• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1491-1498
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• 2000

Objectives : Embolization of intracranial aneurysms by using Guglielmi detachable coils(GDC) is proving to be a safe method of protecting aneurysms from rupture. Occasionally, patients with unruptured intracranial aneurysms present with symptoms related to the aneurysm's mass effect on either the brain parenchyma or cranial nerves. In the present study, the authors conducted a retrospective review to evaluate the response to GDC embolization in a series of 6 patients presenting with cranial nerve dysfunction due to mass effect. Patients and Methods : Aneurysms were classified by size, shape, and amount of intraluminal thrombus. Patients were classified by duration of symptoms prior to GDC treatment(range<1 month to>4 years). Clinical assessment was performed within days of the GDC procedure and at later follow-up appointments(range 5-16 months, mean 9 months). Results : In the immediate post-GDC embolization period, one of the five patients had transient worsening of third nerve palsy, which later improved to better than baseline status. Two patients who presented with third nerve deficit from a internal carotid artery-posterior communicating artery junction aneurysm had complete recovery. One patient who presented with hemiparesis and dysarthria from a giant mid-basilar aneurysm showed improvement of these symptoms. One patient who presented with sixth cranial nerve deficit from a cavernous aneurysm showed no change at the 8-months follow-up examination. Conclusion : The endovascular treatment of intracranial aneurysms by using GDC is suggested as an alternative therapeutic method for improving or alleviating neurological deficits produced by mass effect.

• 대한임상검사과학회지
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• 제50권3호
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• pp.267-274
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• 2018

순천성가롤로병원 어지럼증 센터에 내원한 어지럼증 환자 중 뒤반고리관 양성발작성 두위현기증은 머리나 몸을 움직일 때 갑자기 빙빙도는 느낌 또는 회전성 어지럼증을 호소하는 가장 흔한 질환이다. 대부분 환자들은 1회 치료로 증상이 호전된다. 하지만, 세 번 이상 여러번 치료를 요구하는 경우도 있다. 이석정복술에 의한 뒤반고리관 양성발작성 두위현기증환자의 어지럼증 증상 회복에 영향을 주는 인자을 분석하였다. 어지럼증환자 중 어지럼증 센터에 내원한 뒤반고리관 양성발작성두위현기증 환자를 분류하였다. 2008년 3월부터 2010년 11월까지 165명의 뒤반고리관 양성발작성두위현기증 환자 치료율을 조사하였다. 1회 치료성공율이 57.6%, 2회 치료성공율이 17.6%, 3회 치료성공율이 3.6%, 3회 이상 치료성공율이 21.2%였다. 뒤반고리관 양성발작성두위현기증 치료에 영향을 주는 인자는 외상 후, 내과적 질환, 뇌경색, 작은혈관 질환, 척추뇌바닥동맥기능부전증, 뇌혈관질환, 뇌질환, 안뜰신경염이다. 위와 같은 치료에 영향을 주는 인자들을 고려한다면 구토, 오심, 실신 등을 쉽게 치료 할 수 있을 것이다. 또한, 어지럼증 증상의 회복을 위한 이석정복술과 연관질환을 병행 치료하면 일상생활에 많은 불편함을 주고, 고통을 주는 어지럼증에서 호전될 수 있을 것이다. 앞으로 어지럼증을 유발하는 많은 인자들을 조사하고, 분석할 필요가 있을 것이다.

• 대한한의학방제학회지
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• 제14권1호
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• pp.105-119
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• 2006

