• The Journal of Korean Physical Therapy
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• v.25 no.3
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• pp.126-131
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• 2013

This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.177-177
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• 1993

뇌모세혈관내피세포로 구성된 혈액-뇌관문(BBB)은 tight junction으로 구성되어 있을뿐만 아니라 fenestra가 없는 등 BBB가 가진 특성으로 인해 물질 수송에 장벽역할을 하기 때문에 주로 중추신경계 질환시의 약물요법에 많은 제한이 따른다. 따라서 뇌로의 효율적인 약물 송달방법에 대해 많은 연구가 진행중에 있는데 본 연구에서는 BBB의 hyperosmotic opening법을 이용하여 뇌로 잘 수송되지 않는 약물의 뇌송달 방법에 대해 연구하고자 하였다. 먼저 수용성으로 인해 BBB 에 잘 통과하지 않는 물질로 신장 및 뇌영상 촬영시 사용되는 방사성 의약품이 Tc-DTPA를 이용하여, hyperosmotic opening법에 의한 뇌투과 증가정도를 검토하였으며, 실험방법이 확립됨에 따라 뇌암의 항암요법을 위해 뇌로의 투과가 적은 항암제(5-Fluorouracil, 5-FU)의 뇌송달에 대해 본 방법을 적용하여 검토하였다. 실험동물로는 S.D.계 웅성 랫트를 사용하였으며, 실험방법은 다음과 같이 하였다. 랫트의 좌측 외경동맥(left external carotid artery)에 혈류의 역방향으로 혈관 분지점에서 1-2mm 전까지 PE-50 catheter를 삽입하고, 1.6 molal L－(＋)－ arabinose 고장액(1580mOsm)을 0.12ml/sec의 일정한 속도로 30초간 infusion함으로 BBB를 opening 한 다음, 5분 후에 Tc-DTPA를 대퇴 정맥으로 주사하여 0, 10, 30초, 1, 1.5, 2, 3, 4, 5, 7 및 10분 간격으로 대퇴동맥에 설치한 카테타로부터 혈액을 채취하고 마지막 혈액을 취한 후 즉시 단두하여 뇌를 적출하였다. 채취한 뇌를 액체질소에 담근 후 tissue Tek으로 고정하고 autoradiography를 하기 위한 slice와 농도측정을 위해 필요한 부위를 취한 후 감마카운터로 Tc-DTPA의 brain각 부위별 및 혈장농도를 측정하였다. 뇌조직중 혈액부피의 측정은 Tc-albumin를 이용하여 구하였다. 같은 방법으로 5-FU에 대한 실험도 행하였고, 이때 각 혈장 및 조직중의 5-FU함량은 HPLC로 하였다.

• Archives of Reconstructive Microsurgery
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• v.22 no.1
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• pp.29-32
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• 2013

Purpose: Reconstruction of scalp and calvarial defects should provide both aesthetic and functional aspects. The inelastic nature of the scalp and previous surgery or radiation preclude the use of primary closure or a local flap. With development of microsurgical technique, a free tissue transfer is a good option. We use the latissimus dorsi myocutaneous free flap for reconstruction. Materials and Methods: A review of all latissimus dorsi free flap reconstructions performed in nine patients from 2009 to 2012 was conducted. There were six males and three females, ranging in age from seven to 69 years, and nine different regions, including five temporal regions, two occipital regions, and two frontoparietal regions. The flaps ranged in size from $9.0{\times}10.0cm$ to $14.0{\times}15.0cm$. Recipient vessels available for microanastomosis were most often the superficial temporal vessels and two patients had anastomoses to the external carotid artery and internal jugular vein. Results: All flaps survived postoperatively. With a median follow-up period of 14 months, no major complications were noted. However, two patients developed minor wound dehiscence, and a hematoma was observed in one patient. Conclusion: We performed the latissimus dorsi myocutaneous free flap reconstruction, which is one of the most popular reconstructive methods. The latissimus dorsi myocutaneous free flap reconstruction has been proven successful in our patients with satisfactory results. During the long term follow-up period, even though depressions were observed on the defect area in some patients, they were treated successfully with cranioplasty. Therefore, we recommend the latissimus dorsi myocutaneous free flap for reconstruction of scalp and calvarial defects.

