Yuseong Sun General Hospital

Daejeon, South Korea

Yuseong Sun General Hospital

Daejeon, South Korea
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Shin D.-I.,Chungbuk National University | Lee H.-S.,Yuseong Sun General Hospital | Baek S.-H.,Chungbuk National University | Lee S.-S.,Chungbuk National University | And 3 more authors.
Journal of Neuroimaging | Year: 2015

BACKGROUND: The Qureshi grading scheme is an effective classification system for evaluating the severity of acute arterial occlusion. However, this scheme is of limited utility because it is based on invasive angiography. In this study, we assessed whether a relationship between a noninvasive Qureshi score, based on magnetic resonance angiography (MRA) or computed tomography angiography (CTA), and 90-day functional outcome could be observed in patients with acute ischemic stroke. METHODS: A stroke neurologist evaluated all patients with acute ischemic stroke who presented to the emergency room within 12 hour of symptom onset. Two neurologists independently assessed the noninvasive Qureshi score from initial MRA or CTA. We assessed the relationship between the noninvasive Qureshi grading scheme and clinical outcome on day 90. RESULTS: Of a total 125 patients, 75 underwent MRA and 50 underwent CTA. Interobserver reliability showed good agreement (κ = .62). The noninvasive Qureshi score for MRA or CTA and that for CTA alone were directly associated with a good 90-day functional outcome (odds ratio, .672; P = .016 and odds ratio, .511; P = .042). CONCLUSIONS: The noninvasive Qureshi scheme using MRA or CTA provides meaningful information about long-term functional outcomes in patients with acute ischemic stroke. © 2015 by the American Society of Neuroimaging.


PubMed | University of California at Los Angeles, Yuseong Sun General Hospital and Chungbuk National University
Type: Journal Article | Journal: Journal of neuroimaging : official journal of the American Society of Neuroimaging | Year: 2015

The Qureshi grading scheme is an effective classification system for evaluating the severity of acute arterial occlusion. However, this scheme is of limited utility because it is based on invasive angiography. In this study, we assessed whether a relationship between a noninvasive Qureshi score, based on magnetic resonance angiography (MRA) or computed tomography angiography (CTA), and 90-day functional outcome could be observed in patients with acute ischemic stroke.A stroke neurologist evaluated all patients with acute ischemic stroke who presented to the emergency room within 12 hour of symptom onset. Two neurologists independently assessed the noninvasive Qureshi score from initial MRA or CTA. We assessed the relationship between the noninvasive Qureshi grading scheme and clinical outcome on day 90.Of a total 125 patients, 75 underwent MRA and 50 underwent CTA. Interobserver reliability showed good agreement ( = .62). The noninvasive Qureshi score for MRA or CTA and that for CTA alone were directly associated with a good 90-day functional outcome (odds ratio, .672; P = .016 and odds ratio, .511; P = .042).The noninvasive Qureshi scheme using MRA or CTA provides meaningful information about long-term functional outcomes in patients with acute ischemic stroke.


Lee H.-S.,Yuseong Sun General Hospital | Lee H.L.,Chungbuk National University | Han H.-S.,Yuseong Sun General Hospital | Yeo M.,Chungbuk National University | And 4 more authors.
Journal of Biomedical Research | Year: 2016

