1.Gut Microbiota and Ischemic Stroke: The Role of Trimethylamine N-Oxide
Journal of Stroke 2019;21(2):151-159
Trimethylamine N-oxide (TMAO) is produced when trimethylamine, a waste product of gut microbes, is converted via hepatic flavin monooxygenases. As TMAO is a potential causative factor in various cardiovascular diseases (CVDs) considerable research interest has arisen on its use as a biomarker. Higher TMAO levels are associated with future risk of both incident CVD in the general population and established CVD, including stroke. The addition of TMAO into models with traditional risk factors significantly improved the prediction of future CVD risk. TMAO promotes atherosclerosis and is associated with platelet hyperreactivity and inflammation, which are in turn associated with the development of stroke and its secondary consequences. Additionally, TMAO may play a key mediator role in the relationship between the diet, gut microbiota, and CVD development. Compelling evidence suggesting that TMAO is both a risk factor and prognostic marker of stroke and CVD. Potential therapeutic strategy of diet and drugs in reducing TMAO levels have emerged. Thus, TMAO is a novel biomarker and target in stroke and CVD prevention.
Atherosclerosis
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Blood Platelets
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Cardiovascular Diseases
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Diet
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Gastrointestinal Microbiome
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Inflammation
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Mixed Function Oxygenases
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Prognosis
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Risk Factors
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Stroke
;
Waste Products
2.Neural Substrates of Aphasia in Acute Left Hemispheric Stroke Using VoxelBased Lesion-symptom Brain Mapping
Eun Ji PARK ; Yong Wook KIM ; Hyo Suk NAM ; Hyo Seon CHOI ; Deog Young KIM
Brain & Neurorehabilitation 2021;14(2):e14-
It is unclear how these brain lesions fit into the language processing in acute stroke. In this study, we aimed to investigate the neuroanatomical lesion related to language processing in acute stage of stroke patients using voxel-based lesion-symptom mapping (VLSM). 73 acute first-ever post-stroke patients were enrolled in this retrospective study, who had undertaken brain magnetic resonance imaging (MRI) and Korean version of the Western Aphasia Test within 1 month from onset. Each voxel was compared with aphasia quotient and subtest scores as dependent variables using VLSM. The aphasia group showed significantly much more involvement of extra-nuclear area, insula, inferior frontal gyrus and superior temporal gyrus compared to non-aphasia group. The deficit of spontaneous speech domain was associated with the inferior parietal lobule, inferior and middle frontal gyrus and insula.The insular cortex, inferior parietal lobule, inferior frontal gyrus, middle frontal gyrus and superior temporal gyrus were related to deficit of comprehension. The inferior parietal lobule, insula, precentral gyrus, inferior frontal gyrus were related to the deficit of repetition. The deficit of naming was related to inferior parietal lobule, insula and inferior frontal gyrus. In conclusion, VLSM from early MRI imaging study after stroke may be useful to understand the language process network and establish early rehabilitation strategies after stroke.
3.Facilitating Stroke Management using Modern Information Technology.
Hyo Suk NAM ; Eunjeong PARK ; Ji Hoe HEO
Journal of Stroke 2013;15(3):135-143
BACKGROUND AND PURPOSE: Information technology and mobile devices may be beneficial and useful in many aspects of stroke management, including recognition of stroke, transport and triage of patients, emergent stroke evaluation at the hospital, and rehabilitation. In this review, we address the contributions of information technology and mobile health to stroke management. SUMMARY OF ISSUES: Rapid detection and triage are essential for effective thrombolytic treatment. Awareness of stroke warning signs and responses to stroke could be enhanced by using mobile applications. Furthermore, prehospital assessment and notification could be streamlined for use in telemedicine and teleradiology. A mobile telemedicine system for assessing the National Institutes of Health Stroke Scale scores has shown higher correlation and fast assessment comparing with face-to-face method. Because the benefits of thrombolytic treatment are time-dependent, treatment should be initiated as quickly as possible. In-hospital communication between multidisciplinary team members can be enhanced using information technology. A computerized in-hospital alert system using computerized physician-order entry was shown to be effective in reducing the time intervals from hospital arrival to medical evaluations and thrombolytic treatment. Mobile devices can also be used as supplementary tools for neurologic examination and clinical decision-making. In post-stroke rehabilitation, virtual reality and telerehabilitation are helpful. Mobile applications might be useful for public awareness, lifestyle modification, and education/training of healthcare professionals. CONCLUSIONS: Information technology and mobile health are useful tools for management of stroke patients from the acute period to rehabilitation. Further improvement of technology will change and enhance stroke prevention and treatment.