Objectives & Methods : This present study was performed to investigate the effect of Hwadamtongrak-Tang extract (HTT) on the regulation of cerebral hemodynamics in terms of regional cerebral blood flow (rCBF) and mean arterial blood pressure (MABP)] in normal and cerebral ischemic rats. Also the effects of HTT on changes in local blood flow, inhibition of LD H activity in neuronal cells, and levels of cytokine production in the serum were determined in the ischemic rat model. The major findings are summarized below. Results : 1. HTT significantly increased rCBF in a dose-dependent manner, but MABP was not changed by HTT treatment. These results suggest that HTT may increase rCBF by dilating cerebral arterial diameter. 2. HTT-induced increase in rCBF was blocked by pretreatment with cyclooxygenase inhibitor indomethacin (IDN, 1 mg/kg, i.p.) and MABP was significantly increased by ID N. 3. Pretreatment of methylene blue $(MTB,\;10\;{\mu}g/kg,\;i.p.)$, an inhibitor of guanylate cyclase, significantly decreased both rCBP and MABP in HTT-treated rats. 4. HTT treatment significantly increased rCBP to a stable level during the period of cerebral reperfusion. 5. HTT significantly inhibited LD H activity in neuronal cells, suggesting a neuroprotection by HTT. 6. Serum interleukin $(IL)-1{\beta}$ and tumor necrosis factor $(TNF)-{\alpha}$ levels were significantly decreased in the femoral artery 1 hr after middle cerebral arterial occlusion in HTT-treated rats. IL-10 levels in the serum were significantly increased by HTT treatment whereas transforming growth factor $(TGF)-{\beta}$ levels were similar between HTT-treated and control groups. 7. Serum interleukin $(IL)-1{\beta}$ and tumor necrosis factor $(TNF)-{\alpha}$ levels were significantly decreased in the femoral artery 1 hr after reperfusion in HTT-treated rats. Serum IL-10 levels were significantly decreased in HTT-treated rats compared with the control group, and no significant changes in $(TGF)-{\beta}$ in the serum were observed by HTT treatment. Conclusions: The present data suggest that HTT may have an anti-ischemic effect via the improvement of cerebral hemodynamics and thus protect the brain from ischemic damage.

• Korean Journal of Acupuncture
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• 제19권2호
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• pp.63-78
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• 2002

Kupunggibodan(KU), Gamisamul-tang(GA) and Whangryunhaedok-tang(WH) are clinically the most popular prescriptions as an herbal medicine in the treatment of ischemia. In order to compare and evaluate their protective effects on the ischema-induced cognitive deficits by middle cerebral artery occlusion (MCAO), we examined its ability to improve ischemia-induced cell loss and impairements of learning and memory in the Morris water maze and eight-arm radial arm maze. Focal cerebral ischemia produced a marked cell loss, decrease in acetylcholinesterase(AchE) reactivity in the hippocampus, and learning and memory deficits in two behavioral tasks. Pretreatment with WH (100 mg/kg, p.o.) produced a substantial increase in acquisition in the Morris water maze. Pretreatment with KU increased the perfomance of the resention test in the Morris water maze. WH, KU and GA caused a significant improvement in choice accuracy in radial arm maze test. WH was superior to KU and GA in perfomance of the radial arm maze test. Consistent with behavioral data, staining with cresyl violet showed that pretreatments with WH, but not KU and GA significantly recovered the ischemia-induced cell loss in the hippcampal CA1 area. In addition, pretreatments with WH and KU recovered the ischemia-induced reduction of AchE reactivity in the hippocampal CA1 area. These results demonstrated that KU, GA and WH have protective effects against ischimea-induced learning and memory impairments and that the efficacy was the order of WH>KU>GA in tratment of ischemia induced memory deficits. The present studies provide an evidence of KU, GA and WH as putative treatment of vascular dementia. Supported by a fund from the Ministry of Health and Welfare(HMP-00-OO-04-0004), and the Brain Korea 21 Project from Korean Ministry of Education, Korea.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.545-550
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• 2019

Objective : Penumbra ACE68 reperfusion catheter is a new large bore aspiration catheter used for reperfusion of large vessel occlusion. The objective of this study was to investigate the efficacy of this catheter in comparison to that of previous Penumbra catheters in patients with acute ischemic stroke related to internal carotid artery (ICA) occlusion. Methods : Data of all eligible patients who received endovascular treatment (EVT) for ICA occlusion using Penumbra aspiration catheters between January 2015 and December 2018 were retrospectively reviewed. After dividing into two groups according to use of penumbra ACE68, baseline characteristics of patients, successful recanalization rate, puncture to recanalization time, and switch to stent base technique rate were assessed. Successful recanalization was defined by a thrombolysis in cerebral infarction (TICI) score ${\geq}2b$ and favorable functional outcome was defined according to modified Rankin scale (score, 0-2). Results : ACE68 reperfusion catheter was used in 29 of 75 eligible patients (39%). The puncture to recanalization time was significantly shorter ($26{\pm}18.2$ minutes vs. $40{\pm}24.9$ minutes, p=0.011) and the rate of switch to stent-based retrieval was significantly lower (3% vs. 20%, p=0.046) in ACE68 catheter group. Moreover, although not statistically significant, the successful recanalization rate was higher (83% vs. 76%, p=0.492) in ACE68 catheter group. Favorable functional outcome was observed in 48% of patients treated with ACE68 reperfusion catheter and in 30% of patients treated using other Penumbra systems (p=0.120). Baseline Alberta Stroke Program Early CT Scores ${\geq}8$ (odds ratio [OR], 9.74; 95% confidence interval [CI], 1.72-54.99; p=0.010) and successful recanalization (OR, 10.20; 95% CI, 1.13-92.46; p=0.039) were independent predictors of favorable outcome. Conclusion : EVT using ACE68 reperfusion catheter can be considered a first-line therapy in patients with acute ICA occlusion as it can achieve rapid recanalization and reduce the frequency of conversion to stent-retrieve therapy.

