• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.91-101
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• 1989

The goal of therapy in patients with traumatic carotid-cavernous fistulas is to occlude the fistula, preferably while maintaining the carotid blood flow. Since the introduction of the concepts of detachable balloon technique to occlude arteriovenous fistulas, the technique has become the treatment of choice in the management of traumatic carotid-cavernous fistulas. The major symptoms of traumatic CCFs are (1)pulsating exophthalmos, (2)orbital and cephalic bruit and murmur, (3) headache, (4) chemosis. (5) extraocular palsies, and (6) visual failure. Traumatic CCFs are combined with multiple associated lesions. We tried the occlusion of fistulas using Goldvalve balloons in 8 consecutive cases of traumatic CCF and the result of our experience is reported. Transarterial approach with manually-tied latex balloons is tried in all cases and the fistulas was successfully occluded in all cases. In 5 cases. the internal carotid artery was preserved and the arterial lumen was occluded along with fistula opening in :3 cases. In one case, surgical ligation was done because of symptoms recurred and incomplete occlusion of fistula. We experienced hemiparesis as a major complication in one case during occlusion tolerance test, which was remitted spontaneously. The results of Debrun balloon treatment were relatively excellent. We consider that the first choice of treatment of traumatic CCF is occlusion of the fistula by a detachable balloons.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.105-116
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• 2004

Objective : In this study, we used the aged bilateral common carotid artery occlusion (BCAO) rats were used to measure the effect of Bupleuri Radix (Si-Ho) on the brain ischemic injury, because aging is an important factor in storke, Method : The brian ischemic injury was induced by temporary closing of carotids on both sides in a low blood pressure state. Bupleuri Radix (Si-Ho) was orally administered in 18-month-old BCAO rats. Result : The Ischemic Damaged Hippocampus and HSP expression were analyzed by the immunohistochemical staining and the result were as follows: 1. The low numbers of pyramid cells in the hippocampus CA1 area for the ischemically injured experimental group rose to numbers simillar to those of the control group. 2. The thin neuronal cell layer in the hippocampus CA1 area for the ischemically injured experimental group returned to thickness simillar to those of the control group. 3. The normalized optical density of HSP70 expression was suppressed in CA2, DG and CA1 expression was significantly suppressed in the experimental group compared to the control group. Conclusion : These results suggested that Bupleuri Radix (Si-Ho) has a neuroprotective effect by reducing neural cell injury in the initial ischemic state.

• The Journal of Internal Korean Medicine
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• v.27 no.3
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• pp.589-602
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• 2006

Hwangryunagyotang is supposed to have significant effects on some sorts of cardiovascular diseases like atherosclerosis. For this study. ACAT inhibitor was put in LDLR -/- mice to derive free cholesterol from it. This was to examine the effectiveness of Hwangryunnagyotang on its protecting and recovering function with endothelial cells damaged by free cholesterol through experimental. The results reported below. Hwangryunagyotang suppressed the crystallization of reactive oxygen species in macrophages and the numbers of free cholesterol crystal plate structured and reduced fragmentation of nucleus in ECV 304 cell strain by ACAT inhibitor significantly. Hwangryunagyotang also suppressed the necrosis of tissue in LDLR -/- mice' (treated with ACAT inhibitor) inflammatory portion which is adjacent to aortic root, proximal aorta and carotid artery by immunohistochemistry and fluorescence microscopy. On the whole, Hwangryunagyotang suppressed the necrosis of endothelial cells and especially it's effcet for the necrosis of para-myocardial tissues by free cholesterol. With this result, I suggest Hwangryunagyotang might have protective and recovery effects on atherosclerosis, so we need to carry on this study henceforth clinically and experimentally as well.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.665-675
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• 2020

Purpose This study aimed to identify independent predictors of favorable outcomes associated with emergent carotid artery stenting (CAS) in patients with acute anterior circulation stroke. Materials and Methods This study included 93 patients with acute stroke who underwent emergent CAS to treat stenoocclusive lesions in the cervical internal carotid artery (ICA) within 6 hours of the onset of the associated symptoms. Data were compared between patients with and without favorable outcomes. The independent predictors of a favorable outcome were determined via logistic regression analysis (modified Rankin Scale 0-2 at 90 days). Results Intracranial tandem occlusion was noted in 81.7% of patients (76/93) among which (76/93), 55 of whom underwent intracranial recanalization therapy. Intracranial reperfusion was successful in 74.2% (69/93) and favorable outcomes were noted in 51.6% of patients (48/93). The mortality rate was 6.5% (6/93). In logistic regression analysis, diffusion-weighted imaging-Alberta Stroke Program Early CT Score [odds ratio (OR), 1.487; 95% confidence interval (CI), 1.018-2.173, p = 0.04], successful reperfusion (OR, 5.199; 95% CI, 1.566-17.265, p = 0.007), and parenchymal hemorrhage (OR, 0.042; 95% CI, 0.003-0.522, p = 0.014) were independently associated with a favorable outcome. Conclusion Baseline infarct size, reperfusion status, and parenchymal hemorrhage were independent predictors of favorable outcomes after emergent CAS to treat stenoocclusive lesions in the cervical ICA in patients with acute anterior circulation stroke.

