• 제목/요약/키워드: 뇌보호

검색결과 250건 처리시간 0.023초

관상동맥우회로 이식술 후 이환과 사망의 위험요인 (Risk Factors of Morbidity and Mortality after Coronary Artery Bypass Grafting)

  • 박창률;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • 제31권12호
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    • pp.1159-1164
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    • 1998
  • 배경: 수술수기와 심근보호법의 발달로 인하여 최근 관상동맥우회로 이식술의 수술성적이 향상되고 있지만 술후 사망과 이환에 직면하고 있는 일부 환자들은 점점 증가하고 있어 수술후 이환과 사망에 대한 관심이 높아지고 있다. 대상 및 방법: 저자들은 관상동맥우회로 이식술을 받은 총 137명을 대상으로 술전 위험요인과 술후 이환 및 사망(이하 이환)과의 관계를 후향적으로 조사하였다. 수술전 위험요인으로는 나이, 성별, 술전심근경색, 응급수술, 좌심실박출계수, 비만 그리고 3혈관 질환 등 7개의 변수를 선택하였으며 수술후 이환은 부정맥, 상처감염, 뇌손상, 술후입원기간의 장기화, 폐렴, 급성신부전증, 인공호흡기의 장기간 사용 그리고 수술사망 등으로 하고 이중 하나만 발생하여도 이환이 있다고 간주하였다. 결과: 전체 환자의 평균 나이는 56.7세였고, 27세부터 74세까지의 분포를 보였다. 전체 환자의 수술사망률은 6.6%였고 이중 계획수술은 3.9%(5/128), 응급 또는 긴급수술은 44.4%(4/9)의 사망률을 보였다. 65세 이상의 환자에서 이환율은 65세 미만의 환자보다 통계적으로 유의하게 높았다. 성별에 의한 이환율의 차이는 없었으나 수술 사망률은 여자(5/41, 12.19%)에게서 남자(4/96, 4.17%)보다 더 높게 나타났다. 응급수술의 이환율은 100%로 계획수술의 환자에서보다 유의하게 높게 나타났다. 술전 좌심실 박출계수가 50% 미만인 환자에서 50% 이상인 환자보다 사망률이 유의하게 높게 나타났다. 결론: 결론적으로 관상동맥우회로 이식술 후 이환의 위험요인은 65세 이상의 고령과 응급 또는 긴급수술이었고 수술사망의 위험요인은 50% 미만의 술전 좌심실 박출계수와 응급 또는 긴급수술이었다.

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중풍 동물 모델에서의 트레드밀 운동이 허혈성 신경손상에 미치는 효과: 뇌혈관 통합성 강화 (The Effect of Treadmill Exercise on Ischemic Neuronal Injury in the Stroke Animal Model: Potentiation of Cerebral Vascular Integrity)

  • 강경아;성호현;진한별;박종민;이종민;전재용;김연정
    • 대한간호학회지
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    • 제41권2호
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    • pp.197-203
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    • 2011
  • Purpose: This study was done to identify whether pre-conditioning exercise has neuroprotective effects against cerebral ischemia, through enhance brain microvascular integrity. Methods: Adult male Sprague-Dawley rats were randomly divided into four groups: 1) Normal (n=10); 2) Exercise (n=10); 3) Middle cerebral artery occlusion (MCAo), n=10); 4) Exercise+MCAo (n= 10). Both exercise groups ran on a treadmill at a speed of 15 m/min, 30 min/day for 4 weeks, then, MCAo was performed for 90 min. Brain infarction was measured by Nissl staining. Examination of the remaining neuronal cell after MCAo, and microvascular protein expression on the motor cortex, showed the expression of Neuronal Nuclei (NeuN), Vascular endothelial growth factor (VEGF) & laminin. Results: After 48 hr of MCAo, the infarct volume was significantly reduced in the Ex+MCAo group ($15.6{\pm}2.7%$) compared to the MCAo group ($44.9{\pm}3.8%$) (p<.05), and many neuronal cells were detected in the Ex+ MCAo group ($70.8{\pm}3.9%$) compared to the MCAo group ($43.4{\pm}5.1%$) (p<.05). The immunoreactivity of laminin, as a marker of microvessels and Vascular endothelial growth factor (VEGF) were intensively increased in the Ex+MCAo group compared to the MCAo group. Conclusion: These findings suggest that the neuroprotective effects of exercise pre-conditioning reduce ischemic brain injury through strengthening the microvascular integrity after cerebral ischemia.

