• 한국방사선학회논문지
• /
• 제15권1호
• /
• pp.29-35
• /
• 2021

본 연구의 목적은 주기적으로 follow up CT를 촬영하는 뇌출혈 환자에게 조영제의 양을 줄임으로써 줄이기 전과 후의 영상의 화질의 차이가 있는지에 관하여 조사하는 것이었고, 줄이기 전과 후의 영상을 검사한 후 MMWP 프로그램을 이용하여 각각의 혈관 위치에 ROI를 설정하여 화질을 평가하였다. 먼저 Rt. CCA, Lt.CCA. Rt.MCA, Lt.MCA, Basilar artery에 각각 ROI를 잡았다. 둘째, 잡은 ROI에 대한 평균값과 표준편차값을 구하였다. 셋째, 구해진 평균값과 표준편차 값을 통하여 SNR과 CNR을 구하였다. 구하여진 SNR값과 CNR값을 T-test 통계를 구한 결과 SNR에 대한 결과 값은 Rt.CCA 0.765, Lt.CCA 0.871, Rt.MCA 0.343, Lt.MCA 0.235, Basilar artery 0.916이며, CNR에 대한 결과 값은 Rt.CCA 0.088, Lt.CCA 0.069, Rt.MCA 0.818, Lt.. MCA 0.579, Basilar artery 0.878로 나타났다. 구해진 SNR값과 CNR값을 통하여 통계를 구한 결과값이 조영제를 줄이기 전과 후의 영상의 화질에 차이가 없는 것으로 나타났다. 따라서 본 연구가 주기적으로 CT검사를 하는 환자들에게 조영제에 대한 부담이 덜어질 수 있는 지표가 되기를 바랍니다.

• Journal of Korean Neurosurgical Society
• /
• 제38권5호
• /
• pp.375-379
• /
• 2005

Objective : Papaverine has been used in treating vasospasm following subarachnoid hemorrhage[SAH]. However, its action mechanism for cerebral vascular relaxation is not clear. Potassium channels are closely related to the contraction and relaxation of cerebral smooth muscle. Therefore, to identify the role of potassium and calcium channels in papaverine-induced vascular relaxation, we examine the effect of papaverine on potassium channels in freshly isolated smooth muscle cells from rat basilar artery. Methods : The isolation of rat basilar smooth muscle cells was performed by special techniques. The whole cell currents were recorded by whole cell patch clamp technique in freshly isolated smooth muscle cells from rat basilar artery. Papaverine was added to the bath solution. Results : Papaverine of $100{\mu}M$ into bath solution increased the amplitude of the outward $K^+$ current which was completely blocked by BKCa[large conductance calcium dependent potassium channels]blocker, IBX[iberiotoxin], and calcium chealator, BAPTA[l,2-bis[o-aminophenoxy]ethane-N,N,N',N'-tetraacetic acid], in whole cell mode. Conclusion : These results strongly suggest that potassium channels may play roles in papaverine-induced vascular relaxation in rat basilar artery.

• Journal of Korean Neurosurgical Society
• /
• 제53권4호
• /
• pp.235-240
• /
• 2013

Fusiform aneurysms on the basilar artery (BA) trunk are rare. The microsurgical management of these aneurysms is difficult because of their deep location, dense collection of vital cranial nerves, and perforating arteries to the brain stem. Endovascular treatment is relatively easier and safer compared with microsurgical treatment. Selective occlusion of the aneurysmal sac with preservation of the parent artery is the endovascular treatment of choice. But, some cases, particularly giant or fusiform aneurysms, are unsuitable for selective sac occlusion. Therefore, endovascular coiling of the aneurysm with parent vessel occlusion is an alternative treatment option. In this situation, it is important to determine whether a patient can tolerate parent vessel occlusion without developing neurological deficits. We report a rare case of fusiform aneurysms in the BA trunk. An 18-year-old female suffered a headache for 2 weeks. Computed tomography and magnetic resonance image revealed a fusiform aneurysm of the lower basilar artery trunk. Digital subtraction angiography revealed a $7.1{\times}11.0$ mm-sized fusiform aneurysm located between vertebrovasilar junction and the anterior inferior cerebellar arteries. We had good clinical result using endovascular coiling of unruptured fusiform aneurysm on the lower BA trunk with parent vessel occlusion after confirming the tolerance of the patient by balloon test occlusion with induced hypotension and accompanied by neurophysiologic monitoring, transcranial Doppler and single photon emission computed tomography. In this study, we discuss the importance of preoperative meticulous studies for avoidance of delayed neurological deficit in the patient with fusiform aneurysm on lower basilar trunk.

