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Biomedical subjects

Soo Joo Lee

Publications and source records attributed to Soo Joo Lee.

6 recordsLinked to original sources

Age-related changes in glycogen synthase kinase 3beta (GSK3beta) immunoreactivity in the central nervous system of rats.

Although glycogen synthase kinase 3beta (GSK3beta) is emerging as a prominent drug target in the treatment of neurodegenerative diseases such as Alzheimer's disease (AD) and stroke, very little is known about age-related changes in GSK3beta expression and GSK3beta phosphorylation. Therefore, we examined age-related changes in immunoreactivities for GSK3beta and phosphorylated GSK3beta (pGSK3beta) in the central nervous system. In aged rats, there were significant increases in GSK3beta immunoreactivity in the cell bodies and processes of pyramidal cells in most cortical regions. GSK3beta immunoreactivity was also significantly increased in the pyramidal layer of CA1-3 regions, and the granule cell layer of dentate gyrus. Age-related increases were prominent in lateral septal nuclei, compared to the medial septal nuclei. Interestingly, both GSK3beta and pGSK3beta was increased in the prefrontal cortex, while GSK3beta and pGSK3beta was differentially localized in the cerebellar cortex. The first demonstration of age-related alterations in immunoreactivities for GSK3beta and pGSK3beta in the basal forebrain area and cholinergic projection targets may provide useful data for investigating the pathogenesis of age-related neurodegenerative diseases including AD.

Aging↗

Multiphasic helical computed tomography predicts subsequent development of severe brain edema in acute ischemic stroke.

OBJECTIVE: To evaluate the use of multiphasic helical computed tomography (CT) in predicting subsequent development of severe brain edema in patients with acute middle cerebral artery (MCA) stroke. DESIGN: Case-control study. SETTING: Tertiary referral hospital. PATIENTS: We studied 31 patients with acute MCA stroke who had a baseline National Institutes of Health Stroke Scale score of 15 or higher within 6 hours of symptom onset. Sequential 4-phasic enhanced helical CT scans were performed after taking precontrast CT scans. The severity of perfusion deficit was graded as "severe" or "moderate" depending on collateral blood flow. MAIN OUTCOME MEASURES: Patients were classified as having severe brain edema if they showed signs of uncal herniation or deterioration with mass effect leading to hemicraniectomy. RESULTS: Severe brain edema developed in 10 patients (32%). Severe perfusion deficit greater than 50% of the presumed MCA territory on multiphasic helical CT was more often found in patients with severe brain edema than in those without (8 of 10 vs 4 of 21, P =.002). In contrast, parenchymal hypodensity greater than 50% on precontrast CT was observed only in 5 patients with severe brain edema (5 of 10 vs 4 of 21, P =.10). Additional involvement of the anterior or posterior cerebral artery territory was found on multiphasic CT (6 of 10 vs 0 of 21, P <.001) and on precontrast CT (4 of 10 vs 0 of 21, P =.007) only in patients with severe brain edema. CONCLUSION: Multiphasic helical CT is more useful than precontrast CT for predicting subsequent severe brain edema in acute MCA stroke based on the findings of severe perfusion deficit greater than 50% of the MCA territory and additional involvement of the anterior or posterior cerebral artery territory.

Academic Medical Centers↗

Combined extracranial and intracranial atherosclerosis in Korean patients.

OBJECTIVES: To evaluate the frequency of intracranial atherosclerosis among patients with steno-occlusive extracranial carotid artery disease and to determine if there are factors related to the combined intracranial atherosclerosis. DESIGN: Cross-sectional study. SETTING: A tertiary referral hospital. Patients We studied 142 consecutive patients who had atherosclerotic steno-occlusive lesions (defined as > or =30% narrowing of the luminal diameter or occlusion) of an extracranial carotid artery confirmed by conventional angiography. We excluded patients who had potential cardiogenic sources of embolism. Potential vascular risk factors for each patient were obtained from medical records. Main Outcome Measure We determined the location and severity of atherosclerotic lesions by conventional angiography. We compared the vascular risk factors between patients with steno-occlusive extracranial carotid artery disease alone and patients with combined intracranial atherosclerosis and extracranial carotid artery disease. RESULTS: Intracranial steno-occlusive lesions (> or =30% stenosis or occlusion) were found in 80 patients (56.3%). Of 121 patients with significant (> or =50% stenosis or occlusion) extracranial carotid artery disease, 58 (47.9%) also had significant lesions of intracranial arteries. Univariate and multivariate analyses showed that diabetes mellitus was the only significant factor associated with combined intracranial atherosclerosis in patients with extracranial carotid artery disease. CONCLUSIONS: Intracranial atherosclerosis is common in Korean patients with steno-occlusive extracranial carotid artery disease. Diabetes mellitus is associated with intracranial atherosclerosis in patients who had steno-occlusive extracranial carotid artery disease.

Aged↗

Multiphasic perfusion computed tomography in hyperacute ischemic stroke: comparison with diffusion and perfusion magnetic resonance imaging.

