• 제목/요약/키워드: Cerebral protection

검색결과 85건 처리시간 0.021초

대동맥궁 절제술의 임상적 고찰 (Clinical Experiences of Aortic Arch Replacement)

  • 김경환;안혁
    • Journal of Chest Surgery
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    • 제27권11호
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    • pp.907-913
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    • 1994
  • From October 1990 to May 1993, 19 patients underwent replacement of the transverse aortic arch. [10 men, 9 women, mean age 52.5 years] Underlying diseases were acute aortic dissection [10 cases], chronic aortic dissection [4 cases],and aortic arch aneurysm [ 5 cases]. In 19 patients, 10 underwent partial replacement and 9 underwent total arch replacement. The cerebral protection was achieved by profound hypothermia [rectal temperature,16$^{\circ}$ to 2$0^{\circ}C$] associated with total circulatory arrest [mean 35.5 minutes]. In one patient, the aortic arch distal to the left common carotid artery was resected with the distal arch being cross-clamped and in another two patients, the selective cerebral perfusion was also applied during the period of total circulatory arrest via innominate artery and left common carotid artery because of longer total circulatory arrest time. Among 14 patients of aortic dissecton, 10 presented hypertension, 1 presented Marfan syndrome, 1 presented pregnancy-induced hypertension and 2 revealed no evidence of hypertension. All of the above 14 patients complained chest pain. Among 5 patients of aortic arch aneurysm, Be het disease was suspected in only one patient and atherosclerotic aneurysm was proved in another 4 patients. The overall hospital mortality was 32% [6/19]. In aortic dissection, the mortality was 43% [Acute aortic dissection 30%, chronic aortic dissection 75%] and in aortic arch aneurysm, the mortality was 0%. Follow-up was done in all survivors for from 7 months to 36 months[mean,17.3%].

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PC12 손상 세포 및 전뇌허혈 유발 Gerbil에 대한 지실의 세포보호효과 연구 (Protective Effect of Aurantii Immaturus Fructus on Hypoxia Reperfusion Induced by PC12 Cell Damage and Global Ischemia in Gerbil)

  • 김완식;정승현;신길조;문일수;이원철
    • 대한한의학회지
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    • 제24권1호
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    • pp.29-40
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    • 2003
  • Object : This research was performed to investigate the protective effect of Aurantii Immaturus Fructus against ischemic damage using PC12 cells and global ischemia in gerbils. Methods : To observe the protective effect of Aurantii Immaturus Fructus on ischemia damage, viability and changes in activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase and production of malondialdehyde (MDA) were observed after treating PC12 cells with Aurantii Immaturus Fructus during ischemic insult. Gerbils were divided into three groups : a normal group, a 5-min two-vessel occlusion (2VO) group, and an Aurantii Immaturus Fructus administered after 2VO group. The CCAs were occluded by microclip for 5 minutes. Aurantii Immaturus Fructus was administered orally for 7 days after 2VO. The histological analysis was performed at 7 days after the surgery. For histological analysis, the brain tissue was stained with 1% cresyl violet solution. Results : The results showed that 1. Aurantii Immaturus Fructus had a protective effect against ischemia in the CAI area of the gerbil hippocampus 7 days after 5-minute occlusion, 2. In the hypoxia/reperfusion model using PC12 cells, the Aurantii Immaturus Fructus had a protective effect against ischemia in the dose of $0.2{\;}\mu\textrm{g}/ml,{\;}2{\;}\mu\textrm{g}/ml{\;}and{\;}20{\;}\mu\textrm{g}/ml$ 3. Aurantii Immaturus Fructus increased the activities of glutathione peroxidase and catalase, 4. The activity of superoxide dismutase (SOD) was increased by ischemic damage, which might represent self protection. This study suggests that Aurantii Immaturus Fructus has some neuroprotective effect against neuronal damage following cerebral ischemia in vivo with a widely used experimental model of cerebral ischemia in Mongolian gerbils, and it also has protective effects on a hypoxia/reperfusion cell culture model using PCq2 cells. Conclusions : Aurantii Immaturus Fructus has protective effects against ischemic brain damage at the early stage of ischemia.