• Science of Emotion and Sensibility
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• v.11 no.4
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• pp.565-574
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• 2008

Functions of human brain including sensibility and emotion may be affected by drugs mediated by the blood-brain barrier (BBB). The present study was performed to evaluate whether injection route, volume and concentration of mannitol could alter the degree of disruption of the BBB. Under urethane anesthesia, female Sprague-Dawley rats were infused with 20% mannitol into the right internal carotid artery (ICA). In the other group, intravenous injection of mannitol through the femoral vein was performed. Evans blue(EB) dye was used as a marker of BBB disruption. When mannitol was injected via the ICA, the content of EB dye in the ipsilateral hemisphere was markedly increased. However, the content of EB in the brain was not increased when mannitol was injected via the femoral vein, even though the volume or concentration of mannitol was increased. These results suggest that the BBB was disrupted only through ICA injection route and this may provide a useful strategy for transient opening of the BBB to control the functions of human brain.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.12
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• pp.6284-6289
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• 2013

With the application of k-space trajectory in a different manner and analyzing the influence of noise and its direction, this study was conducted to obtain high-quality images with minimal influence of noise during an MRI examination for cerebrovascular disease, which has a low signal for imaging. To evaluate influence of the noise of different k-space trajectories, a linear Cartesian coordination trajectory and non-Cartesian coordination trajectory were applied to 38 people who had received a high-resolution MRI examination for the early detection of cerebrovascular disease. As a result, the non-Cartesian coordination trajectory showed a 43.32% lower signal of lumens in the internal carotid artery than a linear Cartesian coordination trajectory, and the noise level was also 50.19% lower in a non-Cartesian coordination trajectory. This result shows that noise occurs less in a non-Cartesian coordination trajectory than a linear Cartesian coordination trajectory, and a non-Cartesian coordination trajectory is more effective in low-signal and low-resolution MRI examination. Therefore, when performing high-resolution MRI examination with a low-signal cerebrovascular system, the use of non-Cartesian coordination k-space trajectory will minimize the influence of noise and provide good images.

• Herbal Formula Science
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• v.25 no.1
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• pp.69-87
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• 2017

Objectives : Cheongnoemyeongsin-hwan (CNMSH) is a herb medicine to treat cognitive impairment. This study was investigated the effects of CNMSH on learning and memory impairment induced by cerebral hypoperfusion. Cerebral hypoperfusion was produced chronically by permanent bilateral common carotid artery occlusion (BCCAO) in rats. Methods : CNMSH was administered orally once a day (250 mg/kg) for 28 days starting at 4th week after the BCCAO. The acquisition of learning and the retention of memory were tested on 9th week after the BCCAO using the Morris water maze. In addition, effect of CNMSH on neuronal apoptosis and ${\beta}-amyloid$ accumulation in the hippocmapus was evaluated with immunohistochemistry and Western blotting. Results : 1. CNMSH and ChAL significantly shortened the escape latencies on the 2nd day of acquisition training trials. 2. ChAL significantly prolonged the swimming time spent in the target and peri-target zones and CNMSH also significantly prolonged the swimming time spent in the peri-target zone. 3. CNMSH and ChAL significantly increased the number of target heading in the retention test. 4. ChAL significantly shortened the time of the 1st target heading in the retention test, but CNMSH insignificantly shortened the time of that. 5. CNMSH and ChAL significantly increased the memory score in the retention test. 6. CNMSH and ChAL significantly attenuated the reduction of CA1 neurons, but insignificantly attenuated the reduction of CA1 thickness. 7. CNMSH and ChAL significantly attenuated the up-regulation of Bax expression in the CA1 of hippocampus. 8. CNMSH and ChAL significantly attenuated the up-regulation of cascapse-3 expression in the CA1 of hippocampus. 9. CNMSH and ChAL significantly attenuated the ${\beta}-amyloid$ accumulation in the CA1 of hippocampus. 10. CNMSH and ChAL significantly attenuated the up-regulation of APP expression in the CA1 of hippocampus. 11. CNMSH and ChAL significantly attenuated the up-regulation of BACE-1 expression in the CA1 of hippocampus. Conclusions : The results show that CNMSH attenuates neuronal apoptosis and ${\beta}-amyloid$ accumulation in the hippocampus and alleviates the impairment of learning and memory produced by chronic cerebral hypoperfusion. These results suggest that CNMSH may be a beneficial medicinal herb to treat cognitive impairment associated with neurodegenerative diseases.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.545-550
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• 2019