Delivery of Health Care
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Humans
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Life Style
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National Institutes of Health (U.S.)
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Neurologic Examination
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Stroke
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Telemedicine
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Teleradiology
;
Triage
4.EXPERIMENTAL STUDY ON THE PREVENTION OF TRAUMATIC NEUROMA.
Nam Ho KIM ; Hyo Jook JANG ; In Pyo HONG ; Jong Hwan KIM ; Sung Suk PANG ; Jung Il SUH
Journal of the Korean Society of Plastic and Reconstructive Surgeons 1997;24(6):1358-1366
No abstract available.
Neuroma*
5.A Case of Acute Respiratory Muscle Weakness Complicated by Sjogren Syndrome.
Hyo Suk NAM ; Bum Chun SUH ; Jeong Hee CHO ; Yeon Kyung JUNG ; Seung Min KIM ; Il Nam SUNWOO
Journal of the Korean Neurological Association 2007;25(2):240-243
Sjogren syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in dry mouth and eyes. Approximately one-third of patients present with systemic manifestations, but respiratory muscle involvements have been rarely reported. We report a case of acute respiratory failure complicated by primary Sjogren syndrome. Muscle biopsy revealed perivascular lymphocytic infiltrations. Corticosteroid therapy improved respiratory muscle weakness. Sjogren syndrome should be considered as one of the underlying diseases causing acute respiratory failure.
Autoimmune Diseases
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Biopsy
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Exocrine Glands
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Humans
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Mouth
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Muscular Diseases
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Respiratory Insufficiency
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Respiratory Muscles*
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Respiratory Paralysis
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Sjogren's Syndrome*
6.Development of Smartphone Application That Aids Stroke Screening and Identifying Nearby Acute Stroke Care Hospitals.
Hyo Suk NAM ; Joonnyung HEO ; Jinkwon KIM ; Young Dae KIM ; Tae Jin SONG ; Eunjeong PARK ; Ji Hoe HEO
Yonsei Medical Journal 2014;55(1):25-29
PURPOSE: The benefits of thrombolytic treatment are time-dependent. We developed a smartphone application that aids stroke patient self-screening and hospital selection, and may also decrease hospital arrival time. MATERIALS AND METHODS: The application was developed for iPhone and Android smartphones. Map data for the application were adopted from the open map. For hospital registration, a web page (http://stroke119.org) was developed using PHP and MySQL. RESULTS: The Stroke 119 application includes a stroke screening tool and real-time information on nearby hospitals that provide thrombolytic treatment. It also provides information on stroke symptoms, thrombolytic treatment, and prescribed actions when stroke is suspected. The stroke screening tool was adopted from the Cincinnati Prehospital Stroke Scale and is displayed in a cartoon format. If the user taps a cartoon image that represents abnormal findings, a pop-up window shows that the user may be having a stroke, informs the user what to do, and directs the user to call emergency services. Information on nearby hospitals is provided in map and list views, incorporating proximity to the user's location using a Global Positioning System (a built-in function of smartphones). Users can search for a hospital according to specialty and treatment levels. We also developed a web page for hospitals to register in the system. Neurology training hospitals and hospitals that provide acute stroke care in Korea were invited to register. Seventy-seven hospitals had completed registration. CONCLUSION: This application may be useful for reducing hospital arrival times for thrombolytic candidates.
*Cellular Phone
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Geographic Information Systems
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Hospitals
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Humans
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Republic of Korea
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Stroke/*diagnosis
7.Superior Mesenteric Artery Occlusion in Acute Cardioembolic Stroke.
Moon Kyu LEE ; Dong Woo LEE ; Kyoo Ho CHO ; Hyo Suk NAM ; Ji Hoe HEO ; Young Dae KIM
Journal of the Korean Neurological Association 2009;27(3):299-300
No abstract available.
Atrial Fibrillation
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Mesenteric Arteries
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Mesenteric Artery, Superior
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Stroke
8.A Case of Constitutional Interstitial Deletion of 5q.
