Adipokines, Superoxide Dismutases와 유증상 두개 내 동맥경화성 협착의 진행

류위선,정상욱 순천향대학교 순천향의학연구소 2016 Journal of Soonchunhyang Medical Science Vol.22 No.2

Objective: We aimed to investigate the relationship between adipokines and antioxidation enzyme and the risk of progression of symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: Of 409 patients who participated in the TOSS-2 (trial of cilostazol in symptomatic intracranial stenosis-2) study, 52 patients showed progression of symptomatic ICAS on magnetic resonance angiography at seven months after an index stroke. We randomly selected 20 patients with progression and 20 age- and sex-matched control patients. We serially collected blood sample initially, one month, and seven months after an index stroke. Then, multiplex analysis of biomarkers was performed for adiponectin, resistin, leptin, and superoxide dismutase-1, 2, 3. Results: Demographic features and risk factors such as hypertension, diabetes, and smoking history were comparable between the two groups. Control group showed higher adiponectin levels at 7 months than progression group (P=0.05) and a significant increasing trend (P for trend=0.01). Resistin, leptin, and superoxide dismutase-1, 2, 3 levels were not different between the progression and control group initially, one month, and seven months after an index stroke. Conclusion: Increase of adiponectin level showed protective effect in the progression of ICAS. Resistin, leptin, and superoxide dismutase- 1, 2, 3 levels are not different between the groups. Further large numbers of patients with longer follow-up studies are needed.

Hyperintense Vessel Sign in Large-Vessel Occlusion Stroke of Mild-to-Moderate Severity Ineligible for Recanalization

류위선,윤호상,정상욱,김동억 대한신경과학회 2021 Journal of Clinical Neurology Vol.17 No.4

Background and Purpose The impact of fluid-attenuated inversion recovery hyperintense vessels (FHVs) on outcomes in patients ineligible for recanalization therapy with large-vessel occlusion (LVO) is unclear. We investigated the impact of FHVs determined using the FHV– Alberta Stroke Program Early CT Score (ASPECTS) on clinical outcomes in patients with LVO stroke of mild-to-moderate severity ineligible for recanalization therapy. Methods Sixty-eight consecutive patients with M1-middle cerebral artery occlusion who underwent magnetic resonance imaging within 24 hours of symptom onset and were ineligible for recanalization were included. Patients were dichotomized into a severe-FHV group (FHV-ASPECTS ≤4; n=33) and a mild-FHV group (FHV-ASPECTS >4; n=35), and multiple logistic regression analysis was used to examine the relationships of FHV scores with early neurological deterioration (END) and an unfavorable 3-month outcome (modified Rankin Scale score ≥3). Results Mean age was 66.2±13.5 years (mean±SD), and 30 (44%) were female. The severe- FHV group had a larger infarct volume (median, 5.5 mL vs. 3 mL) and more frequently exhibited the susceptibility vessel sign (30% vs. 3%) than the mild-FHV group. Ipsilateral old nonlacunar infarct was more frequent in the mild-FHV group than in the severe-FHV group (37% vs. 15%). The severe-FHV group had a fivefold higher risk of END (odds ratio [OR] 5.02, 95% confidence interval [CI] 1.36–18.45) and unfavorable outcome (OR 5.97, 95% CI 1.18–33.31, p= 0.03) compared with the mild-FHV group. Conclusions Greater FHV extent was associated with higher risk of END and unfavorable outcome in patients with LVO stroke of mild-to-moderate severity.

