BACKGROUND AND PURPOSE: Intracranial atherosclerotic stenosis (ICAS) is considered as a major cause of stroke. The carotid intima-media thickness (CIMT), which accurately reflects the burden of generalized atherosclerosis, is also associated with stroke. The aim of this study was to determine the association between the CIMT and ICAS responses to medical treatment. METHODS: This study constituted part of the "Trial of cilostazol in symptomatic intracranial arterial stenosis"-2 that evaluated the ICAS response after randomized antiplatelet treatment. Magnetic resonance angiography and CIMT measurement were performed at baseline and after 7 months of treatment. CIMT was measured using semiautomated software, and was presented as maximum (CIMT-max) and average (CIMT-ave) values. The change in CIMT was compared relative to the ICAS response (i.e., progression, no-change, and regression). Ordinal logistic regression and analysis of covariance (ANCOVA) were used to analyze the association between the responses. RESULTS: Among the 101 enrolled patients, 85 underwent follow-up CIMT measurement. CIMT increased most in the ICAS progression group (CIMT-max: 0.09+/-0.23, CIMT-ave: 0.04+/-0.12), and to a lesser degree in the no-change group (CIMT-max: 0.02+/-0.16, CIMT-ave: 0.02+/-0.11), but decreased in patients with ICAS regression (CIMT-max: -0.04+/-0.11, CIMT-ave: -0.03+/-0.07; CIMT-max: p=0.010, CIMT-ave: p=0.015). Ordinal logistic regression analysis demonstrated that the change in CIMT-max was independently associated with the ICAS response (p=0.032). However, the ANCOVA revealed that the reverse was not true, in that the ICAS response was not independently associated with the change in CIMT after adjusting for confounding factors. CONCLUSIONS: The ICAS response may be associated with the CIMT response to medical treatment.
Atherosclerosis ; Carotid Intima-Media Thickness* ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Intracranial Arteriosclerosis* ; Logistic Models ; Magnetic Resonance Angiography ; Stroke ; Tetrazoles

BACKGROUND: Measurement of the maximum oxygen uptake in patients with chronic obstructive pulmonary disease (COPD) has been used to determine the intensity of exercise and to estimate the patient's response to treatment during pulmonary rehabilitation. However, cardiopulmonary exercise testing is not widely available in Korea. The 6-minute walk test (6MWT) is a simple method of measuring the exercise capacity of a patient. It also provides high reliability data and it reflects the fluctuation in one's exercise capacity relatively well with using the standardized protocol. The prime objective of the present study is to develop a regression equation for estimating the peak oxygen uptake (VO2) for men with moderate to very severe COPD from the results of a 6MWT. METHODS: A total of 33 male patients with moderate to very severe COPD agreed to participate in this study. Pulmonary function testing, cardiopulmonary exercise testing and a 6MWT were performed on their first visits. The index of work (6Mwork, 6-minute walk distance [6MWD]xbody weight) was calculated for each patient. Those variables that were closely related to the peak VO2 were identified through correlation analysis. With including such variables, the equation to predict the peak VO2 was generated by the multiple linear regression method. RESULTS: The peak VO2 averaged 1,015+/-392 ml/min, and the mean 6MWD was 516+/-195 meters. The 6Mwork (r=.597) was better correlated to the peak VO2 than the 6MWD (r=.415). The other variables highly correlated with the peak VO2 were the FEV1 (r=.742), DLco (r=.734) and FVC (r=.679). The derived prediction equation was VO2 (ml/min)=(274.306xFEV1)+(36.242xDLco)+(0.007x6Mwork)-84.867. CONCLUSION: Under the circumstances when measurement of the peak VO2 is not possible, we consider the 6MWT to be a simple alternative to measuring the peak VO2. Of course, it is necessary to perform a trial on much larger scale to validate our prediction equation.
Exercise Test ; Humans ; Korea ; Linear Models ; Male ; Oxygen ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests

BACKGROUND: Although several hospital-based stroke studies were published, there has not been any reliable data representing the clinical characteristics of stroke in Korea. We analyzed the clinical characteristics of patients with ischemic stroke registered in the Korean Stroke Registry (KSR), which is the largest prospective hospital-based nation-wide stroke registry in Korea. METHODS: The KSR provided standardized protocols for collecting data, which includes the data of demographics, subtypes of stroke, risk factors, and neurological outcome at discharge. The brain imaging studies, including CT or MRI, were performed in all cases. RESULTS: KSR registered 10,811 patients of acute ischemic stroke between Nov. 2002 and Jun. 2004. The large-artery atherosclerosis was the most common subtype (37.3%), followed by small vessel occlusion (30.8%). Hypertension (65.4%) was the most common risk factor, followed by smoking (34.5%) and diabetes (28.3%). Although most of the hypertensive and diabetic patients had been diagnosed before the stroke, less than 45.4% and 32.5% of them were under regular control. The steno-occlusive lesion of extracranial carotid artery was only 29.3% and the ratio of intra- to extracranial artery disease was more than 2 in KSR. Only 20.5% of patients were admitted within 3 hours after stroke onset and 2.1% were treated with intravenous thrombolysis. In-hospital case-fatality was 5.2%, which is relatively comparable to those of previous studies. CONCLUSIONS: The KSR provided informative data in understanding the clinical characteristics of ischemic stroke in Korea. Further analysis of KSR will facilitate clinical trials and development of guidelines for the management of stroke patients.
Arteries ; Atherosclerosis ; Carotid Arteries ; Cerebrovascular Disorders ; Demography ; Epidemiology ; Humans ; Hypertension ; Korea ; Magnetic Resonance Imaging ; Neuroimaging ; Prospective Studies* ; Registries ; Risk Factors ; Smoke ; Smoking ; Stroke*