Hypoxic brain damage after carbon monoxide (CO) occurs predominantly in the basal ganglia, cerebral white matter and cerebral cortex. CO poisoning is complicated by various neurological manifestations as well as hemorrhagic infarction. Acute cerebral thromboembolic infarction following CO poisoning is very rare. We experienced a case of thromboembolic infarction in the middle cerebral artery territory occurred in a healthy young adult without any risk factor for stroke during treatment for hypoxic encephalopathy caused by acute CO poisoning.
Basal Ganglia ; Carbon ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Cerebral Cortex ; Cerebral Infarction ; Humans ; Hypoxia, Brain ; Infarction ; Middle Cerebral Artery ; Neurologic Manifestations ; Risk Factors ; Stroke ; Young Adult

BACKGROUND: Common carotid artery intima-media thickness (IMT) is an accepted sonographic marker of early atherosclerosis, and increased IMT represents a risk of ischemic stroke. The purpose of this study was to evaluate the correlation between common carotid artery IMT and stroke risk factors in patients with ischemic stroke. METHODS: Subjects were 381 patients with acute ischemic stroke. High resolution B-mode ultrasonography was performed to measure IMT at common carotid artery. Multivariate regression analysis was performed to determine the independent factors related to common carotid artery IMT. RESULTS: The variables that strongly predicted an increase in the common carotid artery IMT were age (P <0.001) and diabetes mellitus (P <0.001). CONCLUSION: Increased common carotid artery IMT is independently associated with age and diabetes mellitus in patients with ischemic stroke.
Atherosclerosis ; Carotid Arteries ; Carotid Artery, Common ; Diabetes Mellitus ; Humans ; Risk Factors ; Stroke

PURPOSE: To determine the prevalence of anxiety and depression in epilepsy patients and to evaluate the relationship of folate, vitamin B12 and homocysteine to anxiety and depression. METHODS: Subjects were 39 epilepsy patients, and controls were composed of age- and sex-matched 20 healthy person. Anxiety and depression was evaluated by using the Hospital Anxiety and Depression Scale (HADS). The plasma folate, vitamin B12 and homocysteine levels were measured by chemiluminescence immunoassay. HADS-A and HADS-D scores between patients and controls were compared. Univariate regression analysis was performed to assess the relationship of folate, vitamin B12 and homocysteine to anxiety and depression. RESULTS: In epilepsy patients, the prevalence rates of moderate to severe degree of anxiety and depression were 43.6% and 69.2% respectively. When compared with normal controls, the folate level of epilepsy patients was significantly decreased (p<0.05). Depression was significantly correlated with decreased serum folate level in epilepsy patients (p<0.001). However, association between depression and vitamin B12 or homocysteine was not statistically significant. Anxiety of epilepsy patients was not correlated with folate, vitamin B12 or homocysteine. CONCLUSIONS: Anxiety and depression are common in epilepsy patients, and low serum folate level may be correlated with depression.
Anxiety ; Depression ; Epilepsy ; Folic Acid ; Homocysteine ; Humans ; Immunoassay ; Luminescence ; Plasma ; Prevalence ; Vitamin B 12 ; Vitamins

PURPOSE: Fatigue is a frequent symptom of epilepsy, and is commonly reported as a side effect of many antiepileptic drugs. The aim of this study is to determine the rate of fatigue in epilepsy patients and its relation to C-reactive protein (CRP), fibrinogen and homocysteine levels. METHODS: Subjects were 39 epilepsy patients who were receiving antiepileptic drugs, and controls were composed of age- and sex-matched 20 healthy person. Fatigue was evaluated by using Fatigue Severity Scale (FSS). The plasma CRP, fibrinogen, and homocysteine levels were measured by turbidimetric immunoassay, scattered light detection method, and chemiluminescence immunoassay respectively. Univariate regression analysis was performed to assess the relationship between fatigue and CRP, fibrinogen, and homocysteine. RESULTS: In patients with epilepsy the mean score of FSS was 4.54+/-1.69, and the rate of fatigue was 66.7%. When compared with normal controls, the mean CRP level of epilepsy patients was significantly elevated (p<0.01). Fatigue was significantly correlated with elevated serum CRP level in epilepsy patients (p<0.05). However, associations between fatigue and fibrinogen and homocysteine were not statistically significant. CONCLUSIONS: These findings suggest that fatigue in epilepsy patients may be correlated with elevated serum CRP level.
Anticonvulsants ; C-Reactive Protein ; Epilepsy ; Fatigue ; Fibrinogen ; Homocysteine ; Humans ; Immunoassay ; Light ; Luminescence ; Plasma

