• Archives of Plastic Surgery
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• v.36 no.4
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• pp.489-492
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• 2009

Purpose: Autologous fat injection is ideal for patients who wish to add contour, projection and gross volumization of the aging, atrophic face and is claimed to be a safe procedure. However, there are several case reports in the literature where patients have suffered from acute visual loss and cerebral infarction after facial fat injection. This paper will explore a rare case of vessel related complication, an arteriovenous fistula that occurs after fat injection on forehead. Method: A 28 - year - old female who showed a non - tender, soft $1.0{\times}2.5cm$ sized mass on forehead for 3 weeks. A thrill could be detected on the totuous dilatated vessel - like structure around the mass. She had a fat injection on forehead for soft tissue augmentation 3 months prior to developing the mass. 3 - dimensional brain CT angiography showed arteriovenous fistula. Results: The fistula is totally excised with ligation of feeding vessels. Pathology report showed an atypical vessel which had intimal thickening, myxoid degeneration and thrombus formation. There were no evidences of recurrence at least for 2 months of follow - up. Conclusion: An occurrence of arteriovenous fistula after autologous fat injection is very rare. After perforation of artery and vein by coincidence, blood extravasates with the formation of a hematoma capsule and a pseudocapsule around it. The hematoma capsule would expand and clot would reabsorb resulting in a cavity leading to fistula formation. Other vessel related complications like acute visual loss or cerebral infarction are very severe. Therefore, surgeons should be cautious during facial fat injection to avoid vessel injuries.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.105-116
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• 2004

Objective : In this study, we used the aged bilateral common carotid artery occlusion (BCAO) rats were used to measure the effect of Bupleuri Radix (Si-Ho) on the brain ischemic injury, because aging is an important factor in storke, Method : The brian ischemic injury was induced by temporary closing of carotids on both sides in a low blood pressure state. Bupleuri Radix (Si-Ho) was orally administered in 18-month-old BCAO rats. Result : The Ischemic Damaged Hippocampus and HSP expression were analyzed by the immunohistochemical staining and the result were as follows: 1. The low numbers of pyramid cells in the hippocampus CA1 area for the ischemically injured experimental group rose to numbers simillar to those of the control group. 2. The thin neuronal cell layer in the hippocampus CA1 area for the ischemically injured experimental group returned to thickness simillar to those of the control group. 3. The normalized optical density of HSP70 expression was suppressed in CA2, DG and CA1 expression was significantly suppressed in the experimental group compared to the control group. Conclusion : These results suggested that Bupleuri Radix (Si-Ho) has a neuroprotective effect by reducing neural cell injury in the initial ischemic state.

• Journal of Preventive Medicine and Public Health
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• v.40 no.5
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• pp.411-417
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• 2007

Objectives: Although risk factors for coronary artery disease are also associated with increased carotid intima-media thickness (IMT), there is little information available on the asymptomatic, young adult population. We examined the association between multiple cardiovascular risk factors and the common carotid IMT in 280 young Korean adults. Methods: The data used for this study was obtained from 280 subjects (130 men and 150 women) aged 25 years who participated in the Kangwha Study follow-up examination in 2005. We measured cardiovascular risk factors, including anthropometries, blood pressure, blood chemistry, carotid ultrasonography, and reviewed questionnaires on health behaviors. Risk factors were defined as values above the sex-specific 75th percentile of systolic blood pressure, body mass index, total cholesterol/ high-density lipoprotein cholesterol ratio, fasting blood glucose and smoking status. Results: The mean carotid IMT${\pm}$standard deviation observed was $0.683{\pm}0.079mm$ in men and $0.678{\pm}0.067mm$ in women (p=0.567) and the evidence of plaque was not observed in any individuals. Mean carotid IMT increased with an increasing number of risk factors(p for trend <0.001) and carotid IMT values were 0.665 mm, 0.674 mm, 0.686 mm, 0.702 mm, and 0.748 mm for 0, 1, 2, 3, and 4 to 5 risk factors, respectively. The odds ratio for having the top quartile carotid IMT in men with 3 or more risk factors versus 0-2 risk factors was 5.09 (95% CI, 2.05-12.64). Conclusions: Current findings indicate the need for prevention and control of cardiovascular risk factors in young adults and more focus on those with multiple cardiovascular risk factors.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.59-74
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• 1998

