, 1.01–6.31], P =0.041) and being on anticoagulant (HR, 2.36 [95% CI, 1.00–5.62], P =0.047)] during the trial were significant predictors. On-treatment low LDL cholesterol was not a predictor of ICH. Conclusions: Targeting an LDL cholesterol of Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875; EUDRACT identifier: 2009-A01280-57.

Published
2021
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9. Cilostazol and Probucol for Cognitive Decline after Stroke: A Cognitive Outcome Substudy of the PICASSO Trial

Author

Man Seok Park, Jin Man Jung, Dong-Eog Kim, Yeonwook Kang, Jee Hyun Kwon, Ji Sung Lee, Jaeseol Park, Jae-Sung Lim, Sung Il Sohn, Joung-Ho Rha, Jong-Moo Park, Yong-Jae Kim, Mi Sun Oh, Byung-Chul Lee, Sun U. Kwon, Sungwook Yu, Juneyoung Lee, Ju-Hun Lee, Yang-Ha Hwang, Hyo Suk Nam, Seong Hwan Ahn, Jae Kwan Cha, Sung Hyuk Heo, Jimi Choi, Eung Gyu Kim, Hee-Joon Bae, Woo-Keun Seo, Kyung Ho Yu, Hahn Young Kim, and Jong Ho Park

Subjects
medicine.medical_specialty, business.industry, Probucol, MEDLINE, Cognition, medicine.disease, Outcome (game theory), Cilostazol, Physical medicine and rehabilitation, medicine, Neurology (clinical), Cognitive decline, Cardiology and Cardiovascular Medicine, business, Letter to the Editor, Stroke, medicine.drug
Published
2021
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10. The Relationship between the Transcranial Doppler Pulsatility Changes and the CYP2C19 Genotype on Clopidogrel Treatment

Author

Joong Hyun Park, Taemin Kim, Jinyoung Oh, Jeong Yeon Kim, Sang Won Han, Jae Hyeon Park, Jong Sam Baik, Ji Eun Han, and Eung-Gyu Kim

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Cyp2c19 genotype, Blood viscosity, Hematocrit, Clopidogrel, medicine.disease, Transcranial Doppler, Internal medicine, medicine, Cardiology, Ultrasonography, business, Stroke, medicine.drug
Published
2020
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11. Cilostazol Versus Aspirin in Ischemic Stroke Patients With High-Risk Cerebral Hemorrhage

Author

Jee Hyun Kwon, Sun U. Kwon, Seongheon Kim, Hyo Suk Nam, Hahn Young Kim, Dong-Wha Kang, Keun-Sik Hong, Yong-Jae Kim, Bum Joon Kim, Woo-Keun Seo, Joung Ho Park, Sung Il Sohn, Lawrence K.S. Wong, Juneyoung Lee, Jose C. Navarro, Jin Man Jung, Man Seok Park, Eung Gyu Kim, Ju-Hun Lee, Jong-Moo Park, Seong Hwan Ahn, Ji Sung Lee, Jong Ho Rha, Sungwook Yu, Yang-Ha Hwang, Jae Kwan Cha, and Sung Hyuk Heo

Subjects
Male, medicine.medical_specialty, Subgroup analysis, 030204 cardiovascular system & hematology, Brain Ischemia, White matter, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes mellitus, Internal medicine, Heart rate, medicine, Humans, Stroke, Aged, Cerebral Hemorrhage, Advanced and Specialized Nursing, Aspirin, business.industry, Middle Aged, medicine.disease, Cilostazol, medicine.anatomical_structure, Ischemic stroke, Cardiology, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Follow-Up Studies, medicine.drug
Abstract

Background and Purpose— Although cilostazol has shown less hemorrhagic events than aspirin, only marginal difference was observed in hemorrhagic stroke events among patients at high risk for cerebral hemorrhage. To identify patients who would most benefit from cilostazol, this study analyzed interactions between treatment and subgroups of the PICASSO trial (Prevention of Cardiovascular Events in Asian Ischemic Stroke Patients With High Risk of Cerebral Hemorrhage). Methods— Ischemic stroke patients with a previous intracerebral hemorrhage or multiple microbleeds were randomized to treatment with cilostazol or aspirin and followed up for a mean 1.8 years. Efficacy, defined as the composite of any stroke, myocardial infarction, and vascular death, and safety, defined as the incidence of hemorrhagic stroke, were analyzed in the 2 groups. Interactions between treatment and age, sex, presence of hypertension and diabetes mellitus, index of high-risk cerebral hemorrhage, and white matter lesion burden were analyzed for primary and key secondary outcomes. Changes in vital signs and laboratory results were compared in the 2 groups. Results— Among all 1534 patients enrolled, a significant interaction between treatment group and index of high risk for cerebral hemorrhage on hemorrhagic stroke ( P for interaction, 0.03) was observed. Hemorrhagic stroke was less frequent in the cilostazol than in the aspirin group in patients with multiple microbleeds (1 versus 13 events; hazard ratio, 0.08 [95% CI, 0.01–0.61]; P =0.01). A marginal interaction between treatment group and white matter change on any stroke ( P for interaction, 0.08) was observed. Cilostazol reduced any stroke significantly in patients with mild (5 versus 16 events; hazard ratio, 0.36 [95% CI, 0.13–0.97]; P =0.04)-to-moderate (16 versus 32 events; hazard ratio, 0.50 [95% CI, 0.29–0.92]; P =0.03) white matter changes. Heart rate and HDL (high-density lipoprotein) cholesterol level were significantly higher in the cilostazol group than in the aspirin group at follow-up. Conclusions— Cilostazol may be more beneficial for ischemic stroke patients with multiple cerebral microbleeds and before white matter changes are extensive. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT01013532.

Published
2020
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12. Usefulness of Diffusion-Weighted MRI for Differentiation between Parkinson’s Disease and Parkinson Variant of Multiple System Atrophy

Author

Eun Joo Chung, Eung Gyu Kim, Jong Seok Bae, Choong Ki Eun, Kwang Sig Lee, Minkyung Oh, and Sang Jin Kim

Subjects
Parkinson’s disease, Multiple system atrophy, Diffusion-weighted imaging, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background and Purpose: Several studies have reported that diffusion-weighted imaging (DWI) is able to help discriminate a Parkinson variant of multiple system atrophy (MSA-p) from Parkinson’s disease (PD) on the basis of the increased regional apparent diffusion coefficient (rADC). We analyzed the usefulness of DWI by using the rADC for differential diagnosis between MSA-p and PD and investigated the correlation between the rADC value and clinical features of MSA-p and PD. Methods: Twelve patients with PD and 10 with MSA-p were studied. The rADC value was determined in different brain regions, including the dorsal putamen (DP) and middle cerebellar peduncles (MCP). Results: The rADC values of the DP showed a greater increase in MSA-p patients than in PD patients (p=0.03). MSA-p patients also presented increased rADC values of the MCP compared with PD patients (p=0.0001). In particular, the sensitivity, specificity and positive predictive values of the MCP rADC were higher than those of the DP rADC. However, DP and MCP rADC values were not correlated with clinical features in either MSA or PD patients. Conclusions: DWI discriminated between PD and MSA-p based on rADC values in DP and MCP. The MCP rADC value, in particular, could better discriminate MSA-p from PD.

Published
2009
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13. Benefit of Targeting a LDL (Low-Density Lipoprotein) Cholesterol \textless70 mg/dL During 5 Years After Ischemic Stroke

Author

Pierre Amarenco, Jong S. Kim, Julien Labreuche, Hugo Charles, Maurice Giroud, Byung-Chul Lee, Marie-Hélène Mahagne, Norbert Nighoghossian, Philippe Gabriel Steg, Éric Vicaut, Eric Bruckert, Pierre-Jean Touboul, Didier Leys, Yannick Béjot, Philippa Lavallée, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, Yun Jeong In, Elena Meseguer, Philippa C Lavallée, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-Bègue Marsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Angel Olaru, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, Emilie, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, Eric Alnajar-Carpentier, Michèle Levasseur, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, null Stantescu, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Woo-Keun Seo, Jongwon Chung, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Fibrose Inflammation Remodelage [Hôpitaux Universitaires Paris Nord Val de Seine] (DHU FIRE ), Hôpitaux Universitaires Paris Nord Val de Seine, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Asan Medical Center [Seoul], University of Ulsan, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université de Bourgogne (UB), Hallym University Sacred Heart Hospital [Anyang, South Korea] (HUS2H), Hôpital Pasteur [Nice] (CHU), Hospices Civils de Lyon (HCL), Université de Lyon, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Royal Brompton Hospital, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Treat Stroke to Target Investigators: Pierre-Jean Touboul, Didier Leys, Yannick Béjot, Philippa Lavallée, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Pierre-Jean Touboul, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, Yun Jeong In, Elena Meseguer, Philippa C Lavallée, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Bertrand Lapergue, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Fernando Pico, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Gurkan Mutlu, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Candice Sabben, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Marion Yger, Yannick Béjot, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-Bègue Marsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Angel Olaru, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Emmanuel Touzé, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani Emilie, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, Eric Alnajar-Carpentier, Michèle Levasseur, Pierre Louchart, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, Stantescu, Marc Bataillard, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-Kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Woo-Keun Seo, Jongwon Chung, and UPJV, BU Santé

Subjects
Male, medicine.medical_specialty, Statin, Time Factors, medicine.drug_class, [SDV]Life Sciences [q-bio], Brain Ischemia, LDL, chemistry.chemical_compound, Drug Delivery Systems, Ezetimibe, Internal medicine, medicine, Clinical endpoint, Humans, angiography, Myocardial infarction, Stroke, Aged, Advanced and Specialized Nursing, Cerebral infarction, Cholesterol, business.industry, Anticholesteremic Agents, informed consent, cholesterol, Cholesterol, LDL, Middle Aged, medicine.disease, stroke, [SDV] Life Sciences [q-bio], aorta, chemistry, Number needed to treat, Cardiology, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Background and Purpose— The TST trial (Treat Stroke to Target) evaluated the benefit of targeting a LDL (low-density lipoprotein) cholesterol of 4 mm, in a French and Korean population. The follow-up lasted a median of 5.3 years in French patients (similar to the median follow-up time in the SPARCL trial [Stroke Prevention by Aggressive Reduction in Cholesterol Level]) and 2.0 years in Korean patients. Exposure duration to statin is a well-known driver for cardiovascular risk reduction. We report here the TST results in the French cohort. Methods— One thousand seventy-three French patients were assigned to Results— After a median follow-up of 5.3 years, the achieved LDL cholesterol was 66 (1.69 mmol/L) and 96 mg/dL (2.46 mmol/L) on average, respectively. The primary end point occurred in 9.6% and 12.9% of patients, respectively (HR, 0.74 [95% CI, 0.57–0.94]; P =0.019). Cerebral infarction or urgent carotid revascularization following transient ischemic attack was reduced by 27% ( P =0.046). Cerebral infarction or intracranial hemorrhage was reduced by 28% ( P =0.023). The primary outcome or intracranial hemorrhage was reduced by 25% ( P =0.021). Intracranial hemorrhages occurred in 13 and 11 patients, respectively (HR, 1.17 [95% CI, 0.53–2.62]; P =0.70). Conclusions— After an ischemic stroke of documented atherosclerotic origin, targeting a LDL cholesterol of Registration— URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875.

Published
2020
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14. Radiographic Features in a Patient Diagnosed with Neurosyphilis

Author

Yoon Ah Park, Eung Gyu Kim, Jung Woo Ann, Seok Hwi Jeon, Seokmo Lee, Joong Hyun Park, and Eun Joo Chung

Subjects
Neurosyphilis, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Radiography, Medicine, Magnetic resonance imaging, Radiology, business, medicine.disease
Published
2019
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16. Safety and Efficacy of Otaplimastat in Patients with Acute Ischemic Stroke Requiring tPA (SAFE‐TPA): A Multicenter, Randomized, Double‐Blind, Placebo‐Controlled Phase 2 Study

Author

Byung Su Kim, Eun-Jae Lee, Yang-Ha Hwang, Eung-Gyu Kim, Jei-Man Ryu, Jong Ho Park, Chung Ju, Jong S. Kim, Dae-Il Chang, Kyungmi Oh, Sang Min Sung, Kyung Bok Lee, and Won-Ki Kim

Subjects
Adult, Male, 0301 basic medicine, Placebo, Brain Ischemia, law.invention, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Fibrinolytic Agents, Randomized controlled trial, law, Modified Rankin Scale, Multicenter trial, Acetamides, medicine, Humans, Adverse effect, Stroke, Research Articles, Aged, Quinazolinones, Aged, 80 and over, Intracerebral hemorrhage, business.industry, Middle Aged, medicine.disease, Neuroprotective Agents, Treatment Outcome, 030104 developmental biology, Neurology, Tissue Plasminogen Activator, Anesthesia, Administration, Intravenous, Female, Chills, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Research Article
Abstract

Objective Otaplimastat is a neuroprotectant that inhibits matrix metalloprotease pathway, and reduces edema and intracerebral hemorrhage induced by recombinant tissue plasminogen activator (rtPA) in animal stroke models. We aimed to assess the safety and efficacy of otaplimastat in patients receiving rtPA. Methods This was a phase 2, 2‐part, multicenter trial in stroke patients (19–80 years old) receiving rtPA. Intravenous otaplimastat was administered

Published
2019
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17. Therapeutic-induced hypertension in patients with noncardioembolic acute stroke