BACKGROUND: The role of stroke risk factors as a determinant of clinical outcome is not well established. This study aimed to evaluate the prognostic value of stroke risk factors in patients with ischemic stroke by determining whether or not they contribute to stroke severity and disability after ischemic stroke. METHODS: Subjects were 433 patients with ischemic stroke. National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the severity of neurological deficit and clinical disability respectively. Multiple linear regression analysis was performed to evaluate the relation of stroke risk factors to stroke severity and disability. RESULTS: Among stroke risk factors, atrial fibrillation was significantly correlated with NIHSS (P<0.001) and mRS scores (P=0.006). Hypertension and age were significantly correlated with mRS scores (P=0.010, P=0.018, respectively). CONCLUSION: Atrial fibrillation was an independent factor associated with severe stroke and disability. Hypertension, and older age were independently correlated with serious disability after ischemic stroke.
Atrial Fibrillation ; Humans ; Hypertension ; Linear Models ; National Institutes of Health (U.S.) ; Risk Factors ; Stroke

PURPOSE: Fatigue is defined as a tired feeling, lack of energy, or feeling of exhaustion. Antiepileptic drugs, seizure and frequent interictal epileptiform activity can cause fatigue in epilepsy patients. The aim of this study is to determine the rate of fatigue and to assess the influence of clinical and demographic factors on fatigue in patients with epilepsy. METHODS: Fatigue was evaluated in 39 epilepsy patients by using Fatigue Severity Scale (FSS). Multiple regression analysis was performed to assess the influence of different factors on fatigue. RESULTS: In patients with epilepsy the mean score of FSS was 4.54+/-1.69, and the rate of fatigue was 66.7%. Among these patients, 23.1% had medium fatigue, and 43.6% had serious fatigue. The variable that strongly predicted a high FSS mean score was high seizure frequency. Conclusion: Fatigue is very common, and seizure frequency is an important factor influencing on fatigue in epilepsy patients.
Anticonvulsants ; Demography ; Epilepsy ; Fatigue ; Humans ; Seizures

BACKGROUND AND PURPOSE: Stroke is common among cancer patients. However, risk factors and biomarkers of stroke in cancer patients are not well established. This study aimed to investigate risk factors and biomarkers as well as etiology of ischemic stroke in cancer patients. METHODS: A retrospective review was conducted in cancer patients with ischemic stroke who were admitted to a general hospital in Busan, Korea, between January 2003 and December 2012. The risk factors and biomarkers for stroke and stroke subtypes in cancer patients were compared with age- and sex-matched noncancer patients with ischemic stroke who were admitted to the same hospital during the same period. RESULTS: One hundred fifty-six cancer patients with ischemic stroke were identified. Cancer patients with ischemic stroke were found to have a significantly lower proportion of hypertension, atrial fibrillation, hyperlipidemia, and ischemic heart disease than noncancer patients with ischemic stroke. However, stroke biomarkers, such as erythrocyte sedimentation rate and high-sensitivity C-reactive protein, fibrinogen, pro-brain natriuretic peptide, and D-dimer levels, were significantly increased in cancer patients with ischemic stroke than in noncancer patients. Large-artery atherosclerosis and stroke of undetermined cause were more common in cancer patients with ischemic stroke than in noncancer patients with ischemic stroke. CONCLUSIONS: Cancer patients with ischemic stroke showed different risk factors, stroke biomarkers, and stroke etiology compared with noncancer patients with ischemic stroke.
Atherosclerosis ; Atrial Fibrillation ; Biomarkers* ; Blood Sedimentation ; Busan ; C-Reactive Protein ; Fibrinogen ; Hospitals, General ; Humans ; Hyperlipidemias ; Hypertension ; Korea ; Myocardial Ischemia ; Retrospective Studies ; Risk Factors* ; Stroke*

