• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.280-285
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• 2000

Posterior transarticular screw fixation for atlantoaxial instability due to trauma or rheumatoid arthritis provides immediate rigid fixation of the C1-2 vertebral segment while preserving motion between the occiput and C1. This technique provides more resistance to translational and rotational forces than wiring technique. However, the technique of transarticular screw fixation is inherently demanding because of the complex anatomy of the occipitocervical region and vertebral artery(VA) at risk for arterial damage. VA injury may lead to serious subsequent neurological deficits and possibly death from bilateral VA injury. We report a case of a vertebral artery-to-epidural venous plexus fistula after posterior transarticular screw fixation which was treated with balloon occlusion.

• Natural Product Sciences
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• 제26권1호
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• pp.71-78
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• 2020

The plant Dendropanax morbifera Léveille is effective folk medicines for the treatment of several conditions, such as infectious diseases, skin diseases, and other illnesses. Although the inhibitory effects of D. morbifera on the proliferation and migration of vascular smooth muscle cells (VSMCs) have been shown in our previous study, its effects in vivo remain to be elucidated. In this study, we aimed to investigate the protective effects of the extracts from D. morbifera (EDM) on neointimal hyperplasia of rat carotid artery and explore the underlying mechanisms. We observed that the ratio of intima to media thickness (I/M) was significantly decreased in the EDM-treated groups by ~80% compared to that of the control. The expression of Ki-67 and proliferating cell nuclear antigen was decreased by ~70% in the EDM-treated groups compared to that of the control. In addition, matrix metalloproteinase (MMP)2 and MMP9 significantly reduced in the neointimal layer of the EDM-treated groups. Moreover, the decreased levels of contractile phenotypic markers of VSMCs, such as α-smooth muscle actin, myocardin, and smooth muscle-myosin heavy chain, were successfully restored by EDM treatment. Furthermore, the levels of synthetic phenotypic markers, cellular retinal binding protein 1 and connexin 43 were also restored to normal levels. These results suggest that EDM inhibits vascular neointimal hyperplasia induced by balloon injury in rats via phenotypic modulation of VSMCs. Therefore, EDM may be a potential drug candidate for the prevention of restenosis.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.153-158
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• 2001

Traumatic carotid-cavernous fistula is a rare complication of moderate to severe head injury. For the treatment of carotid-cavernous fistula, detachable balloon occlusion is the best method of choice. A 26 year old male patient was hurt with a left periorbital penetrating injury 20 years ago, and then left side exophthalmos, bruit and right hemiparesis developed 10 years later. We experienced the very rare case of direct carotidcavernous fistula with cavernous dural arteriovenous fistula. Brain MRIs and cerebral angiograms revealed that direct carotid-cavernous fistula was accompanied by cavernous dural arteriovenous fistula due to longstanding venous hypertension and development of collateral circulation. Detachable balloon occlusion and surgical internal carotid artery ligation were not enough to occlude fistular flow, so cavernous dural arteriovenous fistula embolization was necessary. The authors present a case of long-standing traumatic carotid-cavernous fistula with cavernous dural arteriovenous fistula, with review of the literature.

• Journal of Korean Neurosurgical Society
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• 제42권5호
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• pp.363-366
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• 2007

Objective : Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. Methods : The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, Injected cement volume, clinical outcome and complications. Results : Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was $4.2{\pm}1.5\;cc$. The mean cobb angle and compression rate were improved from $12.1{\pm}6.5^{\circ}$ to $8.5{\pm}7.2^{\circ}$ and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental arte 이 Injury, pulmonary embolism, or epidural leakage. Conclusion : Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate.

• 한국임상수의학회지
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• 제27권5호
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• pp.546-552
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• 2010

대부분 척수손상 모델에서의 척수 손상 정도 평가는 자기공명 영상 등을 통한 유발 후 평가를 실시하고 있으며, 유발 전 평가를 위해 풍선 카테타에 주입된 공기 양을 기준한 예가 있으나 종 특이성과 개체 차이를 고려하지 못하는 단점이 있다. 이러한 단점을 극복한 척수손상 기준모델을 제시하기 위해 본 실험을 실시하였다. 방사선 평가를 통해 요추 1 번 척수강 높이가 8 mm로 측정된 임상적으로 건강한 비글견 8 마리를 풍선카테타의 직경과 척수 압박시간을 기준으로 4개 군 (4 mm/3 시간, 4 mm/6 시간, 4 mm/12 시간 그리고 6 mm/3 시간)으로 구분하였다. 손상 정도는 행동 관찰, 자기공명영상 해석, 체성감각유발전위평가 그리고 병리조직검사를 실시하여 평가하였다. 실험결과, 행동평가와 체성감각유발전위평가는 단지 손상 유발 여부만 지시할 뿐 정도 평가에는 유용하지 못하였다. 자기공명영상 평가에서 척수손상 부위는 단시간반전회복영상과 T2강조영상에서 불균질한 고신호강도 영역으로 관찰되었다. 고신호강도 영역은 삽입된 풍선 직경과 압박시간 증가에 따라 보다 확장되어 관찰되었으며, 이러한 소견은 공포화 등의 손상부위 증가와 카스파제-3 및 PARP 면역반응 세포의 수적 증가로 나타난 병리조직검사 결과와 일치하였다. 이러한 결과로 미루어 정형화된 척수손상 모델 유발을 위한 척수강 직경과 풍선카테타 직경 그리고 압박시간의 변수 이용과 손상 정도 평가를 위해 자기공명영상은 매우 유용할 것으로 판단된다.

