• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.3
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• pp.760-764
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• 2005

This research was performed to investigate protective effect of Sophora Subprostrata fractions against focal ischemic brain damage after middle cerebral artery(MCA) occlusion. Rats were divided into six groups: MCA-occluded group(Control); each administered groups with Sophora Subprostrata total phase(Total), Sophora Subprostrata Aqueous phase (Aqueous), Sophora Subprostrata BuOH phase(BuOH), and Sophora Subprostrata Alkaloid phase(Alkaloid) after MCA-occlusion; sham-operated group(Sham). The right MCA was occluded by A poly-L-lysine coated 4-0 nylon suture thread through the internal carotid artery permanently. Sophora Subprostrata and fractions were administered orally(5mg/ml) for 7 days after MCA-occlusion. The behavior of ischemic rats were examined at 24 hours, 3, 5 and 7 days after MCA-occlusion from the views of 4 different aspects: posture & balance tests(4 subtests), reflex tests(6 subtests), muscle-tone tests(3 subtests), and foot-fault test. The results showed that 1) in muscle tone test, Sophora Subprostrata total phase only increased reduced muscle tone function from 3 to 7 days, 2) in reflex test, Sophora Subprostrata total and Aqueous phase increased fast recovery from 24 hours and 3 days, 3) in posture & balance test, Sophora Subprostrata total and Aqueous phase increased fast recovery from 24 hours, and Sophora Subprostrata BuOH and Alkaloid phase increased posture & balance function from 3 days, but 4) in motor function test, Sophora Subprostrata did not show effective recovery compared with control group. In conclusion, Sophora Subprostrata has protective effects against brain damage at the early stage of focal cerebral ischemia. Sophora Subprostrata total and Aqueous phase produced more pronounced protective effect against focal ischemic brain damage.

• Journal of Genetic Medicine
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• v.18 no.2
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• pp.142-146
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• 2021

Alagille syndrome (AGS) is a rare autosomal dominant inherited disorder, with major clinical manifestations of bile duct paucity, cholestasis, cardiovascular anomaly, ophthalmic abnormalities, butterfly vertebrae, and dysmorphic facial appearance. It is caused by heterozygous mutations in JAG1 or NOTCH of the Notch signaling pathway presenting with variable phenotypic penetrance and involving multiple organ systems. The following case report describes a unique case of a 16-year-old female with AGS who presented with the primary complaint of renovascular hypertension. She had a medical history of ventricular septal defect and polycystic ovary syndrome. The patient had a dysmorphic facial appearance including frontal bossing, bulbous tip of the nose, a pointed chin with prognathism, and deeply set eyes with mild hypertelorism. Stenoocclusive changes of both renal arteries, celiac artery, lower part of the abdominal aorta, and left intracranial artery, along with absence of the left internal carotid artery were found on examination. Whole exome sequencing was performed and revealed a pathologic mutation of JAG1, leading to the diagnosis of AGS. Reverse phenotyping detected butterfly vertebrae and normal structure and function of the liver and gallbladder. While the representative symptom of AGS in most scenarios is a hepatic problem, in this case, the presenting clinical features were the vascular anomalies. Clinical manifestations of AGS are diverse, and this case demonstrates that renovascular hypertension might be in some cases a presenting symptom of AGS.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.215-223
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• 2022

