• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.85-85
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• 1993

뇌동맥계는 일과성 저혈압에 반응하여 혈관확장이 야기되고, 혈압 상승시에는 혈관수축이 일어남으로서 뇌혈류가 일정하게 조절된다. 이러한 자가조절은 뇌손상 등의 병적 상태에서 야기된다. 연구의 목적은 \circled1 Cromakalim, CGRP(calcitonin-gene related peptide), 및 substance P에 의하여 뇌연막동맥의 직경이 어떻게 변동하는가를 관찰하고 \circled2 이들 신경성 peptide의 작용에 대하여 $K^{＋}$ 통로 개방 봉쇄제인 glibenclamide의 전처치 효과를 검색하고 \circled3 Capsaicin 전처치가 뇌혈류 자가조절에 어떻게 영향을 미치는가를 검색하였다. 그 결과는 다음과 같다. 1. 뇌혈류 자가조절은 대퇴동맥을 통한 사혈에 의하여 혈압하강을 일으킬 때 뇌연막 동맥은 이완하였고, reservoir내의 혈액을 체내로 주입함로서 혈압반전을 일으켰을 때는 혈관 수축이 일어났다. 2. 연막동맥은 glibenclamide (1~3$\mu$M)의 관류에 의하여는 영향을 받아니하였다. 3. 혈압변동에 따른 혈관직경의 변화를 회기직선으로 분석하였다. Glibenclamide 1과 3$\mu$M의 전처치 관류에 의하여 혈압하강에 따른 혈관 이완경사도와 혈압반전에 따른 혈관수축 경사도가 대조군에 비하여 현저히 약화되었다. 4. Cromakalim (0.1-30$\mu$M)의 각 농도를 대뇌표면에 관류시 연막동맥의 기초직경은 약물농도에 의존하여 증가되었고, 이는 glibenclamide (1$\mu$M) 전처치 관류에 의하여 억제되었다. 5. CGRP (0.1~100 nM)와 substance P (0.1~10nM)도 용량에 의존하여 혈관이완을 일으켰다. 전자는 glibenclamide (1$\mu$M) 전처치 관류에 의하여 억제되었으나 후자는 영향을 받지 아니하였다. 6. Capsaicin(50 nmol: intracisternally) 주사에 의하여 뇌혈류자가조절의 변동이 초래되었다. 이상의 결과들을 종합하면 CGRP가 혈압변동에 의하여 반사적으로 유리되고, 이는 glibenclamide-sensitive $K^{＋}$ 통로에 작용하는 것으로 시사된다.

• The Journal of the Korea Contents Association
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• v.5 no.5
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• pp.296-304
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• 2005

Quantitative analysis compare to dynamic characteristic change of the regional cerebral blood volume(rCBV) after development of cerebral fat embolism in cats using perfusion magnetic resonance(MR) Imaging. Twenty cats were used. Linoleic acid (n=11) were injected into the internal carotid artery using microcatheter through the transfemoral approach. Polyvinyl alcohol (Ivalon) (n=9) was injected as a control group. Perfusion MR images were obtained at 30 minutes and 2 hours after embolization, based on T2 and diffusion-weighted images. The data was time-to-signal intensity curve and ${\Delta}R_2^*$ curve were obtained continuously with the aid of home-maid image process algorithm and IDL(interactive data Banguage, USA) softwares. The ratios of rCBV increased significantly at 2 hours compared with those of 30 minutes (P<0.005). In conclusion, cerebral blood flow decreased in cerebral fat embolism immediately after embolization and recovered remarkably in time course. It is thought that clinically informations to dynamic characteristic change of the cerebral hemodynamics to the early finding in cerebral infarction by diffusion weighted imaging(DWI) and perfusion weighted imaging(PWI).

