• 제목/요약/키워드: Carotid Artery

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Implementation of Regional Cerebral Blood Volume Map Using Perfusion Magnetic Resonance Image Process Algorithm (관류자기공명 영상처리 알고리즘을 이용한 대뇌 혈류량 맵의 구현)

  • Park Byung-Rae
    • 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).

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Cardiac Troponin I Elevation in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jeon, Ik-Chan;Chang, Chul-Hoon;Choi, Byung-Yon;Kim, Min-Su;Kim, Sang-Woo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.99-102
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    • 2009
  • Objective: Cardiac dysfunction after aneurysmal subarachnoid hemorrhage (SAH) is associated with elevation of serum cardiac troponin I (cTnl) levels. Elevation of cTnl predicts cardiopulmonary and neurological complications, and poor outcome. Methods: We retrospectively reviewed the medical and radiologic records of 114 (male: 30, female: 84) patients who developed aneurysmal SAH between January 2006 and June 2007 and had no history of previous cardiac problems. We evaluated their electrocardiography and cTnl level, which had been measured at admission. A cTnl level above 0.5 $\mu$g/L was defined as an indicator of cardiac injury following SAH. We examined various clinical factors for their association with cTnl elevation and analyzed data using chi-square test, t-test and logistic regression test with SPSS version 12.0. The results were considered significant at p< 0.05. Results: The following parameters shows a correlation with cTnl elevation: higher Hunt-Hess (H-H) grade (p = 0.000), poor Glasgow Outcome Scale (GOS) score (p = 0.000), profound pulmonary complication (p = 0.043), higher heart rate during initial three days following SAH (p = 0.029), ruptured aneurysm on communicating segment of internal carotid artery (p = 0.025), incidence of vasospasm (p = 0.421), and duration of hyperdynamic therapy for vasospasm (p = 0.292). A significant determinants for outcome were cTnl elevation (p = 0.046) and H-H grade (p = 0.000) in a multivariate study. Conclusion: A cTnl is a good indicator for cardiopulmonary and neurologic complications and outcome following SAH. Consideration of variable clinical factors that related with cTnl elevation may be useful tactics for treatment of SAH and concomitant complications.

Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke

  • Oh, Jae-Sang;Yoon, Seok-Mann;Shim, Jai-Joon;Doh, Jae-Won;Bae, Hack-Gun;Lee, Kyeong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.155-164
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    • 2017
  • Objective : To evaluate the efficacy of balloon guiding catheter (BGC) during thrombectomy in anterior circulation ischemic stroke. Methods : Sixty-two patients with acute anterior circulation ischemic stroke were treated with thrombectomy using a Solitaire stent from 2011 to 2016. Patients were divided into the BGC group (n=24, 39%) and the non-BGC group (n=38, 61%). The number of retrievals, procedure time, thrombolysis in cerebral infarction (TICI) grade, presence of distal emboli, and clinical outcomes at 3 months were evaluated. Results : Successful recanalization was more frequent in BGC than in non-BGC (83% vs. 66%, p=0.13). Distal emboli occurred less in BGC than in non-BGC (23.1% vs. 57.1%, p=0.02). Good clinical outcome was more frequent in BGC than in non-BGC (50% vs. 16%, p=0.03). The multivariate analysis showed that use of BGC was the only independent predictor of good clinical outcome (odds ratio, 5.19 : 95% confidence interval, 1.07-25.11). More patients in BGC were successfully recanalized in internal carotid artery (ICA) occlusion with small retrieval numbers (<3) than those in non-BGC (70% vs. 24%, p=0.005). In successfully recanalized ICA occlusion, distal emboli did not occur in BGC, whereas nine patients had distal emboli in non-BGC (0% vs. 75%, p=0.001) and good clinical outcome was superior in BGC than in non-BGC (55.6% vs. 8.3%, p=0.01). Conclusion : A BGC significantly reduces the number of retrievals and the occurrence of distal emboli, thereby resulting in better clinical outcomes in patients with anterior circulation ischemic stroke, particularly with ICA occlusion.

