• 대한의생명과학회지
• /
• 제8권3호
• /
• pp.143-154
• /
• 2002

The effect of cardiopulmonary bypass (CPB) on cerebral physiology during heart surgery remains incompletely understood. This study was carried out to investigate changes of cerebral metabolism and the association between the changes and clinical factors during heart surgery. Seventy adult patients (n=70) scheduled for elective cardiac surgery were participated in the present study. Middle cerebral artery blood flow velocity (V$_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v)O$_2$), cerebral oxygen extraction (COE), and modified cerebral metabolic rate for oxygen (MCMRO$_2$) were measured during six phases of the operation; Pre-CPB, CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34$^{\circ}C$), Rewarm-2 (nasopharyngeal temperature 37$^{\circ}C$), CPB-off, and Post-OP (at skin closure after CPB-off). Each relationship of age, arterial blood gas parameters, or other variables to V$_{MCA}2$, C(a-v)O$_2$, COE, or MCMRO$_2$ was evaluated. V$_{MCA}$ increased (P<0.0001) whereas C(a-v)O$_2$ decreased (P<0.01) throughout the five phases of the operation compared to Pre-CPB value (control). COE diminished at CPB-10, Rewarm-1, and CPB-off (P<0.05) while MCMRO$_2$ reduced at CPB-10 and Rewarm-1 (P<0.05) compared to Pre-CPB value. Positive correlation was found between age and cerebral metabolic parameters (V$_{MCA}$, C(a-v)O$_2$, COE, or MCMRO$_2$) during CPB (range r=0.24 to 0.38, p<0.05). Four cerebral metabolic parameters had partially negative or positive correlation with arterial blood gas parameters and other variables (arterial blood pH, $O_2$ tension, $O_2$ content, $CO_2$ tension, blood pressure, blood flow, temperature, or hematocrit) during the operation. In conclusion, CPB led to marked alterations of cerebral metabolism and age, pH, and $CO_2$ tension profoundly influenced the changes during cardiac surgery.

• 대한한방내과학회지
• /
• 제25권3호
• /
• pp.440-450
• /
• 2004

Objectives: Uwhangchungsim-won(UC) has been used in the treatment of a wide variety of conditions including stroke, hypertension, arterosclerosis, autonomic imbalance, and mental instability, in Korean traditional hospitals. The aim of this study was to evaluate the effect of DC on cerebral hemodynamics and to determine the appropriate dosage. Methods: We studied changes in hyperventilation-induced cerebrovascular reactivity and mean blood flow velocity of the middle cerebral arteries(MCAs) were studied by means of transcranial Doppler ultrasound. Changes in mean blood pressure, pulse rate and expiratory CO2(PECO2) were observed using Cardiocap TM/5. Six healthy young volunteers who were administrated with full doses of DC for group A, and half doses for group B. Six other healthy subjects comprised the control group. The evaluation was performed during basal condition, and repeated at 20, 40, 60, 120, and 180 minutes after administration. Results: Increases of cerebrovascular reactivity and mean blood flow velocity in the middle cerebral artery in group A were significantly different compared with group B and the control group (p<0.1). Mean blood pressure, pulse rate and expiratory CO2 did not change during the observation and were not different among these three groups. We observed that in cerebrovascular reactivity induced hyperventilation, group A was most effective at 40 minutes after administration, and its effectiveness lasted for 120 minutes. Conclusions: This study provides evidence for UC, in full doses, as an agent for dilation of the cerebral arteriols to increase hyperventilation-induced cerebrovascular reactivity as a consequence of faster recovery of blood flow velocity.

• Annals of Clinical Neurophysiology
• /
• 제1권1호
• /
• pp.26-30
• /
• 1999

본 연구에서는 ERP검사 중에는 중뇌동맥의 MFV가 검사전후와 비교하여 유의하게 증가힌 소견을 보였다. 비록 중뇌동맥의 혈류속도의 변화가 뇌활동정도를 직접 반영할 수는 없다고 생각이 되지만 이 연구의 결과로 P300의 생성에 중뇌동맥에 의해서 영양받는 전두엽, 측두엽 및 두정엽이나 다른 대뇌부위가 관여할 것으로 사료된다. 경두개도플러검사는 다른 뇌기능활동을 반영할 수 있는 양전자방출단층촬영이나 단일광자방출단층촬영과 같이 혈류역학을 볼 수 있는 검사와 병행하여 연구하면 P300의 발생부위를 규명하는데 도움을 줄 것으로 사료되며 뇌활동을 역동적으로 평가하는데 도움을 줄 것으로 생각된다.

