Korea-Taiwan Young Stroke Investigators Meeting

TIME TOPIC SPEAKER MODERATOR

TSS President
08:50-09:00 Welcome & introduction Li-Ming Lien
Shin Kong WHS Memorial Hospital, Taipei

Eung-Gyu Kim,
Chairman, Inje University Busan Paik Hospital
Gyeong-Moon Kim,
Vice-president, Samsung Medical Center
09:00-09:20 KSS Representatives Sung-Il Sohn,
Vice-president, Keimyung University Hospital
Keun-Sik Hong,
Director of International Affairs, Inje University
Ilsan Paik Hospital.

Hsin-Hsi Tsai
The Application of Amyloid PET in National Taiwan
09:20-09:45 Jiann-Shing Jeng
Cerebral Amyloid Angiopathy Research University Hospital,
National Taiwan
Taipei
University Hospital,
Evaluation of Cellular Immunity in Taipei
Seong-Joon Lee
Human Acute Ischemic Stroke by Eung-Gyu Kim
09:45-10:10 Ajou University School
Acquisition of Blood during Mechanical Pusan Paik Hospital
of Medicine
Thrombectomy Meng Lee
Chang Gung Memorial
Caregiver Burden during the COVID-19
Meng-Tsang Hsieh Hospital, Chiayi
10:10-10:35 Pandemic: A Study on Stroke Patients'
Chi-Mei Medical Center
Caregivers

10:35-10:55 BREAK

Jun Yup Kim

Long-Term Incidence of Seoul National
10:55-11:20 Gastrointestinal Bleeding after University Bundang
Gyeong-Moon Kim
Ischemic Stroke Hospital, Seongnam-si,
Samsung Medical
Rep. of Korea
Center in Korea
Chun-Jen Lin I-Hui Lee
Large Artery Atherosclerosis – from
11:20-11:45 Taipei Veterans General Taipei Veterans General
Stroke to Cognition.
Hospital, Taipei Hospital, Taipei
Cheng-Yang Hsieh
Jong-Won Chung
Sin-Lau Hospital,
Samsung Medical
Recent Advances in Cancer-Related Tainan
11:45-12:10 Center, Sungkyunkwan
Stroke
University School of
Medicine, Seoul, Korea

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12:00-13:30 LUNCH

Hyung Jong Park Sung-Il Sohn

13:30-13:55 Thrombus and Stroke Etiology Keimyung University Keimyung University
Donsan Hospital Dongsan Hospital,
Keimyung University
School of Medicine,
Chih-Hao Chen Daegu, South Korea
CADASIL in Taiwan – Clinical Features National Taiwan
13:55-14:20 Sung-Chun Tang
and Potential Biomarkers University Hospital,
National Taiwan
Taipei University Hospital,
Taipei
Joonsang Yoo
Cancer and Stroke: Outcomes and Li-Kai Tsai
14:20-14:45 Yonsei University Yongin National Taiwan
Thrombus Histology
Severance Hospital University Hospital,
Taipei
Yu-Kai Lin Jiunn-Tay Lee
Noninvasive Brain Stimulation for
14:45-15:10 Tri Service General Tri Service General
Motor Recovery after Stroke
Hospital, Taipei Hospital, Taipei

15:10-15:30 BREAK

Kang-Ho Choi
Exploring the Undetermined Sources
Chonnam National
15:30-15:55 and Novel Treatment Strategies for
University Hospital
Stroke
Gwangju, Korea
Keun-Sik Hong
Inje University
The New Web-Based Acute Stroke
Pi-Shan Sung Lung Chan
Transferring Software System in
National Cheng Kung Shuang Ho Hospital,
13:55-16:20 Regional Stroke Network: Focus on
University Hospital, New Taipei City
Stroke Transferring Efficiency and
Tainan
Transferring Model Cheng-Yang Hsieh
Sin-Lau Hospital,
Beom Joon Kim Tainan
Widening Sex Disparity of Intravenous
Seoul National
16:20-16:45 Thrombolysis as with Declining Stroke Tsong-Hai Lee
University Bundang
Care Quality University Bundang
Hospital
Hospital
Vasculopathy and Stroke after Chi-Hung Liu
16:45-17:10 Radiation Therapy in Head and Neck Chang Gung Memorial
Cancer Patients: An Update Hospital, Linkou

TSS President
KSS Chairman
Li-Ming Lien
Eung-Gyu Kim
17:10-17:30 Closing Shin Kong WHS
Inje University Busan
Memorial Hospital,
Paik Hospital
Taipei

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 CURRICULUM VITAE

Eung-Gyu Kim, M.D., Ph.D.

PERSONAL INFORMATION
Business Address : Department of Neurology, College of MedicineInje
University, Paik Hospital
633-165, Gaegeum-Dong, Jin-gu,
Busan, 614-735, South Korea.
Tel. 82-51-890-8641
Fax. 82-51-895-6367
E-mail : kgstroke@gmail.com

PRESENT ACADEMIC AND HOSPITAL APPOINTMENTS

Professor : Department of Neurology, Pusan Paik Hospital,
College of Medicine, Inje University, Pusan, Korea
Director Department Neurology, Pusan Paik Hospital
Chairman of Korean Stroke Society.
Director of Korean Neurocritical care Society
Dirctor of Korean Neurosonology Society
Councilor of Korean Headache Society.
Past president of Korean Stroke Society, Pusan-Gyung Nam District

EDUCATION
1982-1984 B.S. Dept. of Premedicine, College of Liberal arts and science,
Inje University, Pusan, Korea
1984-1988 M.D. Dept. of Medicine, College of Medicine,
Inje University, Pusan, Korea
1995-1997 M.S. Dept. of Medicine, Postgraduate School,
Inje University, Pusan, Korea
1997-2000 Ph.D. Dept. of Medicine, Postgraduate School,
Kosin University, Pusan, Korea.
2002-2003 Research fellow, Department of Neurologic Science
University of Western Ontario, Canada.

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 CURRICULUM VITAE

Gyeong-Moon Kim, MD, PhD

Dr. Kim graduated from Seoul National University College of Medicine in 1990. He
subsequently enrolled at Seoul National University Graduate School where he obtained a
Ph.D. degree in 1998, majoring in anatomy and neuroscience. After training as an intern and
resident in neurology at Seoul National University Hospital, he completed a clinical fellowship
at Samsung Medical Center. He then received post-doctoral training in the Center for the
Study of Nervous System injury (CSNSI) at Washington University School of Medicine. He
also worked as a visiting professor in A.A. Martinos Center for Biomedical Imaging at MGH/
Harvard Medical School. Dr. Kim is currently a professor of neurology in Sungkyunkwan
University School of Medicine and director of Stroke Center at Samsung Medical Center in
Korea. He is now vice president of Korean Stroke Society. Dr. Kim's clinical expertise are in
acute stroke management and etiologic diagnosis of stroke mechanism. His research interest is
focused on stroke neuroimaging, carotid artery diseases, genetics and molecular and cellular
mechanism of ischemic cell death.

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 CURRICULUM VITAE

Sung-Il Sohn, M.D, PhD

□ Professor of Neurology, Cerebrovascular Center, Keimyung University Dongsan Hospital,

Keimyung University School of Medicine, Daegu, South Korea
□ President of Daegu-Gyeongsangbuk-do chapter of Korean Stroke Society, South Korea.
(2011-2020)
□ President of Daegu-Gyeongsangbuk-do chapter of Korean Neurological Association, South
Korea (2021-2023)
□ National PI of RES-Q registry, South Korea (2020-)
□ Vice President of the Korean Stroke Society (2022~2023)

Board Certification
□ BS, Keimyung University School of Medicine, 1992
□ Resident, Neurology, Dongsan Medical Center, Keimyung University. 1997
□ PhD, Neurology, Dongsan Medical Center, Keimyung University 2002
□ Research Fellow at Calgary Stroke Team, Foothill Hospital, University of Calgary, Canada.
2009-2010

Participated Major International Clinical Trials:

DIAS III trial. ESCAPE trial, NAVIGATE ESUS trial, SOCRATRS trial, THALRES trial,
ESCAPE-NA1 trial et al
CKCS-K Investigator

Publications (About 230 articles)

https://scholar.google.com/citations?hl=ko&user=6HeVwycAAAAJ&view_op=list_
works&sortby=pubdate

Main articles
Sohn SI, Park SW, Lee Y, Park H, Chang H, Choi HA, et al. Determinants of Visceral
Infarction in Acute Cardioembolic Stroke Due to Atrial Fibrillation. J Stroke. 2021;23(2):277-
80.

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Hill MD, Goyal M, Menon BK, Nogueira RG, McTaggart RA, Demchuk AM, Sohn SI, et al.
Efficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1):
a multicentre, double-blind, randomised controlled trial. Lancet. 2020;395(10227):878-87.
Yoo J, Choi JW, Lee S-J, Hong JM, Hong J-H, Kim C-H, Sohn SI, et al. Ischemic Diffusion
Lesion Reversal After Endovascular Treatment: Prevalence, Prognosis, and Predictors. Stroke.
2019;50(6):1504-9.
Menon BK, FS Al-Ajlan, M Najm, J Puig, M Castellanos, D Dowlatshahi, Sung-Il Sohn,
et al. Association of Clinical, Imaging, and Thrombus Characteristics With Recanalization
of Visible Intracranial Occlusion in Patients With Acute Ischemic Stroke. JAMA. 2018;320;
1017-1026.
Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, Roy D, Jovin TG,
Willinsky RA, Sohn SI, et al. Randomized assessment of rapid endovascular treatment of
ischemic stroke. N Engl J Med. 2015;372:1019-1030.

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 CURRICULUM VITAE

Keun-Sik Hong

Education
M.D., magna cum laude, College of Medicine Seoul National University, 1985-1991

Postgraduate Training and Education

Internship, Residence, Fellowship: Seoul National University Hospital, Mar 1991-Feb 2000
MS, Phd Department of Epidemiology, Department of Neurology, College of Medicine
Seoul National University, Mar 1994-Feb 1996 & Mar 2000-Feb 2002

Present positions:
Professor, Department of Neurology, Inje University, Apr 2011 – present

Professional Activities
Board member of Asia-Pacific region of the World Stroke Organization
Associate Editor, Journal of Stroke, 2016 – present
Editorial Board and Reviewer, Journal of Stroke, 2013 – present
Director, International Affair, Korean Stroke Society: 2023.3. – present
Director of Guideline Development Committee, Scientific Committee, and Public Relationship
Committee Korean Stroke Society: 2004.3.–2023.2.
Director, Public Relationship Committee, Korean Neurological Association: 2016.3. – 2018.2.

Publications and Citations

More than 200 publications & more than 9000 citations (as of 20 JUL APR 2023)

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(https://scholar.google.ro/citations?hl=en&user=H8qr5okAAAAJ&view_op=list_
works&sortby=pubdate)

Awards
Award for the contribution to National Cardiovascular Disease Prevention Education Program
from Korea Centers for Disease Control and Prevention, 2012.
Award for the contribution to National Healthcare Program from the Ministry of Health &
Welfare of Korea, 2012.
Award for the contribution to the Journal of Stroke from the Korean Stroke Society, 2015.
Distinguished Scholar Award from Gyeonggi Province Medical Association, 2011.
Award for Distinguished Topic Presentation from the Korean Stroke Society, 2010.
Distinguished Scholar Awards fromInje Univ & Ilsan Paik Hospital, 2008, 2005, 2010, 2012,
2015, 2016, 2017, 2018.

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 CURRICULUM VITAE

Hsin-Hsi (Cynthia) Tsai, MD, PhD

Bio:
Dr. Hsin-Hsi Cynthia Tsai is the clinical assistant professor in Neurology department in
National Taiwan University College of Medicine. She is also the neurology attending
physician in National Taiwan University Hospital. Her research interests and clinical specialty
mainly focus on diagnosis and prognosis in intracerebral hemorrhage, novel therapeutics for
intracerebral hemorrhage, as well as molecular and functional imaging in cerebral amyloid
angiopathy, cerebral small vessel disease and vascular cognitive impairment. She has actively
participated in both clinical and research work for the contribution of cerebrovascular factor
in neurodegenerative disorders, and her results have been published in several high impact
journals.

Education
2017.09-2021.06: PhD, Graduate Institute of Clinical Medicine, College of Medicine,
National Taiwan University
2005.09-2012.06: MD, College of Medicine, National Taiwan University

Publications (Selected)
1. Chen SJ, *Tsai HH (Corresponding author), Lo YL, Chen YF, Tang SC, Jeng JS, Tsai
LK. Interaction Between Cerebral Small Vessel Disease, Blood Pressure and Remote
Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage, European Stroke
Journal online ahead of print.
2. Lee BC, *Tsai HH (Corresponding author), Liu CJ, Chen YF, Tsai LK, Jeng JS, Yen
RF. Cerebral Venous Reflux and Cerebral Amyloid Angiopathy: An Magnetic Resonance
Imaging/Positron Emission Tomography Study. Stroke. 2023 Apr;54(4):1046-1055.
3. Tsai HH, Lee BC, Chen YF, Jeng JS, Tsai LK. Cerebral Venous Reflux and Dilated Basal
Ganglia Perivascular Space in Hypertensive Intracerebral Hemorrhage. J Stroke. 2022;
24(3):363-371.
4. Tsai HH, Hsieh YC, Lin JS, Kuo ZT, Ho CY, Chen CH, Chang CF. Functional
investigation of meningeal lymphatic system in experimental intracerebral hemorrhage.
Stroke. 2022 Mar;53(3):987-998.