Effect of Samhwangsasim-tang, Samigangap-tang and Bangtan-tang on Blood Pressure in Stroke Prone Spontaneously Hypertensive Rats (뇌졸중성(腦卒中性) 본태성(本態性) 고혈압(高血壓) 백서(白鼠) 모델에서 삼황사심탕(三黃瀉心湯), 사미강압탕(四味降壓湯), 방탄탕(防癱湯)의 혈압(血壓)에 미치는 영향(影響))

  • Kim, Eun-Ju;Kim, Hye-Yoom;Lee, Jae-Yun;Lee, Jun-Kyoung;Kim, Seung-Ju;Choi, Kyoung-Min;Kang, Dae-Gill
    • The Korea Journal of Herbology
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    • v.26 no.1
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    • pp.75-80
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    • 2011
  • Objectives : The aim of the present study is to investigate the hypotensive effect of Samhwangsasim-tang (SHSST), Samigangap-tang (SMGAT) and Bangtan-tang (BTT) in stroke-prone spontaneously hypertensive rats (SHR-SP). Methods : SHR-SP rats were treated with SHSST, SMGAT and BTT at dose of 200 mg/kg/day orally for 5 weeks, respectively. Results : Treatment SHR-SP rats with SMGAT significantly lowered blood pressure but not in the SHSST or BTT treat groups. On the other hand, SHSST, SMGAT and BTT ameliorated endothelium-dependent and independent vascular relaxation in the phenylephrine-precontracted aorta and carotid artery, respectively. Conclusions : These results indicated that SMGAT has an antihypertensive effect and SHSST, SMGAT and BTT improve vascular function in stroke-prone hypertensive rat model, respectively.

Effect of Acute Unilateral Ureteral Obstruction on Handling of $Li^+$ by Contralateral Kidney in Rabbits (급성 일측 수뇨관 폐쇄후 상대신의 $Li^+$처리에 관한 연구)

  • Sung, Ho-Kyung;Earm, Yung-E
    • The Korean Journal of Physiology
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    • v.16 no.2
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    • pp.165-175
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    • 1982
  • Changes in handling of $Li^+$ by contralateral kidney during acute $Li^+$ loading were investigated immediately after unilateral ureteral obstruction. Carotid artery, jugular vein, renal vein and ureter of experimental animal were catheterized and renal venous flow was shunted to .external jugular vein. In experimental group right ureter was ligated. One to two hours after operation a single shot of LiCl solution (2 mEq/kg) was intravenously injected and then .arterial, renal venous blood and urine samples were taken sequentially for 1 to $1{\frac{1}{2}}$ hours. Urine volume, plasma and urinary concentrations of $Li^+$, $Na^+$ and $K^+$ were measured and urinary excretion of them were calculated. Results obtained were as follows: 1) In experimental group urine volume, urinary excretion of $Na^+$, and $K^+$ by contralateral kidney after unilateral ureteral obstruction were slightly larger than mean value of both kidney in control group. 2) During acute $Li^+$ loading contralateral kidney in experimental group showed limited $K^+$ excretion, but urinary flow and $Na^+$ excretion were comparable to mean value of both kidney in control group. 3) Urinary osmolar concentration in experimental group was much lower than that in control group, and it was maintained at low level even after Li loading. 4) In experimental group plasma$Li^+$ concentration decreased more slowly than in control group after a single shot of LiCl solution. 5) Urinary excretion of $Li^+$ in experimental group was markedly decreased, even lesseer than mean of both kidney in control group. 6) From the above results it was concluded that immediately after unilateral ureteral obstruction contralateral kidney showed normal water and $Na^+$ diuretic response to Li load but urinay $Li^+$ excretion was decreased and reclaimed $Li^+$ to systemic circulation.