Objective : This retrospective study investigated the clinical and angiographic characteristics of ruptured true posterior communicating artery (PCoA) aneurysms in comparison with junctional PCoA aneurysms presenting with a subarachnoid hemorrhage. Methods : The medical records and radiological data of 93 consecutive patients who underwent three-dimensional rotational angiography and surgical or endovascular treatment for a ruptured junctional or true PCoA aneurysm over an 8-year period were examined. Results : The maximum diameter of the ruptured true PCoA aneurysm (n=13, 14.0%) was significantly smaller than that of the ruptured junctional PCoA aneurysms (n=80, 4.45±1.44 vs. 7.68±3.36 mm, p=0.001). In particular, the incidence of very small aneurysms <4 mm was 46.2% (six of 13 patients) in the ruptured true PCoA aneurysm group, yet only 2.5% (two of 80 patients) in the ruptured junctional PCoA aneurysm group. Meanwhile, the diameter of the PCoA was significantly larger in the true PCoA aneurysm group than that in the junctional PCoA aneurysm group (1.90±0.57 vs. 1.15±0.49 mm, p<0.001). In addition, the ipsilateral PCoA/P1 ratio was significantly larger in the true PCoA aneurysm group than that in the group of a junctional PCoA aneurysm (mean PCoA/P1 ratio±standard deviation, 2.67±1.22 vs. 1.14±0.88; p<0.001). No between-group difference was identified for the modified Fisher grade, clinical grade at admission, and 3-month modified Rankin Scale score. Conclusion : A true PCoA aneurysm was found to be associated with a larger PCoA and ruptured at a smaller diameter than a junctional PCoA aneurysm. In particular, the incidence of a ruptured aneurysm with a very small diameter <4 mm was significantly higher among the patients with a true PCoA aneurysm.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.4
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• pp.468-472
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• 2023

Bilateral posterior communicating (pComm) artery aneurysms represent only 2% of mirror intracranial aneurysms. Usually, these are surgically approached through bilateral craniotomies for clipping. We present the case of a 50-year-old female presenting with headache and horizontal diplopia. Neurological examination revealed a left oculomotor palsy, with no other neurological deficits. Imaging studies revealed bilateral aneurysmatic lesions in both internal carotid arteries (ICA). A conventional left pterional approach was planned in order to treat the symptomatic aneurysm, and, if deemed feasible, a contralateral clipping through the same approach. The procedure was performed in a hybrid operating room (HOR), performing an intraoperative digital subtraction angiography (DSA) and roadmapping assistance during dissection and clipping. Transoperatively, a post-fixed optic chiasm was identified, with a wide interoptic space, which allowed us to perform the contralateral clipping through a unilateral approach. This technique for clipping bilateral pComm aneurysms can be performed when the proper anatomical features are met.

• Journal of Korean Neurosurgical Society
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• v.30 no.12
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• pp.1361-1368
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• 2001

Objective : "Paraclinoid" aneurysms include those aneurysms arising from the internal carotid artery between the site of emergence of the carotid artery from the roof of the cavernous sinus and the origin of the posterior communicating artery. The authors reviewed and analysed the results of surgical approaches to paraclinoid aneurysms treated with transcranial surgery and endovascular surgery. Methods : Between January 1998 and May 1999, 14 patients were treated surgically through ipsilateral and contralateral pterional approaches, and anterior interhemispheric approach, and endovascular surgery for paraclinoid aneurysms. All transcranial approaches were performed by same surgeon. The medical records, neuroimaging studies and videotapes which had been recorded operations were reviewed retrospectively. Results : Twelve patients presented with subarachnoid hemorrhage and ICH. Nine of fourteen patients had multiple aneurysms. Thirteen cases were small and one was a large aneurysm. Six patients were treated through ipsilateral approaches, six contralateral pterional approaches, one anterior interhemispheric approach and one primarily by GDC embolization. All aneurysms treated through contralateral approaches were multiple aneurysms. Neck clipping was performed in 9(69.2%) of the thirteen aneurysms, wrapping in four cases, among them three cases were followed by GDC embolization. The surgical outcomes were : Glasgow Outcome Scale(GOS) I 71.4%, GOS II 21.4% and GOS V 7.1%. Conclusion : The surgical approaches to paraclinoid aneurysms should be chosen after careful anatomical evaluation of aneurysm and its neighboring structures. 3D-CT angiography and/or the raw data of MR angiography were useful. This study supports the usefulness of the contralateral approach to paraclinoid aneurysm associated with multiple aneurysms, unruptured and small aneurysms whose dome projecting medially, superiorly and dorsally. The determination of contralateral approach to small and medially projecting paraclinoid aneurysm may be stressful to operator, thus we believe anterior interhemispheric approach is better alternated. Also we recommend the endovascular surgery after reinforcement of aneurym neck and dome in the case with difficulty in clipping.

