• The Journal of Internal Korean Medicine
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• v.35 no.1
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• pp.24-36
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• 2014

Objectives : This study was performed to evaluate the effects of moxibustion on cerebral blood flow, peripheral blood flow and blood pressure. Methods : We designed a randomized, cross-over study that included 20 healthy, male volunteers who were randomly assigned to one of two groups (the moxibustion group or the control group). The initial trial was followed by a washout period of one week before the groups were switched and the trial repeated. The cerebral blood flow and peripheral blood flow of the volunteers in both groups were measured by mean velocity (Vm), peak systolic velocity (Vs), pulsatility index (PI), perfusion units (PU) and mean blood pressure (BP) before the intervention (baseline), 30 minutes after the intervention, and again 60 minutes after the intervention. Results : 1. The Vm increased significantly in the moxibustion group. The Vs also constantly increased in moxibustion group, but there was no significant difference. 2. The PI decreased significantly in the control group at 0-30 minutes and in the moxibustion group at 30-60 minutes. 3. The PU constantly decreased in moxibustion group. In control group, the PU decreased at 30 minutes and increased slightly at 60 minutes. 4. The mean blood pressure did not show any significant difference between the two groups. Conclusions : This study shows that moxibustion at CV12 increased the cerebral blood flow. Based on this result, we can suggest that moxibustion at CV12 might be helpful in improving the functional recovery of stroke patients. However, further research needs to be conducted on a larger numbers of subjects in order to confirm these effects.

• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.250-261
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• 2007

Objectives : The purpose of this study was to evaluate the blood flow using doppler ultrasound of the MCA, ACA, PCA, BA, ICA in the patients with risk factor for stroke. Methods : 110 patients with risk factor for stroke were selected who had hypertension, diabetes mellitus, hyperlipidemia, or heart disease, as well as 89 healthy adults who did not have any symptoms of those diseases. To evaluate the blood flow, the Vs and Vm of the MCA, ACA, PCA, BA, and ICA in the two groups were measured. Result : In normal healthy adults, subjects showed a decrease in the Vs and Vm: with advancing in age, there was a significant difference in the Vs of MCA, PCA, BA, and ICA. There was a significant difference in the Vm of MCA, PCA, BA, and ICA. In normal healthy adults, females showed high velocities in all examined vessels. There was a significant difference in the Vs of BA. There was a significant difference in the Vm of BA, and ICA. There was a decrease in the Vs, and Vm of all examined vessels of patients with risk factors for stroke in comparison with normal healthy adults. There was no significant difference in the Vs. There was a significant difference in the Vm of MCA, ACA, and PCA. Results were the same between patients aged under 50 and total patients in the Vs and Vm of examined vessels. There were differences between patients aged over 50 and total patients in the Vs of MCA, PCA, BA and for patients aged over 50; patients with risk factor for stroke who had hypertension, diabetes mellitus, hyperlipidemia, or heat disease has higher Vs than healthy adults. Conclusions : There was a significant difference in the blood flow velocity between patients with risk factors for stroke and healthy adults. However, this result was different from results of comparison of TCD findings between patients and healthy individuals by age. Therefore, more detailed studies about aged patients are needed.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.1-9
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• 1999

Since Hans Berger reported the first paper on the human electroencephalogram in 1920s, huge technological advance have made it possible to use a number of electrophysiological approaches to neurological diagnosis in clinical neurology. In majority of the neurology training hospitals they have facilities of electroencephalography(EEG), electromyography(EMG), evoked potentials(EP), polysomnography(PSG), electronystagmography(ENG) and, transcranial doppler(TCD) ete. Clinicials and electrophysiologists should understand the technologic characteristics and general applications of each electrophysiological studies to get useful informations with using them in clinics. It is generally agreed that items of these tests are selected under the clinical examination, the tests are performed by the experts, and the test results are interpretated under the clinical background. Otherwise these tests are sometimes useless and lead clinicians to misunderstand the lesion site, the nature of disease, or the disease course. In this sense the clinical utility of neurophysiological tests could be summerized in the followings. First, the abnormal functioning of the nervous system and its environments can be demonstrated when the history and neurological examinations are equivocal. Second, the presence of clinically unsuspected malfunction in the nervous system can be revealed by those tests. Finally the objective changes can be monitored over time in the patient's status. Also intraoperative monitoring technique becomes one of the important procedures when the major operations in the posterior fossa or in the spinal cord are performed. In 1996, the Korean Society for Clinical Neurophysiology(KSCN) was founded with the hope that it will provide the members with the comfortable place for discussing their clinical and academic experience, exchanging new informations, and learning new techniques of the neurophysiological tests. The KSCN could collaborate with the International Federation of Clinical Neurophysiology(IFCN) to improve the level of the clinical neurophysiologic field in Korea as will as in Asian region.1 In this paper the clinical neurophysiological tests which are commonly used in clinical neurology and which will be delt with and educated by the KSCN in the future will be discussed briefly in order of EEG, EMG, EP, PSG, TCD, ENG, and Intraoperative monitoring.