Author

Suk Jae Kim, Soo Kyoung Kim, Sang Min Sung, Jong-Won Chung, Jaechun Hwang, Oh Young Bang, Mi Ji Lee, Woo-Keun Seo, Eung Gyu Kim, Sung Il Sohn, Yeon Soo Ha, and Moon Ku Han

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Collateral Circulation, Blood Pressure, Brain Edema, Revascularization, Patient Care Planning, Article, law.invention, Randomized controlled trial, Modified Rankin Scale, law, Internal medicine, medicine, Humans, cardiovascular diseases, Myocardial infarction, Mortality, Stroke, Aged, Aged, 80 and over, business.industry, Brain, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Diffusion Magnetic Resonance Imaging, Treatment Outcome, Blood pressure, Hypertension, Cardiology, Female, Neurology (clinical), business, Intracranial Hemorrhages
Abstract

ObjectiveTo evaluate the safety and efficacy of induced hypertension in patients with acute ischemic stroke.MethodsIn this multicenter randomized clinical trial, patients with acute noncardioembolic ischemic stroke within 24 hours of onset who were ineligible for revascularization therapy and those with progressive stroke during hospitalization were randomly assigned (1:1) to the control and intervention groups. In the intervention group, phenylephrine was administered intravenously to increase systolic blood pressure (SBP) up to 200 mm Hg. The primary efficacy endpoint was early neurologic improvement (reduction in NIH Stroke Scale [NIHSS] score of ≥2 points during the first 7 days). The secondary efficacy endpoint was a modified Rankin Scale score of 0 to 2 at 90 days. Safety outcomes included symptomatic intracranial hemorrhage/edema, myocardial infarction, and death.ResultsIn the modified intention-to-treat analyses, 76 and 77 patients were included in the intervention and control groups, respectively. After adjustment for age and initial stroke severity, induced hypertension increased the occurrence of the primary (odds ratio 2.49, 95% confidence interval [CI] 1.25–4.96, p = 0.010) and secondary (odds ratio 2.97, 95% CI 1.32–6.68, p = 0.009) efficacy endpoints. Sixty-seven (88.2%) patients of the intervention group exhibited improvements in NIHSS scores of ≥2 points during induced hypertension (mean SBP 179·7 ± 19.1 mm Hg). Safety outcomes did not significantly differ between groups.ConclusionAmong patients with noncardioembolic stroke who were ineligible for revascularization therapy and those with progressive stroke, phenylephrine-induced hypertension was safe and resulted in early neurologic improvement and long-term functional independence.ClinicalTrials.gov identifierNCT01600235.Classification of evidenceThis study provides Class III evidence that for patients with acute ischemic stroke, therapeutic-induced hypertension increases the probability of early neurologic improvement.

Published
2019
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18. Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society

Author

Soo Joo Lee, Kyusik Kang, Yang-Ha Hwang, Ye Jin Kim, Jay Chol Choi, Hyung Geun Oh, Jeong-Min Kim, Wook-Joo Kim, Jong-Moo Park, Jong Ho Park, Ji Sung Lee, Keon-Joo Lee, Jung Hwa Seo, Min Sun Kim, Hyori Yun, Tae Jin Song, Kijeong Lee, Dae-Hyun Kim, Seong Hwan Ahn, Juneyoung Lee, Seong-Eun Kim, Min Uk Jang, Hee Won Han, Jihoon Kang, Moo Seok Park, Jun Yup Kim, Kwang-Yeol Park, Sungwook Yu, Jin Hyuk Hong, Joon-Tae Kim, Sujung Jang, Yong-Jin Cho, Hyun Wook Nah, Kyung Bok Lee, Sang Hwa Lee, Jinmi Seok, Hong Kyun Park, Eung Gyu Kim, Jaseong Koo, Seokwan Han, Tai Hwan Park, Hee-Joon Bae, Keun-Sik Hong, Mi Sun Oh, Chulho Kim, Woo-Keun Seo, Jong-Won Chung, Jimi Choi, Beom Joon Kim, Jae Guk Kim, and Kang Ho Choi

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Epidemiology, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Statistics, medicine, Emergency medical services, Cumulative incidence, cardiovascular diseases, Stroke, Intracerebral hemorrhage, business.industry, Incidence (epidemiology), Atrial fibrillation, medicine.disease, lcsh:RC666-701, Special Review, Attributable risk, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract

Despite the great socioeconomic burden of stroke, there have been few reports of stroke statistics in Korea. In this scenario, the Epidemiologic Research Council of the Korean Stroke Society launched the “Stroke Statistics in Korea” project, aimed at writing a contemporary, comprehensive, and representative report on stroke epidemiology in Korea. This report contains general statistics of stroke, prevalence of behavioral and vascular risk factors, stroke characteristics, pre-hospital system of care, hospital management, quality of stroke care, and outcomes. In this report, we analyzed the most up-to-date and nationally representative databases, rather than performing a systematic review of existing evidence. In summary, one in 40 adults are patients with stroke and 232 subjects per 100,000 experience a stroke event every year. Among the 100 patients with stroke in 2014, 76 had ischemic stroke, 15 had intracerebral hemorrhage, and nine had subarachnoid hemorrhage. Stroke mortality is gradually declining, but it remains as high as 30 deaths per 100,000 individuals, with regional disparities. As for stroke risk factors, the prevalence of smoking is decreasing in men but not in women, and the prevalence of alcohol drinking is increasing in women but not in men. Population-attributable risk factors vary with age. Smoking plays a role in young-aged individuals, hypertension and diabetes in middle-aged individuals, and atrial fibrillation in the elderly. About four out of 10 hospitalized patients with stroke are visiting an emergency room within 3 hours of symptom onset, and only half use an ambulance. Regarding acute management, the proportion of patients with ischemic stroke receiving intravenous thrombolysis and endovascular treatment was 10.7% and 3.6%, respectively. Decompressive surgery was performed in 1.4% of patients with ischemic stroke and in 28.1% of those with intracerebral hemorrhage. The cumulative incidence of bleeding and fracture at 1 year after stroke was 8.9% and 4.7%, respectively. The direct costs of stroke were about ₩1.68 trillion (KRW), of which ₩1.11 trillion were for ischemic stroke and ₩540 billion for hemorrhagic stroke. The great burden of stroke in Korea can be reduced through more concentrated efforts to control major attributable risk factors for age and sex, reorganize emergency medical service systems to give patients with stroke more opportunities for reperfusion therapy, disseminate stroke unit care, and reduce regional disparities. We hope that this report can contribute to achieving these tasks.

Published
2019
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19. Fimasartan-Based Blood Pressure Control after Acute Cerebral Ischemia: The Fimasartan-Based Blood Pressure Control after Acute Cerebral Ischemia Study

Author

Jee Hyun Kwon, Joung-Ho Rha, Man Seok Park, Mi Sun Oh, Hee-Joon Bae, Kyung Bok Lee, Bum Joon Kim, Jaseong Koo, Sang Min Sung, Soo Joo Lee, Yang-Ha Hwang, Jay Chol Choi, Hyo Suk Nam, Jong-Moo Park, S. U. Kwon, Oh Young Bang, Jae Kwan Cha, Sang Won Han, Jong Ho Park, Keun-Sik Hong, Kyung-Yul Lee, Yong Seok Lee, Seong Hwan Ahn, Sung Il Sohn, Eung Gyu Kim, Jin Man Jung, and Yong-Jae Kim

Subjects
Blood pressure control, medicine.medical_specialty, Neurology, business.industry, Ischemia, blood pressure, fimasartan, medicine.disease, stroke, Blood pressure, Internal medicine, medicine, Cardiology, Clinical endpoint, Fimasartan, Original Article, prevention and control, Neurology (clinical), business, Adverse effect, Stroke, medicine.drug
Abstract

BACKGROUND AND PURPOSE Blood pressure (BP) control is strongly recommended, but BP control rate has not been well studied in patients with stroke. We evaluated the BP control rate with fimasartan-based antihypertensive therapy initiated in patients with recent cerebral ischemia. METHODS This multicenter, prospective, single-arm trial involved 27 centers in South Korea. Key inclusion criteria were recent cerebral ischemia within 90 days and high BP [systolic blood pressure (SBP) >140 mm Hg or diastolic blood pressure (DBP) >90 mm Hg]. BP lowering was initiated with fimasartan. BP management during the follow-up was at the discretion of the responsible investigators. The primary endpoint was the target BP goal achievement rate (

Published
2020

20. Low- versus Standard-Dose Intravenous Alteplase in the Context of Bridging Therapy for Acute Ischemic Stroke: A Korean ENCHANTED Study

Author

Yang-Ha Hwang, Yeon Jung Kim, Kyung Bok Lee, Jei Kim, Craig S. Anderson, Joung-Ho Rha, Jae Kwan Cha, Richard I. Lindley, Woo-Keun Seo, Jaseong Koo, Dong-Eog Kim, John Chalmers, Jong-Moo Park, Jong S. Kim, Xia Wang, Thompson G. Robinson, Eung Gyu Kim, and Yong-Jae Kim

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_treatment, intracranial hemorrhages, Context (language use), 03 medical and health sciences, 0302 clinical medicine, Modified Rankin Scale, medicine, Clinical endpoint, 030212 general & internal medicine, Stroke, Intracerebral hemorrhage, business.industry, Cerebral infarction, Odds ratio, Thrombolysis, medicine.disease, cerebral infarction, thrombectomy, lcsh:RC666-701, Anesthesia, Original Article, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract

Background and purpose Following the positive results from recent trials on endovascular therapy (EVT), bridging therapy (intravenous alteplase plus EVT) is increasingly being used for the treatment of acute ischemic stroke. However, the optimal dose of intravenous alteplase remains unknown in centers where bridging therapy is actively performed. The optimal dose for eventual recanalization and positive clinical outcomes in patients receiving bridging therapy also remains unknown. Methods In this prospective Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) sub-study, we explored the outcomes following treatment with two different doses (low- [0.6 mg/kg] or standard-dose [0.9 mg/kg]) of intravenous alteplase across 12 Korean centers where EVT is actively performed. The primary endpoint was a favorable outcome at 90 days (modified Rankin Scale scores 0 to 1). Secondary endpoints included symptomatic intracerebral hemorrhage (ICH) in all patients, and the recanalization rate and favorable outcome in patients who underwent cerebral angiography for EVT (ClinicalTrials.gov, number NCT01422616). Results Of 351 patients, the primary outcome occurred in 46% of patients in both the standard-(80/173) and low-dose (81/178) groups (odds ratio [OR], 1.14; 95% confidence interval [CI], 0.72 to 1.81; P=0.582), although ICHs tended to occur more frequently in the standard-dose group (8% vs. 3%, P=0.056). Of the 67 patients who underwent cerebral angiography, there was no significant difference in favorable functional outcome between the standard- and low-dose groups (39% vs. 21%; OR, 2.39; 95% CI, 0.73 to 7.78; P=0.149). Conclusions There was no difference in functional outcome between the patients receiving different doses of alteplase in centers actively performing bridging therapy.

Published
2018

21. Ischemic Stroke Caused by a Hyaluronic Acid Gel Embolism Treated with Tissue Plasminogen Activator

Author

Jin-Ho Jung, Eung-Gyu Kim, Jung Hwa Seo, and Sukyoon Lee

Subjects
Pathology, medicine.medical_specialty, business.industry, medicine.disease, Tissue plasminogen activator, lcsh:RC346-429, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Embolism, chemistry, Ischemic stroke, Hyaluronic acid, 030221 ophthalmology & optometry, medicine, business, lcsh:Neurology. Diseases of the nervous system, 030217 neurology & neurosurgery, medicine.drug
Published
2017
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22. Analysis of Changes in Stride Length, Time, and Electromyography Finding Depending on Athletic Crouch Start Method

Author

Kyung-Ill Lee, Eung Gyu Kim, and Wan-Ki Hong

Subjects
medicine.medical_specialty, medicine.diagnostic_test, Vastus medialis, Medial gastrocnemius, Electromyography, Kinematics, Stride length, Physical medicine and rehabilitation, medicine, Muscle activity, human activities, Foot (unit), Mathematics, Electromyography finding
Abstract

Objective: The purpose of this study was to compare and analyze the kinematic variables and electromyography (EMG) findings that change with varying characteristics of crouch start and feedback provision, and to provide the fundamental data for record improvement in 400 mH. Method: Four short-distance runners participated in the experiment. The analyzed variables were elapsed time per interval, stride length, and muscle activities in three lower limb muscles. These variables were analyzed by using Kwon3d XP and Noraxon Myoresearch. The participants were subjected to three conditions, including two conditions that relate to the thrusting foot on the rear block and another condition pertinent to feedback provision. Results: In terms of a one-step interval, the elapsed time in condition A was longer than that in condition B, and the one after the feedback was the longest. The stride length of a one-step interval was the longest in condition A. The stride length of a two-step interval was the shortest in condition A. The muscle activity during a one-step interval showed differences in vastus medialis and medial gastrocnemius, with condition A being the highest. Conclusion: When the non-dominant left foot was located at the back, negative results were observed in terms of elapsed time and stride length. Moreover, an imbalance in muscle activity was observed between the left and right feet when the left foot was placed at the back. As a result, significant differences in elapsed time, stride length, and muscle activity were observed depending on the foot placed on the rear block. In conclusion, we identified the characteristics of crouch start in 400 mH, and a specialized program must be suggested.