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 5. Tsai HH, Chen YF, Yen RF, Lo YL, Yang KC, Jeng JS, Tsai LK, Chang CC. Plasma
Soluble TREM2 is Associated with White Matter Lesions Independent of Amyloid and
Tau. Brain. 2021 Dec 16;144(11):3371-3380.
6. Tsai HH, Pasi M, Tsai LK, Huang CC, Chen YF, Lee BC, Yen RF, Gurol ME, Jeng
JS. Centrum-semiovale Perivascular Space and Amyloid Deposition in Spontaneous
Intracerebral Hemorrhage, Stroke. 2021 Jul;52(7):2356-2362.
7. Tsai HH, Chen SJ, Tsai LK, Pasi M, Lo YL, Chen YF, Tang SC, Jeng JS. Long Term
Vascular Outcomes in Patients with Mixed Location Intracerebral Hemorrhage and
Microbleeds. Neurology. 2021 Feb 16;96(7):e995-e1004.
8. Tsai HH, Pasi M, Tsai LK, Chen YF, Chen YW, Tang SC, Gurol ME, Yen RF, Jeng
JS. Superficial Cerebellar Microbleeds and Cerebral Amyloid Angiopathy: A Magnetic
Resonance Imaging/Positron Emission Tomography Study. Stroke. 2020 Jan;51(1):202-
208.
9. Tsai HH, Pasi M, Tsai LK, Chen YF, Lee BC, Tang SC, Fotiadis P, Huang CY, Yen
RF, Jeng JS, Gurol ME. Microangiopathy underlying mixed-location intracerebral
hemorrhages/microbleeds A PiB-PET study. Neurology. 2019 Feb 19;92(8):e774-e781.
10. Tsai HH, Kim JS, Jouvent E, Gurol ME. Updates on Prevention of Hemorrhagic and
Lacunar Strokes. J Stroke. 2018 May;20(2):167-179.
11. Tsai HH, Pasi M, Tsai LK, Chen YF, Lee BC, Tang SC, Fotiadis P, Huang CY, Yen
RF, Gurol ME, Jeng JS. Distribution of Lacunar Infarcts in Asians with Intracerebral
Hemorrhage: An MRI and Amyloid PET Study. Stroke. 2018 Jun;49(6):1515-1517.

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 The application of amyloid PET in cerebral amyloid
angiopathy research

Cerebral amyloid angiopathy (CAA), the major etiology of spontaneous lobar intracerebral
hemorrhage (ICH), is caused by deposition of β-amyloid (Aβ) proteins in the leptomeningeal
and cortical small vessels of the brain. In addition to brain MRI which shows a characteristic
strictly lobar distribution of hemorrhagic lesions, molecular imaging tool such as amyloid
PET has provided the perspective of vascular amyloid load and amyloid distribution in CAA
patients. Our group in National Taiwan University Hospital has established the cohort of
spontaneous ICH patients with comprehensive neuroimaging study since 2014, with special
focus on understanding the underlying small vessel subtype in ICH. We also aim to use this
cohort to delineate the potential pathogenic mechanisms of CAA.

We first identified CAA in patients presenting with mixed lobar and deep hemorrhages, and
confirmed these patients harbor detrimental vascular outcome in the long-term, reinforcing
its clinical significance in ICH population. We then expanded the current knowledge of
CAA neuroimaging spectrum, showing that CAA can involve not only supratentorial, but
also infratentorial small vessels in superficial cerebellar area. By showing the association
between CAA and lacunar infarct, we further extended the parenchymal injury of CAA from
hemorrhage to cerebral ischemia. With the advantage of quantitative data in amyloid PET,
we investigate the association between markers of cerebral drainage system dysfunction and
amyloid depositions in CAA, which shows a close relationship between vascular amyloid
amount and enlarged perivascular spaces in centrum-semiovale, decreased cerebrospinal fluid
drainage function or even cerebral venous insufficiency.

Despite of its advantage in research, amyloid PET is not able to provide adequate diagnostic
utility in CAA, especially in differentiating CAA from another Aβ-related disorders, the
Alzheimer’s disease. Our study with combined amyloid and tau scans suggests that there is
a great overlap between CAA and AD. Although it appears that the whole amyloid amount
is significantly lower in CAA group than in AD group, the role of applying it in diagnosing
individual patient is still very limited. Future work should be emphasized on developing
tracers that is more specific to bind vascular amyloid plaque and to explore its roles in clinical
practice, including as a cognitive prognostic marker or as a therapeutic outcome marker in
clinical trials.

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 CURRICULUM VITAE

Seong-Joon Lee, MD,. PhD.

Position: Assistant proffessor

Subspecialties: Stroke, Cerebrovascular disease, Neuro-otology/Neuro-ophthalmology,
Neurointervention
Department of Neurology, Ajou University School of Medicine.
San 5, Woncheon-dong, Youngtong-gu, Suwon 443-721, Republic of Korea

Education
2008 Bachelor’s degree, Ajou University School of Medicine
2013 Mastor of Science in Medicine, Ajou University Graduate School
2018 Doctor of Philosophy in Medicine, Ajou University Graduate School

Professional Experience
2008~2009 Medical Internship, Ajou University Medical Center
2009~2013 Neurology Residency, Ajou University Medical Center
2013~2016 Public Health Doctor, Hoengsung-gun, Gangwondo
2016~2018 Clinical Fellow, Department of Neurology, Ajou University School of
Medicine.
2016.11~2017.3 Department of Radiology (Neurointervention), Ajou University School
of Medicine.
2018 Dedicated Doctor, Neurocritical Care Unit, Ajou University School of
Medicine.
2019~2021 Clinical assistant proffessor Department of Neurology, Ajou University
School of Medicine.
2019~ Certified Subspecialist of Korean Society of Critical Care Medicine
2020~ Certified Neurointerventionist of Korean Society of Interventional
Neuroradiology
2022~ Assistant proffessor Department of Neurology, Ajou University School
of Medicine.

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Awards
2023 Young Investigator Award, the Korean Stroke Society
2022 Distinguished Presentation Award, Korean Stroke Society Spring Academic
Conference
2019 Distinguished Presentation Award, Japan-Korea Joint Stroke Conference
2017 Distinguished Presentation Award, The Korean Neurocritical Care society
2016 Distinguished Poster Award, The Korean Neurocritical Care society
2012 Distinguished Presentation Award, 31st Annual Meeting of the Korean
Neurological Association
2011 Distinguished Research Paper Award, Korean Dementia Association

Publications as main author

Clinical evaluation of a deep-learning model for automatic scoring of the Alberta stroke
program early CT score on non-contrast CT. Lee SJ, Park G, Kim D, Jung S, Song S, Hong
JM, Shin DH, Lee JS. J Neurointerv Surg. 2023 Apr 4:jnis-2022-019970. (1st)
Aperiodic alternating nystagmus in adult-onset Alexander disease with a novel mutation. Kim
MH, Lee JS, Hong JM, Sohn YB, Lee SJ. J Neurol. 2022 Sep 25. (corresponding)
Influence of endothelial function and arterial stiffness on the behavior of cervicocephalic
arterial dissections: An observational study. Lee SJ, Lee JS, Kim M, Park SY, Park JH, Park B,
Jung WS, Choi JW, Hong JM. Front Neurol. 2022 Aug 29;13:968488. (corresponding)
Endovascular Treatment for Posterior Circulation Stroke: Ways to Maximize Therapeutic
Efficacy. Lee SJ, Hong JM, Kim JS, Lee JS. J Stroke. 2022 May;24(2):207-223. (1st)
Significance of Vertigo, Imbalance, and Other Minor Symptoms in Hyperacute Treatment
of Posterior Circulation Stroke. Kim M, Park SY, Lee SE, Lee JS, Hong JM, Lee SJ. Front
Neurol. 2022 May 16;13:845707. (corresponding)
Evaluating the Risk of Paroxysmal Atrial Fibrillation in Noncardioembolic Ischemic Stroke
Using Artificial Intelligence-Enabled ECG Algorithm. Changho Han, Oyeon Kwon, Mineok
Chang, Sunghoon Joo, Yeha Lee, Jin Soo Lee, Ji Man Hong, Seong-Joon Lee, Dukyong
Yoon. Front Cardiovasc Med. 2022 Apr 8;9:865852. (co-corresponding)
Influence of cerebral microbleeds on mechanical thrombectomy outcomes. Lee SJ, Hwang
YH, Hong JM, Choi JW, Park JH, Park B, Kang DH, Kim YW, Kim YS, Hong JH, Yoo J, Kim
CH, Sohn SI, Lee JS. Sci Rep. 2022 Mar 7;12(1):3637. (co-1st)
Effects of co-administration of metformin and evogliptin on cerebral infarct volume in the
diabetic rat. Lee SJ, Yoon BS, Hong JM, Joe EH, Lee JS. Exp Neurol. 2022 Feb;348:113922.
(1st)
Predictors of Early Neurological Deterioration in Stroke Due to Vertebrobasilar Occlusion.
Koh S, Lee SE, Jung WS, Choi JW, Lee JS, Hong JM, Lee SJ. Front Neurol. 2021 Sep 14;12:
696042. (corresponding)
Opsoclonus myoclonus ataxia may differentiate postinfectious autoimmune encephalitis from
infectious encephalitis. Lee SJ, Shin IJ, Kim TJ. Neurol Sci. 2021 Dec;42(12):5395-5398.
(corresponding)
Etiological Approach to Understanding Recanalization Failure in Intracranial Large Vessel
Occlusion and Thrombectomy: Close to Embolism but Distant From Atherosclerosis. Seong-
Joon Lee, So Young Park, Ji Man Hong, Jin Wook Choi, Dong-Hun Kang et al. Front Neurol.
2021 Jan 18;11:598216. (co-1st)

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Evaluation of Cellular immunity in Human Acute Ischemic Stroke
by Acquisition of Blood during Mechanical Thrombectomy
Seong-Joon Lee1, Min Kim1, So Young Park1, Woo Sang Jung, MD2,
Jin Wook Choi, MD, PhD2, Jin Soo Lee1, Ji Man Hong1

1
Department of Neurology, Ajou University School of Medicine, 164, World Cup-ro,
Yeongtong-gu, Suwon-si, Gyeonggi-do 16499, South Korea.
2
Department of Radiology, Ajou University School of Medicine, 164, World Cup-ro,
Yeongtong-gu, Suwon-si, Gyeonggi-do 16499, South Korea.

ABSTRACT

Background: During mechanical thrombectomy for hyperacute stroke due to large vessel
occlusion, a momentary opportunity to study the pathophysiology of human ischemia-
reperfusion process is offered. Inflammation is known to take role in the pathophysiology of
ischemic stroke, and based on preclinical studies, the role of cellular immunity is known to be
important during the hyperacute phase of large vessel occlusion. By ischemic blood probing
during mechanical thrombectomy, we aimed to evaluate the role of cellular immunity in
human ischemia-reperfusion process.
Methods: Starting from September, 2021, we have enrolled consecutive ischemic stroke
patients with large vessel occlusion of the anterior circulation (ICA to MCA M1) who
underwent mechanical thrombectomy. From them, microcatheter aspiration is performed from
(1) within the core of the occluded vascular segment, before recanalization (distal), and (2)
proximal carotid artery (proximal, after reperfusion or end of the procedure). The distal and
proximal blood is preserved in RNA preservation tubes, then RNA transcriptome sequencing
is performed for each blood samples, and differentially Expressed Genes (DEG) analysis was
performed between distal and proximal blood to identify genes selectively upregulated in
blood of human brain ischemic environment. The data below are the preliminary results of the
first three acquired specimen.
Results: In human brain ischemic environment of 3 patients, we identified 608 genes
downregulated and 443 genes upregulated in distal blood compared to proximal blood. Using
gene set enrichment analysis, there was predominant decreases in overall transcription,
including general immunologic and inflammatory activity, pointing to a transient hypofunction
of innate immunity. Upregulated genes were enriched with RNA sets associated with
chromatin remodeling, oxidative aerobic respiration, RNA processing, and mitochondrial
gene translation. The upregulated gene sets imply proliferation of inflammatory cells and its
phenotypic modification through epigenetic changes with associated metabolic reprogramming
of the microglia.
Conclusion: Surprisingly, in the hyperacute phase of cerebral ischemia, there seems to be
a transient hypofunction of immune responses. However, there is transcriptional evidence
of phenotypic changes of immune cells, supported by evidence of epigenetic modification,
metabolic reprogramming, and RNA processing.

