Cerebral Infarction Group Research Articles

Changes of deceleration and acceleration capacity of heart rate in patients with acute hemispheric ischemic stroke.

Background and purposeAutonomic dysfunction is common after stroke, which is correlated with unfavorable outcome. Phase-rectified signal averaging is a newly developed technique for assessing cardiac autonomic function, by detecting sympathetic and vagal nerve activity separately through calculating acceleration capacity (AC) and deceleration capacity (DC) of heart rate. In this study, we used this technique for the first time to investigate the cardiac autonomic function of patients with acute hemispheric ischemic stroke.MethodsA 24-hour Holter monitoring was performed in 63 patients with first-ever acute ischemic stroke in hemisphere and sinus rhythm, as well as in 50 controls with high risk of stroke. DC, AC, heart rate variability parameters, standard deviation of all normal-to-normal intervals (SDNN), and square root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals (RMSSD) were calculated. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of stroke. We analyzed the changes of DC, AC, SDNN, and RMSSD and also studied the correlations between these parameters and NIHSS scores.ResultsThe R–R (R wave to R wave on electrocardiogram) intervals, DC, AC, and SDNN in the cerebral infarction group were lower than those in controls (P=0.003, P=0.002, P=0.006, and P=0.043), but the difference of RMSSD and the D-value and ratio between absolute value of AC (|AC|) and DC were not statistically significant compared with those in controls. The DC of the infarction group was significantly correlated with |AC|, SDNN, and RMSSD (r=0.857, r=0.619, and r=0.358; P=0.000, P=0.000, and P=0.004). Correlation analysis also showed that DC, |AC|, and SDNN were negatively correlated with NIHSS scores (r=−0.279, r=−0.266, and r=−0.319; P=0.027, P=0.035, and P=0.011).ConclusionBoth DC and AC of heart rate decreased in patients with hemispheric infarction, reflecting a decrease in both vagal and sympathetic modulation. Both DC and AC were correlated with the severity of stroke.

Correlation between PPARg2 gene Pro12Ala polymorphism and cerebral infarction in an Inner Mongolian Han Chinese population.

The variant of PPAR-g2 has been shown to promote the increase of carotid IMT in patients suffering from cerebral infarction and the Pro12Ala polymorphism in the peroxisome proliferator-activated receptorg2 (PPARg2) gene may be associated with cerebral infarction. However, due to the different genetic background, race, and regional variations of cerebral infarction patient, the results of investigations into this subject differ. The aim of this study was to investigate this polymorphism in relation to cerebral infarction among the Inner Mongolian Han Chinese population. A total of 574 Han Chinese individuals from Inner Mongolian were selected randomly, including 302 patients with cerebral infarction and 272 healthy controls. Polymerase chain reaction-restriction fragment length polymorphism was used to determine genotypes of the PPARg2 Pro12Ala variant and results were confirmed by direct sequencing. Genotype frequencies were found to be 90.7 and 91.9% for P/P, 8.6 and 7.7% for P/A, and 0.7 and 0.4 for A/A in the cerebral infarction and control groups, respectively. No statistically significant differences in genotype distribution were observed between the two groups (P > 0.05). Moreover, PPARg2 Pro12Ala genotype was not significantly associated with altered fasting blood glucose, blood pressure, or serum lipid profiles. After adjustment for gender, body mass index, and smoking habit, logistic regression was used to analyze the relationship between the Pro12Ala polymorphism and cerebral infarction (odds ratio = 0.888, 95% confidence interval = 0.106-7.460, P > 0.05), revealing that this variant was not the main pathogenic factor involved. Therefore, the Pro12Ala mutation of PPARg2 may not be associated with cerebral infarction in the Inner Mongolian Han Chinese population.

Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke.

Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group (n = 22), a midbrain and pons infarction group (n = 16), and a multiple cerebral infarction group (n = 26) according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan (PC6), Renzhong (DU26), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), and Yifeng (SJ17). Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction (95.9%). These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient's swallowing ability and quality of life.