Clinical observation was done on 272 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1997. 1. The cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage. and transient ischemic attack. The most case of them was the cerebral infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension. and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 7. The common symptoms were motor disability and verbal disturbance. 8 The average time to start physical therapy was 1l.3rd day after stroke in cerebral infarction and it was 15.2th day after stroke in cerebral hemorrhage. 9. The common complications were urinary tract infection, pneumonia, myocardial infarction. 10. Hypercholesterolemia and hypertriglyceridemia are usually found more frequently in cerebral infarction than in hemorrhage. 11. In acute or subacute stage, the methods of smoothening the flow of ki(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. and in recovering stage, the methods of replenishing ki(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

• Journal of Magnetics
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• v.21 no.2
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• pp.266-272
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• 2016

Transcranial magnetic stimulation devices has been used mainly for diagnostic purposes by measuring the functions of the nervous system rather than for treatment purposes, and has a problem of considerable energy fluctuations per repeated pulse. The majority of strokes are caused by ischemia and result in brain tissue damage, leading to problems of the central nervous system including hemiparesis, dysfunction of language and consciousness, and dysfunction of perception. Control is difficult and the size is large due to the difficulty of digitalizing the energy stored in a capacitor, and there are many heavy devices. In addition, there are many constraints when it is used for a range of purposes such as head and neck diagnosis, treatment and rehabilitation of nerve palsy, muscle strengthening, treatment of urinary incontinence etc. Output stabilization and minimization of the energy variation rate are required as the level of the transcranial magnetic stimulation device is dramatically improved and the demand for therapeutic purposes increases. This study developed a compact, low cost transcranial magnetic stimulation device with minimal energy variation of a high repeated pulse and output stabilization using a real time capacitor charge discharge voltage. Ischemia was induced in male SD rats by closing off the common carotid artery for 5 minutes, after which the blood was re-perfused. In the cerebrum, the number of PARP reactive cells after 24 hours significantly decreased (p < 0.05) in the TMS group compared to the GI group. As a result, TMS showed the greatest effect on necrosis-related PARP immuno-reactive cells 24 hours after ischemia, indicating necrosis inhibition, blocking of neural cell death, and protection of neural cells.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.255-257
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• 2007

Giant cell arteritis, which is also referred to as temporal arteritis, is defined as a systemic vasculitis in individuals over 50 years of age. Here, we report a case of giant cell arteritis combined with oculomotor nerve palsy. An 81-year old female patient experienced a headache for 10 days in her left temporoparietal area, that was characterized by a continuous dull ache and heaviness with intermittent shooting and lancinating pain. Her symptoms persisted in spite of receiving strong analgesics in another hospital. Upon physical examination, she was found to have marked tenderness over the left temporal area, especially along the path of the temporal artery as well as limitation of adduction, supraduction and infraduction of the left eyeball. At the time of admission, her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were 52 mm/hr and 3.94 mg/dl. In addition her brain MRI revealed no specific findings. Giant cell arteritis was suspected based on the clinical symptoms and signs as well as the elevated ESR and CRP. Oral steroid therapy started was started with an initial dose of 40 mg of prednisolone per day that was gradually tapered to 5 mg a day for 2 weeks. Her headache subsided one day after the steroid therapy and oculomotor nerve palsy was markedly improved after 2 weeks of the therapy. After 2 months she had recovered completely from her symptoms.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.4
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• pp.1014-1020
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• 2006

This study was intended to examine the effects of electroacupuncture(EA) and therapeutic exercise on the improvement of exercise function, BNDF, and HSP70 protein expression in an ischemic stroke model induced by MCA occlusion. Experiments were conducted for 1, 3 days, 1, 8 weeks respectively. Group I was a group of EA and therapeutic exercise; Group II was a group of therapeutic exercise; Group III was a group of EA; Group IV was a sham group of EA; Group V was a control group; and Group VI was a sham group without ischemic stroke. In each group, neurologic motor behavior test, histologic observations, BDNF, and HSP70 expression were observed and analyzed. The following results were obtained. The results of behavior test suggest that 8 weeks after ischemic stroke was induced, Group I improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group VI. In immunohistochemical observations, Group I showed increase in BDNF and decrease in HSP70. Based on these results, EA and therapeutic exercise may improve muscle atrophy and change in BDNF and HSP70 expression of ischemic stroke rats and contribute to the improvement of exercise function.

