• 제목/요약/키워드: Cerebral perfusion

검색결과 231건 처리시간 0.031초

Hyperperfusion in DWI Abnormality in a Patient with Acute Symptomatic Hypoglycemic Encephalopathy

  • Park, Ji Kang
    • Investigative Magnetic Resonance Imaging
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    • 제21권2호
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    • pp.106-108
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    • 2017
  • The perfusion change in acute symptomatic hypoglycemic encephalopathy (ASHE) is not well known. We present the perfusion-weighted imaging of a patient with ASHE. The area of diffusion-weighted imaging abnormalities and adjacent normal-appearing white matter showed increased cerebral blood volume and flow, and shortening of time-to-peak.

돼지에서 초저체온 순환정지 하의 역행성 뇌관류시 뇌대사, 혈류역학 지표, 뇌조직 소견 및 혈청 내 neuron-specific enolase의 변화 (The Changes of Cerebral Metabolic and Hemodynamic Parameters, Brain Histology, and Serum Levels of Neuron-Specific Enolase During Retrograde Cerebral Perfusion Under Pofound Hypothermic total Circulatory Arrest in Pigs)

  • 김경환;안혁
    • Journal of Chest Surgery
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    • 제33권6호
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    • pp.445-468
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    • 2000
  • Background: Retrograde cerebral perfusion(RCP) is currently used for brain protection during aorta surgery, however, for the safety of it, various data published so far are insufficient. We performed RCP using pig and investiaged various parameters of cerebral metabolism and brain injury after RCP under deep hypothermia. Material and Method: We used two experimental groups: in group I(7 pigs, 20 kg), we performed RCP for 120 minutes and in group II (5 pigs, 20 kg), we did it for 90 minutes. Nasopharyngeal temperature, jugular venous oxygen saturation, electroencephalogram were continuously monitored, and we checked the parameters of cerebral metabolism, histological changes and serum levels of neuron-specific enolose(NSE) and lactic dehydrogenase(LDH). Central venous pressure during RCP was mainained in the range of 25 to 30 mmHg. Result: Perfusion flow rates(ml/min) during RCP were 130$\pm$57.7(30 minutes), 108.6$\pm$55.2(60 minutes), 107.1$\pm$58.8(90 minutes), 98.6$\pm$58.7(120 minutes) in group I and 72$\pm$11.0(30 minutes), 72$\pm$11.0(60 minutes), 74$\pm$11.4(90 minutes) in group II. The ratios of drain flow to perfusion flow were 0.18(30 minutes), 0.19(60 minutes), 0.17(90 minutes), 0.16(120 minutes) in group I and 0.21, 0.20, 0.17 in group II. Oxygen consumptions(ml/min) during RCP were 1.80$\pm$1.37(30 minutes), 1.72$\pm$1.23(60 minutes), 1.38$\pm$0.82(90 minutes), 1.18$\pm$0.67(120 minutes) in group I and 1.56$\pm$0.28(30 minutes), 1.25$\pm$0.28(60 minutes), 1.13$\pm$0.26(90 minutes). We could observe an decreasing tendency of oxygen consumption after 90 minutes of RCP in group I. Cerebrovascular resistance(dynes.sec.cm-5) during RCP in group I incrased from 71370.9$\pm$369145.5 to 83920.9$\pm$49949.0 after the time frame of 90 minutes(p<0.05). Lactate(mg/min) appeared after 30 minutes of RCP and the levels were 0.15$\pm$0.07(30 minutes), 0.18$\pm$0.10(60 minutes), 0.19$\pm$0.19(90 minutes), 0.18$\pm$0.10(120 minutes) in group I and 0.13$\pm$0.09(30 minutes), 0.19$\pm$0.03(60 minutes), 0.29$\pm$0.11(90 minutes) in group II. Glucose utilization, exudation of carbon dioxide, differences of cerebral tissue acidosis between perfusion blood and drain blood were maintained constantly during RCP. Oxygen saturation levels(%) in drain blood during RCP were 22.9$\pm$4.4(30 minutes), 19.2$\pm$4.5(60 minutes), 17.7$\pm$2.8(90 minutes), 14.9$\pm$2.8(120 minutes) in group I and 21.3$\pm$8.6(30 minutes), 20.8$\pm$17.6(60 minutes), 21.1$\pm$12.1(90 minutes) in group II. There were no significant changes in cerebral metabolic parameters between two groups. Differences in serum levels of NSE and LDH between perfusion blood and drain blood during RCP showed no statistical significance. Serum levels of NSE and LDH after resuming of cardipulmonary bypass decreased to the level before RCP. Brain water contents were 0.73$\pm$0.03 in group I and 0.69$\pm$0.06 in group II and were higher than those of the controls(p<0.05). The light microscopic findings of cerebral neocortex, basal ganglia, hippocampus(CA1 region) and cerebellum showed no evidence of cerebral injury in two groups and there were no different electron microscopy in both groups(neocortex, basal ganglia and hippocampus), but they were thought to be reversible findings. Conclusion: Although we did not proceed this study after survival of pigs, we could perform the RCP successfully for 120 minutes with minimal cerebral metabolism and no evidence of irreversible brain damage. The results of NSE and LDH during and after RCP should be reevaluated with survival data.