• Bulletin of the Korean Chemical Society
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• v.29 no.2
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• pp.422-426
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• 2008

Hemodialysis graft coated with paclitaxel prevents stenosis; however, large initial burst release of paclitaxel causes many negative effects such as drug toxicity and inefficient drug loss. Therefore we developed and tested a novel coating method, double dipping, to provide controlled and sustained release of paclitaxel locally. Expanded polytetrafluoroethylene (ePTFE) grafts were dipped twice into a solution of several different paclitaxel concentrations. In vitro release tests of the double dipping method showed that early burst release could be somewhat retarded and followed by sustained release for a long time. We observed the effect of paclitaxel coating by double dipping in porcine model of arterio-venous (AV) grafts between the common carotid artery and the external jugular vein. 12 weeks after constructing AV grafts, cross sections of the graft venous anastomosis were obtained and analyzed. Paclitaxel coated ePTFE grafts by double dipping were observed to prevent neointimal hyperplasia and therefore reduced stenosis of the arteriovenous hemodialysis grafts, especially at the graft venous anastomosis sites. Our results demonstrate that second dipping of ePTFE graft, which was already coated once with paclitaxel, washes off the drug on a surface of the graft and affects the ratio of paclitaxel on the surface to that of the inner space, possibly by diffusion: thus the early burst of drug can be somewhat reduced.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.61-68
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• 1996

In Fibrous dysplasia(FD) of the jaws, the majority of cases can await the cessation of growth before surgical intervention, and it seems prudent to delay surgery whenever possible until growth has ceased. In craniofacial FD, however, the dangers of dystopia, dystopia and loss of vision may require early surgery to prevent or control cranio-orbital complications. Delaying surgery in those circumstances may be significantly detrimental to such patients. Conservative surgical management of FD is widely practised and we advocate an extension to this conservative treatment by combining surgical recontouring with appropriate osteotomies if indicated, to achieve an optimal esthetic and functional results in craniofacial FD. One case will be presented to illustrate the feasiblility of such combined treatment, to report the uneventful healing of osteotomies in the FD of the jaws, and to demonstrate the use of titanium miniplate fixation in dysplastic bone. The other case had expansile disease of the left facial and fronto-temporal bones and osteolytic change left mandible. This patient complained of severe spontaneous bleeding of left mandibular premolar area and it was suspected as central hemangioma of the left mandible and craniofacial FD. Angiogram disclosed generalized dilation of the external carotid artery and its branches, especially terminal branches of the left facial and inferior alveolar arteries. But no specific abnormalities, such as A-V shunt, venous lake, or early venous drainage, was seen. So it was diagnosed craniofacial FD with hypercellularity and generalized bony recontouring was performed via coronal and transoral approaches.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.2
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• pp.105-110
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• 2018

Background: A stellate ganglion block (SGB) causes increased blood flow in the maxillofacial region, exhibiting the potential for regenerative effects in damaged tissue. The focus of this study was to understand the efficacy of SGB for regenerative effects against nerve damage. A rat model of the superior cervical ganglion block (SCGB) was created instead of SGB, and facial blood flow, as well as sympathetic nervous system function, were measured. Methods: A vertical incision was made on the left side of the neck of a Wistar rat, and a 5-mm resection of the superior cervical ganglion was performed at the back of the bifurcation of the internal and external branches of the left common carotid artery. Blood flow in the skin at the mandibular angle and mean facial temperature were measured using a laser-Doppler blood flow meter and a thermographic camera, respectively, over a 5-week period after the block. In addition, the degree of ptosis and miosis were assessed over a period of 6 months. Results: The SCGB rat showed significantly higher blood flow at the mandibular angle on the block side (P < 0.05) for 3 weeks, and significantly higher skin temperature (P < 0.05) for 1 week after the block. In the SCGB rat, ptosis and miosis occurred immediately after the block, and persisted even 6 months later. Conclusions: SCGB in rats can cause an increase in the blood flow that persists over 3 weeks.

