• 대한한의학회지
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• 제38권3호
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• pp.86-95
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• 2017

Objectives: The purpose of this clinical research was to investigate the effects of herbal cosmetics containing Caffeic acid phenethyl ester (CAPE), an ingredient compound of various herbs including Vespae Nidus, on the Whitening Effects. Methods: A total of 20 subjects who visited Pusan National University Hospital from March 2nd, 2017 to April 11th, 2017 were included. In this study, we evaluated the visual evaluation, the melanin index (M) and erythema index (E) through skin analysis equipment, the subjective whitening improvement analysis, and the adverse reaction according to product use. Statistical analysis was performed with independent t-test and Mann-Whitney's U test. Statistical significance was achieved if the probability was less than 5% (p<0.05) Results: As a result of the visual evaluation, it was effective in improving skin whitening. The subjective whitening improvement analysis also showed positive results. However, no statistically significant differences were found between the test and control cosmetics in the melanin index (M) and erythema index (E) through skin analysis equipment. In the safety evaluation, some adverse reactions were reported, but no significant were observed directly from cosmetics. Conclusions: Considering the above results, we have confirmed the possibility of herbal cosmetics containing containing CAPE of Vespae Nidus Extracts.

• Korean Journal of Radiology
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• 제23권2호
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• pp.202-217
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• 2022

Pulmonary arteriovenous malformation (AVM) is a congenital vascular disease in which interventional radiologists can play both diagnostic and therapeutic roles in patient management. The diagnosis of pulmonary AVM is simple and can usually be made based on CT images. Endovascular treatment, that is, selective embolization of the pulmonary artery feeding the nidus of the pulmonary AVM, and/or selectively either the nidus or draining vein, has become a first-line treatment with advances in interventional devices. However, some vascular diseases can simulate pulmonary AVMs on CT and pulmonary angiography. This subset can confuse interventional radiologists and referring physicians. Vascular mimickers of pulmonary AVM have not been widely known and described in detail in the literature, although some of these require surgical correction, while others require regular follow-up. This article reviews the clinical and radiologic features of pulmonary AVMs and their mimickers.

• 한국의학물리학회지:의학물리
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• 제21권3호
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• pp.274-280
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• 2010

선형가속기를 이용하여 single-fraction stereotactic radiosurgery (SRS)를 시행하였던 뇌동맥 기형 치료 환자 25예 중 13예의 임상결과와 혈관조영술 소견에 대해 알아보고자 하였다. 2002년부터 2009년까지 뇌동정맥 기형으로 SRS를 시행하였던 25명 중 추적 혈관조영술이 시행된 기간이 12개월 이상인 환자 15명(남자 6명, 여자 9명)을 대상으로 하였으며 후향적으로 MRI와 혈관조영술에서 동정맥기형 핵의 크기와, 위치, 파열유무, 추적기간 동안의 합병증 유무, 혈관조영술에서의 변화를 분석하였다. 평균 30개월(12~89개월) 동안 추적 혈관조영술이 시행되었던 15명의 환자 (평균나이 33세, 14~56세) 중 모든 환자에서(100%) 동정맥기형이 완전 소실되었고 3명(20%)에서 유출정맥만이 동맥기 촬영에서 확인되었다. 추적기간 중 1명에서 경련이 있었으며 출혈이나 뇌부종에 의한 임상증상이 있었던 환자는 없었다. 동정맥기형 핵의 부피는 평균 4.3 cc (SD 3.7 cc, 범위 0.69~11.7 cc)였으며 방사선 조사 선량은 평균 17 Gy (12~20 Gy)였다. 동정맥기형의 위치는 대엽이 11예, 기저핵이 1예, 뇌교가 1예, 소뇌가 2예였다. 9예는 파열, 나머지 6예는 비 파열 예였다. 선형가속기를 이용한 뇌동정맥기형 방사선 치료의 성적은 추적기간을 4년 이상으로 할 때 높은 완치율을 보이며 동맥기에 유출정맥이 남아 있을 경우 유출정맥이 완전히 소멸될 때까지 추적 관찰이 요구된다.

• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.534-540
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• 2012

Objective : Brainstem arteriovenous malformation (AVM) is rare and radiosurgical management is complicated by the sensitivity of the adjacent neurological structures. Complete obliteration of the nidus is not always possible. We describe over 20 years of radiosurgical procedures for brainstem AVMs, focusing on clinical outcomes and radiosurgical techniques. Methods : Between 1992 and 2011, the authors performed gamma knife radiosurgery (GKRS) in 464 cerebral AVMs. Twenty-nine of the 464 patients (6.3%) reviewed had brainstem AVMs. This series included sixteen males and thirteen females with a mean age of 30.7 years (range : 5-71 years). The symptoms that led to diagnoses were as follows : an altered mentality (5 patients, 17.3%), motor weakness (10 patients, 34.5%), cranial nerve symptoms (3 patients, 10.3%), headache (6 patients, 20.7%), dizziness (3 patients, 10.3%), and seizures (2 patients, 6.9%). Two patients had undergone a previous nidus resection, and three patients had undergone a previous embolization. Twenty-four patients underwent only GKRS. With respect to the nidus type and blood flow, the ratio of compact type to diffuse type and high flow to low flow were 17 : 12 and 16 : 13, respectively. In this series, 24 patients (82.8%) had a prior hemorrhage. The mean target volume was 1.7 $cm^3$ (range 0.1-11.3 $cm^3$). The mean maximal and marginal radiation doses were 38.5 Gy (range 28.6-43.6 Gy) and 23.4 Gy (range 18-27 Gy), and the mean isodose profile was 61.3% (range 50-70%). Results : Twenty-four patients had brainstem AVMs and were followed for more than 3 years. Obliteration of the AVMs was eventually documented in 17 patients (70.8%) over a mean follow-up period of 77.5 months (range 36-216 months). With respect to nidus type and blood flow, the obliteration rate of compact types (75%) was higher than that of diffuse types (66.7%), and the obliteration rate of low flow AVMs (76.9%) was higher than that of high flow AVMs (63.6%) (p<0.05). Two patients (6.9%) with three hemorrhagic events suffered a hemorrhage during the follow-up period. The annual bleeding rate of AVM after GKRS was 1.95% per year. No adverse radiation effects or delayed cystic formations were found. Conclusion : GKRS has an important clinical role in treatment of brainstem AVMs, which carry excessive surgical risks. Angiographic features and radiosurgical techniques using a lower maximal dose with higher isodose profiles are important for lesion obliteration and the avoidance of complications.

• 혜화의학회지
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• 제10권1호
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• pp.167-174
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• 2001

According to the literatual study on the external treatment of premature ejaculation, the results were as follows. 1. Linition is inunction glans penis after infiltrate ASARI HERBA CUM RADICE(細辛), CARYOPHYLLI FLOS(丁香), CHEBULAE FRUCTUS(訶子), PAPAVERIS FRUCTUS(罌粟殼), FOSSILIA OSSIS MASTODI(龍骨), OSTREAE CONCHA(牡蠣 in oenostagma. 2. Retrojection or hypoatmism method is boiling CHINENSIS GALLA(五倍子), CNIDII FRUCTUS(蛇牀子) and hypoatmism, down temperature infiltrate glans penis. 3. Mesompharion apposition method is calorization VESPAE NIDUS(露蜂房), ANGELICAE DAHARICAE RADIX(白芷), and utilization vineger apposite mesompharion. 4. Medicament belt method is belt on lumbus and bythus by ROSAE LAEVIGATAE FRUCTUS(金櫻子), EURYALES SEMEN, OSTREAE CONCHA(牡蠣), TRIBULI FRUCTUS, AIPINIAE OXYPHYLLAE FRUCTUS(益智仁), NELUMBINIS SEMEN(蓮子肉) Powders. 5. Enema is injection in the rectum ANGELICAE GIGANTIS RADIX(當歸) effusion. 6. Much utilization agent are ASARI HERBA CUM RADICE(細辛), CHINENSIS GALLA(五倍子), OSTREAE CONCHA(牡蠣), CNIDII FRUCTUS(蛇床子), GRANATI PERICARPIUM(石榴皮), CARYOPHYLLI FLOS(丁香), CHEBULAE FRUCTUS(訶子), FOSSILIA OSSIS MASTODI(龍骨), VESPAE NIDUS(露蜂房), PAPAVERIS FRUCTUS(罌粟殼) etc. They are occupied in adstringentia, juventia, divergence agent, liver stabilizer agent.