• 동국한의학연구소논문집
• /
• 제8권1호
• /
• pp.117-131
• /
• 1999

Yangkyuksanhoa-tang is frequently used for cerebrovascular accident(CVA). The present study was performed to investigate the effect of Yangkyuksanhoa-tang on the peri vascular immunoreactive nerve fiber of the basilar artery after experimentally induced subarachnoid hemorrhage(SAH). Sprague Dawley rats weighing between 350-400g were used. The SAH induced by injection of the fresh autologus heart blood(0.3-0.4ml) into the cisterna magna through the posterior atlanto-occipital membrane. Sample group was given a $3.3m{\ell}/kg/day$ of Yangkyuksanhoa-tang extracts for 2 days after SAH. The experimental animals divided into 48hrs after SAH. The changes of perivascular immunoreactive nerve fiber was examined by using indirect immunofluorescence method. The meshlike perivascular nerve fiber appeared in the basilar artery of normal rats. In basilar artery of SAH elicitated rat, the distribution of calcitonin gene-related peptide (CGRP)-immunoreactivity(IR) and vasoactive intestinal polypeptide(VIP)-IR of the perivascular nerve fiber were remarkably diminished, also dopamine beta hydroxylase(DBH)-IR, neuropeptide Y(NPY)-IR and serotonin-IR were diminished. In SAH elicitated rat with Yangkyuksanhoa-tang treatment, the CGRP-IR and VIP-IR degree were repaired as well as normal rat's, but DBH-IR, NPY-IR and serotonin-IR had no changes. These results provide the basic data to investigate the effect of Yangkyuksanhoa-tang on the vasospasm after SAH.

• 대한추나의학회지
• /
• 제1권1호
• /
• pp.45-53
• /
• 2000

Objectives : CHUNA therapy that removes compression of dislocated vertebral bones has positive effect, but sometimes improper CHUNA manual therapy may give rise to negative effect. The aim of this study is to make sure that cervical CHUNA manual therapy give positive effect or negative effect to the blood flow velocity of vertebral artery(VA) and basilar artery(BA) by Trancranial Doppler sonography(TCD). Methods : We performed TCD study on 20patients(male 5, female 15, mean ages 38.5 years) with diagnosis like cervical movement related disorder, headache or dizziness. After we measured mean blood flow velocity(Vm) of VA and BA before cervical CHUNA therapy(Pre-CCT) and after cervical CHUNA therapy(Post-CCT), statistically evaluated the results. Results: The patients received cervical CHUNA therapy for TA sequel, HIVD of cervical spine, headache, dizziness, neck stiffness etc. VA Vm was $31.9{\pm}8.0cm/sec$ before CHUNA therapy, but significantly increased $35.0{\pm}8.7cm/sec$ after CHUNA therapy (p < 0.05). But, there was no significant variation of BA Vm between $41.8{\pm}7.5cm/sec$ Pre-CCT and $41.2{\pm}8.5cm/sec$ Post-CCT(p>0.05). Though VA Vm slightly increased after CHUNA therapy in normal range group, there was no significant variation between VA Vm Pre-CCT and VA Vm Post~CCT. In VA Vm decrease group, VA Vm significantly increased after CHUNA therapy(p<0.05). But, there was no significant variation of BA Vm between Pre-CCT and Post-CCT in BA Vm normal range group and BA Vm decrease group(p>0.05). Conclusions: These findings suggest that cervical CHUNA manual therapy have positive effect on blood flow velocity of VA and BA.

