• Title/Summary/Keyword: 허혈성 뇌혈관질환

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Tc-99m-HMPAO Regional Cerebral Blood Flow SPECT in Cerebral Rete Mirabile (Cerebral Rete Mirabile의 Tc-99m-HMPAO 국소뇌혈류 SPECT소견)

  • Park, Young-Ha;Chung, Soo-Kyo;Lee, Sung-Yong;Shinn, Kyung-Sub;Kim, Jong-Woo;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.2
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    • pp.157-161
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    • 1988
  • Cerebral rete mirabile는 잘 알려진 뇌혈관 질환으로 뇌혈관촬영상 내경동맥이 심한 협착 혹은 폐색, 뇌저부의 이상혈관망 형성 및 다수의 연수막동맥간문합과 경경수막 외내경동맥간문합의 특징적 소견을 나타낸다. 최근 방사성의약품의 발전과 함께, Tc-99m-HMPAO를 이용한 뇌SPECT는 뇌혈류역학의 평가, 병소의 조기발견 및 병소의 정확한 위치를 알기위한 상용진단 방법이 되었다. 저자들은 뇌 혈관촬영으로 확진된 10명 의 Cerebral rete mirabile 환자에서 뇌 전산화단층촬영과 Tc-99m-HMPAO를 이용한 국소뇌혈류 SPECT를 검토하였다. 대상환자중 남자는 3명, 여자는 7명이었으며, 연령분포는 6세에서 38세이었다. 1) Tc-99m-HMPAO를 이응한 국소 뇌혈류 SPECT는 뇌의 경색부위 뿐만 아니라 허혈부위까지 나타냈으며, cerebral rete mirabile에서의 뇌의 침습된 부위를 나타내는데 있어서 뇌전산화단층촬영보다 우월하였다. 또한 모든 예에서 뇌전산화반층촬영보다 더 넓은 허혈부위를 보여주었다. 2) 다른 허혈성 뇌혈관질환과 비교하여 cerebral rete mirabile는 비균질성 방사능을 나타냈고, 이는 측부순환로에 의한 것으로 추측된다. 3) Tc-99m-HMPAO를 이용한 국소뇌혈류 SPECT는 뇌의 허혈부위의 범위를 평가, 문합수술의 계획 및 cerebral rete mirabile의 경과를 추적하는데 유용한 검사이다.

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Brain MRI Template-Driven Medical Images Mapping Method Based on Semantic Features for Ischemic Stroke (허혈성 뇌졸중을 위한 뇌 자기공명영상의 의미적 특징 기반 템플릿 중심 의료 영상 매핑 기법)

  • Park, Ye-Seul;Lee, Meeyeon;Lee, Jung-Won
    • KIPS Transactions on Software and Data Engineering
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    • v.5 no.2
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    • pp.69-78
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    • 2016
  • Ischemic stroke is a disease that the brain tissues cannot function by reducing blood flow due to thrombosis or embolisms. Due to the nature of the disease, it is most important to identify the status of cerebral vessel and the medical images are necessarily used for its diagnosis. Among many indicators, brain MRI is most widely utilized because experts can effectively obtain the semantic information such as cerebral anatomy aiding the diagnosis with it. However, in case of emergency diseases like ischemic stroke, even though a intelligent system is required for supporting the prompt diagnosis and treatment, the current systems have some difficulties to provide the information of medical images intuitively. In other words, as the current systems have managed the medical images based on the basic meta-data such as image name, ID and so on, they cannot consider semantic information inherent in medical images. Therefore, in this paper, to provide core information like cerebral anatomy contained in brain MRI, we suggest a template-driven medical images mapping method. The key idea of the method is defining the mapping characteristics between anatomic feature and representative images by using template images that can be representative of the whole brain MRI image set and revealing the semantic relations that only medical experts can check between images. With our method, it will be possible to manage the medical images based on semantic.

Cardiac Surgery Using CPB in Moyamoya Disease - A Case Report- (모야모야 환자에게서의 인공심폐기를 이용한 개심술 -1예 보고-)

  • 이기복;김응중;신윤철;박종운;이원진;박진흥;손정환;지현근
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.772-775
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    • 2003
  • Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries, but the etiology remains unclear. Angiographic characteristics include bilateral stenosis or occlusion of the terminal portions of the intracranial internal carotid arteries and bilateral development of fine collateral vessels at the base of the brain known as ‘Moyamoya vessels’. Cardiac surgery using cardiopulmonary bypass due to coronary artery disease and others among patients with moyamoya disease is very rare, and cardiac surgery for such patients has a potential risk of intraoperative and perioperative brain ischemia. We successfully treated a patient who underwent artrial septal defect closure and coronary artery bypass graft using the cardiopulmonary bypass, so we report this case with a brief literature review.

