• Journal of Korean Neurosurgical Society
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• v.49 no.3
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• pp.157-162
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• 2011

Objective : Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm. Methods : Eleven patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications. Results : TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement in all patients except one. Conclusion : This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm.

• Bulletin of the Korean Chemical Society
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• v.29 no.2
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• pp.422-426
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• 2008

Hemodialysis graft coated with paclitaxel prevents stenosis; however, large initial burst release of paclitaxel causes many negative effects such as drug toxicity and inefficient drug loss. Therefore we developed and tested a novel coating method, double dipping, to provide controlled and sustained release of paclitaxel locally. Expanded polytetrafluoroethylene (ePTFE) grafts were dipped twice into a solution of several different paclitaxel concentrations. In vitro release tests of the double dipping method showed that early burst release could be somewhat retarded and followed by sustained release for a long time. We observed the effect of paclitaxel coating by double dipping in porcine model of arterio-venous (AV) grafts between the common carotid artery and the external jugular vein. 12 weeks after constructing AV grafts, cross sections of the graft venous anastomosis were obtained and analyzed. Paclitaxel coated ePTFE grafts by double dipping were observed to prevent neointimal hyperplasia and therefore reduced stenosis of the arteriovenous hemodialysis grafts, especially at the graft venous anastomosis sites. Our results demonstrate that second dipping of ePTFE graft, which was already coated once with paclitaxel, washes off the drug on a surface of the graft and affects the ratio of paclitaxel on the surface to that of the inner space, possibly by diffusion: thus the early burst of drug can be somewhat reduced.

• Journal of Biomedical Engineering Research
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• v.17 no.3
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• pp.337-346
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• 1996

The patency of small size vascular grafts is poor, and the blood flow characteristics in the artery graft anastomosis are suspected as one of the important factors influencing intimal hyperplasia. Disturbed flow patterns caused by sixte and compliance mismatch generate unfavorable flow environment which promotes intimal thickening. Tapered vascular yuts are suggested in order to reduce sudden expansion near the anastomosis. The photochromic flow visualization method is used to measure the flout fields in the end-to-end anastomosis model under the carotid and femoral artery flow wave form. The results show that flow disturbance near the anastomosis is diminished in the tapered grafts comparing to the tubular graft. As the divergent ang1e decreases, we can reduce the low and oscillatory wall shear stress zone which is prone to intimal hyperplasia. The flow wave form effects the wall shear rate dis- tribution significantly. The steep deceleration and back flow in the femoral flow wAve form cause low mean wall shear rate and high oscillatory shear index.

• Imaging Science in Dentistry
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• v.48 no.2
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• pp.121-125
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• 2018

Purpose: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: A total of 312 regions(142 bilateral, 10 left, 18 right) in 170 patients(140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient(${\kappa}$) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators(sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. Results: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (${\kappa}=0.684$ and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. Conclusion: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

• Journal of Korean Medicine Rehabilitation
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• v.25 no.1
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• pp.1-15
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• 2015

Objectives The aim of this study was to investigate the effects of Cannabis Fructus on exercise capacity and cognitive function in chronic hypoperfusion induced vascular dementia rat model. Methods Vascular dementia rat models were induced by chronic cerebral hypoperfusion through bilateral common carotid arteries occlusion (BCCAO). All rats were randomly divided into 4 groups: normal group; control group; CF I group (feeding Cannabis Fructus 100 mg/kg); CF II group (feeding Cannabis Fructus 300 mg/kg). In order to study the effects of oral administration of Cannabis Fructus on vascular dementia rat models, corner turn test, hole board test, radial arm maze test, passive avoidance test were taken and Acetylcholine (ACh) activity, Acetylcholinesterase (AChE) activity, serum of Vascular endothelial growth factor (VEGF) protein level were measured. Also histological findings of the liver, kidney, brain and the change of Tau immunoreactive neurons in hippocampus were observed. Results CF I and CF II showed significant improvement in corner turn test, hole board test, radial arm maze test, passive avoidance test, Acetylcholine (ACh) activity, Acetylcholinesterase (AChE) activity, the serum of Vascular endothelial growth factor (VEGF) protein level and the change of Tau immunoreactive neurons in hippocampus. CF I showed more significant effect than CF II in these tests. However in histological observations of the liver and kidney both CF I and CF II showed glomerular injury and hepatotoxicity. Conclusions These results suggest that Cannabis Fructus was helpful in improving exercise capacity and cognitive function on Chronic hypoperfusion induced Vascular Dementia rats. However Cannabis Fructus affects the liver and kidney, therefore suggest that this is an area for further study.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.4
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• pp.103-120
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• 2008

Objectives : This study aims to educate clinical doctors of the valuable practice of Manipulative Therapy(MT) as an opportunity for evidence-based medicine. Consequently it also serves to review the effectiveness and safety of MT. Methods : The literature studies of overseas were done by Cochrane Library and Medline website; those of domestic researches were completed by utilizing the sources which are gained from KERIS, KISS, DBpia, Kisti, and domestic institutes related with MT. Results : Eight papers related to the effectiveness of MT were published in South Korea, which concluded with the positive effects of MT. None of them are, however, well-designed randomized controlled trials(RCT). On the other hand, fifteen cases of nine articles indicate the adverse reaction of MT, and numbers of the researches in overseas revealed the side effects of MT in order of cervical, lumbar, and thoracic vertebrae. A vascular adverse reaction such as vertebral and carotid artery dissection was a highly reported cervical adverse reaction; in the thoracic and lumbar regions, neurological adverse reaction in terms of disc hemiation was frequently discovered. Conclusions : Henceforth, highly qualitative studies are required developing the effective outcomes and preventing any possible complications of MT. Therefore, systemic curriculums in institutions and sufficient clinical training in the filed are strongly recommended.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.22-32
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• 2000