• The KIPS Transactions:PartA
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• v.14A no.2
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• pp.77-84
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• 2007

The intima media thickness(IMT) of the carotid artery from B mode ultrasound images has recently been proposed as the most useful index of individual atherosclerosis and can be used to predict major cardiovascular events. Ultrasonic measurements of the IMT are conventionally obtained by manually tracing interfaces between tissue layers. The drawbacks of this method are the inter and intra observer variability and its inefficiency. In this paper, we present a multiresolution snake method combined with the dynamic programming, which overcomes the various noises and sensitivity to initialization of conventional snake. First, an image pyramid is constructed using the Gaussian pyramid that maintains global edge information with smoothing in the images, and then the boundaries are automatically detected in the lowest resolution level by minimizing a cost function based on dynamic programming. The cost function includes cost terms which are representing image features and geometrical continuity of the vessel interfaces. Since the detected boundaries are selected as initial contour of the snake for the next level, this automated approach solves the problem of the initialization. Moreover, the proposed snake improves the problem of converging th the local minima by defining the external energy based on multiple image features. In this paper, our method has been validated by computing the correlation between manual and automatic measurements. This automated detection method has obtained more accurate and reproducible results than conventional edge detection by considering multiple image features.

• Restorative Dentistry and Endodontics
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• v.30 no.6
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• pp.470-476
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• 2005

The purpose of this Study was to invest)gate the function or calcitonin gene-related peptide (CGRP) in regulatory mechanism of pulpal microcirculation with the aim of elucidating neurogenic inflammation. Experiments were performed on twelve cats under general anesthesia. CGRP was administered through the femoral vein to see the systemic Influence and through the external carotid artery to see the local effect. Sympathetic nerve to the dental pulp was stimulated electrically and pulpal blood flow (PBF) was measured with a laser Doppler flowmeter on the canine teeth to the drug administration. The paired variables of control and experimental data were compared by paired t-test and differences with p < 0.05 were considered statistically significant. Systemic administration of CGRP $(0.3{\mu}g/ka)$ exerted decreases in systemic blood pressure and caused changes in PBF with an initial increase i311owed by decrease and a move marked second increase and decrease. Close intra-arterial (i.a.) injection of CCRP $(0.03{\mu}g/kg)$ resulted in slight PBF increase. The effect of CGRP resulted in no significant increase in PBF in the presence of $CGRP_{8-37}$. The electrical stimulation of the sympathetic nerve alone resulted in PBF decreases. The j.a. administration of CGRP following the electrical stimulation of the sympathetic nerve compensated the decreased PBF. Therefore, CGRP effectively blocked the sympathetic nerve stimulation-induced PBF decrease. Results of the present study have provided evidences that even though the local vasodilatory function of CGRP are weak, CCRP is effectively involved in blocking the vasoconstriction caused by sympathetic nerve stimulation in the feline dental pulp.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.588-596
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• 2009

Background: To clarify the effect of hypoxia on vascular contractility, we tried to show whether hypoxia induced the release of endothelium-derived relaxing factor (EDRF) and the nature of the underlying mechanism for this release. Material and Method: Isometric contractions were observed in rabbit aorta, and the released EDRF from the rabbit aorta was bioassayed by using rabbit denuded carotid artery. The intracellular $Ca^{2+}$ concentration ($[Ca^{2+}]_i$) in the cultured rabbit aortic endothelial cells was recorded by a microfluorimeter with using Fura-2/AM. Hypoxia was evoked to the blood vessels or endothelial cells by eliminating the $O_2$ in the aerating gases in the external solution. Chemical hypoxia was evoked by applying deoxyglucose or $CN^-$. Result: Hypoxia relaxed the precontracted rabbit thoracic aorta that had its endothelium, and the magnitude of the relaxation was gradually increased by repetitive bouts of hypoxia. In contrast, hypoxia-induced relaxation was not evoked in the aorta that was denuded of endothelium. In a bioassay experiment, hypoxia released endothelium-derived relaxing factor (EDRF) and the release was inhibited by L-NAME or the $K^+$ channel blocker tetraethylammonium (TEA). In the cultured endothelial cells, hypoxia augmented the ATP-induced increase of the intracellular $Ca^{2+}$ concentration ($[Ca^{2+}]_i$) and this increase was inhibited by TEA. Furthermore, chemical hypoxia also increased the $Ca^{2+}$ influx. Conclusion: From these results, it can be concluded that hypoxia might induce the release of NO from rabbit aortic endothelial cells by increasing $[[Ca^{2+}]_i$.