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The Effect of Sohabhyangwon(蘇合香元) on Regional Cerebral Blood Flow and Area of Cerebral Infarction in the Experimentally induced Cerebral Infarction in Rats (소합향원(蘇合香元)이 실험적(實驗的) 뇌경색(腦梗塞) 흰쥐의 국소뇌혈류량(局所腦血流量) 및 경색(梗塞) 면적에 미치는 영향(影響))

  • Choi, Eun-Jeong;Shin, Gil-Cho;Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.456-469
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    • 1997
  • The cerebral infarction arised from occulsion of cerebral artery has a high mortality rate and fatal sequelae. Sohabhyangwon(蘇合香元) is generally regarded to have a effect of walking up the patient from unconsiousness and promoting the flow of Qj(氣) by warming channel. METHOD The purpose of this study is to find out the effections of Sohabhyangwon(蘇合香元) on regional cerebral blood flow and relative cerebral infarction area in the experimentally induced infartion in rats In this experiment, 12 Spraque-Dawley rats weighting 280-350g were used. Cerebral ischemia induced by intraluminal suture technique of Kozumi's and Zea-Longer's method. $Co_{2},\;O_2$, pH, arterial blood pressure in rats were checked by Blood Gas Analyzer every 30 minutes for 2 hours. And regional cerebral blood flow were checking by hydrogen clearance technique, cerebral infarcted area was megsured by Image Analysis System. RESULTS 1. During the experiment, $CO_{2},\;O_2$, pH, arterial blood pressure in rats had no change in both sample group and control group. 2. Cortical cerebral blood flow decreased at same rate in both sample group and control group after inducing cerebral infarction. 3. On comparison of relative cerebral infarcted area, Sohabhyangwon(蘇合香元) perfused group showed a significant decrease. CONCLUSION According to the result above, Sohabhyangwon has a protection effect on cranial nerve and-has no effect on cerebral blood flow.

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A Study on the Usability of Echo Planar Image T2 FLAIR Sequence in the MRI of Acute Ischemic Cerebral Infarction (급성 허혈성 뇌경색 환자의 자기공명영상 검사 시 Echo Planar Image T2 FLAIR 기법의 유용성에 관한 연구)

  • Roh, Taegwan;Jo, Yongkeun
    • Journal of the Korean Society of Radiology
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    • v.14 no.7
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    • pp.957-964
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    • 2020
  • T2 FLAIR sequence of MRI in Acute Ischemic Stroke patients is meaningful to those who have the diagnosis of cerebral hemorrhage and neurological deficiency, including the detection of cerebral infarction around Cerebrospinal fluid. However, because of the long acquisition time and mutative motion artifacts caused by movement, It is difficult to take the MRI image acquisition for non-cooperative patients who need to apply a rapid image acquisition. In this study, we applied the EPI-FLAIR sequence, which is one of the fastest pulse sequences in use, which is a combination of EPI sequence and T2 FLAIR sequence, to patients with acute ischemic cerebral infarction. Based on the qualitative and quantitative evaluation results of the EPI-FLAIR and T2 FLAIR image, we will evaluate the diagnostic usefulness of the EPI-FLAIR sequence.

Clinical Study of Group B β-Hemolytic Streptococcal Meningitis (B군 연쇄상구균 뇌막염에 대한 임상적 고찰)

  • Lee, Seo-Young;You, Sou-Jeong;Kim, Deok-Soo;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1224-1229
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    • 2003
  • Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.

Influence of Ischemic Lesions on $^{99m}Tc$-HMPAO SPECT Findings in the Diagnosis of Alzheimer's Disease ($^{99m}Tc$-HMPAO SPECT를 이용한 알쯔하이머병의 진단에서 허혈성 뇌병변이 미치는 영향)