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 CURRICULUM VITAE

Hsieh Meng-Tsang (謝孟倉)

Current Positions:
Attending Physician at Stroke Center and Department of Neurology, Chi-Mei Medical Center,
Tainan, Taiwan

Experience:
Attending Physician at Department of Neurology, E-Da Hospital, Kaohsiung, Taiwan
Director of Stroke Center at E-Da Hospital, Kaohsiung, Taiwan
Director of Dementia Care Center at E-Da Hospital, Kaohsiung, Taiwan
Assistant Professor at School of Medicine, I-Shou University, Kaohsiung, Taiwan

Education:
Graduated from the Department of Medicine, National Cheng Kung University
PhD candidate in Institute of Clinical Medicine, National Cheng Kung University

Expertise:
Cerebrovascular and stroke diseases
Dementia and neurodegenerative diseases
Neurointensive care
Neurological medical education

Research Interesting:
Stroke and associated risk factors management
Epidemiology of stroke
Caregiver burden of stroke patients

Recent Awards:
TCIA Taiwan Continuous Improvement Awards 2021 Gold Award
2021 Taiwan Stroke Society Oral Presentation Winner
2020 Taiwan Stroke Society Best Oral Presentation

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 Caregiver Burden During the COVID-19 Pandemic:
A Study on Stroke Patients' Caregivers

Hsieh Meng-Tsang

Background: During the COVID-19 pandemic, caregivers faced unprecedented challenges,

but existing research minimally addresses their burden. Our study aimed to investigate the
relationship between caregiver burden, psychological stress, satisfaction with support, and
fear of COVID-19 in caregivers of stroke patients. Additionally, we explored the connection
between caregiver burden and motivation for COVID-19 vaccine acceptance in caregivers of
stroke patients, investigating the mediating roles of social media use, fear of COVID-19, and
worries.
Methods: A cross-sectional survey study with total of 172 caregivers of patients with
stroke in a community hospital in Taiwan. All participants completed the Zarit Burden
Interview, Depression, Anxiety, Stress Scale (DASS-21), satisfaction of support survey, Fear
of COVID-19 Scale, Bergen Social Media Addiction Scale, Worry of Infection Scale, and
Motors of COVID-19 Vaccine Acceptance Scale. Pearson correlations were used to examine
the bivariate correlations between study variables. Then, with the control of demographic
confounders, Multiple linear regression model was applied to construct and explain the
association among the variables.
Results: The proposed model explained the caregiver burden was negatively correlated with
satisfaction with family support, but positively with psychological distress and the fear of
COVID-19. Despite the increased care burden associated with decreased vaccine acceptance,
problematic social media use positively mediated this association. Care burden was associated
with motivation of vaccine acceptance through problematic social media use followed by
worry of infection.
Conclusions: Lower family support satisfaction, higher psychological distress, and greater
fear of COVID-19 increase burden for caregivers of stroke patients. Higher burden may lead
to reduced COVID-19 vaccine acceptance. Problematic social media use positively affects
vaccine motivation.

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 CURRICULUM VITAE

Jun Yup Kim, M.D. (金俊燁)

Date of Birth July 28, 1985

Office Address 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si,
Gyeonggi-do, 13620, Republic of Korea.
Name of Hosipital Seoul National University Bundang Hosipital
Email junyupkim85@gmail.com
Specialty Certification Korean Board of Neurology since 2015 (1846)
Profesional qualification for Neurointerventionist by the Korean
Society of Interventional Neuroradiology since 2021 (179)

CURRENT ACADEMIC POSITIONS

- Assistant Professor, Department of Neurology, Seoul National University Bundang
Hospital, Seongnam-si, Rep. of Korea (March 2022 - Present)
- Assistant Secretary General, Korean Stroke Society (March 2022 – Present)

EDUCATION
Ph.D. (March 2018 – February 2020)
- Department of Translational Research, Neuroscience Course, Seoul National
University College of Medicine, Seoul, KOREA
M.S. (March 2013 – February 2015)
- Department of Neurology, Neuroscience Course, Seoul National University College
of Medicine, Seoul, KOREA
M.D. (March 2006 – February 2010)
- Seoul National University, College of Medicine, Seoul, KOREA

CLINICAL EXPERIENCES
Clinical Fellowship, Department of Radiology, Seoul National University Bundang Hospital,
Seongnam-si, Rep. of Korea (May 2018 – March 2019)
Clinical Fellowship, Department of Radiology, Seoul National University Bundang Hospital,
Seongnam-si, Rep. of Korea (May 2018 – April 2019)
Medical Officer, Department of Neurology, Armed Forces Seoul District Hospital, Seoul, Rep.

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of Korea (April 2015 – April 2018)
Residency, Department of Neurology, Seoul National University Hospital, Seoul, Rep. of
Korea (March 2011 – February 2015)
Internship, Seoul National University Hospital, Seoul, Rep. of Korea (May 2010 – February 2011)

History of Winning Awards

- Best Platform Presentation Award at Annual Conference and General Assembly of Korean
Society of Interventional Neurology 2020 (December 12th, 2020. Virtual Conference).
- Best Poster Presentation Award at the 9th Japan-Korea Joint Stroke Conference (November
14th, 2019. Songdo Conventia, Incheon, Korea).
- Junior Travel Grants 2018 of the European Stroke Conference and the European Stroke
Research Foundation for excellent research in cerebrovascular diseases as reviewed by the
scientific and programme committees and presented at the 27th annual meeting (April 13th,
2018, Athens, ESC and ESRF)
- Best Platform Presentation Award at ICSU & ICAS Joint Conference 2016 (September 8th,
2016, Jeju, The Korean Stroke Society)

BIBLIOGRAPHY

ORIGINAL ARTICLES (in English) (First author)

1. Kim, J. Y., et al. Annual Case Volume and One-Year Mortality for Endovascular Treatment
in Acute Ischemic Stroke. Journal of Korean Medical Science, 2022, 37.36.
2. Kim, J. Y., et al. Fasting and Non-Fasting Triglycerides in Patients With Acute Ischemic
Stroke. Journal of Korean Medical Science, 2022, 37.13.
3. Kim, J. Y., et al. Cerebral magnetic resonance imaging of coincidental infarction and small
vessel disease in retinal artery occlusion. Scientific Reports, 2021, 11.1:1-12.
4. Kim, J. Y., et al. Unilateral blindness with bilateral brain infarction after cosmetic facial filler
injection. Journal of Neuro-Ophthalmology, 2021, 41.4:e566-e571.
5. Kim, J. Y., et al. Development of stroke identification algorithm for claims data using the
multicenter stroke registry database. PLoS One, 2020, 15.2:e0228997.
6. Kim, J. Y., et al. Acute stroke care in Korea in 2013-2014: national averages and disparities.
J Korean Med Sci, 2020, 35.20:e167.

REVIEW ARTICLES (in English) (First author)

1. Kim J. Y., et al. Executive summary of stroke statistics in korea 2018: A report from the
epidemiology research council of the korean stroke society. Journal of stroke. 2019;21:42
2. Kim J. Y., Bae H-J. Spontaneous intracerebral hemorrhage: Management. Journal of Stroke
2017;19(1):28-39

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 Long-term incidence of gastrointestinal bleeding after
ischemic stroke
Jun Yup Kim, Beom Joon Kim, Jihoon Kang, Moon-Ku Han,
Seong-Eun Kim, Hee-Joon Bae

Department of Neurology, Seoul National University Bundang Hospital, Seoul National

University College of Medicine, Seongnam, Republic of Korea

Background: The incidence of major gastrointestinal bleeding (GIB) requiring blood

transfusion in patients with acute ischemic stroke (AIS) has been reported as 0.5% during
hospitalization due to the index stroke. However, despite the effect of GIB on stroke outcome,
the long-term incidence in this population is not well understood.
Methods: We identified patients with AIS admitted between 2011 and 2013 to the 14 hospitals
participating in a nationwide multicenter prospective stroke registry. The incidence rates of
major GIB, defined as GIB requiring at least 2 units of blood transfusion and captured through
linkage between the registry database and claims data provided by the National Health
Insurance Service, were estimated for different time periods following AIS; 0-30 days, 31-90
days, 91-180 days, 181-365 days, 1-2 years, 2-3years, after 3 years from the stroke onset.
Results: Among 10,818 patients with AIS (men, 59%; age, 68±13 years), 947 patients (8.8%)
experienced a total of 1,224 episodes of major GIB during a median follow-up of 3.1 years.
Among these 947 patients, 20% had 2 or more episodes of major GIB, with the second
episode predominantly occurring within a month of the first episode. The incidence rates were
highest in the first month following AIS (19.21 per 100 person-years), gradually decreasing
to about 1/6 at the first year, and plateauing thereafter. In the multivariable recurrent event
analysis, anemia at presentation, estimated glomerular filtration rate <60 mL/min/1.73 m2,
and a 3-month modified Rankin scale ≥4 were independently associated with a higher risk of
major GIB.
Conclusions: Major GIB frequently occurs in patients with AIS, especially within the first
month following stroke onset, after which the risk gradually decreases. Preventive efforts are
needed, particularly in patients with AIS presenting with anemia and decreased renal function.

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 CURRICULUM VITAE

Chun-Jen Lin, MD, PhD

E-mail: zenlin1981@hotmail.com

Current position
Attending Physician, Department of Neurology and Stroke Center, Taipei Veterans General
Hospital, Taipei, Taiwan.
Assistant Professor, School of Medicine, National Yang Ming Chiao Tung University, Taipei,
Taiwan.

Education
2017 PhD, Institute of Brain Science, National Yang Ming Chiao Tung University,
Taipei, Taiwan.
2006 MD, School of Medicine, National Defense Medical Center, Taipei, Taiwan.

Training and relevant experience

2018–2019 Clinical Researcher, Stroke Center of UCLA medical center, USA.
2013–2014 A ttending Physician, Taipei Veterans General Hospital, Hsinchu branch,
Hsinchu, Taiwan.
2012–2013 Attending Physician, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan.
2011–2012 Chief Resident, Taipei Veterans General Hospital, Taipei, Taiwan.
2007–2011 Resident, Taipei Veterans General Hospital, Taipei, Taiwan.

Major awards and honors

2022 Bedside teaching award of Taipei Veterans General Hospital
2021 Best research article award of Wu Shun-Wen Foundation
2019 Excellent scholar award of Taiwan Stroke Society
2017 Jih-Hsin memorial scholar award
2014 Best young scholar award at Annual meeting of Taiwan Neurological Society
(Golden medal)
2013 Scholar award of Li-Fu Medical Research Foundation

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Expertise and Research Interest
1. Endovascular thrombectomy for acute ischemic stroke.
2. Treatment and prevention of cerebrovascular diseases.
3. Vascular cognitive impairment.
4. Dizziness and orthostatic intolerance.
5. Brain functional connectivity research.

Selected Publications (SCI)

1. Lin CJ, Chung CP, Cheng HM, Liu CH, Hsu LC, Chi NF, Tang SC, Lee JT, Po HL, Jeng
JS, Wang TD, Lee IH. The 2020 Taiwan Stroke Society guidelines for blood pressure
control at the acute stage of ischemic stroke. J Formos Med Assoc 2023;122:98-105.
2. Lee YC, Liao YC, Lin CJ, Chung CP. Baseline P2Y12 reactivity, kidney function, and
CYP2C19 genotype determine clopidogrel responsiveness in acute stroke. Sci Rep 2023;
13:8085. doi: 10.1038/s41598-023-34481-5.
3. Yu HT, Chen KH, Lin CJ, Hsu CC, Chang YL. Evaluation of the timing of using direct
oral anticoagulants after ischemic stroke for patients with atrial fibrillation. Heliyon 2023;
9:e14456; doi: 10.1016/j.heliyon.2023.e14456
4. Lin CJ*, TY Tseng, Saver JL. Dual vs Mono Antiplatelet Therapy for Acute Ischemic
Stroke or Transient Ischemic Attack with Evidence of Large Artery Atherosclerosis.
Frontiers Neruol 2022; doi: 10.3389/fneur.2022.923142
5. Lin CJ, Chang FC, Lin CJ, Liaw YC, Tu PC, Wang PN, Saver JL, Lee IH. Long-term
cognitive and multimodal imaging outcomes after carotid artery stenting vs intensive
medication alone for severe asymptomatic carotid stenosis. J Formos Med Assoc 2022;121:
134-143
6. Chi NF, Chung CP, Cheng HM, Liu CH, Lin CJ, Hsu LC, Tang SC, Lee JT, Po HL, Jeng
JS, Wang TD, Lee IH. 2021 Taiwan Stroke Society Guidelines of blood pressure control
for ischemic stroke prevention. J Chin Med Assoc 2022;85:651-664.
7. Chen CY, Lin PT, Wang YH, Syu RW, Hsu SL, Chang LH, Tsai JY, Huang HC, Liu TC,
Lin CJ, Tang CW, Hsu LC, Chung CP, Liu HY, Chi NF, Lee IH. Etiology and risk factors
of intracranial hemorrhage and ischemic stroke in young adults. J Chin Med Assoc 2021;
84:930-936.
8. Lin CJ*, Saver JL. The Minimal Clinically Important Difference for Achievement of
Substantial Reperfusion with Endovascular Thrombectomy Devices in Acute Ischemic
Stroke Treatment. Frontier Neurol 2020; doi: 10.3389
9. Chien C, Lin CJ, Chang FC, Chung CP, Lin CJ, Liu HY, Chi NF, Hsu LC, Tang CW,
Guo WY, Luo CP, Lai YJ, Lee IH. Quantitative CT Angiography Predicts Large Artery
Occlusion Types and Successful Thrombectomy in Acute Ischemic Stroke. J Chin Med
Assoc 2021;84:61-67.
10. Lin CJ, Luo CB, Chien C, Chang FC, Lin CJ, Lee IH, Hsu LC, Chung CP, Liu HY,
Chi NF, How CK, Guo WY, Wang SJ, Lin YY. Better Endovascular Mechanical
Thrombectomy Outcome in Atrial Fibrillation Patients with Acute Ischemic Stroke – A
Single Center Experience. J Chin Med Assoc 2020;83:756-760.
11. Lin CJ*, Saver JL. Non-Inferiority Margins in Trials of Thrombectomy Devices for Acute
Ischemic Stroke: Is the Bar Being Set Too Low? Stroke 2019;50:3519-3526.

