• 제목/요약/키워드: ischemic brain

검색결과 508건 처리시간 0.02초

뇌지주막하 출혈 후 뇌혈관 연축에 대한 동맥내 Papaverine 주입의 치료효과 (Effect of the Intra-arterial Papaverine Infusion on the Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage)

  • 신준재;이재환;신용삼;허승곤;김동익;이규창
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.325-333
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    • 2001
  • Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

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Neuroprotection of Dexmedetomidine against Cerebral Ischemia-Reperfusion Injury in Rats: Involved in Inhibition of NF-κB and Inflammation Response

  • Wang, Lijun;Liu, Haiyan;Zhang, Ligong;Wang, Gongming;Zhang, Mengyuan;Yu, Yonghui
    • Biomolecules & Therapeutics
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    • 제25권4호
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    • pp.383-389
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    • 2017
  • Dexmedetomidine is an ${\alpha}2$-adrenergic receptor agonist that exhibits a protective effect on ischemia-reperfusion injury of the heart, kidney, and other organs. In the present study, we examined the neuroprotective action and potential mechanisms of dexmedetomidine against ischemia-reperfusion induced cerebral injury. Transient focal cerebral ischemia-reperfusion injury was induced in Sprague-Dawley rats by middle cerebral artery occlusion. After the ischemic insult, animals then received intravenous dexmedetomidine of $1{\mu}g/kg$ load dose, followed by $0.05{\mu}g/kg/min$ infusion for 2 h. After 24 h of reperfusion, neurological function, brain edema, and the morphology of the hippocampal CA1 region were evaluated. The levels and mRNA expressions of interleukin-$1{\beta}$, interleukin-6 and tumor nevrosis factor-${\alpha}$ as well as the protein expression of inducible nitric oxide synthase, cyclooxygenase-2, nuclear factor-${\kappa}Bp65$, inhibitor of ${\kappa}B{\alpha}$ and phosphorylated of ${\kappa}B{\alpha}$ in hippocampus were assessed. We found that dexmedetomidine reduced focal cerebral ischemia-reperfusion injury in rats by inhibiting the expression and release of inflammatory cytokines and mediators. Inhibition of the nuclear factor-${\kappa}B$ pathway may be a mechanism underlying the neuroprotective action of dexmedetomidine against focal cerebral I/R injury.

일시적 국부 뇌허혈 동물모델에서 한약재의 신경보호 효과 (Neuroprotective Effects of Medicinal Herbs in the Transient Focal Ischemia in Rats)

  • 오진경;정지욱;안남윤;오혜림;정재훈;류종훈
    • 생약학회지
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    • 제34권4호통권135호
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    • pp.335-338
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    • 2003
  • It is thought that highly reactive oxygen species generated after strokes plays a key role in damaging the brain. We examined free radical scavenging activity and neuroprotective effects of several medicinal herbs in a rat model of transient ischemia. Free radical scavenging property of medicinal herbs was examined in vitro using 1,1-diphenyl-2-picrylhydrazyl stable free radical. Transient ischemia was induced by intraluminal occlusion of the right middle cerebral artery for 120 min, followed by reperfusion for 22 hr in rats. Aqueous extracts of 8 medicinal herbs (200 mg/kg) were orally administered twice to transient ischemic rat prior to reperfusion and 2 hr after reperfusion. Total infarction volume in the hemisphere ipsilateral to the ischemia-reperfusion was significantly decreased in 7 groups treated with Sophora flavescens, Lycopus lucidus, Sanguisorba officinalis, Caesalpinia sappan, Albizia julibrissin, Rubia akane, Psoralea corylifolia, or Prunella vulgaris. However, neuroprotective effects of these medicinal herbs were not correlated with their antioxidative activities. These results suggest that these medicinal herbs exert neuroprotection via antioxidative as well as unknown mechanism.

