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다중 임계 기법과 영역확장법을 이용한 뇌졸중 병변 정합 방법 연구
탁윤오,김태윤,황해길,김동억,최흥국 인제대학교 2009 仁濟論叢 Vol.24 No.1
In clinical studies of brain stroke, it generally involves the process that spatially normalizes MR images into the standard brain template in order to find out distributions of lesion. So far MNI305, which is people’s standard brain template, has been commonly used. However in this study, to reduce some morphological differences caused by human races, ages, and sexes, we used the Korean Statistical Probabilistic Anatomical Map(Korean-SPAM). As a preprocessing methods, brightness and position of a brain had been adjusted at the first Then, stroke lesions were segmented using multiple threshold and region growing methods. Finally, stroke lesions were registered to the Korean-SPAM using Mesh Warp algorithm. We can registered various stroke MR brain images to Korean-SPAM rightly by the proposed method.
Long-Term Changes in Post-Stroke Depression, Emotional Incontinence, and Anger
Boseong Kwon,Eun-Jae Lee,박성호,Ji Sung Lee,Min Hwan Lee,Daeun Jeong,Dongwhane Lee,Hyuk Sung Kwon,Dae-Il Chang,Jong-Ho Park,Jae-Kwan Cha,허지회,Sung-Il Sohn,Dong-Eog Kim,Smi Choi-Kwon,Jong S. Kim 대한뇌졸중학회 2021 Journal of stroke Vol.23 No.2
Background and Purpose Long-term changes in post-stroke depression (PSD), post-stroke emotional incontinence (PSEI), and post-stroke anger (PSA) have rarely been studied. Methods This is a sub-study of EMOTION, a randomized, placebo-controlled trial, that examined the efficacy of escitalopram on PSD, PSEI, and PSA in patients with stroke. We interviewed patients at the long-term period (LTP) using predefined questionnaires: Montgomery-Åsberg depression rating scale (MADRS) for PSD, modified Kim’s criteria for PSEI, and Spielberger trait anger scale for PSA. Additionally, the ENRICHD Social Support Instrument (ESSI) for the social support state and the modified Rankin Scale (mRS) were measured. We investigated the changes in and factors behind PSD, PSEI, and PSA at LTP. Results A total of 222 patients were included, and the median follow-up duration was 59.5 months (interquartile range, 50 to 70). Compared to the data at 6 months post-stroke, the prevalence of PSEI (11.7% at 6 months, 6.3% at LTP; P=0.05) and mean anger score (21.62, 16.24; P<0.01) decreased, while the prevalence of PSD (35.6%, 44.6%; P=0.03) and mean MADRS (6.16, 8.67; P<0.01) increased at LTP. ESSI was associated with PSD and PSA, but not with PSEI. The effect of the baseline National Institutes of Health Stroke Scale score on PSD decreased over time. The effect of low social support on PSD was greater than that of mRS at LTP. Conclusions The prevalence and degree of PSD significantly increased, while those of PSEI and PSA decreased at LTP. PSD in this stage appeared to be more closely associated with a lack of social support than patients' physical disabilities.
Kim, Dong-Eog,Kim, Jeong-Yeon,Nahrendorf, Matthias,Lee, Su-Kyoung,Ryu, Ju Hee,Kim, Kwangmeyung,Kwon, Ick Chan,Schellingerhout, Dawid Ovid Technologies Wolters Kluwer -American Heart A 2011 Stroke Vol.42 No.12
<P>High experimental variability in mouse embolic stroke models could mask the effects of experimental treatments. We hypothesized that imaging thrombus directly would allow this variability to be controlled.</P>
Kim, Dong-Eog,Kim, Jeong-Yeon,Jeong, Sang-Wuk,Cho, Yong-Jin,Park, Jong-Moo,Lee, Ju-Hun,Kang, Dong-Wha,Yu, Kyung-Ho,Bae, Hee-Joon,Hong, Keun-Sik,Koo, Ja-Seong,Lee, Seung-Hoon,Lee, Byung-Chul,Han, Moon- American Heart Association] 2012 Stroke Vol.43 No.7
<P>Predictors of progression of intracranial atherosclerotic stenosis have not been clearly identified. We investigated whether poststroke changes in lipid profiles would affect the prognosis of symptomatic intracranial atherosclerotic stenosis.</P>
Kim, Dong-Eog,Kim, Jeong-Yeon,Schellingerhout, Dawid,Ryu, Ju Hee,Lee, Su-Kyoung,Jeon, Sangmin,Lee, Ji Sung,Kim, Jiwon,Jang, Hee Jeong,Park, Jung E.,Kim, Eo Jin,Kwon, Ick Chan,Ahn, Cheol-Hee,Nahrendorf American Heart Association 2017 Stroke Vol. No.