• Journal of Oriental Neuropsychiatry
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• v.18 no.1
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• pp.143-151
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• 2007

Objective : This study was performed to evaluate the effects of Hap-Kok(LI4) and Jok-Sam-Lee(ST36) acupuncture on blood flow in In-Young(ST9). Method : Monitoring of TCD was examined in each 25's healthy men and wemen in 20s before and after acupucture on both(right and left) Hap-kok(LI4) and was done on both(right and left) Jok-Sam-Lee(ST36) by different group with same condition. Mean velocity and Pulsatility index analyzed from TCD at both In-Young(ST9). Both group was acupuctured for 15-20 minutes laying at bed. Results : The results showed a significant($p{\le}0.05:$ Paired T-test) decrease in mean velocity and increase in pulsatility index at both group. Conclusion : These results suggest that acupuncture could have a specific effect on blood flow called In-Young acupoint.

• The Journal of Korean Physical Therapy
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• v.17 no.2
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• pp.126-147
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• 2005

TCD(transcranial doppler, TCD) units is a equipment that measure a blood flow velocity in the middle cerebral artery(MCA), anterior cerebral artery(ACA), posterior cerebral artery(PCA), and vertebral artery(VA). The aim of this study was to determine the influence on cerebral blood flow velocity according to different stimulation frequency of interferential currents. 50 patients who has a cervical pain were participated in this study and randomly divided into one of the three experimental, placebo, and control group: (1)IFS 1; $10{\sim}30Hz$ was applied, (2)IFS 2; $30{\sim}50Hz$ was applied, (3)IFS 3; $50{\sim}100Hz$ was applied, (4)placebo; suction only applied, and (5)control; neither suction nor interferential stimulation applied. In the IFS groups, interferential stimulations were applied through four suction electrodes application from the 5th cervical to the 1st thoracic level. The results were as follow; 1. MCA was statistically significant with IFS 1, IFS 2, IFS 3, and Placebo group(p<0.05), But there was no statistical significance between IFS 1 and IFS 3 group(p>0.05). 2. ACA was statistically significant with IFS 1, IFS 2, and IFS 3 group(p<0.05). And IFS 1 was more statistical significance than IFS 3 group on ACA(p<0.05). 3. PCA was statistically significant with IFS 1, IFS 2, and IFS 3 group(p<0.05). And IFS 1 was more statistical significance than IFS 3 group on PCA(p<0.05). 4. VA was statistically significant with IFS 1, IFS 2, and IFS 3 group(p<0.05). And IFS 1 was more statistical significance than IFS 3 group on VA(p<0.05).

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.172-178
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• 2012

Objective : The aim of this study was to determine the role of intra-arterial (IA) nimodipine injections for cerebral vasospasm secondary to ruptured subarachnoid hemorrhage (SAH) and to investigate the factors that influence vasodilation and clinical outcomes. Methods : We enrolled 29 patients who underwent aneurysm clipping for ruptured cerebral aneurysms between 2009 and 2011, and who received IA nimodipine after subsequently presenting with symptomatic vasospasm. The degree of vasodilation shown in angiography was measured, and the correlation between the degree of vasodilation and both the interval from SAH to cerebral vasospasm and the interval from clipping to cerebral vasospasm was determined. The change in blood flow rate after IA injection was assessed by transcranial Doppler ultrasound. Multiple clinical parameters were completed before and after IA nimodipine injection to evaluate any improvements in clinical symptoms. Results : For eight patients, Glasgow Coma Scale (GCS) scores increased by two or more points. The regression analysis demonstrated a positive correlation between the change in GCS scores after IA nimodipine injection and the change in blood vessel diameter (p=0.025). A positive correlation was also observed between the interval from SAH to vasospasm and the change in diameter (p=0.040); and the interval from clipping to vasospasm and the change in diameter (p=0.022). Conclusion : IA nimodipine injection for SAH-induced vasospasm led to significant vasodilation in angiography and improvement in clinical symptoms without significant complications. Our findings suggest that IA nimodipine injection should be utilized when intractable vasospasm develops despite rigorous conservative management.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.159-163
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• 2013