PURPOSE: The purpose of this study was to compare multiphasic perfusion computed tomography (CT) with diffusion and perfusion magnetic resonance imaging (MRI) in predicting final infarct volume, infarct growth, and clinical severity in patients with hyperacute ischemia untreated by thrombolytic therapy. METHOD: Multiphasic perfusion CT was performed in 19 patients with ischemic stroke within 6 hours of symptom onset. Two CT maps of peak and total perfusion were generated from CT data. Diffusion-weighted imaging (DWI) and perfusion MRI were obtained within 150 minutes after CT. Lesion volumes on CT and MRI were compared with final infarct volume and clinical scores, and mismatch on CT or MRI was compared with infarct growth. RESULTS: The lesion volume on the CT total perfusion map strongly correlated with MRI relative cerebral blood volume (rCBV), and that on the CT peak perfusion map strongly correlated with MRI relative cerebral blood flow (rCBF) and rCBV (P < 0.001). The lesion volume on unenhanced CT or DWI moderately correlated with final infarct volume, but only lesion volume on unenhanced CT weakly correlated with baseline clinical scores (P = 0.024). The lesion volumes on the CT peak perfusion map and MRI rCBF similarly correlated with final infarct volume and clinical scores and more strongly than those on mean transit time (MTT) or time to peak (TTP). DWI-rCBF or CT mismatch was more predictive of infarct growth than DWI-MTT or DWI-TTP mismatch. CONCLUSION: Multiphasic perfusion CT is useful and of comparable utility to diffusion and perfusion MRI for predicting final infarct volume, infarct growth, and clinical severity in acute ischemic stroke.

Acute Disease↗

Malignant middle cerebral artery infarction in hyperacute ischemic stroke: evaluation with multiphasic perfusion computed tomography maps.

OBJECTIVE: The purpose of this study was to compare the incidence of large hypoperfusion (greater than two-thirds of MCA territory) on computed tomography (CT) perfusion maps between hyperacute middle cerebral artery (MCA) stroke patients without or with malignant cerebral edema. METHODS: Twenty-seven patients diagnosed with a hyperacute MCA stroke who had an initial National Institutes of Health Stroke Scale (NIHSS) score greater than 10 were included. Multiphasic perfusion CT was performed within 6 hours of symptom onset. Patients were divided into 2 groups: the malignant group (n = 11), composed of patients who died within 7 days, and the nonmalignant group, which included all other patients (n = 16). Unenhanced CT and CT perfusion maps were assessed and compared between the 2 groups with special emphasis on examining the CT findings, including hyperdense MCA sign, large (greater than two-thirds) hypoattenuation and hypoperfusion in the MCA territory, and hypoattenuation in the basal ganglia and other vascular territories. RESULTS: The incidence of large hypoattenuation (greater than two-thirds of MCA territory) on unenhanced CT and large hypoperfusion on CT perfusion maps differed significantly between the 2 groups (P < 0.05). Large hypoperfusion on the CT total perfusion map was most accurate (93%) among various CT findings for the prediction of malignant MCA infarction with high sensitivity (91%), specificity (94%), and positive predictive value (91%). CONCLUSIONS: The incidence of large hypoperfusion on a CT perfusion map was higher in the malignant group than the nonmalignant group. CT perfusion maps may provide added information about cerebral perfusion and could be a useful predictor of malignant MCA infarction.

Acute Disease↗

Multiphasic perfusion CT in acute middle cerebral artery ischemic stroke: prediction of final infarct volume and correlation with clinical outcome.

OBJECTIVE: To assess the utility of multiphasic perfusion CT in the prediction of final infarct volume, and the relationship between lesion volume revealed by CT imaging and clinical outcome in acute ischemic stroke patients who have not undergone thrombolytic therapy. MATERIALS AND METHODS: Thirty-five patients underwent multiphasic perfusion CT within six hours of stroke onset. After baseline unenhanced helical CT scanning, contrast-enhanced CT scans were obtained 20, 34, 48, and 62 secs after the injection of 90 mL contrast medium at a rate of 3 mL/sec. CT peak and total perfusion maps were obtained from serial CT images, and the initial lesion volumes revealed by CT were compared with final infarct volumes and clinical scores. RESULTS: Overall, the lesion volumes seen on CT peak perfusion maps correlated most strongly with final infarct volumes (R(2)=0.819, p<0.001, slope of regression line=1.016), but individual data showed that they were less than final infarct volume in 31.4% of patients. In those who showed early clinical improvement (n=6), final infarct volume tended to be overestimated by CT peak perfusion mapping and only on total perfusion maps was there significant correlation between lesion volume and final infarct volume (R(2)=0.854, p=0.008). The lesion volumes depicted by CT maps showed moderate correlation with baseline clinical scores and clinical outcomes (R=0.445-0.706, p< or = 0.007). CONCLUSION: CT peak perfusion maps demonstrate strong correlation between lesion volume and final infarct volume, and accurately predict final infarct volume in about two-thirds of the 35 patients. The lesion volume seen on CT maps shows moderate correlation with clinical outcome.

Acute Disease↗