Association between norepinephrine transporter gene polymorphism and decision-making processing in patients with cerebral infarction

Objective To investigate the association between norepinephrine transporter (NET) gene polymorphism and decision-making processing in patients with cerebral infarction. Methods A total of 145 patients with cerebral infarction and 188 normal controls were enrolled in our study. In all subjects, the polymerase chain reaction (PCR) for NET-T182C/G1287A polymorphism assay, gel electrophoresis, image analysis and enzymatic reaction, gene sequencing methods were used. The relationships of NET-T182C/G1287A genotypes and alleles with decision-making processing were analyzed in patients with cerebral infarction.All participants completed six kinds of choice situational problems. Results There were significant differences in genotype and allele frequencies of T182C and G1287A polymorphism in NET between the patients with cerebral infarction and control group(for NET-T182C: genotype, χ2=4.437, P=0.049, allele frequency, χ2=4.363, P=0.037, OR=0.625, 95%CI: 0.436-0.895; for NET-G1287A: genotype, χ2=8.435, P=0.038, allele frequency, χ2=2.765, P=0.036, OR=1.520, 95%CI: 1.053-2.193). The cerebral infarction patients with three NET-T182C genotypes and T/C alleles all completed six choice scenarios, and the scheme selection probability had no significant difference (all P>0.05). In high-risk and no-risk loss situation (scenario 4), the scheme selection probability had significant difference in cerebral infarction patients with NET-G1287A genotypes and G/A alleles (P 0.05). Conclusions NET-G1287A polymorphism may be associated with decision-making processing in patients with cerebral infarction. In the high-risk and no-risk loss condition, patients with GG genotype and G allele have more loss risk aversion. Key words: Brain infarction; Choice behavior; Norepinephrine plasma membrane transport proteins; Polymorphism, single nucleotide

ALDH2*2 Allele is a Negative Risk Factor for Cerebral Infarction in Chinese Women.

Unlike its reported role in the cardiovascular diseases, little information is available for mitochondrial aldehyde dehydrogenase 2 (ALDH2) in the cerebrovascular function. We investigated the different effects of ALDH2 genotypes on the risk of cerebral infarction between the genders, because different genders had different smoking and/or dinking status which are also risk factors for cerebral infarction. 247 healthy Chinese Han people (controls, group 1), 287 Chinese Han male patients with cerebral infarction (group 2), and 82 Chinese Han female patients with cerebral infarction (group 3) were involved in this study. The frequencies of the ALDH2*2 allele in group 3 were significantly higher than those in other groups (with P=0.001 and P=0.002, respectively). The difference of ALDH2*2 allele frequency between group 1 and group 2 was not significant (P=0.652). After adjustment for smoking and drinking status, the male patients without smoking or drinking status (group 4) had higher ALDH2*2 allele frequency than group 1, but the difference was still not significant (P=0.139). Thus, we conclude that ALDH2*2 allele may be a significant negative risk factor for cerebral infarction in Chinese women [odds ratio (OR)=2.207, 95% CI 1.416-3.439]. But for Chinese male patients, the negative effects of ALDH2*2 allele on cerebral infarction which might be concealed by other risk factors were not significant.

Correlating interleukin-10 promoter gene polymorphisms with human cerebral infarction onset.

Evidence suggests that interleukin-10 (IL-10) deficiency exacerbates inflammation and worsens the outcome of brain ischemia. In view of the critical role of the single nucleotide polymorphic sites -1082 (A/G) and -819 (C/T) in the promoter region of the IL-10 gene, we hypothesized that they are associated with cerebral infarction morbidity in the Chinese Han population. We genotyped these allelic gene polymorphisms by amplification refractory mutation system-polymerase chain reaction methods in 181 patients with cerebral infarction (cerebral infarction group) and 115 healthy subjects (control group). We identified significant differences in genotype distribution and allele frequency of the IL-10-1082 A/G allele between cerebral infarction and control groups (χ2 = 6.643, P = 0.010). The IL-10-1082 A allele frequency was significantly higher in the cerebral infarction group (92.3%) than in the control group (86.1%) (P = 0.015). Moreover, cerebral infarction risk of the AA genotype was 2-fold higher than with the AG genotype (OR = 2.031, 95%CI: 1.134–3.637). In addition, AA genotype together with hypertension was the independent risk factor of cerebral infarction (OR = 2.073, 95%CI: 1.278–3.364). No statistical difference in genotype distribution or allele frequency of IL-10-819 C/T was found between cerebral infarction and control groups (P > 0.05). These findings suggest that the IL-10-1082 A/G gene polymorphism is involved in cerebral infarction, and increased A allele frequency is closely associated with occurrence of cerebral infarction.

Comparison of Long-Term Clinical Outcomes after Drug-Eluting Stent Implantation in Patients with Coronary Artery Disease with and without Prior Cerebral Infarction.