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백서의 피부 및 뇌혈류에 미치는 고려홍삼 사포닌 및 비사포닌의 영향 (Effects of Crude Saponin and Saponin-free Fraction of Korea Red Ginseng on the Skin and Cerebral Blood Flow in the Rats)

  • 김신희;김국성;박진봉;한찬수;김광진;김신혜;김세훈;남기열;전병화
    • Journal of Ginseng Research
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    • 제26권3호
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    • pp.132-138
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    • 2002
  • 본 연구에서는 혈류량의 변화를 실시간으로 측정할 수 있는 레이져 도플러 혈류량측정장치를 이용하여 피부혈류 및 뇌혈류량에 미치는 고려홍삼의 사포닌과 비사포닌의 효능을 연구하고자 고려홍삼의 정맥내 복강내 및 구강내로 주입하고 혈류의 변화를 관찰하여 다음과 같은 결론을 얻었다. 고려 홍삼의 사포닌 성분은 피부혈류량에는 영향을 주지 않으나 뇌혈류량을 증가시키는 효능이 있다. 고려 홍삼의 비사포닌 성분은 피부혈류량 및 뇌혈류량에 거의 영향을 주지 않았다. 고려홍삼사포닌에 의한 뇌혈류량의 증가는 복강내 및 경구로 투여할 경우는 관찰할 수 있으나 정맥내로 직접 투여할 경우는 관찰되지 않았다. 이상의 결과를 종합해 볼 때 고려홍삼의 사포닌 성분은 뇌혈류량을 증가시키는 혈류개선작용이 있는 것으로 사료된다.

시상 증후군에 동반된 대뇌 피질 혈류 변화에 대한 $^{99m}Tc-HMPAO$ Brain SPECT (Thalamic Syndrome with Related Cortical Hypoperfusion on $^{99m}Tc-HMPAO$ Brain SPECT)

  • 김은경;정태섭;서정호;김동익;이종두;박창윤;홍용국;이명식
    • 대한핵의학회지
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    • 제26권1호
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    • pp.33-39
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    • 1992
  • Spontaneous pain and painful overreaction to external stimuli resulting from lesion confined central nervous system (CNS) were named as thalamic syndrome. Thalamic lesion and decreased regional cortical perfusion thought to the pathogenesis of thalamic syndrome due to decreased function of thalamocortical tract. We performed $^{99m}Tc-HMPAO$ regional cerebral perfusion in 10 patients with clinical diagnosis of thalamic syndrome due to thalamic lesion or near the thalamic lesion at Yonsei University Hospital, from January 1989 to August 1991. In contrast to five patients with lesions near the thalamus who did not show secondarily decreased perfusion at cerebral cortex, four among the five patients with thalamic lesions revealed decreased cortical perfusion in the ipsilateral cerebral cortex on brain SPECT. These phenomena may suggest the loss of afferent activating stimuli from the thalamus led to decreased neuronal activity and the followitng hypoperfusion of cerebral cortex, and might be one of the indirect signs for suggesting presence of the thalamocortical tract. A causal relationship between cortical hypoperfusion and neuropsychological deficit is strongly suggested.