• Biomolecules & Therapeutics
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• v.25 no.3
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• pp.272-278
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• 2017

Fucoidan has been reported to exhibit various beneficial activities ranging from to antivirus and anticancer properties. However, little information is available about the effects of fucoidan on cerebral ischemia-reperfusion injury (IRI). Our study aimed to explore the effects of fucoidan on cerebral IRI, as well as the underlying mechanisms. Sprague-Dawley (SD) rats were randomly subjected to four groups: Sham, IRI+saline (IRI+S), IRI+80 mg/kg fucoidan (IRI+F80), and IRI+160 mg/kg fucoidan (IRI+F160). Fucoidan (80 mg/kg or 160 mg/kg) was intraperitoneally injected from 7 days before the rats were induced to cerebral IRI model with middle cerebral artery occlusion (MCAO) method. At 24 h after reperfusion, neurological deficits and the total infarct volume were determined. The levels of inflammation-associated cytokines (interleukin (IL)-$1{\beta}$, IL-6, myeloperoxidase (MPO), and tumor necrosis factor (TNF)-${\alpha}$), oxidative stress-related proteins (malondialdehyde (MDA) and superoxide dismutase (SOD)) in the ischemic brain were measured by enzyme-linked immunosorbent assay (ELISA). Besides, the levels of apoptosis-related proteins (p-53, Bax, and B-cell lymphoma (Bcl)-2) and mitogen-activated protein kinase (MAPK) pathway (phosphorylation-extracellular signal-regulated kinase (p-ERK), p-c-Jun N-terminal kinase (JNK), and p-p38) were measured. Results showed that administration of fucoidan significantly reduced the neurological deficits and infarct volume compared to the IRI+S group in a dose-dependent manner. Also, fucoidan statistically decreased the levels of inflammation-associated cytokines, and oxidative stress-related proteins, inhibited apoptosis, and suppressed the MAPK pathway. So, Fucoidan plays a protective role in cerebral IRI might be by inhibition of MAPK pathway.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.73-78
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• 2001

Objective : Intraoperative rupture of an intracranial aneurysm can interrupt a microsurgical procedure and jeopardize the patient's chance to favorable outcome. The purpose of this study was to analyse and evaluate intraoperative aneurysmal rupture and render ideal prevention and management to intraoperative rupture. Patients and Methods : The authors retrospectively analysed the results of 609 patients who underwent cerebral aneurysm surgery from January 1991 to December 2000. Results : 1) Intraoperative aneurysmal rupture occurred in 73 of 609 consecutive aneurysm surgery, so the incidence was about 12.0% and it was relatively lower than other reports. 2) Aneurysms arising from anterior communicating artery appeared more prone to intraoperative rupture. 3) The size of aneurysm and timing of operation didn't influence intraoperative aneurysmal rupture and temporary clipping didn't reduce the incidence of intraoperative aneurysmal rupture. 4) Intraoperative aneurysmal rupture occured during three specific periods : (1) dissection stage in 61%, (2) clip application stage in 29 %, (3) predissection stage in 10%. 5) In the patients with intraoperative aneurysmal rupture, surgical outcome was relatively good and there was no significant difference in outcome compared with unruptured group. Conclusion : Our suggestion for prevention methods of intraoperative aneurysmal rupture are as follows : 1) minimal brain retraction, 2) sharp and careful aneurysmal neck dissection, 3) gentle clipping with proper clip selection etc. Management methods after intraoperative aneurysmal rupture are as follows : 1) strong aspiration of bleeding point, 2) rapid application of temporary and/or tentative clip, 3) following rapid dissection of neck and proper clip application, 4) use of encircling clip etc.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.153-158
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• 2001

Traumatic carotid-cavernous fistula is a rare complication of moderate to severe head injury. For the treatment of carotid-cavernous fistula, detachable balloon occlusion is the best method of choice. A 26 year old male patient was hurt with a left periorbital penetrating injury 20 years ago, and then left side exophthalmos, bruit and right hemiparesis developed 10 years later. We experienced the very rare case of direct carotidcavernous fistula with cavernous dural arteriovenous fistula. Brain MRIs and cerebral angiograms revealed that direct carotid-cavernous fistula was accompanied by cavernous dural arteriovenous fistula due to longstanding venous hypertension and development of collateral circulation. Detachable balloon occlusion and surgical internal carotid artery ligation were not enough to occlude fistular flow, so cavernous dural arteriovenous fistula embolization was necessary. The authors present a case of long-standing traumatic carotid-cavernous fistula with cavernous dural arteriovenous fistula, with review of the literature.