• 한국산학기술학회논문지
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• 제19권7호
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• pp.239-244
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• 2018

뇌경색의 주요 원인인 동맥 박리와 죽상경화증으로 인한 동맥 폐색 모두 고식적 자기공명혈관조영술이나 컴퓨터단층혈관조영술에서 혈관이 막힌 것처럼 보이지만, 발생 기전이 다르기 때문에 치료 방향에 차이가 생길 수 있다. 최근 고해상도MRI가 발달하면서 비침습적으로 혈관벽의 영상을 확인할 수 있게 되었다. 임상적으로 혹은 영상학적으로 동맥 박리가 의심되는 환자에게 고해상도MRI는 매우 유용한 검사방법으로 자리 잡고 있으나, 아직 두 질환의 감별점이 완전히 적립 되지는 않았다. 저자들은 컴퓨터단층혈관조영술에서 척추동맥폐색이 관찰된 두 환자에서 고해상도MRI를 통해 척추동맥박리와 죽상경화증의 차이점을 찾아보았고, 이를 추적 관찰하였다. 지금까지 알려진 혈관벽의 형태, 내막 판, 이중 내막, 혈관벽내 혈종, 가성 동맥류, 동맥벽의 초승달 모양 고신호 강도와 같은 동맥박리의 특징뿐만 아니라 저자들이 경험한 증례와 같이 긴 협착 길이, 폐쇄 부위 혈관의 재개통도 동맥 박리를 시사하는 소견이라고 판단하였다. 고해상도MRI를 통해 확인된 추가적인 동맥박리의 특징과 함께 향후 다양한 연구들을 통해 진단 기준이 명확해 진다면 치료에 많은 도움을 줄 수 있을 것으로 생각한다.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.521-527
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• 2000

Objective : In general, most of saccular aneurysms arise at arterial divisions, but those arising at unbranched site are rare. These aneurysms might impose neurosurgeons a formidable surgical challenge, due to uncommon features and a difficult surgical technique. Methods : Between the period of Jan. 1996 and Dec. 1998, a total of 110 cases of aneurysms were operated. Among them, five cases of unbranched site aneurysms were retrospectively analyzed through medical records, angiographic and operative findings. Results : The incidence of aneurysms unrelated to arterial branches was 4.5%. All cases presented with subarachnoid hemorrhage(SAH) ; three(60%) were at internal carotid artery(ICA) and two(40%) at middle cerebral artery (MCA). Two had a history of hypertension and three showed atherosclerotic changes in the arterial wall. One ICA and one MCA aneurysms proved to be a blood blister-like aneurysm(BBA) in their shape. Strikingly, a rapid neurological deterioration was shown in two ruptured ICA variants, which resulted in death and another two aneurysms left with morbidity. Conclusion : The preoperative neurological status in most cases was relatively poor compared to that of aneurysms arising at a branched site. Regarding its pathogenesis, atherosclerosis as well as hemodynamic factors may play an important role in formation of these variant aneurysms among various etiological factors. The overall prognosis of unbranched site aneurysms was worse than that of branched site aneurysms. In cases of BBAs, special attention was requisite to handle them during clipping and/or wrapping due to an easy fragile, thin aneurysmal wall.

• Journal of Nutrition and Health
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• 제48권2호
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• pp.167-179
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• 2015

