• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.241-250
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• 2001

Purpose: Vasospasm is a complication of aneurysmal subarachnoid hemorrhage (aSAH). We assessed the role of acetazolamide-enhanced brain perfusion SPECT (ACZ-SPECT) with Tc-99m ECD for predicting the prognosis of patients with aSAH. Materials and methods: Two SPECT studios (baseline with 740 MBq and ACZ-SPECT with 1480 MBq) with image subtraction were performed in 21 patients with aSAH. All patients had brain CT and angiogram. Vasoreactivity on ACZ-SPECT, perfusion defect on baseline SPECT, and vasospasm on angiogram were correlated with Hunt-Hess grading, extent of SAH (unilateral or bilateral) on CT, and clinical outcome. Vasoreactivity was considered decreased when cerebral/cerebellar uptake ratio difference from baseline SPECT to ACZ-SPECT was greater than 2SD of normal control values. Results: Decreased vasoreactivity was observed in 38% (8/21), perfusion defect in 81% (17/21), and vasospasm in 38% (8/21). The preserved vasoreactivity group showed better outcome scale (92%, 12/13) and the decreased vasoreactivity group showed poorer outcome scale (62.5%, 5/8) (p=0.014). Extensive SAH was more frequently seen in the decreased vasoreactlvlty group (87.5%, 7/8) than in the preserved vasoreactivity group (30.7%, 4/13)(p=0.017). The perfusion defect and vasospasm did not show good correlation with outcome scale, extent of SAH, and Hunt-Hess grading (p=ns). Vasoreactivity represented the patient's outcome better than the vasospasm in all of the vasoreactivity/vasospasm-mismatched cases (6 cases). Conclusions: Our data show that decreased vasoreactivity on ACZ-SPECT does not always represent vasospastic condition. But patients with decreased vasoreactivity reveal poorer outcome than patients with angiographic vasospasm do. Therefore ACZ-SPECT is a valuable, noninvasive test for predicting the prognosis of patients with aSAH.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.11 no.1
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• pp.300-318
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• 1998

Background : The vasoreactivity of cerebral artery is currently the subject of increasing interest. Transcranial Doppler Sonography(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral artery. We wished to assess the vasoreactivity between age-matched normal and cerebral infarction group. Method : We performed TCD findings in 40 normals and 20 cb-inf. subjects who arrived at hospital during 48 hours after attack. The former were devided into twenties normal group and fifties normal group. Result : 1. Fibrinogen levels showed significant changes between age-matched normal and cb-inf. group. 2. $V^{MEAN}$ of the both side Carotid Siphon during rest state increased significantly in cb-inf. group as compared with the age-matched normal group. 3. $V^{MEAN}and\;V^{MAX}$ of the both side carotid siphon during breath-hold state increased significantly in cb-inf. group as compared with the age-matched normal group. 4. Vasoreactivity of cerebral artery increased significantly in cb-inf. group as compared with the age-matched normal group. 5. $V^{MEAN}and\;V^{MAX}$ of the both side Radial artery during heat-stimuration state increased significantly in cb-inf. group as compared with the age-matched normal group. 6. Vasoreactivity of Radial artery increased significantly in cb-inf. group as compared with the age-matched normal group.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.11 no.1
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• pp.240-250
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• 1998

Background: Ginkgo biloba extract is used in disorser of cerebral and peripheral blood circulation, dysfunction of brain, atherosclerosis etc., but there are little study about GbE in oriental medicine. We wished to assessthe efficacy of GbE for the treatment of cerebral infarction Method : The study group comprised 40 patients who arrived at hospital during 48 hours after attack. All patient were devided into two group. The control group was treated with Uhuangcheongsimhuan, Seonghyangjeonggisan, acupuncture therapy only, while the GbE group was treated with above therapy plus 5 days of administration of GbE(40mg three times per day). Result: 1. Symptom improve scores did not showed significant difference between control and GbE group. 2. Vasoreactivity of carotid siphon increased significantly in GbE group after treatment (in the left only : p<0.05). 3. Vasorcactivity of radial artery increased significantly in GbE group after treatment(in the right only ; p<0.05). 4. PT, a-PTT, Fibrinogen did not showed significant changes between before and after treatment in both group. Conclusion: These findings suggest that vasoreactivity increasing effect of GbE may be useful in the prevention and treatment of cerebral infarction. But the vasoreactivity increasing effect of GbE may be different from symptom imroving.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.1
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• pp.43-48
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• 2004