• Journal of Korean Neurosurgical Society
• /
• 제39권3호
• /
• pp.215-220
• /
• 2006

Objective : Tyrosine kinase inhibitors may be useful in the management of cerebral vasospasm. It has not yet been reported whether L-type $Ca^{2+}$ channels playa role in tyrosine kinase inhibitors-induced vascular relaxation of cerebral artery. This study was undertaken to clarify the role of L-type $Ca^{2+}$ channels in tyrosine kinase inhibitors-induced vascular relaxation, and to investigate the effect of tyrosine kinase inhibitors on L-type $Ca^{2+}$ channels currents in freshly isolated smooth muscle cells from rat basilar artery. Methods : The isolation of rat basilar smooth muscle cells was performed by special techniques. The whole cell currents were recorded by whole cell patch clamp technique in freshly isolated smooth muscle cells from rat basilar artery. Results : Patch clamp studies revealed a whole-cell current which resembles the L-type $Ca^{2+}$ current reported by others. The amplitude of this current was decreased by nimodipine and increased by Bay K 8644. Genistein[n=5], tyrphostin A-23[n=3]. A-25[n=6] $30{\mu}M$ reduced the amplitude of the L -type $Ca^{2+}$ channel current in whole cell mode. In contrast, diadzein $30{\mu}M$ [n=3]. inactive analogue of genistein, did not decrease the amplitude of the L-type $Ca^{2+}$ channels current. Conclusion : These results suggest that tyrosine kinase inhibitors such as genistein, tyrphostin A-23, A-25 may relax cerebral vessel through decreasing level of intracellular calcium, [$Ca^{2+}$]i, by inhibition of L-type $Ca^{2+}$ channel.

• Journal of Korean Neurosurgical Society
• /
• 제30권6호
• /
• pp.769-773
• /
• 2001

Moyamoya disease is defined as the development of collateral pathways, associated with bilateral chronic progressive stenosis of the carotid fork. Persistent trigeminal artery is the vessel most frequently observed to persist into adult life among persistent carotid-basilar and carotid-vertebral anastomotic vessels. The authors present a man who had a sudden, severe headache and brain CT showed subarachnoid hemorrhage in left interpeduncular and prepontine cistern. Four-vessel angiogram revealed moyamoya disease associated with aneurysm arising from the junction of persistent trigeminal artery aneurysm and basilar artery. As a treatment, coil embolization was tried but it was failed because of anatomical difficulty of aneurysm. The aneurysm was successfully treated with clipping surgery 10 days later. To our knowledge, this is the first case being reported.

• 한국자원식물학회지
• /
• 제33권5호
• /
• pp.467-475
• /
• 2020

고혈압은 성인의 수축기 혈압이 140 mmHg 이상이거나 이완기 혈압이 90 mmHg 이상일 때를 의미하며 고혈압은 뇌졸중, 신부전 및 관상동맥질환 등 인체 전반에 걸쳐 다양한 합병증을 일으키며 고혈압 유병자의 생명과 건강을 직접적으로 위협한다(Kim and Kim, 2018). 그러나 고혈압 유병자들은 증상이 거의 나타나지 않으므로 혈압을 측정하기 전까지는 진단되지 않는다. 진득찰 즉 한방에서 희렴은 고혈압을 치료하는 처방 제제로 주로 사용됐기에 이에 착안하여 털진득찰을 이용하여 엔도델린(Endothelin)로 강제 수축 시킨 토끼 기저동맥의 이완 효과를 평가하였다. 본 연구에서는 털진득찰(Sigesbeckia pubescens)의 전초를 이용하여 키레놀 화합물을 분리 후 혈관 이완 효과를 평가하였다. 인체 내 가장 강력한 혈관수축 물질로 알려진 엔도델린은 혈관 평활근 세포막에 존재하는 엔도델린 수용체 아형 A (ET_AR)와 혈관 내피세포막에 존재하는 수용체 아형 B2(ET_B2R)에 작용하여 혈관의 긴장도를 높이고, ET_B1R에 작용하여 긴장도를 낮추는 조절자 임무를 수행한다(Lucchelli et al., 1999). 일반적으로 엔도델린 펩타이드의 경우 염증, 당뇨, 및 심혈관계 질환에서 혈중 농도가 증가하며, 엔도델린 체계의 비정상적 항진은 만성신부전 및 사구체 경화증과 같은 신질환, 특발성 폐섬유화증 및 만성폐쇄성 폐 질환 등의 호흡기계 질환, 대사질환의 중요한 관심거리가 되는 당뇨병성 신경병증 및 망막증, 수족괴사 등의 질환과 전립선 및 대장 등의 암질환 등을 초래한다(Lavoie et al., 1997; Pancrazio et al., 1998). 본 연구에서 엔도델린 유도 뇌 기저동맥의 수축을 억제하는 키레놀의 농도(EC₅₀)를 관찰한 결과 10 ㎍/mL의 농도에서 48% 이상의 유효한 혈관 이완 효능이 관찰되었다. 따라서 키레놀을 이용하여 엔도델린 활성조절 신소재로의 구조적·기능적 도출 연구가 추가로 진행된다면건강 기능성 식품 소재 또는 의약학 소재로의 개발이 가시화될 수 있을 것으로 사료된다.