• Korean Journal of Acupuncture
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• 제26권4호
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• pp.195-209
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• 2009

Objectives : Transient inflammation has been demonstrated to alter visceral sensory function in animal models and acute mucosal inflammation may precede the manifestation of visceral hyperalgesia. Thus in this study we compared effects of herbal acupuncture of Nidus Vespae (NV) applied to the different acupoints in the acute colitis induced by trinitrobenzenesulphonic acid (TNBS) intracolonic injection in rats. Methods : In Male Sprague-Dawley rats, weighing 250 ~ 400 g, TNBS (5 mg/kg) was infused intrarectally through a silicon rubber catheter into the anus under isoflurane anaesthesia. Under general anesthesia, acupoints of LI4 (Hapkok), SI25 (Cheonchu), ST36 (Joksamni), BL25 (Daejangsu) were intramuscularly injected by NV. Expressions of cFos protein in the periaqueductal gray (PAG), locus coeruleus (LC), nucleus of solitary tract (Sol), and the 6th lumbar spinal cord (L6 s.c.) were observed at 24 hrs after TNBS induced colitis by immunohistochemistry. Results : The expression of c-Fos protein in L6 s.c., Sol, LC and PAG increased 24 hrs after TNBS injection into colorectum as compared to normal group. NV herbal acupuncture also inhibited the expression of c-Fos protein in Sol but not L6 s.c., LC, and PAG. NV to ST36 inhibited significantly the c-Fos expression in Sol and PAG. NV to ST25 inhibited the c-Fos protein expression all over the observation area. NV to BL25 showed the inhibitory effects in the areas except LC. Whether or not a role of endogenous opioids, intrathecal injection of naltrexone (30 ug / 30 ul) was applied before the 2nd herbal acupuncture treatment 24 hrs after TNBS-induced colitis in rat. Naltrexone reversed the inhibition of c-Fos protein expression in the spinal cord and brainstem under different conditions such as type of herbal acupuncture compound and choice of acupoint. Conclusions : In summary, these data show that herbal acupuncture of NV inhibits signal pathways such as spinal cord and brain stem ascending hypersensitivity of colorectum after TNBS induced colitis. This effect may be mediated by acupoints through the endogenous opioid system involving the pain modulation.

• Journal of Korean Neurosurgical Society
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• 제30권12호
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• pp.1406-1416
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• 2001

Objective : The goal of this study was to evaluate the effect of Gamma Knife radiosurgery(GKS) on cerebral arteriovenous malformation(AVM) and the factors associated with complete occlusion. Patients and Methods : A total of 369 radiosurgical procedures for 336 patients with cerebral AVMs were performed between December 1988 and June 2001. Three hundreds and twenty-four cases of 293 patients who were treated with GKS procedures from May 1992 to December 2000 were analyzed. Various clinical and radiologic parameters were evaluated. Results : The total obliteration rate for the cases with satisfactory radiological follow-up(more than 2 years) after GKS was 79.3%. In multivariate analysis, maximal diameter, angiographic form of AVM nidus, and number of draining veins significantly influenced the result of radiosurgery. In addition, marginal radiation dose, Spetzler-Martin grade, and flow pattern of AVM nidi also partly influenced the radiosurgical outcome. Conclusion : GKS on cerebral AVM is considered as an effective treatment modality. The risk of hemorrhage seems to decrease within the latency interval between GKS and complete occlusion of nidus. Along with the size, topography, or radiosurgical parameters of AVMs, it is necessary to consider the angioarchitectural and hemodynamic aspects to select proper candidates for radiosurgery.