• 한국자원식물학회지
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• 제26권6호
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• pp.678-685
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• 2013

The objective of this study was to examine the effect of 7 traditional Korean formulations (7TKFs) on intimal thickening of rat carotid artery injured by balloon catheter in vivo and on the proliferation of human smooth muscle cells (HASMCs) and secretion of matrix metalloproteinase-2 (MMP-2) in vitro. 7TKFs (400 mg/kg) were administered orally for 4 weeks from the day of balloon injury in the rats. HASMC proliferation was assessed by 3-(4,5-dimethylthiazol-2)-2,5-diphenyltetrazolium bromide (MTT) assay while enzymatic action of MMP-2 was carried out by gelatin zymography. Among 7TKFs, Samhwang-sasim-tang (SST), Banha-sasim-tang (BST) and Kegi-honghwa-tang (KHT) significantly reduced the intimal thickening by suppressing HASMC proliferation and MMP-2 expression in both extracellular and intracellular levels. Thus, the results suggest that SST, BST and KHT can be considered as a therapeutic value in the prevention of atherosclerosis because restenosis after PTCA (percutaneous transluminal coronary angioplasty) is supposed to be 'accelerated atherosclerosis'.

• Journal of Trauma and Injury
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• 제33권3호
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• pp.162-169
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• 2020

Purpose: There is increasing evidence in the literature regarding resuscitative endovascular balloon occlusion of the aorta (REBOA) globally, but few cases have been reported in Korea. We aimed to describe our experience of successful Zone III REBOA and to discuss its algorithm, techniques, and related complications. Methods: We reviewed consecutive cases who survived from hypovolemic shock after Zone III REBOA placement for 4 years. We reviewed patients' baseline characteristics, physiological status, procedural data, and outcomes. Results: REBOA was performed in 44 patients during the study period, including 10 patients (22.7%) who underwent Zone III REBOA, of whom seven (70%) survived. Only one patient was injured by a penetrating mechanism and survived after cardiopulmonary resuscitation. All patients underwent interventions to stop bleeding immediately after REBOA placement. Conclusions: This case series suggests that Zone III REBOA is a safe and feasible procedure that could be applied to traumatic shock patients with normal FAST findings who receive a chest X-ray examination at the initial resuscitation.

• Journal of Trauma and Injury
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• 제33권3호
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• pp.191-194
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a novel technique to maintain proximal arterial pressure. It is important to locate the balloon catheter correctly in performing REBOA but it is inaccurate to check the catheter position by external measurement. Even if the position of the catheter is initially confirmed by X-ray, it is difficult to determine the location of the catheter that changes according to various situations. We performed REBOA under real-time fluoroscopy and could maintain the catheter in correct position under various situations.

• Journal of Ginseng Research
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• 제47권2호
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• pp.237-245
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• 2023

Background: Ginsenoside Rg2 (Rg2) has a variety of pharmacological activities and provides benefits during inflammation, cancer, and other diseases. However, there are no reports about the relationship between Rg2 and atherosclerosis. Methods: We used 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) to detect the cell viability of Rg2 in vascular smooth muscle cells (VSMCs) and human umbilical vein endothelial cells (HUVECs). The expression of inflammatory factors in HUVECs and the expression of phenotypic transformation-related marker in VSMCs were detected at mRNA levels. Western blot method was used to detect the expression of inflammation pathways and the expression of phenotypic transformation at the protein levels. The rat carotid balloon injury model was performed to explore the effect of Rg2 on inflammation and phenotypic transformation in vivo. Results: Rg2 decreased the expression of inflammatory factors induced by lipopolysaccharide in HUVECs-without affecting cell viability. These events depend on the blocking regulation of NF-κB and p-ERK signaling pathway. In VSMCs, Rg2 can inhibit the proliferation, migration, and phenotypic transformation of VSMCs induced by platelet derived growth factor-BB (PDGF-BB)-which may contribute to its anti-atherosclerotic role. In rats with carotid balloon injury, Rg2 can reduce intimal proliferation after injury, regulate the inflammatory pathway to reduce inflammatory response, and also suppress the phenotypic transformation of VSMCs. Conclusion: These results suggest that Rg2 can exert its anti-atherosclerotic effect at the cellular level and animal level, which provides a more sufficient basis for ginseng as a functional dietary regulator.

• 한국산학기술학회논문지
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• 제20권1호
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• pp.371-375
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• 2019

혈역학적으로 불안정한 췌장손상의 치료에서 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)의 역할은 아직 불명확하다. 저자들은 출혈을 동반한 췌장손상에서 REBOA와 경도관 동맥색전술을 시행하여 출혈을 먼저 제어한 후 수술을 시행한 증례를 보고하고자 한다. 65세 남자가 20 m 높이에서 추락하면서 발생한 복통과 흉통을 호소하며 본원 응급실을 통하여 내원하였다. 전산화단층촬영에서 췌장 미부에 grade III 손상이 의심되고 비장동맥으로부터 조영제 누출이 관찰되었다. 전산화단층촬영 시행 후 수축기혈압이 60 mmHg까지 하강하여 혈역학적 안정을 위해 REBOA를 시행하였다. REBOA 시행 후 수축기혈압이 130 mmHg로 상승하였으며, 비장동맥에 대해 색전술을 시행하였다. 혈관조영술에서 더 이상 출혈이 없는 것을 확인하고, REBOA 제거 후 응급 개복 및 췌장미부절제술을 시행하였다. 수술 소견에서 췌장미부의 주췌관 손상을 동반한 열상이 관찰되었으며, 수술 중 큰 출혈은 관찰되지 않았고 주 췌관의 손상이 확인되었다. 술 후 환자는 합병증 없이 회복하였다. 본 증례에서 저자들은 혈역학적으로 불안정한 출혈을 동반한 췌장손상 환자에서 REBOA와 동맥색전술 시행 후 췌장미부절제술을 안전하고 효과적으로 진행할 수 있었다.