Published
2017
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23. Changes in High-Density Lipoprotein Cholesterol and Risks of Cardiovascular Events: A Post Hoc Analysis from the PICASSO Trial

Author

Joung-Ho Rha, Sungwook Yu, Hahn Young Kim, Jin Man Jung, Hyo Suk Nam, Woo-Keun Seo, Jong-Moo Park, Yang-Ha Hwang, Ji Sung Lee, Jong Ho Park, Eun-Jae Lee, Jee Hyun Kwon, Sung Hwan Ahn, Jae Kwan Cha, Sung Hyuk Heo, Ju-Hun Lee, Sung Il Sohn, Dong-Wha Kang, Eung Gyu Kim, Man Seok Park, Juneyoung Lee, Sung-Hun Kim, Keun-Sik Hong, Yong-Jae Kim, and Sun U. Kwon

Subjects
medicine.medical_specialty, Probucol, chemistry.chemical_compound, High-density lipoprotein, Internal medicine, Post-hoc analysis, medicine, Myocardial infarction, Stroke, Aspirin, Cholesterol, business.industry, Secondary prevention, Cholesterol, HDL, medicine.disease, Cilostazol, chemistry, Cardiology, Original Article, Neurology (clinical), Cholesterol ester transfer proteins, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Background and purpose Whether pharmacologically altered high-density lipoprotein cholesterol (HDL-C) affects the risk of cardiovascular events is unknown. Recently, we have reported the Prevention of Cardiovascular Events in Asian Patients with Ischaemic Stroke at High Risk of Cerebral Haemorrhage (PICASSO) trial that demonstrated the non-inferiority of cilostazol to aspirin and superiority of probucol to non-probucol for cardiovascular prevention in ischemic stroke patients (clinicaltrials.gov: NCT01013532). We aimed to determine whether on-treatment HDL-C changes by cilostazol and probucol influence the treatment effect of each study medication during the PICASSO study.Methods Of the 1,534 randomized patients, 1,373 (89.5%) with baseline cholesterol parameters were analyzed. Efficacy endpoint was the composite of stroke, myocardial infarction, and cardiovascular death. Cox proportional hazards regression analysis examined an interaction between the treatment effect and changes in HDL-C levels from randomization to 1 month for each study arm.Results One-month post-randomization mean HDL-C level was significantly higher in the cilostazol group than in the aspirin group (1.08 mmol/L vs. 1.00 mmol/L, PP

Published
2019

24. E-119 Feasibility for extracranial carotid artery stenting in acute ischemic stroke patients after IV-tPA treatment

Author

Jung Hwa Seo and Eung-Gyu Kim

Subjects
medicine.medical_specialty, Extracranial carotid artery, business.industry, medicine.medical_treatment, medicine.disease, Balloon, Thrombosis, 030218 nuclear medicine & medical imaging, Surgery, 03 medical and health sciences, 0302 clinical medicine, Modified Rankin Scale, Angioplasty, Antithrombotic, Occlusion, medicine, business, Acute ischemic stroke, 030217 neurology & neurosurgery
Abstract

Purpose The clinical benefit of endovascular thrombectomy (EVT) after intravenous recombinant tissue plasminogen activator (IV rt-PA) has been demonstrated in several studies. Near 10% of acute ischemic stroke (AIS) patients are accompanied with carotid artery atherosclerotic occlusion. The MR Clean study in the Netherlands reported that acute carotid artery stenting (CAS) was performed in 30 patients in the intervention group (12.9%). However, there is no evidence of the benefit for emergent CAS in AIS patients, and there are no clear guidelines for specific medications as an adjunctive therapy within 24 hours of IV rt-PA. Methods We analyzed single-center registry data retrospectively for 2006 to 2018. Emergent CAS during EVT was performed in select patients according to the operator’s decision. Most patients for emergent CAS was not used to antithrombotic medications routinely within 24 hours of IV rt-PA. Only some complicated cases were used intra-arterial or oral antithrombotics within 24 hours of IV rt-PA. Recanalization results were assessed by TICI grade immediately after the procedure. The clinical outcome was evaluated using the 3 months modified Rankin Scale. Results Among 177 consecutive patients with AIS treated with rt-PA and EVT from 2006 to 2018, twenty-three(12.9%) patients underwent CAS as an EVT. Eighteen patients (78.3%) were accompanied with tandem occlusion. Median age was 68. Median NIHSS was 13. During the emergent carotid artery stenting, pre-stent balloon angioplasty was performed in 20 patients. Carotid Wallstent (Boston Scientific, Natick, USA) was used in all patients who treated with emergency CAS. Successful installation of CAS was achieved in 22 patients (95.6%). One case of CAS was failed. Two patients were installed multiple carotid stent for carotid dissection. And embolic protection device was used in 13 patients.However, four cases of CAS experienced thromboembolic complications including in-stent thrombosis and distal migration of emboli. In those cases, IA glycoprotein IIb/IIIa infused as a rescue method, and early antiplatelet within 24 hours of rt-PA was administered in one patient.Final successful recanalization (mTICI 2b-3) was achieved in 16 patients (69.5%). Eleven patients (47.8%) had a good functional outcome (modified mRS 0–2). Intracranial hemorrhage was occurred in 4 cases. The mortality case was two. The accompanying tandem occlusion was 61%. Conclusions In this analysis, successful rate of emergency CAS and intracranial EVT after IV rt-PA was high as 95.6% and 69.5%. The good functional outcomes (mRS 0–2) were 46.7% in patients treated with emergency CAS and the overall clinical outcome would be acceptable. Disclosures J. Seo: None. E. Kim: None.

Published
2019
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25. Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis

Author

Bum Joon Kim, Yang-Ha Hwang, Juneyoung Lee, Seung-Hoon Lee, Joon-Tae Kim, Jae Kwan Cha, Sung Hyuk Heo, Eung Gyu Kim, Soo Joo Lee, Tai Hwan Park, Hyung-Min Kwon, Jong-Moo Park, Dong-Wha Kang, Ji Sung Lee, Man Seok Park, Jun Lee, Joung-Ho Rha, Hee-Jung Song, Sungwook Yu, Sun U. Kwon, and Jong Ho Park

Subjects
Male, medicine.medical_specialty, Time Factors, White matter lesion, Blood Pressure, 030204 cardiovascular system & hematology, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, Leukoencephalopathies, Recurrence, Risk Factors, Internal medicine, Republic of Korea, Internal Medicine, medicine, Humans, Aged, business.industry, Odds ratio, Middle Aged, medicine.disease, Intracranial Arteriosclerosis, Hyperintensity, Confidence interval, Stroke, Stenosis, Blood pressure, Ischemic stroke, Hypertension, Cardiology, Female, Intracranial Atherosclerosis, business, 030217 neurology & neurosurgery
Abstract

BACKGROUND High blood pressure variability (BPV) is associated with recurrent stroke. We investigated the association between BPV, new ischemic lesions (NILs), and white matter lesion (WML) growth in patients with ischemic stroke due to intracranial atherosclerosis (ICAS). METHODS This study was performed as a post-hoc analysis of the STABLE-ICAS trial, which enrolled subacute ischemic stroke patients with symptomatic ICAS (>50% stenosis) and hypertension. BPV was measured at the office (visit by visit) and at home (day by day). Patients were divided into 3 groups (tertiles) according to their home BPV. WML growth and the occurrence of NILs were compared among the 3 groups. Multivariable analyses were performed to identify the independent risk factors of WML growth and NILs. RESULTS Of the 111 enrolled patients, 69 patients (67.6%) demonstrated WML growth and 15 patients (13.7%) had NILs. Patients with higher BPV demonstrated a more WML growth (50% vs. 61.8% vs. 83.8; P = 0.02, by tertiles) and more NILs (5.4% vs. 5.4% vs. 29.7%; P = 0.002, by tertiles). In multivariable analyses, old age [odds ratio (OR) = 1.052 (95% confidence interval (CI) = 1.005–1.101); P = 0.03] and home BPV [OR = 1.149 (95% CI = 1.013–1.304); P = 0.02] were independently associated with WML growth. Low mean diastolic blood pressure [OR = 0.913 (95% CI = 0.874–0.984); P = 0.02] and high home BPV [OR = 1.287 (95% CI = 1.086–1.526); P = 0.004] were independently associated with NILs at follow-up. CONCLUSIONS High BPV is associated with WML growth and NIL in ischemic stroke patients with symptomatic ICAS. BPV monitoring at home may be helpful.

Published
2019

26. Comparison of the Solitaire and Trevo Stents for Endovascular Treatment of Acute Ischemic Stroke: A Single.Center Experience

Author

Sung Tae Kim, Hae Woong Jeong, Jin Wook Baek, Eung-Gyu Kim, Young Jin Heo, and Jung Hwa Seo

Subjects
Solitaire Cryptographic Algorithm, medicine.medical_specialty, medicine.medical_treatment, Single Center, Brain Ischemia, medicine, Humans, cardiovascular diseases, Endovascular treatment, Stroke, Acute ischemic stroke, Ischemic Stroke, Retrospective Studies, Thrombectomy, business.industry, Cerebral infarction, Stent, Thrombolysis, medicine.disease, Surgery, Treatment Outcome, Neurology, Stents, Neurology (clinical), business
Abstract

Aims: Limited studies have compared the effectiveness of Solitaire and Trevo stentrievers for endovascular thrombectomy to achieve recanalization and improve functional outcomes of patients with acute ischemic stroke. Therefore, we compared the safety and efficacy of the two stents during endovascular thrombectomy for patients with acute ischemic stroke. Materials and Methods: This study included 130 patients who underwent endovascular thrombectomy using either the Trevo (n = 51) or the Solitaire (n = 79) stent for anterior circulation acute ischemic stroke. Recanalization was classified using thrombolysis in cerebral infarction (TICI) grading. Efficacy and safety of the devices during endovascular thrombectomy were analyzed by evaluating the rate of good recanalization after the first pass, clot retrieval rate, final recanalization grade, use of rescue treatment, recanalization time, and hemorrhagic and thromboembolic complications. Results: Overall, good recanalization (TICI grades 2b and 3) was achieved (Solitaire: n = 57, 72.2%; Trevo: n = 46, 90.2%) (P = 0.01). The rate of good recanalization after the first pass and clot retrieval rate were similar between groups; however, the use of rescue treatment was more frequent in the Solitaire group. Recanalization time was shorter in the Trevo group. The good clinical outcome rate was higher in the Trevo group but not statistically significantly. The rates of symptomatic hemorrhage and thromboembolism were not significantly different between groups. Conclusion: The Trevo stent achieved more successful recanalization with less need for rescue treatment and less time for recanalization than the Solitaire stent. There was no statistically significant difference in the clinical outcomes.

Published
2021
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27. An Unusual Case of Bilateral Meralgia Paresthetica Following Femoral Cannulations

Author

Sang Jin Kim, Seong-il Oh, and Eung Gyu Kim

Subjects
0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, Femoral vein, Case Report, Lateral femoral cutaneous nerve, Electromyography, Thigh, lcsh:RC321-571, Lesion, Mononeuropathy, 03 medical and health sciences, 0302 clinical medicine, lateral femoral cutaneous nerve, medicine, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Meralgia paresthetica, Cardiac catheterization, lcsh:R5-920, medicine.diagnostic_test, business.industry, meralgia paresthetica, medicine.disease, femoral cannulation, Surgery, 030104 developmental biology, medicine.anatomical_structure, medicine.symptom, lcsh:Medicine (General), business, 030217 neurology & neurosurgery
Abstract

Meralgia paresthetica (MP) is a sensory mononeuropathy of the lateral femoral cutaneous nerve (LFCN). MP has rarely been reported after a femoral intervention approach. We report a case of bilateral meralgia paresthetica following bilateral femoral cannulation. A 64-year-old male received cardiac catheterization and treatment via a bilateral femoral vein. After cardiac catheterization, the patient presented with paresthesia in the anterolateral aspect of the bilateral thigh. After performing nerve conduction studies and electromyography, he was diagnosed as MP. Although a bilateral LFCN lesion following a femoral approach is very rare, MP might require caution regarding potential variations in LFCN when performing the femoral approach.

