Objective: : Korea’s healthcare system and policy promotes early, actively stroke treatment to improve prognosis. This study represents stroke epidemiology and outcomes in Korea. Methods: : This study investigated data from the Acute Stroke Assessment Registry. The registry collects data from over 220 hospitals nationwide, focusing on quality stroke service management. Data analysis included patient demographics, stroke severity assessment, and discharge prognosis measurement using standardized scales. Results: : Eighty-six thousand five hundred sixty-eight acute stroke patients were collected with demographic and clinical characteristics during 18 months from 2016, 2018, and between 2020 to 2021, focusing on acute subarachnoid hemorrhage (SAH), acute intracerebral hemorrhage (ICH), and acute ischemic stroke. Of these 86568 patients, 8.3% was SAH, 16.3% ICH, and 74.9% ischemic stroke. Trends showed decreasing SAH and increasing ICH cases over the years. 68.3% stroke patients had the clear onset time. 49.6% stroke patients arrived within 4.5 hours of symptom onset, with more patients treated at general hospitals. Good functional outcomes at discharge was obtained with 58.3% of acute stroke patients, 55.9% of SAH patients, 34.6% of ICH patients, and 63.8% of ischemic stroke patients. Conclusion : The results showed that ischemic stroke was the most common subtype, followed by ICH and SAH. Prognosis differed among subtypes, with favorable outcomes more common in ischemic stroke and SAH compared to ICH.

Objective: : Korea’s healthcare system and policy promotes early, actively stroke treatment to improve prognosis. This study represents stroke epidemiology and outcomes in Korea. Methods: : This study investigated data from the Acute Stroke Assessment Registry. The registry collects data from over 220 hospitals nationwide, focusing on quality stroke service management. Data analysis included patient demographics, stroke severity assessment, and discharge prognosis measurement using standardized scales. Results: : Eighty-six thousand five hundred sixty-eight acute stroke patients were collected with demographic and clinical characteristics during 18 months from 2016, 2018, and between 2020 to 2021, focusing on acute subarachnoid hemorrhage (SAH), acute intracerebral hemorrhage (ICH), and acute ischemic stroke. Of these 86568 patients, 8.3% was SAH, 16.3% ICH, and 74.9% ischemic stroke. Trends showed decreasing SAH and increasing ICH cases over the years. 68.3% stroke patients had the clear onset time. 49.6% stroke patients arrived within 4.5 hours of symptom onset, with more patients treated at general hospitals. Good functional outcomes at discharge was obtained with 58.3% of acute stroke patients, 55.9% of SAH patients, 34.6% of ICH patients, and 63.8% of ischemic stroke patients. Conclusion : The results showed that ischemic stroke was the most common subtype, followed by ICH and SAH. Prognosis differed among subtypes, with favorable outcomes more common in ischemic stroke and SAH compared to ICH.

Objective: : Korea’s healthcare system and policy promotes early, actively stroke treatment to improve prognosis. This study represents stroke epidemiology and outcomes in Korea. Methods: : This study investigated data from the Acute Stroke Assessment Registry. The registry collects data from over 220 hospitals nationwide, focusing on quality stroke service management. Data analysis included patient demographics, stroke severity assessment, and discharge prognosis measurement using standardized scales. Results: : Eighty-six thousand five hundred sixty-eight acute stroke patients were collected with demographic and clinical characteristics during 18 months from 2016, 2018, and between 2020 to 2021, focusing on acute subarachnoid hemorrhage (SAH), acute intracerebral hemorrhage (ICH), and acute ischemic stroke. Of these 86568 patients, 8.3% was SAH, 16.3% ICH, and 74.9% ischemic stroke. Trends showed decreasing SAH and increasing ICH cases over the years. 68.3% stroke patients had the clear onset time. 49.6% stroke patients arrived within 4.5 hours of symptom onset, with more patients treated at general hospitals. Good functional outcomes at discharge was obtained with 58.3% of acute stroke patients, 55.9% of SAH patients, 34.6% of ICH patients, and 63.8% of ischemic stroke patients. Conclusion : The results showed that ischemic stroke was the most common subtype, followed by ICH and SAH. Prognosis differed among subtypes, with favorable outcomes more common in ischemic stroke and SAH compared to ICH.

Objective: : Korea’s healthcare system and policy promotes early, actively stroke treatment to improve prognosis. This study represents stroke epidemiology and outcomes in Korea. Methods: : This study investigated data from the Acute Stroke Assessment Registry. The registry collects data from over 220 hospitals nationwide, focusing on quality stroke service management. Data analysis included patient demographics, stroke severity assessment, and discharge prognosis measurement using standardized scales. Results: : Eighty-six thousand five hundred sixty-eight acute stroke patients were collected with demographic and clinical characteristics during 18 months from 2016, 2018, and between 2020 to 2021, focusing on acute subarachnoid hemorrhage (SAH), acute intracerebral hemorrhage (ICH), and acute ischemic stroke. Of these 86568 patients, 8.3% was SAH, 16.3% ICH, and 74.9% ischemic stroke. Trends showed decreasing SAH and increasing ICH cases over the years. 68.3% stroke patients had the clear onset time. 49.6% stroke patients arrived within 4.5 hours of symptom onset, with more patients treated at general hospitals. Good functional outcomes at discharge was obtained with 58.3% of acute stroke patients, 55.9% of SAH patients, 34.6% of ICH patients, and 63.8% of ischemic stroke patients. Conclusion : The results showed that ischemic stroke was the most common subtype, followed by ICH and SAH. Prognosis differed among subtypes, with favorable outcomes more common in ischemic stroke and SAH compared to ICH.