Objective : Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid endarterectomy (CEA). However, the prevalence of CHS has decreased as techniques have improved. This study evaluates the role of strict blood pressure (BP) control for the prevention of CHS. Methods : All 18 patients who received CEA from February 2009 through November 2012 were retrospectively reviewed. All patients were routinely managed in an intensive care unit by a same protocol. The cerebral perfusion state was evaluated on the basis of the regional cerebral blood flow (rCBF) study by perfusion computed tomography (pCT) and mean velocity by transcranial doppler (TCD). BP was strictly controlled (<140/90 mm Hg) for 7 days. When either post-CEA hyperperfusion (>100% increase in the rCBF by pCT or in the mean velocity by TCD compared with preoperative values) or CHS was detected, BP was maintained below 120/80 mm Hg. Results : TCD and pCT data on the patients were analyzed. Ipsilateral rCBF was significantly increased after CEA in the pCT (p=0.049). Post-CEA hyperperfusion was observed in 3 patients (18.7%) in the pCT and 2 patients (12.5%) in the TCD study. No patients developed clinical CHS for one month after CEA. Furthermore, no patients developed additional neurological deficits related to postoperative cerebrovascular complications. Conclusion : Intensive care with strict BP control (<140/90 mm Hg) achieved a low prevalence of post-CEA hyperperfusion and prevented CHS. This study suggests that intensive care with strict BP control can prevent the prevalence of post-CEA CHS.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.235-240
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• 2013

Fusiform aneurysms on the basilar artery (BA) trunk are rare. The microsurgical management of these aneurysms is difficult because of their deep location, dense collection of vital cranial nerves, and perforating arteries to the brain stem. Endovascular treatment is relatively easier and safer compared with microsurgical treatment. Selective occlusion of the aneurysmal sac with preservation of the parent artery is the endovascular treatment of choice. But, some cases, particularly giant or fusiform aneurysms, are unsuitable for selective sac occlusion. Therefore, endovascular coiling of the aneurysm with parent vessel occlusion is an alternative treatment option. In this situation, it is important to determine whether a patient can tolerate parent vessel occlusion without developing neurological deficits. We report a rare case of fusiform aneurysms in the BA trunk. An 18-year-old female suffered a headache for 2 weeks. Computed tomography and magnetic resonance image revealed a fusiform aneurysm of the lower basilar artery trunk. Digital subtraction angiography revealed a $7.1{\times}11.0$ mm-sized fusiform aneurysm located between vertebrovasilar junction and the anterior inferior cerebellar arteries. We had good clinical result using endovascular coiling of unruptured fusiform aneurysm on the lower BA trunk with parent vessel occlusion after confirming the tolerance of the patient by balloon test occlusion with induced hypotension and accompanied by neurophysiologic monitoring, transcranial Doppler and single photon emission computed tomography. In this study, we discuss the importance of preoperative meticulous studies for avoidance of delayed neurological deficit in the patient with fusiform aneurysm on lower basilar trunk.

• Journal of Oriental Neuropsychiatry
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• v.20 no.1
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• pp.199-214
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• 2009

Objectives : This study was performed to change of blood flow in In-Young(ST9) after treatment on chronic daily headache patients. Methods : Monitoring of TCD was examined in 10' s chronic daily headache patients before and after treatment. Mean velocity flow, systolic velocity and pulsatility index were analyzed from TCD at In-Young(ST9). The patients was laid for 20 minutes before treatment and also for treatment. Results : The results showed a significant(p<0.05: Paired T-test) decrease in mean velocity flow and systolic velocity. but there were no significant differences in pulsatility index. Conclusions : These results suggest that there were significant change on blood flow in In-young of chronic daily headache patients.

• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.118-121
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• 2015

Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.