뇌해마의 장기양 조직배양을 이용한 한약물의 뇌신경세포손상 보호효능 연구 (Neuroprotective Effects of Medicinal Herbs in Organotypic Hippocampal Slice Cultures)

  • 정혁상;손낙원;이원철
    • 대한한방내과학회지
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    • 제25권3호
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    • pp.461-472
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    • 2004
  • Objectives : For the screening of neuroprotective effects of medicinal herbs, the complex system of animal models suffer some disadvantages in controlling critical parameters such as blood pressure and body temperature. Additionally, application of drugs to the appropriate brain area sometimes is difficult, due to poor permeability though the blood brain barrier, and so potential protective effects might be masked. Methods : Organotypic hippocampal slice culture (OHSC) method has the advantages of being relatively easy to prepare and of maintaining the general structure, including tissue integrity and the connections between cells. Drugs can easily be applied and neuronal damage can easily be quantified by using tissues and culture media. This study demonstrates neuroprotective effects of Puerariae radix (葛根, PR), Salviae miltiorrhizae radix (丹蔘, SR), Rhei rhizoma (大黃, RR), and Bupleuri radix (柴胡, BR). These were screenedand compared to MK-801, antagonist of NMDA receptors, by using OHSC of 1 week-old Sprague-Dawley rats. Oxygen/glucose deprivation (OGD) were conducted in an anaerobic chamber $(85%\;N_2,\;10%\;CO_2\;and\;5%\;H_2)$ in a deoxygenated glucose-free medium for 60 minutes. Water extracts of each herbs were treated to culture media with $5\;{\mu}g/ml$ for 48 hours. Results : Neuronal cell death in the cultures was monitored by densitometric measurements of the cellular uptake of propidium iodide (PI). PI fluorescence images were obtained at 48 hours after the OGD and medicinal herb treatment. Also TUNEL-positive cells in the CAI and DG regions and LDH concentrations in culture media were measured at 48 hours after the OGD. According to measured data, MK-801, PR, SR and BR demonstrated significant neuroprotective effect against excessive neuronal cell death and apoptosis induced by the OGD insult. Especially, PR revealed similar neuroprotective effect to MK-801 and RR demonstrated weak neuroprotective effect. Conclusions : These results suggest that OHSC can be a suitable method for screening of neuroprotective effects of medicinal herbs. (This work was supported by the research program of Dongguk University and Grant 01-PJ9-PG1-01CO03-0003 from Ministry of Health & Welfare.)

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콜라겐 펩타이드 및 GABA 복합물의 섭취가 피부 및 수면장애 개선에 미치는 영향 (Beneficial Effect of Collagen-Peptide Mixture with GABA on Improvement Skin and Sleep Quality)

  • 김정기;임성환;김완기;조창희;하재현;서대방
    • 대한화장품학회지
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    • 제44권3호
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    • pp.277-284
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    • 2018
  • 콜라겐 펩타이드(collagen peptide)는 단백질의 가수 분해물로서 주름 완화, 보습력 증대, 탄력 개선 등의 특정 피부 효능을 나타낼 수 있어 화장품 혹은 피부 개선 기능식품으로서 활용되고 있다. ${\gamma}-aminobutyric$ acid (GABA)는 척추 동물의 뇌, 척수에 존재하는 신경전달 물질로서 수면의 질과 양을 개선해 준다고 알려져 있다. 본 연구에서는 콜라겐 펩타이드와 GABA의 복합물이 수면 장애가 있는 여성에게 8주 경구 섭취를 통해서 수면 및 피부 상태를 개선할 수 있는가에 관하여 확인하였다. 복합물(J85091900)은 8주간 연속적으로 섭취 시, 수면장애지수(PSQI)가 유의적으로 감소하였으며, 수면 시간을 7% 증가시켰다. 또한, 피부 거칠기, 눈가 주름 및 피부 수분량(capacitance)을 유의적으로 개선하였다. 이상의 결과에서 콜라겐과 GABA의 복합물은 복합 수면 장애에 따른 피부의 노화 현상으로부터 피부를 보호할 수 있음을 확인하여 먹는 화장품의 핵심 소재로 활용 가능함을 확인하였다.

