• Korean Circulation Journal
• /
• v.53 no.8
• /
• pp.566-577
• /
• 2023

Background and Objectives: The left atrial appendage (LAA) can contribute significantly to LA mechanical contraction. Nevertheless, the preventive effect of LAA occlusion during the maze procedure against cerebral infarction remains controversial. In this study, we compared the surgical, cardiac hemodynamic, and neurologic outcomes between LAA preservation and occlusion performed during the maze procedure. Methods: Between January 2015 and August 2021, 252 patients underwent the maze procedure using cryoablation at our medical center. After excluding patients according to our exclusion criteria (i.e., mechanical prosthesis implantation, preexisting LAA thrombus), LAA was preserved in 113 patients (non-occlusion group) and occluded in 75 patients (occlusion group). Outcomes were compared using propensity score matching (PSM). Results: PSM did not reveal significant intergroup differences in baseline characteristics between the non-occlusion (n=53) and occlusion (n=53) groups. During a median follow-up of 44 months, 2 patients in the non-occlusion group (3.8%) experienced ischemic strokes. There was no significant difference in the rate of freedom from stroke (p=0.19) and major adverse cardiac events (p=0.43) between the 2 groups. Through echocardiography at 1-year follow-up, a statistically significant difference in LA mechanical contraction was observed between the non-occlusion group and occlusion group (24 of 33 [72.7%] vs. 18 of 37 [48.6%], respectively; p=0.04). Conclusions: In this study, preservation of the LAA during the maze procedure resulted in better LA function than LAA occlusion, with similar rates of stroke.

• Journal of Korean Neurosurgical Society
• /
• v.50 no.6
• /
• pp.497-502
• /
• 2011

Objective : This study was conducted to compare the effect of etomidate with that of thiopental on brain protection during temporary vessel occlusion, which was measured by burst suppression rate (BSR) with the Bispectral Index (BIS) monitor. Methods : Temporary parent artery occlusion was performed in forty one patients during cerebral aneurysm surgery. They were randomly assigned to one of two groups. General anesthesia was induced and maintained with 1.5-2.5 vol% sevoflurane and 50% $N_2O$. The pharmacological burst suppression (BS) was induced by a bolus injection of thiopental (5 mg/kg, group T) or etomidate (0.3 mg/kg, group E) according to randomization prior to surgery. After administration of drugs, the hemodynamic variables, the onset time of BS, the numerical values of BIS and BSR were recorded at every minutes. Results : There were no significant differences of the demographics, the BIS numbers and the hemodynamic variables prior to injection of drugs. The durations of burst suppression in group E ($11.1{\pm}6.8$ min) were not statistically different from that of group T ($11.1{\pm}5.6$ min) and nearly same pattern of burst suppression were shown in both groups. More phenylephrine was required to maintain normal blood pressure in the group T. Conclusion : Thiopental and etomidate have same duration and a similar magnitude of burst suppression with conventional doses during temporary arterial occlusion. These findings suggest that additional administration of either drug is needed to ensure the BS when the temporary occlusion time exceed more than 11 minutes. Etomidate can be a safer substitute for thiopental in aneurysm surgery.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.23 no.2
• /
• pp.186-195
• /
• 2010

Objective : This study was performed to prove the effect of the oriental medical treatments like acupuncture, moxibustion, herbal medicine on macular edema resulted from branch retinal vein occlusion which could lead to terrible result like permanent visual loss at worst. Methods : The patient was treated 62 times, from July 15th, 2009 through May 12th, 2010. We used fundus photography and Dr. Hann's standard test chart for 5m to examinate the patient's eyesight. We used acupuncture, electropuncture, moxibustion and herbal medicine to treat the patient. We considered visual field, scotoma, metamorphopsia and vitreous floater to measure the effect of treatment. Results : After about 10 months of treatment, the eyesight of Rt eye was improved from 0.8 to 0.9, Lt. eye from zero to 0.3. The visual field turbidity were absolutely cleared. The scotomas in Lt. eye were reduced from 5 to 2. The metamorphopsia were improved. The vitreous floaters in Rt. eye were decreased from 5~6 to 1~2. Conclusion : These results show that the oriental medical treatment can be conservative measure to the macular edema resulted from branch retinal vein occlusion.

