• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1998년도 추계학술대회
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• pp.281-282
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• 1998

Recently, there has been growing interest in the assessment of physiological parameters on brain perfusion that provide more information than pure morphologic diagnosis. Quantification of parameters that characterize cerebral micro-circulation with magnetic resonance imaging is of great relevance for clinical application. We determine the local tissue concentration by exponential relationship between the relative signal reduction S(t)/$S_0$ and local tissue concentration of contrast material $C_m(t)$ in dynamic susceptibility contrast enhanced MR imaging. And then we made relative regional blood volume map by calculating the area under the measured concentration-time curves $C_m(t)$ during first pass of paramagnetic contrast material as a preliminary step for perfusion map. These images make it possible to compare the rCBV in different brain regions in one individual at a time. We have it in contemplation to obtain arterial and brain signal time curves simultaneously to make absolute rCBV and perfusion (rCBF) map. These maps may provide the method of comparative investigations of different patients having strong variation in AIF.

• 대한핵의학회지
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• 제28권1호
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• pp.22-30
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• 1994

Encephalo-duro-arterio-synangiosis (EDAS) is a relatively new surgical procedure for treatment of childhood moyamoya disease. We assessed regional cerebral perfusion in moyamoya patients before (1.3 mo) and after (6.8 mo) EDAS with $^{99m}Tc$-HMPAO brain SPECT. A total of 21 EDAS operations in 17 moyamoya patients was included. Preoperative CT or MRI showed cerebral infarction in 14 patients and carotid angiography showed Suzuki grade I to V stenosis in 6%, 9%, 62%, 12% and 12% of the hemispheres respectively. Preoperative SPECT showed regional hypoperfusion in all patients, bilateral frontal and temporal lobes being the most frequently involved site. $4{\times}4$ pixel sized ROIs were applied on the frontotemporal cortex in 3 slice averaged transverse tomographic images. An index of regional perfusion was measured as: PI (%)=average F-T activity/average cerebellar activity${\times}100$ Pre-EDAS ipsilateral PI ranged from 23.7 to 98.4% (mean: $74.3{\pm}17%$) and increased significantly after operation ($81.4{\pm}17%$, p<0.001). Individual post-EDAS PI improved in 15/21 cases, showed no significant change in 5 and was slightly aggravated in 1. The amount of clinical improvement (${\Delta}CI$) was graded with a scale of 0 to 4 based on frequency and severity of TIA attacks. When patients were grouped according to pre-EDAS PI, group II (PI 70-89) showed a significantly higher ${\Delta}CI$ (3.3) compared to group I (PI< 70, 1.57) or group III (PI >90, 0.5) (P< 0.001). The amount of perfusion improvement (${\Delta}PI$) showed significant correlation with ${\Delta}CI$ (r=0.42, p=0.04). ${\Delta}PI$ did not, however, correlate with the amount of neovascularization assessed angiographically in 8 patients. Serial HMPAO SPECT is an useful noninvasive study for assessing perfusion improvement after EDAS in childhood moyamoya patients.

• 대한핵의학회지
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• 제30권4호
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• pp.570-575
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• 1996

우리는 혈전 용해요법을 시행한 뇌경색 환자를 대상으로 과잉관류가 발생한 아급성기에 $^{99m}Tc$-HMPAO SPECT와 $^{99m}Tc$-ECD SPECT를 같은 날 실시하여 $^{99m}Tc$-HMPAO SPECT에서는 과잉관류 소견이 보이나, $^{99m}Tc$-ECD SPECT 에서는 결손으로 나타남을 관찰하였다. 이 환자는 임상적으로 신경학적 이상에 호전이 없이 증상 발생 42일째 사망하였다. 문헌을 검토하여 종합하고 우리 환자예를 분석한 결과 $^{99m}Tc$-HMPAO SPECT가 뇌혈류를 반영하여 관류회복과 과잉관류상태를 나타내었고, $^{99m}Tc$-ECD SPECT는 뇌세포의 대사 및 생존여부를 반영하여 뇌세포 손상이 넓고 심각함을 나타내었다고 보았다.

• Biomolecules & Therapeutics
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• 제10권4호
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• pp.218-223
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• 2002

This study compared the blood-brain barrier permeability of [$^3H$] taurine in senescence-accelerated mouse (SAM) and normal mouse with common carotid artery perfusion (CCAP) method and intravenous injection technique to establish a possible relation between aging and changes in tissue levels of taurine. The SAM strains show senescence acceleration and age-associated pathological phenotypes similar to geriatric disorders seen in humans. In the result of this experiments, the plasma clearance of [$^3H$]taurine in SAM was almost comparable with that of normal mice by intravenous injection technique, but the brain volume of distribution ($V_{D brain}$) of [$^3H$]taurine in SAM by CCAP method reduced by 85% compared with that in normal mice. These results suggest that aging may have an effect on the brain transport activity of taurine in disease state model animal.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2001년도 제6차 학술대회 초록집
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• pp.169-169
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• 2001