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Effect of Bupleuri Radix on HSP70 Expression and Hippocampus of Ischemically Damaged Aged BCAO Rats (시호(柴胡)가 뇌허혈 유발 노령 흰쥐의 해마 손상 및 HSP70 발현에 미치는 영향)

  • Bae, Cheol-Hwan;Jeong, Sung-Hyun;Shin, Gil-Cho;Lee, Won-Chul;Kim, Jin-Su
    • 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.

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Effect of Aqueous Extract of Polygoni Multiflori Radix on Hypertension and Arterial Contraction in Animal Models (하수오(何首烏)가 고혈압과 수축혈관에 미치는 영향)

  • Seo, Yong-Won;Kim, Ho-Hyun;Ko, Heung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.3
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    • pp.593-599
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    • 2008
  • This research was aimed to examine the effect of Polygoni Multiflori Radix extract on the blood pressure in spontaneous hypertensive rat (SHR) and norepinephrine - induced arterial contraction in rabbit. In order to investigate the effect of Polygoni Multiflori Radix on rabbit's contracted vascular ring detached from common carotid artery, vascular ring with intact or damaged endothelium was used for the experiment using organ bath. To analyze the mechanism of Polygoni Multiflori Radix-induced relaxation, Polygoni Multiflori Radix extract was infused into contracted vascular ring which had been pretreated by $N{\omega}$-nitro-L-arginine(L-NNA), Methylene blue(MB), and $Ca^{2+}$ was infused into contracted vascular ring induced by NE after treatment of Polygoni Multiflori Radix extract in $Ca^{2+}$-free solution. The results were as follows: Systolic blood pressure was significantly attenuated by administration of Polygoni Multiflori Radix. Blood flow and aldosterone were significantly decreased, but velocity and renin were not affected by Polygoni Multiflori Radix. Polygoni Multiflori Radix had an effective relaxation to the contracted vascular ring by NE in 0.03 mg/ml, 0.1 mg/ml and 0.3 mg/ml level. Polygoni Multiflori Radix had an effective relaxation to the intact endothelium vascular ring, but when endothelium was removed, vascular ring did not relax. Polygoni Multiflori Radix-induced relaxation was inhibited by the pretreatment of L-NNA and MB. Pretreatment of Polygoni Multiflori Radix extract inhibit the contraction by influx of extra-$Ca^{2+}$ in contracted vascular ring induced by NE in $Ca^{2+}$-free solution. As mentioned above, we suggest that Polygoni Multiflori Radix relaxes vascular ring through suppress influx of extra-cellular $Ca^{2+}$ by the action of nitric oxide from endothelium.

Endothelium Dependent Vasorelaxant Action of ChungGongGo Extract on Arterial Contraction in Rabbit (청공고(淸空膏)의 내피세포 의존성 혈관이완효과)

  • Oh, Chul;Kim, Ho-Hyun;Ko, Heung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.3
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    • pp.666-671
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    • 2008
  • This study was undertaken to define the effect of ChungGongGo extract on norepinephrine-induced arterial contraction in rabbit. In order to investigate the effect of ChungGongGo extract on rabbit's contracted vascular ring detached from common carotid artery, vascular ring with intact or damaged endothelium was used for the experiment using organ bath. To analyze the mechanism of ChungGongGo extract-induced relaxation, ChungGongGo extract was infused into contracted vascular ring which had been pretreated by $N{\omega}$-nitro-L-arginine(L-NNA), Methylene blue(MB), and $Ca^{2+}$ was infused into contracted vascular ring induced by NE or KCl after treatment of ChungGongGo in $Ca^{2+}$-free solution. The results were as follows: ChungGongGo extract had an effective relaxation to the contracted vascular ring by NE in 1.0mg/ml and 0mg/ml level. ChungGongGo extract had an effective relaxation to the intact endothelium vascular ring, but when endothelium was removed, vascular ring did not relax. ChungGongGo extract-induced relaxation was inhibited by the pretreatment of L-NNA and MB. Pretreatment of ChungGongGo extract inhibit the contraction by influx of extra-$Ca^{2+}$ in contracted vascular ring induced by NE in $Ca^{2+}$-free solution. As mentioned above, we suggest that ChungGongGo relaxes vascular ring through suppress influx of extra-cellular $Ca^{2+}$ by the action of nitric oxide from endothelium.