Hyo Jung SUK ; Nam Hyang GU ; Jo Won JUNG ; Moon Sung PARK
Journal of the Korean Society of Neonatology 2003;10(2):254-258
Constitutional interstitial deletions of 5q are rare conditions and phenotypic correlations are not well defined in the literature. We report a case of a male infant with constitutional interstitial deletion 5q15q22. The infant showed hypertelorism, cleft palate and bilateral undescended testis. He also had atrial septal defect and small patent ductus arteriosus, and showed no response in brain stem audoimetry. Our report gives weight to the previously reported cases that karyotype-phenotype correlation may be speculated in 5q deletion.
Brain Stem
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Cleft Palate
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Cryptorchidism
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Ductus Arteriosus, Patent
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Heart Septal Defects, Atrial
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Humans
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Hypertelorism
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Infant
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Male
9.The Prediction of Changes in Mean Corneal Refractive Power by Pterygium Size after Pterygium Surgery.
Ki Tae NAM ; Young Sub EOM ; Jay Won RHIM ; Su Yeon KANG ; Hyo Myung KIM ; Jong Suk SONG
Journal of the Korean Ophthalmological Society 2014;55(11):1613-1617
PURPOSE: To assess the changes in mean corneal refractive power (DeltaK) following pterygium surgery and to predict DeltaK in cases of combined cataract and pterygium surgery. METHODS: Thirty-seven eyes of unilateral pterygium patients who underwent pterygium surgery were analyzed retrospectively with at least more than 1 month of follow-up. Preoperative and postoperative 1 month corneal refractive power was measured using auto-keratometer (RK-F1, Canon, Tokyo, Japan). Pterygium horizontal extension, width, and area were measured and correlation with DeltaK before and after surgery analyzed. We also compared DeltaK of the contralateral normal eye. RESULTS: The mean corneal refractive (Km) power measured before and 1 month after surgery was 43.30 +/- 1.66 D and 44.07 +/- 1.42 D, respectively. The Km significantly increased at 4 weeks after surgery (p < 0.001). However, postoperative Km was not significantly different when compared with the contralateral normal eye (43.86 +/- 1.34 D; p = 0.59). All parameters of pterygium size including horizontal extension, width, and area were positively correlated with the mean DeltaK. Among parameters, horizontal extension was best correlated with mean DeltaK (p < 0.001). The mean DeltaK with horizontal extension was predicted using linear regression (2.5 mm to 1 D, 4.0 mm to 1.8 D). CONCLUSIONS: We recommend contralateral corneal refractive power or prediction of corneal refractive power using linear regression with pterygium horizontal extension for determining intraocular lens power in cases of combined cataract and pterygium surgery.
Cataract
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Follow-Up Studies
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Humans
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Lenses, Intraocular
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Linear Models
;
Pterygium*
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Retrospective Studies
10.A Case of Cerebellar Infarction Caused by Acute Subclavian Thrombus Following Minor Trauma.
Hyeyoung PARK ; Hee Jin KIM ; Myoung Jin CHA ; Jong Yun LEE ; Im Seok KOH ; Hyo Suk NAM
Yonsei Medical Journal 2013;54(6):1538-1541
Subclavian steal syndrome caused by an acute thrombus is very rare. We present a case of cerebellar infarction with proximal subclavian artery thrombosis. A 56-year-old woman was admitted for sudden vertigo. One day prior to admission, she received a shoulder massage comprised of chiropractic manipulation. On examination, her left hand was pale and radial pulses were absent. Blood pressure was weak in the left arm. Downbeat nystagmus and a right falling tendency were observed. Brain MRI showed multiple acute infarctions in the left cerebellum. The findings of Doppler ultrasonography in the left vertebral artery were compatible with a partial subclavian artery steal phenomenon. Digital subtraction angiography demonstrated a large thrombus in the left subclavian artery. After heparin infusion, thrombus size markedly decreased. Cerebellar infarction caused by acute subclavian thrombosis following minor trauma is rare, but the thrombus can be successfully resolved with anticoagulation.
Brain Infarction/*diagnosis/etiology/pathology
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Cerebellar Diseases/diagnosis/etiology
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Female
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Humans
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Magnetic Resonance Imaging
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Middle Aged
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Thrombosis/*complications