The Effects of tDCS and Montoya Stair Task on Sensorimotor Recovery and GFAP Expression in MCAo induced Stroke Rat Model

  • Sim, Ki-Cheol;Kim, Gi-Do;Kim, Kyung-Yoon;An, Ho-Jung;Lee, Joon-Hee;Min, Kyoung-Ok;Kim, Gye-Yeop
    • 국제물리치료학회지
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    • 제2권1호
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    • pp.193-200
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    • 2011
  • This study is intended to examine the tDCS and Montoya stair task(MST) on sensorimotor recovery and glial scar expression in MCAo induced stroke model of rat. To achieve this goal, this study selected 80 SD rats of 8 weeks. The experiment groups were divided them into four groups, and assigned 20 rats to each group. Group I was a experimental control group; GroupII was a tDCS application group after MCAo; Group III was a MST application group after MCAo; Group IV was a tDCS and MST application group after MCAo. In each group, neurological function test measurement, motor behavior test, montoya stair task test, immunohistochemistric finding of GFAP expression finding were analyzed. In motor behavior test, the outcome of group I was significantly difference than the other group, especially from 14days. In montoya stair task test, the outcome of group I was significantly lower than the other group especially, group II were significantly different on 14days and group IV was most significantly difference than the other group. In immunohistochemistric finding, group II, III, IV were decrease GFAP expression on depend on time stream. These results throughout the MCAo due to focal ischemic brain injury rat model four weeks tDCS and MST was applied, when the neurobehavioural, upper extremity function and ability, histopathologic data suggest that sensorimotor function recovery and a positive influence on glial scar decrease and confirmed that.

급성 일산화탄소 중독 환자에서 급성 심혈관계, 신경학적 독성의 위험요인과 노출 경로의 역학적 특성 (The Risk Factors of Acute Cardiovascular and Neurological Toxicity in Acute CO Poisoning Patients and Epidemiologic Features of Exposure Routes)

  • 박진수;신승열;서영호;정현민
    • 대한임상독성학회지
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    • 제18권1호
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    • pp.34-41
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    • 2020
  • Purpose: This study evaluated aggressive hyperbaric oxygen therapy (HBOT) by understanding various exposure routes of acute carbon monoxide (CO) poisoning, the risk factors causing acute cardiovascular, and neurological toxicity caused by poisoning. Methods: A retrospective study was conducted based on the medical records of 417 acute CO poisoning patients who visited the emergency care unit from March 2017 to August 2019. The exposure routes, HBOT performance, age, sex, medical history (hypertension, diabetes mellitus, ischemic heart disease, heart failure), intentionality, loss of consciousness (LOC), intake with alcohol or sedatives, and initial test results (carboxyhemoglobin (COHb), troponin-I, electrocardiography, echocardiography, brain MRI) were examined. Comparative analysis of the clinical information was conducted between the groups that showed acute cardiovascular toxicity and neurological toxicity, and groups that did not. Results: Among 417 patients diagnosed with acute CO poisoning, 201 cases (48.2%) were intentional, and charcoal briquette was the most common route (169 patients (40.5%)). Two hundred sixteen cases (51.8%) were accidental, and fire was the most common route (135 patients (32.4%)). The exposure route was more diverse with accidental poisoning. Three hundred ninety-nine patients were studied for acute cardiovascular toxicity, and 62 patients (15.5%) were confirmed to be positive. The result was statistically significant in intentionality, LOC, combined sedatives, initial COHb, HTN, and IHD. One hundred two patients were studied for acute neurological toxicity, which was observed in 26 patients (25.5%). The result was statistically significant in age and LOC. Conclusion: Active HBOT should be performed to minimize damage to the major organs by identifying the various exposure routes of CO poisoning, risk factors for acute cardiovascular toxicity (intentionality, LOC, combined sedatives, initial COHb, HTN, IHD), and the risk factors for acute neurological toxicity (age, LOC).

완전순환정지와 심근허혈 없이 시행한 변형 Norwood 술식 - 2 례 보고 - (Modified Norwood Procedure without Circulatory Arrest and Myocardial Ischemia - Report of 2 cases -)

  • 백만종;김웅한;전양빈;김수철;공준혁;류재욱;오삼세;나찬영;김양민
    • Journal of Chest Surgery
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    • 제34권7호
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    • pp.547-551
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    • 2001
  • 대동맥궁 재건술시 시행하는 완전순환정지는 술후 신경학적 손상과 관련된다. 저자들은 국소 순환으로 뇌와 심근혈류를 유지하면서 완전순환정지를 시키지 않고 시행한 변형 Norwood술식을 2명에서 시행하였기에 보고한다. 한 명은 체중이 3.1kg인 생후 13일된 여아로서 좌심형성부전증후군의 이형 환자였고 다른 한 명은 생후 38일된 체중 3.4kg의 남아로서 심한 대동맥 발육부전 및 축착증과 좌심실유출로 협착을 동반한 Taussig-Bing 기형이었다. 두 환아 모두 무명동맥에 직접 동맥캐뉼라를 삽관한 다음 저체온 상태에서 무명동맥과 관상동맥 혈류를 유지하면서 Norwood술식을 시행하였으며 두 명 모두 술후 신경학적, 심장 혹은 신기능 합병증은 없었다. 이 방법은 좌심형성부전증후군이나 대동맥 축착증 혹은 단절증과 같은 대동맥궁 기형 환자의 수술시 완전순환정지로 인해 발생될 수 있는 허혈성 손상으로부터 뇌와 심장을 보호할 수 있는 한 방법으로 생각된다.

