• Journal of Acupuncture Research
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• v.30 no.3
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• pp.1-13
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• 2013

Objectives : This study was performed to choose more effective neuro-protective acupuncture point and to verify the effect of acupuncture in promoting neurogenesis and angiogenesis as a result of its neuro-vasculo-regenerative effect in middle cerebral artery occlusion model in rats. Methods : By TTc staining we chose the most effective acupuncture point with neuro-protection. We randomly divided into four groups: Such as (1) sham group(with sham-operation), (2) sham+acupuncture group(with sham-operation), (3) middle cerebral artery occlusion group, (4) MCAO+AT group. Acupuncture procedure was performed for four days. Total RNA was extracted using TRIzol reagent, according to the manufacturer's instructions, and was purified using an RNAeasy mini kit. Immuno-histochemistry was performed using primary antibody mouse anti-BrdU, NeuN, Dcx, and VEGF. Results : We found that $ST_{36}$ had the more neuroprotective effect than $LI_{11}$ and $SP_3$. The microarray analysis revealed that 54 genes were more expressed neurogenesis pathway in MCAO+AT group compared with MCAO group(fold changes greater than or equal to twofold change). 11 genes were more expressed angiogenesis pathway. And 7 genes were more expressed VEGF pathway. Immuno-histochemistry revealed that cell proliferation, cell migration and cell maturation were increased. Conclusions : This study demonstrated that acupuncture on $ST_{36}$ had neuro-protective and neuro-restorative effect in ischemic brain injuries. And its mechanism might be related to promote neurogenesis and angiogenesis. These results suggest that acupuncture have potential benefits for the treatment of ischemic stroke.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.504-510
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• 2017

Objective : To investigate the morphological and hemodynamic parameters associated with middle cerebral artery (MCA) bifurcation aneurysm rupture. Methods : A retrospective study of 67 consecutive patients was carried out based on 3D digital subtraction angiography data. Morphological and hemodynamic parameters including aneurysm size parameters (dome width, height, and perpendicular height), longest dimension from the aneurysm neck to the dome tip, neck width, aneurysm area, aspect ratio, Longest dimension from the aneurysm neck to the dome tip (Dmax) to dome width, and height-width, Bottleneck factor, as well as wall shear stress (WSS), low WSS area (LSA), percentage of LSA (LSA%) and energy loss (EL) were estimated. Parameters between ruptured and un-ruptured groups were analyzed. Receiver operating characteristics were generated to check prediction performance of all significant variables. Results : Sixty-seven patients with MCA bifurcation aneurysm were included (31 unruptured, 36 ruptured). Dmax (p=0.008) was greater in ruptured group than that in un-ruptured group. D/W (p<0.001) and the percentage of the low WSS area ($0.09{\pm}0.13$ vs. $0.01{\pm}0.03$, p<0.001) were also greater in the ruptured group. Moreover, the EL in ruptured group was higher than that in unruptured group ($6.39{\pm}5.04$ vs. $1.53{\pm}0.86$, p<0.001). Multivariate regression analysis suggested D/W and EL were significant predictors of rupture of MCA bifurcation aneurysms. Correlation analyses revealed the D/W value was positively associated with the EL (R=0.442, p<0.01). Conclusion : D/W and EL might be the most two favorable factors to predict rupture risk of MCA bifurcation aneurysms.

• Journal of Yeungnam Medical Science
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• v.36 no.3
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• pp.208-218
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• 2019

Background: The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms. Methods: From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed. Results: Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only 3 aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, 5 (6.9%) remnant neck, and 1 (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of 8 asymptomatic and 2 symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included 1 major and 3 minor recanalizations. Conclusion: Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.294-302
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• 2022

This work reports the case of a middle cerebral artery infarction patient with hyperhidrosis and left upper extremity paresthesia whose condition improved following Korean medicine treatment. The patient was hospitalized for 10 days and treated with herbal medicine, mainly Hwanggigyeji-tang, and acupuncture, electroacupuncture, and moxibustion. The hyperhidrosis was clinically classified and the patient's subjective discomfort in this regard was also checked. A subjective percentage of strength and sensation in the left extremity was evaluated to assess the clinical effects of the treatment. After treatment, the hyperhidrosis classification improved from Grade 3 to Grade 0, and the patient's subjective discomfort was greatly improved and continued for the two weeks after discharge. In addition, subjective strength and sensation improved by 20% and 5%, respectively, compared to time of admission. These results suggest that Korean medicine is effective in treating paresthesia after stroke and long-lasting hyperhidrosis.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.4
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• pp.267-274
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• 2008

