• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.15-21
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• 1995

To evaluate availability of cerebral radionuclide imaging for diagnosis of brain death, we examined 25 patients with a suspected clinical diagnosis of brain death. 8 patients were studied by $^{99m}Tc$ DTPA and 15 patients were studied by $^{99m}Tc$ HMPAO (Hexamethyl propyleneamine oxime). Seven patients with $^{99m}Tc$ DTPA studies revealed absence of cerebral blood flow and sagittal sinus activity. All of 15 patients with $^{99m}Tc$ HMPAO studies revealed complete absence of cerebral perfusion. The results of the cerebral radionuclide studies of brain death correlated with other clinical conditions, such as intracranial pressure(ICP), EEG, transcranial doppler sonography(TCDS), and neurologic examination. The ICP of 8 patients, who are confirmed by brain death with $^{99m}Tc$ HMPAO study are elevated in all cases. In conclusion, cerebral radionuclide imaging for diagnosis of brain death is available. $^{99m}Tc$ HMPAO imaging is unequivocal, easily interpreted, well reflect the physiologic state of increased ICP, and provides adequate assessment of posterior fossa activity. In addition, the SPECT imaging with $^{99m}Tc$ HMPAO produces more accurate results due to it's superiority of image contrast and proper localization of radiopharmaceutical distribution than conventional planar imaging.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.582-595
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• 2022

Objectives: To investigate the effects of acupuncture at GV20 and EX-HN1 on cerebral blood flow (CBF) velocity and cerebrovascular reactivity (CVR) in the middle cerebral arteries (MCA) and anterior cerebral arteries (ACA) and to compare the effects to acupuncture at GV20. Methods: The study was a randomized, crossover trial that included 10 healthy men aged 20 to 29 years who underwent acupuncture treatment four times with a washout period of one week. The CBF velocity and CVR were measured by transcranial Doppler sonography (TCD) on both MCAs at the first and second visits, and both ACAs at the third and fourth visits. Participants were randomly assigned to one of two groups (A and B) before the first and third visits. Group A received two phases of acupuncture intervention at a single GV20 point and a combination of GV20 and EX-HN1 acupoints. Group B received the same interventions, but in the reverse order. Results: The increase in CO₂ reactivity was significantly higher for the combination acupoints of GV20 and EX-HN1 than for the GV20 single acupoint in both MCAs (Right: 136 to 178, p=0.017; Left: 127 to 191, p=0.017) and ACAs (Right: 133 to 158, p=0.013; Left: 122 to 168, p=0.025). No significant change was noted in the corrected velocity at PETCO₂ 40 mmHg, blood pressure, or heart rate. Conclusions: The findings suggest that improvement of the CBF in the MCA and ACA after GV20 acupuncture increases when acupuncture is also performed at EX-HN1. These results clinically support the combined use of EX-HN1 and GV20 to treat disorders of MCA and ACA circulation.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.941-947
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• 2000

Background: Central nervous system complication after coronary artery bypass grafting(CABG) is one of the major prognostic determinants and the use of the cardiopulmonary bypass(CPB) may increase the incidence of this devastating complication. In this study, the outcomes after off-pump CABG were studied and compared with those following the conventional CABG using CPB. Material and Method: Among the consecutive isolated CABG's performed in SNUH during Feb. 1995 and Jun. 1999, 338 coronary artery bypass grafting were divided into two groups. 223 patients underwent CABG using the CPB(Group I), and 115 patients underwent CABG without CPB(OPCAB)(Group II). All patients enrolled in this study received extensive preoperative examinations including thorough neurologic examination before and after surgery, transcranial doppler study, carotid duplex ultrasonography, and magnetic resonance angiography if necessary. Central nervous system(CNS) complications were defined as stroke, seizure, metabolic or hypoxic encephalopathy and transient delirium after surgery. Result: There were 61 cases(27.3%) who developed postoperative CNS complication in Group I, whereas 8 cases(7.0%) of CNS complications developed postoperatively in group II(p<0.05). Statistically significant predictors of postoperative CNS complications in group I were age and the use of cardiac assist devices perioperatively. Conclusion: This study suggested that omitting the use of CPB in CABG resulted in significant decrease of the postoperative CNS complications. OPCAB should be more widely applied especially to the elderly who have preexisting cerebrovascular disease.