Purpose： To assess the clinical usefulness of Transfer Insensitive Labeling Technique (TILT) in t evaluation of ischemic cerebrovascular disease. Method： Arterial spin labeling (ASL) is a method of perfusion weighted imaging usin endogenous water as a tracer. To avoid MT-related artifacts, which is common in usual A technique, a transfer insensitive labeling technique (TILT) was used, which globall manipulate macromolecular spins in the same way by both labeling and reference preparatio while free water is labeled in one case and left unchanged in the other. Philips Interal 1.5 T system was used. 40cm FOV and 32 repeated measurements were done because of the wea perfusion signal. 5 slices of supratentorial brain were obtained in 5 patients ｛MCA infar (n=3), moyamoya disease (n=2)｝. We simultaneously obtained contrast enhanced T2＊-weighted perfusion MRI and correlate to TILT images.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제4권1호
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• pp.68-78
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• 1993

Tourette씨병과 만성틱장애는 7세 전후한 연령에서 가장 흔히 시작되는 소아 또는 청소년기의 행동장애로서 서로 밀접한 관련성을 가지고 있으며, 또한 유전적인 경향이 아주 강한 질환들로 알려져 있다. 원인으로서도 여러가지 가설이 있으나 뇌의 기능 또는 기질적인 장애로 인하여 발병될 가능성도 클 것으로 추정되고 있다. 이에 본 연구는 이 질환들의 생물학적인 원인들 중 일부를 살펴보기 위하여 단일광자방출 전산화단층촬영술을 시행하고 다음과 같은 결과를 얻었다. 1) 31.0%(13/42)에서 대뇌피질의 혈류감소 소견을 보였으며, 전두엽이 가장 흔한 혈류 이상 소견을 보인 부위였다.2) 4.8%(2/42)애서 대뇌기저핵의 혈류에 감소를 나타내었다. 3) 4.8%(2/42)에서 시상부의 혈류감소가 관찰되었다. 4) 16.7%(7/42)에서 소뇌의 혈류감소가 관찰되었다. 5) 주의력결핍과잉운동장애가 동반된 군과 동반되지 않은 군간에 혈류장애의 빈도에 있어서의 차이는 관찰되지 않았다. 6) Tourette씨병과 만성틱장애에 있어서, 혈류장애가 동반된 빈도에 있어서의 차이는 관찰되지 않았다. 이상의 걸과로 미루어 Tourette씨병과 만성틱장애의 생물학적인 원인중의 하나로 뇌혈류장애와 관계가 있을 가능성이 있으며, 뇌혈류의 정도를 정량화시키거나, 또는 자기공명영상과 같은 방법을 병행하여 연구를 시행함으로써, 본 연구의 타당성을 높여줄 수 있으리라 기대된다.

• 대한의생명과학회지
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• 제6권4호
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• pp.229-235
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• 2000

췌장에서 분비하는 인슐린과 글루카곤의 자극-분비 coupling 과정은 주로 혈당 농도와 중추신경계에 의하여 조절되어진다. 본 연구는 두부에 포도당이 결핍되었을 때에 중추신경계가 췌장에서 인슐린과 글루카곤이 분비되는 패턴을 Sprague-Dawley 흰쥐를 대상으로 하여 살펴보았으며, 실험 방법은 in situ 뇌-췌장 관류법을 이용하였다. 관류액은 100 mg/dL glucose와 20 mM arginine를 포함한 Krebs-Ringer 완충액 (pH 7.4)으로 하였으며, 95% $O_2$-5% $CO_2$ 가스를 계속적으로 주입시키면서 5 ml/min의 속도로 30분간 정주하였다. 대조군은 cephalic glucopenia가 일어나지 않는 군으로 하였고, 실험군은 두 군으로 나누어서 GLP1군은 cephalic glucopenia가 0분에 일어나도록 하였고, CLP2군은 16분에 일어나도록 하였다. 문맥으로 유출되는 췌장의 effluent액에서 인슐린과 글루카곤 농도를 RIA법으로 측정하였고 호르몬의 분비 속도를 산출하여 분비동태 양상을 분석하였다. 결과에서 인슐린 분비량은 GLP1군에서 가장 낮아서 cephalic glucopenia에 의하여 다소 감소하는 경향이었으나, 세 군간에 통계적으로 유의적인 차이는 없었다. 인슐린의 분비동태 양상을 살펴보면 이봉성의 정규 양상을 보였으나, GLP1군에서 첫번째 peak (4 min)가 다소 둔화되는 현상을 보였다. 글루카곤의 분비동태 양상도 이봉성의 정규 양상을 보였으며, 특히 GLP1군에 있어서 0~15분간의 글루카곤 분비량은 cephalic glucopenia에 의하여 유의성 있게 (p<0.05) 증가하였다. GLP2군에 있어서 글루카곤 분비량은 관류 후 15~30분 사이에 중가하는 경향을 볼 수 있었으나 통계적인 유의성은 없었다. 따라서 頭部의 포도당 결핍은 글루카곤의 분비를 증가시키는 것으로 나타났고, 이러한 현상은 특히 관류의 early period에서 현저하였다.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1996년도 춘계학술대회
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• pp.246-246
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• 1996