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.489-495
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• 2005

In the surgical treatment of aortic dissection, aortic arch replacement under total circulatory arrest is often performed after careful inspection to determine the severity of disease progression. Under circulatory arrest, antegrade or retrograde cerebral perfusion is required for brain protection. Recently, antegrade cerebral perfusion has been used more, because of the limitation of retrograde cerebral perfusion. This study is to compare these two methods especially in the respect to neurological complications. Material and Method: Forty patients with aortic dissection involving aortic arch from May 2000 to May 2004 were enrolled in this study, and the methods of operation, clinical recovery, and neurological complications were retrospectively reviewed. Result: In the ACP (antegrade cerebral perfusion) group, axillary artery cannulation was performed in 10 out of 15 cases. In the RCP (retrograde cerebral perfusion) group, femoral artery Cannulation was performed in 24 out of 25 cases. The average esophageal and rectal temperature under total circulatory arrest was $17.2^{\circ}C\;and\;22.8^{\circ}C$ in the group A, and $16.0^{\circ}C\;and\;19.7^{\circ}C$ in the group B, respectively. Higher temperature in the ACP group may have brought the shorter operation and cardiopulmonary bypass time. However, the length of period for postoperative clinical recovery and admission duration did not show any statistically significant differences. Eleven out of the total 15 cases in the ACP group and thirteen out of the total 25 cases in the RCP group showed neurological complication but did not show statistically significant difference. In each group, there were 5 cases with permanent neurological complications. All 5 cases in the ACP group showed some improvements that enabled routine exercise. However all 5 cases in RCP group did not show significant improvements. Conclusion: The Antegrade, cerebral perfusion, which maintains orthordromic circulation, brings moderate degree of hypothermia and, therefore, shortens the operation time and cardiopulmonary bypass time. We concluded that Antegrade cerebral perfusion is safe and can be used widely under total circulatory arrest.

• The Korean Journal of Pharmacology
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• v.29 no.1
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• pp.1-8
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• 1993

To elucidate involvement of platelet-activating factor (PAF) in cerebral ischemia-reperfusion injury, male Sprague-Dawley rats and albino mice of either sex were subjected to a 10-min bilateral carotid artery occlusion and 6-hr recirculation. The McGraw stroke index in mice was markedly inhibited by PAF antagonists, BN 52021 and CV 6209 (1 mg/kg, i.p., each) When they were administered 10 min before bilateral carotid artery occlusion or 1 hr after reperfusion. The increases in brain water content were significantly attenuated by treatment with BN 52021 or CV 6209 in both animals. BN 52021 exhibited a significant improvement in the postischemic blood pressure change in association with a beneficial effect on the delayed dilatation of pial arterioles after 10 min of ischemia. Thus it is suggested that PAF plays an important role as an endogenous mediator in development of cerebral ischemia-reperfusion injury, and further, specific antagonists to PAF will be able to prevent or reverse the pathological sequelae of cerebral ischemia.

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.116-123
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• 2003

Purpose : The present study was undertaken to evaluate the usefulness of cerebral diffusion (DWI) and perfusion MR imaging (PWI) in rabbit models with hyperacute cerebral ischemic infarction. Materials and Methods : Experimental cerebral infarction were induced by direct injection of mixture of Histoacryl glue, lipiodol, and tungsten powder into the internal cerebral artery of 6 New-Zealand white rabbits, and they underwent conventional T1 and T2 weighted MR imaging, DWI, and PWI within 1 hour after the occlusion of internal cerebral artery. The PWI scan for each rabbit was obtained at the level of lateral ventricle and 1cm cranial to the basal ganglia. By postprocessing using special imaging software, perfusion images including cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) maps were obtained. The detection of infarcted lesion were evaluated on both perfusion maps and DWI. MTT difference time were measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Results : In all rabbits, there was no abnormal signal intensity on T2WI. But on DWI, abnormal high signal intensity, suggesting cerebral infarction, were detected in all rabbits. PWI (rCBV, CBF and MTT map) also showed perfusion defect in all rabbits. In four rabbits, the calculated square of perfusion defect in MTT map is larger than that of CBF map and in two rabbits, the calculated size of perfusion defect in MTT map and CBF map is same. Any rabbits do not show larger perfusion defect on CBF map than MTT map. In comparison between CBF map and DWI, 3 rabbits show larger square of lesion on CBF map than on DWI. The others shows same square of lesion on both technique. The size of lesion shown in 6 MTT map were larger than DWI. In three cases, the size of lesion shown in CBF map is equal to DWI. But these were smaller than MTT map. The calculated square of lesion in CBF map, equal to that of DWI and smaller than MTT map was three. And in one case, the calculated square of perfusion defect in MTT map was largest, and that of DWI was smallest. Conclusion : DWI and PWI may be useful in diagnosing hyperacute cerebral ischemic infarction and in e-valuating the cerebral hemodynamics in the rabbits.

