T-S Nam

Chonnam National University Hospital, Sŏul, Seoul, South Korea

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Publications (5)24.9 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Because hemorrhagic transformation (HT) is associated with morbidity and mortality, we need a better understanding of the factors that predict HT after ischaemic stroke. HT is a well-known factor that limits the use of thrombolytics and it negates the effect of treatment. This study investigated whether a high serum ferritin level is associated with HT in acute ischaemic stroke. Seven hundred and fifty-two consecutive patients with acute ischaemic stroke within 24 h after a vascular event were enrolled. HT was diagnosed using magnetic resonance imaging (MRI) or computed tomography (CT) and the HT was classified into hemorrhagic infarction (HI) type 1, 2 and parenchymal hematoma (PH) type 1, 2. HT was also classified into no HT, asymptomatic HT, minor symptomatic HT (sHT), and major sHT. Computed tomography or MR showed HT in 90 patients (HI in 58 and PH in 32; asymptomatic in 53, minor symptomatic in 23 and major symptomatic in 14). The ferritin levels were higher in the patients who developed HT, PH and sHT. After adjustment for confounding variables, multivariate analysis showed that a high ferritin level remained an independent predictor of HT in the patients with acute ischaemic stroke (P < 0.001). Serum ferritin levels higher than 171.8 ng/ml were independently associated with sHT. This study suggests that a high ferritin level is an important predictor of HT, PH, and sHT in patients with acute ischaemic stroke. Lowering the ferritin level with iron-modifying agents or using free radical scavengers could be helpful to prevent HT in ischaemic stroke.
    European Journal of Neurology 10/2011; 19(4):570-7. · 4.16 Impact Factor
  • European Journal of Neurology 08/2011; 18(8):e98-9. · 4.16 Impact Factor
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    ABSTRACT: The presence of collateral middle cerebral artery (MCA) flow via the primary collateral pathway is thought to protect against the progression of cerebral ischaemia. However, there have been few reports on early clinical outcomes according to the presence of collateral MCA flow in acute ischaemic stroke (AIS) with internal carotid artery (ICA) occlusion. Therefore, we sought to investigate the early clinical outcomes and lesion patterns according to the presence of collateral MCA flows in AIS with ICA occlusion. This is a retrospective study of patients with AIS with ICA occlusion consecutively admitted to our stroke center between October 2008 and March 2010. Patients were included if they were admitted within 12 h of symptom onset with AIS and symptomatic ICA occlusion. Collateral MCA flow was defined as the presence of MCA signals from proximal M1 to distal MCA branches ipsilateral to the ICA occlusion by magnetic resonance angiography. Early neurological deterioration (END) was defined as a 4-point increase in the National Institutes of Health Stroke Scale (NIHSS) score and persistent neurological deterioration for at least 24 h or newly developed neurological symptoms within 7 days. Sixty-five patients (42 men, 23 women) were finally included. Initial NIHSS scores were significantly lower, and favorable outcomes at 3 months were better in patients with collateral MCA flow than in those without (P < 0.001). Initial lesion patterns were different according to the collateral MCA flow. However, patients with mild AIS might more frequently deteriorate than those with moderate to severe AIS. In our study, collateral MCA flow reduced initial stroke severity and was associated with favorable outcomes at 3 months but did not seem to protect against END in mild AIS patients with ICA occlusion. Therefore, the results of this study suggest that mild AIS patients with ICA occlusion should be carefully managed because their conditions may deteriorate.
    European Journal of Neurology 04/2011; 18(12):1384-90. · 4.16 Impact Factor
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    ABSTRACT: Clinical and radiological features of patients with unclear-onset stroke do not differ significantly from those with known-onset stroke. There is a lack of evidence for the safety and efficacy of thrombolysis in patients with unclear-onset stroke. We sought to provide supportive data on the safety and efficiency of thrombolysis in patients with unclear-onset stroke. We retrospectively identified patients with unclear-onset stroke (<3 h of first found abnormal time) from our stroke registry. We performed following protocols for thrombolysis in patients with unclear-onset stroke; initial conventional CT-based intravenous thrombolysis (IVT), repeat MRI during IVT, and then decision to maintain IVT or to perform combined intra-arterial thrombolysis. In addition, we compared clinical outcomes and safety between thrombolyzed and non-thrombolyzed patients. A total of 78 patients with unclear-onset stroke were included. Twenty-nine patients underwent thrombolysis. Thrombolysis (OR, 6.842; 95% CI, 1.950-24.004; P = 0.003) and baseline NIHSS (OR, 0.769; 95% CI, 0.645-0.917; P = 0.003) were associated with favorable outcomes at 3 months in multivariate logistic regression analysis. The frequency of hemorrhagic transformation and symptomatic ICH was not significantly different between the thrombolyzed and non-thrombolyzed patients (34.4% vs. 40.7% and 10.3% vs. 8.2%, respectively). The results of this study suggest that thrombolysis in unclear-onset stroke could be independently associated with favorable outcomes at 3 months and that thrombolysis based on repeat imaging appears to be safely applied to patients with unclear-onset stroke.
    European Journal of Neurology 02/2011; 18(7):988-94. · 4.16 Impact Factor
  • Neurology 06/2010; 74(23):1925. · 8.25 Impact Factor

Publication Stats

17 Citations
24.90 Total Impact Points

Institutions

  • 2011
    • Chonnam National University Hospital
      Sŏul, Seoul, South Korea
  • 2010–2011
    • Chonnam National University
      • Department of Neurology
      Gwangju, Gwangju, South Korea