• 대한두경부종양학회지
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• 제12권2호
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• pp.224-229
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• 1996

Head and neck arteriovenous malformation usually forms huge mass, cause profuse bleeding or potenially compromise the airway. This bleeding is vulnerable to be uncontrollable and life­threatening. Sometimes it has a high mortality. Although surgical resection is possible in some cases, the morbidity such as a defects of soft tissue is very high and its reconstruction is very difficult. The authors report an 11 year old female patient in whom occlusion of arteriovenous malformation with glue after transcutaneous embolization made a satisfactory results. At the beginning, she was transferred for massive oral bleeding. The bleeding was persistent and it was not possible to remove the packing in spite of many times of embolizations through feeding arteries. The massive bleeding trom the left upper alveolar mucosa compromised the airway and tracheotomy was done. Whenever the hypovolemic shock was occurred in a short time, blood transfusion and cardiopulmonary resucitation were done. To embolize the vascular mass of arteriovenous malformation, as a final trial before operation, the spinal needle was administered through the left upper gingiva under the fluoroscopy. The glue was injected on the target. The bleeding was stopped and we have noticed the absence of nidus on follow-up angiography after 3 weeks. We experienced that some cases of arteriovenous malformation in head & neck revealing the bleeding could be treated with transcutaneous embolization instead of surgical resection.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.116-122
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• 2009

Objective: Intracranial arteriovenous malformation (AVM) associated with aneurysm has been infrequently encountered and the treatment for this malady is challenging. We report here on our clinical experience with AVMs associated with arterial aneurysms that were managed by multimodality treatments, including clipping of the aneurysm, microsurgery, Gamma-knife radiosurgery (GKS) and Guglielmi detachable coil (GDC) embolization. Methods: We reviewed the treatment plans, radiological findings and clinical courses of 21 patients who were treated with GKS for AVM associated with aneurysm. Results: Twenty-seven aneurysms in 21 patients with AVMs were enrolled in this study. Hemorrhage was the most frequent presenting symptom (17 patients: 80.9%). Bleeding was caused by an AVM nidus in 11 cases, aneurysm rupture in 5 and an undetermined origin in 1. Five patients were treated for associated aneurysm with clipping followed by GKS for the AVM and 11 patients were treated with GDC embolization combined with GKS for an AVM. Although 11 associated aneurysms remained untreated after GKS, none of them ruptured and 4 aneurysms regressed during the follow up period. Two aneurysms increased in size despite the disappearance of the AVM nidus after GKS and then these aneurysms were treated with GDC embolization. Conclusion: If combined treatment using microsurgery, GKS and endovascular treatment can be adequately used for these patients, a better prognosis can be obtained. In particular, GKS and GDC embolization are considered to have significant roles to minimize neurologic injury.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.35-45
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• 2019

Objective : To describe our experiences with a fully equipped high-end digital subtraction angiography (DSA) system within a hybrid operating room (OR). Methods : A single-plane DSA system with 3-dimensional rotational angiography, cone-beam computed tomography (CBCT), and real-time navigation software was used in our hybrid OR. Between April 2014 and January 2018, 191 sessions of cerebrovascular procedures were performed in our hybrid OR. After the retrospective review of all cases, the procedures were categorized into three subcategorical procedures : combined endovascular and surgical procedure, complementary rescue procedure during intervention and surgery, and frameless stereotaxic operation. Results : Forty-nine of 191 procedures were performed using hybrid techniques. Four cases of blood blister aneurysms and a ruptured posterior inferior cerebellar artery aneurysm were treated using bypass surgery and endovascular trapping. Eight cases of ruptured aneurysm with intracranial hemorrhage (ICH) were treated by partial embolization and surgical clipping. Six cases of ruptured arteriovenous malformation with ICH were treated by Onyx embolization of nidus and subsequent surgical removal of nidus and ICH. Two (5.4%) of the 37 cases of pre-mature rupture during clipping were secured by endovascular coil embolization. In one (0.8%) complicated case of 103 intra-arterial thrombectomy procedures, emergency surgical embolectomy with bypass surgery was performed. In 27 cases of ICH, frameless stereotaxic hematoma aspiration was performed using $XperGuide^{(R)}$ system (Philips Medical Systems, Best, the Netherlands). All procedures were performed in single sessions without any procedural complications. Conclusion : Hybrid OR with a fully equipped DSA system could provide precise and safe treatment strategies for cerebrovascular diseases. Especially, we could suggest a strategy to cope flexibly in complex lesions or unexpected situations in hybrid OR. CBCT with real-time navigation software could augment the usefulness of hybrid OR.