Published
2017
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28. Risk for Major Bleeding in Patients Receiving Ticagrelor Compared With Aspirin After Transient Ischemic Attack or Acute Ischemic Stroke in the SOCRATES Study (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes)

Author

J. Donald Easton, Maria Aunes, Gregory W. Albers, Pierre Amarenco, Sara Bokelund-Singh, Hans Denison, Scott R. Evans, Peter Held, Marianne Jahreskog, Jenny Jonasson, Kazuo Minematsu, Carlos A. Molina, Yongjun Wang, K.S. Lawrence Wong, S. Claiborne Johnston, Sebastiá F. Ameriso, Geoffrey Donnan, Robin Lemmens, Ayrton Massaro, Ekaterina Titianova, Michael D. Hill, Pablo Lavados, David Skoloudik, Joachim Röther, Szegedi Norbert, Giancarlo Agnelli, Natan Bornstein, Norio Tanahashi, Angel Arauz Góngora, Edwin Pretell, Maria Cristina Z. San Jose, Anna Czlonkowska, Ovidiu Bajenaru, Ludmila Stakhovskaya, Miroslav Brozman, Jong-Sung Kim, Nils Wahlgren, Patrik Michel, Tsong Hai Lee, Nijasri Charnnarong Suwanwela, Kursad Kutluk, Sergii Moskovko, Scott Kasner, Daniel Laskowitz, Wayne Clark, Huy Thang Nguyen, Sebastian Ameriso, Sandra Lepera, Marina Romano, David Paulon, Pablo Ioli, Cristina Zurru, Guadalupe Bruera, Lorena Jure, Francisco Klein, Guillermo Povedano, Christopher Levi, Thanh Phan, Romesh Markus, Craig Anderson, Arman Sabet, Stephen Davis, Andrew Lee, Timothy Kleinig, Andrew Wong, Martin Krause, Jim Jannes, Tissa Wijeratne, Dimitri Hemelsoet, André Peeters, Philippe Tack, Peter Vanacker, Patrice Laloux, William Van Landegem, Geert Vanhooren, Philippe Desfontaines, Marc Van Orshoven, Fabio Oliveira, Mauricio Friedrich, Rosane Brondani, Rubens Gagliardi, Soraia Fabio, Marianna Dracoulakis, Rodrigo Bazan, Luiz Marrone, Octavio Pontes Neto, Gisele Silva, Pedro Kowacs, Paraskeva Stamenova, Marin Daskalov, Ivan Staikov, Dimo Baldaranov, Dimitar Maslarov, Hristo Lilovski, Plamen Petkov, Neli Petrova, Radoslav Mavrov, Veska Markova, Valeria Petrova, Tanya Beleva, Borislav Kralev, Nikolay Sotirov, Veska Lekova, Dimcho Hristov, Vera Ermenkova, Lyudmil Mateev, Rumeliya Mitkova, Liybomir Haralanov, Rosen Ikonomov, Margarita Mihailova, Ivan Georgiev, Ashfaq Shuaib, Vladimir Hachinski, Jean-Martin Boulanger, Sharan Mann, Ayman Hassan, Ariane Mackey, Bijoy Menon, Jeffrey Minuk, Muzaffar Siddiqui, Marsha Eustace, Lucia Vieira, Daniel Selchen, Michel Beaudry, Grant Stotts, Angel Castro, Kristo Gasic, Rodrigo Rivas, Pablo Sanchez, Andres Roldan, Ingrid Grossmann, Christian Figueroa, Jimei Li, Xiaolin Xu, Huisheng Chen, Xiaohong Li, Yi Yang, Chunsheng Zhang, Baojun Wang, Guanglai Li, Dong Wang, Hong Lin, Yamei Tang, Anding Xu, Yanjiang Wang, Wenke Hong, Zhi Song, Xu Zhang, Xiaoping Jin, Yun Xu, Fuling Yan, Weihong Zheng, Xiaoping Wang, Qiang Dong, Zhongxin Zhao, Baorong Zhang, Wangtao Zhong, Guoqiang Wen, Jun Xu, Guozhong Li, Xueshuang Dong, Xiangyang Tian, Zhaohui Zhang, En Xu, Kaixiang Liu, Jun Chen, Ondrej Skoda, Edvard Ehler, Daniel Vaclavik, Daniel Sanak, Sylva Klimosova, Eva Vitkova, Jan Fiksa, Robert Mikulik, Jiri Neumann, Richard Plny, Didier Leys, Igor Sibon, Jean-Louis Mas, Sonia Alamowitch, Fernando Pico, Hassan Hosseini, Marie-Hélène Mahagne, Emmanuel Touze, Wilfried Vadot, Stéphane Vannier, Norbert Nighoghossian, Yves Samson, Pierre Garnier, Emmanuel Ellie, Benoît Guillon, Serge Timsit, Maurice Giroud, Frédéric Philippeau, Aude Bagan-Triquenot, Valérie Wolff, Nicolas Raposo, Michel Obadia, Severine Debiais, Jérôme Grimaud, Stéphane Illouz, Didier Smadja, Cédric Urbanczyk, Jörg Berrouschot, Christian Weimar, Georg Gahn, Hassan Soda, Sven Klimpe, Darius Nabavi, Jörg Glahn, Martin Köhrmann, Lars Krause, Christoph Terborg, Peter Urban, Thorsten Steiner, Andreas Ferbert, Rainer Dziewas, Günter Seidel, Götz Thomalla, Richard Li, Wing Chi Fong, Raymond Cheung, Norbert Szegedi, Krisztián Pozsegovits, Attila Valikovics, Gyula Pánczél, Csilla Rózsa, László Németh, Péter Diószeghy, Csaba Óváry, Attila Csányi, Levente Kerényi, Valéria Nagy, Sámuel Komoly, Dániel Bereczki, Sándor Molnár, István Kondákor, David Tanne, Guy Raphaeli, Gregory Telman, Ronen Leker, Yair Lampl, Francesco Corea, Stefano Ricci, Donata Guidetti, Giovanni Malferrari, Simona Marcheselli, Giuseppe Micieli, Andrea Zini, Vincenzo Di Lazzaro, Carlo Gandolfo, Andrea Salmaggi, Rossana Tassi, Maurizia Rasura, Giovanni Orlandi, Giancarlo Comi, Michelangelo Mancuso, Marialuisa Delodovici, Paolo Bovi, Domenico Consoli, Kimiaki Utsugisawa, Tsuneo Fujita, Hideyuki Kurihara, Chikashi Maruki, Takeshi Hayashi, Tsuneaki Ogiichi, Morio Kumagai, Katsunobu Takenaka, Kazunori Toyoda, Kazuhiro Takamatsu, Ryo Ogami, Shigenari Kin, Takeshi Aoki, Katsumi Takizawa, Shigehiro Omori, Takehiko Umezawa, Yasuyuki Toba, Yutaka Nonoyama, Hidemitsu Nakagawa, Takashi Naka, Masanori Morimoto, Shuichi Matsumoto, Tsutomu Hitotsumatsu, Tatsuya Shingaki, Satoshi Okuda, Mamoru Ota, Nobuyuki Sakai, Takeshi Yamada, Jun Niwa, Hitoshi Fujita, Akihito Moriki, Kimihiro Yoshino, Yoshihisa Fukushima, Takahisa Mori, Atsushi Sato, Yoshikazu Kusano, Michiya Kubo, Masashi Yamazaki, Takao Ooasa, Takafumi Nishizaki, Naoki Kitagawa, Masahiro Yasaka, Yasuhiro Manabe, Akira Yoshioka, Masayuki Ishihara, Takato Kagawa, Toshikazu Ichihashi, Hideki Matsuoka, Yasuhiro Ito, Masahiro Yamasaki, Hitonori Takaba, Hisatoshi Saito, Masahiro Sato, Kazumasa Fukuda, Sumio Endo, Minoru Kidooka, Toshitaka Umemura, Yuriko Kikkawa, Shuta Toru, Kentaro Yamada, Hideki Sakai, Jun Asari, Masayuki Ezura, Hisashi Nitta, Keiko Nagano, Jun Ochiai, Keiichi Sakai, Yasutaka Kobayashi, Yasuhiro Yoshii, Hirotomo Miake, Tomohiro Takita, Hidekazu Taniguchi, Kazuhiko Kuroki, Takamitsu Mizota, Kenichi Yamamoto, Hiroshi Nakane, Takeshi Iwanaga, Kei Chiba, Tetsuyuki Yoshimoto, Tsuyoshi Torii, Takeo Kitagawa, Hiroshi Takashima, Naoki Shirasaki, Makoto Dehara, Naomichi Wada, Kensuke Hamada, Noriyuki Kato, Yoshinori Go, Ichiro Izumi, Hirotomo Ninomiya, Junichiro Kumai, Yoshikazu Nakajima, Yasuhiko Kaku, Yukihiro Isayama, Masahiro Kawanishi, Shinya Noda, Kazuhide Yamamoto, Takanori Hazama, Hiroshi Takahashi, Yohei Tanaka, Takashi Hata, Kiyoshi Kazekawa, Eisuke Furui, Hideki Hondo, Nobuyuki Sato, Katsusuke Kusunoki, Kazunori Nanri, Satoshi Abe, Noboru Sasaoka, Takayuki Kuroyanagi, Hisahiko Suzuki, Kouzou Fukuyama, Kimihiro Nakahara, Fernando Gongora, Carlos Cantú Brito, Jorge Villarreal Careaga, Rosalia Vazquez Alfaro, Geronimo Aguayo Leytte, Percy Berrospi, Carlos Chavez, Liliana Rodriguez, Nilton Custodio, Cesar Castañeda, Julio Perez, Maria Cristina San Jose, Alejandro Baroque, Epifania Collantes, Abdias Aquino, Alejandro Díaz, Artemio Roxas, Johnny Lokin, Joel Advincula, Emerito Calderon, Jose Navarro, John Hiyadan, Arturo Surdilla, Danuta Ryglewicz, Grzegorz Krychowiak, Waldemar Fryze, Piotr Sobolewski, Ryszard Nowak, Urszula Fiszer, Beata Papierowska, Justyna Zielińska-Turek, Anetta Lasek-Bal, Ewa Kołodziejska, Anna Kamińska, Bożena Adamkiewicz, Andrzej Tutaj, Dorota Szkopek, Krzysztof Musiatowicz, Zbigniew Bąk, Sławomir Brzozowski, Waldemar Brola, Antoni Ferens, Marek Zalisz, Konrad Rejdak, Monika Rudzińska, Cristina Panea, Mihaela Simu, Rodica Balasa, Iulian Cuciureanu, Bogdan Popescu, Monica Sabau, Corina Roman-Filip, Leonid Pimenov, Alla Gekht, Anna Milto, Ivan Shchukin, Vladimir Parfenov, Liudmila Stakhovskaya, Mikhail Arkhipov, Nadezhda Sokolova, Enver Bogdanov, Radiy Esin, Dina Khasanova, Konstantin Golikov, Elena Melnikova, Leonid Zaslavskiy, Igor Voznyuk, Alexander Nazarov, Leila Akhmadeeva, Aida Iakupova, Nikolay Shamalov, Galina Belskaya, Svetlana Chuprina, Olga Denisova, Ekaterina Drozdova, Yuliya Karakulova, Ilya Sholomov, Nikolay Spirin, Elena Vostrikova, Elena Mordvintseva, Vera Grigoryeva, Dmitry Zateyshchikov, Vladimir Gorbachev, Zhanna Chefranova, Mikhail Dudarev, Rostislav Nilk, Alexey Rozhdestvenskiy, Ladislav Gurcik, Miloslav Dvorak, Georgi Krastev, Egon Kurca, Juraj Vyletelka, Jong Sung Kim, Hee-Joon Bae, Yong-Won Kim, Joon-Tae Kim, Jae-Kwan Cha, Hyo Suk Nam, Dae-Il Chang, Yong-Seok Lee, Kyungmi Oh, Sung-Wook Yu, Sung-Il Sohn, Jun Lee, Han Jin Cho, Eung-Gyu Kim, Joung-Ho Rha, Seo Hyun Kim, Carlos Molina Cateriano, Joaquín Serena Leal, José Vivancos Mora, Manuel Rodríguez Yañez, Jaume Roquer González, Francisco Purroy García, Meritxell Gomis Cortina, Jaime Masjuan Vallejo, Juan Arenillas Lara, Tomás Segura Martín, José Antonio Egido Herrero, Jose Ignacio Tembl Ferrairó, Jaime Gállego Culleré, Francisco Moniche Álvarez, Anna Steinberg, Margarita Callander, Ann Charlotte Laska, Lena Bokemark, Thomas Mooe, Tor-Björn Käll, Lennart Welin, Lars Sjöblom, Joakim Hambraeus, Jörg Teichert, Hans Wannberg, Johan Sanner, Bo Ramströmer, Bo Ziedén, Stefan Olsson Hau, Claes Gustafsson, Timo Kahles, Philippe Lyrer, Marcel Arnold, Martin Liesch, Friedrich Medlin, Carlo Cereda, Georg Kägi, Andreas Luft, Emmanuel Carrera, Tsong-Hai Lee, Helen L. Po, Chang-Ming Chern, Li-Ming Lien, Lung Chan, Chung-Hsiang Liu, Shey-Lin Wu, Jiann-Der Lee, Chih-Hung Chen, Huey-Juan Lin, Ruey-Tay Lin, Wei-Hsi Chen, Yu Sun, Tasanee Tantirittisak, Sombat Muengtaweepongsa, Yongchai Nilanont, Somsak Tiamkao, Chesda Udommongkol, Kanokwan Watcharasaksilp, Witoon Jantararotai, Hadiye Sirin, Birsen Ince, Talip Asil, Murat Arsava, Tulay Kurt Incesu, Hulya Tireli, Hayriye Kucukoglu, Fikri Ak, Ali Unal, Serefnur Ozturk, Nevzat Uzuner, Galyna Chmyr, Volodymyr Lebedynets, Vadym Nikonov, Lyudmyla Shulga, Volodymyr Smolanka, Marta Khavunka, Valentyna Yavorska, Nataliya Tomakh, Olexandr Kozyolkin, Galyna Litovaltseva, Maarten Lansberg, Richard Bernstein, David Brown, Jonathan Dissin, Carmelo Graffagnino, Jonathan Harris, William Hicks, Irene Katzan, Jeffrey Kramer, Joshua Willey, Scott Silliman, Sidney Starkman, David Thaler, Margaret Tremwel, Mauricio Concha, Kumar Rajamani, Bhuvaneswari Dandapani, Brian Silver, Nathan Deal, Ira Chang, Ameer Hassan, Steven Rudolph, Kenneth Fischer, Howard Kirshner, William Logan, Sidney Mallenbaum, Hebah Hefzy, Julius Latorre, Steven Levine, Anthony Ciabarra, Rima Dafer, Benjamin Anyanwu, Laurel Cherian, Spozhmy Panezai, Anna Khanna, Jodi Dodds, Michel Torbey, James Gebel, Henry Woo, David Chiu, Xiao Androulakis, William Burgin, Maria Pineda, Engin Yilmaz, Irfan Altafullah, Christine Boutwell, Salvador Cruz-Flores, Biggya Sapkota, Pierre Fayad, Michael Jacoby, Shahid Rafiq, Efrain Salgado, Eugene Lafranchise, Warren Felton, Ramesh Madhavan, Osama Zaidat, Connie Pieper, Ralph Riviello, Aaron Burnett, Michelle Fischer, Nina Gentile, Christopher Calder, Dennis Dietrich, Jonathan Cross, Larry Blankenship, Liliana Montoya, Wendell Grogan, Mark Young, Farrukh Khan, Duane Campbell, Nizar Daboul, Andrey Espinoza, Paul Cullis, Gilberto Concepcion, John Wulff, Haider Afzal, Naseem Jaffrani, William Reiter, Tamjeed Arshad, Timothy Lukovits, James Welker, Fen Lei Chang, Aamir Badruddin, Viken Babikian, Ravi Menon, James Sander, Mellanie Springer, Ashish Nanda, Luis Mas, Raj Rajan, Bruce Silverman, David Huang, David Carpenter, Joni Clark, Marilou Ching, Sunitha Santhakumar, Jeffrey Gould, Vibhav Bansal, Gabriel Vidal, Timothy Mikesell, John Brick, William French, Qaisar Shah, Christine Holmstedt, Nadir Ishag-Osman, John Kostis, Abbas Shehadeh, Pramodkumak Sethi, Asher Imam, Carl Mccomas, Duc Tran, Mehari Gebreyohanns, Brian Wiseman, Maheen Malik, Aron Schwarcz, Dorothea Altschul, John Castaldo, Amer Alshekhlee, Stephen Gancher, Nagesh Krish, Mai Nguyen-Huynh, Margaret Tremwell, Jitendra Sharma, Lance Lee, William Neil, Fazeel Siddiqui, Ali Malek, Charles Romero, Thang Nguyen Huy, Hoa Hoang, Thang Nguyen, Anh Nguyen, Hung Nguyen, Laboratoire de Recherche Vasculaire Translationnelle ( LVTS ), Université Paris 13 ( UP13 ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), AstraZeneca, National Cerebral and Cardiovascular Center ( NCCC - OSAKA ), Osaka University [Osaka], Department of Neurology ( Dep Neuro - BEIJING ), Tiantan Hospital, University of Melbourne, Faculty of Mathematics and Statistics, Ton Duc Thang University, Ho Chi Minh City, Heidelberg University, Centre hospitalier de Namur, IBM Thomas J. Watson Research Center, IBM, Bulgarian Academy of Sciences, Department of Clinical Neurological Sciences [London, Canada], University of Western Ontario ( UWO ), Servicio de Neurologia ( SANTIAGO - Neurologie ), Universidad de Santiago de Chile [Santiago] ( USACH ) -Universidad del Desarrollo, Institut de Chimie de Clermont-Ferrand - Clermont Auvergne ( ICCF ), Sigma CLERMONT ( Sigma CLERMONT ) -Université Clermont Auvergne ( UCA ) -Centre National de la Recherche Scientifique ( CNRS ), Universidad de Talca, Shanghai Second Polytechnic University, Northwest Normal University [Lanzhou], Zhongda Hospital, Southeast University [Jiangsu], Cryogenics Laboratory ( CRYOGENICS LABORATORY ), Huazhong University of Science and Technology [Wuhan] ( HUST ) -Wuhan University [China], Centre for Synthetic and Systems Biology, University of Edinburgh-School of Biological Sciences, Duke university [Durham], Fiber Glass, Glass Business and Discovery Center, PPG Industries, National University of Defense Technology [Changsha], School of Oceanography [Seattle], University of Washington [Seattle], Key Laboratory of New Processing Technology for Nonferrous Metals and Materials, Guilin University of Technologie, Laboratoire de Génie Electrique et Ferroélectricité ( LGEF ), Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université de Lyon-Institut National des Sciences Appliquées ( INSA ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Université de Bordeaux ( UB ), Service de Pédiatrie, Centre Hospitalier Universitaire de Nice ( CHU Nice ) -Hôpital l'Archet, Université Pierre et Marie Curie - Paris 6 ( UPMC ), Centre Hospitalier de Versailles ( CHV ), Service de neurologie, Hôpital Sainte-Anne, Functional Exploration of Nervous, CHU Grenoble, Service de Neurologie [Rennes], Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière ( NEMESIS-CRICM ), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière ( CRICM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Institut Français de Mécanique Avancée ( IFMA ), Neurologie - Côte Basque ( NEUROLOGIE ), Hopital, Laboratoire d'Intégration des Systèmes et des Technologies ( LIST ), Université Paris-Saclay-Direction de Recherche Technologique (CEA) ( DRT (CEA) ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) ( GGB ), Institut Brestois Santé Agro Matière ( IBSAM ), Université de Brest ( UBO ) -Université de Brest ( UBO ) -EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), CIC Brest, Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital de la Cavale Blanche, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), CHU Strasbourg, Imagerie cérébrale et handicaps neurologiques, Institut des sciences du cerveau de Toulouse. ( ISCT ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès ( UT2J ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès ( UT2J ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Department of Neurology, Asklepios Klinik Altona, Department of Neurology and Stroke Center, Universität Duisburg-Essen [Essen], Department of Neurology, University of Mainz, Vivantes Klinikum Neukölln, University of Erlangen, University Hospital Münster, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] ( UKE ), PROTOMED, Neurology Department, Ichilov Medical Center, Internal and Cardiovascular Medicine - Stroke Unit ( PERUGIA - ICM-SU ), Università degli Studi di Perugia ( UNIPG ), University Hospital San Raffaele Milan, Scientific Institute and University Ospedale San Raffaele, Dipartimento di Scienze Fisiche, della Terra e dell'Ambiente., Università degli Studi di Siena ( UNISI ), Department of Education, Yamagata University, Nippon Medical School, Catalan Institute of Ornithology (ICO), Museu de Ciències Naturals (Zoologia), Wroclaw University of Science and Technology, Department of neurology, Jagiellonian University [Krakow] ( UJ ), LInguistique et DIdactique des Langues Étrangères et Maternelles ( LIDILEM ), Université Stendhal - Grenoble 3-Université Grenoble Alpes ( UGA ), Metacohorts Consortium, GenXpro GmBH, Lausanne University Hospital, Lausanne university hospital, Northeastern University [Boston], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Cerebral and Cardiovascular Center (NCCC - OSAKA), Department of Neurology (Dep Neuro - BEIJING), Bulgarian Academy of Sciences (BAS), University of Western Ontario (UWO), Servicio de Neurologia (SANTIAGO - Neurologie), Universidad del Desarrollo, Institut de Chimie de Clermont-Ferrand (ICCF), SIGMA Clermont (SIGMA Clermont)-Institut de Chimie du CNRS (INC)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Shanghai Polytechnic University (SSPU), Cryogenics Laboratory (CRYOGENICS LABORATORY), Huazhong University of Science and Technology [Wuhan] (HUST)-Wuhan University [China], Centre for Synthetic and Systems Biology (Ssynthsys), University of Edinburgh, Duke University [Durham], National University of Defense Technology [China], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Bordeaux (UB), Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Université Pierre et Marie Curie - Paris 6 (UPMC), Centre Hospitalier de Versailles André Mignot (CHV), Service de Neurologie [Rennes] = Neurology [Rennes], CHU Pontchaillou [Rennes], Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière (NEMESIS-CRICM), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Institut Français de Mécanique Avancée (IFMA), Neurologie - Côte Basque (NEUROLOGIE), Centre hospitalier universitaire de Nantes (CHU Nantes), Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) (GGB), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Internal and Cardiovascular Medicine - Stroke Unit (PERUGIA - ICM-SU), Università degli Studi di Perugia (UNIPG), Università degli Studi di Siena = University of Siena (UNISI), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Neurologie - Côte Basque, Centre Hospitalier de la Côte Basque (CHCB), EFS-Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Universität Duisburg-Essen = University of Duisburg-Essen [Essen], Università degli Studi di Perugia = University of Perugia (UNIPG), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Jagiellonian University [Krakow] (UJ), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM), Weimar, Christian (Beitragende*r), and Calvez, Ghislaine