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 Large Artery Atherosclerosis – From stroke to cognition
Chun-Jen Lin, MD, PhD

Abstract

Large artery atherosclerosis (LAA) is one of the most important causes of ischemic stroke.
The mechanism of LAA to develop stroke includes hypoperfusion, artery to artery emboli
and branch occlusion. Recent studies proved that early and short term dual antiplatelet
therapy (DAPT) was beneficial for stroke prevention in minor stroke and high risk TIAs. We
conducted a meta-analysis to explore the value of DAPT in LAA subgroups, and found that
DAPT is still beneficial and safe in stroke patients with LAA, even when used in more than 24
hours after onset.
On the other hand, severe carotid stenosis was associated with cognitive impairment even
before stroke occurrence. Our serial resting state functional MRI studies showed that
functional connectivity disruption developed early in patients with asymptomatic carotid
stenosis, which was associated with delayed verbal memory performance. Notably, successful
stenting was associated with memory improvement along with restoration of cerebral
perfusion. These results indicated that cognition may be an important marker and treatment
target in patients with severe carotid stenosis.

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 CURRICULUM VITAE

Jong-Won Chung, MD. PhD.

Assistant Professor
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seoul, Republic of Korea
E-mail: neurocjw@gmail.com, jongwon.chung@samsung.com

PERSONAL INFORMATION
– Gender: Male
– Date of birth: Jan 19, 1982
– Medical doctor (License No. 92287)
– Board certification – Korean Neurological Association (License No. 1536)

EDUCATION & TRAINING

2001. 3 – 2003. 2 Seoul National University, College of Natural Science, Seoul, Korea
2003. 3 – 2007. 2 Seoul National University, College of Medicine, Seoul, Korea
2007. 3 – 2008. 2 Internship, Seoul National University Hospital, Seoul, Korea
2008. 3 – 2012. 2 Residency, Department of Neurology, Seoul National University
Hospital, Seoul, Korea
2010. 3 – 2012. 2 M.S., Neuroscience (Seoul National University College of Medicine,
Seoul, Korea)
2011.10 – 2011.11 Visiting fellow, Harvard Medical School, Beth Israel Deaconess
Medical Center, Boston, MA, USA
2012. 4 – 2015. 4 Public health officer (Military service)
2015. 3 – 2018. 8 PhD, Sungkyunkwan University School of Medicine, Seoul, Korea
2015. 5 – 2017. 2 Clinical fellow, Samsung Medical Center, Seoul, Korea
2017. 3 ¬ 2018. 2 Clinical instructor, Samsung Medical Center, Seoul, Korea
2018. 3 – 2021. 2 Clinical Assistant Professor, Samsung Medical Center, Seoul, Korea
2021. 3 – Present Assistant Professor, Samsung Medical Center, Sungkyunkwan
University, Seoul, Korea

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History of Winning Awards
1. Korean Stroke Society, Young Investigator Award (September 16, 2017)
2. Korean Neurological Association, SK Young Investigator Award (November 2, 2018)

PEER-REVIEWED PUBLICATIONS
1. Hong SW, Song HN, Choi JU, Cho HH, Baek IY, Lee JE, Kim YC, Chung D, Chung
JW, Bang OY, Kim GM, Park HJ, Liebeskind DS, Seo WK. Automated in-depth cerebral
arterial labelling using cerebrovascular vasculature reframing and deep neural networks.
Sci Rep. 2023 Feb 24;13(1):3255.
2. Lim JS, Lee J, Kang Y, Park HT, Kim DE, Cha JK, Park TH, Heo JH, Lee KB, Park
JM, Oh MS, Kim EG, Chang DI, Heo SH, Park MS, Park H, Yi S, Lee YB, Park KY,
Lee SJ, Kim JG, Lee J, Cho KH, Rha JH, Kim YI, Lee JH, Choi JC, Oh KM, Kwon JH,
Kim C, Park JH, Jung KH, Sung SM, Chung JW, Lee YS, Kim HY, Cho HJ, Park JW,
Moon WJ, Bae HJ. Efficacy and safety of oxiracetam in patients with vascular cognitive
impairment: A multicenter, randomized, double-blinded, placebo-controlled, phase IV
clinical trial. Contemp Clin Trials. 2023 Mar;126:107108.
3. Kim JY, Kim HJ, Choi EH, Pan KH, Chung JW, Seo WK, Kim GM, Jee TK, Yeon JY,
Kim JS, Hong SC, Seong MJ, Cha J, Kim KH, Jeon P, Bang OY. Vessel Wall Changes
on Serial High-Resolution MRI and the Use of Cilostazol in Patients With Adult-Onset
Moyamoya Disease. J Clin Neurol. 2022 Nov;18(6):610-618.
4. Kim HJ, Park MS, Yoo J, Kim YD, Park H, Kim BM, Bang OY, Kim HC, Han E, Kim
DJ, Heo J, Choi JK, Lee KY, Lee HS, Shin DH, Choi HY, Sohn SI, Hong JH, Lee JY,
Baek JH, Kim GS, Seo WK, Chung JW, Kim SH, Han SW, Park JH, Kim J, Jung
YH, Cho HJ, Ahn SH, Lee SI, Seo KD, Chang Y, Nam HS, Song TJ; SECRET Study
Investigators. Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen
Stroke Risk Scores and Functional Outcomes in Acute Ischemic Stroke Patients Who
Received Endovascular Thrombectomy. J Clin Med. 2022 Sep 23;11(19):5599.
5. Park H, Kim YD, Nam HS, Yoo J, Sohn SI, Hong JH, Kim BM, Kim DJ, Bang OY, Seo
WK, Chung JW, Lee KY, Jung YH, Lee HS, Ahn SH, Shin DH, Choi HY, Cho HJ, Baek
JH, Kim GS, Seo KD, Kim SH, Song TJ, Kim J, Han SW, Park JH, Lee SI, Heo JN, Lee
HW, Lee IH, Baik M, Heo JH; SECRET Study Investigators. Impact of Renal Function
on Short-Term Outcome After Reperfusion Therapy in Patients With Ischemic Stroke.
Stroke. 2022 Dec;53(12):3622-3632.
6. Sim JE, Chung JW, Seo WK, Bang OY, Kim GM. Association of Systolic Blood
Pressure and Cerebral Collateral Flow in Acute Ischemic Stroke by Stroke Subtype.
Front Neurol. 2022 May 13;13:863483.
7. Kim YC, Chung JW, Bang OY, Hong M, Seo WK, Kim GM, Yeop Kim E, Lee JS, Hong
JM, Liebeskind DS, Saver JL. A Deep Learning-Based Automatic Collateral Assessment
in Patients with Acute Ischemic Stroke. Transl Stroke Res. 2022 May 21. doi: 10.1007/
s12975-022-01036-1.
8. Chung JW, Chang WH, Bang OY, Moon GJ, Kim SJ, Kim SK, Lee JS, Sohn SI, Kim
YH; STARTING-2 Collaborators. Efficacy and Safety of Intravenous Mesenchymal Stem
Cells for Ischemic Stroke. Neurology. 2021 Feb 16;96(7):e1012-e1023. doi: 10.1212/
WNL.0000000000011440. Epub 2021 Jan 20.

− 227 −
 Recent advances in cancer-related stroke

Jong-Won Chung, MD, PhD

Department of Neurology, Samsung Medical Center, Seoul, Korea

Systemic cancer and ischemic stroke are common conditions and two of the most frequent
causes of death among the elderly. The association between cancer and stroke has been
reported worldwide. Stroke causes severe disability for cancer patients, while cancer increases
the risk of stroke. Moreover, cancer-related stroke is expected to increase due to advances
in cancer treatment and an aging population worldwide. Patients with stroke due to cancer-
related coagulopathy showed the characteristics findings of etiologic work ups, D-dimer
levels, and infarct patterns. In this session, the frequency of cancer-related stroke among
patients with ischemic stroke, mechanisms of stroke within cancer patients, and evaluation
and treatment of cancer-related stroke will be addressed. The possibility of cancer-related
stroke as a stroke subtype and present the most recent discoveries in the pathomechanisms and
treatment of stroke due to cancer-related coagulopathy will be discussed.

− 228 −
 CURRICULUM VITAE

Hyung Jong Park

Address: 1035. Dalgubeol-daero, Dalseo-gu, Daegu, South Korea

E-mail: hjpark209042@gmail.com
phj209042@dsmc.or.kr

Academic qualification
2009 Bachelor
2013 Master, Neurology, Wonkwang University
2015 Bachelor, Information Statistics, Korean National Open University

Professional experience
2009 – 2010 Intern, Wonkwang University Hospital
2010 – 2014 Resisdent, Wonkwang University Hospital
2017 – 2018 Lecturer, Yonsei University Severance Hospital
2018 – 2019 Clinical Assistant professor, Yonsei University Severance Hospital
2019.03 – Assistant professor, Keimyung University Donsan Hospital

Paper
1st and corresponding author
H Park, J Kim, J Ha, IG Hwang, T-J Song, J Yoo, SH Ahn, K Kim, BM kim, DJ Kim, YD
Kim, HS Nam, I K, H-J Choi, S-I Sohn, HS Lee, JH Heo. Histologic features of intracranial
thrombi in stroke patients with cancer. Ann Neurology, 2019;86:143-149.
H Park, YD Kim, HS Nam, J Yoo, S-I Sohn, et al. Impact of renal function on short-term
outcome after reperfusion therapy in patients with ischemic stroke. Stroke 2022;53:3622-3632.
SH Jang, H Park, J Yoo, J-H Hong, JS Lee, S-J Lee, Y-W Kim, JM Hong, JW Choi, D-H
Kang, Y-S Kim, Y-H Hwang, S-I Sohn. Intracranial non-occlusive intraluminal thrombus may
indicate underlying etiology of large vessel occlusion in patients undergoing endovascular
therapy. Journal of Neurointerventional Surgery 2022;14:997-100.
H Park. BM Kim, J-H Baek, J-H Kim, JH Heo, DJ Kim, HS Nam, YD Kim. Predictors of
good outcomes in patients with failed endovascular thrombectomy. Korean J Radiol 2020;21:
582-571

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SH Jang, H Park, J-H Hong, J Yoo, H Lee, HA Kim, S-I Sohn. Impact of high-intensity statin
on early neurological deterioration in patients with single small subcortical infarction. J Clin
Medicine. 2023;12:3260.
H Park, YS Jeong, SH Lee, SH Hang, DH Kwon, J-H Hong, S-I Sohn, J Yoo. Clinical
prognosis of isolated anterior cerebral artery territory infarction: a retrospective study. BMC
Neurology 2021;21.
H Kwon, JH Hong, M Choi, S Kim, H Park, KT Kim, J-H Hong, S-I Sohn. Endovascular
recanalization of life-threatening cerebral venous thrombosis secondary to iatrogenic
intracranial hypotension. Journal of Neurosonology and Neuroimaging 2020;12:62-65.
CH Chung, Y-N Roh, SH Lee, YS Jeong, J-H Hong, S-I Sohn, H. Park. Endovascular treatment
for pseudoaneurysm after carotid blowout syndrome. J Neurocrit Care 2020;13:115-118.
H Park, Commentary to: Garbled and incoherent text messages are a sign of acute ischemic
stroke: a new sign of aphasia in the era of chat application. Neurointervention 2021;16:88-89.
H Park, J Yoo. Use of Non-vitamin K dependent oral anticoagulant in ischemic stroke.
Journal of Korean Neurological Association. 2022;43:1-14.
SH Lee, YS Jeong, C-H Kim, J-H Hong, S-I Sohn, H Park. Malignant cerebral infarction after
COVID-19 myocarditis in 22-year-old female: a case report. J Neurocrit Care 2022;15:65-68.
YS Jeong, SJ Bang, GY Kim, JH Jeon, GR Oh, CH Chung, H Park. A case of de novo MPO-
associated central nervous system vasculitis following heterogeneous mRNA1273 COVID-19
Booster vasccination. J Korean Neurol Assoc 2023;41:145-148.

