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

• Journal of Medicine and Life Science
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• 제21권1호
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• pp.15-19
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• 2024

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic necrotizing vasculitis that predominantly affects small vessels of the body. The two most common ANCAs are myeloperoxidase ANCA and proteinase 3 ANCA. Neurological manifestations are frequent in patients with AAV, including peripheral neuropathy, meningitis, and stroke. AAV-associated ischemic stroke usually affects small vessels supplying the white matter or brainstem. This case report details the presentation and treatment course of a 70-year-old man with rapidly progressive multiple intracranial large artery involvement attributed to myeloperoxidase ANCA-associated vasculitis. Despite treatment with high-dose steroids and a rituximab infusion, the patient developed new speech difficulties and respiratory distress, and brain imaging confirmed new stroke lesions with progressive multiple intracranial large cerebral artery involvement. The patient died from SARS-CoV-2 infection 4 months after the diagnosis. This case emphasized the rare presentation of rapidly progressive large vessel involvement in a patient with myeloperoxidase ANCA-associated vasculitis despite active immunotherapy.

• 한국임상수의학회지
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• 제33권1호
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• pp.70-73
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• 2016

Necrotizing meningoencephalitis (NME) is a unique idiopathic nonsuppurative inflammatory disease of central nervous system in small-sized breed dogs. A 9-year-old intact male Shih-Tzu dog with anorexia, vomiting, salivation and intermittent seizures was submitted to the Jeju National University for diagnosis. Grossly, there were no obvious lesions in the brain, except dilatation of most blood vessels in meninges. Histopathologically, brain revealed severe multifocal nonsuppurative inflammation in perivascular area of meninges and cerebral cortex. Some areas of cerebral parenchyma were replaced with lots of macrophages contained periodic acid-Schiff positive materials. Many new-formed blood vessels were observed around the necrotic regions using Gomori reticulum stain. Immunohistochemistry and reverse transcription-polymerase chain reaction were negative for toxoplasmosis and canine distemper virus. Based on the gross, histopathologic features and antigen detection methods, this case was diagnosed as NME. Here we reported the NME in relatively uncommon breed, Shih-Tzu dog, than other small breed dogs.

• Journal of Korean Neurosurgical Society
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• 제41권1호
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• pp.30-38
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• 2007

Objective : To elucidate the role of aquaporin-4[AQP4] in cerebral edema formation, we studied the expression and subcellular localization of AQP4 in astrocytes after focal cerebral ischemia. Methods : Cerebral ischemia were induced by permanent middle cerebral artery[MCA] occlusion in rats and estimated by the discoloration after triphenyltetrazolium chloride[TTC] immersion. Change of AQP4 expression were evaluated using western blot. Localization of AQP4 was assessed by confocal microscopy and its interaction with ${\alpha}-syntrophin$ was analyzed by immunoprecipitation. Results : After right MCA occlusion, the size of infarct and number of apoptotic cells increased with time. The ratio of GluR1/GluR2 expression also increased during ischemia. The polarized localization of AQP4 in the endfeet of astrocytes contacting with ventricles, vessels and pia mater was changed into the diffuse distribution in cytoplasm. The interactions of AQP4 and Kir with ${\alpha}-syntrophin$, an adaptor of dystrophin complex, were disrupted by cerebral ischemia. Conclusion : The deranged spatial buffering function of astrocytes due to mislocalized AQP4/Kir4.1 channel as well as increased assembly of $Ca^{2+}$ permeable AMPA receptors might contribute to the development of edema formation and the excitotoxic neuronal cell death during ischemia.