Subjects
Male, Risk, Ticagrelor, Adenosine, [SDV]Life Sciences [q-bio], Population, Medizin, Hemorrhage, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Platelet aggregation inhibitors, Physiology (medical), [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, medicine, Humans, Myocardial infarction, education, Stroke, ComputingMilieux_MISCELLANEOUS, Aged, Aspirin, Ischemic attack, Transient, Female, Ischemic Attack, Transient, Purinergic P2Y Receptor Antagonists, Treatment Outcome, Cardiology and Cardiovascular Medicine, education.field_of_study, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [ SDV ] Life Sciences [q-bio], Ischemic Attack, business.industry, medicine.disease, Clopidogrel, [SDV] Life Sciences [q-bio], Anesthesia, Platelet aggregation inhibitor, business, 030217 neurology & neurosurgery, TIMI, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug
Abstract

Background: Patients with minor acute ischemic stroke or transient ischemic attack are at high risk for subsequent stroke, and more potent antiplatelet therapy in the acute setting is needed. However, the potential benefit of more intense antiplatelet therapy must be assessed in relation to the risk for major bleeding. The SOCRATES trial (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes) was the first trial with ticagrelor in patients with acute ischemic stroke or transient ischemic attack in which the efficacy and safety of ticagrelor were compared with those of aspirin. The main safety objective was assessment of PLATO (Platelet Inhibition and Patient Outcomes)–defined major bleeds on treatment, with special focus on intracranial hemorrhage (ICrH). Methods: An independent adjudication committee blinded to study treatment classified bleeds according to the PLATO, TIMI (Thrombolysis in Myocardial Infarction), and GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) definitions. The definitions of ICrH and major bleeding excluded cerebral microbleeds and asymptomatic hemorrhagic transformations of cerebral infarctions so that the definitions better discriminated important events in the acute stroke population. Results: A total of 13 130 of 13 199 randomized patients received at least 1 dose of study drug and were included in the safety analysis set. PLATO major bleeds occurred in 31 patients (0.5%) on ticagrelor and 38 patients (0.6%) on aspirin (hazard ratio, 0.83; 95% confidence interval, 0.52–1.34). The most common locations of major bleeds were intracranial and gastrointestinal. ICrH was reported in 12 patients (0.2%) on ticagrelor and 18 patients (0.3%) on aspirin. Thirteen of all 30 ICrHs (4 on ticagrelor and 9 on aspirin) were hemorrhagic strokes, and 4 (2 in each group) were symptomatic hemorrhagic transformations of brain infarctions. The ICrHs were spontaneous in 6 and 13, traumatic in 3 and 3, and procedural in 3 and 2 patients on ticagrelor and aspirin, respectively. In total, 9 fatal bleeds occurred on ticagrelor and 4 on aspirin. The composite of ICrH or fatal bleeding included 15 patients on ticagrelor and 18 on aspirin. Independently of bleeding classification, PLATO, TIMI, or GUSTO, the relative difference between treatments for major/severe bleeds was similar. Nonmajor bleeds were more common on ticagrelor. Conclusions: Antiplatelet therapy with ticagrelor in patients with acute ischemic stroke or transient ischemic attack showed a bleeding profile similar to that of aspirin for major bleeds. There were few ICrHs. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01994720.

Published
2017

29. Potential for the Use of the Solitaire Stent for Recanalization of Middle Cerebral Artery Occlusion without a Susceptibility Vessel Sign

Author

Hee-Joon Bae, Eung-Gyu Kim, Cheolkyu Jung, Moon-Ku Han, Byung Se Choi, Moon Hee Han, Jae Hyoung Kim, and Youn Jung Bae

Subjects
Male, Reoperation, Middle Cerebral Artery, Solitaire Cryptographic Algorithm, medicine.medical_specialty, medicine.medical_treatment, Infarction, Balloon, Blood vessel prosthesis, Angioplasty, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Stroke, Aged, Aged, 80 and over, Cerebral Revascularization, Interventional, business.industry, Stent, Infarction, Middle Cerebral Artery, Middle Aged, Prognosis, medicine.disease, Magnetic Resonance Imaging, Blood Vessel Prosthesis, Stenosis, Treatment Outcome, Surgery, Computer-Assisted, cardiovascular system, Feasibility Studies, Female, Stents, Neurology (clinical), Radiology, business
Abstract

BACKGROUND AND PURPOSE: Absence of the MCA susceptibility vessel sign (negative MCA susceptibility vessel sign) on gradient recalled-echo MR imaging in acute stroke is commonly associated with in situ stenosis and thrombotic occlusion. We evaluated the effectiveness and safety of the Solitaire stent as the first-line device for the recanalization of MCA occlusion with a negative MCA susceptibility vessel sign. MATERIALS AND METHODS: Thirty-eight consecutive patients presenting with acute ischemic stroke due to MCA occlusion were treated by using the Solitaire AB stent alone or combined with thrombolytic drugs. Among these patients, 11 (7 men and 4 women; median age, 70 years; range, 49–89 years) who underwent multimodal stroke MR imaging before the endovascular procedure and had no MCA susceptibility vessel sign on the initial gradient recalled-echo MR imaging were included in this study. The primary end point was the recanalization of the occluded artery evaluated by the arterial occlusive lesion score. Clinical outcome was assessed at discharge and 90 days, as was the degree of residual MCA stenosis or reocclusion. RESULTS: Successful recanalization (arterial occlusive lesion score ≥ II) without balloon angioplasty was obtained in 9 patients (81.8%). Six patients (54.5%) had an mRS score of ≤2 at 90 days. After a median of 147 days, no patient showed reocclusion on follow-up imaging. There were no symptomatic intracerebral hemorrhages. CONCLUSIONS: The Solitaire stent is a feasible tool as the first-line device for multimodal endovascular recanalization therapy in acute ischemic stroke with a negative MCA susceptibility vessel sign. It has a good rate of successful and complete recanalization and is a fast yet safe procedure.