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안구운동 민감 소실 및 재처리 요법(Eye Movement Desensitization and Reprocessing) 치료 후 국소 뇌 혈류 변화:두 증례의 SPECT 연구 (Changes in the Regional Cerebral Perfusion after Eye Movement Desensitization and Reprocessing:A SPECT Study of Two Cases)

  • 오동훈;최준호
    • 생물정신의학
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    • 제11권2호
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    • pp.173-180
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    • 2004
  • Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR. Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99. In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex. These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample.

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Value of Perfusion Weighted Magnetic Resonance Imaging in the Diagnosis of Supratentorial Anaplastic Astrocytoma

  • Lee, Kyung Mi;Kim, Eui Jong;Jahng, Geon-Ho;Park, Bong Jin
    • Journal of Korean Neurosurgical Society
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    • 제56권3호
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    • pp.261-264
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    • 2014
  • We report perfusion weighted imaging (PWI) findings of nonenhanced anaplastic astrocytoma in a 30-year-old woman. Brain magnetic resonance imaging showed a nonenhanced brain tumor with mild peritumoral edema on the right medial frontal lobe and right genu of corpus callosum, suggesting a low-grade glioma. However, PWI showed increased relative cerebral blood volume, relative cerebral blood flow, and permeability of nonenhanced brain tumor compared with contralateral normal brain parenchyma, suggesting a high-grade glioma. After surgery, final histopathological analysis revealed World Health Organization grade III anaplastic astrocytoma. This case demonstrates the importance of PWI for preoperative evaluation of nonenhanced brain tumors.

개방성 승모판막 절개술에 관한 연구 (Open Mitral Commissurotomy: A Report of 21 Cases)

  • 이영균
    • Journal of Chest Surgery
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    • 제6권1호
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    • pp.69-88
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    • 1973
  • Twenty-one cases of open mitral commissurotomy were done between October 1963 and March 1973. 1] Preoperative embolism consists of 7 cerebral and 2 peripheral cases. Two operative cerebral embolism cases were noted. 2] There were two cases of restenosis, one associated valvular disease, three mitral insufficiency cases, and six cases of pulmonary hypertension. 3] Out of 21 cases, 13 cases of atrial fibrillation were found and two cases of atrial fibrillation were found postoperatively among 8 cases of preoperatively normal sinus rhythm. 4] During operation 10 cases of valvular calcification and 6 cases of left atrial thrombus were noted. 5] Complete blood count, electrolyte and acid base balance showed normal range of data. 6] Four helix reservoir whole blood total body perfusion and 17 cases of .hemodilution perfusion utilizing Rygg-Kyvsgaard bag oxygenator with sigma motor were performed. 7] EACA 125 mg/kg intravenous administration before cardiopulmonary bypass resulted in markedly diminished postoperative bleeding. 8] Post-perfusion urine amount was in satisfactory range. 9] There were 2 operative mortality due to coronary embolism and three cases of hospital death, 2 due to severe hepatic failure and one due to cerebral embolism. 10] Sixteen survival cases showed marked clinical improvements and almost all of them returned to their occupation satisfactorily after operation.