<P>Conclusions-Thromboembolic burden and the efficacy of tPA therapy can be assessed serially, noninvasively, and quantitatively using high-resolution microcomputed tomography and a fibrin-binding nanoparticle imaging agent.</P>
Kim, Dong-Eog,Ryu, Wi-Sun,Schellingerhout, Dawid,Jeong, Han‐,Gil,Kim, Paul,Jeong, Sang-Wuk,Park, Man-Seok,Choi, Kang-Ho,Kim, Joon-Tae,Kim, Beom Joon,Han, Moon-Ku,Lee, Jun,Cha, Jae-Kwan,Kim, Dae- Korean Stroke Society 2019 Journal of stroke Vol.21 No.1
<P><B>Background and Purpose</B></P><P>Thrombectomy within 24 hours can improve outcomes in selected patients with a clinical-infarct mismatch. We devised an easy-to-use visual estimation tool that allows infarct volume estimation in centers with limited resources. </P><P><B>Methods</B></P><P>We identified 1,031 patients with cardioembolic or large-artery atherosclerosis infarction on diffusion-weighted images (DWIs) obtained before recanalization therapy and within 24 hours of onset, and occlusion of the internal carotid or middle cerebral artery. Acute DWIs were mapped onto a standard template and used to create visual reference maps with known lesion volumes, which were then used in a validation study (with 130 cases) against software estimates of infarct volume. </P><P><B>Results</B></P><P>The DWI reference map chart comprises 144 maps corresponding to 12 different infarct volumes (0.5, 1, 2, 3, 5, 7, 9, 11, 13, 15, 17, and 19 mL) in each of 12 template slices (Montreal Neurological Institute z-axis –15 to 51 mm). Infarct volume in a patient is estimated by selecting a slice with a similar infarct size at the corresponding z-axis level on the reference maps and then adding up over all slices. The method yielded good correlations to software volumetrics and was easily learned by both experienced and junior physicians, with approximately 1 to 2 minutes spent per case. The sensitivity, specificity, and accuracy for detecting threshold infarct volumes (<21, <31, and <51 mL) were very high (all about >90%). </P><P><B>Conclusions</B></P><P>We developed easy-to-use reference maps that allow prompt and reliable visual estimation of infarct volumes for triaging patients to thrombectomy in acute stroke.</P>
Kim, Jeong-Yeon,Park, Jong-Ho,Jeong, Sang-Wuk,Schellingerhout, Dawid,Park, Jin-Eok,Lee, Dong Kun,Choi, Won Jun,Chae, Seok-Lae,Kim, Dong-Eog 대한신경과학회 2011 Journal of Clinical Neurology Vol.7 No.4
<P><B>Background and Purpose</B></P><P>Remnant lipoproteins (RLPs) are products of partially catabolized chylomicrons and very-low-density lipoprotein, from which some triglycerides have been removed. These particles are smaller and denser than the parent particles and are believed to be strongly atherogenic. We explored the association between RLP cholesterol (RLP-C) and ischemic stroke, including stroke subtypes.</P><P><B>Methods</B></P><P>A cohort of 142 ischemic stroke patients (90 men and 52 women; age, 65.2±12.8 years, mean±SD) was enrolled; all had acute infarcts confirmed by diffusion-weighted MRI, and had fasting lipograms. A full stroke-related evaluation was conducted on each patient. An outpatient population of 88 subjects without a history of cerebrovascular or cardiovascular disease served as a control group. Serum RLP fractions were isolated using an immunoaffinity gel containing specific antiapolipoprotein (anti-apo)B-100 and anti-apoA-I antibodies. RLP-C values were considered to be high when they were in the highest quartile of all values in the study.</P><P><B>Results</B></P><P>High RLP-C values were more common in stroke patients than in control patients (31.0% vs. 14.8%, <I>p</I>=0.01), when 5.6 mg/dL (>75th percentile) was used as the cutoff value. Multivariable analyses indicated that RLP-C was a risk factor for stroke, with an odds ratio of 2.54 (<I>p</I>=0.045). The RLP-C level was higher in the large artery atherosclerosis subgroup (5.7±3.9 mg/dL) than in any other stroke subgroup (small vessel occlusion, 4.9±5.9 mg/dL; cardioembolism, 1.8±2.3 mg/dL; stroke of undetermined etiology, 3.1±2.9 mg/dL).</P><P><B>Conclusions</B></P><P>We have found an association between high RLP-C levels and ischemic stroke, and in particular large artery atherosclerotic stroke.</P>
Kim, Dong Wook,Im, So-Hyang,Kim, Jeong-Yeon,Kim, Dong-Eog,Oh, Goo Taeg,Jeong, Sang-Wuk Journal of Neurosurgery Publishing Group 2009 Journal of Neurosurgery Vol.111 No.5
<B>Object</B><P>Hematoma size and brain edema after intracerebral hemorrhage (ICH) are important prognostic factors. Inducible nitric oxide synthase (iNOS) is induced after cerebral ischemia and is known to be involved in secondary neuronal injury, but its significance in ICH is unknown. The authors tested whether iNOS would influence hematoma size and brain edema after ICH.</P><B>Methods</B><P>The authors used C57BL/6 and iNOS knockout mice for all the experiments. Experimental ICH was induced by the intrastriatal stereotactic administration of bacterial collagenase. Brain tissue was obtained at 72 hours after ICH. The volume of hematoma was quantified by spectrophotometric assay, and the brain water content was measured. The investigators also measured blood-brain barrier permeability using Evans blue dye.</P><B>Results</B><P>There was no significant difference in hematoma size between the 2 groups. The brain water content of the lesional hemisphere was higher in C57BL/6 mice than in iNOS knockout mice. More Evans blue leakage in the brain was observed in C57BL/6 control mice than in iNOS knockout mice. Immunohistochemistry showed iNOS immunoreactivity in the perihematoma areas of C57BL/6 mice but not in the iNOS knockout mice.</P><B>Conclusions</B><P>When hematoma size was similar, iNOS knockout mice had significantly less brain edema than their littermates. These results suggest that iNOS modulation might become an antiedematous therapy for ICH.</P>