Purpose : Histopathologic observation was performed in order to determine which type of suture material is superior in microvascular anastomoses. Materials & Methods : The interrupted end to end anastomosis of the transected carotid arteries of 105 Sprague-Dawley rats, weighing 180 to 200g, were performed using 9-0 polypropylene ($Prolene^{TM}$, Ethicon, U.K.), 9-0 polyglactin 910 monofilament($Vicryl^{TM}$, Ethicon, U.K.), and 9-0 polyamide($Ethilon^{TM}$, Ethicon, U.K.) under intramuscular Ketamine and Xylazine anesthesia(5mg/100g). In all cases, 10 to 12 sutures were placed to complete the anastomoses. The specimens were obtained at 1, 2, 3 days, and 1, 2, 4 and 6 weeks after the surgery and prepared with H&E and Van-Gieson stains and investigated the histologic changes in anastomotic sites under light microscope. The histologic changes we were concerned about were followings- thrombus formation, intimal edema, infiltration of inflammatory cells in media and adventitia, proliferation of endothelial cells and subintimal hyperplasia. Results : 1. All of the anastomosed arteries were patent when they were exposed for examination. 2. Thrombus formation and intimal edema were most severe in Vicryl group, followed by Ethilon, Prolene group in order. 3. The inflammatory cells infiltrated to the media and the adventitia most severely in Ethilon group, followed by Vicryl, Prolene group in order. 4. There was little difference in proliferation of endothelial cells in each group. 5. Subintimal hyperplasia was greater in Vicryl group than the others, but there was no significant difference between the Prolene and Ethilon groups. Conclusions : On the basis of these observations, we could conclude that Prolene may be the better suture material for microvascular anastomoses regarding the tissue responses than Ethilon and Vicryl.

• Korean Journal of Oriental Medicine
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• v.11 no.1
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• pp.97-107
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• 2005

Objectives : This experiments were performed to determine the effect of Linderae Radix extract on norepinephrine-induced arterial contraction in rabbit. Methods : In order to investigate the effect of Linderae Radix extract on contracted rabbit carotid arterial strips, transverse strips with intact or damaged endothelium were used for the experiment using organ bath. To analyze the mechanism of Linderae Radix extract-induced relaxation, Linderae Radix extract infused into contracted arterial strips induced by norepinephrine after treatment of indomethacin, tetraethylammonium chloride, $N{\omega}-nitro-L-arginine$ or methylene blue. Results : Linderae Radix extract relax arterial strip with endothelium contracted by norepinephrine, but in the strips without endothelium, Linderae Radix extract-induced relaxation was significantly inhibited. Linderae Radix extract-induced relaxation was decreased by the pre-treatment of $N{\omega}-nitro-L-arginine$ or methylene blue, but it was not observed in the strips pre-treated with indomethacin or tetraethylammonium chloride. When $Ca^{2+}$ was applied, the strips which were contracted by norepinephrine in a $Ca^{2+}$-free solution, arterial contraction was increased. But pre-treatment of Linderae Radix extract inhibited contractile response to norepinephrine and $Ca^{2+}$. Conclusions : We suggest that Linderae Radix may suppress influx of extra-cellular $Ca^{2+}$ through the formation of nitric oxide, and release of intra-cellular $Ca^{2+}$.

• YAKHAK HOEJI
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• v.41 no.6
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• pp.817-828
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• 1997

In order to investigate pharmacological properties of New Woohwangchungsimwon Pill (NWCH) and Woohwangchungsimwon Pill(WCH), effects of NWCH and WCH on cerebral ischemia and central nervous system were compared. Cerebral ischemia insult was performed using unilateral carotid artery occlusion in Mongolian gerbils. The histological observations showed preventive effect of NWCH and WCH treatments with ischemia-induced brain damage. The ATP in brain tissue was decreased in vehicle-treated ischemic gerbils. This decrease was prevented by NWCH and WCH treatment. In contrast to what was seen with ATP, the lactate and lipid peroxide were both elevated in vehicle-treated ischemic gerbils. This elevation was inhibited by NWCH and WCH treatments. In central nervous system, NWCH and WCH had sedative effect in rotarod and spontaneous activity test, but no effects on the hexobarbital-induced sleeping time. And, NWCH and WCH had weak anticonvulsion effects in electric shock- and pentetrazol-induced convulsion test. NWCH and WCH increased the respiration rate, but decreased the respiration depth in rats. Furthermore, NWCH and WCH showed antistress effect. Our findings suggest that the pharmacological profiles of NWCH on cerebral ischemia and central nervous system are similar to that of WCH.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.351-355
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• 2000

Penetrating injuries in the head and neck region are not common but can pose difficult situations to manage properly. In small cross-sectional area, the neck housed many vital structures, such as carotid artery, internal jugular vein, cervical spines, esophagus, laryngotracheal complex and nerves. Because each vital structure is located within the fascial compartments, bleeding into these closed spaces can give rise to compression of surrounding structures, which may result in compromised airway. Therefore, management of the penetrating injuries should be based on the fully understanding of anatomical relationships, accurate clinical examinations, a careful history taking and the proper treatment planning. We present two cases of penetrating injuries in the head and neck region and discuss on the clinical considerations for the proper management with the literature review.