OBJECTIVES: Fatigue, anxiety and depression are common psychiatric symptoms in epilepsy patients. The aim of this study is to evaluate the relationship between fatigue and anxiety and depression in epilepsy patients. METHODS: Subjects were 39 patients with epilepsy. The degrees of fatigue, anxiety and depression were evaluated by using Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS) respectively. Univariate regression analysis was performed to assess the relationship of fatigue to anxiety and depression. RESULTS: In patients with epilepsy, the prevalence rate of fatigue was 66.7%, and the prevalence rates of moderate to severe degree of anxiety and depression were 10.3% and 25.6% respectively. Fatigue was significantly correlated with anxiety in epilepsy patients (P < 0.01). However there was no relationship between fatigue and depression. CONCLUSIONS: Fatigue may be correlated with anxiety in epilepsy patients.
Anxiety ; Depression ; Epilepsy ; Fatigue ; Humans ; Prevalence

OBJECTIVE: To evaluate the relationship of high sensitivity C-reactive protein (hs-CRP), fibrinogen and homocysteine to carotid intima-media thickness (IMT) in acute ischemic stroke. METHODS: Subjects were 347 patients with acute cerebral infarction. The carotid arterial wall thickness was measured using high resolution B-mode ultrasound. The serum levels of hs-CRP, fibrinogen and homocysteine were measured by latex-enhanced turbidimetric immunoassay, clot scattering method, and chemiluminescence immunoassay respectively. Univariate regression analysis was performed to evaluate the relationship between these levels and carotid IMT. RESULTS: In patients with acute ischemic stroke, carotid IMT was significantly correlated with increased serum levels of hs-CRP and fibrinogen (P < 0.05, P < 0.01, respectively). However association between serum homocysteine and carotid IMT was not statistically significant. CONCLUSIONS: Increased serum levels of hs-CRP and fibrinogen may be correlated with carotid IMT. Measurement of serum hs-CRP and fibrinogen may be helpful for predicting degrees of atherosclerosis in acute ischemic stroke.
Atherosclerosis ; C-Reactive Protein ; Carotid Intima-Media Thickness ; Cerebral Infarction ; Fibrinogen ; Homocysteine ; Humans ; Immunoassay ; Luminescence ; Stroke

This study investigated the role of nitric oxide on the oxidative damage in gastric mucosa of rats which received ischemia/reperfusion and its relation to mucus. Nitric oxide synthesis modulators such as L-arginine and NG-nitro-L-arginine methyl ester, and sodium nitroprusside, a nitric oxide donor, were injected intraperitoneally to the rats 30 min prior to ischemia/reperfusion which was induced by clamping the celiac artery and the superior mesenteric artery for 30 min and reperfusion for 1 h. Lipid peroxide production, the contents of glutathione and mucus, and glutathione peroxidase activities of gastric mucosa were determined. Histological observation of gastric mucosa was performed by using hematoxylin-eosin staining and scanning electron microscopy. The result showed that ischemia/reperfusion increased lipid peroxide production and decreased the contents of glutathione and mucus as well as glutathione peroxidase activities of gastric mucosa. Ischemia/reperfusion induced gastric erosion and gross epithelial disruption of gastric mucosa. Pretreatment of L-arginine, a substrate for nitric oxide synthase, and sodium nitroprusside prevented ischemia/reperfusion-induced alterations of gastric mucosa. However, NG-nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, deteriorated oxidative damage induced by ischemia/reperfusion. In conclusion, nitric oxide has an antioxidant defensive role on gastric mucosa by maintaining mucus, glutathione, and glutathione peroxidase of gastric mucosa.
Animals ; Arginine ; Celiac Artery ; Constriction ; Gastric Mucosa ; Glutathione ; Glutathione Peroxidase ; Humans ; Mesenteric Artery, Superior ; Microscopy, Electron, Scanning ; Mucus* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Nitric Oxide* ; Nitroprusside ; Rats ; Reperfusion ; Tissue Donors