Ankle brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are widely used noninvasive modalities to evaluate atherosclerosis. Recently, evidence has increased supporting the use of ABI and baPWV as markers of cerebrovascular disease. This study sought to examine the relationship between ABI and baPWV with ischemic stroke. This study also aimed to determine which pathogenic mechanism, large artery disease (LAD) or small vessel disease (SVD), is related to ABI or baPWV. Retrospectively, 121 patients with ischemic stroke and 38 subjects with no obvious ischemic stroke history were recruited. First, ABI and baPWV were compared between the groups. Then, within the stroke group, the relevance of ABI and baPWV with regard to SVD and LAD, which were classified by brain magnetic resonance image (MRI) and magnetic resonance angiography (MRA) or computed tomography angiography (CTA) findings, was assessed. The baPWV was higher in the stroke group than non-stroke group (1,944.18±416.6 cm/s vs. 1,749.76±669.6 cm/s, P < 0.01). Regarding LAD, we found that mean ABI value was lower in the group with extracranial large artery stenosis (P < 0.01), and there was an inverse linear correlation between ABI and the grade of extracranial large artery stenosis (P < 0.01). For SVD, there was a significant correlation between SVD and baPWV (2,057.6±456.57 cm/s in the SVD (+) group vs. 1,491±271.62 cm/s in the SVD (-) group; P < 0.01). However, the grade of abnormalities detected in SVD did not correlate linearly with baPWV. These findings show that baPWVis a reliable surrogate marker of ischemic stroke. Furthermore, baPWVand ABI can be used to indicate the presence of small vessel disease and large arterial disease, respectively. © 2016 by the Journal of Biomedical Research.


Shin D.-I.,Chungbuk National University | Lee H.-S.,Yuseong Sun General Hospital | Baek S.-H.,Chungbuk National University | Han H.-S.,Yuseong Sun General Hospital | And 2 more authors.
Neurology Asia | Year: 2015

Background & Objective: EGB 761 is a standardized natural extract used to treat impaired cerebral perfusion and nutrition (cerebrovascular insufficiency) in Korea. Although several animal studies have been conducted, few studies have investigated the clinical effects of EGB 761 in acute stroke. This study assessed the clinical benefit of intravenous EGB 761 in patients with acute ischemic stroke. Methods: This retrospective study examined a prospectively collected stroke database. We evaluated 232 patients with acute ischemic stroke within 48 hours of symptom onset. All patients were treated with antiplatelet or anticoagulation agents. We compared baseline characteristics between the EGB 761-treated and non-treated groups. The functional outcome measure was the modified Rankin Scale (mRS) score 90 days after stroke onset. Results: Of the 232 patients, 170 received EGB 761 during the first 3 days after arrival in the emergency department. We found no significant differences in baseline characteristics between the groups, with the exception of atrial fibrillation (p=0.032). After adjusting for baseline factors, intravenous administration of EGB 761 was associated with an improved 90-day functional outcome (mRS ≤2) compared with the control group (odds ratio, 2.56; p<0.05). Conclusions: Our results showed a clinical benefit of intravenous EGB 761 in patients with acute ischemic stroke. © 2015, ASEAN Neurological Association. All rights reserved.


PubMed | Yuseong Sun General Hospital and Chungbuk National University
Type: Journal Article | Journal: Journal of medical case reports | Year: 2016

Behcets disease is a heterogeneous, multisystem, inflammatory disorder of unknown etiology. The classic triad of oral and genital ulcerations in conjunction with uveitis was originally described by the Turkish dermatologist Hulusi Behcet in 1937, but associated symptoms of the cardiovascular, central nervous, pulmonary, and gastrointestinal systems were later identified. In fact, Behcets disease with neurological involvement (neuro-Behcets disease) is not uncommon. Patients with neuro-Behcets disease typically exhibit a diverse array of symptoms, most commonly in the brainstem and diencephalic regions. Herein, we report an unusual case of neuro-Behcets disease in a patient who presented with a solitary cerebellar hemorrhage.A 39-year-old Asian woman was admitted to our hospital with complaints of a sudden speech difficulty that had manifested the same morning, and dizziness and mild vomiting experienced over the previous 3 days. Magnetic resonance images revealed target-like hemorrhagic lesions in the right hemisphere of the cerebellum. Risk factors that may result in cerebellar hemorrhage, such as high blood pressure or bleeding diathesis, were ruled out, and subsequent brain angiograms were normal.These findings suggest that the patients cerebellar hemorrhage could have been due to intracranial vasculitis in a rare, if not unique, complication of neuro-Behcets disease.

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