To compare the clinical and angiographic outcomes after implantation of drug-eluting stents (DESs) in patients with coronary artery disease (CAD) with or without prior cerebral infarction. Ninety-eight consecutive patients (130 lesions) who underwent successful coronary DES implantation were prospectively classified into two groups: those with a clinical history of symptomatic cerebral infarction (cerebral infarction group, 49 patients, 69 lesions) and those without a clinical history of symptomatic cerebral infarction (noncerebral infarction group, 49 patients, 61 lesions). The primary endpoint was defined as death, nonfatal myocardial infarction, and cerebrovascular events. The Kaplan-Meier method was used to create a primary endpoint curves to determine the time-dependent cumulative primary endpoint-free rate, which were compared using the log-rank test. The incidence of primary endpoints was higher in the cerebral infarction group than in the noncerebral infarction group (p = 0.0075). The Cox proportional hazards regression model for primary endpoint identified prior cerebral infarction (p = 0.0331, hazard ratio = 2.827) and patients with peripheral artery disease (p = 0.0271, hazard ratio = 2.757) as explanatory factors. The results showed that clinical outcomes were poorer in patients with CAD who had prior cerebral infarctions than in those who did not have infarction.

Clinical investigation on relationship among lipoprotein(a), cerebral infarction and carotid atherosclerosis

Objective To investigate the correlation among Lp(a), cerebral and carotid atherosclerosis. Methods 180 cases were equally divided into 3 groups(60 cases in each group). The patients with both cerebral and carotid atherosclerosis composed one group(cerebral for short); the patients of carotid atherosclerosis which without cerebral composed another group(no cerebral infarction group for short); the control group composed with those who had neither cerebral nor carotid atherosclerosis. The level, outlier detection rate about Lp(a)and usual risk factors of cerebral were compared in this research. Results The level and detection rate of Lp(a)in the cerebral group were(512±156)mg/L and 46.7%;the level and detection rate of Lp(a)in the no cerebral group were(316±87)mg/L and 20.0%; the level and detection rate of Lp(a)in the control group were(199±123)mg/L and 5.0%. The differences of the level and outlier detection rate of Lp(a)among the three group were significant(F= 13.87,χ2= 29.394,P< 0.01). Cerebral patients had more usual risk factors of cerebral (hypertension, diabetes, hyperlipemia, drinking, smoking, obesity and lack of exercise)than those who without cerebral infarction(χ2= 15.523,P< 0.01). Conclusion The abnormal of Lp(a) was an important risk factor of cerebral infarction. The general survey of Lp(a) was significant in the primary and secondary prevention of stroke. To the people whose assay of Lp(a)was abnormal, the control of governable risk factors of cerebral should actively be carried out. Key words: Lipoprotein(a); Cerebral infarction; Carotid artery diseases; Atherosclerosis

Evaluating the risk of ischemic cerebral vascular disease with ocular hemodynamics in carotid artery stenosis patients

To evaluate the association between the ocular hemodynamic and the incidence of ischemic cerebral vascular diseases in carotid artery stenosis patients. Case-control study. Seventy-two cases patients with carotid artery stenosis including 22 cases of cerebral infarction group, 14 cases of lacunar cerebral infarction group and the control group of the other 36 patients without cerebral infarction were recruited. All patients were measured with hemodynamic parameters of the ophthalmic artery, central retinal artery and posterior ciliary artery. PSV, EDV, PI and RI were also measured. The other risk ischemic cerebral vascular factors were obtained through the questionnaire and venous blood sampling. The differences of 3 groups and the influences of the other risk factor of hemodynamic were calculated. PSV of ophthalmic artery was (25.96 ± 12.63)cm/s in cerebral infarction group, (32.63 ± 13.25) cm/s in lacunar infarction group and (39.46 ± 14.97) cm/s in control group. EDV of ophthalmic artery was(6.09 ± 3.10) cm/s in cerebral infarction group, (6.57 ± 2.85) cm/s in lacunar infarction group and (9.73 ± 5.02) cm/s in control group. PSV of central retinal artery was (8.06 ± 2.98) cm/s in cerebral infarction group, (8.91 ± 2.76) cm/s in lacunar infarction group and (9.71 ± 2.60) cm/s in control group. The differences were statistically significant (F = 13.393, 12.609, 5.027, P < 0.01). EDV of central retinal artery was (2.46 ± 0.77) cm/s in cerebral infarction group, (2.35 ± 0.89) cm/s in lacunar infarction group and (2.73 ± 0.86) cm/s in control group. There was no statistical difference of EDV of CRA in three group (F = 2.405, P = 0.094). There was association between the ocular hemodynamic parameters and the incidence of ischemic cerebrovascular disease in the carotid artery stenosis patients. Increased level of PSV and EDV of the ophthalmic artery raised the risk of the incidence of ischemic cerebrovascular disease.