Awards
2017 Best poster presentation award, Korean stroke society
2019 Best oral presentation award, Korean society of Interventional neuroradiology
2020 Achievement award, Korean society of Interventional neuroradiology
2022 Achievement award, Korean society of Interventional neuroradiology

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 Thrombus and stroke etiology
Hyungjong Park, MD

Department of Neurology, Keimyung University School of Medicine.

Thrombus is the primary cause of ischemic stroke and main target for acute and secondary
prevention of IS. Thrombus is developed through diverse etiologies. Therefore, knowledge on
thrombus can give valuable information into etiologies of thrombosis and this information can
apply the better and further strategies on the stroke treatment. Nowadays, EVT has given fresh
thrombi that can provide valuable information about stroke etiology through histopathologic
analysis. As a result, several studies have reported the association of stroke etiology and
histopathologic composition of thrombus. Traditionally, in determined etiology, thrombus
that are dominated by erythrocytes was cardiac origin, while thrombus that was dominated
by platelets are arterial origin. This was based on the analysis of relative amounts of each
thrombus component. However, the reliability of these past beliefs has been challenged by
inconsistent results. In addition, in undetermined etiology, the proportion of thrombus was
not significantly different between patients with an undetermined etiology, cardiac origin or
large artery atherosclerosis, but other studies have shown that undetermined etiology and
cardiac origin have similar histologic features. Additionally, other efforts to reveal the etiology
of stroke using new biomarkers of clot such as neutrophil extracellular traps, thrombin
have been conducted. Based on various researchs about clot histology and stroke etiology,
tailored approach can be possible and lead to the better outcome with the effective secondary
prevention of stroke.

− 231 −
 CURRICULUM VITAE

Chih-Hao Chen, MD, PhD

Current position
Attending physician & Clinical Assistant Professor, Department of Neurology, National
Taiwan University Hospital, Taipei

Education background
MD, National Taiwan University College of Medicine, 2009
PhD, National Taiwan University College of Public Health, 2020

Research areas and activities

Acute stroke care, cerebral small vessel disease & CADASIL

Biography
Dr. Chen completed his medical school in 2009 and his PhD in epidemiology and preventive
medicine in 2020, both at the National Taiwan University. He also received training in
neurology at the National Taiwan University Hospital. From 2013 to 2017, he helped
established the neurocritical care unit in Far-Eastern Memorial Hospital. Later, since 2017, he
became a staff member at the Department of Neurology, National Taiwan University Hospital.
Dr. Chen has dedicated his research to the field of acute stroke. His study interests focus on the
risk factors, outcomes, and quality improvement studies on thrombolysis and thrombectomy.
Additionally, he focuses on the research of cerebral small vessel disease and has participated
in the establishment of the Taiwan CADASIL cohort. He has also completed a research
fellowship at the University of Calgary, Canada, focusing on the analysis of neuroimaging
features of cerebral small vessel disease.

Publication (selected)
● Modifiable Vascular Risk Factors Contribute to Stroke in 1,080 NOTCH3 R544C Carriers
in Taiwan Biobank. Lin HJ, Chen CH, … Tang SC, Jeng JS. Int J Stroke 2023 Jul 24;
17474930231191991
● Comparison of clinical and neuroimaging features between NOTCH3 mutations and
nongenetic spontaneous intracerebral haemorrhage. Chen CH, … Tang SC, Jeng JS. Eur J

− 232 −
 Neurol 2022;29:3243.
● Prominent Juxtacortical White Matter Lesion Hallmarks NOTCH3-related Intracerebral
Hemorrhage. Chen CH, … Tang SC, Jeng JS. Stroke Vasc Neurol. 2022;7(1):38-46.
● Plasma Neurofilament Light Chain and Glial Fibrillary Acidic Protein Predict Stroke in
CADASIL. Chen CH, … Tang SC, Jeng JS. J Neuroinflammation 2020;17(1):124.
● Detrimental effects of intracerebral haemorrhage on patients with CADASIL harbouring
NOTCH3 R544C mutation. Chen CH, Tang SC, … Jeng JS. J Neurol Neurosurg Psychiatry
2019;90:841.
● Acute Infarcts on Brain MRI Following Aortic Arch Repair With Circulatory Arrest:
Insights From the ACE CardioLink-3 Randomized Trial. Chen CH, … Smith EE. Stroke
2023;54:67.
● Contrast-Induced Encephalopathy After Endovascular Thrombectomy for Acute Ischemic
Stroke. Chu Y T, Lee KP, Chen CH*, … Jeng JS. Stroke 2020;51:3756. (*corresponding)
Full list in Google scholar: https://scholar.google.com/citations?hl=en&user=osvbAMQAAA
AJ

Awards
2022 Invited Speaker, World Stroke Congress (Singapore)
2021 Oral Presentation Gold Award, Asian Oceanian Congress of Neurology (Taipei)
2020 Best E-Poster Award, ESO-WSO Conference (virtual)
2019-2021 Best Thesis Award, Taiwan Stroke Society Annual Meeting

− 233 −
 CADASIL in Taiwan – clinical features and
potential biomarkers

Chih-Hao Chen, MD, PhD

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy

(CADASIL), caused by NOTCH3 mutation, is a common hereditary cerebral small vessel
disease. In Taiwan, it is estimated that ~3% of acute stroke patients harbor NOTCH3
mutations. Moreover, more than a third of Taiwanese CADASIL patients with stroke manifest
as intracerebral hemorrhage (ICH), and those with ICH have a higher risk of recurrent stroke.
We thoroughly evaluate the clinical and neuroimaging features that can help clinicians identify
stroke patients potentially carrying NOTCH3 mutations. Furthermore, effective disease-
modifying interventions are essential to halt the progression in pre-symptomatic NOTCH3
mutation carriers. Therefore, we study factors that can predict or modify disease progression,
including vascular risk factors, blood pressure management, fluid biomarkers, and even retinal
microvasculature. In conclusion, our study highlights the importance of identifying NOTCH3
mutations in acute stroke patients in Taiwan and provides valuable insights into clinical
features and disease progression, paving the way for effective interventions in CADASIL.

− 234 −
 CURRICULUM VITAE

Joonsang Yoo

Address: 56, Dalseong-ro, Jung-gu, Daegu

e-mail: quarksea@gmail.com

Academic qualification
2006 Bachelor, Yonsei university
2013 Master, Neurology, Yonsei university
PhD candidate, Neurology, Yonsei university

Professional experience
2006 – 2007 Intern, Yonsei University Severance Hospital
2007 – 2011 Resident, Yonsei University Severance Hospital
2014 – 2016 Lecturer, Yonsei University Severance Hospital
2016 – 2017 Clinical Assistant professor, Yonsei University Severance Hospital
2017 – 2020 Assistant professor, Keimyung University Dongsan Hospital
2020 – 2021 Specialist, National Health Insurance Hospital
2021 – present Clinical Associate professor, Yonsei University Yongin Severance Hospital

Academic society
2007 – present Member, Korean Neurological Association
2007 – present Member, Korean Stroke Society
2014 – present Member, Early carrier, American Heart Association/ American Stroke
Association
2020 – present Manuscript editor, Journal of Stroke
2023 – present Finance director, Korean Neurocritical Care Society

Paper
Jang SH, Park H, Hong JH, Yoo J, Lee H, Kim HA, Sohn SI. Impact of High-Intensity Statin
on Early Neurologic Deterioration in Patients with Single Small Subcortical Infarction. J Clin
Med. 2023 May 3;12(9):3260.

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(First author) Yoo J, Jeon J, Baik M, Kim J. Lobeglitazone, a novel thiazolidinedione, for
secondary prevention in patients with ischemic stroke: a nationwide nested case-control study.
Cardiovasc Diabetol. 2023 May 5;22(1):106.
(First author) Yoo J, Shin JY, Jeon J, Kim J. Impact of statin treatment on cardiovascular
events in patients with retinal vein occlusion: a nested case-control study. Epidemiol Health.
2023 Mar 15:e2023035. doi: 10.4178/epih.e2023035.
(First author) Yoo J, Jeon J, Baik M, Kim J. Association between statin therapy and the risk
of stroke in patients with moyamoya disease: a nationwide cohort study. Stroke Vasc Neurol.
2022 Dec 22:svn-2022-001985. doi: 10.1136/svn-2022-001985.
(Co-first author) Park JY, Yoo J, Jeon J, Kim J, Kang S. Proton pump inhibitors and risk of
cardiovascular disease: a self-controlled case series study. Am J Gastroenterol. 2022 Jul 1;
117(7):1063-1071.
(Co-first author) Yoo J, Kim JH, Jeon J, Kim J, Song TJ. Risk of COVID-19 Infection and of
Severe Complications Among People With Epilepsy: A Nationwide Cohort Study. Neurology.
2022 May 10;98(19):e1886-e1892.
(Corresponding author) You S, Hong JH, Yoo J. Analysis of pupillometer results according
to disease stage in patients with Parkinson's disease. Sci Rep. 2021 Sep 9;11(1):17880.
(First author) Yoo J, Kim YD, Park H, Kim BM, Bang OY, Kim HC, Han E, Kim DJ, Heo
J, Kim M, Choi JK, Lee KY, Lee HS, Shin DH, Choi HY, Sohn SI, Hong JH, Lee JY, Baek
JH, Kim GS, Seo WK, Chung JW, Kim SH, Song TJ, Han SW, Park JH, Kim J, Jung YH, Cho
HJ, Ahn SH, Lee SI, Seo KD, Heo JH, Nam HS; SECRET Study Investigators. Immediate
and Long-Term Outcomes of Reperfusion Therapy in Patients With Cancer. Stroke. 2021
Jun;52(6):2026-2034.
(Corresponding author) Park H, Jeong YS, Lee SH, Jang SH, Kwon DH, Hong JH, Sohn
SI, Yoo J. Clinical prognosis of isolated anterior cerebral artery territory infarction: a
retrospective study. BMC Neurol. 2021 Apr 21;21(1):171.
(First author) Yoo J, Lee SJ, Hong JH, Kim YW, Hong JM, Kim CH, Kang DH, Choi JW,
Kim YS, Sohn SI, Hwang YH, Lee JS. Immediate effects of first-line thrombectomy devices
for intracranial atherosclerosis-related occlusion: stent retriever versus contact aspiration.
BMC Neurol. 2020 Jul 18;20(1):283.
(First author) Yoo J, Choi JK, Kim YD, Nam HS, Park H, Lee HS, Heo JH. Outcome of
Stroke Patients with Cancer and Nonbacterial Thrombotic Endocarditis. J Stroke. 2020 May;
22(2):245-253.
(First author) Yoo J, Hong JH, Lee SJ, Kim YW, Hong JM, Kim CH, Choi JW, Kang DH,
Kim YS, Hwang YH, Lee JS, Sohn SI. Acute Kidney Injury after Endovascular Treatment in
Patients with Acute Ischemic Stroke. J Clin Med. 2020 May 14;9(5):1471.

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 Cancer and stroke: Outcomes and thrombus histology

Joonsang Yoo, MD

Cancer and cerebrovascular diseases are major causes of death and disability worldwide. As
cancer treatments improve and survival times increase, the incidence of cerebral infarction in
cancer patients is gradually increasing. In addition, the prognosis is poorer in stroke patients
with systemic malignancy than in those without. Reperfusion therapy is the standard treatment
for hyperacute ischemic stroke. However, it is uncertain which stroke patients with systemic
malignancy will have a life expectancy of more than 6 months. Therefore, it is not easy to
determine treatment protocol in patients with acute ischemic stroke and active cancer.
In stroke patients with cancer, the prognosis may vary depending on the cause of the stroke.
Nonbacterial thrombotic endocarditis (NBTE) is characterized by noninfectious vegetation
on the cardiac valves. NBTE is a cause of stroke and most frequently develops in patients
with systemic cancer. Cancer may be associated with an increased risk of cerebral infarction
through several thrombotic mechanisms including NBTE, paradoxical embolism of venous
thrombi through arteriovenous shunt, and diffuse arterial thrombosis from disseminated
intravascular coagulation. Although patients with acute stroke and active cancer are known
to have a substantial short-term risk of recurrent stroke, the outcomes of stroke patients with
cancer-associated NBTE are not well known.
Meanwhile, since the successful introduction of EVT in patients with acute ischemic stroke,
fresh arterial thrombi can be obtained. The analysis of thrombi may provide insight into
the mechanism of thrombosis, thereby aiding the determination of the treatment strategy.
Although tumor cells can induce hypercoagulability by generating and activating coagulation
factors, the expression of coagulation factors in the arterial thrombi of patients with cancer-
associated stroke is not well known.
In this lecture, I will discuss the prognosis of stroke patients with cancer, including those who
have undergone reperfusion therapy and those in unique situations such as NBTE, based on
my previous research. Additionally, I will discuss my current investigation on the composition
of thrombi obtained from stroke patients with cancer.

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 CURRICULUM VITAE

Yu-Kai Lin M.D.