• Annals of Clinical Neurophysiology
• /
• 제1권1호
• /
• pp.64-69
• /
• 1999

Background : Syncope was defined as transient loss of consciousness and postural tone. The mechanisms of changes in cerebral hemodynamics during syncope have not been fully evaluated. Transcranial Doppler Ultrasonography can continuously monitor the changes in cerebral hemodynamics during head-up tilt (HUT). TCD could reveal the different patterns of changes in cerebral hemodynamics during syncope. Syncope without hypotension or bradycardia could be detected by TCD. We investigated the changes in cerebral blood flow velocity during HUT using TCD in 33 patients with a history of recurrent syncope or presyncope of unknown origin. Methods & Results : The positive responses were defined as presyncope or syncope with hypotension, bradycardia, or both. During HUT without isoproterenol infusion, there were a $86{\pm}23%$ drop in DV and a $41{\pm}34%$ drop in SV in 5 patients with positive reponses, and mean changes in those were less than 10% in patients with negative reponses (p=.00, p=.00). During HUT with isoproterenol infusion, TCD showed a $80{\pm}18%$ drop in diastolic velocity in 14 patients with positive reponses, and a $47{\pm}10%$ drop in that in patients with negative reponses (p=.00), however the change in systolic velocity did not differ. TCD showed three patterns during positive responses; loss of all flow, loss of end diastolic flow, and a decrease in diastolic velocity. Loss of consciousness occurred in the patients with loss of all flow or end-diastolic flow during positive reponses. Conclusions : TCD shows different patterns of changes in cerebral hemodynamics during HUT. TCD can be used to investigate the pathophysiology of neurocardiogenic syncope.

• Annals of Clinical Neurophysiology
• /
• 제1권1호
• /
• pp.39-46
• /
• 1999

Transcranial doppler ultrasonography (TCD) is a new, non-invasive and easily applicable method to evaluate cerebral hemodynamics. Last 10 years, its use in Korea has been dramatically expanded, but the qualification of TCD laboratory has yet to be settled. Since duplex sonography is seldom used in Korea, we have to depend totally on TCD to evaluate cerebral hemodynamic changes. Thus, all of the available data from every detectabler cerebral arteries has to be obtained for accurate interpretation of TCD measurements. Moreover, flow direction and wave form should be concerned in addition to the flow velocity. In this article, I present technique to measure the anterior, meddle and posterior cerebral arteries, the internal carotid artery siphon and at cervical level, and the vertebral and the basilar artery, and normal values for these measurements which is essential for the adequate interpretation.

• Annals of Clinical Neurophysiology
• /
• 제17권2호
• /
• pp.68-72
• /
• 2015

Background: The effects of omega-3 polyunsaturated fatty acids (PUFAs) on cerebral vessels have not been clarified until now. Thus we investigated the efficacy of omega-3 PUFAs supplementation on cerebral blood flow velocity and vascular resistance via transcranial doppler (TCD). Methods: Consecutive twenty patients (13 male and 7 female) with at least 1 cerebrovascular risk factor or a known cerebrovascular disease were enrolled. Patients were treated with omega-3 PUFAs (1 g, two times per day) for 12 weeks. Cerebral blood flow velocity, resistance index, and pulsatile index were checked before and after 12 weeks of treatment using TCD. Results: The change of resistance index in right MCA (from $0.58{\pm}0.07$ to $0.55{\pm}0.07$, p = 0.042) and left PCA (from $0.56{\pm}0.07$ to $0.53{\pm}0.06$, p = 0.037) showed significant improvement after 12 weeks of omega-3 PUFAs treatment. The changes in other vessels, however, failed to show any significant changes compared to the baseline. Conclusions: Omega-3 PUFAs treatment showed feasible efficacies for cerebral vascular resistances in this open label trial. To confirm these results, larger samples of patients and longer period of follow-up is warranted.