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PC12 손상 세포 및 전뇌허혈 유발 Gerbil에 대한 백지의 세포보호효과 (Protective Effect of Angelicae Dahuri Radix on Hypoxia Reperfusion Induced by PC12 Cell Damage and Global Ischemia in Gerbil)

  • 이영효;정승현;신길조;문일수;이원철
    • 대한한의학회지
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    • 제24권1호
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    • pp.110-121
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    • 2003
  • Objective : This research was performed to investigate the protective effect of Angelicae Dahuri Radix against ischemic damage using PC12 cells and global ischemia in gerbils. Methods : To observe the protective effect of Angelicae Dahuri Radix on ischemia damage, viability and changes in activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase and production of malondialdehyde (MDA) were observed after treating PC12 cells with Angelicae Dahuri Radix during ischemic insult. Gerbils were divided into three groups : a normal group, a 5-min two-vessel occlusion (2VO) group, and an Angelicae Dahuri Radix administered after 2VO group. The CCAs were occluded by microclip for 5 minutes. Angelicae Dahuri Radix was administered orally for 7 days after 2VO. The histological analysis was performed at 7 days after surgery. For histological analysis, the brain tissue was stained with 1% cresyl violet solution. Results : 1. Angelicae Dahuri Radix has a protective effect against ischemia in the CA1 area of the gerbil hippocampus 7 days after 5-minute occlusion, 2. In the hypoxia/reperfusion model using PC12 cells, Angelicae Dahuri Radix has a protective effect against ischemia in the dose of $0.2\mu\textrm{g}/ml$, $2\mu\textrm{g}/ml$ and $20\mu\textrm{g}/ml$, 3. Angelicae Dahuri Radix increased the activities of glutathione peroxidase and catalase. 4. The activity of superoxide dismutase (SOD) was increased by ischemic damage, which might represent self protection. This study suggests that Angelicae Dahuri Radix has some neuroprotective effect against neuronal damage following cerebral ischemia in vivo with a widely used experimental model of cerebral ischemia in Mongolian gerbils, and it also has protective effects on a hypoxia/reperfusion cell culture model using PC12 cells. Conclusions : Angelicae Dahuri Radix has protective effects against ischemic brain damage at the early stage of ischemia.

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Protection of spontaneous and glutamate-induced neuronal damages by Soeumin Sibjeundaibo-tang and Soyangin Sibimijihwang-tang in cultured mice cerebrocortical cells

  • Lee, Mi-Young;Ma, Jin-Yeul;Choo, Young-Kug;Jung, Kyu-Yong
    • Advances in Traditional Medicine
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    • 제1권1호
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    • pp.55-63
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    • 2000
  • Soeumin Sibjeundaibo-tang (SJDBT) and Soyangin Sibimijihwang-tang (SMJHT) have been used traditionally to improve the systemic blood circulation and biological energy production in the patients with circulatory and neuronal diseases. The object of this study is to determine the protective effects of SJDBT and SMJHT extracts on the spontaneous and glutamate-induced neuronal damages in cultured cells derived from mice cerebral cortex. At 14 days after beginning the cultures, the activity of lactate dehydrogenase released into the culture media was significantly decreased by treatment of cerebroneuronal cells with SJDBT and SMJHT (0.1 mg/ml) for 7 days. By comparison with the normal cells, cerebroneuronal morphology was dramatically changed by treatment of glutamate (1 mM) for 12 hrs, and this was conspicuously recovered by pretreatment of cerebroneural cells with SJDBT and SMJHT (0.1-1.0 mg/ml) for 2 days. Moreover, glutamated-induced DNA fragmentation was also protected by pretreatment of cerebroneuronal cells with those extracts. These results suggest that naturally occurring and glutamate-induced degeneration of cultured cerebrocortical cells may be related, in part, to the process of apoptotic cell death. The pharmacological properties of SJDBT and SMJHT extracts to improve cerebroneuronal degeneration may be considered as one of useful medicines that can prevent cerebrocortical impairments resulted from age-dependent and excitotoxicity-induced neuronal degeneration in human brain.