중앙아시아 수집 꽃피는 마늘의 주아 이용 종구생산 및 통구재배 가능성 검토

이기안,고호철,조규택,이정로,성정숙,이정윤,이영이,류위선,현영실,곽재균 한국국제농업개발학회 2015 韓國國際農業開發學會誌 Vol.27 No.3

중앙아시아에서 수집한 꽃피는 마늘 A. longicuspis의 주아와 주아를 도입해서 생산한 1년생 통구를 각각 노지에 재배하여 우리나라에서 주아재배를 통한 종구(통구)생산과 통구재배를 통한 마늘생산 가능성을 검토하였다. 평균 월동율은 주아재배에서 77.3%, 통구재배에서는 100%로서 우리나라의 대표적인 재래종인 단양마늘이나 의성마늘에 비하여 훨씬 높아서꽃피는 마늘의 주아와 통구를 중부지방에서 재배함에 있어서월동성은 큰 문제가 되지 않을 것으로 사료되었다. 주아재배에서 월동한 모든 개체가 통구 수확이 가능하였고 통구 형성율은 모든 자원이 100%이었다. 통구재배에서 추대율이 100%이었으며, 재래종 대비 화경장이 길고 주아 수가 많았다. 구크기는 대부분이 재래종에 비하여 작았지만 K248215 자원은구중이 40 g으로서 단양마늘과 비슷하였으며 구당 쪽수는 재래종에 비하여 대부분의 자원이 많았고 화기에 꽃과 주아가동시에 존재하였으며 주아를 제거하지 않은 상태에서는 종자가 맺히지 않았다. This study was conducted to investigate the possibility of production of seed garlic using bulbils and production of garlic using none-cloved bulb from bulbils in A. longicuspis Regel, introduced from Central Asia, the main center of garlic diversity. A. longicuspis accessions showed higher overwintering rate than Korean landraces cultivars, Danyang and Euiseong in both bulbils and none-cloved bulb cultivation in the middle part, Korea. In none-cloved bulb cultivation, A. longicuspis accessions showed higher bolting rate, longer scape length and more number of bulbils than Korean landraces cultivar, but size of bulbs and bulbils were smaller. All of the A. longicuspis accessions had more number of cloves per bulb than Korean landraces. All the accessions of A. longicuspis from Central Asia were complete bolters having both many flowers and topsets in umbel.

Ventriculitis Associated with Extended Spectrum Beta-Lactamase Producing Klebsiella pneumoniae after Acupuncture

박수현,류위선 대한신경집중치료학회 2017 대한신경집중치료학회지 Vol.10 No.2

" Background Ventriculitis is a rare and critical infection of the central nervous system. Here, we report a case of ventriculitis by extended spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae, after acupuncture at the low back. Case Report A 72-year-old woman visited our center with fever, headache, and decreased mental status, after undergoing low back acupuncture. Brain imaging showed the fluid-debris level in the lateral ventricle, suggesting ventriculitis. ESBL producing Klebsiella pneumoniae were cultured from the cerebrospinal fluid. After the administration of antibiotics, although the ventriculitis was treated, the quadriplegia remained. Conclusions This case stresses the importance of aseptic techniques during acupuncture"

Platelet-Derived Growth Factor Is Associated with Progression of Symptomatic Intracranial Atherosclerotic Stenosis

김경준,정상욱,류위선,Jeffrey L. Saver,김종성,권순억 대한신경과학회 2021 Journal of Clinical Neurology Vol.17 No.1

Background and Purpose We aimed to determine the relationships of 33 biomarkers of inflammation, oxidation, and adipokines with the risk of progression of symptomatic intracranial atherosclerotic stenosis (ICAS). Methods Fifty-two of 409 patients who participated in the TOSS-2 (Trial of Cilostazol in Symptomatic Intracranial Stenosis-2) showed progression of symptomatic ICAS in magnetic resonance angiography at 7 months after an index stroke. We randomly selected 20 patients with progression as well as 40 age- and sex-matched control patients. We serially collected blood samples at baseline, 1 month, and 7 months after an index stroke. Multiplex analysis of biomarkers was then performed. Results Demographic features and risk factors such as hypertension, diabetes, and smoking history were comparable between the two groups. Univariate analyses revealed that the levels of platelet-derived growth factor (PDGF)-AA [median (interquartile range)=1.64 (0.76–4.57) vs. 0.77 (0.51–1.71) ng/mL], PDGF-AB/BB [10.31 (2.60–25.90) vs. 2.35 (0.74–6.70) ng/mL], and myeloperoxidase [10.5 (7.5–22.3) vs. 7.8 (5.5–12.2) ng/mL] at 7 months were higher in the progression group. In the multivariate analysis using logistic regression, the PDGF AB/BB level at 7 months was independently associated with the progression of ICAS (p=0.02). Conclusions The PDGF-AB/BB level is associated with the progression of ICAS, and so may play a significant role in the progression of human ICAS.