Purpose: Transient neurological deterioration (TND) is one of the complications after extracranial-intracranial bypass surgery, and it has been assumed to be caused by postoperative transient hyperperfusion. This study was performed to evaluate the relationship between TND and preoperative and postoperative cerebral perfusion status on brain perfusion SPECT following superficial temporal artery - middle cerebral artery (STA-MCA) anastomosis surgery. Materials and Methods: A total of 60 STA-MCA anastomosis surgeries of 56 patients (mean age: $50{\pm}16$ yrs; M:F=29:27; atherosclerotic disease: 33, moyamoya disease: 27) which were done between September 2003 and July 2006 were enrolled. The resting cerebral perfusion and cerebral vascular reserve (CVR) after acetazolamide challenge were measured before and 10 days after surgery using 99mTc-ethylcysteinate dimer (ECD) SPECT. Moreover, the cerebral perfusion was measured on the third postoperative day. With the use of the statistical parametric mapping and probabilistic brain atlas, the counts for the middle cerebral artery (MCA) territory were calculated for each image, and statistical analyses were performed. Results: In 6 of 60 cases (10%), TND occurred after surgery. In all patients, the preoperative cerebral perfusion of affected MCA territory was significantly lower than that of contralateral side (p=0.002). The cerebral perfusion on the third and tenth day after surgery was significantly higher than preoperative cerebral perfusion (p=0.001, p=0.02). In TND patients, basal cerebral perfusion and CVR on preoperative SPECT were significantly lower than those of non-TND patients (p=0.01, p=0.05). Further, the increases in cerebral perfusion on the third day after surgery were significant higher than those in other patients (p=0.008). In patients with TND, the cerebral perfusion ratio of affected side to contralateral side on third postoperative day was significantly higher than that of other patients (p=0.002). However, there was no significant difference of the cerebral perfusion ratio on preoperative and tenth postoperative day between patients with TND and other patients. Conclusion: In patients with TND, relative and moderate hyperperfusion was observed in affected side after bypass surgery. These finding may help to understand the pathophysiology of TND.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.4
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• pp.301-309
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• 2000

The purpose of our investigation was to examine the effects of prostaglandin $F_{2{\alpha}}\;(PGF_{2{\alpha}})$ on membrane potentials, $Ca^{2+}-activated\;K^+\;(K_{Ca})$ channels, and delayed rectifier $K^+(K_V)$ channels using the patch-clamp technique in single rabbit middle cerebral arterial smooth muscle cells. $PGF_{2{\alpha}}$ significantly hyperpolarized membrane potentials and increased outward whole-cell K currents. $PGF_{2{\alpha}}$ increased open-state probability of $K_{Ca}$ channels without the change of the open and closed kinetics. $PGF_{2{\alpha}}$ increased the amplitudes of $K_V$ currents with a leftward shift of activation and inactivation curves and a decrease of activation time constant. Our results suggest that the activation of $K_{Ca}$ and $K_V$ channels, at least in part, may lead to attenuate or counteract vasoconstriction by $PGF_{2{\alpha}}$ in middle cerebral artery.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.1
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• pp.246-253
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• 2005

This study was designed to investigate the neuroprotective effects of Guh-Poong-Chung-Sim-Hwan(GCH) on ischemia induced by middle cerebral artery occlusion(MCAO) in Sprague-Dawley rats. The effects of GCH administration on the size of the brain infarct and the functional status of the rats after ischemia were examined, as well as the expression of COX-2 in acute phase. The recovery of motor functions for 7 days and the brain infarct were examined to find out the delayed effects of daily GCH-administration as well. In conclusion, we found that GCH reduced both functional deficits and brain damage in the MCAO rat model of stroke. In addition, high doses of GCH reduced COX-2 expression in the penumbra. It is well known that herbal medication including GCH is very safe for humans. Accordingly, our results support the clinical use of this GKM for the treatment of stroke and offer the possibility that a potent neuroprotective agent could be developed from Korean herbal medicines.

• Proceedings of the Korean Society of Embryo Transfer Conference
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• 2002.11a
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• pp.111-111
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• 2002

Stroke occurs when local thrombosis, embolic particle or the rupture of blood vessele interrupts the blood floe to the brain. $\beta$-estradiol 17-valerate has been reported to exert neuroprotective effects when administered before an ischemic insult. Recently, the pathophysiology of cerebral ischemia has been studied extensively in rat with various methods. In the present study, we investigates whether $\beta$-estrodiol 17-valerate can protect against brain injury. RNA sample were extracted from the hippocampus of female rat, reverse-transcription in the presence of [$\alpha$32p] dATP. Differential gene express-ion profiles were revealed (Bone morphogenetic protein type 1A receptor, Protein disulphide isomerase, Leukemia inhibitor factor receptor, cytochrome bc- 1 complex-x core P, thiol-specific antioxidant protein). RT-PCR was used to validate the relative expression pattern obtained by the cDNA array. The precise relationship between the early expression of recovery genes and stroke is a matter of luther investigation. This Study was supported by the Korea Science and Engineering Foundation(KOSEF) through the Biohealth Products Research Center(BPRC), Inje University, Korea.

• The Journal of Korean Medicine
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• v.30 no.1
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• pp.64-75
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• 2009

Objective: This study was designed to investigate the effect of Samultang (SMT) under hippocampus cells ischemia both in vitro and in vivo. Methods: In the in vitro study, HT22 cells, predominantly detected in the cytoplasm, which coincides with the location of the mitochondria, were used as indicators. In the in vivo study, permanent middle cerebral artery occlusion (MCAO) was induced on rats. SMT was given orally 2 h before induction of permanent focal brain ischemic injury. Result: In the in vitro study, SMT had protective effects in glutamate-induced cytotoxicity, which was revealed as apoptosis characterized by chromatic condensation and the loss of mitochondrial membrane potential in HT22 cells. In the in vivo study, TTC (2,3,5-triphenyltetrazolium chloride) staining showed a marked ischemic injury in blood supply territory of the middle cerebral artery (MCA) such as the cerebral cortex and striatum. However, treatment with SMT significantly reduced infarcted volume. SMT increased marked survival of HT22 cells against glutamate-induced cytotoxicity in MTT assay. Conclusion: These results suggest that water extract of SMT provides neuroprotection against ischemic or oxidative injury by inhibition of apoptotic cell death.

• 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).