• Title/Summary/Keyword: Carotid

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Aortic Arch Debranching and Antegrade Stent Graft Placement in an Expanding Distal Dissecting Aneurysm after Repair of an Acute Type I Aortic Dissection (Type I 급성 대동맥 박리 수술 후 진행하는 원위부 박리성 동맥류에 대한 대동맥궁 탈분지술과 전향적 대동맥궁 스텐트 그라프트의 설치)

  • Baek, Wan-Ki;Kim, Young-Sam;Lim, Hyun-Kyoung;Yoon, Yang-Han;Kim, Joung-Taek;Kim, Kwang-Ho
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.729-733
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    • 2010
  • Endovascular treatment of the aortic aneurysm with a stent graft is rapidly evolving. We describe here a case of hybrid TEVAR (thoracic endovascular aortic repair) in which the stent grafts were placed in the aortic arch after debranching of the arch vessels. The patient had undergone ascending aorta replacement for acute type I aortic dissection 2.5 years earlier. The aneurysmal change of the distal dissection progressed with time. A provisional bypass surgery from the ascending aorta to the innominate artery and left carotid artery was performed and then stent grafts were inserted via an antegrade route that covered the whole aortic arch and proximal descending thoracic aorta.

Comparison of the Neointima Inhibition Between Paclitaxel- and Sirolimus-Eluting Expanded Polytetrafluoroethylene Hemodialysis Grafts in a Porcine Model

  • Baek, Insu;Cho, AJin;Hwang, Jinsun;Kim, Heasun;Park, Jong-Sang;Kim, Dae Joong
    • Bulletin of the Korean Chemical Society
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    • v.34 no.6
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    • pp.1663-1667
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    • 2013
  • Neointimal hyperplasia causes vascular access dysfunction in hemodialysis patients with synthetic arteriovenous (AV) grafts. Several studies have reported that paclitaxel- or sirolimus-eluting AV grafts inhibit neointimal hyperplasia and display lower rates of stenosis compared with control grafts. However, there have been few comparative studies of the efficacy of paclitaxel- and sirolimus-eluting grafts. We compared the neointimal hyperplasia of paclitaxel- and sirolimus-eluting grafts. AV grafts were implanted laterally between the common carotid artery and the external jugular vein in 12 female Landrace pigs. The animals were sacrificed six weeks after surgery. The neointimal hyperplasia at the anastomosis sites of the grafts was quantified using the ratio of the intragraft hyperplasia to the graft area (H/G ratio) at the graft-vessel interface. The area of intimal hyperplasia at the venous (paclitaxel 1.06 [0.72-1.56] vs sirolimus 2.40 [1.72-3.0] $mm^2$, P = 0.04) and arterial anastomosis sites (paclitaxel 0.93 [0.57-1.48] vs sirolimus 2.40 [1.72-3.0] $mm^2$, P = 0.04) was significantly different between the two groups. However, the H/G ratios for the venous anastomosis site (paclitaxel 0.25 (0.17-0.38) vs sirolimus 0.38 (0.2-0.66), P = 0.4) and the arterial anastomosis site (paclitaxel 0.19 (0.08-0.39) vs sirolimus 0.41 (0.34-0.50), P = 0.1) did not differ significantly between the groups. In conclusion, there was no significant difference in the inhibition of neointimal hyperplasia by sirolimus- and paclitaxel-eluting AV grafts.

Hypoxia-Induced EDNO Release is Further Augmented by Previous Hypoxia and Reoxygenation in Rabbit Aortic Endothelium