Intravenous Tissue Plasminogen Activator Improves the Outcome in Very Elderly Korean Patients with Acute Ischemic Stroke

최재철,이진성,박태환,박상순,조용진,박종무,강규식,이경복,이수주,고용채,김재국,이준,조기현,김준태,유경호,이병철,오미선,최재관,김대현,나현욱,김동억,류위선,김범준,배희준,김욱주,신동익,여민주,손성일,홍정호,이준영,홍근식 대한뇌졸중학회 2015 Journal of stroke Vol.17 No.3

Background and Purpose In a recent pooled analysis of randomized clinical trials (RCTs), intravenous tissue plasminogen activator (TPA) improves the outcome in patients aged ≥80 years. However, it is uncertain whether the findings are applicable to clinical practice in Asian populations. Methods From a multicenter stroke registry database of Korea, we identified patients with acute ischemic stroke who were aged ≥80 years. Using multivariable analysis and propensity score (PS)-matched analyses, we assessed the effectiveness and safety of intravenous TPA within 4.5 hours. Results Among 2,334 patients who met the eligible criteria, 236 were treated with intravenous TPA (mean age, 83±5; median NIHSS, 13 [IQR, 8-17]). At discharge, the TPA group compared to the no-TPA group had a favorable shift on the modified Rankin Scale (mRS) score (multivariable analysis, OR [95% CI], 1.51 [1.17-1.96], P=0.002; PS-matched analysis, 1.54 [1.17-2.04], P=0.002) and was more likely to achieve mRS 0-1 outcome (multivariable analysis, 2.00 [1.32-3.03], P=0.001; PS-matched analysis, 1.59 [1.04-2.42], P=0.032). TPA treatment was associated with an increased risk of symptomatic intracranial hemorrhage (multivariable analysis, 5.45 [2.80-10.59], P<0.001; PS-matched analysis, 4.52 [2.24-9.13], P<0.001), but did not increase the creatiin- hospital mortality (multivariable analysis, 0.86 [0.50-1.48], P=0.58; PS-matched analysis, 0.88 [0.52-1.47], P=0.61). Conclusions In the setting of clinical practice, intravenous TPA within 4.5 hours improved the functional outcome despite an increased risk of symptomatic intracranial hemorrhage in very elderly Korean patients. The findings, consistent with those from pooled analysis of RCTs, strongly support the use of TPA for this population.

Case Characteristics, Hyperacute Treatment, and Outcome Information from the Clinical Research Center for Stroke-Fifth Division Registry in South Korea

김범준,박종무,강규식,이수주,고영채,김재국,차재관,김대현,나현욱,한문구,박태환,박상순,이경복,이준,홍근식,조용진,이병철,유경호,오미선,김동억,류위선,조기현,김준태,최재철,김욱주,신동익,여민주,손성일,홍정호,이준영,Ji Sung Lee,윤병우,배희준 대한뇌졸중학회 2015 Journal of stroke Vol.17 No.1

Characteristics of stroke cases, acute stroke care, and outcomes after stroke differ according to geographical and cultural background. To provide epidemiological and clinical data on stroke care in South Korea, we analyzed a prospective multicenter clinical stroke registry, the Clinical Research Center for Stroke-Fifth Division (CRCS-5). Patients were 58% male with a mean age of 67.2±12.9 years and median National Institutes of Health Stroke Scale score of 3 [1-8] points. Over the 6 years of operation, temporal trends were documented including increasing utilization of recanalization treatment with shorter onset-to-arrival delay and decremental length of stay. Acute recanalization treatment was performed in 12.7% of cases with endovascular treatment utilized in 36%, but the proportion of endovascular recanalization varied across centers. Door-to-IV alteplase delay had a median of 45 [33-68] min. The rate of symptomatic hemorrhagic transformation (HT) was 7%, and that of any HT was 27% among recanalization-treated cases. Early neurological deterioration occurred in 15% of cases and were associated with longer length of stay and poorer 3-month outcomes. The proportion of mRS scores of 0-1 was 42% on discharge, 50% at 3 months, and 55% at 1 year after the index stroke. Recurrent stroke up to 1 year occurred in 4.5% of patients; the rate was higher among older individuals and those with neurologically severe deficits. The above findings will be compared with other Asian and US registry data in this article.