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유남태,배효진,김지은,고리영,한진영,김무현,차재관 대한뇌졸중학회 2012 Journal of stroke Vol.14 No.1
Background: Aspirin resistance (AR) in platelet function assays showed substantial variation depending on the methods used to evaluate it. Methods: In this study, we prospectively compared the results of Multiplate impedance platelet aggregometry (IPA) with those of light transmission aggregometry (LTA) and VerifyNow® system in determination of the prevalence of aspirin resistance (AR) and investigated the correlation between its presence and poor outcome (modifi ed Rankin scale >2) in 105patients with aspirin after acute ischemic stroke (AIS). Results: After 5 days of using aspirin, 15 patients (14.3%) were classifi ed as aspirin-resistance with the use of IPA, 24 patients (22.9%) by the LTA, and 14 patients (13.3%) by VerifyNow. Good agreement between the results of IPA and VerifyNow, was found (R=0.674, P <0.01). The concordance rate of AR detection was high between VerifyNow and IPA (k=0.72, P <0.01), albeit quite low between LTA and IPA. Regarding on its infl uence on clinical outcome after AIS, there wasn’t any signifi cant relationship between occurrence of poor outcome and the presence of AR in three platelet function assays. Conclusion: This study reveals that the incidence of AR in AIS might be highly test-specifi c. IPA seems to be similar to VerifyNow as a platelet function test.
두피전극과 경질막밑 전극으로 동시 기록한 발작기 뇌파에서의 뚜렷한 시간차이: 안쪽관자엽간질 환자 1예
구대림,송파멜라,변소영,이정화,유남태,주은연,서대원,홍승철,홍승봉 대한임상신경생리학회 2011 Annals of Clinical Neurophysiology Vol.13 No.2
We present a recordings of 37-year-old woman with simultaneous ictal scalp and subdural electrodes. The ictal rhythm on subdural electrocorticography (ECoG) started earlier (median 24.5 sec) and ended later (median 2.0 sec) compared to ictal rhythm on scalp EEG. Eight ictal ECoG recordings were well localized to left temporal area, whereas ictal scalp EEG recordings were not. Our case shows the obvious timing relations between two recordings, and different electrophysiologic information about localization of ictal onset zone.
박향일,차재관,김해종,최재형,김대현,허재택,유남태 대한뇌졸중학회 2011 Journal of stroke Vol.13 No.3
Background: There are many causes for the failure of aspirin therapy in patients with acute ischemic stroke. Laboratory aspirin resistance (AR) might be involved in clinical aspirin non-response. The PFA-100 is a laboratory method to evaluate AR in the clinical setting. However, there has been limited data regarding concordance with optical platelet aggregometry, which is considered the gold standard for detecting AR. We retrospectively analyzed platelet function tests using the PFA-100 and an optical platelet aggregometer in 86 patients with acute ischemic stroke. Methods: Eighty six patients were enrolled in the study and were evaluated the platelet function test by optical aggregometer and a PFA-100. We determined the variability in the prevalence of AR and the kappa value between the two tests in patients with acute ischemic stroke. Results: Among 86 patients, 27 (31.4%) were detected as AR by the optical aggregometer and 31 (36.0%) by the PFA-100 . There were 13 cases of AR (15.1%)in both laboratory methods. The optical platelet aggregometer results showed that female gender (P =0.03), aspirin monotherapy(P =0.05), and NIHSS at baseline (P =0.04) were related with AR in acute ischemic stroke. Multiple logistic regression analysis showed that NIHSS was independently associated with AR of the optical platelet aggregometer (OR=1.12 95%, CI: 1.00-1.25,P =0.05). Conclusion: The prevalence of AR was similar between the PFA-100 and the optical platelet aggregometer in patients with acute ischemic stroke. However, the concordance rate of these two tools is low. (Korean J Stroke 2011;13:114-119)
기립성 저혈압 진단에 있어 기립경사검사와 누운 자세에서 측정한 자발성 압수용기반사 민감도의 상관관계
하은옥,김영수,박기종,김수경,강희영,최낙천,권오영,임병훈,유남태 대한임상신경생리학회 2010 Annals of Clinical Neurophysiology Vol.12 No.2
Orthostatic hypotension (OH) refers to a fall in systolic blood pressure (BP) of 20 mmHg or more, or in diastolic BP of 10 mm Hg or more within 3 minutes of standing up. The head-up tilt test (HUT) is the most useful, but potentially invasive test for the diagnosis of OH. The purpose of this study was to identify the usefulness of spontaneous baroreflex sensitivity (sBRS). Methods: Ninety one patients with orthostatic intolerance, in whom the HUT data were available,were included in the study. Patients were classified into HUT-positive (group I) and HUT-negative (group II) group. Twenty five healthy volunteers served as normal controls, and were designated as group III. In all subjects, beat-to-beat BP and heart rate were recorded using BeatScope 1.1a. We collected the 50 sBRS data in each patient in a supine position. The average value of one to ten of 50 sBRS data was defined as sBRS10, one to twenty as sBRS20, one to thirty as sBRS 30, one to forty as sBRS 40, and one to fifty as sBRS 50. Differences in sBRS10 and sBRS50 levels were statistically analyzed and compared between groups I, II, and III. Results: No significant difference in the sBRS50 level was found between Groups II and III. sBRS50 was significantly lower in Group I than in Groups II and III (p<0.05), and the same pattern of differences was observed for sBRS40, sBRS30, sBRS20, and sBRS10. Conclusions: Patients with OH showed significantly lower sBRS levels than HUT-negative patients or normal controls. Our study implies that a supine-position sBRS would provide additional diagnostic information for OH.