• 제목/요약/키워드: Brain circulation

검색결과 105건 처리시간 0.034초

이상지질혈증과 치료제 연구개발 경향 (Drug research and development tend to hyperlipidemia)

  • 설인찬
    • 혜화의학회지
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    • 제18권2호
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    • pp.1-12
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    • 2009
  • Most of the cholesterol is synthesized by liver in the body while about one of third is taken via dietary. The main functions of cholesterol is to protect membranes in cell surface, avoid the arterial bleeding by hypertension, and prolong the life of erythrocytes, and so on. However, overload of cholesterol leads to arteriosclerosis associated with leading death cause. Lack of physical activity, emotional and environmental stress, and low intake of protein or vitamin E induce the unbalance between HDL- and LDL-cholesterol so become a basis of ischemic disorders in heart, brain and elsewhere in the body. So far, four major classes of medications for hyperlipidemia are HMG-CoA reductase inhibitors (statins), bile acid sequestrants, nicotinic acid, and fibric acids. The statins can lower LDL and levels triglyceride, but may induce myopathy and an elevation of liver enzyme levels. The bile acid sequestrants lower LDL levels and raise HDL levels with no effect on triglyceride levels but side effects of gastrointestinal (GI) distress, constipation, and a decrease in the absorption of other drugs. Nicotinic acid and fibric acids lower LDL and triglyceride levels with showing flushing, hyperglycemia, hyperuricemia, GI distress, and hepatotoxicity dyspepsia, gallstones, myopathy, and unexplained noncardiac death as adverse effects. Above western drugs lower cholesterol by 15 to 30% while all have notable adverse effects. In traditional medicine, hyperlipidemia is regarded as retention of phlegm and fluid disease. Etiology and pathogenesis of hyperlipidemia is basically based on Spleen-Deficiency and Phlegm-Stagnation, accumulation and stasis of -heat, and Qi & blood stagnation induced by Phlegm-damp, water-dampness, and blood stasis. Thereby, strengthening Spleen and dissolving Phlegm, clearing away heat and diuresis, and supplementing Qi and activating blood circulation are commonly used therapeutic methods for hyperlipidemia. The traditional herbal medicine, have been used for patients with CVA, hypertension or hyperlipidemia in Oriental hospital or Oriental clinic. The lock and key theory is used to develop most of western medicine, however many diseases are caused by mixed factors in body-complex system. We expect that Oriental pharmacological theory could be newborn as a novel drug showing high advantage of blood levels of lipidsand QOL of performance without side effects.

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뇌동맥류 파열에 의한 지주막하 출혈 후 수두증 발생의 위험 인자에 대한 임상 연구 (Clinical Study on Risk Factors of Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage)

  • 최정재;고현송;조준희;김선환;염진영;송시헌;김윤
    • Journal of Korean Neurosurgical Society
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    • 제30권12호
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    • pp.1375-1380
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    • 2001
  • Objective : The authors analyzed the incidence, the cause and the prognosis of hydrocephalus following aneurysmal subarachnoid hemorrhage to evaluate the risk factors of hydrocephalus and to provide the proper treatment method for hydrocephalus following aneurysmal subarachnoid hemorrhage. Methods : The 505 cases of subarachnoid hemorrhage followed by aneurysmal surgery from January 1990 to May 1999, were divided into shunt group and shunt-free group and we were reviewed for the clinical status, Fisher's grade, brain CT findings and prognosis. Results : The incidence of acute hydrocephalus was 37.2% of patients and 18.9% to developed chronic hydrocephalus. Shunt surgery due to chronic hydrocephalus was required in 6.5% of patients. We found following variables were significantly related to shunt-dependent hydrocephalus : high Hunt-Hess and Fisher grade, initial CT findings of intraventricular hemorrahge, posterior circulation aneurysm, preoperative rebleeding, delayed ischemic deficits, and initial high ventricular size index. There were no statistically significant relationships between shunt-dependent hydrocephalus and patient age or sex, timing of operation. The previous hypertension was not related to shunt dependent hydrocephalus. Prognosis in shunt group showed poor result. Conclusion : The risk factors of hydrocephalus following aneurysmal subarachnoid hemorrhage are high Hunt-Hess grade, high Fisher's grade, aneurysms of posterior circulations, preoperative aneurysmal rebleeding, delayed ischemic deficits, initial CT findings of intraventricular hemorrahge and initially increased ventricular size. The patients with these factors should the carefully observed and managed accordingly due to poor prognosis related to hydrocephalus requiring shunt operation.