  • Lee, Kyung-Han;Lee, Myung-Chul;Lee, Dong-Soo;Kwon, June-Soo;Kim, Jong-Ho;Chung, June-Key;Woo, Jong-In;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.282-292
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    • 1994
  • Brain perfusion SPECT shows typical regional perfusion abnormalities in Alzheimer's disease(AD) and is useful for its diagnosis. However, there is also arguement that these patterns show significant overlap with other causes, and the accuracy for SPECT in differentiating AD has shown conflicting results. We postulate that the variation in re-ported results are partly due to a difference in patient or control selection with special reference to the mixture of ischemic cerebral disease in the studied population. To deter-mine the effect of ischemic lesions and the nature of control subjects on SPECT studies for AD, we performed $^{99m}Tc$-HMPAO single photon emission computed tomography (SPECT) in 11 probable AD patients with a low (<4) Hachinski ischemic score and 12 non-demented age matched controls. Magnetic resonance imaging(MRI) disclosed ischemic cerebral lesions in 27% (3/11) of the PAD group and 25% (3/12) of the control group. Regional perfusion indices were quantitated from the SPECT images as follows and the distribution of perfusion indices from both groups were compared. This was repeated with controls after excluding those with significant ischemic lesions by MRI : regional perfusion index = average regional count/average cerebellar count All PAD patients showed perfusion abnormality in SPECT. However, 53% (10/12) of controls also showed perfusion at-normalities, and no pattern could reliably differentiate the two groups. After excluding controls with significant cerebral ischemia, the difference in temporal and parietal perfusion index was increased. A decreased tempore-parietal and any parietal or temporal per-fusion index had a sensitivity of 18% and 36% in detecting AD, respectively. When using a separate group of normal age mathced controls, the indices showed an even more difference in the temporal and parietal lobes and the sensitivity of a decreased tempore-parietal and any parietal or temporal perfusion index had a sensitivity of 36% and 55% in detecting AD, respectively. Thus, the type of control with special reference to the pres-once of ischemic cerebral lesions contribute significantly to the accuracy of perfusion SPECT in diagnosing AD. This nay have particular importance in the diagnosis of AD in populations where the prevalance of cerebrovascular disease is high.

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$^{99m}Tc$-Glucarate Uptake in Ischemic Tissue of Experimental Models of Cerebral Ischemia (실험적 뇌허혈증 모델에서 허혈 조직의 $^{99m}Tc$-glucarate 섭취)

  • Jeong, Jae-Min;Kim, Young-Ju;Choi, Seok-Rye;Kim, Chae-Kyun;Mar, Woong-Chun;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.484-492
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    • 1996
  • To detect ischemic tissue in experimental model of cerebral ischemia made by middle cerebral artery(MCA)-occlusion, we acquired triple image of $^{99m}Tc$-glucarate, [$^{18}F$]fluoro-deoxyglucose (FDG), and 2,3,5- triphenyltetrazolium (TTC) staining. We made cerebral infarction either with reperfusion (after occlusion of 2 hours) or without reperfusion in 10 Sprague-Dawley rats by inserting thread to MCA through internal carotid artery. After 22 hours, we injected 740 MBq of $^{99m}Tc$-glucarate and 55.5 MBq of [$^{18}F$]FDG through tail vein. Each 1 mm slice of rat brains was frozen and exposed to imaging plate for 20 minutes in freezer to get an [$^{18}F$]FDG image. After 20 hours enough to fade radioactivity of [$^{18}F$]FDG, the slices were again imaged by BAS1500 for $^{99m}Tc$-glucarate uptake. Finally, these brain tissues were stained with TTC. Semi-quantitative visual analysis was done by grading 0 to 3 points according to the degree of uptakes($^{99m}Tc$-glucarate) and decreased uptakes([$^{18}F$]FDG and TTC). Ten rats survived with neurologic symptoms. TTC staining confirmed the development of infarction. The size of the infarction was relatively larger in the group without reperfusion. [$^{18}F$]FDG images were similar to TTC-stained images. However, we found regions with intermediate uptake which were not stained with TTC. We found regions with intermediate [$^{18}F$]FDG uptake where TTC staining was normal. $^{99m}Tc$-glucarate uptake was round only in TTC non-stained region. In the TTC stained regions, there were no uptake of $^{99m}Tc$-glucarate. We could not find clear relation between $^{99m}Tc$-glucarate uptake with [$^{18}F$]FDG uptake. This was partly because percent uptake of $^{99m}Tc$-glucarate was so small (less than 1 percent of injected dose) and because there were quite heterogeneity of patterns of [$^{18}F$]FDG uptake and TTC. With these findings, we could conclude that $^{99m}Tc$-glucarate were taken up only in part of ischemic tissues which were proven to be nonviable. The establishment of MCA-occluded rat model with or without reperfusion and triple imaging for $^{99m}Tc,\;^{18}F$ and TTC helped the characterization of $^{99m}Tc$-glucarate uptakes. Further work is needed to clarify the meaning or diversities or [$^{18}F$]FDG and TTC and their relation with $^{99m}Tc$-glucarate.

