대형 3D 프린팅 기술동향 및 산업전망

비매품/무

상변화 메모리 기술

납본여부: 납본

Association between Low Ankle-Brachial Index and Poor Outcomes in Patients with Embolic Stroke of Undetermined Source

We investigated the association of low ankle-brachial index (ABI < 0.9) with major adverse cardiovascular events (MACE) and all-cause mortality in patients with embolic stroke of undetermined source (ESUS) as well as whether the association differed by ESUS subtype. This retrospective single-center study included ESUS patients who underwent transesophageal echocardiography and ABI during hospitalization. ESUS was classified as ESUS with minor cardioembolic source, arteriogenic embolism, two or more causes, or no cause. Arteriogenic embolism was defined and classified as complex aortic or non-stenotic relevant artery plaque. MACE was defined as stroke recurrence, acute coronary syndrome, hospitalization for heart failure, or death. Overall, 829 patients were included, with a median follow-up of 45.8 months. Of these, 42 (5.1%) and 370 (44.6%) had low ABI and arteriogenic embolism, respectively. ABI < 0.9 was independently associated with MACE (hazard ratio [HR]: 2.038, 95% confidence interval [CI]: 1.093-3.801) and all-cause mortality (HR: 3.608, 95% CI: 1.538-8.465) according to the multivariable Cox regression analysis. Between ESUS subtypes, low ABI was independently associated with MACE (HR: 2.513, 95% CI: 1.257-5.023) and all-cause mortality (HR: 5.681, 95% CI: 2.151-15.008) in arteriogenic embolism patients, especially in those with complex aortic plaque. However, in non-arteriogenic embolism patients, low ABI was not related to MACE and mortality. In ESUS patients, low ABI was linked to MACE and all-cause mortality, especially in those with arteriogenic embolisms from complex aortic plaque.ope

Low Toe–Brachial Index Is Associated With Stroke Outcome Despite Normal Ankle–Brachial Index

Introduction: We investigated whether the toe–brachial index (TBI) is associated with stroke prognosis and evaluated this association in patients with normal ankle–brachial index (ABI). Methods: Acute ischemic stroke patients who underwent TBI measurements were enrolled. Poor functional outcome was defined as modified Rankin Scale score ≥3. Major adverse cardiovascular event (MACE) was defined as stroke recurrence, myocardial infarction, or death. Normal ABI was defined as 0.9 ≤ ABI ≤ 1.4. Results: A total of 1,697 patients were enrolled and followed up for a median 39.7 (interquartile range, 25.7–54.6) months. During the period, 305 patients suffered MACE (18.0%), including 171 (10.1%) stroke recurrences. TBI was associated with hypertension, diabetes, atrial fibrillation, aortic plaque score, ABI, and brachial–ankle pulse wave velocity (all p < 0.05). In multivariable logistic regression, TBI was inversely associated with poor functional outcome in all patients [odds ratio (OR) 0.294, 95% confidence interval (CI) 0.114–0.759], even in patients with normal ABI (OR 0.293, 95% CI 0.095–0.906). In multivariable Cox regression, TBI < 0.6 was associated with stroke recurrence [hazard ratio (HR) 1.651, 95% CI 1.135–2.400], all-cause mortality (HR 2.105, 95% CI 1.343–3.298), and MACE (HR 1.838, 95% CI 1.396–2.419) in all patients. TBI < 0.6 was also associated with stroke recurrence (HR 1.681, 95% CI 1.080–2.618), all-cause mortality (HR 2.075, 95% CI 1.180–3.651), and MACE (HR 1.619, 95% CI 1.149–2.281) in patients with normal ABI. Conclusions: Low TBI is independently associated with poor short- and long-term outcomes in acute ischemic stroke patients despite normal ABI.ope

Automated Composition Analysis of Thrombus from Endovascular Treatment in Acute Ischemic Stroke Using Computer Vision

ope

Impact of Sarcopenia on Functional Outcomes Among Patients With Mild Acute Ischemic Stroke and Transient Ischemic Attack: A Retrospective Study