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Protection of spontaneous and glutamate-induced neuronal damages by Soeumin Sibjeundaibo-tang and Soyangin Sibimijihwang-tang in cultured mice cerebrocortical cells

  • Lee, Mi-Young;Ma, Jin-Yeul;Choo, Young-Kug;Jung, Kyu-Yong
    • Advances in Traditional Medicine
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    • 제1권1호
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    • pp.55-63
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    • 2000
  • Soeumin Sibjeundaibo-tang (SJDBT) and Soyangin Sibimijihwang-tang (SMJHT) have been used traditionally to improve the systemic blood circulation and biological energy production in the patients with circulatory and neuronal diseases. The object of this study is to determine the protective effects of SJDBT and SMJHT extracts on the spontaneous and glutamate-induced neuronal damages in cultured cells derived from mice cerebral cortex. At 14 days after beginning the cultures, the activity of lactate dehydrogenase released into the culture media was significantly decreased by treatment of cerebroneuronal cells with SJDBT and SMJHT (0.1 mg/ml) for 7 days. By comparison with the normal cells, cerebroneuronal morphology was dramatically changed by treatment of glutamate (1 mM) for 12 hrs, and this was conspicuously recovered by pretreatment of cerebroneural cells with SJDBT and SMJHT (0.1-1.0 mg/ml) for 2 days. Moreover, glutamated-induced DNA fragmentation was also protected by pretreatment of cerebroneuronal cells with those extracts. These results suggest that naturally occurring and glutamate-induced degeneration of cultured cerebrocortical cells may be related, in part, to the process of apoptotic cell death. The pharmacological properties of SJDBT and SMJHT extracts to improve cerebroneuronal degeneration may be considered as one of useful medicines that can prevent cerebrocortical impairments resulted from age-dependent and excitotoxicity-induced neuronal degeneration in human brain.

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뇌성마비(腦性痲痺)의 한의학적(韓醫學的) 접근(接近)에 관한 최신(最新) 동향(動向) (Current tendency of oriental approach to the cerebral palsy)

  • 김장현;한윤정
    • 대한한방소아과학회지
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    • 제17권2호
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    • pp.173-198
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    • 2003
  • Back ground : Cerebral palsy(CP) is a static encephalopathy caused by an insult to the brain during the prenatal, perinatal, or postnatal period (ie, up to 2 years). CP can lead to global dysfunction but always includes motor problems Objective : The purpose of this study is to investigate the current tendency of oriental approach to the CP and promote oriental treatment of CP in Korea Method : Investigation of current literature and clinical paper in Korea and Chinese Result and Conclusion : 1) CP fall under the category of wu-chi(five kinds of retardations : 五遲), wu-ruan(five kinds of flaccidity : 五軟), wu-ying(five kinds of Stiffness : 五硬) in oriental medicine and correspond to naoxing-tanhuan in current chinese medicine. 2) CP is mainly caused by weakness of the liver and kidney(肝腎不足), weakness of the spleen and stomach(脾胃虛弱), and the method of treatment is tonify the liver and kidney(補益肝腎), tonify the spleen and replenish qi(補脾益氣), but yu-chi(the faculty of speech : 語遲) is caused by deficiency of the heart(心虛) so that treated with method of invigorating the heart and nourishing blood(補心養血). Recently blood stagnancy the stagnation of qi(氣滯血瘀) is considered as the cause of CP, promoting qi circulation to invigorate blood(行氣活血) is mentioned the treatment of method. 3) In addtion to a herbal medication and acupuncture, the various treatments of scalp acupuncture(頭鍼), acupoint injection(穴位注射), catgut embedding therapy(埋鍼) etc. had been applicated to CP and for the objective evaluation of remedial value, TCD, EEG, BMD have been used.