Published
2013
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30. Frovatriptan is Effective and Well Tolerated in Korean Migraineurs: A Double-Blind, Randomized, Placebo-Controlled Trial

Author

Kyungmi Oh, Min Kyung Chu, Jin Kuk Do, Heui Soo Moon, Eung Gyu Kim, Yong-Jin Cho, Jae Myun Chung, Hyong Gi Jung, Sun Uck Kwon, and Jeong Wook Park

Subjects
Response rate (survey), medicine.medical_specialty, business.industry, Incidence (epidemiology), Placebo-controlled study, frovatriptan, Korean, Placebo, medicine.disease, Double blind, Neurology, Migraine, Multicenter trial, Anesthesia, Physical therapy, Medicine, Original Article, migraine, Neurology (clinical), business, Frovatriptan, medicine.drug
Abstract

Background and PurposezzFrovatriptan is a selective 5-HT1B/1D agonist with a long duration of action and a low incidence of side effects. Although several placebo-controlled trials have documented the clinical efficacy and safety of frovatriptan in adults with migraine, this drug has not previously been studied in Asian including Korean patients. MethodszzIn this double-blind multicenter trial, 229 patients with migraine were randomized to receive frovatriptan 2.5 mg or placebo upon the occurrence of a moderate-to-severe migraine. The primary outcome was the 2-hour headache response rate. ResultszzFrovatriptan significantly increased the 2-hour headache response rate compared with placebo (52.9% vs. 34.0%, p=0.004). The headache response rates at 4, 6, and 12 hours were significantly higher in the frovatriptan group than in the placebo group, as was the pain-free rate at 2 hours (19.0% vs. 5.7%, p=0.004), 4 hours (40.7% vs. 23.0%, p=0.006), and 6 hours (56.1% vs. 34.0%, p=0.002). The median time to a headache response was significantly shorter in the frovatriptan group than in the placebo group (2.00 hours vs. 3.50 hours, p

Published
2010

32. Usefulness of Diffusion-Weighted MRI for Differentiation between Parkinson’s Disease and Parkinson Variant of Multiple System Atrophy

Author

Choong Ki Eun, Eung Gyu Kim, Minkyung Oh, Sang Jin Kim, Eun Joo Chung, Jong Seok Bae, and Kwang Sig Lee

Subjects
Dorsum, Pathology, medicine.medical_specialty, Parkinson's disease, Movement disorders, lcsh:RC346-429, lcsh:RC321-571, Atrophy, stomatognathic system, mental disorders, medicine, Effective diffusion coefficient, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, lcsh:Neurology. Diseases of the nervous system, business.industry, Putamen, Multiple system atrophy, medicine.disease, Predictive value, nervous system diseases, nervous system, Neurology, Parkinson’s disease, Original Article, Diffusion-weighted imaging, Neurology (clinical), medicine.symptom, business, Diffusion MRI
Abstract

Background and Purpose: Several studies have reported that diffusion-weighted imaging (DWI) is able to help discriminate a Parkinson variant of multiple system atrophy (MSA-p) from Parkinson’s disease (PD) on the basis of the increased regional apparent diffusion coefficient (rADC). We analyzed the usefulness of DWI by using the rADC for differential diagnosis between MSA-p and PD and investigated the correlation between the rADC value and clinical features of MSA-p and PD. Methods: Twelve patients with PD and 10 with MSA-p were studied. The rADC value was determined in different brain regions, including the dorsal putamen (DP) and middle cerebellar peduncles (MCP). Results: The rADC values of the DP showed a greater increase in MSA-p patients than in PD patients (p=0.03). MSA-p patients also presented increased rADC values of the MCP compared with PD patients (p=0.0001). In particular, the sensitivity, specificity and positive predictive values of the MCP rADC were higher than those of the DP rADC. However, DP and MCP rADC values were not correlated with clinical features in either MSA or PD patients. Conclusions: DWI discriminated between PD and MSA-p based on rADC values in DP and MCP. The MCP rADC value, in particular, could better discriminate MSA-p from PD. Journal of Movement Disorders 2009;2:64-68

Published
2009
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33. A Multicenter, Open-Label, 24-Week Follow-Up Study for Efficacy on Cognitive Function of Donepezil in Binswanger-Type Subcortical Vascular Dementia

Author

Jae Woo Kim, Dae Seob Choi, Seon Young Ahn, Oh Dae Kwon, Jay Cheol Kwon, Nack Cheon Choi, Myong Jin Kang, Eung Gyu Kim, Byung Hwa Lee, Bong Goo Yoo, and Hyon Ah Yi

Subjects
Male, medicine.medical_specialty, Cognition, Piperidines, Internal medicine, mental disorders, medicine, Humans, Dementia, Donepezil, Psychiatry, Adverse effect, Nootropic Agents, Aged, Aged, 80 and over, medicine.diagnostic_test, Dementia, Vascular, General Neuroscience, Neuropsychology, Magnetic resonance imaging, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Clinical trial, Psychiatry and Mental health, Clinical Psychology, Treatment Outcome, Tolerability, Indans, Female, Geriatrics and Gerontology, Cognition Disorders, Psychology, Follow-Up Studies, medicine.drug
Abstract

Objectives: To evaluate the efficacy and tolerability of donepezil in patients with Binswanger type subcortical vascular dementia. Methods: Patients (n = 34, mean age = 71.8 + 7.12) with Binswanger type subcortical vascular dementia from 8 multicenter, according to clinical and neuroradiological working criteria, were selected to receive donepezil 5 mg/day (n = 2) or donepezil 10 mg/day (n = 32, after 5 mg/day) for 24 weeks. Our primary endpoints were change from baseline to weeks 12 and 24 in the Seoul Neuropsychological Screening Battery-Dementia version (SNSB-D) and the Korean version of neuropsychiatric inventory (K-NPI). Results: A total of 24 patients received donepezil completed the study (mean age = 72.0 + 7.5 K-Mini-Mental State Examination [MMSE] = 21.0 + 5.1). After 12 weeks and 24 weeks, patients showed improvements in cognitive function on the SNSB-D compared baseline of 16.29 points at 12 weeks (P < .05) and 12.44 points at 24 weeks (P < .05). Significant improvements were shown in only memory domain, immediate verbal recall and delayed recall tests. Subgroup with better cognitive function (SNSB-D > 100) were more effective in frontal and memory domains than the other subgroup (SNSB-D < 100). Withdrawal rates due to adverse events were very low (4.16%). Conclusions: Donepezil-treated patients with Binswanger type subcortical vascular dementia demonstrated significant improvement in cognition compared with baseline, and donepezil was well tolerated.

Published
2009
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34. Large-scale synthesis of hexagonal pyramid-shaped ZnO nanocrystals from thermolysis of Zn-oleate complex

Author

Sang-Hyun Choi, Eung-Gyu Kim, Jongnam Park, Kwangjin An, Nohyun Lee, Sung Chul Kim, and Taeghwan Hyeon

Subjects
Zinc oxide -- Electric properties, Chemical synthesis -- Research, Oleic acid -- Electric properties, Chemicals, plastics and rubber industries
Abstract

The synthesis of uniform-sized hexagonal pyramid-shaped ZnO nanocrystals from thermolysis of the Zn-oleate complex is discussed. About 2.83 g of ZnO nanocrystals were synthesized by using 300 mL of oleylamine and 90mL of oleic acid as solvents and stabilizing surfactants.

Published
2005

35. Recurrent Ischemic Lesions After Acute Atherothrombotic Stroke: Clopidogrel Plus Aspirin Versus Aspirin Alone

Author

Dong-Eog Kim, Jay Chol Choi, Byung-Woo Yoon, Chul-Ho Sohn, Ki-Hyun Cho, Jae Kwan Cha, Keun-Sik Hong, Kyung Bok Lee, Soo Joo Lee, Dong-Wha Kang, Yong-Seok Lee, Joung-Ho Rha, Sung Il Sohn, Seung-Hoon Lee, Yong-Jin Cho, Jun Lee, Gyeong Moon Kim, Sun U. Kwon, Hee-Joon Bae, Hahn Young Kim, Jong-Moo Park, Eung Gyu Kim, Kyung Ho Yu, Kwang-Yeol Park, and Dae Il Chang

Subjects
Male, medicine.medical_specialty, Ticlopidine, Ischemia, 030204 cardiovascular system & hematology, Asymptomatic, Loading dose, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Internal medicine, medicine, Secondary Prevention, Humans, Stroke, Aged, Advanced and Specialized Nursing, Aspirin, business.industry, Brain, Thrombosis, Middle Aged, Clopidogrel, medicine.disease, Atherosclerosis, Magnetic Resonance Imaging, Surgery, Cardiology, Platelet aggregation inhibitor, Drug Therapy, Combination, Female, Neurology (clinical), medicine.symptom, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Platelet Aggregation Inhibitors, medicine.drug
Abstract

Background and Purpose— In patients with acute ischemic stroke caused by large artery atherosclerosis, clopidogrel plus aspirin versus aspirin alone might be more effective to prevent recurrent cerebral ischemia. However, there is no clear evidence. Methods— In this multicenter, double-blind, placebo-controlled trial, we randomized 358 patients with acute ischemic stroke of presumed large artery atherosclerosis origin within 48 hours of onset to clopidogrel (75 mg/d without loading dose) plus aspirin (300-mg loading followed by 100 mg/d) or to aspirin alone (300-mg loading followed by 100 mg/d) for 30 days. The primary outcome was new symptomatic or asymptomatic ischemic lesion on magnetic resonance imaging within 30 days. Secondary outcomes were 30-day functional disability, clinical stroke recurrence, and composite of major vascular events. Safety outcome was any bleeding. Results— Of 358 patients enrolled, 334 (167 in each group) completed follow-up magnetic resonance imaging. The 30-day new ischemic lesion recurrence rate was comparable between the clopidogrel plus aspirin and the aspirin monotherapy groups (36.5% versus 35.9%; relative risk, 1.02; 95% confidence interval, 0.77–1.35; P =0.91). Of the recurrent ischemic lesions, 94.2% were clinically asymptomatic. There were no differences in secondary outcomes between the 2 groups. Any bleeding were more frequent in the combination group than in the aspirin monotherapy group, but the difference was not significant (16.7% versus 10.7%; P =0.11). One hemorrhagic stroke occurred in the clopidogrel plus aspirin group. Conclusions— Clopidogrel plus aspirin might not be superior to aspirin alone for preventing new ischemic lesion and clinical vascular events in patients with acute ischemic stroke caused by large artery atherosclerosis. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00814268.