• Journal of radiological science and technology
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• v.30 no.4
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• pp.427-433
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• 2007

This study was conducted to investigate the usefulness of PASL image technique through visual and quantitative assessment by dividing CBF image, conventional perfusion magnetic resonance image, anterior cerebral artery, middle cerebral artery and posterior cerebral artery into 6 territories both right and left in moyamoya disease. In visual assessment, the scope of decreased perfusion in the PASL CBF image and conventional perfusion MR CBF image agreed with the position of deficiency in the MR image. The quantitative assessment, showed that the scope and position of decreased perfusion accord with both in the PASL CBF image and the existing conventional perfusion MR CBF image but the assessment of measuring the quantity of perfusion according to signal intensity showed a little difference.

• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.171-171
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• 2001

목적： 뇌 자기공명영상에서 Z-score를 이용한 관류 영상과 조영전후의 감산에 의한 역동 영상의 관류 양상을 비교 관찰 하고자 한다. 대상 및 방법： 뇌 자기공명영상에서 이상 소견이 없는 젊은 환자 1명, Moya moya 환자 1, 중대뇌동맥 폐색 환자 1명, 외상후 증후군 1명, 뇌종양 1예를 대상으로 하여, 뇌의 routine 자기공명 영상과 함께 Gd-DTPA 0.1 mmol/kg를 급속 주사 후 자화율 대조 EPI 영상을 얻었다. 영상 기기는 Magnetom Vision(Siemens Medical Systems, Erlangen, Germany)이며, EPI 영상 지표들은 TR/TE는 0.8/29 msec, slice 두께 6 mm, slice 수 10, 화소수 128 $\times$ 128, FOV 215 $\times$ 215 mm, 영상획득 1 회, 1회 검사시간 1.32 초, 검사수 30 회로서, 총 검사시간은 40 초였다. 검사 후 영상처리(post processing)는 Magnetom Vision의 VB31D 자체 프로그램을 이용하였는데, 2-score를 이용한 관류영상은 조영제 유입전 영상들, 조영제 최대 유입기 영상들, 그리고 조영제 배출기 영상들 4-5 회를 각각 한 군으로 하여, Z-score 1.2에서 2.0 사이에서 여러번 반복하여 영상을 재구성하였다. 감산에 의한 역동영상은 조영제 도달 전의 영상으로부터 조영제 유입 후의 영상을 차례로 빼어서 영상을 재구성하였으며, 이들 영상을 재정리하여 각 단면의 시간 경과에 따른 관류 양상을 연속하여 관찰하였다 두 방법에 의한 영상 재구성은 각각 약 10분 정도가 소요되었다.