The glucuronide conjugates of morphine have been claimed to exert significant neuropharmacological effects. Morphine-6-glucuronide (M6G) may be a potent opioid agonist in vivo, and morphine-3-glucuronide (M3G) may act as a weak opioid antagonist. The present study addressed the permeability of the blood-brain barrier (BBB) for these metabolites compared to morphine. Tracers were prepared by enzymatic glucuronidation of U-methyl-$^3$H]-morphine. Brain uptake in rats was measured by the internal carotid artery perfusion technique and after i.v. bolus injections. In the perfusion experiments morphine showed a permeability-surface area product (PS) of 3.52${\pm}$0.61 ${\mu}$L min$\^$-1/ g$\^$-1/ Uptake seems to be mediated by passive diffusion and was not saturable by 100 ${\mu}$M morphine in the perfusate. The BBB permeability of [$^3$H]-M3G and [$^3$H]-M6G was too low to be quantified after 5 min of perfusion. Brain uptake of [$^3$H]-M3G and [$^3$H]-M6G 60 min after i.v. bolus injection reached 0.0060${\pm}$0.0003 and 0.0030${\pm}$0.0005% injected dose per g, respectively. From these brain concentrations and from the corresponding plasma concentration - time curves, BBB PS values of 0.14${\pm}$ 0.02 ${\mu}$L min$\^$-1/g$\^$-1/ and 0.11 ${\pm}$ 0.01 ${\mu}$L min$\^$-1/g$\^$-1/, respectively, were calculated. The ratio of BBB PS values is complementary to the analgesic potencies of morphine and M6G after different routes of administration. The low PS of MSG explains, why it is approximate]y equipotent to morphine after systemic injection, although it is about 2 orders of magnitude more potent than morphine after administration directly into the central nervous system.

• Journal of Acupuncture Research
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• 제21권1호
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• pp.111-118
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• 2004

Background and purpose: Opposing-needling technique involves selecting acupoints at unaffected limb. The aim of this study was to evaluate the effect of LI4-LI11 electrical acupuncture at unaffected limb on the cerebral blood flow in ischemic stroke patients using SPECT Methods: We selected 9 ischemic stroke patients. Baseline brain SPECT was done with triple head gamma camera(MultiSPECT3, Siemens, USA) after intravenous administration of 925 MBq of Tc-99m ECD). Fifteen-minute electro-acupuncture at Hapgok(LI 4) and Gokji(LI 11) were applied on unaffected upper limb of subjects. The same dose of Tc-99m ECD was injected during the electro-acupuncture, and the second SPECT images were obtained. Using the computer software(ICON 7.1, Siemens, USA), 3 SPECT slices(upper, middle, lower) surrounding the brain lesion were selected and each slice was divided by 10-16 brain regions. Asymmetry indexes were analyzed in each brain region. We regarded$\geq$10% changes of asymmetry index between before and after electro-acupuncture as significance. Results: Seven Patients(77.8%) had significantly increased perfusion and 2(22.2%) didn't show increased perfusion in post-acupuncture scans compared to pre-acupuncture scans(baseline). The regions of CBF improvement were mostly frontal lobes and anterior temporal lobes. Conclusions: This study demonstrated that LI4-LI11 electro-acupuncture at unaffected limb increased regional cerebral blood perfusion to the corresponding brain areas in ischemic stroke patients.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.270-278
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• 2021

Purpose: The purpose of the study is to analyze the results of surgical treatment of patients with brain and torso injury for 5 years in a single regional trauma center. Methods: We analyzed multiple trauma patients who underwent brain surgery and torso surgery for chest or abdominal injury simultaneously or sequentially among all 14,175 trauma patients who visited Dankook University Hospital Regional Trauma Center from January 2015 to December 2019. Results: A total of 25 patients underwent brain surgery and chest or abdominal surgery, with an average age of 55.4 years, 17 men and eight women. As a result of surgical treatment, there were 14 patients who underwent the surgery on the same day (resuscitative surgery), of which five patients underwent surgery simultaneously, four patients underwent brain surgery first, and one patient underwent chest surgery first, four patients underwent abdominal surgery first. Among the 25 treated patients, the 10 patients died, which the cause of death was five severe brain injuries and four hemorrhagic shocks. Conclusions: In multiple damaged patients require both torso surgery and head surgery, poor prognosis was associated with low initial Glasgow Coma Scale and high Injury Severity Score. On the other hand, patients had good prognosis when blood pressure was maintained and operation for traumatic brain injury was performed first. At the same time, patients who had operation on head and torso simultaneously had extremely low survival rates. This may be associated with secondary brain injury due to low perfusion pressure or continuous hypotension and the traumatic coagulopathy caused by massive bleeding.