• Journal of Pharmaceutical Investigation
• /
• v.40 no.6
• /
• pp.373-378
• /
• 2010

In order to develop a topical preparation which has a high occlusive property with skin moisturization, nano-structured lipid carrier (NLC) systems along with solid lipid nanoparticle (SLN) were designed. Various NLC dispersions were successfully formulated with Compritol 888 ATO as a solid lipid, Labrafil M 1944 CS as an oil, and Tween 80 as a surfactant. The increase of oil content (5 to 50%) led to the decrease in the occlusion factor in the order of SLN > NLC-5 > NLC-15 = NLC-30 > NLC-50. Particle size of lipid particulates was in the range of 100 to 160 nm. NLC-based carbogels were prepared by the employment of humectants such as urea, glycerin, and Tinocare GL to carbomer gel. NLC-30 gel formulations containing 4 or 8 % of lipid particles showed improved occlusive effect in vitro, compared to NLC-free gel base. Even though NLC-free gel base revealed comparable occlusion effect by itself, the occlusion factor of 4 % NLC-30 gel was about 2-fold higher than that of NLC-free gel base.

• The Korean Journal of Physiology and Pharmacology
• /
• v.13 no.1
• /
• pp.23-26
• /
• 2009

During operations, neurosurgeons usually perform multiple temporary occlusions of parental artery, possibly resulting in the neuronal damage. It is generally thought that neuronal damage by cerebral ischemia is associated with extracellular concentrations of the excitatory amino acids. In this study, we measured the dynamics of extracellular glutamate release in 11 vessel occlusion(VO) model to compare between single occlusion and repeated transient occlusions within short interval. Changes in cerebral blood flow were monitored by laser-Doppler flowmetry simultaneously with cortical glutamate level measured by amperometric biosensor. From real time monitoring of glutamate release in 11 VO model, the change of extracellular glutamate level in repeated transient occlusion group was smaller than that of single occlusion group, and the onset time of glutamate release in the second ischemic episode of repeated occlusion group was delayed compared to the first ischemic episode which was similar to that of single 10 min ischemic episode. These results suggested that repeated transient occlusion induces less glutamate release from neuronal cell than single occlusion, and the delayed onset time of glutamate release is attributed to endogeneous protective mechanism of ischemic tolerance.

• Journal of Biomedical Engineering Research
• /
• v.22 no.6
• /
• pp.551-557
• /
• 2001

Occlusion of the dural-sac in the lumbar spine was quantitatively analysed using a one motion segment finite element mode developed in this study. Occlusion was quantified by calculating the cross sectional area chance of the dural-sac. In static analysis. less than 2 kN of compressive load could Produced no dural-sac occlusion. whereas 6kN load reduced cross sectional area by 4%, and produced 7.4%, 10.5% occlusion for additional 8 Nm. 10 Nm extension moments. respectively. In creep analysis, 10 Nm extension reduced cross sectional area and volume of the dural-sac by 6.9% and 2.4%, respectively. However. flexion moment could not produce any occlusion. The results suggested that occlusions may result mainly from slackening of ligamentum flavum and disc budging.

• Journal of Korean Neurosurgical Society
• /
• v.62 no.2
• /
• pp.193-200
• /
• 2019

Objective : Endovascular treatment (EVT) outcomes for acute M2 segment of middle cerebral artery occlusion remains unclear because most results are obtained from patients with large artery occlusion in the anterior circulation. The objective of this study was to assess procedural outcomes for acute M2 occlusion and compare outcomes according to thrombus location (M1 vs. M2). Methods : A systematic review was performed for online literature published from January 2004 to December 2016. Primary outcome was successful recanalization rate and symptomatic intracranial hemorrhage (S-ICH) after the procedure. A fixed effect model was used if heterogeneity was less than 50%. Results : Eight articles were included. EVT showed successful recanalization rate of 69.1% (95% confidence interval [CI], 54.9-80.4%) and S-ICH rate of 6.1% (95% CI, 4.5-8.3%). The rates of good clinical outcome at 3 months and mortality were 59.4% (95% CI, 49.9-68.2%) and 14.9% (95% CI, 11.4-19.3%), respectively. According to thrombus location (M1 vs. M2), successful recanalization (odds ratio [OR], 1.539; 95% CI, 0.293-8.092; p=0.610) and S-ICH (OR, 1.313; 95% CI, 0.603-2.861; p=0.493) did not differ significantly. Good clinical outcome was more evident in M2 occlusion after EVT than that in M1 occlusion (OR, 1.639; 95% CI, 1.135-2.368; p=0.008). However, mortality did not differ significantly according to thrombus location (OR, 0.788; 95% CI, 0.486-1.276; p=0.332). Conclusion : EVT seems to be technically feasible for acute M2 occlusion. Direct comparative studies between EVT and medical treatment are needed further to find specific beneficiary group after EVT in patient with M2 occlusion.