뇌졸중은 국내 3대 사인 중 하나로 칼륨과 마그네슘, 칼슘의 섭취량이 뇌졸중 발병 및 예방에 긍정적인 영향을 미친다는 연구가 지속되고 있지만 연구 결과가 아직 명확하지 않은 실정이다. 또한 뇌졸중 환자들에 있어 영양 상태는 증상의 정도와 합병증 및 예후를 결정짓는 중요한 역할을 함에도 불구하고 현재까지 국내 뇌졸중 환자들의 DQI-I를 이용한 식사의 질 평가에 대한 연구는 미비한 실정이다. 따라서 본 연구에서는 285명의 뇌졸중 환자들의 칼륨과 마그네슘, 칼슘의 섭취량에 따라 4분위로 나누어 섭취량이 가장 적은 Q1 그룹과 섭취량이 가장 많은 Q4 그룹의 식사의 질을 평가 비교하였고, 칼륨과 마그네슘, 칼슘의 섭취량과 대뇌 죽상경화증과의 상관성에 대해 분석하여 그 결과를 요약하면 다음과 같다. 1) 대상자들의 신체계측 및 생화학적 검사결과는 칼륨과 마그네슘, 칼슘의 섭취량에 따라 차이가 나타나지 않았으나, 연령이 낮을수록 마그네슘의 섭취가 유의적으로 높았고, 교육수준이 높을수록 칼륨의 섭취가 많았다. 그리고 칼륨의 섭취가 많을수록 심방세동의 분포가 적었으며, 마그네슘의 섭취가 많을수록 대뇌 죽상경화증의 분포가 적음을 확인하였다. 2) 대상자들의 칼륨과 마그네슘, 칼슘의 섭취량과 한국인 영양섭취 기준$^{28}$을 비교한 결과, Q1에서의 섭취 비율이 Q4에서의 섭취 비율보다 유의적으로 낮았고, 특히 마그네슘의 경우, Q1 그룹과 Q4 그룹 모두 권장섭취량에 비해 부족하게 섭취하고 있었다. 그리고 식품군별 섭취량과 영양소별 섭취량 비교 결과, Q1 그룹의 평균 섭취량보다 Q4 그룹의 평균 섭취량이 유의적으로 많았다. 3) 대상자들의 식사의 질을 비교한 결과, 칼륨과 마그네슘, 칼슘의 섭취량이 많을수록 INQ와 MAR, 총 DQI-I의 점수가 높아 식사의 질이 높음을 확인하였다. 4) 대상자들의 칼륨과 마그네슘, 칼슘의 섭취량과 대뇌죽상경화증의 상관성을 분석한 결과, 유의적인 상관관계가 없었으나, 마그네슘의 경우 보정을 하지 않았을 경우와 나이, 성별, 교육수준, 흡연량, 심방세동의 유무, 총열량 섭취량을 보정한 경우, 섭취량이 많을수록 대뇌 죽상경화증의 발생률이 줄어드는 경향을 보였다. 결론적으로 칼륨과 마그네슘, 칼슘의 섭취량이 많을수록 전반적인 식사의 질이 좋음을 보여준다. 그리고 마그네슘의 경우 섭취량이 높을수록 대뇌 죽상경화증의 발생률이 줄어드는 경향을 보였다. 하지만 DQI-I의 절제성 항목과 균형성 항목에서 칼륨과 마그네슘, 칼슘의 섭취량이 많을수록 점수가 낮아진 점과 대뇌 죽상경화증 발생과의 유의적인 관계가 충분하지 않았던 결과를 보아 제한점들을 보완하고 대상자수를 충분히 확보하여 지속적인 연구를 수행한다면 환자 개인적 차원뿐만 아니라 국가적 보건 차원으로 뇌졸중의 합병증 감소 및 예방에 기초자료를 제공하는 데에 도움이 될 것이라 사료된다.

• 대한의용생체공학회:의공학회지
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• 제13권3호
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• pp.189-194
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• 1992

As people's income and intake of animal fat rapidly increase, so does choresterol concentration in blood. Thus diseases such as non-insulin-dependent diabetes mellitus(NIDDM)myocardial infraction, high blood pressure, cerebral stroke resulting from atherosclerosis rapidly increase recently. It is very difficult to diagnose atherosclerosis early since its progress is so slow and there is no sypmtoms in the beginning of the disease. In this study a mechanical characteristic, compliance, of the lower leg arteries was measured noninvasively. Changes of blood volume and pressure were measured using impedance plethysmgraphy and mercury sphygmomanometer, respectively. The compliance was calculated by dividing the change of blood volume by the change of pulse pressure ( systolic-diastolic pressure ) . Subjects were 24 asymptomatic persons ranging (rom 30 Ic 58yeras and 14 diabetics from 41 to 59years. The compliances, mean, and systolic pressures were statistically analyzed using a t-test be- tween the healthy and diabetic groups. The average compliance of the healthy and diabetic group was measured 2.79 and 1.82U1/mmHg/cm, respectively and these were significantly different(p<0.01). It was also found that the compliance is a better parameter in differentiating the vascular disease than mean or systolic blood pressure.

• Anatomy and Cell Biology
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• 제56권3호
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• pp.360-366
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• 2023

Increased tortuosity of vessel is associated with high incidence of plaque formation leading to atherosclerosis. Surgical procedures are done after analyzing morphology of middle cerebral artery (MCA). However, literature describing MCA morphology using computed tomography angiography (CTA) is limited, so this study was planned to determine its incidence in Indian population. Datasets of CTA from 289 patients (180 males and 109 females), average age: 49.29±16.16 years (range: 11 to 85 years), from a tertiary care hospital were systematically reviewed for morphology of MCA. Cases involving aneurysms and infarcts were excluded. Four shapes of MCA were recognized: straight, U, inverted U, and S-shaped. MCA was straight in 44% (254/578), U-shaped in 37% (215/578), S shaped in 15% (89/578) and inverted U-shaped in 3% (20/578) cases. In males, MCA was straight in 46% (166/360), U-shaped in 37% (134/360), S-shaped in 16% (58/360) and inverted U-shaped in 4% (14/360) cases. In females, MCA was straight in 42% cases (92/218), U-shaped in 37% (81/218), S-shaped in 17% (36/218) and inverted U-shaped in 4% (9/218). On comparing shape with various age groups using chi square test, U shaped (P≤0.001) and S-shaped (P=0.003) MCA were found to be statistically significant. The incidence of straight shape was higher in advanced age group (>60 years). Knowledge of MCA shape will be useful for clinicians and surgeons in successful endovascular recanalization. Also, this data would help surgeons during neurointerventional procedures.