Published
2015

36. Teaching NeuroImages: Isolated peripheral facial palsy due to ipsilateral pontine infarction

Author

Hae Woong Jeong, Sang Jin Kim, Eung-Gyu Kim, and Seong-il Oh

Subjects
medicine.medical_specialty, Brain Stem Infarctions, Facial Paralysis, Nystagmus, Dysarthria, Vertigo, Pons, medicine, Humans, Aged, Diplopia, Palsy, biology, business.industry, Facial weakness, Sensory loss, Anatomy, biology.organism_classification, Magnetic Resonance Imaging, Surgery, stomatognathic diseases, Female, Neurology (clinical), medicine.symptom, business
Abstract

A 72-year-old woman presented left peripheral facial palsy for 1 day. Neurologic examination revealed isolated left peripheral facial palsy (figure 1). She did not have additional pontomedullary symptoms or signs, such as diplopia, abduction weakness, facial sensory loss, vertigo, nystagmus, or dysarthria. A brain diffusion-weighted MRI scan showed a hyperintense signal in the left dorsal pons (figure 2) in the region of the seventh nerve nucleus. Infranuclear facial palsy with isolated facial weakness has been reported rarely, and may be misdiagnosed as Bell palsy.1,2

Published
2015

37. Rivaroxaban vs Warfarin Sodium in the Ultra-Early Period After Atrial Fibrillation–Related Mild Ischemic Stroke

Author

Eung-Gyu Kim, Dong-Wha Kang, Ji Sung Lee, Oh Young Bang, Woo-Keun Seo, Young Dae Kim, Kyung-Ho Yu, Jae-Kwan Cha, Keun-Sik Hong, Man-Seok Park, Byung-Woo Yoon, Yong-Jae Kim, Yang-Ha Hwang, Seong Hwan Ahn, Sang Hun Lee, Hyun Goo Kang, Sun U. Kwon, Tae Jin Song, and Sang Min Sung

Subjects
Male, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Rivaroxaban, Randomized controlled trial, law, Interquartile range, Atrial Fibrillation, Republic of Korea, medicine, Clinical endpoint, Humans, Stroke, Aged, Aged, 80 and over, business.industry, Warfarin, Anticoagulants, Atrial fibrillation, Middle Aged, medicine.disease, Diffusion Magnetic Resonance Imaging, Treatment Outcome, Relative risk, Anesthesia, Female, Neurology (clinical), business, Intracranial Hemorrhages, Magnetic Resonance Angiography, 030217 neurology & neurosurgery, Factor Xa Inhibitors, Follow-Up Studies, medicine.drug
Abstract

Importance In atrial fibrillation (AF)–related acute ischemic stroke, the optimal oral anticoagulation strategy remains unclear. Objective To test whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with AF-related acute ischemic stroke. Design, Setting, and Participants A randomized, multicenter, open-label, blinded end point evaluation, comparative phase 2 trial was conducted from April 28, 2014, to December 7, 2015, at 14 academic medical centers in South Korea among patients with mild AF-related stroke within the previous 5 days who were deemed suitable for early anticoagulation. Analysis was performed on a modified intent-to-treat basis. Interventions Participants were randomized 1:1 to receive rivaroxaban, 10 mg/d for 5 days followed by 15 or 20 mg/d, or warfarin with a target international normalized ratio of 2.0-3.0, for 4 weeks. Main Outcomes and Measures The primary end point was the composite of new ischemic lesion or new intracranial hemorrhage seen on results of magnetic resonance imaging at 4 weeks. Primary analysis was performed in patients who received at least 1 dose of study medications and completed follow-up magnetic resonance imaging. Key secondary end points were individual components of the primary end point and hospitalization length. Results Of 195 patients randomized, 183 individuals (76 women and 107 men; mean [SD] age, 70.4 [10.4] years) completed magnetic resonance imaging follow-up and were included in the primary end point analysis. The rivaroxaban group (n = 95) and warfarin group (n = 88) showed no differences in the primary end point (47 [49.5%] vs 48 [54.5%]; relative risk, 0.91; 95% CI, 0.69-1.20;P = .49) or its individual components (new ischemic lesion: 28 [29.5%] vs 31 of 87 [35.6%]; relative risk, 0.83; 95% CI, 0.54-1.26;P = .38; new intracranial hemorrhage: 30 [31.6%] vs 25 of 87 [28.7%]; relative risk, 1.10; 95% CI, 0.70-1.71;P = .68). Each group had 1 clinical ischemic stroke, and all new intracranial hemorrhages were asymptomatic hemorrhagic transformations. Hospitalization length was reduced with rivaroxaban compared with warfarin (median, 4.0 days [interquartile range, 2.0-6.0 days] vs 6.0 days [interquartile range, 4.0-8.0];P Conclusions and Relevance In mild AF-related acute ischemic stroke, rivaroxaban and warfarin had comparable safety and efficacy. Trial Registration clinicaltrials.gov Identifier:NCT02042534

Published
2017
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38. Abstract 22: New Silent Brain Infarcts after Coronary Artery Bypass Graft Surgery: Lesion Patterns, Mechanism, and Predictors

Author

Hyun-Wook Nah, Jae-Won Lee, Cheol-Hyun Chung, Suk-Jung Choo, Sun U. Kwon, Jong S. Kim, Steven Warach, Eung-Gyu Kim, and Dong-Wha Kang

Subjects
Advanced and Specialized Nursing, cardiovascular diseases, Neurology (clinical), Cardiology and Cardiovascular Medicine
Abstract

Objectives: To investigate the lesion patterns and predictors of silent brain infarction after coronary artery bypass graft (CABG) surgery and propose a mechanism. Background: New brain infarcts after CABG are markedly more frequent than clinically evident stroke and are thought to be associated with postoperative cognitive decline. Thus, identification of the mechanism and risk factors of postoperative silent brain infarction may be clinically relevant. Methods: This was a prospective pre- and postoperative brain MRI study in consecutive patients who underwent isolated CABG. Preoperative MRI included diffusion-weighted imaging (DWI) and magnetic resonance angiography. DWI was repeated on postoperative day 3. Clinical variables, intraoperative findings, and laboratory findings were compared between patients with and without new brain infarcts on DWI. Results: Of a total of 127 included patients, 35 (27.6%) showed new brain infarcts on DWI. Most lesions were clinically silent, were located in the cortical territory (80%), were small ( Conclusions: New brain infarcts on DWI after CABG are frequent and mostly silent. Aortogenic embolisms and a systemic inflammatory response may contribute to the pathogenesis of new brain infarcts.

Published
2014
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39. Abstract T P334: Clopidogrel and Aspirin versus Aspirin Alone for Prevention of Recurrent Ischemic Lesion in Acute Atherothrombotic Stroke: A Randomized, Double-Blind, Placebo-Controlled Trial

Author

Jun Lee, Dong-Eog Kim, Jay Chol Choi, Kyung-Hee Cho, Keun-Sik Hong, Hahn-Young Kim, Dong-Wha Kang, Seung-Hoon Lee, Byung-Woo Yoon, Yongseok Lee, Gyeong-Moon Kim, Kyung Bok Lee, Chulho Sohn, Joung-Ho Rha, Sun U. Kwon, Kyung-Ho Yu, Jae-Kwan Cha, Kwang-Yeol Park, Hee-Joon Bae, Eung Gyu Kim, Ki-Hyun Cho, Dae Il Chang, Yong-Jin Cho, Soo-Joo Lee, and Jong-Moo Park

Subjects
Advanced and Specialized Nursing, medicine.medical_specialty, Aspirin, education.field_of_study, business.industry, Population, Placebo-controlled study, Clopidogrel, medicine.disease, Surgery, Modified Rankin Scale, Internal medicine, Multicenter trial, medicine, Clinical endpoint, cardiovascular diseases, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, education, Stroke, medicine.drug
Abstract

Background: Combination treatment with clopidogrel and aspirin is not currently recommended for secondary prevention of stroke, but its superior effect to aspirin alone has been controversial according to stroke subtype and stage. We sought to compare the effect of aspirin and clopidogrel to aspirin alone for recurrent ischemic lesion in acute stage of atherothrombotic stroke. Methods: Combination of clopidogrel and aspirin for prevention of recurrence in acute atherothrombotic stroke study (COMPRESS) was a prospective, randomized, double-blind, placebo-controlled, multicenter trial. We enrolled 358 patients with acute atherothrombotic stroke within 48 hours after symptom onset, and randomly assigned them to receive clopidogrel (75 mg per day) plus aspirin (100 mg per day) or aspirin alone (100 mg per day) for 30 days. The primary endpoint was proportion of patients with a newly developed ischemic lesion within 30 days, as confirmed with brain MRI. Secondary endpoints were modified Rankin Scale scores at 30 days, occurrence of the composite endpoint of non-fatal stroke, myocardial infarction and cardiovascular death, and incidence of all types of stroke. The clinicaltrials.gov registration number for this trial was NCT00814268. Results: Among 358 patients enrolled, 349 patients who received at least one dose of study medication after randomization were included in the efficacy analysis population (clopidogrel plus aspirin, n=174; aspirin alone, n=175).Recurrent ischemic lesions were observed in 61 patients in the combination group (36.5%) and 60 patients in the aspirin alone group (35.9%; p=0.91). The significant difference was not found between the groups in the secondary endpoints. In the safety analysis, any bleeding incidence was non-significantly higher in the combination group (n=29 vs. n=19; p=0.10), and episodes of life-threatening hemorrhage and major hemorrhage were very low in both groups. Conclusion: Combination treatment of clopidogrel and aspirin is not superior to aspirin alone for prevention of recurrent ischemic lesion in acute atherothrombotic stroke patients. Acknowledgement: This study was co-sponsored by Sanofi-Aventis Korea and BMS Korea.

Published
2014
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40. Magnetic Resonance Imaging Diagnosis of Metastatic Lymph Nodes in aRabbit Model: Efficacy of PJY10, a New Ultrasmall Superparamagnetic IronOxide Agent, with Monodisperse Iron Oxide Core and Multiple-InteractionLigands

Author

Seung Hong Choi, Sun-Won Park, Bong Sik Jeon, Chul-Ho Sohn, Eung Gyu Kim, Ji Hoon Kim, Wan Jae Myeong, Juyoung Park, Yun Sang Lee, Hye Rim Cho, Roh Eul Yoo, Eunbyul Kwon, and Jae Kyung Won

Subjects
Pathology, medicine.medical_specialty, Iron oxide, Contrast Media, lcsh:Medicine, Ligands, computer.software_genre, Ferric Compounds, Diagnostic Radiology, Metastasis, chemistry.chemical_compound, Diagnostic Medicine, Voxel, Medicine and Health Sciences, Cancer Detection and Diagnosis, medicine, Animals, Humans, Magnetite Nanoparticles, lcsh:Science, Lymph node, Multidisciplinary, medicine.diagnostic_test, Chemistry, business.industry, Radiology and Imaging, lcsh:R, Cancer, Dextrans, Magnetic resonance imaging, Image Enhancement, medicine.disease, Magnetic Resonance Imaging, Radiography, Disease Models, Animal, medicine.anatomical_structure, Oncology, Lymphatic Metastasis, Nanoparticles, lcsh:Q, Lymph Nodes, Rabbits, Lymph, Nuclear medicine, business, computer, Quantitative analysis (chemistry), Research Article
Abstract

Background: Accurate diagnosis of lymph node metastasis is crucial in treatment planning for cancer patients. Despite the use of various parameters, making correct diagnosis of a small metastatic or a hyperplastic benign node is still a challenge. In this study, we evaluated the feasibility of detecting lymph node metastasis using a new ultrasmall superparamagnetic iron oxide particle, PJY10, in a rabbit model. Methods: To make metastatic and benign lymph nodes, either VX2 carcinoma or fecal material suspension was inoculated into thighs of 56 rabbits three weeks or three days before magnetic resonance (MR) imaging, respectively. T2*-weighted 3T MR imaging was performed before and 24 hours after PJY10 injection (5.2 [n = 15], 7.8 [n = 17], and 10.4 [n = 24] mg Fe/kg). MR images were correlated with pathologic results to calculate sensitivity and specificity. Quantitative analysis of the signal intensity (SI) - number of voxels([low]) (the fraction of the number of voxels with the normalized SI on the postcontrast image lower than that on the precontrast image) and mean SI ratio - was also performed for each lymph node. Results: Sensitivities were 100% at all three dosages, whereas specificity increased with increasing dosage (89% at 10.4 mg Fe/kg). The benign nodes had a significantly higher number of voxels([low]) and a lower mean SI ratio than the metastatic nodes at the dosage of 10.4 mg Fe/kg (P

Published
2014

41. Tsutsugamushi Meningitis with Parotitis Mimicking Mumps Meningitis

Author

Jeong Min Kim, Eung-Gyu Kim, Sang Jin Kim, Jung Hwa Seo, Zoon-Yup Kim, Ki-Hwan Ji, Jin-Ho Jung, Seong-il Oh, and Eun Joo Chung

Subjects
medicine.medical_specialty, business.industry, Mumps meningitis, Medicine, Scrub typhus, business, medicine.disease, Dermatology, Meningitis, Parotitis
Abstract

Received November 20, 2014 Revised December 26, 2014 Accepted December 26, 2014 Address for correspondence: Seong-il Oh, MD Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 614-735, Korea Tel: +82-51-890-6130 Fax: +82-51-892-8811 E-mail: seongil.oh@gmail.com 츠츠가무시병(tsutsugamushi disease, scrub typhus)은 Orientitia tsutsugamushi에 의해 감염된 털진드기유충에 물렸을 때, 혈액 과 림프액을 통해 전신혈관염이 발생하는 급성 발열질환으로, 물린 부위에 가피(eschar)를 만들고 발진, 전신림프절종대 등을 동반한다. 고열이 지속될 때 적절한 치료를 하지 않으면 중추 신경계합병증인 수막염과 뇌염이 발생하기도 한다. 이러한 이유로 인해 효과적인 독시사이클린(doxycycline)치료를 위하 여 가피의 발견과 혈청검사를 통한 빠른 진단이 중요하다. 츠

Published
2015
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42. Large-Scale Synthesis of Hexagonal Pyramid-Shaped ZnO Nanocrystals from Thermolysis of Zn−Oleate Complex

Author

Sung Chul Kim, Taeghwan Hyeon, Sang-Hyun Choi, Eung-Gyu Kim, Nohyun Lee, Jongnam Park, and Kwangjin An

Subjects
Photoluminescence, Materials science, Inorganic chemistry, Thermal decomposition, Hexagonal pyramid, chemistry.chemical_element, Zinc, Surfaces, Coatings and Films, chemistry.chemical_compound, Oleic acid, chemistry, Oleylamine, Reagent, Materials Chemistry, Physical and Theoretical Chemistry, Absorption (chemistry), Nuclear chemistry
Abstract

We report the large-scale synthesis of uniform-sized hexagonal pyramid-shaped ZnO nanocrystals by the thermolysis of Zn-oleate complex, which was prepared from the reaction of inexpensive and environmentally friendly reagents such as zinc chloride and sodium oleate. Under optimized reaction conditions, we were able to synthesize as much as 2.83 g using 300 mL of oleylamine and 90 mL (284 mmol) of oleic acid (OA) as both solvents and stabilizing surfactants. The UV-vis spectrum showed the absorption onset of 380 nm, and the photoluminescence spectrum showed a near band-edge emission at 387 nm and a broad blue-green emission band above 468 nm.