Cerebral vasoreactivity is an index of autoregulation of cerebral perfusion, and can be measured using functional images such as Xe CT, SPECT and PET in reponse to hypercapneic stimulus. In order to measure cerebral $CO_2$ vasoreactivity in routine TCD study conveniently and reliably, we devised a method of rebreathing into closed volume of reservoir bag as a hypercapneic stimulus, and applied it to 44 healthy volunteers. As a hypercapneic stimulus, we applied fitting mask connected with closed reservoir bag for about 90 seconds, and mean blood flow velocity(MBFV) and pulsatility index(PI) were evaluated at proximal middle cerebral arteries(MCA) of 50-55 mm depth, before and after the hypercapneic stimulus. Age affected the MFV and PI value showed significant and the MFV was 56.45(SD=9.75)cm/sec, while PI was 0.406(SD=0.089). As age increases the flow velocity decreased significantly whereas PI value increased(P<0.05). The vasoreactvity significantly decreased with age(P<0.05). The decrease of cerebral blood flow quantity and cerebral blood flow velocity is not only because of increase of diameter of cerebrovascular resulting from aging, but the resistance increase of small blood vessel resulting from the increase of PI & RI value is regarded. We suppose that the rebreathing method is a reliable and convenient technique as a hypercapneic stimulus in determining cerebral $CO_2$ vasoreactivity. The rebreathing method could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied to the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.195-202
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• 2010

Purpose : Despite recent advances in pulmonary hypertension management and surgery, appropriate guidelines remain to be developed for operability in congenital heart disease with pulmonary artery hypertension (PAH). Our aim was to evaluate clinical outcomes of patients with severe PAH who underwent surgical closure of left-to-right shunt lesions (LRSL) on the basis of pulmonary reactivity. Methods : We retrospectively reviewed 21 patients who underwent surgical closure of LRSL with severe PAH (${\geq}8$ Wood unit) from January 1995 to April 2009. The median age at operation was 26 years. Atrial septal defect, ventricular septal defect (VSD), VSD and patent ductus arteriosus (PDA), and PDA was present in 11, 4, 4, and 2 patients, respectively. Results : Operability was based on vasoreactivity of PAH. Of the 21 patients, 5 showed response to pulmonary vasodilator therapy and 8 showed vasoreactivity after balloon occlusion of defects. The remaining 8 patients were considered operable because of significant left-to-right shunt (Qp/Qs ${\geq}1.5$). Five patients underwent total closure of defects and 16 were left with small residual shunts. The median follow-up duration was 32 months. There was no significant postoperative mortality or morbidity. Systolic pulmonary artery pressure (PAP) decreased in all but 2 patients. All patients except 1 showed improvement of New York Heart Association functional class. Conclusion : Closure of LRSL in patients with severe PAH on the basis of pulmonary vasoreactivity seems reasonable. PAP and clinical symptoms improved in most patients. Further research is needed for the evaluation of long-term results.

• The Korean Journal of Physiology and Pharmacology
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• v.24 no.1
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• pp.53-68
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• 2020

The purpose of this study was to characterize the genetic contribution to endothelial adaptation to exercise training. Vasoreactivity was assessed in aortas from four inbred mouse strains (129S1, B6, NON, and SJL) after 4 weeks of moderate intensity continuous exercise training (MOD), high intensity interval training (HIT) or in sedentary controls (SED). Intrinsic variations in endothelium-dependent vasorelaxation (EDR) to acetylcholine (ACh) as well as vasocontractile responses were observed across SED groups. For responses to exercise training, there was a significant interaction between mouse strain and training intensity on EDR. Exercise training had no effect on EDR in aortas from 129S1 and B6 mice. In NON, EDR was improved in aortas from MOD and HIT compared with respective SED, accompanied by diminished responses to PE in those groups. Interestingly, EDR was impaired in aorta from SJL HIT compared with SED. The transcriptional activation of endothelial genes was also influenced by the interaction between mouse strain and training intensity. The number of genes altered by HIT was greater than MOD, and there was little overlap between genes altered by HIT and MOD. HIT was associated with gene pathways for inflammatory responses. NON MOD genes showed enrichment for vessel growth pathways. These findings indicate that exercise training has non-uniform effects on endothelial function and transcriptional activation of endothelial genes depending on the interaction between genetic background and training intensity.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.76-79
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• 1999

The most significant factor in pathogenesis of vascular headaches like migraine and cluster headache is dynamic changes of diameters of the cerebral arteries. TCD is a valuable noninvasive tool to assess the cerebral hemodynamic status by measuring the flow velocities of the intracranial cerebral arteries around the circle of Willis. TCD can evaluate flow velocities and vasoreactivity of the patients with a vascular headache during the ictal phase as well as during intericatal phase. Distribution of the changes recorded differ between types of headaches and also between the major ictal symptoms. The changes suggest the presence of prolonged vasospasm interictally and more marked relaxation of the cerebral arteries. TCD can be used to monitor the long-term clinical course of patients with vascular headache by correlation the symptomatic improvement and TCD data before and after long-term pharmacological prophylactic treatments. During the ictal phases large intervention. The results may be used in selecting and evaluating the agents for abortive therapy for acute attacks. In conclusion TCD can quantitatively evaluate vascular headaches when making diagnosis and classification and can provide guidelines to choose more individualized therapeutic options for both acute and long-term treatment.