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Carotid Artery Intima-Media Thickness Measured by Iterated Layer-cluster Discrimination (순차적 층위군집(層位群集)판별에 의한 경동맥 내중막 두께 측정)

  • Hwang Jae-Ho;Kim Wuon-Shik
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.43 no.5 s.311
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    • pp.89-100
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    • 2006
  • The carotid intima-media thickness (IMT) is very important, because the severity of it is an independent predictor of transient cerebral ischemia, stroke, and coronary events such as myocardial infarction. The conventional image processing to measure the IMT has not been satisfactory, because the methods have relied on the manual section drawing and a regional segmentation by differential estimation. We propose a new image processing technology effective to extract features from the carotid artery image whose pixels have the directional vector properties with composed color distribution. The technique we presented here is not by differential variation but by verification of the layer properties of carotid artery image. Iterated vertical and horizontal analysis and segmentation of the IMT image show the vector characteristics. This new technique makes it possible to cluster the layers statistically, and to classify mathematical correlation between regions and resulting in correct measurements of thickness and its variation. The advantages and effectiveness of this approach are applicable to region process and character extraction of such a vector image.

Surgical Treatment of Postinfarct Ventricular Double Rupture - A case report - (심근경색 후 발생한 심실이중파열의 외과 치료)

  • Kim Young Sam;Yoon Young Han;Kim Joung Taek;Kim Kwang Ho;Lim Hyun Kyoung;Kwan Jun;Baek Wan Ki
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.717-720
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    • 2005
  • Here we report a case of posterior left ventricular (LV) free wall rupture following postinfarct ventricular septal rupture (VSR). A 58-year-old man was transferred to the hospital under the impression of acute myocardial infarction. Posterior VSR was seen on echocardiographic examination. The intraaortic balloon pump catheter was introduced percutaneously and the emergent operation was proposed. Sudden circulatory collapse was developed shortly after the anesthetic induction and the patient's chest was hurriedly opened while on cardiopulmonary resuscitation. The acute cardiac tamponade was seen and the blood was seen pumping from the longitudinal tear at the mid-level of LV posterior wall, measuring 2 cm in length. The cardiopulmonary bypass was set and LV reconstruction was done. The postoperative recovery was delayed due to the brain injury presumably caused by preoperative cardiac arrest.

The Clinical Experiences of "New Duromedics Valve" Replacement (새로운 Duromedics 인공판막 치환의 임상고찰)

  • Gang, Myeon-Sik;Yu, Gyeong-Jong;Yun, Chi-Sun;Park, Han-Gi
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.979-985
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    • 1997
  • Between October 1991 and May 1995, 256 "New Duromedics Valve"(Edward TEKNA Bileaflet Valve) were implanted in 208 adult patients(171 mitral, 82 aortic and 3 tricuspid) with age ranging from 18 years to 70 years(mean 48.2$\pm$ 11.6 years). Postoperative complication rates were 12.2%, but there was none valve related one. Overall early mortality rate were 1.4%(1.6% for MVR, 2.1% for DVR, and none for AVR or TVR) respectively. Follow-up was 99% completed ranging in duration from 2 months to 46 months. There were 6 valve-related late complications(2.9%) with 2 patients with upper gastrointestinal bleeding, 2 with cerebral thxomtioembolism, 1 with valve thrombosis and 1 with valve endocarditis. Freedom from these valve-related major complications were 89.9% at 40 months. There were 5 late deaths(2.4%). one of these late deaths was considered valve-related. Overall actuarial survival rates at 40 months were 95.5%, 96.8% for mitral, 97.1% for aortic, 100% for tricuspid, and 92.0% for double valve replacement respectively. Preoperative New York Heart Association functional class were 2.9, and 1.3 in post-operative state. We have been trying to keep the international normalized ratio(INR) with range of 2.5 to 3.0. The INR of 4 patients of 5 with anticoagulant ralated complications was beyond the range. To reduce the rate of anticoagulant related complications, we felt very strongly that the INR should be kept between 2.5 and 3.0. In our cases, there was no structural failure or significant hemolysis in the absence of periprosthetic leak. This experience encourages us to continue using the "New Duromedics Valve".omedics Valve".uot;.