Current Position
● Attending Physician: Department of Neurology, Tri-Service General Hospital, National
Defense Medical Center, Taipei, Taiwan (2017/8-present)
● Assistant professor: National Defense Medical Center, Taipei, Taiwan (2020/8-present)

Education
● Department of Medicine, National Defense Medical Center, Taiwan (2003/8-2010/7)

Experience
● Attending Physician: Division of Neurology, Hualien Armed Forced General Hospital,
Hualien county, Taiwan (2018/1-present)
● Attending Physician: Department of Neurology, Tri-Service General Hospital, National
Defense Medical Center, Taipei, Taiwan (2017/8-present)
● Attending Physician: Division of Neurology, Puli Branch, Taichung Veterans General
Hospital, Nantou county, Taiwan (2017/1-2017/12)
● Chief Resident: Department of Neurology, Tri-Service General Hospital, National Defense
Medical Center, Taiwan (2016/8-2017/7)
● Resident: Department of Neurology, Tri-Service General Hospital, National Defense
Medical Center, Taiwan (2013/8-2016/7)

Expertise
● Headache and pain
● Stroke
● Neuromodulation (rTMS)
● Clinical neurology

Selective scientific publications

1. Lin YK, Tsai CL, Lin GY, Chou CH, Yang FC. Pathophysiology of Chronic Migraine:
Insights from Recent Neuroimaging Research. Curr Pain Headache Rep. 2022 Nov;
26(11):843-854.

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 2. Lin YK, Liang CS, Tsai CK, Tsai CL, Lee JT, Sung YF, Chou CH, Shang HS, Yang BH,
Lin GY, Su MW, Yang FC. A Metallomic Approach to Assess Associations of Plasma
Metal Levels with Amnestic Mild Cognitive Impairment and Alzheimer’s Disease: An
Exploratory Study. J Clin Med. 2022 Jun 24;11(13):3655. doi: 10.3390/jcm11133655
3. Lin GM, Liu PY, Tsai KZ, Lin YK, Huang WC, Lavie CJ. Cardiorespiratory Fitness
and Carotid Intima-Media Thickness in Physically Active Young Adults: CHIEF
Atherosclerosis Study. J Clin Med. 2022 Jun 24;11(13):3653. doi: 10.3390/jcm11133653
4. Yeh PK, Liang CS, Tsai CL, Lin YK, Lin GY, Tsai CK, Tsai MC, Liu Y, Tai YM, Hung
KS, Yang FC. Genetic Variants Associated With Subjective Cognitive Decline in Patients
With Migraine. Front Aging Neurosci. 2022 Jun 15;14:860604. doi: 10.3389/fnagi.2022.
860604
5. An YC, Tsai CL, Liang CS, Lin YK, Lin GY, Tsai CK, Liu Y, Chen SJ, Tsai SH, Hung KS,
Yang FC. Identification of Novel Genetic Variants Associated with Insomnia and Migraine
Comorbidity. Nat Sci Sleep. 2022 Jun 7;14:1075-1087. doi: 10.2147/NSS.S365988
6. Sun MT, Wu TJ, Lin YK, Lin YP, Chang YC, Lin GM. Effects of Sacubitril/Valsartan Versus
Telmisartan in Type 2 Diabetic or Pre-Diabetic Patients with Hypertension and Without
Heart Failure: The Rationale and Design of A Randomized Clinical Trial. Cardiovasc
Hematol Disord Drug Targets. 2022 Apr 8.doi: 10.2174/1871529X22666220408223329
7. Lin YK, Tsai KZ, Han CL, Lee JT, Lin GM. Athlete's Heart Assessed by Sit-Up Strength
Exercises in Military Men and Women: The CHIEF Heart Study. Front Cardiovasc Med.
2022 Jan 26;8:737607.
8. Lin W, Lin YH, Gao HW, Chen IF, Ko CA, Tsai CK, Lin YK. Neuroendocrine Carcinoma
of the Endometrium with Ectopic Secretion of Parathyroid Hormone Presenting as
Hypercalcemia- Related Posterior Reversible Encephalopathy syndrome: A Case Report.
Acta Neurol Taiwan. 2022 Jan 25;31(1):36-40.
9. Lin YK, Tsai KZ, Han CL, Lin YP, Lee JT, Lin GM. Obesity Phenotypes and
Electrocardiographic Characteristics in Physically Active Males: CHIEF Study. Front
Cardiovasc Med. 2021 Oct 13;8:738575.
10. Chou KH, Kuo CY, Liang CS, Lee PL, Tsai CK, Tsai CL, Huang MH, Hsu YC, Lin GY,
Lin YK, Lin CP, Yang FC. Shared Patterns of Brain Functional Connectivity for the
Comorbidity between Migraine and Insomnia. Biomedicines. 2021 Oct 9;9(10):1420.
11. Lin W, Ko CA, Sung YF, Chen YC, Lee JT, Lin YQ, Lin YK. Cerebral Venous Sinus
Thrombosis, Pulmonary Embolism, and Thrombocytopenia After COVID-19 Vaccination
in a Taiwanese Man: A Case Report and Literature Review.
12. Lin YK, Liang CS, Lee JT, Lee MS, Chu HT, Tsai CL, Lin GY, Ho TH, Yang FC.
Association of Suicide Risk With Headache Frequency Among Migraine Patients With and
Without Aura. Front Neurol. 2019 Mar 19;10:228.
13. Lin YK, Liu PY, Fan CH, Tsai KZ, Lin YP, Lin JM, Lee JT, Lin GM. Metabolic
biomarkers and long-term blood pressure variability in military young male adults. World
Journal of Clinical Cases. 2020 Jun 6;8(11):2246-2254.
14. Lin Y.K., Lin Y.P., Lee J.T., Lin C.S., Wu T.J., Tsai K.Z., Su F.Y., Kwon Y., Hoshide S.,
Lin G.M. Sex-specific association of hyperuricemia with cardiometabolic abnormalities in
a military cohort: The CHIEF study. Medicine (United States). 2020, 99(12):e19535.

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 Noninvasive Brain Stimulation for Motor Recovery
after Stroke
Yu-Kai Lin M.D.

Stroke is the leading cause of disability worldwide, with motor disability contralateral to
the stroke lesion side being the most common impairment. To address the challenges in
motor recovery after stroke, researchers have explored various neurorehabilitation strategies.
Among these, noninvasive brain stimulation (NIBS) techniques, such as repetitive transcranial
magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have gained
attention for their potential to alter human cortex excitability and promote neural plasticity.
Repetitive transcranial magnetic stimulation (rTMS) involves stimulating the cortex through
the scalp and skull using a wire coil that generates a short-lasting, local magnetic field. This
magnetic field induces an electrical current that flows through neurons, resulting in neuronal
depolarization. High-frequency rTMS has been found to increase cortical excitability, while
low-frequency rTMS suppresses cortical excitability. One effective rTMS method reported
is Theta Burst Stimulation (TBS), which involves repeating bursts of very low-intensity
combined-frequency rTMS. Each burst consists of three stimuli delivered at 50 Hz, repeating
at 5 Hz.
The potential benefits of NIBS in motor recovery after stroke lie in its ability to facilitate
functional interhemispheric balance between the two motor cortices. By either increasing
the excitability of the affected hemisphere or decreasing the excitability of the unaffected
hemisphere, NIBS can contribute to better motor outcomes.
While the results of small-scale studies are encouraging, several questions remain to be
addressed before routine use of NIBS in stroke management can be considered. These
questions include determining the optimal stimulation parameters, the best NIBS
intervention, the timing of intervention (acute or chronic phase), and the selection criteria for
patients who would benefit most from NIBS therapy.
In this lecture, I will present the rationale for rTMS and the current evidence for rTMS in
stroke patients.

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 CURRICULUM VITAE

Kangho Choi, M.D., Ph.D.

Personal Information:
Name in Full: Kang-ho Choi
Sex: Male
Nationality: Korea
Office address:Department of Neurology, Chonnam National University Hospital
8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea
E-mail: ckhchoikang@hanmail.net

Academic Training:
Graduate School (M.S.) March 2006 – February 2008 Chonnam National University
Graduate School Gwangju, Korea
Graduate School (Ph.D.) March 2009 – February 2011 Chonnam National University
Graduate School Gwangju, Korea

Postgraduate Training:
Residency in Neurology March 2006 – February 2010 Chonnam National University
Hospital Gwangju, Korea
Clinical Fellowship March 2010 – February 2011 Chonnam National University
Hospital Gwangju, Korea
Research Fellowship March 2013 – June 2013 School of Clinical Sciences, Bristol
University Bristol, United Kingdom
Assistant Professor March 2011 – Octorber 2016 Chonnam National University
Hospital Gwangju, Korea
Associate Professor November 2016 – Present Chonnam National University
Hospital Gwangju, Korea

Representative publications as first author or corresponding author

1. Kim DY, Choi KH, Kim JH, Hong J, Choi SM, Park MS, Cho KH. Deep learning-
based personalised outcome prediction after acute ischaemic stroke. J Neurol Neurosurg
Psychiatry. 2023 Jan 17;jnnp-2022-330230.

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 2. Thomas RG, Kim JH, Kim JH, Yoon J, Choi KH, Jeong YY. Treatment of Ischemic Stroke
by Atorvastatin-Loaded PEGylated Liposome. Transl Stroke Res. 2023 Jan 14.
3. Kim HY, Kim JH, Kim JH, Oh SG, Choi KH, Yoon JW. Magnetothermal-based non-
invasive focused magnetic stimulation for functional recovery in chronic stroke treatment.
Sci Rep. 2023 Mar 27;13(1):4988.
4. Choi KH, Kim JH, Kim JM, Kang KW, Lee C, Kim JT, Choi SM, Park MS, Cho KH.
d-dimer Level as a Predictor of Recurrent Stroke in Patients With Embolic Stroke of
Undetermined Source. Stroke. 2021 Jul;52(7):2292-2301.
5. Choi KH, Kim JH, Lee C, Kim JM, Kang KW, Kim JT, Choi SM, Park MS, Cho KH.
Troponin Levels and Outcomes in Patients with Embolic Stroke of Undetermined Source.
J Stroke. 2021 May;23(2):285-288.
6. Choi KH, Kim JH, Lee C, Kim JM, Kang KW, Kim JT, Choi SM, Park MS, Cho KH.
Anticoagulation versus Antiplatelet Therapy after Ischemic Stroke in the Patients with
Atrial Fibrillation and Cerebral Microbleeds. J Stroke. 2021 May;23(2):273-276.
7. Choi KH, Kim JH, Lee C, Kim JM, Kang KW, Kim JT, Choi SM, Park MS, Cho KH.
Microbleeds and Outcome in Patients With Acute Ischemic Stroke and Atrial Fibrillation
Taking Anticoagulants. Stroke. 2020 Oct 8.
8. Choi KH, Seo WK, Park MS, Kim JT, Chung JW, Bang OY, Kim GM, Song TJ, Kim BJ,
Heo SH, Jung JM, Oh KM, Kim CK, Yu S, Park KY, Kim JM, Park JH, Choi JC, Hwang
YH, Kim YJ. Effect of Statin Therapy on Outcomes of Patients With Acute Ischemic
Stroke and Atrial Fibrillation. J Am Heart Assoc. 2019 Dec 17;8(24):e013941.
9. Choi KH, Seo WK, Park MS, Kim JT, Chung JW, Bang OY, Kim GM, Song TJ, Kim BJ,
Heo SH, Jung JM, Oh K, Kim CK, Yu S, Park KY, Kim JM, Park JH, Choi JC, Hwang
YH, Kim YJ. Baseline D-Dimer Levels as a Risk Assessment Biomarker for Recurrent
Stroke in Patients with Combined Atrial Fibrillation and Atherosclerosis. J Clin Med. 2019
Sep 13;8(9).
10. Choi KH, Kim JM, Kim JH, Kim JT, Park MS, Choi SM, Lee SH, Kim BC, Kim MK,
Cho KH. Optimal blood pressure after reperfusion therapy in patients with acute ischemic
stroke. Sci Rep. 2019 Apr 5;9(1):5681.
11. Choi KH, Kim JH, Kang KW, Kim JT, Choi SM, Lee SH, Park MS, Kim BC, Kim MK,
Cho KH. HbA1c (Glycated Hemoglobin) Levels and Clinical Outcome Post-Mechanical
Thrombectomy in Patients With Large Vessel Occlusion. Stroke. 2019;50:119-126.
12. Choi KH, Kim JH, Kang KW, Kim JT, Choi SM, Lee SH, Park MS, Kim BC, Kim MK,
Cho KH. Impact of Microbleeds on Outcome Following Recanalization in Patients With
Acute Ischemic Stroke. Stroke. 2019;50:127-134.

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 Exploring the undetermined sources and novel treatment
strategies for stroke
Kangho Choi, M.D., Ph.D.