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심근세포의 산화적 손상에 대한 오미자탕의 효과 및 작용기전 연구 (Effects & Mechanism of Omija-tang on Oxidative Stress-Induced Death of H9c2 Cardiomyoblast Cell)

  • 황보연;양경석;이상관;이기상;문병순;신선호
    • 대한한의학회지
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    • 제23권4호
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    • pp.140-150
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    • 2002
  • Objectives: The water extract of Omija-tang (OMIT) has traditionally been used for treatment of ischemic heart and brain damage in oriental medicine. However, little is known about the mechanism by which the water extract of OMJT rescues cells from these damages. Therefore, this study was designed to investigate the protective mechanisms of OMJT on oxidative stress-induced toxicity in H9c2 cardiomyoblast cells. Methods: Treatments of $H_2O_2$, or $ZnC_{12}$ markedly induced death of H9c2 cardiomyoblast cells in a dose-dependent manner. The characteristics of oxidative stress-induced death of H9c2 showed apparent apoptotic features such as DNA fragmentation. OMJT significantly reduced both ${H_2O_2}-induced$ cell death and chromatin fragmentation. The decrease of B치-XL expression by $H_2O_2$ were inhibited by OMJT. In addition, the increase of Bcl-XS expression was also inhibited by OMJT. In particular, Fas expression, which is generally recognized as cell death-inducing signal by Fas/FasL interaction, was markedly increased by H2O2 in a time-dependent manner. Also, the expression profile of proteins in Chang cells were screened by using two-dimensional (2-D) gel electrophoresis. Among 300 spots resolved in 2-D gels; the comparison of control versus apoptotis cells revealed that signal intensity of 6 spots decreased and 11 spots increased. Results and Conclusions: Taken together, this study suggests that the protective effects of the water extract of OMJT against oxidative damages may be mediated by the modulation of Bcl-XL/S Fas expression.

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보양환오탕이 영양혈청결핍에 의한 PC12 세포의 고사에 미치는 영향 (Protective Effects of Boyanghwanoh-tang on Serum and Glucose Deprivation-induced Apoptosis of PC12 Cells)

  • 김종길;정승원;임준모;장호현;윤종민;이기상;문병순
    • 대한한의학회지
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    • 제24권2호
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    • pp.179-192
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    • 2003
  • Objectives : Boyanghwanoh-tang (Buyanhaiwu-tang) has been used as a prescription for stroke, senile and vascular dementia, ischemic brain and heart damage in Oriental traditional medicine. However, there is little known about the mechanism by which the water extracts of Boyanghwanoh-tang (Buyanhaiwu-tang) rescue cells fromthese damages, and little is known about the protective mechanisms of Boyanghwanoh-tang (Buyanhaiwu-tang) on oxidative stress in neuronal cells. Therefore, we have investigated the role of Boyanghwanoh-tang (Buyanhaiwu-tang) on serum and glucose deprived apoptosis in PC12 cells. Methods : PC12 Cells have been used extensively as a model for studying the cellular and molecular effects of neuronal cells. The viability of cells was measured by MIT assay. We used DNA fragmentation and caspase 1, 2, 3, 6, 9-likeproteases activation assay. Transcriptional activation of NF-kB was assessed by using electrophoretic mobility shift assay. Results : Boyanghwanoh-tang (Buyanhaiwu-tang) rescued PC12 cells from apoptotic death by serum and glucose deprivation in a dose-dependent manner. The nuclear staining of PC12 cells clearly showed that Boyanghwanoh-tang (Buyanhaiwu-tang) attenuated nuclear condensation and fragmentation, which represent typical neuronal apoptotic characteristics. Boyanghwanoh-tang (Buyanhaiwu-tang) also prevents fragmentation of genomic DNA and activation of caspase 3-like protease in serum and glucose deprived PC12 cells. Furthermore, Boyanghwanoh-tang (Buyanhaiwu-tang) reduced the activation of NF-kB by serum and glucose-deprived apoptosis. Conclusions : These findings suggest that serum and glucose deprivation induces reduced glutathione (GSH) depletion, and consequently, apoptosis through endogenously produced reactive oxygen species in PC12 cells. Also, our data indicated that Boyanghwanoh-tang (Buyanhaiwu-tang) has protective effects against the serum and glucose deprived deaths of PC12 cells, which are mediated by the generation of GSH that, in turn, can reduce oxidative stress caused by reactive oxygen species (ROS) such as hydrogen peroxide.