• Journal of Korean Neurosurgical Society
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• 제67권3호
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• pp.333-344
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• 2024

Objective : Markers of neuroinflammation during ischemic stroke are well characterized, but additional markers of neural damage are lacking. The study identified associations of behavioral disorders after stroke with histologic neural damage and molecular biological change. Methods : Eight-week-old, 25 g male mice of the C57BL/6J strain were subjected to middle cerebral artery occlusion (MCAO) to induce ischemic stroke. The control group was a healthy wild type (WT), and the experimental group were designed as a low severity MCAO1 and a high severity MCAO2 based on post-stroke neurological scoring. All groups underwent behavioral tests, realtime polymerase chain reaction, triphenyltetrazolium chloride (TTC) staining and Hematoxylin and Eosin staining. One-way analysis of variance was used to analyze statistical significance between groups. Results : In TTC staining, MCAO1 showed 29.02% and MCAO2 showed 38.94% infarct volume (p<0.0001). The pro-inflammatory cytokine interleukin (IL)-1β was most highly expressed in MCAO2 (WT 0.44 vs. MCAO1 2.69 vs. MCAO2 5.02, p<0.0001). From the distance to target in the Barnes maze test, WT had a distance of 178 cm, MCAO1 had a distance of 276 cm, and MCAO2 had a distance of 1051 (p=0.0015). The latency to target was 13.3 seconds for WT, 27.9 seconds for MCAO1, and 87.9 seconds for MCAO2 (p=0.0007). Prospero homeobox 1 (Prox1) was most highly expressed in MCAO2 (p=0.0004). Doublecortin (Dcx) was most highly expressed in MCAO2 (p<0.0001). Conclusion : The study demonstrated that histological damage to neural cells and changes in brain mRNA expression were associated with behavioral impairment after ischemic stroke. Prox1 and Dcx may be biomarkers of neural damage associated with long-term cognitive decline, and increased expression at the mRNA level was consistent with neural damage and long-term cognitive dysfunction.

• 대한본초학회지
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• 제23권2호
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• pp.225-233
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• 2008

Objectives : The purpose of the present study was to development of neuroprotective antioxidant agents. For the purpose, we investigated the neuroprotective effect of anti oxidant herb, the root of Polygonum cuspidatum on transient focal cerebral ischemia in rats. Methods : The roots of Polygonum cuspidatum were extracted by 85% MeOH (PCE). Radical scavenging effects were investigated using DPPH assay and TBARs (Thiobarbituric acid reaction substance) assay in brian homogenates. Neuroprotective effect was investigated using transient focal cerebral ischemia rat model (2 h of ischemia, 22 h of reperfusion) by behavioral test and measurement of brain damage using 2, 3, 5-triphenyltetrazolium chloride staining. Results : PCE showed potent and dose dependent radical scavenging effects in DPPH and TBARs assay. Oral administration of PCE reduced brain infarct volume by 29.7% and improved the sensory motor functional deficit by 29% compared with vehicle treated group. Conclusions : PCE showed radical scavenging effects and neuroprotective effect on stroke rat model. Therefore, Polygonum cuspidatum could be a candidate for the development of neuroprotective-antioxidant agents.

• The Korean Journal of Physiology and Pharmacology
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• 제24권1호
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• pp.11-18
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• 2020