• 동의생리병리학회지
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• 제18권6호
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• pp.1860-1868
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• 2004

Geijibokryunghwan has a wide range of therapeutic applications, and some reports have indicated that it has protective activity against atherosclerosis, and more specifically stroke and myocardial infarction. A recent report showed that atherosclerotic plaque volume can be reduced by supplying Geijibokryunghwan extracts for several years. In this study, we used a component of Geijibokryunghwan, which has been used for the prevention of atherosclerosis in Korea for several years, and has proven to be useful in lowering the occurrence of cerebral infarction. In a preliminary study, we found that Geijibokryunghwan potently suppressed platelet aggregation induced by various agonists. In this study, we sought to explore the mechanism by which Geijibokryunghwan inhibits platelet aggregations.

• 대한한의학회지
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• 제38권4호
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• pp.104-109
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• 2017

Objectives: Epicardial fat is true visceral fat that is known to be associated with metabolic syndrome, high abdominal fat, insulin resistance, coronary artery diseases, low coronary flow reserve and subclinical atherosclerosis. Dampness-Phlegm pattern is one of the pattern diagnosis of traditional Korean medicine. Previous studies showed that Dampness-Phlegm pattern is associated with hypertension, dyslipidemia, metabolic syndrome. This study is intended to find association between Dampness-Phlegm pattern and epicardial fat thickness. Methods: This study was a community-based single center trial. Ischemic stroke patients within 30 days after their ictus were enrolled. Epicardial fat thickness was measured using transthoracic echocardiography. Other measured and obtained variables are medical history, weight, height, body mass index, fasting blood glucose, cholesterol, triglycerol, high density lipoprotein, lipid and low density lipoprotein. Results: Three hundred sixty six were enlisted, and one hundred forty were diagnosed with the Dampness-Phlegm pattern. Dampness-Phlegm pattern group had significantly thicker epicardial fat. Binary logistic regression also showed statistically significant result. Conclusions: This study showed close association between epicardial fat and Dampness-Phlegm pattern. This result suggests a clue to standardization of pattern identification.

• Journal of Chest Surgery
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• 제22권1호
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• pp.90-94
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• 1989

Ten patients underwent operation for aortic aneurysms from Jan. 1983 to April 1988 at the Department of Thoracic and Cardiovascular Surgery, Keimyung University Hospital. There were 7 males and 3 females in this series. The age ranged from 16 to 70 years with the mean age of 45 years. The cause of the aneurysm was atherosclerosis in 8 patients, mycosis in 1 patient and unknown in 1 patient. There were two patients with ascending aortic aneurysm treated by Dacron graft replacement, with no hospital death. One patient with aortic arch aneurysm was received Dacron graft replacement under cardiopulmonary bypass and died on the 21st postoperative day because of cerebral edema. There were three patients with descending aortic aneurysm. The aneurysm in two patients was successfully repaired by Dacron graft. One additional patient with ruptured aneurysm died at operation because of ventricular fibrillation. Four patients with abdominal aortic aneurysm were underwent Dacron graft replacement and the results were good.

• Korean Journal of Radiology
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• 제20권5호
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• pp.739-748
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• 2019

For recanalization of emergent large vessel occlusions (ELVOs), endovascular therapy (EVT) using newer devices, such as a stent retriever and large-bore catheter, has shown better patient outcomes compared with intravenous recombinant tissue plasminogen activator only. Intracranial atherosclerotic stenosis (ICAS) is a major cause of acute ischemic stroke, the incidence of which is rising worldwide. Thus, it is not rare to encounter underlying ICAS during EVT procedures, particularly in Asian countries. ELVO due to underlying ICAS is often related to EVT procedure failure or complications, which can lead to poor functional recovery. However, information regarding EVT for this type of stroke is lacking because large clinical trials have been largely based on Western populations. In this review, we discuss the unique pathologic basis of ELVO with underlying ICAS, which may complicate EVT procedures. Moreover, we review EVT data for patients with ELVO due to underlying ICAS and suggest an optimal endovascular recanalization strategy based on the existing literature. Finally, we present future perspectives on this subject.

• 대한한의학회지
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• 제30권1호
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• pp.95-108
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• 2009

Objectives: Uwhangchungsim-won (DC) has been used in various medical fields such as stroke, hypertension, atherosclerosis, autonomic imbalance and mental instability, etc. The aim of this study was to evaluate the effect of UC on cerebral hemodynamics and estimate the appropriate dose of UC. Methods: We studied changes of hyperventilation-induced cerebrovascular reactivity and mean blood flow velocity of middle cerebral arteries (MCA) using transcranial Doppler. We observed the changes of mean blood pressure, pulse rate and expiratory CO2 using S/5 Compact Anesthesia Monitor from 10 healthy young volunteers who were administered UC twice a day in the 1 st section and then once a day in the 2nd section. Results: Mean blood pressure tended to decrease at 1 hour and pulse rate tended to decrease at 2 hours after second administration. After 2 hours, mean blood pressure rose to state before administration, but pulse rate maintained from 2 hours to 4 hours. The changes were not statistically significant. Cerebral blood flow velocity in middle cerebral artery was not statistically significant after second administration. Cerebrovascular reactivity increased from 2 hours to 4 hours after second administration. Conclusions: This study provides that administration of UC twice a day is more effective on hyperventilation-induced cerebrovascular reactivity than administration of UC once a day.