Objective: This was a retrospective investigation conducted to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the treatment and outcomes of patients with ischemic stroke. Methods: Data were collected over one year for the COVID-19 and pre-COVID-19 (control) groups, from May 1, 2020, to April 30, 2021, when COVID-19 was prevalent in Korea, and from May 1, 2018 to April 30, 2019, before the COVID-19 outbreak, respectively. Adult patients diagnosed with acute cerebral infarction at three emergency medical centers during the study period were included. COVID-19-positive patients (i.e., those with COVID-19 symptoms but those who tested positive) were excluded from this study to ensure only the evaluation of delays in stroke treatment due to the pandemic. Results: During the COVID-19 pandemic, of the total of 82,558 patients who visited the emergency centers, 710 were diagnosed with ischemic stroke. The study observed that the pandemic caused process delays for these patients, resulting in longer wait times for brain CT scans (P=0.010, P<0.001) and emergency room stays (P=0.0055, P<0.001) during the COVID-19 period. However, the length of time for administration of tissue plasminogen activator remained relatively constant. Notably, the 28-day mortality rate was considerably higher for patients with COVID-19-related symptoms during the pandemic (13.6% vs 3.1%; P=0.006). A cumulative risk analysis revealed an increased mortality risk for patients with COVID-19 related symptoms (P=0.005). Conclusion This study showed the need to improve emergency care procedures during pandemics to ensure prompt treatment of ischemic stroke. Preparation and resource allocation for ischemic stroke patients with COVID-19 symptoms are crucial.

Objective: This was a retrospective investigation conducted to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the treatment and outcomes of patients with ischemic stroke. Methods: Data were collected over one year for the COVID-19 and pre-COVID-19 (control) groups, from May 1, 2020, to April 30, 2021, when COVID-19 was prevalent in Korea, and from May 1, 2018 to April 30, 2019, before the COVID-19 outbreak, respectively. Adult patients diagnosed with acute cerebral infarction at three emergency medical centers during the study period were included. COVID-19-positive patients (i.e., those with COVID-19 symptoms but those who tested positive) were excluded from this study to ensure only the evaluation of delays in stroke treatment due to the pandemic. Results: During the COVID-19 pandemic, of the total of 82,558 patients who visited the emergency centers, 710 were diagnosed with ischemic stroke. The study observed that the pandemic caused process delays for these patients, resulting in longer wait times for brain CT scans (P=0.010, P<0.001) and emergency room stays (P=0.0055, P<0.001) during the COVID-19 period. However, the length of time for administration of tissue plasminogen activator remained relatively constant. Notably, the 28-day mortality rate was considerably higher for patients with COVID-19-related symptoms during the pandemic (13.6% vs 3.1%; P=0.006). A cumulative risk analysis revealed an increased mortality risk for patients with COVID-19 related symptoms (P=0.005). Conclusion This study showed the need to improve emergency care procedures during pandemics to ensure prompt treatment of ischemic stroke. Preparation and resource allocation for ischemic stroke patients with COVID-19 symptoms are crucial.

Objective: This was a retrospective investigation conducted to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the treatment and outcomes of patients with ischemic stroke. Methods: Data were collected over one year for the COVID-19 and pre-COVID-19 (control) groups, from May 1, 2020, to April 30, 2021, when COVID-19 was prevalent in Korea, and from May 1, 2018 to April 30, 2019, before the COVID-19 outbreak, respectively. Adult patients diagnosed with acute cerebral infarction at three emergency medical centers during the study period were included. COVID-19-positive patients (i.e., those with COVID-19 symptoms but those who tested positive) were excluded from this study to ensure only the evaluation of delays in stroke treatment due to the pandemic. Results: During the COVID-19 pandemic, of the total of 82,558 patients who visited the emergency centers, 710 were diagnosed with ischemic stroke. The study observed that the pandemic caused process delays for these patients, resulting in longer wait times for brain CT scans (P=0.010, P<0.001) and emergency room stays (P=0.0055, P<0.001) during the COVID-19 period. However, the length of time for administration of tissue plasminogen activator remained relatively constant. Notably, the 28-day mortality rate was considerably higher for patients with COVID-19-related symptoms during the pandemic (13.6% vs 3.1%; P=0.006). A cumulative risk analysis revealed an increased mortality risk for patients with COVID-19 related symptoms (P=0.005). Conclusion This study showed the need to improve emergency care procedures during pandemics to ensure prompt treatment of ischemic stroke. Preparation and resource allocation for ischemic stroke patients with COVID-19 symptoms are crucial.