The present study was aimed to explore the neuroprotective role of imatinib in global ischemia-reperfusion-induced cerebral injury along with possible mechanisms. Global ischemia was induced in mice by bilateral carotid artery occlusion for 20 min, which was followed by reperfusion for 24 h by restoring the blood flow to the brain. The extent of cerebral injury was assessed after 24 h of global ischemia by measuring the locomotor activity (actophotometer test), motor coordination (inclined beam walking test), neurological severity score, learning and memory (object recognition test) and cerebral infarction (triphenyl tetrazolium chloride stain). Ischemia-reperfusion injury produced significant cerebral infarction, impaired the behavioral parameters and decreased the expression of connexin 43 and phosphorylated signal transducer and activator of transcription 3 (p-STAT3) in the brain. A single dose administration of imatinib (20 and 40 mg/kg) attenuated ischemia-reperfusion-induced behavioral deficits and the extent of cerebral infarction along with the restoration of connexin 43 and p-STAT3 levels. However, administration of AG490, a selective Janus-activated kinase 2 (JAK2)/STAT3 inhibitor, abolished the neuroprotective actions of imatinib and decreased the expression of connexin 43 and p-STAT3. It is concluded that imatinib has the potential of attenuating global ischemia-reperfusion-induced cerebral injury, which may be possibly attributed to activation of JAK2/STAT3 signaling pathway along with the increase in the expression of connexin 43.

• Investigative Magnetic Resonance Imaging
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• 제6권1호
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• pp.55-63
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• 2002

목적 급성 허혈성 뇌졸중에서 관류 MR영상으로 측정한 상대적 뇌혈용적과 단광자방출전산화단층촬영으로 측정한 상대적 뇌혈류량이 나중에 발생할 뇌경색을 예측할 수 있는지 알아보고자 하였다. 대상 및 방법 급성 일측성 중대뇌동맥 폐색 환자에서 증상 발생 6시간 이내에 관류 MR영상과 99mTc-HMPAO 단광자방출전산화단층촬영을 모두 시행한 13명을 대상으로 하였다. 동맥 폐색에 의한 허혈 부위와 반대측 정상 부위에서 각 관류 변수를 측정하여 그 비(허혈 부위 관류변수 값 / 정상 부위 관류 변수 값)를 구한 후, 나중에 경색으로 이행할 부위와 그렇지 않을 부위를 판별할 수 있는 관류변수 비의 절단값을 계산하였다. 결과 : 경색으로 이행한 부위와 그렇지 않은 부위에서 상대적 뇌혈용적 비의 평균값은 각각 $0.58{\pm}0.27{\;}and{\;}0.99{\pm}0.17$ (p<0.001)이었고, 상대적 뇌혈류량 비의 평균 값은 $0.41{\pm}0.22{\;}and{\;}0.71{\pm}0.14$ (p<0.001)이었다. 경색으로 이행할 부위와 그렇지 않을 부위를 판별하는 절단값은 상대적 뇌혈용적 비가 0.80, 상대적 뇌혈류량 비가 0.56이었다. 각 절단값의 민감도, 특이도, 능률은 뇌혈용적 비가 80.6, 87.5, 82.7%이었고 상대적 뇌혈류량 비가 72.2, 75.0, 73.0%이었다. (두 관류변수 사이에서 p>0.05). 결론 : 급성 허혈성 뇌졸중에서 상대적 뇌혈용적과 상대적 뇌혈류량의 측정은 뇌경색의 발생을 예측하는 데에 유용한 것으로 사료된다.

• 대한의용생체공학회:의공학회지
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• 제30권5호
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• pp.401-411
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• 2009

In this paper, we correct pulse wave velocity(PWV) with heart-rate and derive regression equations to estimate intima-media thickness(IMT). Widely used methods for diagnosis of arteriosclerosis are IMT and PWV. Arterial wall stiffness determines the degree of energy absorbed by the elastic aorta and its recoil in diastole but there is not correlation between sclerosis and IMT in an existing study. In this study, we will correct PWV with heart-rate and get regression equation to estimate IMT using heart-rate correction index(HCI). We executed experiments for this study. Made up question of physical condition and measured electrocardiogram(ECG), photoplethysmogram (PPG) of finger-tip and toe-tip and ultrasound image of carotid artery. Calculated PWV and IMT using ECG, PPG and ultrasound image. We found that every p-value between PWV and IMT is not significant(<0.05). But p-value between IMT and HCI which is a corrected PWV using heart-rate is significant(>0.01). We use HCI and various measured parameter for estimating regression equation and apply backward estimation to select parameters for regression analysis. Result of backward estimation, found that only HCI is possible to derive proper regression equation of IMT. Relationship between PWV and IMT is the second order. Result of regression equation of E-H PWV is $R^2$=0.735, adj $R^2$=0.711. This is the best correlation value. We calculate error of its analysis for verification of earlobe PWV regression equation. Its result is RMSEP=0.0328, MAPE(%) = 4.7622. Like this regression analysis, we know that HCI is useful parameter and relationship between PWV, HCI and IMT. In addition, we are able to suggest possibility which is that we can get different parameter of prediction throughout just one measurement.