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

• 대한한방내과학회지
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• 제21권5호
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• pp.805-811
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• 2000

Objectives : To determine the effects on blood flow of vertebrobasal vascular system in cerebral infarction, Methods : We altered 33 normal patients and 12 patients who were diagnosed cerebral infarction on Rt. middle cerebral artery(MCA) region and 8 patients who were diagnosed cerebral infarction on Lt, MCA region, and measured the mean velocity, systolic to diastolic rate(SD rate), asymmetrical index(A/I) by TCD. Results : The mean velocity of posterior cerebral artery(PCA), vertebral artery was increased in same direction as infarcted site and the mean velocity of basal artery was more increased than control, and the SD rate of PCA, vertebral artery, basal artery was larger than control. The A/l of PCA, vertebral artery was revealed that mean velocity of vertebrobasal vascular system is increase the same direction as infarcted area. Conclusion : TCD examination within 7 days(acute stage) after stroke can help to predict the infarcted direction.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1989년도 춘계학술대회
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• pp.67-69
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• 1989

In this paper, principles of Rhcoencephalography(RBG) was described and RBG was designed and developed. Using the developed instrument, RBG waveforms of the left and right brain, RBG waveform changes by posture, were observed. It was found that RBG waveforms could be observed noninvasively. RBG can be easily applied for testing the effect of various drugs related to CBF(Cerebral blood flow) since it is quite sensitive to the relative changes of CBF. Various cerebral diseases can be diagnosed by analyzing the RBG waveforms. The area of restricted cerebral blood vessels can be located by arranging the appropriate electrode configuration.

• 대한의용생체공학회:의공학회지
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• 제10권1호
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• pp.25-32
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• 1989

In this study, Rheoencephalography( REG ) was designed and constructed. Using the cons- tructed instrument cerebral blood flow(CBF) of left and right brain, CBF change by posture, and reproducibility were studied. Followings are important results. Relative CBF could be measured noninvasively and continuously. Since reproducibility of the constructed REG was found to be quite high (4%), the accuracy of the instrument itself was proved. REG can be easily applied for testing the effect of drugs for the patients with cerebral vessel diseases since it is quite sensitive to the relative changes of CBF. Various cerebral diseases can be diagnosed by analyzing the REG waveforms. The area of restricted cerebral blood vessels can be located by arranging the electrode configuration. Comparative studies with the standard techinques of measuring CBF are needed to verify the accuracy of REG. Further studies on optimal electrode configuration and various artifacts are also necessary.

• Journal of Medicine and Life Science
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• 제16권3호
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• pp.55-59
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• 2019

Cerebral vessels are functionally and structurally specialized to provide adequate blood flow to brain which shows high metabolic rates. Cerebral hemorrhage or ischemic infarction due to cerebrovascular injury or occlusion can cause the immediate brain damage, and if not treated rapidly, can lead to serious or permanent brain damages, and sometimes life-threatening. Unlike these popular cerebrovascular diseases, there are diseases caused by genetic problems. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is one of them. CADASIL does not show the high incidence, but it is considered to be significantly affected by regional obstructiveness such as islands and therefore, to be an important genetic disease in Jeju. This paper aims to summarize the possibility of animal model research that can provide preclinical data for CADASIL disease research and to evaluate its applicability in future research plans.

• Journal of Korean Neurosurgical Society
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• 제58권1호
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• pp.30-35
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• 2015

Objective : The clinical and pathological characteristics of 10 cases of cerebral amyloid angiopathy (CAA)-related cerebral lobar hemorrhage (CLH) that was diagnosed at autopsy were investigated to facilitate the diagnosis of this condition. Methods : The clinical characteristics of 10 cases of CAA-related CLH were retrospectively reviewed, and a neuropathological examination was performed on autopsy samples. Results : The 10 cases included two with a single lobar hemorrhage and eight with multifocal lobar hemorrhages. In all of the cases, the hemorrhage bled into the subarachnoid space. Pathological examinations of the 10 cases revealed microaneurysms in two, double barrel-like changes in four, multifocal arteriolar clusters in five, obliterative onion skin-like intimal changes in four, fibrinoid necrosis of the vessels in seven, neurofibrillary tangles in eight, and senile plaques in five cases. Conclusion : CAA-related CLHs were located primarily in the parietal, temporal, and occipital lobes. These hemorrhages normally consisted of multiple repeated CLHs that frequently bled into the subarachnoid space. CAA-associated microvascular lesions may be the pathological factor underlying CLH.