Abstract 11236: Prevalence and Risk Factors of Catheterization-Related Cerebral Infarction: Evaluation at Diffusion-Weighted Magnetic Resonance Imaging

Introduction: Due to improvements of catheter design and approach, catheterization-related cerebral infarctions are expected to decrease, whereas this may be counterbalanced by increased risk profile of patients who undergo catheterization. Aims: The aim of this study is to examine the prevalence and risk factors of symptomatic and asymptomatic catheterization-related cerebral infarctions in the contemporary era, using diffusion-weighted magnetic resonance imaging (MRI). Methods and Results: We retrospectively analyzed 84 patients who underwent 1237 diagnostic and interventional catheterization procedures conducted within 2010 and 2011 in our hospital and who obtained the MRI within 14 days after catheterization. Among these, 10 patients developed a neurological event underwent MRI for suspected cerebral infarction (group A), whereas 74 patients were asymptomatic and underwent MRI for various reasons (group B); 52% of patients for the assessment before coronary bypass or surgery of aortic valve, 19% for the systemic vascular assessment for atherosclerotic diseases, and 28% for other reasons. The MRI revealed a fresh cerebral infarction in 5 patients in group A and 22 patients (29.7%) in group B. In patients with infarct lesions, more number of catheters were used (p=0.01), the intravascular procedure was longer (mean ± SEM, 17.1 ± 1.7 minutes vs. 22.7 ± 2.4 minutes, p=0.06), and the mean age tended to be higher (mean ± SEM, 74.1 ± 1.67 vs. 70.4 ± 1.1, p=0.07). The features of infarction were as follows: 62.9% of patients had multiple lesions and relatively small lesions in asymptomatic patients compared to those in symptomatic patients. Conclusions: Symptomatic cerebral infarction occurred after 5 of 1237 (0.4%) procedures. However, the rate of asymptomatic catheterization-related cerebral infarctions detected using diffusion-weighted MRI remains high in high-risk patients or candidates for cardiac surgery, when the rate is compared to that reported by previous studies conducted around 10 years ago. More number of catheters used and longer procedure time were associated with cerebral infarction in present study and careful procedural planning is warranted.

Level analysis and nursing countermeasures of low density lipoprotein and homocysteine in patients with transient ischemic attack

Objective To explore risk factors of transient ischemic attack (TIA) at the first time,to provide effective and workable nursing intervention and health education in view of risk factors,so as to effectively reduce bad prognosis of TIA.Method 125 cases of TIA and 68 cases of cerebral infarction in neurology department of our hospital from January 2012 to January 2014 were selected,and collected their base data and laboratory test results.Result There were statistically significant differences in smoking,drinking,NIHSS score,MRS score,low density lipoprotein (LDL) and homocysteine (Hcy) between TIA group and cerebral infarction group (P ＜ 0.05).Conclusion In order to reduce poor prognosis of TIA patients for the first time,nurses should take effective measures to assist patients to give up smoking and drinking,keep on a diet,actively lower LDL and Hcy levels according to specific condition of patients. Key words: Transient ischemic attack; Cerebral infarction; Risk factor; Nursing countermeasures

Effects of the difference between peripheral arterial and central arterial blood pressures on patients with cerebral lacunar infarction