One of the challenges in stroke treatment is the significant heterogeneity of potential sources
of embolism in patients with embolic stroke of undetermined source (ESUS). The possible
causes of ESUS include covert AF, hidden malignancy, ipsilateral stenosis <50%, and aortic
arch atherosclerosis. Further studies are needed to understand better the underlying causes
of stroke in patients with ESUS and identify proper treatment strategies for secondary
prevention. We recently developed an AI model to predict the prognosis after acute ischemic
stroke and an AI model that automatically measures abdominal fat in PET-CT. Using these
models, we are conducting a study to distinguish stenosis, which can be the culprit cause of
ESUS, even if it is less than 50% through PET-CT. We are also developing an AI model to
find covert AF.
Another challenge in stroke treatment is the blood-brain barrier (BBB). We previously
investigated the appropriate treatment strategies in patients with CMB, a patient with a
fragile BBB, and follow-up studies are in progress. In contrast, a healthy BBB is a barrier to
overcome in delivering therapeutics. We are developing novel technologies to deliver drugs
across the BBB to targeted brain regions.

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 CURRICULUM VITAE

Pi-Shan Sung (宋碧姍)

Chronology of position held:

Feb. 2022 to present Clinical Associate professor, Department of Neurology, National
Cheng Kung University Hospital, Tainan, Taiwan
Aug. 2018 to Jan. 2022 Clinical Assistant professor, Department of Neurology, National
Cheng Kung University Hospital, Tainan, Taiwan
Aug. 2010 to present Staff Physician, Department of Neurology, National Cheng
Kung University Hospital, Tainan, Taiwan.
Aug. 2009- July 2010 Chief Resident, Department of Neurology, National Cheng
Kung University Hospital, Tainan, Taiwan.
July 2006- July 2009 Resident, Department of Neurology, National Cheng Kung
University Hospital, Tainan, Taiwan.

Education:
1999-2006 Doctor of Medicine, National Cheng Kung University.
2012~2022 The institute of clinical medicine, National Cheng Kung University.

Publication:

Referred paper:
1. Recurrent Ischemic Stroke and Cardiovascular Outcomes in Patients With Atrial
Fibrillation With Ischemic Stroke Despite Direct Oral Anticoagulants. Meng-Tsang Hsieh,
Chi-Hung Liu, Sheng-Hsiang Lin, Po-Yu Lin, Yu-Ming Chang, Chun-Min Wang, Chih-
Hung Chen, Pi-Shan Sung. Stroke. 2023 Apr;54(4):e145-e146. (Corresponding author)
2. Detailed risks and characteristics of postepilepsy stroke in non-traumatic adult-onset
epilepsy. Po-Yu Lin, Chi-Hung Liu, Yu-Ming Chang, Chin-Wei Huang, Hui-Chen Su,
Sheng-Hsiang Lin, Pi-Shan Sung. J Formos Med Assoc. 2022 25;S0929-6646(22)00146-2.
(Corresponding author)
3. Ankle–Brachial Index Predicts Long-Term Renal Outcomes in Acute Stroke Patients. Lee
TL, Chang YM, Liu CH, Su HC, Sung PS, Lin SH, Chen CH. Healthcare (Basel). 2022;
10(5):913. (Corresponding author)

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 4. Memantine Protects against Paclitaxel-Induced Cognitive Impairment through Modulation
of Neurogenesis and Inflammation in Mice. Pi-Shan Sung, Pei-Wen Chen, Chia-Jui Yen,
Meng-Ru Shen, Chih-Hung Chen, Kuen-Jer Tsai*, and Chou-Ching K. Lin* Cancers
2021;13(16):4177 (First author)
5. Hypoperfusion Index Ratio as a Surrogate of Collateral Scoring on CT Angiogram in
Large Vessel Stroke. Wang CM, Chang YM, Sung PS, Chen CH. J Clin Med. 2021. 21;
10(6):1296. (Corresponding author)
6. Factors Associated with Cognitive Outcomes After First-Ever Ischemic Stroke: The Impact
of Small Vessel Disease Burden and Neurodegeneration. Sung PS, Lee KP, Lin PY, Su
HC, Yu RL, Tsai KJ, Lin SH, Chen CH. J Alzheimers Dis. 2021 Jul 27. doi: 10.3233/JAD-
210587. (Co-first author)
7. Simple but organized neurology residency training improves the quality of acute stroke
care: From the outset to long-term effect. Yu Ming Chang, Chun Min Wang, Po Yu Lin, Pi
Shan Sung, Sheng Hsiang Lin, Chih-Hung Chen. Journal of Stroke. 23(2):293-295. https://
doi.org/10.5853/jos.2020.04910 (Corresponding author)
8. Association between Blood Pressure, Blood Pressure Variability, and Post-Stroke
Cognitive Impairment. Kang-Po Lee, Alice Y. W. Chang, Pi-Shan Sung. Biomedicines
2021;9(7):773 (Corresponding author)
9. Hypoperfusion Index Ratio as a Surrogate of Collateral Scoring on CT Angiogram in
Large Vessel Stroke. Chun-Min Wang, Yu-Ming Chang*, Pi-Shan Sung* and Chih-Hung
Chen. J. Clin. Med. 2021;10:1296. (Corresponding author)
10. Po-Yu Lin,Yu-Ming Chang, Chih-Yuan Huang, Chih-Hao Lin, Ming-Tsung Chuang, Po-
Lin Chen, Pi-Shan Sung, Chih-Hung Chen. Management of Hyperacute Stroke during the
Coronavirus Disease of 2019 Pandemic: The Modified Code Stroke in a Medical Center in
Taiwan. Journal of Stroke. 22(2):278-281. (Corresponding author)
11. Lee TL, Liu CH, Chang YM, Lin TY, Chien CY, Chen CH, Tsai KJ, Lin SH, Sung PS (2020,
Jan). The Impact of Antiplatelet Use on the Risk of Intracerebral Hemorrhage in Patients
with Alzheimer’s Disease: A Nationwide Cohort Study. Journal of Alzheimer’s Disease,
2020;73(1):297-306. (Corresponding author)
12. Pi-Shan Sung, Po-Yu Lin, Chi-Hung Liu, Hui-Chen Su, Kuen-Jer Tsai (2020, Jan).
Neuroinflammation and Neurogenesis in Alzheimer’s Disease and Potential Therapeutic
Approaches. International Journal of Molecular Sciences. 21(3):701. (First author).
13. Hui Hua Chang† , Pi-Shan Sung†, Wei Chen Liao, Alice Y. W. Chang, Ya-Hsin Hsiao,
Tzu-Fun Fu, Chin-Ying Huang and Chin-Wei Huang (2020, Aug). An Open Pilot Study of
the Effect and Tolerability of Add-On Multivitamin Therapy in Patients with Intractable
Focal Epilepsy. Nutrients 12(8):2359. (Co-First author).
14. Contrast-Induced Encephalopathy After Endovascular Thrombectomy for Acute Ischemic
Stroke.Chu YT, Lee KP, Chen CH, Sung PS, Lin YH, Lee CW, Tsai LK, Tang SC, Jeng JS.
Stroke Oct.
15. Maintenance of Stroke Care Quality amid the Coronavirus Disease 2019 Outbreak in
Taiwan.Chen CH, Liu CH, Chi NF, Sung PS, Hsieh CY, Lee M, Tang SC, Jeng JS; Taiwan
Stroke Society Investigators. J Stroke. 2020;22(3):407-411.

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 The New Web-Based Acute Stroke Transferring Software System
In Regional Stroke Network: focus on stroke transferring
efficiency and transferring model

Pi-Shan Sung

Background: Endovascular thrombectomy (EVT) is a time-sensitive treatment for acute

ischemic stroke with large-vessel occlusion. To optimize transfer efficiency for potential EVT
candidates, a web-based platform was introduced in the Tainan Stroke Network (TSN). We
assessed its application and effectiveness in regional stroke care.
Method: This new web-based platform containing a questionnaire-style interface was
introduced on October 1, 2021. To assess the transfer efficiency and patient outcomes, acute
stroke patients transferred from PSCs to CSC for EVT from April 01, 2020, to 30, May,
2023, were enrolled. The patients were classified into the traditional transferal pathway (TTP)
group and the new transferal pathway (NTP) group depending on mode of transfer. Patient
characteristics, time segments after stroke onset and outcome were compared between groups.
Result: A total of 123 patients were enrolled, with 86 in the TTP group and 37 in the NTP
group. Compared to the TTP group, the NTP group had a significantly shorter onset-to-door
time (TTP vs. NTP: 274 vs. 198 minutes; p=0.021) and a higher EVT rate (TTP vs. NTP:
23.2% vs. 56.3%, p=0.001). Among EVT patients, those in the NTP group had a significantly
shorter door-to-puncture time (TTP vs. NTP: 123 vs. 102 minutes; p=0.023). The NTP group
had a trend toward a higher rate of good functional outcomes at 3 months (TTP vs. NTP: 25%
vs. 61.5%; p=0.067).
Conclusion: This new web-based TSN platform provides notable improvements in clinical
outcomes, transfer efficiency, and EVT execution for potential EVT candidates without
markedly changing the regional stroke care paradigm.

Key word: endovascular thrombectomy, drip-and-ship model, transfer, quality improvement.

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 CURRICULUM VITAE

Beom Joon Kim, MD. PhD.

Associate Professor,
Cerebrovascular Center and Bundang Clinical Neuroscience Center
Department of Neurology, Seoul National University Bundang Hospital

Office #8710, 2nd Bldg. Seoul National University Bundang Hospital

82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620
ORCID ID: 0000-0002-2719-3012
E-mail: Kim.BJ.stroke@gmail.com; besy1872@snu.ac.kr

EDUCATION
Ph.D. (March 2010 – February 2013)
- Neuroscience (Seoul National University College of Medicine, Seoul, KOREA)
M.S. (September 2005 – August 2007)
- Neuroscience (Seoul National University College of Medicine, Seoul, KOREA)
M.D. (March 1999 – February 2003)
- Seoul National University, College of Medicine, Seoul, KOREA

WORK EXPERIENCE
Assistant / Associate Professor (September 2013 – current)
- Cerebrovascular center and Department of Neurology, Seoul National University
Bundang Hospital
- Chief of the Cerebrovascular Disease center, Gyeonggi Regional Cardiocerebrovascular
Disease Center
Clinical Instructor (March 2012 – August 2013)
- Cerebrovascular center and Department of Neurology, Seoul National University
Bundang Hospital
Fellowship (Apr 2011 – Feb 2012)
- Vascular Neurology (mentor: Prof. Seung-Hoon Lee and Byung-Woo Yoon)
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea

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Epidemic Intelligence Service officer, Korean Center for Disease Control (Apr 2008 – Apr 2011)
- Alternative service of military service obligation
- Participated in the national survey of Creutzfeldt-Jacob disease
Residency (March 2004 – Feb 2008)
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea

ACADEMIC INTERESTS
a) Treatment of stroke
b) Development of neuroimaging or serum markers to predict outcomes after stroke
c) Collateral circulation, cerebral autoregulation and their association with systemic blood
pressure, potentially mitigating progression of ischemia after cerebral large vessel
occlusions
d) Vascular cognitive impairment; Cognitive neuroscience and behavioral symptoms after
stroke
e) Decision making on the hyperacute recanalization treatment for stroke patients
f) Statistical methodology of clinical stroke research
g) Intracranial atherosclerosis
h) Clinical epidemiology and research methodology for stroke

PEER-REVIEWED PUBLICATIONS
1. Zhu K, Bala F, Zhang J, Benali F, Cimflova P, Kim BJ, McDonough R, Singh N, Hill
MD, Goyal M, et al. Automated Segmentation of Intracranial Thrombus on NCCT and
CTA in Patients with Acute Ischemic Stroke Using a Coarse-to-Fine Deep Learning
Model. AJNR Am J Neuroradiol. 2023;44:641-648. doi: 10.3174/ajnr.A7878
2. Weaver NA, Mamdani MH, Lim JS, Biesbroek JM, Biessels GJ, Huenges Wajer IMC,
Kang Y, Kim BJ, Lee BC, Lee KJ, et al. Disentangling poststroke cognitive deficits and
their neuroanatomical correlates through combined multivariable and multioutcome lesion-
symptom mapping. Hum Brain Mapp. 2023;44:2266-2278. doi: 10.1002/hbm.26208
3. Singh N, Kim BJ, Ganesh A, Menon BK. Intravenous Thrombolysis in an Endovascular
Treatment–Dominant Era: What Does the Future Hold? Stroke: Vascular and
Interventional Neurology. 2023;3:e000671. doi: 10.1161/SVIN.122.000671
4. Ryu WS, Chung J, Schellingerhout D, Jeong SW, Kim HR, Park JE, Kim BJ, Kim JT,
Hong KS, Lee K, et al. Biological Mechanism of Sex Difference in Stroke Manifestation
and Outcomes. Neurology. 2023;100:e2490-e2503. doi: 10.1212/WNL.0000000000207346
5. Park HK, Lee KJ, Park JM, Kang K, Lee SJ, Kim JG, Cha JK, Kim DH, Han MK, Kang J,
et al. Prevalence of Mutations in Mendelian Stroke Genes in Early Onset Stroke Patients.
Ann Neurol. 2023;93:768-782. doi: 10.1002/ana.26575
6. Park EH, Hwang SS, Oh J, Kim BJ, Bae HJ, Yang KH, Choi AR, Kang MY, Subramanian
SV. Annual Endovascular Thrombectomy Case Volume and Thrombectomy-capable
Hospitals of Korea in Acute Stroke Care. J Prev Med Public Health. 2023;56:145-153.
doi: 10.3961/jpmph.22.318
7. Kwon HS, Kim C, Kim YS, Koh SH, Kim HY, Lee SH, Jung KH, Kim JM, Kim YD,
Kwon HM, et al. Long sleep duration and dissatisfaction with sleep quality are associated
with ischemic stroke in young patients. Cerebrovasc Dis. 2023. doi: 10.1159/000530003