Objective : Penumbra ACE68 reperfusion catheter is a new large bore aspiration catheter used for reperfusion of large vessel occlusion. The objective of this study was to investigate the efficacy of this catheter in comparison to that of previous Penumbra catheters in patients with acute ischemic stroke related to internal carotid artery (ICA) occlusion. Methods : Data of all eligible patients who received endovascular treatment (EVT) for ICA occlusion using Penumbra aspiration catheters between January 2015 and December 2018 were retrospectively reviewed. After dividing into two groups according to use of penumbra ACE68, baseline characteristics of patients, successful recanalization rate, puncture to recanalization time, and switch to stent base technique rate were assessed. Successful recanalization was defined by a thrombolysis in cerebral infarction (TICI) score ${\geq}2b$ and favorable functional outcome was defined according to modified Rankin scale (score, 0-2). Results : ACE68 reperfusion catheter was used in 29 of 75 eligible patients (39%). The puncture to recanalization time was significantly shorter ($26{\pm}18.2$ minutes vs. $40{\pm}24.9$ minutes, p=0.011) and the rate of switch to stent-based retrieval was significantly lower (3% vs. 20%, p=0.046) in ACE68 catheter group. Moreover, although not statistically significant, the successful recanalization rate was higher (83% vs. 76%, p=0.492) in ACE68 catheter group. Favorable functional outcome was observed in 48% of patients treated with ACE68 reperfusion catheter and in 30% of patients treated using other Penumbra systems (p=0.120). Baseline Alberta Stroke Program Early CT Scores ${\geq}8$ (odds ratio [OR], 9.74; 95% confidence interval [CI], 1.72-54.99; p=0.010) and successful recanalization (OR, 10.20; 95% CI, 1.13-92.46; p=0.039) were independent predictors of favorable outcome. Conclusion : EVT using ACE68 reperfusion catheter can be considered a first-line therapy in patients with acute ICA occlusion as it can achieve rapid recanalization and reduce the frequency of conversion to stent-retrieve therapy.

• The Korean Journal of Nuclear Medicine
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• v.20 no.2
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• pp.47-52
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• 1986

A noninvasive procedure for diagnosis and quantitation of right-to-left intracardiac shunts will enhance the management of patients with cyanotic congenital heart disease. This study describes an application of radionuclide (RN) angiocardiography for quantitation of right-to-left shunt amount. Gamma variate model was fitted to radionuclide data recorded over the carotid artery. Data analysis was performed retrospectively in 35 patients who underwent cardiac catheterization within a week from the day of RN angiocardiography. Thirty one of the patient had right-to-left shunts and 4 of them had left-to-right shunts. Both the radionuclide and Fick measurements correlated well (r=0.93, 0.93, 0.89, p<0.01 in each measurements). Therefore, RN angiocardiography data may be used for accurate calculation of right-to-left shunts in cyanotic congenital heart disease patients.

• Journal of Korean Neurosurgical Society
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• v.51 no.2
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• pp.75-80
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• 2012

Objective : To optimize the recanalization of acute cerebral stroke that were not effectively resolved by conventional intraarterial thrombolysis (IAT), we designed a double device technique to allow for rapid and effective reopening. In this article, we describe the feasibility and efficacy of this technique. Methods : From January 2008 to September 2009, twenty patients with acute cerebral arterial occlusion (middle cerebral artery : n=12; internal carotid artery terminus : n=5; basilar artery : n=3) were treated by the double device technique. This technique was applied when conventional thrombolytic methods using drug, microwires, microcatheters and balloons did not result in recanalization. In the double device technique, two devices are simultaneously placed at the lesion (for example, one microcatheter and one balloon or two microcatheters). Chemicomechanical or mechanicomechanical thrombolysis was performed simultaneously using various combinations of two devices. Recanalization rates, procedural time, complications, and clinical outcomes were analyzed. Results : The initial median National Institute of Health Stroke Scale (NIHSS) was 16 (range 5-26). The double device technique was applied after conventional IAT methods failed. Recanalization was achieved in 18 patients (90%). Among them, 55% (11 cases) were complete (thrombolysis in cerebral infarction 2B, 3). The median thrombolytic procedural time including the conventional technique was $135{\pm}83.7$ minutes (range 75-427). Major symptomatic hemorrhages (neurological deterioration ${\geq}4$ points in NIHSS) developed in two patients (10%). Good long term outcomes (modified Rankin Scale ${\leq}2$ at 90 days) occurred in 25% (n=5) of the cases. Mortality within 90 days developed in two cases (10%). Conclusion : The double device technique is a feasible and effective technical option for large vessel occlusion refractory to conventional thrombolysis.