Published
2005
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43. E-085 Good Baseline Angiographic Collateral Flow Correlates with Successful Recanalization and Clinical Outcome after Endovascular Treatment for Acute Ischemic Stroke Within 24 Hours from Onset

Author

Hae Woong Jeong, Eung-Gyu Kim, and Jung Hwa Seo

Subjects
medicine.medical_specialty, business.industry, Cerebral infarction, medicine.medical_treatment, General Medicine, Odds ratio, Thrombolysis, medicine.disease, Surgery, Collateral flow, Modified Rankin Scale, medicine, In patient, Neurology (clinical), Endovascular treatment, business, Acute ischemic stroke
Abstract

Background Recanalization status is the strongest predictor of clinical outcome in patients undergoing endovascular treatment (EVT). Although the time to reperfusion remains crucial even with EVT, the previous meta-analysis demonstrated that recanalization up to 24 hours after acute ischemic stroke (AIS) onset is strongly associated with improved functional outcomes and reduced mortality. We evaluated the relationships among angiographic collateral flow, successful recanalization, and clinical outcome after EVT in patients experiencing AIS within 24 hours of onset. Methods We assessed patients were experiencing acute anterior circulation ischemic stroke who underwent EVT between 2011 and 2015. Patients with large artery occlusion of anterior circulation and clinical diagnosis of AIS, within 24 hours of first found abnormal time (FAT), were included in the study. Results One hundred seventy-three patients met the inclusion criteria. Mean age was 68.3 ± 12.6 years, and median National Institutes of Health Stroke Scale score was 14 (range, 5–29). Median time from FAT to arrival was 92 minutes. Overall successful recanalization, defined by the Modified Thrombolysis In Cerebral Infarction scale grade 2 b-3, was achieved in 65.3% of patients, and good clinical outcome, as defined by the modified Rankin Scale (mRS 0–2), was achieved in 47.4% of patients. For successful r the angiographic collateral grade was the independent factor. In multiple logistic regression analysis, the angiographic collateral grade was independently associated with clinical outcome after adjusting for other variables (odds ratio, 5.96; 95% CI, 1.76–20.19). Conclusions Our data showed that angiographic collateral grade was a strong independent predictor of successful recanalization after EVT and good clinical outcome in AIS patients when applied up to 24 hours from FAT. Consequently, the good angiographic collateral flow may help predict successful recanalization and better clinical outcomes after EVT in patients with AIS. Disclosures J. Seo: None. E. Kim: None. H. Jeong: None.

Published
2016
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44. Risk factors and stroke mechanisms in atherosclerotic stroke: intracranial compared with extracranial and anterior compared with posterior circulation disease

Author

Byung-Chul Lee, Jei Kim, Jun Lee, Dong-Eog Kim, Eung-Gyu Kim, Ki-Hyun Cho, Su-Kyung Kim, Sun U. Kwon, Hyun-Wook Nah, Yong-Seok Lee, Dong-Wha Kang, Jong S. Kim, Sang-Won Ha, Kyung-Ho Yu, and Sea Mi Park

Subjects
Adult, Male, medicine.medical_specialty, Anterior Cerebral Artery, Hemodynamics, Magnetic resonance angiography, Young Adult, Risk Factors, Diabetes mellitus, Internal medicine, Occlusion, Republic of Korea, medicine, Prevalence, Humans, Prospective Studies, Registries, Stroke, Aged, Advanced and Specialized Nursing, Aged, 80 and over, Posterior Cerebral Artery, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Odds ratio, Middle Aged, medicine.disease, Intracranial Arteriosclerosis, Magnetic Resonance Imaging, Surgery, Embolism, Intracranial Embolism, Cerebrovascular Circulation, Cardiology, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Magnetic Resonance Angiography
Abstract

Background and Purpose— The aim of this study was to investigate differences in risk factors and stroke mechanisms between intracranial atherosclerosis (ICAS) and extracranial atherosclerosis (ECAS) and between anterior and posterior circulation atherosclerosis. Methods— A multicenter, prospective, Web-based registry was performed on atherosclerotic strokes using diffusionweighted magnetic resonance imaging and magnetic resonance angiography. Stroke mechanisms were categorized as artery-to-artery embolism, in situ thrombo-occlusion, local branch occlusion, or hemodynamic impairment. Results— Onethousand patients were enrolled from 9 university hospitals. Age (odds ratio [OR], 1.033; 95% confidence interval [CI], 1.018–1.049), male gender (OR, 3.399; 95% CI, 2.335–4.949), and hyperlipidemia (OR, 1.502; 95% CI, 1.117–2.018) were factors favoring ECAS (vs ICAS), whereas hypertension (OR, 1.826; 95% CI, 1.274–2.618; P =0.001) and diabetes mellitus (OR, 1.490; 95% CI, 1.105–2.010; P =0.009) were related to posterior (vs anterior) circulation diseases. Metabolic syndrome was a factor related to ICAS (vs ECAS) only in posterior circulation strokes (OR, 2.433; 95% CI, 1.005–5.890; P =0.007). Stroke mechanisms included arterytoartery embolism (59.7%), local branch occlusion (14.9%), in situ thrombo-occlusion (13.7%), hemodynamic impairment (0.9%), and mixed (10.8%). Anterior ICAS was more often associated with artery-to-artery embolism (51.8% vs 34.0%) and less often associated with local branch occlusion (12.3% vs 40.4%) than posterior ICAS ( P Conclusions— The prevalence of risk factors and stroke mechanisms differ between ICAS and ECAS, and between anterior and posterior circulation atherosclerosis. Posterior ICAS seems to be closely associated with metabolic derangement and local branch occlusion. Prevention and management strategies may have to consider these differences.

Published
2012

45. Four cases with peripheral trauma induced involuntary movements

Author

Sung Hwa Pang, Eun Joo Chung, Won Yong Lee, Jong Seok Bae, Sang Jin Kim, and Eung Gyu Kim

Subjects
medicine.medical_specialty, Movement disorders, business.industry, Poison control, Human factors and ergonomics, lcsh:RC346-429, Propriospinal myoclonus, lcsh:RC321-571, Surgery, Peripheral, Physical medicine and rehabilitation, Neurology, Injury prevention, Tremor, medicine, Original Article, Neurology (clinical), medicine.symptom, Differential diagnosis, business, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, lcsh:Neurology. Diseases of the nervous system, Induced movement, Peripheral injury, Subclinical infection
Abstract

BACKGROUND AND PURPOSE: Although peripheral trauma induced movement disorders have been rarely reported, diagnostic criteria for peripherally induced movement disorders (PIMD) have been established. Because preexisting subclinical movement disorders, or secondary gain for compensation and legal purposes are difficult to confirm, differential diagnosis for physicians still remains difficult. CASE REPORTS: We present four patients developed movement disorders after relatively various intervals after traffic accident. Three patients of them showed tremor and one patient presented propriospinal myoclonus. In this report, we investigate whether peripheral trauma can lead to movement disorders and describe the relationship between peripheral injury and movement disorders in four cases. CONCLUSIONS: Injury was serious enough to develop involuntary abnormal movements with pain and the latency between injury and the onset of movements in all of cases was less than 1 year. Thus, our cases showed temporal and anatomical correlation between injury and the onset of movement disorder, strongly supporting the cause-and-effect relationship by previous diagnostic criteria for peripherally induced movement disorders. Language: en

Published
2010

46. P2–095: The differences of behavioral and psychological symptoms in the patients of Alzheimer's disease and vascular dementia

Author

Kyung Won Park, Bong Goo Yoo, Soo Jin Yoon, Jae Woo Kim, Mun Seong Choi, Hae-Kwan Cheong, Soo Young Kim, Eung-Gyu Kim, Tae-You Kim, Sang Chan Lee, Eun Ah Lee, Sung Min Yoon, Taehong Sohn, Sang Min Sung, and Tae-Yong Hong

Subjects
medicine.medical_specialty, Epidemiology, Health Policy, Disease, Dementia rating scale, Neuropsychiatric inventory, medicine.disease, Motor symptoms, Psychiatry and Mental health, Cellular and Molecular Neuroscience, Developmental Neuroscience, Internal medicine, mental disorders, medicine, Dementia, Apathy, Neurology (clinical), Geriatrics and Gerontology, Differential diagnosis, medicine.symptom, Vascular dementia, Psychology, Psychiatry
Abstract

Background: Behavioral and psychological symptoms (BPSD) are common in dem entia. These may be helpful for clinical differentiation between Alzheimer's disease (AD) and v ascular dementia (VD). Most previous studies have reported the prevalence and severity of BPSD regardless of severity of progression. However, we evaluated the differences of BPSD by grading de mentia progression and including severe cases only. Methods: 141 dementia outpatients from clinics of Busan-Gyeongnam Dementia Association in Korea were analyzed. All patients were administered the Korean version of the Neuropsychiatric Inventory (K-NPI), the expanded version of Korean Clinic al Dementia Rating Scale (CDR), and the Korean version of Mini-Mental State Examination (K-MMSE). Results: There were 95 patients with AD and 46 patients with VD. AD patients revealed higher frequency of manifested BPSD symptoms and most of subscales showed higher composite scores also. But apathy was more severely and frequently manifested in VD. AD patients had more frequent night-time behavior and aberrant motor symptoms above 3 point in CDR 0.5 and VD patients had more frequent apathy symptom above 3 point in CDR 1. Conclusions: These results suggest that generally AD patients revealed more frequent and severe BPSDs than VD patients. Apathy was a more dominant symptom in VD. It seemed that some of the symptoms were valuable clues for the differential diagnosis even though a better designed study was required. J Korean Neurol Assoc 24(5):458-464, 2006

Published
2006
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47. Anatomical Findings of Hemiplegia Cruciata in Multiple Sclerosis

Author

Jong Seok Bae, Eun Joo Chung, Hye Young Jeong, and Eung Gyu Kim

Subjects
medicine.medical_specialty, Neurology, medicine.diagnostic_test, business.industry, Multiple sclerosis, Magnetic resonance imaging, Anatomy, medicine.disease, Cervicomedullary Junction, Lesion, Paralysis, Medicine, medicine.symptom, business, Stroke, Medulla
Abstract

Hemiplegia cruciata (HC) manifests as paralysis of the ipsilateral arm and contralateral leg. Herein, we report a 64-year-old man with weakness of the right leg and of the left arm after multiple sclerosis (MS). His brain and spine magnetic resonance imaging show a lower medulla lesion, which is extended to posterior part of C1 spine through cervicomedullary junction. HC usually results from stroke or trauma, but it is rare as presenting symptom of MS. (Korean J Clin Neurophysiol 2014;16:39-41)

Published
2014
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50. The Factors Associated with the Decision of r-tPA Use in Acute Ischemic Stroke Patients Aged 80 Years or Older

Author

Jae-Kwan Cha, Yeo Jin Kim, Hyung-Min Kwon, Chulho Kim, Kyung-Ho Yu, Moon-Ku Han, Jay Chol Choi, Yong-Jin Cho, Sung Hyuk Heo, Man-Seok Park, Kyung Bok Lee, Byung-Woo Yoon, Jun Lee, Yerim Kim, Joung-Ho Rha, Dong-Eog Kim, Jee-Hyun Kwon, Hee-Kwon Park, Hee-Joon Bae, Mi-Sun Oh, Jong-Moo Park, Ju-Hun Lee, Ki-Hyun Cho, Byung-Chul Lee, Hyo Suk Nam, Sun Uck Kwon, Tai Hwan Park, Ji Hoe Heo, Min-Gyeong Jeong, Myoung-Jin Cha, Keun-Sik Hong, Eung-Gyu Kim, Soo Joo Lee, and Hahn-Young Kim

Subjects
medicine.medical_specialty, business.industry, Internal medicine, medicine.medical_treatment, medicine, Cardiology, Thrombolysis, Medical emergency, business, medicine.disease, Stroke, Acute ischemic stroke
Abstract

한림대학교 의과대학 신경과학교실, 한림대학교 의과대학 강동성심병원 신경과, 울산대학교 의과대학 신경과학교실, 울산대학교 의과대학 서울아산병원 신경과학교실, 경희대학교 의과대학 신경과학교실, 제주대학교 의과대학 신경과학교실, 서울대학교 의과대학 보라매병원 신경과, 을지대학교 을지병 원 신경과, 인제대학교 부산백병원 신경과, 인하대학교 의과대학 신경과학교실, 서울대학교 의과대학 분당서울대학교병원 신경과, 인제대학교 일산 백병원 신경과, 전남대학교 의과대학 신경과학교실, 건국대학교 의과대학 신경과학교실, 영남대학교 의과대학 신경과학교실, 동국대학교 의과대학 신경과학교실, 을지대학교 을지대학병원 신경과, 순천향대학교 의과대학 신경과학교실, 서울의료원 신경과, 연세대학교 의과대학 신경과학교실, 동아대학교 의과대학 신경과학교실, 서울대학교 의과대학 신경과학교실 정민경·김예림·김여진·오미선·유경호·이병철·이주헌·권지현·권순억·허성혁·최재철· 권형민·박종무·김응규·나정호·박희권·배희준·한문구·홍근식·조용진·박만석· 조기현·김한영·이 준·김동억·이수주·이경복·박태환·차명진·허지회·남효석· 차재관·김철호·윤병우

Published
2011
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