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PC12 손상 세포 및 전뇌허혈 유발 Gerbil에 대한 시호 세포보호효과 (Protective Effect of Bupleuri Radix on Hypoxia Reperfusion Induced by PC12 Cell Damage and Global Ischemia in Gerbil)

  • 최삼열;정승현;신길조;문일수;이원철
    • 대한한의학회지
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    • 제23권4호
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    • pp.113-124
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    • 2002
  • Objects: This research was conducted to investigate the protective effect of Bupleuri Radix against ischemic damage using PC12 cells and global ischemia in gerbils, Methods: To observe the protective effect of Bupleuri Radixon ischemic damage, viability and changes in activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase and production of malondialdehyde (MDA) were observed after treating PC12 cells with Bupleuri Radix during ischemic damage. Gerbils were divided into three groups: a normal group, a 5-minute two-vessel occlusion (2VO) group and a Bupleun Radix administered group after 2VO. The CCAs were occluded by microclip for 5 minutes, Bupleuri Radix was administered orally for 7 days after 2VO. Histological analysis was performed on the 7th day. For histological analysis, the brain tissue was stained with 1 % of cresyl violet solution. Results: 1. Bupleuri Radix has a protective effect against ischemia in the CA1 area of the gerbil's hippocampus 7 days after 5-minute occlusion. 2. In the hypoxia/reperfusion model using PC12 cells, the Bupleuri Radix has a protective effect against ischemia in the dose of 0.2{\;}\mu\textrm{g}/ml,2{\;}\mu\textrm{g}/ml{\;}and{\;} 20{\;}\mu\textrm{g}/ml$. 3. Bupleuri Radix increased the activities of glutathione peroxidase and catalase. 4. The increased activity of superoxidedismutase (SOD) by ischemic damage might have been induced as an act of self-protection. This study suggests that Bupleuri Radix has some neuroprotective effect against neuronal damage following cerebral ischemia in vivo with a widely used experimental model of cerebral ischemia in Mongolian gerbils. Bupleuri Radix also has protective effect on a hypoxia/reperfusion cell culture model using PC12 cells. Conclusions: Bupleuri Radix has protective effect against ischemic brain damage during the early stages of ischemia.

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양격산화탕(凉膈散火湯)이 뇌해마 조직배양의 허혈손상에 따른 신경세포손상에 미치는 영향 (Effect of Yanggyuksanhwa-tang on Ischemic Damage in Organotypic Hippocampal Slice Culture)

  • 이환성;박성준;정광식;손영주;정혁상;박동일;손낙원
    • 대한한방내과학회지
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    • 제29권1호
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    • pp.231-242
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    • 2008
  • Objectives : We can find out the experimental reports of Yanggyuksanhwa-tang, which has the function of regulating blood pressure related with cerebral disease, and increasing local cerebral blood stream volume, also has the recoveries for the damage of vessel endothelium, and endothelium hypertrophy caused by angiospasm after subarachnoid hemorrhage, and reduces the contraction of smooth muscle, so simultaneously improves necrosis. The aim of this study is to investigate effect of Yanggyuksanhwa-tang protecting neuronal cells from being damaged by brain ischemia through using organotypic hippocampal slice cultures. Methods : We caused ischemic damage to organotypic hippocampal slice cultures by oxygen and glucose deprivation, and Yanggyuksanhwa-tang extract was added to cultures. Thereafter we measured area percentage of propidium iodide (PI)-stained neuronal cell, lactate dehydrogenase (LDH) levels in culture media and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL)-positive cells. Results : Area percentage of PI-stained neuronal cells and count of TUNEL-positive cells in CA1 and DG area of organotypic hippocampal slice culture were significantly decreased in pertinent density level of Yanggyuksanhwa-tang extract. LDH levels in culture media of organotypic hippocampal slice culture were significantly decreased in pertinent density level of Yanggyuksanhwa-tang extract. Conclusions : Within pertinent density level, Yanggyuksanhwa-tang has cell protection effect that prevents brain ischemia damaging neuronal cells and apoptosis increasing.