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Streptozotocin으로 유발된 당뇨병 흰쥐 대뇌피질에서 침이 Neuronal Nitric Oxide Synthase 발현에 미치는 영향 (Effects of acupuncture on nNOS-positive neurons in cerebrocortex of streptozotocin-induced diabetic rats)

  • 김이화;황대연;이은용;장미현;김연정;정주호;서정철;김창주
    • Journal of Acupuncture Research
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    • 제18권5호
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    • pp.155-163
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    • 2001
  • It has known that acupuncture exerts various effects, such as analgesia, promotion of homeostasis, improvements in brain circulation, and rectification of internal disorders in Oriental medicine. Of particular, acupuncture at the Zusanli acupoint (ST36) has been widely used to relieve symptoms of diabetes mellitus. The effect of acupuncture at Zusanli on neuronal nitric oxide synthase (nNOS)-positive neurons in streptozotocin (STZ)-induced diabetic rats was investigated via immunohistochemistry. Decreased nNOS-positive neurons was detected in cerebrocortex of STZ-induced diabetic rats. Needling on the Zusanli in diabetic rats resulted in increase of nNOS-positive neurons in cerebrocortex, The present study indicate that acupuncture may affect nNOS-positive neurons in cerebrocortex of STZ-induced diabetic rats.

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거울의 시각적 피드백을 활용한 심폐소생술의 차이 (Difference of Cardiopulmonary Resuscitation Using Visual Feedback of Mirror)

  • 윤성우
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2018년도 추계학술대회
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    • pp.438-440
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    • 2018
  • 심정지(Cardiac arrest)는 원인과 관계없이 심장의 박동이 정지되어 발생하는 일련의 상태를 말한다. 심장질환에 의한 심정지는 매년 우리나라 3대 사망원인에 포함되며 예측이 불가하다. 심정지 발생시 환자의 생명을 구하기 위한 유일한방법 중 하나는 심폐소생술이며 이 술기를 통하여 순환을 유지시킬 수 있다. 시각으로 받아들여진 정보는 시신경을 통하여 뇌로 전달되며, 그중 거울은 자신의 움직임과 자신의 형태를 볼 수 있게 하고, 교정과 분석이 가능하여 다양하게 활용 할 수 있다. 이에 거울을 활용한 시각적 정보에 따른 가슴압박의 질을 비교하였다. 연구결과 거울 사용에 따라 가슴압박의 평균 깊이가 유의한 차이가 있었고($48.93{\pm}6.76$, $53.86{\pm}4.56$, <0.001), 압박 대 이완 비율에도 차이를 보였다($0.87{\pm}0.13$, $0.96{\pm}0.10$, <0.002). 또한 자세를 의식하는 정도에서도 유의한 차이를 보였다($4.93{\pm}0.85$, $8.14{\pm}1.38$, <0.001).

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혈색통연교낭(血塞通軟膠囊)의 산화적 및 흥분성 신경세포독성 억제작용 (Inhibition of Oxidative Stress-induced and Excitotoxic Neuronal Cell Damage by Xuesaitong Ruanjiaonang)

  • 조정숙
    • 약학회지
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    • 제49권1호
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    • pp.30-37
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    • 2005
  • Xuesaitong Ruanjiaonang (XR), a soft capsule containing Panax notoginseng saponins as main ingredients, is believed to remove extravasated blood and increase cerebral blood flow by improving blood circulation, and therefore, has been used in China to treat ischemic stroke or hemiplegia caused by cerebral thrombosis. To characterize pharmacological actions of XR, the present study evaluated its effects on neuronal cell damage induced by various oxidative insults or excitotoxic amino acids in primary cultured rat cortical cells. The neuronal cell viability was not affected by XR with the exposure for 2 h at the concentrations tested in this study ($10{\sim}1000\;{\mu}g/ml$). However, significant reduction of the cell viability was observed when the cultured cells were exposed to XR at $1000\;{\mu}g/ml$ for 24 h. XR was found to concentration-dependently inhibit the oxidative neuronal damage induced by $H_{2}O_2$, xanthine/xanthine oxidase or $Fe^{2+}$/ascorbic acid. In addition, it dramatically inhibited the excitotoxic damage induced by glutamate or N-methyl-D-aspartate (NMDA). We found that the NMDA-induced neurotoxicity was inhibited more effectively and potently than the glutamate-induced toxicity. Moreover, XR was found to exert mild inhibition of lipid peroxidation induced by $Fe^{2+}$/ascorbic acid in rat brain homogenates and some 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity. Taken together, these results demonstrate neuroprotective and antioxidant effects of XR, showing inhibition of oxidative and excitotoxic damage in the cultured cortical neurons, as well as inhibition of lipid peroxidation and its radical scavenging activity. Considering that excitotoxicity and oxidative stress pl ay crucial roles in neuronal cell damage during ischemia and reperfusion, these results may provide pharmacological basis for its clinical usage to treat ischemic stroke.