The Association of the -675 4G/5G and A-844G Polymorphisms of the Plasminogen Activator Inhibitor-1 Gene with a Risk of Ischemic Stroke in Korean Population (한국인의 허혈성 뇌경색 발생과 플라스미노겐 활성 억제인자-1(PAI-1) 유전자 다형성과의 관계)

  • Lee, Byung-Cheol;Byun, Sang-Hyuk;Kim, Soon-Il;Kang, Ki-Hoon;Ahn, Se-Young;Doo, Ho-Kyung;Seo, Jung-Chul;Leem, Kang-Hyun;Cho, Seong-Ho;Oh, Chad K.;Ahn, Young-Min
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.18-24
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    • 2004
  • 연구배경 : 플라스미노겐 활성 억제인자-1 (plasminogen activator inhibitor-1; PAI-1)은 허혈성 뇌경색의 발생의 원인이 되는 섬유소 용해작용의 저하를 매개하는 인자로서, PAI-1의 작용이 촉진되면 섬유소 용해기능이 저하되어 관상동맥 및 뇌혈관질환의 발생을 증가시키게 된다. PAI-1 유전자의 촉진자(promoter) 영역에는 -675 4G/5G (4G/5G)와A -844G (A/G)의 두 개의 유전자 다형성이 존재하며, 이는 PAI-1의 유전자 전사과정에 영향을 미쳐 혈청 PAI-1의 농도를 증가시키고 결과적으로 허혈성 뇌경색의 발생확률을 높이는 작용을 하게 된다. 연구방법 : 허혈성 뇌경색으로 진단 받은 167명의 환자와 173명의 건강인의 말초혈액에서 DNA를 분리한 후 PAI-1의 4G/5G와 A/G 유전자 다형성에 대한 연쇄중합반응 및 제한효소 절편길이 다형성 (polymerase chain reaction-restriction fragment length polymorphism; PCR-RFLP) 방법을 이용하여 허혈성 뇌경색 발생과 유전자 다형성과의 관계를 비교 분석하였다. 결과 : 허혈성 뇌경색 환자에서의 4G/4G의 유전자형의 빈도는 15.0%으로 정상 대조군의 33.5%에 비해 현저하게 낮게 나타났다 (P < 0.0001). 각각의 유전자형과 허혈성 뇌경색의 발생 위험도 (odd ratio ; OR)와의 관계를 분석했을 때 4G/4G 유전자형을 가질 경우 위험도는 0.35배로 현저하게 낮아졌으며, (P < 0.0001), 5G/5G 유전자형을 가질 경우 위험도는 4.49배 로 현저하게 높아졌다 (P < 0.0001). 그러나, A/G 유전자 다형성과 허혈성 뇌경색의 발생과는 유의한 연관성을 발견하지 못하였다. 결론 : 이상의 결과로 볼 때 PAI-1 유전자의 4G/4G 유전자형은 허혈성 뇌경색의 발생 비율을 감소시키는 작용을 하는 것으로 여겨진다.

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Virtual Angioscopy for Diagnosis of Carotid Artery Stenosis (경동맥 협착증 진단을 위한 가상혈관경)

  • 김도연;박종원
    • Journal of KIISE:Software and Applications
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    • v.30 no.9
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    • pp.821-828
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    • 2003
  • The virtual angioscopy was implemented using MR angiography image of carotid artery Inside of the carotid artery is one of the body region not accessible by real optical endoscopy but can be visualized with virtual endoscopy. In order to determine the navigation path, we segmented the common carotid artery and internal carotid artery from the MR angiography image. We used the coordinates as a navigation path for virtual camera that were calculated from medial axis transformation. We used the perspective projection and marching cube algorithm to render the surface from volumetric MRA image data. A stroke occurs when brain cells die because of decreased blood flow to the brain. The carotid artery is the primary blood vessel that supplies the blood flow to the brain. Therefore, the carotid artery stenosis is the primary reason of stroke. The virtual angioscopy is highly recommended as a diagnosis tool with which the specific Place of stenosis can be identified and the degree of stenosis can be measured qualitatively. Also, the virtual angioscopy can be used as an education and training tool for endoscopist and radiologist.