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Routine Shunting is Safe and Reliable for Cerebral Perfusion during Carotid Endarterectomy in Symptomatic Carotid Stenosis

  • Kim, Tae-Yun;Choi, Jong-Bum;Kim, Kyung-Hwa;Kim, Min-Ho;Shin, Byoung-Soo;Park, Hyun-Kyu
    • Journal of Chest Surgery
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    • 제45권2호
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    • pp.95-100
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    • 2012
  • Background: The purpose of this report is to describe the perioperative outcomes of standard carotid endarterectomy (CEA) with general anesthesia, routine shunting, and tissue patching in symptomatic carotid stenoses. Materials and Methods: Between October 2007 and July 2011, 22 patients with symptomatic carotid stenosis (male/female, 19/3; mean age, $67.2{\pm}9.4$ years) underwent a combined total of 23 CEAs using a standardized technique. The strict surgical protocol included general anesthesia and standard carotid bifurcation endarterectomy with routine shunting. The 8-French Pruitt-Inahara shunt was used in all the patients. Results: During the ischemic time, the shunts were inserted within 2.5 minutes, and 5 patients (22.7%) revealed ischemic cerebral signals (flat wave) in electroencephalographic monitoring but recovered soon after insertion of the shunt. The mean shunting time for CEA was $59.1{\pm}10.3$ minutes. There was no perioperative mortality or even minor stroke. All patients woke up in the operating room or the operative care room before being moved to the ward. One patient had difficulty swallowing due to hypoglossal nerve palsy, but had completely recovered by 1 month postsurgery. Conclusion: Routine shunting is suggested to be a safe and reliable method of brain perfusion and protection during CEA in symptomatic carotid stenoses.

뇌동맥류 코일 색전술 시 Bismuth 차폐체 설치에 따른 입사 표면 선량 평가 및 화질 평가 (Evaluation of entrance surface dose and image quality according to the installation of Bismuth shield in the case of endovascular treatment of cerebral aneurysm)

  • 김재석;김영길;최재호
    • 한국정보통신학회논문지
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    • 제23권7호
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    • pp.779-785
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    • 2019
  • 인체공학적으로 개발된 Bismuth 차폐체를 뇌동맥류 코일 색전술에 적용함으로써 의료방사선 피폭으로부터 두피 및 수정체의 방사선 피폭을 감소시키고자 하였다. 광자극 형광 선량계를 이용하여 후두부, 양쪽 측두부, 양쪽 수정체부, 코 끝부를 개발된 Bismuth 차폐체를 사용 전 (A그룹) 후 (B그룹)로 측정하여 입사 표면 선량을 분석하였다. Bismuth 차폐체를 사용할 경우 화질에 대한 평가를 Signal to noise ratio (SNR)과 Contrast to noise ratio (CNR) 분석을 했다. A 그룹과 B 그룹의 입사 표면 평균 선량을 비교한 결과 A 그룹에 비해 B 그룹에서 평균 26.92% 감소되었다. CNR과 SNR의 분석은 로드맵과 디지털 감산조영 모두 동일하게 측정되었다. Bismuth 차폐체의 사용은 뇌혈관 중재적 시술 후 나타날 수 있는 일시적 탈모 및 기타 확률적 영향에 따른 방사선 장애를 화질의 저하 없이 감소시킬 수 있는 대안이 될 것으로 사료된다.

뇌혈관 중재적시술에 있어 측방향 차폐체를 이용한 시술자 피폭 선량 저감화 방법 연구 (Reducing Radiation Exposure Dose on Operator by Using Lateral Protection in Neuro-Intervention)