• 대한한의학회지
• /
• 제30권1호
• /
• pp.95-108
• /
• 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.

• Journal of Korean Neurosurgical Society
• /
• 제29권7호
• /
• pp.923-928
• /
• 2000

Objective : The reliability of transcranial doppler sonography(TCD) for predicting delayed ischemic neurologic deficit( DIND) was investigated in patients with aneurysmal subarachnoid hemorrhage(SAH). Methods : The velocity of blood flow through the middle cerebral artery was measured by TCD in 70 patients treated surgically within 72 hours due to ruptured cerebral aneurysm. A correlation between measured maximal mean blood flow velocities and clinical factors including age, hypertension, Hunt-Hess grade, Fisher grade, DIND, and outcome was made. Results : An age-dependent reduction of the measured maximal mean velocities was found(r＝-0.4043, p<0.001). Flow velocities in hypertensive patients were significantly lower than in the normotensive individuals(two-tailed T test, p<0.05). There was no significant difference between the flow velocities and evaluated other clinical factors. When the flow velocities of 14 patients who developed DIND were compared with those of patients without deficits, no significant difference was seen. A significant increase in flow velocities in the days before the onset of DIND was found only in 4 of 14 cases. High flow velocities did not necessarily mean impending neurological deficits : 6 of 70 patients tolerated flow velocities over 160cm/s. Conclusion : We suggest that TCD readings have limited utility for predicting DIND following SAH, especially in older or hypertensive patients. More direct measurements of blood flow are necessary to adequately predict which patients are at high risk of DIND.

• 동의생리병리학회지
• /
• 제23권6호
• /
• pp.1491-1496
• /
• 2009

Stroke is usually associated with the cerebral blood flow of the central nervous system. However, studies concerning the effects of neurologic sysmptoms induced from stroke on the peripheral blood flow has not taken place sufficiently. To ascertain the feasibility of a blood flow meter adopting to use doppler ultrasonogrphy, under the prospect that hemiparesis induced from stroke may have effect on the peripheral blood flow, the peripheral blood flow velocity was observed. The control group made up of healthy people without any factors capable of effecting the peripheral blood flow velocity, and patient group which consist of hemiparetic people induced from stroke, were recruited. Volumes of recruitment are 21 persons in the patient group, and 29 persons in the control group, but the final numbers of people are 17 and 21 respectively because of the inconsistancy in the method of the test. The non-invasive method of Doppler effect of Ultrasound was used to measure the blood flow velocity. The blood flow velocity in the peripheral part of left and right fourth fingers:dorsal branches of proper palmar digital artery to dorsum of distal phalanges, was measured in the control group and patient group through Doppler Ultrasound. In comparison of the control group and the patient group, the systolic blood flow velocity from the peripheral part of the upper extremity was lower in the patient group than that of the control group. According to such results, it is concluded that hemiparesis induces the reduction of the peripheral blood flow velocity in the systolic phase.

• The Journal of Korean Physical Therapy
• /
• 제15권1호
• /
• pp.196-209
• /
• 2003

The aim of study was compared with the possible role of cranial artery in headache pathogenesis each 2 group (group I : ultrasound therapy alone, group II : myofascial release therapy alone)- divided each 5 tension- type headache patients. Each group were applied ultrasound therapy for 5 minuets and myofascial release therapy for 15 minuets in occipital portion. The study carried out to determine the effects of ultrasound and myofascial release on the cranial arteries velocity from November 11, 2001 to March 29, 2002 the objects were 10 patients who having the tension-type headache at H-hospital. Transcranial doppler ultrasonograpy(TCD) is new non-invasive applicable method to evaluate flow velocities of intrans cranial and extracranial cerebral arteries. TCD was peformed with standard method to measure the Mean Flow Velocity(MFV) of the middle and posterior cerebral arteries, the vertebral arteries.