Objective To analyze the effects of the difference between the peripheral arterial and the central arterial blood pressures on cerebral lacunar infarction.Methods The cerebral lacunar infarction group (n =129) and control group (n =122) were set up.The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the ascending aorta and radial artery were simultaneously recorded postoperatively,and mean artery pressure (MAP) and pulse pressure (PP) were calculated.Results There was no significant difference between cerebral lacunar infarction group and control group in basic blood pressure,blood lipid,blood glucose,heart rate,age and sex (all P ＞ 0.05).The difference of SBP [(7.6 ± 2.3) mmHg(1 mmHg=0.133 kPa) vs.(23.6 ±5.7) mmHg],MAP [(6.6 ±2.1) mmHg vs.(20.1 ±6.2) mmHg] and PP [(5.8 ± 1.7) mmHg vs.(12.9 ±5.3) mmHg] between the peripheral and aortic pressures in cerebral lacunar infarction group was higher than in control group (P ＜ 0.05),but there was no significant difference in SBP [(132.8 ± 13.1) mmHg vs.(134.9 ± 12.5) mmHg],MAP [(107.8 ± 10.1) mmHg vs.(111.2 ±9.4) mmHg],PP [(51.7 ±6.9) mmHg vs.(49.7 ±6.2) mmHg],and DBP [(84.2 ± 9.3) mmHg vs.(82.1 ± 8.6) mmHg] in radial artery between the two groups (all P ＞0.05),and there was no significant difference in DBP [(80.7 ±7.5) mmHg vs.(76.7 ±7.2) mmHg] in the ascending aorta and the difference of DBP between the peripheral and aortic pressures between the two groups,too (all P ＞ 0.05).Conclusion The difference of SBP,MAP and PP between the peripheral arterial and the central arterial blood pressures was correlated with cerebral lacunar infarction. Key words: Peripheral arterial blood pressure; Central arterial blood pressure; Cerebral lacunar infarction

The role of thromboxane A2 receptor gene promoter polymorphism in acute cerebral infarction

To investigate the association between thromboxane A2 receptor (TXA2R) gene promoter rs2271875, rs768963 polymorphism and acute cerebral infarction in Chinese Han population. A prospective study was conducted. From October 2009 to May 2013, 223 patients with cerebral infarction (cerebral infarction group) and 142 cohorts with normal physical examination results (control group) from Taizhou City Central Hospital in Zhejiang Province were enrolled. Triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were determined by enzymatic colorimetry, whereas blood glucose was determined with hexokinase. The genotypes of rs2271875 and rs768963 polymorphism in TXA2R gene were detected by the polymerase chain reaction-ligase detection reaction (PCR-LDR) technique. Differences in gender, age, serum TG, TC, HDL-C, LDL-C, concentration of blood glucose, and blood pressure (systolic pressure, diastolic pressure) between cerebral infarction group and control group were compared as well as TXA2R promoter rs2271875, rs768963 genotype and allele frequencies distribution. The significant differences in males (147 cases vs. 57 cases, χ(2)=23.385, P=0.000), serum TG (2.02±1.14 mmol/L vs. 1.56±0.79 mmol/L, t=4.663, P=0.000), blood glucose (6.40±2.50 mmol/L vs. 5.28±0.92 mmol/L, t=6.084, P=0.000), systolic pressure (146.64±21.34 mmHg vs. 135.73±18.09 mmHg, t=5.234, P=0.000), diastolic blood pressure (86.29±11.79 mmHg vs. 80.74±11.23 mmHg, t=4.468, P=0.000) between cerebral infarction patients and controls were found. The results from multi-logistic regression analysis suggested that male was an independent risk factor for cerebral infarction [odds ratio (OR) 3.300, 95% confidence interval (95%CI) 1.905-5.175, P=0.000]. There were statistically significant differences between infarction group and the control group both in aspects of genotype (TT: 0.112 vs. 0.183, TC: 0.498 vs. 0.535, CC: 0.390 vs. 0.282, χ(2)=6.298, P=0.043) and the allele frequency distribution (T: 0.361 vs. 0.451, C: 0.639 vs. 0.549, χ(2)=5.839, P=0.016) of TXA2R gene rs768963. No statistical significant difference was found in rs2271875 in respect of genotype (GG: 0.336 vs. 0.352, GA: 0.480 vs. 0.451, AA: 0.184 vs. 0.197, χ (2)=0.302, P=0.859) and the allele frequency distribution (G: 0.576 vs. 0.577, A: 0.424 vs. 0.423, χ(2)=0.001, P=0.974). Coefficient of both linkage disequilibrium (D') of rs2271875 and rs768963 was 0.684. When the pair was haplotype AT, the frequency in the infarction group was significantly lower than that in the control group (0.034 vs. 0.081, χ(2)=7.883, P=0.005). rs768963 gene mutation, but not that of the rs2271875, showed significant correlation with the occurrence of cerebral infarction. There was a loose linkage disequilibrium between rs2271875 and rs768963 of TXA2R. Haplotype AT reduces the risk of cerebral infarction.