Introduction: Sarcopenia, a age-related disease characterized by loss of muscle mass accompanied by loss of function, is associated with nutrition imbalance, physical inactivity, insulin resistance, inflammation, metabolic syndrome, and atherosclerosis which are risk factors for cardiovascular disease. However, its association with outcomes after ischemic stroke has not been well-established. This study investigated whether functional outcomes of patients with acute ischemic stroke is associated with sarcopenia. Methods: Data were collected from 568 consecutive patients with acute ischemic stroke with National Institute of Health Stroke Scale 0-5 or transient ischemic attack who underwent bioelectrical impedance analysis between March 2018 and March 2021. Sarcopenia was defined, as low muscle mass, as measured by bioelectrical impedance analysis, and low muscle strength, as indicated by the Medical Research Council score. Unfavorable functional outcome was defined as mRS score of 2-6 at 90 days after discharge. The relationship between functional outcomes and the presence of sarcopenia or its components was determined. Results: Of the 568 patients included (mean age 65.5 ± 12.6 years, 64.6% male), sarcopenia was detected in 48 (8.5%). After adjusting for potential confounders, sarcopenia was independently and significantly associated with unfavorable functional outcome (odds ratio 2.37, 95% confidence interval 1.15-4.73 for unfavorable functional outcome, odds ratio 2.10, 95% confidence interval 1.18-3.71 for an increase in the mRS score). Each component of sarcopenia was also independently associated with unfavorable functional outcome (odds ratio 1.76, 95% confidence interval 1.05-2.95 with low muscle mass, odds ratio 2.64, 95% confidence interval 1.64-4.23 with low muscle strength). The impact of low muscle mass was larger in men than in women, and in patients with lower muscle mass of the lower extremities than in those with lower muscle mass of the upper extremities. Conclusions: In this study, the prevalence of sarcopenia in patients with stroke was lower than most of previous studies and patients with sarcopenia showed higher likelihood for unfavorable functional outcomes at 90 days after acute ischemic stroke or TIA. Further investigation of the interventions for treating sarcopenia and its impact on the outcome of ischemic stroke patients is needed.ope

Usefulness of perfusion-weighted CT imaging in acute cerebral infarction

의학과/석사[한글] 본 연구는 급성 뇌경색 환자에서 관류강조컴퓨터단층촬영이 예후를 예측하는 데에 유용한지에 대해 알아보고자 하였다. 증상 발현 6시간 이내인 29명의 급성 중대뇌동맥 경색 환자를 대상으로 하였고, 관류강조켬퓨터단층촬영에서 뇌혈류량 감소 부위와 뇌혈류 감소 부위의 크기를 비교하였다. 뇌혈류량 감소 부위가 뇌혈류 감소 부위보다 작은 군과 같은 군으로 나눈 뒤, 다시 각 군을 혈전용해제 투여군과 투여하지 않은 군으로 나누었다. 환자의 임상증상 호전 정도는 내원 및 퇴원시에 MRS 점수와 NIHSS 점수를 측정하여 점수의 차이를 비교하였다. 1. 뇌혈류량 감소 부위가 뇌혈류 감소 부위보다 작은 군에서 같은 군보다 유의하지는 않았지만 임상증상이 호전되는 경향을 보였다. 2. 뇌혈류량 감소 부위가 뇌혈류 감소 부위보다 작은 군에서 혈전용해제를 투여한 경우에 유의하게 임상증상이 호전되었으나, 혈전용해제를 투여하는 않은 경우에는 오히려 임상 증상이 악화되었다. 3. 뇌혈류량 감소 부위가 뇌혈류 감소 부위와 같은 군에서 혈전용해제 투여군과 투여하지 않은 군 사이에 임상증상 호전에 있어 유의한 차이가 없었다. 이상의 결과로 급성 뇌경색에서 뇌혈류량 감소 부위가 뇌혈류 감소 부위보다 작고 혈전용해제를 투여한 경우 환자의 예후가 좋았다. 따라서 급성 뇌경색 환자에서 관류강조컴퓨터단층촬영은 환자의 예후를 예측하는데 유용한 검사 방법이 될 것으로 사료된다. [영문] The goal of this study was to evaluate the utility of perfusion-weighted CT in predicting clinical outcome in patients with acute cerebral infarction. Twenty-nine patients with acute middle cerebral artery infarction who were admitted to Wonju Christian Hospital within 6 hours of stroke onset had brain noncontrast CT and perfusion-weighted CT imaging. A total of four groups were assembled by the difference in hypoperfused lesion between cerebral blood volume (CBV) and cerebral blood flow (CBF), then further dividing the two groups according to use of thrombolytic therapy. Degree of clinical improvement was compared. Degree of clinical improvement was significantly different between group 1 and 2 in which hypoperfused lesion in CBV were smaller than that in CBF. Group 1 which was infused with thrombolytic agent had a higher degree of clinical improvement. On the other hand, group 3 and 4 in which hypoperfused lesion in CBV were similar with that in CBF showed no significant difference in clinical outcome even though group 3 was infused with thrombolytic agent According to this study, perfusion CT will be useful tool for prediction of clinical outcome in acute cerebral infarction.ope