A Study on the Management of Non-Communicable Disease in Fiji (피지에서의 만성병 관리)

  • Kim, Daeseon;Romakin, Pablo;Rafai, Eric;Lee, Chulwoo
    • Journal of Appropriate Technology
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    • v.6 no.2
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    • pp.163-173
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    • 2020
  • For the successful execution of an ODA project, it is necessary to know what areas are weak and necessary to the country of demand exactly. The health sector is also a top priority in most of developing countries. This study was carried out to introduce non-communicable disease (NCD) in Fiji for ODA projects planning. The major causes of death in Fiji in 2016 are diabetes, ischemic heart disease, cerebrovascular disease, chronic kidney disease, lower respiratory infect, asthma in ranking. The major causes of death in Korea in same year are cancer, ischemic heart diseases, cerebrovascular diseases, pneumonia, suicide, diabetes in the order of ranking. The chronic disease as non-communicable disease (NCD) has been increasing continuously due to changes in lifestyle and consumption patterns and population aging in prevalence rate. This global trend is also apparent in Fiji and Korea, reflected in increasing mortality and personal costs for the treatment and management of NCD. The need for a sustained comprehensive treatment tailored for individual patients has suggested from many studies and the development of a systematic program to manage NCD patients to provide such care have been recommended. The Fiji government developed Non-communicable Diseases Strategic Plan 2015-2019 and has tried to reduce the prevalence rate of non-communicable diseases by factors. The WHO global action plan guiding national-level NCD policies requires an NCD prevention and control model at the community level, presenting strategic goals and detailed options for the introduction and application of the approach to communities. It is necessary to develop an NCD prevention and control model, consisting of a strategy of community intervention, education for students and NCD patients, and the legal enactment of NCD that adequately meets the needs of community members.

Cilostazol Promotes the Migration of Brain Microvascular Endothelial Cells (Cilostazol에 의한 뇌혈관내피세포의 세포이동 증진 효과연구)

  • Lee, Sae-Won;Park, Jung Hwa;Shin, Hwa Kyoung
    • Journal of Life Science
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    • v.26 no.12
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    • pp.1367-1375
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    • 2016
  • Cilostazol is known to be a selective inhibitor of phosphodiesterase III and is generally used to treat stroke. Our previous findings showed that cilostazol enhanced capillary density through angiogenesis after focal cerebral ischemia. Angiogenesis is an important physiological process for promoting revascularization to overcome tissue ischemia. It is a multistep process consisting of endothelial cell proliferation, migration, and tubular structure formation. Here, we examined the modulatory effect of cilostazol at each step of the angiogenic mechanism by using human brain microvascular endothelial cells (HBMECs). We found that cilostazol increased the migration of HBMECs in a dose-dependent manner. However, it did not enhance HBMEC proliferation and capillary-like tube formation. We used a cDNA microarray to analyze the mechanisms of cilostazol in cell migration. We picked five candidate genes that were potentially related to cell migration, and we confirmed the gene expression levels by real-time PCR. The genes phosphoserine aminotransferase 1 (PSAT1) and CCAAT/enhancer binding protein ${\beta}$ ($C/EBP{\beta}$) were up-regulated. The genes tissue factor pathway inhibitor 2 (TFPI2), retinoic acid receptor responder 1 (RARRES1), and RARRES3 were down-regulated. Our observations suggest that cilostazol can promote angiogenesis by promoting endothelial migration. Understanding the cilostazol-modulated regulatory mechanisms in brain endothelial cells may help stimulate blood vessel formation for the treatment of ischemic diseases.