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Neuroprotective effects of L-carnitine against oxygen-glucose deprivation in rat primary cortical neurons

  • Kim, Yu-Jin;Kim, Soo-Yoon;Sung, Dong-Kyung;Chang, Yun-Sil;Park, Won-Soon
    • Clinical and Experimental Pediatrics
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    • 제55권7호
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    • pp.238-248
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    • 2012
  • Purpose: Hypoxic-ischemic encephalopathy is an important cause of neonatal mortality, as this brain injury disrupts normal mitochondrial respiratory activity. Carnitine plays an essential role in mitochondrial fatty acid transport and modulates excess acyl coenzyme A levels. In this study, we investigated whether treatment of primary cultures of rat cortical neurons with L-carnitine was able to prevent neurotoxicity resulting from oxygen-glucose deprivation (OGD). Methods: Cortical neurons were prepared from Sprague-Dawley rat embryos. L-Carnitine was applied to cultures just prior to OGD and subsequent reoxygenation. The numbers of cells that stained with acridine orange (AO) and propidium iodide (PI) were counted, and lactate dehydrogenase (LDH) activity and reactive oxygen species (ROS) levels were measured. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and the terminal uridine deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling assay were performed to evaluate the effect of L-carnitine (1 ${\mu}M$, 10 ${\mu}M$, and 100 ${\mu}M$) on OGD-induced neurotoxicity. Results: Treatment of primary cultures of rat cortical neurons with L-carnitine significantly reduced cell necrosis and prevented apoptosis after OGD. L-Carnitine application significantly reduced the number of cells that died, as assessed by the PI/AO ratio, and also reduced ROS release in the OGD groups treated with 10 ${\mu}M$ and 100 ${\mu}M$ of L-carnitine compared with the untreated OGD group (P<0.05). The application of L-carnitine at 100 ${\mu}M$ significantly decreased cytotoxicity, LDH release, and inhibited apoptosis compared to the untreated OGD group (P<0.05). Conclusion: L-Carnitine has neuroprotective benefits against OGD in rat primary cortical neurons in vitro.

Phantom을 이용한 뇌 관류 CT검사에서 방사선 피폭선량에 관한 연구 (A Study on the Radiation Exposure Dose of Brain Perfusion CT Examination a Phantom)

  • 정홍량;김기정;모은희
    • 한국융합학회논문지
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    • 제6권5호
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    • pp.287-294
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    • 2015
  • 본 연구의 목적은 급성기 허혈성 뇌졸중 환자의 뇌 관류 CT검사 시 피폭선량을 알아보고자 하였다. 특히, 방사선 감수성이 높은 장기들의 장기선량(Organ dose)을 팬텀과 유리선량계를 이용하여 실측해보고, 제조사가 제시한 기존 프로토콜(고정시간기법)과 새로 제시한 융합 프로토콜(조영제 추적기법)을 적용하여 선량을 측정하여 보고, 피폭선량 저감화 방안을 마련하고자 하였다. 분석결과 기존 프로토콜과 비교하여 새로 제시한 융합 프로토콜에서 최고 39.8 %, 최저 5.8 % 장기선량이 감소하였고, 검사 피폭선량인 $CDTI_{vol}$과 DLP 값은 각각 25 % 감소하였으며, 권고 선량 이하로 측정되었다. 위의 분석결과를 바탕으로 기존에 제시된 프로토콜을 점검해보고, 새로 제시한 융합 프로토콜을 적용하여 피폭선량을 감소시켜 국민보건향상에 이바지 해야 할 것이며, 다른 검사에서도 최적의 프로토콜을 찾기 위한 연구가 계속되어져야 할 것으로 사료된다.