• Investigative Magnetic Resonance Imaging
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• v.4 no.2
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• pp.113-119
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• 2000

Purpose : To know the possibility of clinical application of MRI using oxygen inhalation as a perfusion MRI Materials and methods : Two healthy volunteers and three patients of one moyamoya disease, one acute infarction and one meningioma were studied using a 1.5 Tesla MRI unit. Oxygen (15 liters/min) mixed with room air was given using face mask from 8 second to 35 second during the study. Images were acquired 25 times (scan time per study were 1.6 seconds) using susceptibility contrast EPI (echo planar image) sequence. Difference maps were acquired by early (study 12-18), and late (study 19-25) O2 inhalation image groups minus pre-O2 inhalation image group (study 3-9) with a Z-score of 0.7-1.0 using VB31C program of Magneton Vision. The resulting perfusion images were created by superimposition of difference maps on corresponding T1 weighted anatomic images. On moyamoya patient, similar perfusion images were acquired after Gd-DTPA injection, and compared with O2 inhalation perfusion images. Results ; The author can get the perfusion images of the brain by oxygen inhalation with susceptibility contrast EPI sequence at the volunteers, and the patient of moyomoya disease, acute infarction and meningioma. On moyamoya patient, perfusion images with O2 inhalation are similar with perfusion images by Gd-DTPA injection. Conclusion 1 This study has demonstrated that the susceptibility contrast EPI by oxygen inhalation can be used as the clinically useful perfusion MRI technique

• Journal of radiological science and technology
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• v.32 no.4
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• pp.461-469
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• 2009

To predict the tumor grading, various imaging modalities have been applied clinically. This study determines clinical usefulness of perfusion MRI, using relative cerebral blood volume in grading of the gliomas. We did a retrospective review of 17 patients (mean age, 57.5 years; 11 male, 6 female) who underwent perfusion MR and conventional MRI, and then correlated pathologically after operation. Statistical analysis of regional cerebral blood volume and relative cerebral blood volume(rCBV) was performed by using softwares such as PAT by SIEMENS and Xmap ver 2.0 developed by ourselves. Six patients out of 13 were low-grade gliomas while eleven patients were the high-grade gliomas. Mean relative CBV (m_rCBV/white matter) in the low-grade gliomas was 1.62, and mean relative CBV(m_rCBV/cortex) was 0.12. In the high-grade gliomas, mean relative CBV(m_rCBV/white matter) and mean relative CBV(m_rCBV/cortex) were 33.53 and 0.96. Mean relative CBV of gliomas were elevated with a statistical difference(P<.05), compared with contralateral white matter(P=.019) or cortex(P=.025). Furthermore mean relative CBV(m_rCBV/white matter) was much higher than mean relative CBV(m_rCBV/cortex). Perfusion MRI using regional cerebral blood volume and rCBV is very useful imaging modality for grading the glioma.

• Investigative Magnetic Resonance Imaging
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• v.6 no.1
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• pp.55-63
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• 2002

Purpose : We investigated the predictive values of relative CBV measured with perfusion MR imaging, and relative CBF measured with SPECT for tissue outcome in acute ischemic stroke. Material and Methods : Thirteen patients, who had acute unilateral middle cerebral artery occlusion, underwent perfusion MR imaging, and $^{99m}Tc-HMPAO$ SPECT within 6 hours after the onset of symptoms. Lesion-to-contralateral ratios of perfusion parameters were measured, and best cut-off values of both parameter ratios with their accuracy to discriminate between regions with and without evolving infarction were calculated. Results : Mean relative CBV ratios in regions with evolving infarction and without evolving infarction were $0.58{\pm}0.27$ and $0.9{\pm}0.17$ (p < 0.001), and mean relative CBF ratios in those regions were $0.41{\pm}0.22$ and $0.71{\pm}0.14$ (p < 0.001). The best cutoff values to discriminate between regions with and without evolving infarction were estimated to be 0.80 for relative CBV ratio and 0.56 for relative CBF ratio. The sensitivity, specificity and efficiency of each cutoff value were 80.6, 87.5, 82.7% for relative CBV ratio, and 72.2, 75.0, 73.0% for relative CBF ratio (p > 0.05 between two parameters). Conclusion Measurement of relative CBV and relative CBE may be useful in predicting tissue outcome in acute ischemic stroke.