심정격(心正格) 혈위(穴位)(소충(少衝)${\cdot}$대돈(大敦), 소해(少海)${\cdot}$음곡(陰谷))에 대한 영수(迎隨) 및 염전(捻轉) 보사(補瀉) 침자(鍼刺)가 국소 뇌허혈 유발 흰쥐의 항뇌세포고사와 신경보호 효과에 미치는 영향 (Anti-apoptotic and neuroprotective effects of acupuncture techniques of tonification or sedation at HT9${\cdot}$LR1, HT3${\cdot}$KI10 on focal brain ischemic injury induced by intraluminal filament insertion in rats)

  • 변정윤;윤대환;나창수
    • Korean Journal of Acupuncture
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    • 제25권1호
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    • pp.229-246
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    • 2008
  • Objectives : Acupoints of LR1(Dadun)${\cdot}$HT9(Shaochong), KI10(Yingu)${\cdot}$HT3(Shaohai) are used as controlling the diseases from heart problems. Especially, when they are used, tonification or sedation techniques method is taken as a controlling the medication for an early stroke in the Korean medicine. So the aim of this study is to investigate the anti-apoptotic and neuroprotective effects of Acupuncture techniques of tonification or sedation at LR1${\cdot}$HT9, KI10${\cdot}$HT3 on the focal ischemia induced by intraluminal filament insertion in rats. Materials and Methods : The focal ischemia was induced by intraluminal filament insertion into middle cerebral artery. The animals were divided into five groups (n=7 in each group) : Control group, no therapy group after ischemia induced; AT-1; acupuncture therapy group at LR1${\cdot}$HT9, KI10${\cdot}$HT3 after ischemia-induced. AT-2; acupuncture therapy at right LR1, HT9(forward direction), KI10${\cdot}$HT3(opposite direction) inserting to the direction of route of the each meridian. AT3; acupuncture therapy at right LR1, HT9(twirling forward with the thumb of right hand 9 times), KI10${\cdot}$HT3(twirling forward with the forefinger of right hand 6 times) AT-4; acupuncture therapy at right LR1, HT9(forward direction, twirling forward with the thumb of right hand 9 times), KI10${\cdot}$HT3(opposite direction, twirling forward with the forefinger of right hand 6 times) inserting to the direction of route of the each meridian. The anti-apoptotic and neuroprotective effects of Acupuncture techniques of tonification or sedation at LR1, HT9, KI10${\cdot}$HT3 were observed by Bax, Bcl-2, mGluR5, Cytochrome c, Cresyl violet and ChAT-stain. Results : The intensity of Bax and Bax/Bcl-2 ratio were increased in ACU-2 and ACU-4 group but decreased in ACU-3 group. The intensity of mGluR5 was increased in ACU-1, ACU-2, ACU-3 and ACU-4 group. The intensity of cytochrome c was decreased in ACU-3 and ACU-4 group. The density of neurons stained by Cresyl violet and ChAT were increased in ACU-1, ACU-3 and ACU-4 group. Conclusions : Our study suggests that acupuncture therapy of tonification at LR1, HT9 by twirling forward with the thumb of right hand 9times, sedation at KI10${\cdot}$HT3 by twirling forward with the forefinger of right hand 6 times after perpendicularly inserting needle shows anti-apoptotic and neuroprotective effects on cholinergic neuron in focal cerebral ischemia of the stroke in rats.