  • Han, Jae-Jin;Suh, Suk-Hyo;Suh, Kyung-Phil;Kim, Ki-Whan
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.2
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    • pp.209-216
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    • 1998
  • The present study was designed: (1) to determine whether or not hypoxia stimulates the release of endothelium-derived relaxing factors (EDRFs) from endothelial cells, and (2) to examine whether or not the hypoxia-induced EDRFs release is further augmented by previous hypoxia-reoxygenation, using bioassay system. In the bioassay experiment, rabbit aorta with endothelium was used as EDRFs donor vessel and rabbit carotid artery without endothelium as a bioassay test ring. The test ring was contracted by prostaglandin $F_{2{\alpha}}$ $(3{\times}10^{-6}\;M/L)$, which was added to the solution perfusing through the aortic segment. Hypoxia was evoked by switching the solution aerated with 95% $O_2/5%\;CO_2$ mixed gas to one aerated with 95% $N_2/5%\;CO_2$ mixed gas. When the contraction induced by prostaglandin $F_{2{\alpha}}$ reached a steady state, the solution was exchanged for hypoxic one. And then, hypoxia and reoxygenation were interchanged at intervals of 2 minutes (intermittent hypoxia). The endothelial cells were also exposed to single 10-minute hypoxia (continuous hypoxia). When the bioassay ring was superfused with the perfusate through intact aorta, hypoxia relaxed the precontracted bioassay test ring markedly. Whereas, when bioassay ring was superfused with the perfusate through denuded aorta or polyethylene tubing, hypoxia relaxed the precontracted ring slightly. The relaxation was not inhibited by indomethacin but by nitro-L-arginine or methylene blue. The hypoxia-induced relaxation was further augmented by previous hypoxia-reoxygenation and the magnitude of the relaxation by intermittent hypoxia was significantly greater than that of the relaxation by continuous hypoxia. The results suggest that hypoxia stimulates EDNO release from endothelial cells and that the hypoxia-induced EDNO release is further augmented by previous hypoxia-reoxygenation.

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Effect of Arsenic on Heat Shock Protein and Vascular Contractility of Rat Aorta (횐쥐 대동맥의 수축반응과 열충격단백질에 대한 비소의 영향)

  • 박태규;권윤정;김중영
    • Journal of Environmental Science International
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    • v.12 no.6
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    • pp.651-657
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    • 2003
  • In order to examine if arsenic, one of environmental stresses, contributes to hypertension as one of cardiovas cular pathological factors, this study was perfarmed in vivo and in vitro, using intacted or pithed rats and aorta ring preparation, respectively. And also the relationship between expression of heat shock protein (HSP) 90 and vasoactives-induced contractile response was elucidated. To measure blood pressure, the carotid arterial pressure was recorded on physiograph(Grass Co. 79E) connected to strain gauge. On the other hand, contractile response of vascular ring preparation isolated from rat was determined in organ bath and was recorded on physiograph connected to isometric transducer. And HSP was detacted by Western blotting whole cell Iysis. Preganglionic nerve stimulation was increased by 26.0% in arterial pressure of rat treated with arsenic. Vascular contractile response was monitored and HSP were measured by Western blotting of whole Iysis prepared from samples exposed with 0, 0.5, 1, 2 and 4 mM of arsenic for 8 hours. The dose-vascular responses of potassium chloride were augmented by increasing dose of arsenic in the strips exposed to arsenic for 8 hours, and were not augmented for 1, 3, 5 hours. And the response of relaxation of rat aorta induced by histamine was not influenced by arsenic stress. The increase of HSP 90 expression in rat aorta was pronounced at 8 hours after 4 mM of arsenic treatment, but HSP 60 expression was not. Arsenic stress not only increased the expression of HSP 90 in the rat aorta, but also augmented contractions to potassium chloride. These results indicated that arsenic stress was sufficient to induce heat shock protein 90, resulting in increased vascular contractility in rat aorta.

Effect of NEES on the Occurrence of c-Fos in the Cerebrum of a Rat With Transient Global Ischemia (일과성 전뇌허혈 유발 쥐의 침전극 저주파자극 후 대뇌의 c-Fos 발현에 미치는 영향)

  • Lee, Jung-Sook;Kim, Sung-Won
    • Physical Therapy Korea
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    • v.17 no.1
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    • pp.69-76
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    • 2010
  • Ischemia that causes stroke induces inflammation of brain cells and apoptosis and as a result, it influences much on the functional part of a man. The needle electrode electrical stimulation (NEES) that combines acupuncture of oriental medicine with electric therapy of western medicine relieves inflammation of cells and has effect on regrowth of nerve tissues. This study was conducted to verify the influence of NEES on the occurrence of c-Fos of cerebrum after applying NEES to the meridian point, Zusanli (ST 36) of a rats with induced ischemia. Global ischemia was induced by using ligation method on common carotid artery of male Sprague Dawley (SD) rats. The ligation was maintained for 5 minutes and then suture was removed for blood reperfusion. After inducing global ischemia, NEES was done to the left and right meridian points of Joksamri of a rat for 30 minutes after 12 hours, 24 hours, and 48 hours. The findings were as follows. 1. In the result of immunohistochemical method, the number of c-Fos immune response cells significantly decreased (P<.05) in NEES group than the control group (GI) that did not get NEES. 2. In the result of western blotting, the occurrence of c-Fos after 24 hours from the inducement of ischemia significantly decreased (P<.05) in NEES group than the control group (GI) that did not get NEES. Therefore, as the effect of NEES was shown highest after 24 hours from the ischemia, it is suspected that NEES would take important role in early treatment after cerebral stroke.