The Determination of Blood-Brain Barrier Permeability and Pharmacokinetics of a Rat Transferrin Receptor Monoclonal Antibody by Brain Perfusion Method and Intravenous Injection Technique in Mice (마우스에서 뇌관류법과 정맥투여법에 의하여 흰쥐 트란스페린 단일항체의 체내동태 및 혈액-뇌 관문 투과성의 검토)

  • 강영숙
    • Biomolecules & Therapeutics
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    • v.10 no.1
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    • pp.37-42
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    • 2002
  • Brain drug targeting through the blood-brain barrier (BBB) in vivo is possible with peptidornirnetic monoclonal antibodies that undergo receptor-mediated transcytosis through the BBB. Monoclonal antibody to the rat transferrin receptor, such as the OX26 was studied in rats as a transport vector through BBB on the transferrin receptor. But, OX26 is not an effective brain delivery vector in mouse. In the present studies, rat monoclonal antibody, 8D3 to the mouse transferrin receptor were evaluated for brain drug targeting vector intransgenic mouse model. Pharrnacokinetic parameters in plasma and organ uptakes were determined at varioustimes after i.v. bolus injection of [$^{}125}I$] 8D3 in Balb/c mice. Brain uptake of [$^{}125}I$] 8D3 was also studied with an internal carotid artery perfusioncapillary depletion method. After i.v. injection of [$^{}125}I$] 8D3, plasma concentrations declined biexponentially with elimination half lift of approximately 2.2 hours. Brain uptake of [$^{}125}I$] 8D3 was $0.50{\pm}0.09$ persent of injected dose per g brain after 2 hours i.v. injection. After perfusion 5 min the apparent volume of distibution of [$^{}125}I$] 8D3 in brain was $22.3 {\mu}l/g,$ which was 4.8 fold higher than the intravascular volume. These studies indicate rat monoclonal antibody to the mouse transferrin receptor, 8D3 may be used for brain drug targeting vector in mice.

Risk Factors of and Treatments for Pharyngocutaneous Fistula Occurring after Oropharynx and Hypopharynx Reconstruction

  • Do, Su Bin;Chung, Chul Hoon;Chang, Yong Joon;Kim, Byeong Jun;Rho, Young Soo
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.530-538
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    • 2017
  • Background A pharyngocutaneous fistula is a common and difficult-to-manage complication after head and neck reconstruction. It can lead to serious complications such as flap failure, carotid artery rupture, and pharyngeal stricture, and may require additional surgery. Previous radiotherapy, a low serum albumin level, and a higher T stage have been proposed as contributing factors. We aimed to clarify the risk factors for pharyngocutaneous fistula in patients who underwent flap reconstruction and to describe our experiences in treating pharyngocutaneous fistula. Methods Squamous cell carcinoma cases that underwent flap reconstruction after cancer resection from 1995 to 2013 were analyzed retrospectively. We investigated several significant clinical risk factors. The treatment modality was selected according to the size of the fistula and the state of the surrounding tissue, with options including conservative management, direct closure, flap surgery, and pharyngostoma formation. Results A total of 127 cases (18 with fistulae) were analyzed. A higher T stage (P=0.048) and tube-type reconstruction (P=0.007) increased fistula incidence; other factors did not show statistical significance (P>0.05). Two cases were treated with conservative management, 1 case with direct closure, 4 cases with immediate reconstruction using a pectoralis major musculocutaneous flap, and 11 cases with direct closure (4 cases) or additional flap surgery (7 cases) after pharyngostoma formation. Conclusions Pharyngocutaneous fistula requires global management from prevention to treatment. In cases of advanced-stage cancer and tube-type reconstruction, a more cautious approach should be employed. Once it occurs, an accurate diagnosis of the fistula and a thorough assessment of the surrounding tissue are necessary, and aggressive treatment should be implemented in order to ensure satisfactory long-term results.