• Bulletin of the Korean Chemical Society
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• v.34 no.6
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• pp.1663-1667
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• 2013

Neointimal hyperplasia causes vascular access dysfunction in hemodialysis patients with synthetic arteriovenous (AV) grafts. Several studies have reported that paclitaxel- or sirolimus-eluting AV grafts inhibit neointimal hyperplasia and display lower rates of stenosis compared with control grafts. However, there have been few comparative studies of the efficacy of paclitaxel- and sirolimus-eluting grafts. We compared the neointimal hyperplasia of paclitaxel- and sirolimus-eluting grafts. AV grafts were implanted laterally between the common carotid artery and the external jugular vein in 12 female Landrace pigs. The animals were sacrificed six weeks after surgery. The neointimal hyperplasia at the anastomosis sites of the grafts was quantified using the ratio of the intragraft hyperplasia to the graft area (H/G ratio) at the graft-vessel interface. The area of intimal hyperplasia at the venous (paclitaxel 1.06 [0.72-1.56] vs sirolimus 2.40 [1.72-3.0] $mm^2$, P = 0.04) and arterial anastomosis sites (paclitaxel 0.93 [0.57-1.48] vs sirolimus 2.40 [1.72-3.0] $mm^2$, P = 0.04) was significantly different between the two groups. However, the H/G ratios for the venous anastomosis site (paclitaxel 0.25 (0.17-0.38) vs sirolimus 0.38 (0.2-0.66), P = 0.4) and the arterial anastomosis site (paclitaxel 0.19 (0.08-0.39) vs sirolimus 0.41 (0.34-0.50), P = 0.1) did not differ significantly between the groups. In conclusion, there was no significant difference in the inhibition of neointimal hyperplasia by sirolimus- and paclitaxel-eluting AV grafts.

• The Journal of Korean Physical Therapy
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• v.12 no.3
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• pp.349-359
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• 2000

The aim of study was to evaluated the possible role of cranial artery velocity in headache pathogenesis. The present study was studied of five headache(F=5. Mean $age=29.80\pm6.76yrs$) were compared to 4 controls(F=4, Mean $age=29.00\pm5.48yrs$). Transcranial doppler ultrasonography(TCD) is a new non-invasive and easily applicable method to evaluate flow velocities of the intracranial and extracranial cerebral arteries. TCD was performed with standard method to measure the mean Flow Velocity(MFV) of the middle and posterior cerebral arteries, the internal carotid artery, the vertebral and the basilar artery. We reviewed the whole TCD results performed at Taejon Veterans Hospital from October. 11. 2000 to November. 10. 2000. Mean flow velocities in headaches and controls at their 6 decades are $28.00\pm3.61cm/sec$ and $41.25pm1.71cm/sec$ in lent PCA (P<0.01), $50,000\pm23.07cm/sec$ and $82.75\pm15.59cm/sec$ in right MCA(P<0.05), $26.20\pm4.82cm/sec$ and $45.50\pm4.51cm/sec$ in fight PCA(P<0.01). $26.60\pm4.56cm/sec$ and $38.25\pm4.92cm/sec$ in right VAC(P<0.01). After treatment for 2 weeks, mean of velocity on pre treatment and post treatment and post treatment are $28.00\pm3.61cm/sec$ and $38.20\pm5.81cm/sec$ in left PCA (P<0.05), $26.20\pm4.827cm/sec$ and $39.20\pm5.54cm/sec$ in right PCA(P<0.05), $40.60\pm9.18cm/sec$ in right VA(P<0.01). It is concluded that Electrical Therapy for two weeks was effected to promote Mean Flow of Velocity in cranial artery. Mean of velocity in cranial artery with headaches observed in this study was lower than controls, but MFV was promote after treatment for 2 weeks.