Feature Points Tracking of Digital Image By One-Directional Iterating Layer Snake Model (일방향 순차층위 스네이크 모델에 의한 디지털영상의 특징점 추적)

  • Hwang, Jung-Won;Hwang, Jae-Ho
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.44 no.4 s.316
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    • pp.86-92
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    • 2007
  • A discrete dynamic model for tracking feature points in 2D images is developed. Conventional snake approaches deform a contour to lock onto features of interest within an image by finding a minimum of its energy functional, composed of internal and external forces. The neighborhood around center snaxel is a space matrix, typically rectangular. The structure of the model proposed in this paper is a set of connected vertices. Energy model is designed for its local minima to comprise the set of alternative solutions available to active process. Block on tracking is one dimension, line type. Initial starting points are defined to the satisfaction of indent states, which is then automatically modified by an energy minimizing process. The track is influenced by curvature constraints, ascent/descent or upper/lower points. The advantages and effectiveness of this layer approach may also be applied to feature points tracking of digital image whose pixels have one directional properties with high autocorrelation between adjacent data lines, vertically or horizontally. The test image is the ultrasonic carotid artery image of human body, and we have verified its effect on intima/adventitia starting points tracking.

Application of Transcranial Doppler Ultrasonography(TCD) for the Diagnosis of Migraine : Preliminary Results (Transcranial Doppler Ultrasonography를 이용한 편두통의 진단: 예비연구)

  • Lee, Young-Seok;Kim, Byung-Kun
    • Annals of Clinical Neurophysiology
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    • v.1 no.1
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    • pp.31-35
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    • 1999
  • Dignosis of migraine is only based on the medical history, and objective methods to aid the clinical diagnosisare absent. Although transcranial Doppler ultrasonography (TCD) abnormalities in headache-free migraineurs have been reported previously, diagnostic criteria for migraine is still lacking and this may limit the practical application of TCD for migraine. We prospectively studied several abnormal TCD indices in interictal migraineurs and their sensitivity and specificity to define the optimal diagnostic criteria. Young (20 yrs$age=29.0{\pm}6.1yrs$) were compared to 69 controls (M:F=25:44, Mean $age=31.2{\pm}5.5yrs$). Elevated MFV (> 2SD)was observed in 63% of migraineurs while n 12% of control (p<0.01). High AI (>25%) or high HI (>3.0) was present in 17% of migraineurs, while 3% and none in controls (p<0.01). Sensitivity of elevated MFV, high AI, and high HI was 63%, 17%, 17% and specificity was 88%, 97%, 100%, respectively. If all these indices were combined, sensitivity and specificity reached 69% and 86%. These preliminary results suggest pathophysiological implication of vasospasm in interictal migraineurs, and TCD may be practically applicable for migraine. Optimal diagnostic criteria and therapeutic options for patients with abnormal TCD findings remain to bo determined.

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Experimental Study on the Effect of Temporary Clipping on the Histological Changes of the Arterial Walls of Rats

  • Koh, Hyeon-Song;Kwon, O-Yu
    • Biomedical Science Letters
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    • v.13 no.2
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    • pp.111-117
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    • 2007
  • Temporary occlusion of the parent artery or feeding artery is an useful method in microsurgery for cerebrovascular diseases. The advantages of the temporary clipping for intracranial aneurysm surgery have already been proven by many experimental and clinical reports. Currently, there are two methods of temporary clipping: 1) intermittent clipping, 2) continuous clipping. In many previous studies, the intermittent, repeated clipping technique was reported to reduce ischemic damage to the brain, but it is still debated. On the other hand, a comparison of the histological changes on the arterial wall between each clipping method has not been sufficiently reported yet. So the authors performed experimental temporary clipping on the common carotid and femoral arteries of about 25 rats using the Sugita temporary mini-clip. The specimens were divided into two major groups and seven subgroups: Group I (I-1, I-2, I-3, I-4, intermittent clippings for 5 minutes were done once, twice, three times, and few times), and Group C (C-10, C-15, C-20, continuous clippings for 10, 15, 20 minutes, respectively). The reperfusion time after the temporary clipping was the same as the clipping duration. Under light microscope, the histological findings by Hematoxylin-Eosin staining were examined in all specimens, which were obtained at each time interval after temporary clipping. Then the histological changes of the arterial walls by two different methods were compared with the normal specimen. The results suggest that intermittent temporary clipping is less damaging on the arterial wall than single continuous clipping.