Background: and Purpose The accurate prediction of functional outcomes in patients with acute ischemic stroke (AIS) is crucial for informed clinical decision-making and optimal resource utilization. As such, this study aimed to construct an ensemble deep learning model that integrates multimodal imaging and clinical data to predict the 90-day functional outcomes after AIS. Methods: We used data from the Korean Stroke Neuroimaging Initiative database, a prospective multicenter stroke registry to construct an ensemble model integrated individual 3D convolutional neural networks for diffusion-weighted imaging and fluid-attenuated inversion recovery (FLAIR), along with a deep neural network for clinical data, to predict 90-day functional independence after AIS using a modified Rankin Scale (mRS) of 3–6. To evaluate the performance of the ensemble model, we compared the area under the curve (AUC) of the proposed method with that of individual models trained on each modality to identify patients with AIS with an mRS score of 3–6. Results: Of the 2,606 patients with AIS, 993 (38.1%) achieved an mRS score of 3–6 at 90 days post-stroke. Our model achieved AUC values of 0.830 (standard cross-validation [CV]) and 0.779 (time-based CV), which significantly outperformed the other models relying on single modalities: b-value of 1,000 s/mm2 (P<0.001), apparent diffusion coefficient map (P<0.001), FLAIR (P<0.001), and clinical data (P=0.004). Conclusion The integration of multimodal imaging and clinical data resulted in superior prediction of the 90-day functional outcomes in AIS patients compared to the use of a single data modality.

BACKGROUND: Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases, following Alzheimer’s disease. The onset of PD is characterized by the loss of dopaminergic neurons in the substantia nigra. Stem cell therapy has great potential for the treatment of neurodegenerative diseases, and human nasal turbinate-derived stem cells (hNTSCs) have been found to share some characteristics with mesenchymal stem cells. Although the Hippo signaling pathway was originally thought to regulate cell size in organs, recent studies have shown that it can also control inflammation in neural cells. METHODS: Dopaminergic neuron-like cells were differentiated from SH-SY5Y cells (DA-Like cells) and treated with 1-Methyl-4-phenylpyridinium iodide to stimulate Reactive oxidative species (ROS) production. A transwell assay was conducted to validate the effect of hNTSCs on the Hippo pathway. We generated an MPTP-induced PD mouse model and transplanted hNTSCs into the substantia nigra of PD mice via stereotaxic surgery. After five weeks of behavioral testing, the brain samples were validated by immunoblotting and immunostaining to confirm the niche control of hNTSCs. RESULTS: In-vitro experiments showed that hNTSCs significantly increased cell survival and exerted anti-inflammatory effects by controlling ROS-mediated ER stress and hippocampal signaling pathway factors. Similarly, the in-vivo experiments demonstrated an increase in anti-inflammatory effects and cell survival rate. After transplantation of hNTSCs, the PD mouse model showed improved mobility and relief from PD symptoms. CONCLUSION hNTSCs improved the survival rate of dopaminergic neurons by manipulating the hippocampal pathway through Yes-associated protein (YAP)/transcriptional coactivator with a PDZ-binding motif (TAZ) by reducing inflammatory cytokines. In this study, we found that controlling the niche of hNTSCs had a therapeutic effect on PD lesions.

Background: and Purpose We investigated the impact of comorbidity burden on troponin elevation, with separate consideration of neurological conditions, in patients with acute ischemic stroke (AIS). Methods: This prospective, observational cohort study consecutively enrolled patients with AIS for 2 years. Serum cardiac troponin I was repeatedly measured, and disease-related biomarkers were collected for diagnosis of preassigned comorbidities, including atrial fibrillation (AF), ischemic heart disease (IHD), myocardial hypertrophy (MH), heart failure (HF), renal insufficiency (RI), and active cancer. The severity of neurological deficits and insular cortical ischemic lesions were assessed as neurological conditions. Adjusted associations between these factors and troponin elevation were determined using a multivariate ordinal logistic regression model and area under the receiver operating characteristic curve (AUC). Cox proportional hazards model was used to determine the prognostic significance of comorbidity beyond neurological conditions. Results: Among 1,092 patients (66.5±12.4 years, 63.3% male), 145 (13.3%) and 335 (30.7%) had elevated (≥0.040 ng/mL) and minimally-elevated (0.040–0.010 ng/mL) troponin, respectively. In the adjusted analysis, AF, MH, HF, RI, active cancer, and neurological deficits were associated with troponin elevation. The multivariate model with six comorbidities and two neurological conditions exhibited an AUC of 0.729 (95% confidence interval [CI], 0.698–0.759). In Cox regression, AF, IHD, and HF were associated with adverse cardio-cerebrovascular events, whereas HF and active cancer were associated with mortality. Conclusion Troponin elevation in patients with AIS can be explained by the burden of comorbidities in combination with neurological status, which explains the prognostic significance of troponin assay.