뇌경막 동정맥루를 동반한 장기간 지속된 외상성 경동맥-해면정맥동루 - 증례보고 - (Long-Standing Traumatic Carotid-Cavernous Fistula with Dural Arteriovenous Fistula - Case Report -)

  • 박경범;박인성;김준수;김기정;황수현;김은상;정진명;한종우;김재형
    • 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.

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Numerical Model for Cerebrovascular Hemodynamics with Indocyanine Green Fluorescence Videoangiography

  • Hwayeong Cheon;Young-Je Son;Sung Bae Park;Pyoung-Seop Shim;Joo-Hiuk Son;Hee-Jin Yang
    • Journal of Korean Neurosurgical Society
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    • 제66권4호
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    • pp.382-392
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    • 2023
  • Objective : The use of indocyanine green videoangiography (ICG-VA) to assess blood flow in the brain during cerebrovascular surgery has been increasing. Clinical studies on ICG-VA have predominantly focused on qualitative analysis. However, quantitative analysis numerical modelling for time profiling enables a more accurate evaluation of blood flow kinetics. In this study, we established a multiple exponential modified Gaussian (multi-EMG) model for quantitative ICG-VA to understand accurately the status of cerebral hemodynamics. Methods : We obtained clinical data of cerebral blood flow acquired the quantitative analysis ICG-VA during cerebrovascular surgery. Varied asymmetric peak functions were compared to find the most matching function form with clinical data by using a nonlinear regression algorithm. To verify the result of the nonlinear regression, the mode function was applied to various types of data. Results : The proposed multi-EMG model is well fitted to the clinical data. Because the primary parameters-growth and decay rates, and peak center and heights-of the model are characteristics of model function, they provide accurate reference values for assessing cerebral hemodynamics in various conditions. In addition, the primary parameters can be estimated on the curves with partially missed data. The accuracy of the model estimation was verified by a repeated curve fitting method using manipulation of missing data. Conclusion : The multi-EMG model can possibly serve as a universal model for cerebral hemodynamics in a comparison with other asymmetric peak functions. According to the results, the model can be helpful for clinical research assessment of cerebrovascular hemodynamics in a clinical setting.

Proper Indication of Decompressive Craniectomy for the Patients with Massive Brain Edema after Intra-arterial Thrombectomy

  • Sang-Hyuk Im;Do-Sung Yoo;Hae-Kwan Park
    • Journal of Korean Neurosurgical Society
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    • 제67권2호
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    • pp.227-236
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    • 2024
  • Objective : Numerous studies have indicated that early decompressive craniectomy (DC) for patients with major infarction can be life-saving and enhance neurological outcomes. However, most of these studies were conducted by neurologists before the advent of intra-arterial thrombectomy (IA-Tx). This study aims to determine whether neurological status significantly impacts the final clinical outcome of patients who underwent DC following IA-Tx in major infarction. Methods : This analysis included 67 patients with major anterior circulation major infarction who underwent DC after IA-Tx, with or without intravenous tissue plasminogen activator. We retrospectively reviewed the medical records, radiological findings, and compared the neurological outcomes based on the "surgical time window" and neurological status at the time of surgery. Results : For patients treated with DC following IA-Tx, a Glasgow coma scale (GCS) score of 7 was the lowest score correlated with a favorable outcome (p=0.013). Favorable outcomes were significantly associated with successful recanalization after IA-Tx (p=0.001) and perfusion/diffusion (P/D)-mismatch evident on magnetic resonance imaging performed immediately prior to IA-Tx (p=0.007). However, the surgical time window (within 36 hours, p=0.389; within 48 hours, p=0.283) did not correlate with neurological outcomes. Conclusion : To date, early DC surgery after major infarction is crucial for patient outcomes. However, this study suggests that the indication for DC following IA-Tx should include neurological status (GCS ≤7), as some patients treated with early DC without considering the neurological status may undergo unnecessary surgery. Recanalization of the occluded vessel and P/D-mismatch are important for long-term neurological outcomes.