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Protective effects of EDTA and EGTA against CCl4-induced acute hepatotoxicity in mice (마우스에서 사염화탄소로 유발된 급성 간독성에 대한 EDTA 및 EGTA의 보호효과)

  • Park, Seung-Guk;Cho, Yong-Do;Shin, Taekyun;Wie, Myung-Bok
    • Korean Journal of Veterinary Research
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    • v.47 no.3
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    • pp.265-271
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    • 2007
  • This study investigated the protective effects of ethylene glycol-bis(${\beta}$-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA), an extracellular calcium chelator, and ethylenediaminetetraacetic acid (EDTA), which chelates calcium and most metal ions, against carbon tetrachloride ($CCl_4$)-induced acute hepatotoxicity in mice. Mice were treated with EGTA or EDTA at a dose of 20 (low) or 100 mg/kg (high) subcutaneously 1h before $CCl_4$ administration. The mice were fasted and sacrificed 18h after $CCl_4$ treatment. Blood samples were collected from the carotid artery by decapitation under light ether anesthesia. Serum alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), triglyceride (TG), and cholesterol levels were measured. Malondialdehyde (MDA) production was determined as an index of lipid peroxidation in the liver. The liver, kidneys, and spleen were weighed. We also evaluated the histopathological changes in the liver in each group. The relative weights of the liver were significantly higher in the $CCl_4$-treatment group than in the normal group, except in the high-EDTA treatment group. EGTA and EDTA treatment caused a significant decrease in serum ALP, ALT, and AST levels. Of all of the doses of EGTA and EDTA tested, the high-EDTA dose resulted in the most remarkable inhibitory action. The protective effect in the high-EDTA-treatment group was confirmed histopathologically. The low-EGTA-treatment group showed a significant decrease in serum TG and cholesterol levels. Liver MDA levels were significantly decreased in the EGTA (20 mg/kg) and EDTA (20, 100 mg/kg) groups. These results suggest that EDTA, which chelates both calcium and metal ions, confers better protection in $CCl_4$-induced acute liver damage than does EGTA, a calcium chelator.

Surgical Observations of Diseases of the Aorta (대동맥질환에 대한 외과적 고찰)

  • Rho, Joon Ryang
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.251-264
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    • 1976
  • Forty three patients with disease of the aorta were admitted in this department during the period from beginning of 1956 to the end of 1976. They consisted of eighteen cases of aortic aneurysms, eight cases of Takayasu's arteritis, eight Leriche syndromes, six dissecting aneurysms, two aortic coarctations and one case of vascular ring. Of eighteen aortic aneurysms, twelve were operated resulting in eight survivors. Three of four mortalities were in shock preoperatively because of aneurysmal rupture. Among six dissecting aortic aneurysms, four were type III and two were type I according to DeBakey's classification. For the purpose of relief of acute arterial insufficiency in the lower extremities, a re-entry operation grafting a Y-shaped dacron vessel between abdominal aorta and common iliac arteries was performed. The patient regained consciousness soon after the operation and was well until postoperative second day, when severe convulsion developed abruptly and died. And in a chronic case of type III dissecting aneurysm, a dacron graft bypass shunt between ascending aorta and lower descending thoracic aorta with resection of the aneurysm was performed, but acute severe aortic insufficiency developed soon after the operation and fell into intractable heart failure resulting in death. The cause of the aortic insufficiency seems to be retrograde dissection from the proximal anastomosis site in the ascending aorta. Three cases were treated medically with Wheat's regimen. Two of them survived with relief of symptoms. Eight patients of Takayasu's arteritis were all females and aged between twenty and forty-four averaging twenty nine. Bypass graft operation between aortic arch and carotid arteries using Y-shaped nylon prostheses were performed in three patients resulting in death in two cases postoperatively due to severe cerebral arterial insufficiency during the procedure. All the patients with Leriche syndrome were males and over forty. In two cases, bypass graft with Y-shaped dacron vessel between terminal aorta and common iliac or femoral arteries were performed with good result. Thromboembolectomy or thromboendarterectomy was employed in three patients, of whom one was aggravated in sexual problem postoperatively. One out of two aortic coarctations and a vascular ring were treated surgically with excellent results.

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