• YAKHAK HOEJI
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• v.45 no.1
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• pp.78-84
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• 2001

Heme oxygenase is a rate-limiting enzyme in heme catabolism that cleaves heme to form biliverdin, iron, and carbon monoxide. Heme oxygenase-1 is expressed in many types of cells and tissues and is highly induced in response to oxidative stress. Carbon monoxide, one of the products of heme oxygenase, can stimulate soluble guanylate cyclase and dilate the vascular smooth muscle. So, the induction of heme oxygenase by lipopolysaccharide (LPS)-induced oxydative stress and the effect of the resultant carbon monoxide on aortic contractility were examined in this study. Zinc protoporphyrine IX (ZnPP), a inhibitor of heme oxygenase, elicited weak contraction of thoracic aortic ring, and this effect was more potent in aorta of LPS-treated rats than control and was blocked by methylene blue. The hyperreactivity to ZnPP in LPS-treated group was blocked by co-treatment with aminoguanidine. In the aortic ring of LPS-treated rats, ZnPP didn't change the vasoreactivity to phenylephrine or acetylcholine. ZnPP elicited hyper-tensive effect in concious rats, and pretreatment with LPS did not affect this effect. Prazosin significantly diminished the hypertensive effect of ZnPP. These results indicate that LPS induced heme oxygenase in aotra, and the resultant carbon monoxide diminished the aortic reactivity to vasoconstrictor.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.12 no.1
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• pp.143-153
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• 1999

Background: The vasoreactivity of cerebral artery is currently the subject of increasing interest Transcranial Doppler The purpose of this study was to investigate the analgesic effect of acupuncture in a model of neuropathic pain produced by segmental spinal nerve injury (SSI) in rats. The left L5 and L6 spinal nerves of Sprague-Dawley rats were tightly ligated, and one week later, manual or electro-acupuncture was applied for 30 minutes to the contralateral hindlimb (right side) while the animal was lightly anesthetized with halothane. The mechanical threshold of the paw for ipsilateral (left side) hind limb flinching was determined prior to and 0.5, 1, 2, 4, and 24 hours after termination of acupuncture. The mechanical threshold for flinching was significantly elevated for about 4 hours after manual acupuncture applied to the BL. 60 (Kunlun) point or electro-acupuncture to the BL. 60 and BL. 40 (Weizhong) points. However, manual acupuncture applied to the ST. 36 (Zusanli) point was not effective. Furthermore, systemic naloxone pretreatment had no effect on the acupuncture induced threshold elevation. These data suggests that acupuncture produces a point specific, naloxone independent analgesia in a rat neuropathic pain model. ※ This paper is supported by a grant from the '1996 Jusan Foundation of Wonkwang university.)

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.5
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• pp.467-472
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• 2015

Histone deacetylase (HDAC) has been recognized as a potentially useful therapeutic target for cardiovascular disorders. However, the effect of the HDAC inhibitor, trichostatin A (TSA), on vasoreactivity and hypertension remains unknown. We performed aortic coarctation at the inter-renal level in rats in order to create a hypertensive rat model. Hypertension induced by abdominal aortic coarctation was significantly suppressed by chronic treatment with TSA (0.5 mg/kg/day for 7 days). Nicotinamide adenine dinucleotide phosphate-driven reactive oxygen species production was also reduced in the aortas of TSA-treated aortic coarctation rats. The vasoconstriction induced by angiotensin II (Ang II, 100 nM) was inhibited by TSA in both endothelium-intact and endothelium-denuded rat aortas, suggesting that TSA has mainly acted in vascular smooth muscle cells (VSMCs). In cultured rat aortic VSMCs, Ang II increased p66shc phosphorylation, which was inhibited by the Ang II receptor type I ($AT_1R$) inhibitor, valsartan ($10{\mu}M$), but not by the $AT_2R$ inhibitor, PD123319. TSA ($1{\sim}10{\mu}M$) inhibited Ang II-induced p66shc phosphorylation in VSMCs and in HEK293T cells expressing $AT_1R$. Taken together, these results suggest that TSA treatment inhibited vasoconstriction and hypertension via inhibition of Ang II-induced phosphorylation of p66shc through $AT_1R$.