  • 김종덕;안병주;이준행
    • 한국방사선학회논문지
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    • 제8권1호
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    • pp.1-10
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    • 2014
  • 양방향 뇌혈관촬영기는 하나의 선원에서 방사선이 나오는 것이 아니라 정방향과 측방향에서 방사선 피폭이 이루어지기 때문에 방사선 관계종사자의 피폭이 더욱 많아질 수밖에 없다. 따라서 환자가 받는 선량도 중요하겠지만 시술을 시행하고 있는 방사선 관계종사자 역시 피폭선량을 줄일 수 있는 방법에 대해 많은 관심을 보이고 있다. 본 연구의 목적은 양방향 뇌혈관촬영기의 혈관검사 및 중재적방사선시술에 있어 X-선 관구에서 직접 조사되는 1차 방사선, 정방향관구와 측방향 검출기사이에서 발생하는 1차 산란방사선, 상대적으로 적지만 촬영실 벽이나 바닥에서 반사되는 2차 산란방사선 발생을 간과하지 않을 수 없기에 기존의 일반적인 차폐방법인 천정형 차폐, 테이블형 차폐방법에서 보다 더 적극적인 차폐방법인 측방향 차폐체의 방어용구를 설치하여 시술자가 받는 직접방사선 및 산란방사선에 의한 피폭선량을 최대한 줄이고자 노력하였다. 그 결과 투시측정에서는 생식샘 약 3.64배, 갑상샘 약 3.13배, 눈 약 4.42배 정도 더 감소하였고, 디지털 감산 혈관조영측정에서는 생식샘 약 4.98배, 갑상샘 약 3.00배, 눈 약1.67배의 피폭선량 감소효과를 얻어내었다. 결론적으로 양방향 뇌혈관촬영기의 혈관검사 및 중재적방사선시술시 설치하였던 측방향 차폐체의 방어용구는 일반적인 차폐방법보다 시술자의 피폭선량을 감소시키는데 많은 효과를 주었다고 사료된다.

하행대동맥 및 흉복부 대동맥 수술의 임상적 경험 (The Clinical Experience of The Descending Thoracic and Thoracoabdominal Aortic Surgery)

  • 조광조;우종수;성시찬;최필조
    • Journal of Chest Surgery
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    • 제35권8호
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    • pp.584-589
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    • 2002
  • 배경: 흉복부 대동맥 질환 수술은 부위에 따라 사용되는 수술법이 다양하며 각 방법마다 장단점이 있어 논란의 대상이 되고 있다. 이에 저자들은 지금까지 여러 방법으로 흉복부 대동맥 질환을 수술한 성적과 위험 요소를 분석하여 보고하고자 한다. 대상 및 방법: 1992년 6월부터 2001년 8월까지 저자들은 36명의 흉복부 대동맥 수술을 시행하였다. 이중 17명은 대동맥 박리증, 17명은 대동맥류, 1명은 대동맥 축착증에 병발한 대동맥박리증, 1명은 외상성 대동맥손상이었다. 수술은 26례에서 흉부대동맥 치환술을, 10명에서 흉복부 대동맥 치환술을 시행하였다. 흉부대동맥치환술은 11명에서 좌심방대퇴동맥간 centrifugal 펌프을 통한 우회로를 하며 수술하였고, 11명에서 대퇴동정맥 사이에, 4명은 우심방과 상행대동맥 사이에 심폐기를 가동하며 이중 6명은 극저체온순환정지하에 수술을 하였다. 흉복부대동맥 치환술은 6명에서 대퇴동정맥을 통한 심폐기를 가동시키며 수술하였고 3명은 대퇴정맥에 삽관하여 흡입한 혈액을 pump 로 주입하며 수술을 하였고 한 명은 심폐기의 도움없이 수술하였다. 결과: 수술합병증은 신부전 7례, 간기능부전 11례, 폐혈증 2례, 호흡부전 5례, 심부전 2례, 뇌경색 7례, 허혈성 척추손상 1례 등이 발생되었다. 술 후 원내 사망은 9례로 수술직후 24시간 이내 사망한 경우가 6례로 사망원인은 출혈 2례, 심부전 2례, 신부전 2례 등이었고, 수술 후 1주 뒤 원내 사망은 3례로 패혈증, 호흡부전증, 뇌경색증 등으로 사망하였다. 퇴원 후 만기 사망은 3례로 사인은 원위부 파열로 인한 쇽 와 뇌경색증 폐렴 합병증으로 사망하였다. 결론: 흉부대동맥치환술을 받은 환자 26명 중 수술사망은 5명이며 이중 3명이 극저체온 순환정지하에 수술을 시행받은 환자들이었다. 흉복부대동맥 치환술을 받은 10명 중 수술사망은 4명이었고 이중 2명이 복부동맥을 같이 광범위하게 치환한 환자들이었다.