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 8. Kim YS, Kim BJ, Menon BK, Yoo J, Han JH, Kim BJ, Kim CK, Kim JG, Kim JT, Park H,
et al. Leptomeningeal Collaterals and Infarct Progression in Patients With Acute Large‐
Vessel Occlusion and Low NIHSS. Stroke: Vascular and Interventional Neurology. 2023.
doi: 10.1161/svin.122.000819
9. Kim JT, Lee JS, Kim BJ, Park JM, Kang K, Lee SJ, Kim JG, Cha JK, Kim DH, Park
TH, et al. Frequency, management, and outcomes of early neurologic deterioration due
to stroke progression or recurrence. J Stroke Cerebrovasc Dis. 2023;32:106940. doi:
10.1016/j.jstrokecerebrovasdis.2022.106940
10. Kim JT, Lee JS, Kim BJ, Kang J, Lee KJ, Park JM, Kang K, Lee SJ, Kim JG, Cha JK,
et al. Admission hyperglycemia, stroke subtypes, outcomes in acute ischemic stroke.
Diabetes Res Clin Pract. 2023;196:110257. doi: 10.1016/j.diabres.2023.110257
11. Kim JT, Kang J, Kim BJ, Kim JY, Han MK, Cho KH, Park MS, Choi KH, Park JM,
Kang K, et al. Dual antiplatelet Use for extended period taRgeted to AcuTe ischemic
stroke with presumed atherosclerotic OrigiN (DURATION) trial: Rationale and design.
Int J Stroke. 2023:17474930231168742. doi: 10.1177/17474930231168742
12. Kim DY, Han SG, Jeong HG, Lee KJ, Kim BJ, Han MK, Choi KH, Kim JT, Shin DI,
Cha JK, et al. Covert Brain Infarction as a Risk Factor for Stroke Recurrence in Patients
With Atrial Fibrillation. Stroke. 2023;54:87-95. doi: 10.1161/STROKEAHA.122.038600
13. Kang K, Park JM, Ryu WS, Jeong SW, Kim DE, Park HK, Cho YJ, Hong KS, Lee KB,
Park TH, et al. Body mass index and waist circumference as predictors of recurrent
vascular events after a recent ischemic stroke. J Stroke Cerebrovasc Dis. 2023;32:107221.
doi: 10.1016/j.jstrokecerebrovasdis.2023.107221
14. Chung I, Bae HJ, Kim BJ, Kim JY, Han MK, Kim J, Jung C, Kang J. Interactive Direct
Interhospital Transfer Network System for Acute Stroke in South Korea. J Clin Neurol.
2023;19:125-130. doi: 10.3988/jcn.2022.0158
15. Choi JY, Kim S, Boo D, Yoo S, Kim HJ, Kim JY, Lee KJ, Kang J, Kim BJ, Han MK,
et al. Risk of future stroke in patients with a diagnosis of peripheral vertigo in the
emergency department. Eur J Neurol. 2023;30:2062-2069. doi: 10.1111/ene.15543
16. Bala F, Qiu W, Zhu K, Kappelhof M, Cimflova P, Kim BJ, McDonough R, Singh N,
Kashani N, Zhang J, et al. Ability of Radiomics Versus Humans in Predicting First‐Pass
Effect After Endovascular Treatment in the ESCAPE‐NA1 Trial. Stroke: Vascular and
Interventional Neurology. 2023;3. doi: 10.1161/svin.122.000525
17. Bala F, Kim BJ, Najm M, Thornton J, Fainardi E, Michel P, Alpay K, Herlihy D, Goyal
M, Casetta I, et al. Outcomes with Endovascular Treatment of Patients with M2 Segment
MCA Occlusion in the Late Time Window. AJNR Am J Neuroradiol. 2023;44:447-452.
doi: 10.3174/ajnr.A7833
18. Bala F, Kappelhof M, Ospel JM, Cimflova P, Qiu W, Singh N, Zhu K, Kim BJ, Wadhwa
A, Almekhlafi MA, et al. Distal Embolization in Relation to Radiological Thrombus
Characteristics, Treatment Details, and Functional Outcome. Stroke. 2023;54:448-456.
doi: 10.1161/STROKEAHA.122.040542
19. Bala F, Cimflova P, Singh N, Zhang J, Kappelhof M, Kim BJ, Najm M, Golan R, Elebute
I, Benali F, et al. Impact of vessel tortuosity and radiological thrombus characteristics on
the choice of first-line thrombectomy strategy: Results from the ESCAPE-NA1 trial. Eur
Stroke J. 2023:23969873231183766. doi: 10.1177/23969873231183766

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 Widening sex disparity of intravenous thrombolysis as with
declining stroke care quality

Beom Joon Kim, Yoon A Ko, Hee-Joon Bae

Department of Neurology and Cerebrovascular Center,

Seoul National University Bundang Hospital,
Seongnam-si, Gyeonggi-do, Republic of Korea

Presenting author: Beom Joon Kim

Background and Objective: Several studies have reported disparities in care access between
men and women for the treatment of hyperacute ischemic stroke. The proportion of patients
receiving intravenous thrombolysis has decreased in the Republic of Korea over the past
decade. We intended to investigate how these changes influence sex disparity in acute stroke
treatment.
Methods: The authors analyzed patients enlisted in a prospective, nationwide, multicenter
stroke registry in South Korea between April 2008 and December 2022, when 96,855
admissions for ischemic stroke were recorded. The authors defined thrombolysis candidates
as patients admitted within 4.5 hours of their last known well time and with an initial
NIHSS score of 4 or greater, by which 15,732 candidates were identified. The intravenous
thrombolysis trend was analyzed using a joinpoint regression model.
Results: Of the 15,732 candidates for thrombolysis, 9194 (58.4%) received thrombolysis
treatment. In comparison to untreated patients, treated patients were on average younger, more
likely to be male, less dependent prior to the stroke, presented earlier, and had higher NIHSS
scores. The trend in the proportion of candidates who had thrombolysis was divided into
three phases, with statistically significant annual percent change (APC) for phases 1 (10.91)
and 2 (-5.40; Panel A). The 90th percentile of arrival to IV thrombolysis time demonstrates
a consistent improving trend from 2008 to 2013 (1.56 hours to 0.92 hours), followed by a
deteriorating trend from 2014 to 2018 (1.15 hours in 2018; Panel B). Panel C demonstrates
that the significant downward trend in Phase 2 appears to be predominantly driven by
a significant negative APC (-8.71) for female candidates. Female sex was significantly
associated with a decrease in the odds ratio of receiving thrombolysis during the 2014 – 2022
period (adjusted OR and 95% CI, 0.85 [0.75 – 0.93]) but not during 2008 – 2013 (0.91 [95%
CI, 0.80 - 1.05]).
Conclusions: The quality of acute stroke care in South Korea improved steadily from 2008 to
2013. However, it is estimated to have deteriorated gradually since 2014 with a widening sex
disparity in intravenous thrombolysis access. In addition to addressing sex disparities in acute
stroke care, it is necessary to enhance the overall quality of care in Korea.

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 CURRICULUM VITAE

Chi-Hung Liu

Education:
1997 – 2004 China Medical University, M.D.
2014 – 2018 Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang
Gung University, MSc.
2022 – PhD student, Institute of Health Policy and Management, College of Public
Health, National Taiwan University.

Employment Record:
Current position:
1. Associate Chair and Assistant Professor, School of Medicine, Chang Gung University.
2. Professor, Department of Neurology and stroke center, Chang Gung Memorial Hospital.
3. Director, Taiwan stroke society.
4. Supervisor, Taiwan Neurological Society.

Past positions:
2019 Oct. ~2021. May. Secretary-general, Taiwan Neurological Society.

Research Interest:
Cerebrovascular disease, Medical education, Neuro-sonography, Neurology

Publications
1. Chi-Hung Liu, Yi-Ling Wu, Chih-Cheng Hsu, Tsong-Hai Lee. Early Antiplatelet
Resumption and the Risk of Intracranial Bleeding in Patients after Intracerebral
Hemorrhage. Stroke. 2023;54(2):537-545.
2. Meng-Tsang Hsieh, Chi-Hung Liu, Sheng-Hsiang Lin, et al. Recurrent Ischemic Stroke
and Cardiovascular Outcomes in AF Patients with Ischemic Stroke Despite Direct Oral
Anticoagulants. Stroke 2023;54(4):e145-e146.
3. Chi-Hung Liu, Bing-Shen Huang, Chien-Yu Lin, et al. Head and Neck Cancer Types and
Risks of Cervical–cranial vascular Complications within 5 Years after Radiation Therapy.
J Pers Med. 2022 Jun;12(7):1060.

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 4. Chi-Hung Liu, June Hung, Chun-Wei Chang, John J. H. Lin, et al. Oral Presentation
Assessment and Image Reading Behaviour on Brain Computed Tomography Reading in
Novice Clinical Learners: An Eye-tracking Study. BMC Medical Education. 2022;22(1):
738
5. Chi-Hung Liu, Pi-Shan Sung, Yan-Rong Li, et al. Telmisartan Use and Risk of Dementia
in Type 2 Diabetic Patients with Hypertension: A Population-based Cohort Study. PLoS
Med. 2021 Jul;18(7):e1003707.
6. Chi-Hung Liu, Joseph Tung-Chieh Chang*, Tsong-Hai Lee1, et al. Hypothyroidism and
Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer
After Radiotherapy. BMC Neurology. 2021 Jan;21(1):30.
7. Chi-Hung Liu, Joseph Tung-Chieh Chang*, Tsong-Hai Lee, et al. Total Plaque Score
Helps to Determine Follow-up Strategy for Carotid Artery Stenosis Progression in Head
and Neck Cancer Patients after Radiation Therapy. PLoS One. 2021 Feb;16(2):e0246684.
8. Chi-Hung Liu, Tsong-Hai Lee, Yu-Sheng Lin, et al. Pioglitazone and PPAR-γ Modulating
Treatment in Hypertensive and Type 2 Diabetic Patients after Ischemic Stroke: a national
cohort study. Cardiovasc Diabetol. 2020 Jan;19(1):2.
9. Chi-Hung Liu*, (Corresponding author) Comparison of long-term efficacy and safety
between cilostazol and clopidogrel in chronic ischemic stroke: a nationwide cohort study.
Therapeutic Advances in Chronic Disease. 2020 Jul;11: 2040622320936418.
10. Wen-Kuan Huang, Chi-Hung Liu, See-Tong Pang, et al. Type of Androgen Deprivation
Therapy and Risk of Dementia in Patients with Prostate Cancer. JAMA Network Open.
2020 Aug;3(8):e2015189.

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 Vasculopathy and stroke after modern radiation therapy
methods in head and neck cancer patients:
an am-bidirectional dynamic cohort study
Chi-Hung Liu1, 2, 3

1
Associate Chair and Assistant Professor, School of Medicine, Chang Gung University.
2
Professor, Department of Neurology and stroke center, Chang Gung Memorial Hospital,
Linkou medical center.
3
Institute of Health Policy and Management, College of Public Health, National Taiwan
University, Taipei, Taiwan

Abstract

Radiotherapy (RT) is one of the standard treatments for head-and-neck cancer (HNC) but
often followed with inevitable complications. Carotid artery stenosis (CAS), vertebral artery
stenosis (VAS), and ischemic stroke may develop gradually. The CAS/VAS of HNC patients
after RT usually carries a more advanced progression and higher stroke risk than non-HNC
patients. In addition, carotid blow out syndrome, one of the rare but lethal complication after
RT also draw the attention form clinical doctors and HNC survivors.
Although these complications had been noted for decades, with the advancement in the
modern RT technology, the radiation-associated injury are assumed to be fewer due to the
improvement and precise of the radiation field. The application of proton beam therapy (PBT)
in the treatment of HNC has been growing in the past few years. The physical properties
of the Bragg peak allow for precise dose delivery, and localization of the Bragg peak to the
tumor target minimizes or prevents an exit dose from affecting normal tissues located beyond
the specified depth. Studies have demonstrated a lower regional toxicity in patients receiving
PBT. However, the prevalence of late toxicities, particularly those that occur in the cervical-
cranial vasculatures, remains uncertain.
There were few data regarding the frequency and prognosis of these complications in the
modern era. Besides, previous reports could be cross-sectional, claim-database design, with
small sample size, or only recruited HNC patients under traditional RT methods, and therefore
might be limited to answer some clinical questions.
In the following session, we will introduce you our registry databank and present some study
results regarding vascular complications of HNC patients after RT based on this dataset.

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