• Molecules and Cells
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• v.40 no.11
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• pp.837-846
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• 2017

As a component of the neurovascular unit, cerebral smooth muscle cells (CSMCs) are an important mediator in the development of cerebral vascular diseases such as stroke. Epoxyeicosatrienoic acids (EETs) are the products of arachidonic acid catalyzed by cytochrome P450 epoxygenase. EETs are shown to exert neuroprotective effects. In this article, the role of EET in the growth and apoptosis of CSMCs and the underlying mechanisms under oxygen glucose deprivation (OGD) conditions were addressed. The viability of CMSCs was decreased significantly in the OGD group, while different subtypes of EETs, especially 14,15-EET, could increase the viability of CSMCs under OGD conditions. RAPA (serine/threonine kinase Mammalian Target of Rapamycin), a specific mTOR inhibitor, could elevate the level of oxygen free radicals in CSMCs as well as the anti-apoptotic effects of 14,15-EET under OGD conditions. However, SP600125, a specific JNK (c-Jun N-terminal protein kinase) pathway inhibitor, could attenuate oxygen free radicals levels in CSMCs as well as the anti-apoptotic effects of 14,15-EET under OGD conditions. These results strongly suggest that EETs exert protective functions during the growth and apoptosis of CSMCs, via the JNK/c-Jun and mTOR signaling pathways in vitro. We are the first to disclose the beneficial roles and underlying mechanism of 14,15-EET in CSMC under OGD conditions.

• Archives of Reconstructive Microsurgery
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• v.1 no.1
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• pp.9-16
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• 1992

Volkmann's ischemic contracture is the end result of an untreated, delayed or Inadequately decompressed compartment syndrome in which muscle ischemia and necrosis have occurred. Once the muscle necrosis have happened, the involved muscle undergo permanent change into fibrous tissue. So secondary shortening and distal joint contracture will be a final outcome, which results in marked functional impairment of hand and forearm. Even though several procedures, such as muscle sliding operation has been attempted, overall results were far from satisfaction, compare to healthy opposite hand. The management of these unfavorable condition of the forearm and hand was regarded as one of challenging area in orthopedics. Recently new approach, using microsurgical technique which transfers functioning muscle unit, has been developed and its result was much better than any other methods in the aspect of an active motion. Among these musculocutaneous free flaps, gracilis has obtained special reputation due to its easiness to handle such as elevation of flap and reliable neurovascular pedicle. Other advantages are flexibility of flap size to adjust variable size of the defect in the forearm and minor morbidity of the donor site. Authors have performed 7 cases of functioning gracilis musulocutaneous free flap transplantation for the functional loss of forearm and hand due to Volkmann's ischemic contracture or muscle and skin defect due to severe trauma since November, 1981 till May, 1991. The results in most cases were satisfactory and acceptable.

• Journal of Korean Neurosurgical Society
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• v.61 no.4
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• pp.478-484
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• 2018

Objective : Cerebrovascular disease (CVD) was the third most common cause of death in South Korea in 2014. Evidence from abroad suggests that comprehensive stroke centers play an important role in improving the mortality rate of stroke. However, surgical treatment for CVD is currently slightly neglected by national policy, and there is still regional imbalance in this regard. For this reason, we conducted a survey on the necessity of, and the requirements for, establishing regional comprehensive cerebrovascular surgery centers (CCVSCs). Methods : This investigation was performed using the questionnaire survey method. The questionnaire was consisted with two sections. The first concerned the respondent's opinion regarding the current status of demand and the regional imbalance of cerebrovascular surgery in South Korea. The second section asked about the requirements for establishing regional CCVSCs. We sent the questionnaire to 100 board members of the Korean Society of Cerebrovascular Surgeons. Results : Most experts agreed that cerebrovascular surgery patients were concentrated in large hospitals in the capital area, and 83.6% of respondents agreed that it was necessary to alleviate the regional imbalance of cerebrovascular surgery. With regards to personnel, over 90% of respondents answered that at least two neuro-vascular surgeons and two neuro-interventionists are necessary to establish a CCVSC. Regarding facilities, almost all respondents stated that each CCVSC would require a neuro-intensive care unit and hybrid operating room. The survey asked the respondents about 13 specific neurovascular surgical procedures and whether they were necessary for a regional CCVSC. In the questions about the necessity of cerebrovascular surgical equipment, all seven pieces of equipment were considered essential by all respondents. A further five pieces of equipment were considered necessary on site: computed tomographic angiography, magnetic resonance angiography, conventional angiography, surgical microscope, and surgical navigation. Our results may provide a basis for future policy regarding treatment of cerebrovascular disease, including surgery. Conclusion : Raising the comprehensiveness of treatment at a regional level would lower the national disease burden. Policies should be drafted regarding comprehensive treatment including surgery for cerebrovascular disease, and related support plans should be implemented.