Correlation between the single nucleotide polymorphisms of the human phosphodiesterase 4D gene and the risk of cerebral infarction in the Uygur and Han ethnic groups of Xinjiang, China

In this study, the correlation between the single nucleotide polymorphisms (SNPs) at rs2910829 and rs918592 in the phosphodiesterase 4D (PDE4D) gene and cerebral infarction in the Uygur and Han ethnic groups of Xinjiang, China were examined. The study population consisted of 373 Uygur and Han patients with cerebral infarction and 377 Uygur and Han control participants with no nervous system diseases. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and gene sequencing methods were used to assess the SNPs at the rs2910829 and rs918592 loci in the PDE4D gene. The differences in genotype and allele frequency distribution were compared between the two groups. The C allele frequency of the rs2910829 locus in the PDE4D gene of the cerebral infarction group (81.0%) was significantly higher than that of the control group (76.4%) (P<0.05). Furthermore, the A allele frequency of the rs918592 locus in the PDE4D gene in the Uygur cerebral infarction group was significantly higher than that of the Uygur control group (P<0.05). There were no significant differences in the genotype and allele frequency distributions between the Uygur and Han groups (P>0.05). The A allele of the rs918592 locus may be associated with the occurrence of cerebral infarction in the Uygur population. In addition, it was indicated that the C allele of the rs2910829 locus in the PDE4D gene confers susceptibility to cerebral infarction; however, no significant difference was identified between Uygur and Han patients with cerebral infarction.

Susceptibility gene for stroke or cerebral infarction in the Han population in Hunan Province of China.

The scavenger receptor class B type I gene can protect against atherosclerosis; a mononucleotide polymorphism is associated with differences in blood lipid metabolism, postprandial serum lipid levels, insulin resistance, coronary artery disease and familial hyperlipidemia. In this study, the scavenger receptor class B type I gene exon 1 G4A gene polymorphism in atherosclerotic cerebral infarction patients, cerebral hemorrhage patients and normal controls was detected using the polymerase chain reaction-restriction fragment length polymorphism method. The results showed that the GA + AA genotype frequency of scavenger receptor class B type I gene G4A in atherosclerotic cerebral infarction patients was similar to that in cerebral hemorrhage patients and normal controls; however, the A allele frequency was significantly lower than that in normal controls. The serum level of high-density lipoprotein cholesterol in patients with the scavenger receptor class B type I gene G4A GA + AA genotype was significantly higher, while the serum level of low-density lipoprotein cholesterol was significantly lower than that in patients with the GG genotype, in both the atherosclerotic cerebral infarction and cerebral hemorrhage groups. The serum level of high-density lipoprotein cholesterol in patients with the scavenger receptor class B type I gene G4A GA + AA genotype was significantly higher, while the serum levels of low-density lipoprotein cholesterol and total cholesterol were significantly lower than those in normal controls with the GG genotype. Our experimental results suggest that the G4A polymorphism of the scavenger receptor class B type I gene is a possible predisposing risk factor for atherosclerotic cerebral infarction, and that it has no association with cerebral hemorrhage in the Han population in Hunan province of China. The A allele is possibly associated with the metabolism of high-density and low-density lipoprotein cholesterol.

Significance of brain stem auditory evoked potential and somatosensory evoked potential on prognosis evaluation in patients with acute cerebral infarction

Objective To investigate changes of brainstem auditory evoked potential (BAEP)and somatosensory evoked potential (SEP) in patients with acute cerebral infarction,and discuss their relation with prognosis of the patients.Methods The study involved 60 patients with acute cerebral infarction.Changes of BAEP and SEP in each patient were detected and recorded continuously.Prognosis evaluation was performed by using GCS.Another 60 age-matched and gender-matched healthy human beings were enrolled as controls.Results Incubation period of BAEP wave Ⅰ had no significant difference between the cerebral infarction and control groups (P ＞ 0.05).However,interspike intervals of other BAEP waves in cerebral infarction group were different from those in control group (P ＜ 0.05).A series of waves of SEP (P14-N60) were all significantly prolonged in cerebral infarction group (P ＜0.05).Conclusion BAEP and SEP can effectively reflect function of brain stem in patients with acute cerebral infarction and have some values in determining their prognosis. Key words: Brain injuries; Evoked potential,auditory; Evoked potential,somatosensory; Acute cerebral infarction

