• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.157-167
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• 1998

Background and Purpose : Cerebrovascular reactivity(CVR) can be estimated by measuring the change of cerebral blood flow that occurs during vasostimulation. To estimate the cerebrovascular reactivity, we investigated the change of flow velocity of the middle cerebral artery(MCA) during hyperventilation and hypoventilation with the transcranial doppler. So we studied whether the CVR measured by this method could show a significant difference between the normal and the cerebral infarction subjects and whether the CVR may decrease with age in normal subjects. Methods : Using transcranial doppler, we measured the mean velocity(Vm), the pulsatility index(P.I.) at the resting state, the end of breath-holding and the end of hyperventilation in 36 normal and 10 cerebral infarction subjects, so we calculated the percentile change of mean velocity(%${\Delta}$Vm) and P.I.(%${\Delta}$P.I.) after the vasostimulation. We estimated the change of Vm, P.I., %${\Delta}$Vm and %${\Delta}$P.I. by the age group and compared those parameters between the age-matched normal control and cerebral infarction subjects. Results : The Vm in MCA significantly decreased with age(p<0.05), but there was no significant difference in Vm and P.I. between normal and cerebral infarction subjects. The %${\Delta}$Vm and %${\Delta}$P.I. in response to hyperventilation significantly decreased with age in MCA and there was significant difference in $%{\Delta}Vm$ of MCA after breath-holding between the normal and cerebral infarction subjects. Conclusion : The breath-holding and hyperventilation tests could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied in the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

• 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 Internal Korean Medicine
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• v.25 no.3
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• pp.418-426
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• 2004

Objectives : This study was designed to research whether transcranial doppler ultrasound(TCD) can yield a suitable diagnosis or prognosis for dizziness. Methods : To evaluate the blood flow, we measured the mean velocity(Vm), peak systolic velocity(Vs) and pulsatility index(PI) of the middle cerebral artery(MCA), vertebral artery(VA) and basilar artery(BA) in 54 dizziness patients and 44 normal subjects. To investigate the difference between dizziness patients and normal subjects, we selected 54 dizziness patients diagnosed normal by Brain MRI, and 44 normal subjects who did not have any symptoms of hyperlipemia, hypertension, diabetes melitus, heart disease, or smoking, diagnosed normal by Brain MRI. 30-69 year olds were divided into 30-49 year olds, 50-59 year olds and 60-69 year olds. Results : In normal subjects, there was a significantly higher Vm, Vs in the MCA and BA, and Vs in the VA of female subjects, and there was a significant difference in PI in the MCA and BA increasing with age. In comparison with normal subjects, dizziness patients had a significantly lower Vm in the BA. Male dizziness patients had significantly lower PI in the MCA. 30-49 year olds had significantly lower Vm in the BA. Conclusions : The significant difference in blood flow velocities in the BA between dizziness patients and normal subjects suggests that dizziness is related to blocking of blood flow in the BA and that diagnosis and prognosis can be made through TCD. More detailed study of dizziness patients will be needed.

• Biomedical Science Letters
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• v.13 no.3
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• pp.231-237
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• 2007

Subway environments such as crowd, passenger's gab, or subway-generated mechanical noise may become a potential stressor. The present study was sought to determine whether subway noise with or without mental activity affects cerebral hemodynamics and sympathetic system. Fifty-four healthy volunteers were divided group I which underwent subway noise (n=24) and group II which underwent a combined mental activity (mental arithmetic) with subway noise (n=30). Sympathetic factors such as heart rate (HR), blood pressure (BP) and heart rate-systolic pressure product (RPP), and mean blood flow velocity in the middle cerebral artery (MCAV) were measured before (baseline), during and after the noise-exposure. Systolic and diastolic blood pressure, HR and RPP significantly increased in group II (P<0.05) but not in group I during the noise-exposure. Peak-MCAV, diastolic-MCAV and mean-MCAV in the both groups were elevated during the noise-exposure (P<0.05) and the increased ratios in group II were greater than those in group I. These results suggest that a combined mental activity with subway noise may be a stressor which affects cerebral hemodynamics and sympathetic system.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.77-84
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• 1997

We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index, resistive index. Intracranial velocities and pulsatility indexes were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a useful noninvasive means of monitoring cerebrohemodynamics in normal preterm neonates and flow change of sick babies.

• 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.

• The Journal of Korean Medicine
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• v.26 no.1 s.61
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• pp.115-122
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• 2005

Background and objective: Gastrodiae Rhizoma (GR), the rhizoma of Gastrodia elata BL., is one of the popular drugs to treat headache, dizziness, blackout, numbness of limbs, hemiplegia, facial paralysis, dysphrasia, and infantile convulsions. It has been reported that it provides an antihypertensive effect and lowers cerebrovascular resistance in animal experiments. However, there has been no data about these effects with human subjects. In this study, the author examined the effect of Gastrodiae water extracts on blood pressure and cerebrovascular reactivity in human subjects. Methods: We selected 16 normal volunteers, who were divided into 2 groups: Gastrodiae extract administration group and placebo (creamy powder) group. Using transcranial Doppler ultrasound, we monitored changes of mean flow velocity and breath-holding induced CO2 reactivity of middle cerebral artery in both groups. Mean blood pressure, heart rate and PETCO2 were measured using Compact Anesthesia Monitor. In both groups, all evaluation was performed during basal condition, and repeated at 30, 60, and 90 min after administration. Results: Gastrodiae extract decreased CO2 reactivity after administration, reaching the lowest level at 90 minutes $(-29.1\%\;vs.\;basal\;level)$, which showed significant difference compared with the placebo group (p = 0.004). In the placebo group, the pulse rates tended to decrease over time (at 90 minute, $-5.2\%$ vs. basal level) while in the Gastrodiae group the values showed nearly no change, which showed significant difference between both groups (p = 0.036). However, the changes of mean blood pressure and mean flow velocity did not show significant difference between both groups. Conclusion : This study demonstrated that Gastrodiae extract significantly decreased breath-holding induced CO2 reactivity. This result suggests that the clinical effect of Gastrodiae extract might be caused by increasing cerebral blood flow via dilation of cerebral resistant vessels instead of antihypertensive effect.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.345-360
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• 1996

