As, until now, many studies have failed to establish the clinical effect of numerous neuroprotectives, antithrombotic therapy must be emphasized as one of critical options among limited treatment strategies in acute ischemic stroke. Based on the accumulating evidences that platelets and coagulating proteins play an important role in the thrombus formation, antiplatelets and anticoagulants are served as antithrombotics. Recently, major advances have been made in understanding the effects of antiplatelets and anticoagulants. Large randomized clinical trials have highlighted the effectiveness and safety of early and continuous antiplatelet therapy in reducing atherothrombotic stroke recurrence. Urgent anticoagulation has been used often to prevent early recurrent stroke and to improve neurological outcomes, however, its formal use in acute stroke has been the subject of debate even in cardioembolic stroke. That's because anticoagulants also increase the risk of fatal or disabling intracranial hemorrhage and it is difficult to monitor proper anticoagulation. Although early administration of anticoagulants should be considered to prevent the secondary injury and the propagation of thrombosis in patients with atherothrombotic stroke, more evidences are needed especially in patients with infractions secondary to large artery thrombosis or cardioembolism. This review discusses recent advances related to antithrombotic strategies and putative neuroprotectives.
Anticoagulants ; Arteries ; Blood Platelets ; Humans ; Intracranial Hemorrhages ; Organothiophosphorus Compounds ; Proteins ; Recurrence ; Stroke ; Thrombosis

Background and Objectives: This study aimed to describe the ischemic stroke subtypes and risk factors in young Korean adults, focusing mainly on traditional risk factors and management of ischemic stroke. Methods: The study patients were the fi rst-ever acute cerebral ischemic infarction age 49 years or below admitted to the Kyung Hee University Medical Centre from September 2003 to June 2009, with ischaemic stroke patients >50 years as control. The stroke subtypes was categorized according to Trial of Org 10172 in Acute Stroke Treatment classifi cation. The traditional risk factors of ischemic stroke were examined. For those known to have hypertension and diabetes prior to onset of stroke, their adherence to treatment of hypertension and diabetes was also assessed. Results: Close to half of the patients ≤49 years were due to premature atherosclerosis from small vessel occlusion and large artery atherosclerosis. The most common risk factor in declining order was hypertension, smoking, dyslipidemia and obesity. On logistic regression analysis, hypertension, dyslipidemia, and obesity were strongly associated with small vessel occlusion. In patients who were known to have hypertension and diabetes prior to the onset of stroke, the younger patients were less adherent to the treatment as primary prevention than the older stroke patients. Conclusion: This study suggests that premature atherosclerosis from small vessel occulusion is the most common cause of ischaemic stroke among young adults in Korea. Non-adherence to primary preventive treatment of hypertension and diabetes is common.

OBJECTIVES: The purpose of this study was to design an integrated data management system based on the POCT1-A2, LIS2-A, LIS2-A2, and HL7 standard to ensure data interoperability between mobile equipment, such as point-of-care testing equipment and the existing hospital data system, its efficiency was also evaluated. METHODS: The method of this study was intended to design and realize a data management system which would provide a solution for the problems that occur when point-of-care testing equipment is introduced to existing hospital data, after classifying such problems into connectivity, integration, and interoperability. This study also checked if the data management system plays a sufficient role as a bridge between the point-of-care testing equipment and the hospital information system through connection persistence and reliability testing, as well as data integration and interoperability testing. RESULTS: In comparison with the existing system, the data management system facilitated integration by improving the result receiving time, improving the collection rate, and by enabling the integration of disparate types of data into a single system. And it was found out that we can solve the problems related to connectivity, integration and interoperability through generating the message in standardized types. CONCLUSIONS: It is expected that the proposed data management system, which is designed to improve the integration point-of-care testing equipment with existing systems, will establish a solid foundation on which better medical service may be provided by hospitals by improving the quality of patient service.
Clinical Laboratory Information Systems ; Database Management Systems ; Dietary Sucrose ; Hospital Information Systems ; Humans ; Information Systems ; Medical Order Entry Systems ; Point-of-Care Systems

PURPOSE: There are some controversial opinions on the prognostic value of metastasis- associated tumor markers in breast cancer. Out of them, the overexpression of c-erbB-2 proto-oncogene or CD44 gene has been debated on their activities in promoting metastatic potential. MATERIALS AND METHODS: To detennine the relationship between expression of these genes, and, clinicopathological parameters and disease outcomes including relapse and survival, 48 archival paraffin-embeded breast-cancer tissues were stained using monoclonal antibody against each gene product by immunohistochemical staining method, and the result was analyzed. RESULTS: The positive expression rates of c-erbB-2 and CD44 genes were 45.8% and 18.8%, respectively. The expression rates of both genes were 14.6% and 50% of cases showed no expression of either gene. Except the statistically significant positive correlation between CD44 and tumor size (P=0.003), the expression of c-erbB-2 or CD44 expression had no significant relationship with tumor size, stage, lymph node status, and disease recurrence (P>0.05). In the positive expression cases for CD44, disesase-free survival (DFS) and overall survival (OS) in months were shorter than the negative ones (53+/- 8 vs. 64+/-5 and 67+/-8 vs. 77+/-5 S.E.). And, the c-erbB-2 positive cases had longer OS than the negative ones (78+/- 6 vs. 71+/- 6). The OS of positive co-expression cases with the c-erbB-2 and CD44 was shorter than that of one-gene expression ones (66+/- 6 vs. 75+/-7). Thus the OS result observed in the expression of c-erbB-2 alone was reversed in the co-expression study. Though these results had no statistically significant level (P> 0.05). CONCLUSION: We suggest a question if there is any interaction or dependency between c-erbB-2 and CD44 expression in view of disease process including OS. Finally, further randomised controlled studies are advisable for the reproducible and significant results.
Breast Neoplasms* ; Breast* ; Genes, erbB-2 ; Lymph Nodes ; Recurrence ; Biomarkers, Tumor

No abstract available.
Aged ; Alcohol-Induced Disorders, Nervous System/etiology/*pathology ; Alcoholism/complications/*pathology ; Cerebellum/*pathology ; Diagnosis, Differential ; Early Diagnosis ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Reproducibility of Results ; Sensitivity and Specificity ; Spinocerebellar Degenerations/*etiology/*pathology

Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing after cardiopulmonary bypass.
Antacids ; Cardiopulmonary Bypass ; Diagnosis ; Dizziness ; Duodenal Ulcer ; Early Diagnosis ; Emergencies ; Heart* ; Hemorrhage ; Humans ; Hypotension ; Laparotomy ; Melena ; Oliguria ; Paracentesis ; Postoperative Complications ; Tachycardia ; Thoracic Surgery* ; Ulcer

No abstract available.
Infarction*

Eales’ disease is an idiopathic disorder induced by ischemic retinal vasculitis, usually affecting the peripheral retina. We encountered a young patient diagnosed as cerebral infarction with a history of Eales’ disease. The patient’s middle cerebral artery showed multifocal stenosis with contrast enhancement, suggesting vasculitis. These findings might give clues to a rare cause of cerebral artery stenosis.