• Journal of Yeungnam Medical Science
• /
• v.20 no.1
• /
• pp.1-12
• /
• 2003

Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.

• Clinical and Experimental Pediatrics
• /
• v.59 no.5
• /
• pp.242-245
• /
• 2016

Thromboembolic complications (TECs) are clinically important sequelae of nephrotic syndrome (NS). The incidence of TECs in children is approximately 2%-5%. The veins are the most commonly affected sites, particularly the deep veins in the legs, the inferior vena cava, the superior vena cava, and the renal veins. Arterial thrombosis, which is less common, typically occurs in the cerebral, pulmonary, and femoral arteries, and is associated with the use of steroids and diuretics. Popliteal artery thrombosis in children has been described in cases of traumatic dissection, osteochondroma, Mycoplasma pneumoniae infection, and fibromuscular dysplasia. We report of a 33-month-old girl with bilateral iliac and popliteal arterial thrombosis associated with steroid-resistant NS due to focal segmental glomerulosclerosis. Her treatment involved thrombectomy and intravenous heparinization, followed by oral warfarin for 8 months. Herein, we report a rare case of spontaneous iliac and popliteal arterial thrombosis in a young child with NS.

• Journal of Korean Neurosurgical Society
• /
• v.51 no.4
• /
• pp.222-226
• /
• 2012

The waffle-cone technique is a modified stent application technique, which involves protrusion of the distal portion of a stent into an aneurysm fundus to provide neck support for subsequent coiling. The authors report two cases of wide necked basilar bifurcation aneurysms, which were not amenable to stent assisted coiling, that were treated using the waffle-cone technique with a Solitaire AB stent. A 58-year-old woman presented with severe headache. Brain CT showed subarachnoid hemorrhage and angiography demonstrated a ruptured giant basilar bifurcation aneurysm with broad neck, which was treated with a Solitaire AB stent and coils using the waffle-cone technique. The second case involved an 81-year-old man, who presented with dizziness caused by brain stem infarction. Angiography also demonstrated a large basilar bifurcation unruptured aneurysm with broad neck. Solitaire AB stent deployment using the waffle-cone technique, followed by coiling resulted in near complete obliteration of aneurysm. The waffle-cone technique with a Solitaire AB stent can be a useful alternative to conventional stent application when it is difficult to catheterize bilateral posterior cerebral arteries in patients with a wide-necked basilar bifurcation aneurysm.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.39 no.6
• /
• pp.289-291
• /
• 2013

Moyamoya disease is a rare neurovascular disorder that involves constriction of certain arteries in the brain. In patients with moyamoya disease, it is very important to prevent cerebral ischemic attacks and intracerebral bleeding caused by fluctuating blood pressure and increased respiration. A 40-year-old woman with moyamoya disease was scheduled for extraction of her right upper and lower impacted wisdom teeth. Her lower impacted wisdom tooth was situated close to the inferior alveolar nerve. We decided to continue her oral antiplatelet therapy and planned intravenous sedation with analgesic agents administered approximately five minutes prior to extraction of the root of the mandibular wisdom tooth. Oral analgesic medications were regularly administered postoperatively to alleviate pain and anxiety. During the perioperative period, no cerebrovascular event occurred, and the wisdom teeth were successfully extracted as per the planned procedure. It is thought that the perioperative risks of wisdom tooth extraction in patients with moyamoya disease can be minimized with the use of our protocols.

• Journal of Korean Neurosurgical Society
• /
• v.48 no.6
• /
• pp.528-531
• /
• 2010

Ehlers-Danlos syndrome (EDS) type IV is characterized by its clinical manifestations, which are easy bruising, thin skin with visible veins, and rupture of arteries, uterus, or intestines. Arterial complications are the leading cause of death in vascular EDS because they are unpredictable and surgical repair is difficult due to tissue fragility. The authors report a case presented with cervical radiculopathy due to a segmental fusiform aneurysm of the cervical vertebral artery. Transfemoral cerebral angiography (TFCA) was done to verify the aneurysmal dilatation. However, during TFCA, bleeding at the puncture site was not controlled, skin and underlying muscle was disrupted and profound bleeding occurred during manual compression after femoral catheter removal. Accordingly, surgical repair of the injured femoral artery was performed. At this time it was possible to diagnose it as an EDS with fusiform aneurysm on cervical vertebral artery. Particularly, cervical fusiform aneurysm is rare condition, and therefore, connective tissue disorder must be considered in such cases. If connective tissue disorder is suspected, the authors suggest that a noninvasive imaging modality, such as, high quality computed tomography angiography, be used to evaluate the vascular lesion to avoid potential arterial complications.

• Journal of Biomedical Engineering Research
• /
• v.13 no.3
• /
• pp.189-194
• /
• 1992

As people's income and intake of animal fat rapidly increase, so does choresterol concentration in blood. Thus diseases such as non-insulin-dependent diabetes mellitus(NIDDM)myocardial infraction, high blood pressure, cerebral stroke resulting from atherosclerosis rapidly increase recently. It is very difficult to diagnose atherosclerosis early since its progress is so slow and there is no sypmtoms in the beginning of the disease. In this study a mechanical characteristic, compliance, of the lower leg arteries was measured noninvasively. Changes of blood volume and pressure were measured using impedance plethysmgraphy and mercury sphygmomanometer, respectively. The compliance was calculated by dividing the change of blood volume by the change of pulse pressure ( systolic-diastolic pressure ) . Subjects were 24 asymptomatic persons ranging (rom 30 Ic 58yeras and 14 diabetics from 41 to 59years. The compliances, mean, and systolic pressures were statistically analyzed using a t-test be- tween the healthy and diabetic groups. The average compliance of the healthy and diabetic group was measured 2.79 and 1.82U1/mmHg/cm, respectively and these were significantly different(p<0.01). It was also found that the compliance is a better parameter in differentiating the vascular disease than mean or systolic blood pressure.