Background and Purpose: To evaluate the blood flow velocity using doppler ultrasound of the carotid artery, vertebral artery, and basilar artery in stroke patients Material and Methods: To evaluate the blood flow, I measured the peak systolic velocity and mean velocity of the common carotid artery(CCA), internal carotid artery(ICA), external carotid artery (ECA). vertebral artery(VA), and basilar artery(BA) in 44 stroke patients and 15 healthy adults. To investigate the difference between ischemic stroke patients and normal healthy adults, I selected 44 ischemic stroke patients diagnosed by brain CT and brain MRI, and 15 healthy adults who did not have any symptoms of stroke, hypertension, heart disease, and diabetes melitus. Results: Peak velocity in normal adults was 50.6${\pm}$1.6cm/sec in the CCA, 67.2${\pm}$1.7cm/sec in the ICA, 62.5${\pm}$2.4cm/see in the ECA, 45.5${\pm}$1.9cm/sec VA. and 50.5${\pm}$3.5cm/sec in the BA. Mean velocity in normal adults was 26.9${\pm}$1.1cm/sec in the CCA, 43.7${\pm}$1.4cm/sec in the ICA, 26.7${\pm}$1.3cm/sec in the ECA. 31.6${\pm}$1.9cm/sec in the VA and 33.0${\pm}$2.6cm/sec in the BA. In this study, there was a significant increase in the velocity of ICA, ECA, and VA of ischemic stroke patients in comparison with normal healthy adults. And the blood flow velocity of this study in the CCA and ECA was different from other reported foreign values and the other known values in my country. Conclusion: There was a significant difference in the blood flow velocity between ischemic stroke patients and normal healthy adults. And the blood flow velocity of this study was different from other reported foreign values and the other known values in my country. Therefore, it needs more detailed studies about old aged Korean and ischemic stroke patients than previous studies.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.171-189
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• 1996

Background and Purpose: The greater part of patients to visit Hospital of Oriental Medicine suffer from cerebrovascular accident(CVA). There is transcranial Doppler(TCD) in the diagnostic method to confirm cerebrovascular accident(CVA). Transcranial Doppler(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral vessels and have been generally used to prevent symptomatic vasospasm and confirm cerebral infarction. So we studied, in the crebrovascular accident(CVA), to estimate whether transcranial Doppler(TCD) is useful to. Methods: Using transcranial doppler(Multigon Model 500M Transcranial Doppler System), we measured the mean and peak velocity and the direction of blood flow in 10 cerebrovascular accident(CVA)'s subjects who had been examined by Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). Results : As an anticipation, in cerebrovascular accident(CVA)'s subject with Cb-infarction, the mean and peak velocity of blood flow fell down remarkably and the direction of blood flow was change or irritable. But didn't find out any signal in lacunar infarction. Also, in case with spontaneous hemorrhage, the velocity and direction of blood flow was change but this signal was short of diagnosis for Cb-hemorrhage. Besides, we found signals about embolism, stenosis, thrombosis and occlusion in cerebrovascular accident(CVA)'s subjects. Conclusion: In Cb-infarction, the result of TCD was equal to diagnosis with Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). But about lacunar infarction or spontaneous hemorrhage, signals of TCD couldn't be found out or was insufficient more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). In cerebrovascular accident(CVA)'s subject with embolism, stenosis, thrombosis or occlusion, signals of TCD were found out more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). Therefore transcranial doppler(TCD) is necessary method which makes a diagnosis of cerebrovascular accident(CVA), with Computed Tomography(CT) or Magnetic Resonance Imaging(MRI).

• The Journal of Korean Medicine
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• v.27 no.3 s.67
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• pp.38-50
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• 2006

Objectives: The aim of this study was to evaluate the effects of Korean ginseng (KG), Korean red ginseng (KRG) and fermented Korean red ginseng (FKRG) extracts on cerebral hemodynamics and to compare distinction of each extract. Methods: Ten healthy male volunteers $(26.0{\pm}1.8yrs)$ participated in the study according to double-blind and cross-over protocols. Each volunteer was blindly administered 500mg of KG, KRG, FKRG extract or placebo (Dextrin). Blinded researchers measured changes of hyperventilation-induced cerebrovascular reactivity (CVR), mean blood flow velocity (MBFV) of middle cerebral arteries (MCAs) and corrected blood flow velocity at $P_{ETCO2}=40mmHg$ (CV40) using transcranial Doppler ultrasound (DWL Co., Germany). Researchers also observed changes of mean blood pressure (MBP), pulse rate (PR) and expiratory $CO_2$ using S/5 Collector (Datex-Ohmeda Co., Finland). The evaluation was performed at basal condition, and repeated at 1, 2, 3, 4 and 5 hours after administration. Results: MBFV and CV40 in the KRG group tended to rise at I hour after administration, while those of the FKRG group tended to rise at 2 hours after administration. CVR increased significantly after 1 hour in the KRG group (p=0.009) and after 2 hours in the FKRG group (p=0.035), respectively. The KG group showed increasing tendency at 4 hours after administration. No group showed significant difference from the placebo in changes of MBP and PR. Conclusions: It is suggested that KG, KRG and FKRG extracts have effects of enhancing CVR and thus of increasing cerebral blood flow in human subjects.