뇌졸중 환자의 체질별 혈액학적 특성 -1개 한방병원의 입원환자를 중심으로-

Objectives The purpose of this study is to know hematologic characteristics of patients with stroke in Sasang Constitutional Medicine which will be helpful for the prevention and treatment of stroke. Methods We collected data from 111 patients who received treatment as a stroke inpatient at one Korean medicine hospital in Busan, Korea. A Sasang Constitutional Medicine(SCM) specialist diagnosed their Sasang Constitutional types based on the four diagnosis standard of SCM and herbal medicine reaction. Results of hematologic tests were classified according to gender, age, stroke types and Sasang Constitutional types and analysed by SAS system. Results 1. Male's mean value of RBC count, Hemoglobin and Hematocrit was lower than normal range. 2. The mean value of hsCRP of above age 65 group was 3.19 times significantly higher than under age 65 group. 3. The mean value of platelet of cerebral hemorrhage group was significantly higher than cerebral infarction group. 4. The mean value of triglyceride of Taeeumin was significantly higher than Soyangin and Soeumin. Conclusions For the prevention of stroke, appropriate treatment of stress, trauma and infections is needed and male require a regular and balanced meals. Especially Taeeumin need to eat small meals to avoid excessive accumulation of energy.

Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease.

Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases (83%) with convict vascular stenosis and perfusion abnormalities, and five cases (45%) with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores ≥ 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores < 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.

Does Motor Dysfunction After Cerebral Infarction Impede the Development of Angina Symptoms?

Previous studies based on coronary angiography or computed tomography coronary angiography have demonstrated a high prevalence of coronary stenosis in patients with cerebral infarction and no prior history of coronary artery disease (CAD). The purpose of the present study was to compare the coronary angiographic findings of patients with prior cerebral infarction with those of patients with no prior cerebral infarction. Consecutive patients (n = 126) who underwent a first coronary angiography for suspected CAD but had no prior history of CAD were classified into 2 groups, those with a clinical history of cerebral infarction (cerebral infarction group) and those without a clinical history of cerebral infarction (noncerebral infarction group). The incidences of diabetes mellitus, peripheral artery disease, coronary stenosis, and multivessel disease were significantly higher in the cerebral infarction group than in the noncerebral infarction group. Multiple logistic regression analysis relating to coronary stenosis identifi ed prior cerebral infarction (P = 0.0027, odds ratio = 4.414) and diabetes mellitus (P = 0.0446, odds ratio = 2.619) as explanatory factors. Thirty-four of 78 patients (44%) with coronary stenosis did not have angina symptoms. Multiple logistic regression analysis regarding the lack of angina symptoms identified motor dysfunction (modified Rankin scale ≥ 2) (P = 0.0028, odds ratio = 8.323) as an explanatory factor. The results of the present study suggest that compared with patients without cerebral infarction those with the disorder have a high prevalence of coronary stenosis, and indicate that the development of angina symptoms is influenced by the severity of motor dysfunction.

Interaction between ALOX5AP-SG13S114A/T and COX-2-765G/C increases susceptibility to cerebral infarction in a Chinese population

We made a case-control study to investigate a possible association between ALOX5AP-SG13S114A/T, COX-2-765G/C, and COX-1-50C/T polymorphisms with cerebral infarction in a Chinese population. A total of 411 cases with cerebral infarction were included; 411 controls matched for age, gender, and risk factors were also selected. The ALOX5AP-SG13S114A/T (rs10507391), COX-2-765G/C (rs20417), and COX-1-50C/T (rs3842787) polymorphisms were determined using PCR-RFLP. The generalized multifactor dimensionality reduction method was employed to detect gene-gene interactions. Based on single-gene analysis, there were no significant differences in the genotype and allele frequency distributions of ALOX5AP-SG13S114A/T, COX-2-765G/C, and COX-1-50C/T between the cerebral infarction group and controls. However, in those cases carrying ALOX5AP-SG13S114AA as well as COX-2-765CC, the risk of cerebral infarction increased significantly by 2.84 times (95%CI = 1.324-6.543). The single-gene ALOX5AP-SG13S114A/T, COX-2-765G/C, and COX-1-50C/T polymorphisms appear not to be associated with the development of cerebral infarction in Chinese populations. However, the interaction between ALOX5AP-SG13S114AA and COX-2-765CC apparently increases susceptibility to cerebral infarction.