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천궁(川芎)의 구강투여(口腔投與) 및 약침시술(藥鍼施術)이 흰쥐 MCAO로 유발된 국소뇌허혈(局所腦虛血)에 대(對)한 콜린성 신경보호효과(神經保護效果) 연구(硏究) (Effects of Cnidium of ficinale(CO) extracts through administrated by means of oral and herbal acupuncture method at GB2l acupoint on focal ischemic brain injury induced by MCAO in rats)

  • 김경선;윤대환;홍석;나창수
    • Korean Journal of Acupuncture
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    • 제22권3호
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    • pp.137-156
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    • 2005
  • Objectives : Cnidium officinale(CO) has been used for medication for stroke in the Oriental Medicine. So this study was planned to investigate the effects of CO on the focal ischemia-induced by Middle Cerebral Artery Occlusion(MCAO) in rats Materials and methods : The focal ischemia was induced by MCAO. CO extracts through oral administration and herbal acupuncture at GB2l was carried out during 3 weeks after focal ischemia-induced. Eight-arm radial maze was used for the behavioral task. For the neuroprotective effect of CO, we investigated AchE, ChAT, and NGF-expression by immnohistochemical method. Results : The error rate in the eight-arm radial maze task was significantly decreased in normal group compared to control group on 1-6days, OA-CO1(CO oral administration, 0.8g/kg) group on 1-6days, OA-CO2(CO oral administration, 1.6g/kg) group on 1-3,5,6days, HA-CO1(CO herbal acupuncture, 0.016g/kg) group on 2,3,6days, HA-CO2(CO herbal acupuncture, 0.008g/kg) group on 1-3,5,6days. The rate of correct choice was significantly increased in OA-CO1, HA-CO2. The density of neurons in the hippocampal CA1 was the most increased in OA-CO1, HA-CO1, HA-CO2. The density of ChAT in the hippocampal CA1 was increased in OA-CO1, HA-CO2. The density of ChAT in the hippocampal CA1 was significantly increased in OA-CO1, HA-CO2. The density of NGE in the hippocampal CAI was significantly increased in OA-CO1, OA-CO2, HA-CO2. Conclusions : These results suggest that CO oral administration with 0.8g/kg and CO herbal acupuncture with 0.008g/kg might be used as a regulator of cell death of cholinergic system induced by stroke.

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녹용 약침이 국소 뇌허혈 모델 백서에서 방사형 미로과제 학습 및 뇌신경 보호에 미치는 영향 (Effect of Cervus Elaphus-Herbal Acupuncture on Focal Ischemia Induced by Inserted Intraluminal Filament in MCA of Rats)

  • 김성옥;윤대환;나창수
    • Korean Journal of Acupuncture
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    • 제22권4호
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    • pp.67-81
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    • 2005
  • Objectives : Cervus Elaphus(CE) has been used to medication for ischemic stroke in the Oriental Medicine. So this study was planned to investigate the effects of CE herbal acupuncture therapy(CE-HAT) on the focal ischemia-induced by intraluminal filament insertion in the rats. Materials and methods : The focal ischemia was induced by middle cerebral artery occlusion for 2hours. The groups divided into 6 groups, normal(intachess group), control(no theray group after ischemia-induced), CE-HAT1(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9 after ischemia-induced), CE-HAT2(Cervus Elaphus-herbal acupuncture therapy group at LU8, KI7 after ischemia-induced), CE-HAT3(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9, LU8, KI7 after ischemia-induced), CE-HAT4(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9, HT3, KI10 after ischemia-induced). CE-HAT was carried out during 3 weeks after focal ischemia-induced. Eight-arm radial maze was used for the behavioral task and neuropretective effect of CE-HAT was observed by Cresyl violet, AchE, ChAT-stain. Results : The error rate in the eight-arm radial maze task was significantly decreased in CE-HAT1, CE-HAT2, CE-HAT4 on 3days, CE-HAT4 on 4days, CE-HAT2, CE-HAT4 on 5days, CE-HAT3, CE-HAT4 on 6days. The rate of correct choice was significantly increased in CE-HAT4. The density of neurons in the hippocampal CA1 was significantly increased in CE-HAT1, CE-HAT2, CE-HAT3, CE-HAT4, compared to control group. The density of ChAT in the hippocampal CA1 was significantly increase in CE-HAT4. The density of ChAT in the hippocampal CA1 was significantly increased CE-HAT1. Conrlusions : These results suggest that the Cervus Elaphus-herbal acupuncture therapy could be used as a medication for controlling the stroke induced by deficiency.