• Journal of Pharmacopuncture
• /
• v.14 no.3
• /
• pp.5-17
• /
• 2011

Objectives : Gliosis becomes physical and mechanical barrier to axonal regeneration. Reactive gliosis induced by middle cerebral artery occlusion is involved with up-regulation of CD81 and GFAP (Glial fibrillary acidic protein). The current study is to examine the effect of the Angelica gigas Nakai(intravenous injection. 100 mg/kg twice in a day) on CD81 and GFAP of the rat in the brain after middle cerebral artery occlusion. Methods : Cerebral infarction was induced by middle cerebral artery occlusion. And after intravenous injection of water extract of Angelica gigas Nakai, the size of cerebral infarction was measured. Examination of optical microscope were also used to detect the expression of CD81 and GFAP in the brain of the rat. Results : The following results were obtained : We found that size of cerebral infarcion induced by MCAO (Middle Cerebral Artery Occlusion) in rats were decreased after intravenous injection of Angelica gigas Nakai. We injected the extract of Angelica gigas Nakai to the MCAO in rats, and the optical microscope study showed that Angelica gigas Nakai had effect on protecting the cells of hippocampus. We found that GFAP, CD81 and ERK of the brain in rats with cerebral infarction after MCAO were meaningfully decreased after intravenous injecting Angelica gigas Nakai. We found that c-Fos expression of the brain in rats with cerebral infarction after MCAO were significantly increased after intravenous injecting Angelica gigas Nakai. Conclusions : These results indicate that Angelica gigas Nakai could suppress the reactive gliosis, which disturbs the astrocyte regeneration in the brain of the rat with cerebral infarction after MCAO by controlling the expression of CD81 and GFAP. And the effect may be modulated by the up-regulation of c-Fos and ERK.

• The korean journal of orthodontics
• /
• v.17 no.1
• /
• pp.23-32
• /
• 1987

There are variations in regional cranial and facial balance as a normal developmental process and regional imbalances often tend to compensate each other to provide functional equilibrium. This study was designed to analyse the patterns of morphologic harmony and inharmony inherent in normal occlusion and malocclusion. The subjects consisted of 92 individuals with normal occlusion and 60 Class III malocclusion patients. Their lateral cephalograms were traced and analysed using the counterpart analysis described by Enlow. The normal occlusion group was divided into Normal Types A and B according to the relative positions of Points A and B. The following conclusions were reached: 1 The normal occlusion consisted of $28.3\%$ of Normal Type A and $69.6\%$ of Normal Type B. 2. The Normal Type A and B differed from each other in the morphology of the cranial base, the mandibular ramus and corpus, and the functional occlusal plane. The Normal Type B showed considerable mandibular protrusion effect in the effective dimension and alignment of the above factors. 3. Most normal individuals showed some degree of disharmony among morphologic factors but the deviations were relatively small. 4. The Normal Type B was less balanced than the Normal Type A. 5. More regional imbalances were involved in Class III malocclusion and the imbalances were more severe.

• Korean Journal of Pharmacognosy
• /
• v.31 no.4
• /
• pp.373-382
• /
• 2000

This study was performed to investigate the antithrombotic activity and protective effect of hexane fraction of Kamihyulbuchukeotang (KHCTH) on brain injury by KCN and MCA occlusion a prescription of HCT added with Lumbricus and Notoginseng Radix. Experiemental parameters are brain ischemia by MCA occlusion assay, KCN-induced brain injury, pulmonary thrombosis and platelet aggregation assay. The results were summarized as follows; 1. KHCTH extracts significantly inhibited the duration of KCN-induced coma (67%) and mortality (80%). 2. KHCTH extracts significantly suppressed brain ischemic area and edema following MCA occlusion and protected neuron cells as compared with control data. 3. KHCTH extracts inhibited pulmonary thrombosis induced by collagen and epinephrine. 4. KHCTH extracts inhibited platelet aggregation induced by collagen, ADP as agonist up to 76.9% and 32.3% respectivey at 1 mg/ml more effective than water extract of KHCT These data suggested that KHCTH could be applied as the protector of brain ischemia and injury and antithrombotic agent.