• Journal of Chest Surgery
• /
• v.45 no.5
• /
• pp.326-329
• /
• 2012

Pulmonary arteriovenous malformation (PAVM) is a rare anomalous direct communication between the pulmonary artery and vein with a considerable risk of serious complications such as cerebral thromboembolism or abscess and pulmonary hemorrhage. Although the past, surgical resection such as lobectomy was mostly used to treat PAVM, the recent development of endovascular treatment has made it a primary consideration to perform transcatheter embolization using coils or detachable balloons. We report a case of successful transcatheter embolization of giant PAVM with the second generation Amplatzer vascular plug II as a new self-expanding device.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.6 no.1
• /
• pp.63-68
• /
• 2005

Objective: The purpose of this case study is to show a case of early neurological recovery from stroke by recannalization. Methods: The patient was admitted from 12 July, 2004 to 26 July, 2004. The patient received Herb-Medication and Acupuncture Therapy. Brain MRI and Tc-99m HM-PAO brain SPECT was used to diagnose and prognose. Results: The patient fully recovered within a few hours. She was diagnosed as acute infarction in Lt. BG by using brain MRI. Tc-99m HM-PAO brain SPECT showed focal increased perfusion at Lt. BG. Conclusions: We suggest that the important thing to recovery from stroke is recannalization of cerebral arteries in early stage.

• Proceedings of the Plant Resources Society of Korea Conference
• /
• 2023.04a
• /
• pp.39-39
• /
• 2023

The purpose of this study is to investigate vasodilatation effect of complex saponin separated from Scrophulariae radix, Asparagus cochinchinensis and Liriope platyphylla mixture extract on rabbit carotid artery. In this study, to determine vasodilatation effect of complex saponin separated from Scrophulariae radix, Asparagus cochinchinensis and Liriope platyphylla mixture extract on rabbit carotid artery, arterial rings with intact or damaged endothelium were used for experiment using organ bath, and were contracted by endothelin. complex saponin, major active constituents of Scrophulariae radix, Asparagus cochinchinensis and Liriope platyphylla mixture extract, showed a moderate vasodilatation effect on the basilar arteries of rabbits. Therefore, treatment with complex saponin separated from Scrophulariae radix, Asparagus cochinchinensis and Liriope platyphylla mixture extract may selectively accelerate cerebral blood flow through dilatation of the basilar artery. Theseis result suggest a potential role of complex saponin separated from Scrophulariae radix, Asparagus cochinchinensis and Liriope platyphylla mixture extract as source of vasodilatation agent.

• Korean Journal of Veterinary Research
• /
• v.41 no.4
• /
• pp.467-475
• /
• 2001

Cardiac arrest, hypoxia, shock or seizure has been known to induce cerebral ischemia. This study was designed to investigate the effect of ischemia on hippocampal pyramidal layer induced by transient bilateral occlusion of the common carotid arteries. Mature Mongolian gerbils were sacrificed at days 2, 4, and 7 after carotid occlusion for 10 minutes. Sham-operated gerbils of control group were subjected to the same protocol except for carotid occlusion. During operation for ischemia, body temperature was maintained $37{\pm}0.5^{\circ}C$ in all gerbils. Paraffin-embedded brain tissue blocks were cut into coronal slices and stained with H-E stain or immunostain by TUNEL method. Neurons with the oval and prominent nucleus and without the eosinophilic cytoplasm in the subfield of hippocamapal pyramidal layer were calculated as to be viable neurons. Their chromatins were condensed or clumped. Their nuclei appeared multiangular or irregularly shrinked. The width of the pyramidal layer was reduced due to the loss of nuclei. At day 2 after reperfusion, some neurons in the CA1 subfield were slightly eosinophilic. But most neurons in the CA2 subfield were strongly eosinophilic. At day 4 day, most neurons in the CA1 subfield were severely damaged and at day 7 day, only a few survived neurons were observed. Survived neurons per longitudinal 1mm sector in the CA1, CA2, CA3, and CA4 subfields of pyramidal layer were investigated. At day 2, the mean numbers of pyramidal neurons in CA1, CA2, CA3, and CA4 subfiedls were 104.5/mm (54.3%), 51.0/mm (33.8%), 105.5/mm (85.6%), and 124.3/mm (93.5%) compared to the nonischemic control group, respectively. At day 4, the mean numbers of pyramidal neurons in CA1, CA2, CA3, and CA4 subfields were 3.2/mm (1.7%), 51.5/mm(34.2%), 95.3/mm (77.4%), and 112.5/mm (84.6%), respectively. At day 7, the mean numbers of pyramidal neurons in CA1, CA2, CA3, and CA4 subfiedls were 0.8/mm (0.4%), 5.7/mm(3.8%), 9.8/mm (8.0%), and 5.0/mm (3.7%), respectively. The mean numbers of apoptotic positive neurons in the CA1 subfield at day 2, 4, and 7 after reperfusion were 67.8/mm, 153.2/mm and 123.7/mm, respectively. These results suggest that the transient cerebral ischemia cause severe damages in most neurons at day 7 and that the prosminent apoptotic positive neurons in hippocampal pyramidal layer are the delayed neuronal death induced by ischemia.