• Journal of Korean Neurosurgical Society
• /
• 제45권4호
• /
• pp.224-230
• /
• 2009

Objective : We aimed to analyze clinical and radiological outcomes retrospectively in patients with basilar apex aneurysms treated by coiling or clipping. Methods : Outcomes of basilar bifurcation aneurysms were assessed retrospectively in 77 consecutive patients (61 women, 16 men), ranging in age from 25 to 79 years (mean, 53.7 years) from 1999 to 2007. Results : Forty-nine patients out of 77 patients (63.6%) presented with subarachnoid hemorrhages of the 49 patients treated with coiling, 27 (55.1 %) showed complete occlusion of the aneurysm sac. Of these, 13 patients (26.5%) developed coil compaction on angiographic or MRI follow-up, with recoiling required in 9 patients (18.4%). Procedural complications of coiling were acute infarction in nine patients and the bleeding of the aneurysms in six patients. The remaining 28 patients underwent microsurgery : twenty-six of these (92.9%) with microsurgery followed up with conventional angiography. Complete occlusion of the aneurysm sac was achieved in 19 patients (73.1%). Operation-related complications of microsurgery were thalamoperforating artery injuries in three patients, retraction venous injury in two, postoperative epidural hemorrhage (EDH) in one, and transient partial or complete occulomotor palsy in 14 patients. Glasgow Outcome Scores (GOS) were 4 or 5 in 21 of 28 (75%) patients treated with microsurgery at discharge, and at 6 month follow-up, 20 of 28 (70.9%) maintained the same GOS. In comparison, GOS of four or 5 was observed in 36 of 49 (73.5%) patients treated with coiling at discharge and at 6 month follow-up, 33 of 49 patients (67.3%) maintained the GOS from discharge. Conclusion : Basilar top aneurysms were still challenging lesions based on our series. Endovascular or microsurgery endowed with its inborn risks and procedural complications for the treatment of basilar apex aneurysms individually. Microsurgery provided better outcome in some specific basilar apex aneurysms. For reaching the most favorable outcome, endovascular modality as well as microsurgery was inevitably considered for each specific basilar apex aneurysm.

• 대한영상의학회지
• /
• 제83권1호
• /
• pp.184-188
• /
• 2022

지속성 원시 삼차신경동맥은 퇴화하지 않고 남아있는 내경동맥-기저추골동맥 문합이다. 변형 지속성 원시 삼차신경동맥은 드문 비정상적인 문합으로, 내경동맥과 기저동맥의 연결 없이 내경동맥에서 직접 혈관이 분지 되어 소뇌 동맥의 영역에 혈액을 공급한다. 본 연구진들은 그중에서도 변형 지속성 원시 삼차신경동맥이 동측의 상소뇌동맥 영역에 직접 혈액을 공급하는 특히 드문 증례를 발견하였다. 시행된 전산화단층촬영 혈관조영술, 디지털감산 혈관 조영술, 자기공명 혈관조영술 사진을 이용하여 이를 보고하고자 한다. 추가적으로 본 연구진들은 지속성 원시 삼차신경동맥과 변형 지속성 원시 삼차신경동맥의 발생학과 임상적 의미에 대하여 검토하였다.