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일측 뇌경색 환자에서 반대측 뇌의 보상성 뇌관류 증가에 대한 SPM 분석 (Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis)

  • 홍선표;윤준기;최봉회;주인수;윤석남
    • Nuclear Medicine and Molecular Imaging
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    • 제42권5호
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    • pp.347-353
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    • 2008
  • 목적: 본 연구는 일측 뇌관류결손이 있는 뇌경색 환자들에서 $^{99m}Tc-ECD$ 단일 광자방출단층촬영술을 이용하여 반대측 국소 뇌관류의 변화를 관찰하고자 하였다. 대상 및 방법 : 뇌관류결손이 있는 뇌경색 환자 57명이 대조군에 포함되었으며, 좌측과 우측 뇌경색 환자군으로 구분하였으며, 이들은 발병 시기에 따라 6개월을 기준으로 급성 뇌경색 환자군, 만성뇌경색 환자군으로 구분하였다. 대조군들 모두 국소 뇌관류를 측정하고자 SPM분석을 이용한 $^{99m}Tc-ECD$ 단일 광자방출단층촬영술을 실시하였다. 모든 대조군의 결과를 정상 대조군과 비교하였다. 결과: 모든 대조군에서 뇌경색 반대측 대뇌피질에서 뇌관류 증가가 관찰되었으며, 뇌경색 대뇌측에서의 뇌관류 증가는 관찰되지 않았다. 만성 뇌경색 대조군에서는 뇌병변 반대측 일차 감각운동피질에서의 뇌관류 증가가 관찰되었으나, 급성 뇌경색 대조군에서는 관찰되지 않았다. 만성 좌측 뇌경색 대조군에서는 우측 소뇌 뇌관류 증가가 관찰되었다. 결론: 뇌혈류 SPECT의 SPM분석에서 일측성 뇌경색 환자에서 뇌경색 반대측 대뇌의 혈류가 증가하고, 일부 환자군에서는 뇌경색 동측 소뇌의 혈류도 증가함을 관찰하였다. 그러나 이러한 소견이 뇌기능의 회복 기전과 직접적으로 연관성이 있는지 증명하기 위해서는 추가적인 연구가 필요하다.

초급성 허혈성 뇌졸중에서 관류 전산화단층촬영의 임상적 적용에 대한 연구 (Clinical Application of Acute Ischemic Stroke in Perfusion Computed Tomography)

  • 이종석;유병규;권대철
    • 한국의학물리학회지:의학물리
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    • 제18권3호
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    • pp.149-160
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    • 2007
  • 초급성 허혈성 뇌졸중 환자를 대상으로 관류 전산화단층촬영(CT)의 임상적 적용을 평가하였다. 뇌졸중 증상 발현 62명의 환자를 대상으로 하였고, 관류 CT는 소뇌 기저부위에서 8 cm 상방으로 스캔하여 후처리 과정을 거쳐 뇌혈용적(cerebral blood volume, CBV), 뇌혈류량(cerebral blood flow, CBF), 평균 조영제 통과시간(mean transit time, MTT) 및 조영제 최고 도달시간(time to peak, TTP) 등의 네 가지 지도의 영상을 얻었다. 관류 CT의 CBV, CBF, MTT, TTP 지도에서 병변을 평가하였으며, 병변 부위와 정상측 대칭부위에서 MTT와 TTP를 측정하여 차이를 비교하였다. 관류 CT의 네 가지 지도 모두에서 관류결손을 인지할 수 있었고, 관류 결손이 인지되는 부위에서 MTT와 TTP의 현저한 지연이 있었다. 관류 CT의 MTT와 TTP영상이 초급성 허혈성 경계부위의 페넘브라를 반영하였다. 관류 CT의 네 가지 지도를 이용하면 뇌졸중의 조기 진단, 허혈 중심부, 허혈 페넘브라를 알 수 있게 되어 관류결손 부위의 혈류역동학적 평가가 가능함으로써, 허혈성 뇌졸중 환자의 진단 및 효과적인 치료를 위해 관류 CT가 유용하여 임상적 적용이 가능하다.

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