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Effect of Probiotics on Risk Factors for Human Disease: A Review (인간 질병의 위험 요인에 대한 Probiotics의 효과: 총설)

  • Chon, Jung-Whan;Kim, Dong-Hyeon;Kim, Hyun-Sook;Kim, Hong-Seok;Hwang, Dae-Geun;Song, Kwang-Young;Yim, Jin-Hyuk;Choi, Dasom;Lim, Jong-Soo;Seo, Kun-Ho
    • Journal of Dairy Science and Biotechnology
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    • v.32 no.1
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    • pp.17-29
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    • 2014
  • GRAS probiotics can be used to modulate intestinal microbiota and to alleviate various gastrointestinal disorders. In several recent studies, researchers have explored the potential expansion and usability of probiotics to reduce the risk factors associated with diseases, including obesity, hypercholesterolemia, arterial hypertension, hyperhomocysteinemia, and oxidative stress. In this review, our aim was to clarify the mechanism underlying interactions between hosts (animal or human) and probiotics and the beneficial effects of probiotics on human health.

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Early and Mid-term Results of Operation for Infective Endocarditis on Mitral Valve (감염성 승모판 심내막염의 중단기 수술 성적)

  • Ahn, Byong-Hee;Chun, Joon-Kyung;Yu, Ung;Ryu, Sang-Wan;Choi, Yong-Sun;Kim, Byong-Pyo;Hong, Sung-Bum;Bum, Min-Sun;Na, Kook-Ju;Park, Jong-Chun;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.27-34
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    • 2004
  • Background: Infective endocarditis shows higher operative morbidity and mortality rates than other cardiac diseases. The vast majority of studies on infective endocarditis have been made on aortic endocarditis, with little attention having been paid to infective endocarditis on the mitral valve. This study attempts to investigate the clinical aspects and operative results of infective endocarditis on the mitral valve. Meterial and Method: The subjects of this study consist of 23 patients who underwent operations for infective endocariditis on the mitral valve from June 1995 to May 2003. Among them, 2 patients suffered from prosthetic valvular endocarditis and the other 21 from native valvular endocarditis. The subjects were evenly distributed age-wise with an average age of 44.8$\pm$15.7 (11∼66) years. Emergency operations were performed on seventeen patients (73.9%) due to large vegetation or instable hemodynamic status. In preoperative examinations, twelve patients exhibited congestive heart failure, four patients renal failure, two patients spleen and renal infarction, and two patients temporary neurological defects, while one patient had a brain abscess. Based on the NYHA functional classification, seven patients were determined to be at Grade II, 9 patients at Grade III, and 6 patients at Grade IV. Vegetations were detected in 20 patients while mitral regurgitation was dominant in 19 patients with 4 patients showing up as mitral stenosis dominant on the preoperative echocardiogram. Blood cultures for causative organisms were performed on all patients, and positive results were obtained from ten patients, with five cases of Streptococcus viridance, two cases of methicillin-sensitive Staphylococcus aureus, and one case each of Corynebacteriurn, Haemophillis, and Gernella. Operations were decided according to the AA/AHA guidelines (1988). The mean follow-up period was 27.6 $\pm$23.3 (1 ∼ 97) months. Result: Mitral valve replacements were performed on 43 patients, with mechanical valves being used on 9 patients and tissue valves on the other 4. Several kinds of mitral valve repair or mitral valvuloplasty were carried out on the remaining 10 patients. Associated procedures included six aortic valve replacements, two tricuspid annuloplasty, one modified Maze operation, and one direct closure of a ventricular septal defect. Postoperative complications included two cases of bleeding and one case each of mediastinitis, low cardiac output syndrome, and pneumonia. There were no cases of early deaths, or death within 30 days following the operation. No patient died in the hospital or experienced valve related complications. One patient, however, underwent mitral valvuloplasty 3 months after the operation. Another patient died from intra-cranial hemorrhage in the 31st month after the operation. Therefore, the valve-related death rate was 4.3%, and the valve-related complication rate 8.6% on mid-term follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, 3-, and 5-year survival rates were 100%, 88.8%, and 88.8%, respectively. Conclusion: The findings suggest that a complete removal of infected tissues is essential in the operative treatment of infectious endocarditis of the mitral valve. It is also suggested that when infected tissues are completely removed, neither type of material nor method of operation has a significant effect on the operation result. The postoperative results also suggest the need for a close follow-up observation of the patients suspected of having brain damage, which is caused by preoperative blood contamination or emboli from vegetation, for a possible cerebral vascular injury such as mycotic aneurysm.