운동으로 건강을

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.26 no.4 s.281
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    • pp.6-13
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    • 2002
  • 우리 몸은 적절한 운동을 함으로써 각각의 기능이 정상으로 적응하도록 되어있으며 적절한 운동을 하지 않으면 신체의 기능은 점점 약화되어 건강에 나쁜 영향을 주게 된다. 우리 주위의 많은 사람들은 이러한 사실을 알고 있어도, 시간이 없다는 핑계로, 다른 할 일이 많다는 핑계로 운동 부족을 자초하고 있다. 우리나라의 사망원인 순위를 보면 위기 암(악성신생물), 위가 뇌혈관 질환, 3위가 심장질환으로 식생활, 운동부족 등 잘못된 생활습관이나 스트레스등으로 인한 만성질환이다. 특히 운동부족은 심장병, 암, 당뇨병, 근골격계 질환(골다공증) 등의 위험요인이 되는데 운동부족과 밀접한 관계가 있는 허혈성 심질환의 경우 사망률이 1985년 인구 10만명당 3.8명에서 2000년 21.5명으로 5배 이상 증가하였으며 당뇨병의 경우 1985년 인구 10만명당 6.8명에서 2000년 22.6명으로 3배 이상 증가하였나(통계청, 200년 조사), 우리나라 성인들의 운동 실천율은 매우 낮은 편으로 규칙적으로 운동하는 사람의 비율이 0.8%에 머물러 운동부족의 심각성을 보여주고 있다(한국보건사회연구원 1998) 세계보건기구(WHO)와 보건복지부는 2002년 4월 7일 세계 보건의 날을 맞아 ‘Move for health'라는 구호로 운동의 중요성 및 생활 속의 활기찬 움직임에 대한 중요성을 일깨우기 위해 보건의 날 올해의 주제로 선정하였다. 4월의 이달의 건강 길라잡이에서는 생활 속에서 쉽게 실천할 수 있는 운동, 나에게 맞는 운동에 대하여 알아본다.

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Early and Mid-term Results of Operation for Acute Limb Ischemia (급성 사지 허혈증의 증단기 수술 성적)

  • 김대환;최창석;황상원;김한용;유병하;김종석
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.787-792
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    • 2004
  • Even though there well developments in various treatment techniques for acute limb ischemia, this disease is both life threatening and limb threatening. We investigated early and mid-term results of operation for acute limb ischemia with symptoms, the combined diseases, location of occlusion, complication in our patients. Material and Method: A retrospective review was conducted in 54 patients (43 men, 11 women, mean age 67.2 years) presenting with acute limb ischemia due to arterial thrombosis or embolism between Jan. 1996 and Dec. 2003, initially underwent thromboembolectomy. Result: In 33 patients (61.1%) the timeinterval from the onset of symptom to admission was within 24 hours. Causes of acute limb ischemia were embolic occlusion (27.8%), native arterial thrombosis (66.7%), and bypass graft thrombosis (5.6%). The distribution of arterial occlusion location was at 8 aortoiliac (14.8%) and 43 distal to femoral (79.6%) and brachial (5.6%). Clinical categories were grade I in 64.8%, IIa in 24.1%, IIb in 7.4%, and III in 3.7%, All the patients were received embolectomy. Underlying diseases were heart disease (72.2%), hypertension (33.3%), cerebrovascular accident (16.7%) and diabetes (18.5%). History of smoking was noted in 96,3% of the cases. Mortality rate was 5.6% and overall amputation rate was 9.3% (5/54). The 1-year limb salvage rate was 93.62%. Postoperative complications were 1 wound infection, 1 G1 bleeding, 3 acute renal failure, and 1 compartment syndromes. The functional outcomes of the salvaged limb according to the recommended scale for gauging changes in clinical status, revised version in 1997 were +3 in 68.5%, +2 in 9.3%, +1 in 7.4%, -1 in 5.6%, -2 in 3.7%, and -3 in 5.6%. Conclusion: This study revealed 5.6% mortality and the amputation rate was 9.3%. We have retrospectively shown good results from early diagnosis & early operation. To improve outcome, early diagnosis and understand the underlying diseases, prompt treatment and operation would be appreciated.

Clinical Effect through Histological Characteristics of Focal Ischemia Region (뇌허혈성 부위의 조직학적 특성을 통한 임상적 영향)

  • Lee, Tae-Hoon
    • Journal of Industrial Convergence
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    • v.17 no.4
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    • pp.39-43
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    • 2019
  • Mouse embryonic stem cell could show an substitutional materials of cells of neuron differentiation, positively increasing their effectiveness in the treatment of nervous symptom. We examined that mouse embryonic stem cells (mESCs) can be induced to undergo neuronal differentiation. After neuronal induction, the phenotype of mESCs changed towards neuronal morphology and mESCs were injected into the lateral ventricle of the experimental animal brain. Transplanted cells migrated to various parts of the brain and ischemic brain injury by middle cerebral artery occlusion (MCAO) increased their migration to the injured cortex. Intracerebral grafting of mESCs mostly improve sensory and motor nervous system of neurological injury in focal cerebral rats.