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직자(直刺), 영수(迎隨) 및 염전수기법(捻轉手技法)에 따라 시행한 경거(經渠)${\cdot}$복류(復溜) 침자(鍼刺)가 중대뇌동맥(中大腦動脈) 폐새(閉塞)에 의하여 유발(誘發)된 국소(局所) 뇌허혈(腦虛血) 백서(白鼠) hippocampus의 항세포자멸사(抗細胞自滅死) 및 복경보호(福經保護)에 미치는 영향(影響) (Effects of acupuncture at the $LU8{\cdot}K17$ on Anti-apoptotic cell death and neuroprotection in Rat hippocampus following focal brain ischemic injury induced by Intraluminal Filament insertion in Rats)

  • 윤대환;변정윤;최찬헌;백진웅;정지연;정연진;나창수
    • Korean Journal of Acupuncture
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    • 제24권3호
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    • pp.205-221
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    • 2007
  • Objectives : Aims of this study is to investigate the effects of $LU8{\cdot}KI7$ in rat induced by experimental focal ischemia. Materials and methods : The focal ischemia was induced by intraluminal filament insertion into middle cerebral artery. The groups divided into 6groups, control; no therapy group after ischemia-induced, AT1; acupuncture therapy group at $LU8{\cdot}KI7$ after ischemia-induced, AT2; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally and the needle was twirled and rotated forward with the thumb of the right hand 9times, AT3; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally and the needle was twirled and rotated forward with the forefinger of the right hand 9times, AT4; acupuncture therapy at$LU8{\cdot}KI7$ bilaterally and the needle was inserted to the direction following the flowing route of the meridian(digital direction), AT5; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally, the needle was inserted to the direction following the flowing route of the meridian(digital direction) and the needle was twirled and rotated forward with the thumb of the right hand 9times. Acupuncture therapy was carried out 7times during 2weeks after focal ischemia-induced. The anti-apoptotic and neuroprotective effects of acupuncture are observed by Bax, Bcl-2, mGluR5, cytochrome c, Cresyl violet and ChAT-stain. Results : The intensity of Bax was decreased in AC1, AC4, AC5 group, was increased in AC2, AC3 group. The intensity of Bcl-2 was increased in AC2, AC3, AC4, AC5 group. The intensity of mGluR5 was decreased in AC1 group, was increased in AC4, AC5 group. The intensity of Cytochrome c was increased in ACI, AC2 group, was decreased in AC4, AC5 group. The density of neurons stained by Cresyl violet was increased in all group without control group. The density of ChAT was increased in AC2, ACS group. Conclusions : Our study suggests that AC5 group show anti-apoptotic and neuroprotective effects on cholinergic neuron in focal cerebral ischemia of the stroke in rats.