• The Journal of Korean Medicine
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• v.27 no.2 s.66
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• pp.1-13
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• 2006

Objectives : Ischemic brain injury is a worldwide problem that often causes irreversible brain damage. Moreover, prevention of ischemic brain injury is more important than anything else, since after-effects of stroke significantly threat the quality of life. Jukryukjichul-hwan (JRH) is an oriental medicinal formula for stroke patients in Korea. This study evaluated neuroprotective effects of methanol extract of JRH on global cerebral ischemia in rats. Changes of the pyramidal neurons, Bax and TUNEL immuno-positive neurons in CA1 hippocampus were observed using immunohistochemistry. Methods : Sprague-Dawley Rats were induced with temporal global cerebral ischemia (TGI) by occluding the bilateral common carotid artery with hypotension, The rats were divided into 3 groups. We treated one group with methanol extract of JRH after operation, another group before and after the operation. We observed Bax expressions inducing apoptosis of neurons and TUNEL-positive Pyramidal Neurons as an index of survival and apoptosis of pyramidal neurons in CA1 Hippocampus. Results : JRH treatment before and after TGI inhibited Bax expression in CA1 hippocampus. JRH treatment before and after TGI reduced the cell death of pyramidal neurons in CA1 hippocampus. JRH treatment after TGI reduced the cell death of pyramidal neurons in CA1 hippocampus. JRH treatment before and after TGI reduced TUNEL-positive cells in CA1 hippocampus. Conclusion : These results suggest that JRH has a neuroprotective effect (by anti-apoptosis) against cerebral ischemia.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.3
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• pp.666-671
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• 2008

This study was undertaken to define the effect of ChungGongGo extract on norepinephrine-induced arterial contraction in rabbit. In order to investigate the effect of ChungGongGo extract on rabbit's contracted vascular ring detached from common carotid artery, vascular ring with intact or damaged endothelium was used for the experiment using organ bath. To analyze the mechanism of ChungGongGo extract-induced relaxation, ChungGongGo extract was infused into contracted vascular ring which had been pretreated by $N{\omega}$-nitro-L-arginine(L-NNA), Methylene blue(MB), and $Ca^{2+}$ was infused into contracted vascular ring induced by NE or KCl after treatment of ChungGongGo in $Ca^{2+}$-free solution. The results were as follows: ChungGongGo extract had an effective relaxation to the contracted vascular ring by NE in 1.0mg/ml and 0mg/ml level. ChungGongGo extract had an effective relaxation to the intact endothelium vascular ring, but when endothelium was removed, vascular ring did not relax. ChungGongGo extract-induced relaxation was inhibited by the pretreatment of L-NNA and MB. Pretreatment of ChungGongGo extract inhibit the contraction by influx of extra-$Ca^{2+}$ in contracted vascular ring induced by NE in $Ca^{2+}$-free solution. As mentioned above, we suggest that ChungGongGo relaxes vascular ring through suppress influx of extra-cellular $Ca^{2+}$ by the action of nitric oxide from endothelium.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.53-56
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• 2008

Objectives：The purpose of this study was to evaluate the variable sonographic features in addition to classic findings and to find the helpful characteristic findings for diagnosis of branchial cleft cysts. Subjects and Methods：We retrospectively analyzed the sonographic finding of 16 histopathologically proven branchial cleft cysts. Assessment involved the following variables : location related to carotid artery, size, cyst wall, border, margin, shape, internal echotexture, post echoic enhancement, orientation of longitudinal axis relative to the long axis of the neck, and tapering edge. Results：Most branchial cleft cysts were seen as well defined(15/16), oval shape(13/16), smooth inner (12/16) and outer margin(13/16), and post echoic enhancement(16/16). Their diameter varied from 1 to 6cm (mean 3.3cm). The branchial cleft cysts showed variable internal echopatterns；hyperechogenicity or pseudosolid appearance(1/16), heterogeneous echogenicity(4/16) in addition to classic form of anechoic(5/16) or hypoechoic internal echogenicity(6/16). Longitudinal axis of most branchial cleft cysts were arranged in the direction of the long axis of the neck(13/16) and some branchial cleft cysts had tapering edge(6/16). Conclusion：If both atypical sonographic findings and location are showed, longitudinal arrangement of long axis and tapering edge of branchial cleft cysts are helpful findings for differential diagnosis.