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백서의 국소 뇌허혈/재관류로 인한 신경손상에서 상경부 교감 신경절 블록의 급성기 및 장기 보호효과 (The Effects of Superior Cervical Sympathetic Ganglion Block on the Acute Phase Injury and Long Term Protection against Focal Cerebral Ischemia/Reperfusion Injury in Rats)

  • 전혜영;정경운;최재문;김유경;신진우;임정길;한성민
    • The Korean Journal of Pain
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    • 제21권2호
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    • pp.119-125
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    • 2008
  • Background: Cerebral blood vessels are innervated by sympathetic nerves from the superior cervical ganglia (SCG), and these nerves may influence the cerebral blood flow. The purpose of the present study was to evaluate the neuroprotective effect of superior cervical sympathetic ganglion block in rats that were subjected to focal cerebral ischemia/reperfusion injury. Methods: Eighty male Sprague-Dawley rats (270-320 g) were randomly assigned to one of two groups (the ropivacaine group and a control group). In all the animals, brain injury was induced by middle cerebral artery (MCA) reperfusion that followed MCA occlusion for 2 hours. The animals of the ropivacaine group received $30{\mu}l$ of 0.75% ropivacaine, and their SCG. Neurologic score was assessed at 1, 3, 7 and 14 days after brain injury. Brain tissue samples were then collected. The infarct ratio was measured by 2.3.5-triphenyltetrazolium chloride staining. The terminal deoxynucleotidyl transferase mediated dUTP-biotin nick-end labeled (TUNEL) reactive cells and the cells showing caspase-3 activity were counted as markers of apoptosis at the caudoputamen and frontoparietal cortex. Results: The death rate, the neurologic score and the infarction ratio were significantly less in the ropivacaine group 24 hr after ischemia/reperfusion injury. The number of TUNEL positive cells in the ropivacaine group was significantly lower than those values of the control group in the frontoparietal cortex at 3 days after injury, but the caspase-3 activity was higher in the ropivacaine group than that in the control group at 1 day after injury. Conclusions: The study data indicated that a superior cervical sympathetic ganglion block may reduce the neuronal injury caused by focal cerebral ischemia/reperfusion, but it may not prevent the delayed damage.

갈근(葛根)의 뇌해마(腦海馬) 신경세포 손상보호와 항산화(抗酸化) 효능에 대한 연구 (Neuroprotective and Anti-Oxidative Effect of Puerariae Radix on Hippocampal Neurons and BV-2 Microglia Cells)

  • 김상현;김연섭
    • 동의생리병리학회지
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    • 제19권2호
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    • pp.416-425
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    • 2005
  • This study demonstrated neuroprotective and anti-oxidative effects of Puerariae Radix for cerebral ischemia. Neuroprotective effects were studied by using oxygen/glucous deprivation of the organotypic hippocampal slice cultures to complement limitations of in vivo and in vitro models for cerebral ischemia study. Anti-oxidative effects were studied on BV-2 microglia cells damaged by $H_2O_2$ and nitric oxide. The results obtained are as follows; The groups treated with 0.5 and $5{\mu}g/m{\ell}$ of Puerariae Radix revealed significant decreases of neuronal cell death area and cell death area percentages in CA1 region of ischemic damaged hippocampus cultures during whole 48 hours of the experiment. The groups treated with 0.5 and $5{\mu}g/m{\ell}$ of Puerariae Radix revealed significant decreases of neuronal cell death area and cell death area percentages in DG region of ischemic damaged hippocampus cultures during whole 48 hours of the experiment. The groups treated with 0.5 and $5{\mu}g/m{\ell}$ of Puerariae Radix revealed significant decreases of TUNEL-positive cells in both CA1 region and DG region of ischemic damaged hippocampus cultures. The group treated with $50\;{\mu}g/m{\ell}$ of Puerariae Radix demonstrated significant decrease of TUNEL-positive cells in CA1 region. The groups treated with 0.5 and $5{\mu}g/m{\ell}$ of Puerariae Radix revealed significant decreases of LDH concentrations in culture media of ischemic damaged hippocampus cultures. The groups treated with 0.5 and $5{\mu}g/m{\ell}$ of Puerariae Radix revealed significant increases of cell viabilities of BV-2 microglia cells damaged by $H_2O_2$. The group treated with $5{\mu}g/m{\ell}$ of Puerariae Radix revealed significant increase of cell viability of BV-2 microglia cells damaged by nitric oxide. These results suggested that Puerariae Radix of cerebral ischemic revealed neuroprotective effects through the control effect of apoptosis and oxidative damages.