• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.159-163
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• 2013

Objective : Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid endarterectomy (CEA). However, the prevalence of CHS has decreased as techniques have improved. This study evaluates the role of strict blood pressure (BP) control for the prevention of CHS. Methods : All 18 patients who received CEA from February 2009 through November 2012 were retrospectively reviewed. All patients were routinely managed in an intensive care unit by a same protocol. The cerebral perfusion state was evaluated on the basis of the regional cerebral blood flow (rCBF) study by perfusion computed tomography (pCT) and mean velocity by transcranial doppler (TCD). BP was strictly controlled (<140/90 mm Hg) for 7 days. When either post-CEA hyperperfusion (>100% increase in the rCBF by pCT or in the mean velocity by TCD compared with preoperative values) or CHS was detected, BP was maintained below 120/80 mm Hg. Results : TCD and pCT data on the patients were analyzed. Ipsilateral rCBF was significantly increased after CEA in the pCT (p=0.049). Post-CEA hyperperfusion was observed in 3 patients (18.7%) in the pCT and 2 patients (12.5%) in the TCD study. No patients developed clinical CHS for one month after CEA. Furthermore, no patients developed additional neurological deficits related to postoperative cerebrovascular complications. Conclusion : Intensive care with strict BP control (<140/90 mm Hg) achieved a low prevalence of post-CEA hyperperfusion and prevented CHS. This study suggests that intensive care with strict BP control can prevent the prevalence of post-CEA CHS.

• Journal of Sasang Constitutional Medicine
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• v.12 no.1
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• pp.228-239
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• 2000

1. Purpose : For many years, Soumin Seonghyangjeongkisan(少陰人 星香正氣散, SJ) has been used in Sasang(四象) constitutional medicine as a therapeutic agent for cerebral disease. The effects of SJ on the vascular system is not well-know. The purpose of this study is to make it clear the effects of SJ and composing drugs on blood pressure(BP) and regional cerebral blood flow(rCBF). 2. Method : We measured BP with Pressure Transducer, rCBF with Laser-Doppler flowmeter. Propranolo and methylene blue were used to determine the mechanisms of SJ effects. 3. Results and Conclusion : BP was not affected by SJ in rats, and rCBF was significantly increased by SJ in rats. rCBF was increased by Folium Perillae(蘇葉), Rhizoma Atractylodis(蒼朮), Pericarpium Arecae(大腹皮) and Rhizoma Arisaematic(南星), but decreased by Radix Saussurea(木香) in rats. The increase of rCBF is mediated by adrenergic ${\beta}-receptor$ and guanylyl cyclase which is enzyme producing cyclic GMP.

• Journal of Sasang Constitutional Medicine
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• v.12 no.1
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• pp.216-227
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• 2000

1. Purpose For many years, Taeumin Chungsimyoinjatang(太陰人 淸心蓮子湯, CS) has been used in Sasang(四象) constitutional medicine as a therapeutic agent for cerebral disease. The effects of CS on the vascular system is not well-known. The purpose of this study is to make it clear the effects of SJ and composing drugs on blood pressure(BP) and regional cerebral blood flow(rCBF). 2. Method We measured BP with Pressure Transducer, rCBF with Laser-Doppler flowmeter. Propranolol and methylene blue were used to determine the mechanisms of CS effects. 3. Results and Conclusion BP was not affected by CS in rats, and rCBF was significantly increased by CS in rats. rCBF was increased by Nelumbinis Semen(蓮于肉), Ophiopogonis Radix(麥門冬), Asparagi Radix(天門冬), Polygalae Radix(遠志), Zizyphi Spinosae Semen(酸棗仁), Longnae Arillus(龍眼肉), Raphani Semen, Chrysanthemi Flos(甘菊) in rats. The increase of rCBF is mediated by adrenergic ${\beta}$- receptor and guanylyl cyclase which is enzyme producing cyclic GMP.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.1-9
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• 2009

Objectives : This study was designed to investigate the effects of Gleditsiae spina(GS) on changes in cerebral blood flow in rats. Methods : The present study was investigated regional cerebral blood flow(rCBF) and mean arterial blood pressure(MABP) in rats. In addtion, the present study also investigated action mechanisms of GS on changes in rCBF and MABP by Pre-treatment with indomethacin(IDM) and methylene blue(MTB), an inhibitor of a vasodepressor material. Results : Treatment with GS elevated rCBF in dose-dependent manner, but MABP levels were not affected by treatment with GS. Pre-treatment with indomethacin(IDM), an inhibitor of cyclooxygenase, inhibited increase of rCBF effectively. And pre-treatment with methylene blue(MTB), an inhibitor of guanylate cyclase, inhibited increase of rCBF induced by GS too. In addition, Pre-treatment with MTB inhibited increase of MABP too. But, pre-treatment with IDM did not affect MABP levels. Conclusions : These results suggest that GS is effective to treat patient with disease related to cerebral ischemia, because GS can increase rCBF. In addition, the mechanisms are thought to be related to both of cyclooxygenase and guanylate cyclase pathways.

• The Korean Journal of Nuclear Medicine
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• v.22 no.2
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• pp.163-170
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• 1988

8 patients of delayed CO sequelae were evaluated using Brain CT and $^{99m}Tc-HMPAO$ SPECT. The results were as follows; 1) CT findings of delayed CO sequleae were bilateral low density lesion in globus pallidus (l pt.), diffuse low density in white matter with bilateral low density in white matter (l pt.), diffuse low density in white matter with bilateral low density in globus pallidus (l pt.), diffuse low density in white matter with cortical atrophy (l pt.), bilateral low density in globus pallidus and diffuse low density in white matter with cortical atrophy (l pt.) and normal in 3 pts. 2) $^{99m}Tc-HMPAO$ Brain SPECT findings of delayed CO sequelae were decreased regional cerebral blood flow (rCBF) in frontal (1 among 8 pts.), frontal and basal ganglia (3 among 8 pts.), and diffuse patch decreased rCBF pattern (4 among 8 pts.) 3) $^{99m}Tc-HMPAO$ Brain SPECT study was well correlated with neurologic symptoms and signs in delayed CO sequelae. Our results may suggest that reduced cerebral blood flow contributes to the development of delayed CO sequelae.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.4
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• pp.891-897
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• 2007

This experimental Study was designed to investigate the mechanism of Acanthopanacis Cortex Roots(ACR) 50% ethyl alcohol extract on the improvement of regional cerebral blood flow and cytokines production in cerebral ischemic rats. And was designed to investigate whether ACR inhibits lactate dehydrogenase(LDH) activity in neuronal cells The results were as follows; ACR significantly inhibited LDH activity in neuronal cells. These results suggest that ACR prevents the neuronal death. rCBF was significantly and stably increased by ACR(10 mg/kg, i.p.) during the period of cerebral reperfusion, which contrasted with the findings of rapid and marked increase in control group. In cytokine production of serum by drawing from femoral arterial blood at 1 hr after middle cerebral arterial occlusion, experimental group was significantly decreased $IL-1{\beta}$ and $TNF-{\alpha}$ production, and significantly increased IL-10 production compared with control group. In cytokine production of serum by drawing from femoral arterial blood at 1 hr after reperfusion, experimental group was significantly decreased $IL-1{\beta}$ and $TNF-{\alpha}$ production, and significantly increased IL-10 production compared with control group. According to above results, the author suggest that ACR had an anti-ischemic effect through the improvement of cerebral hemodynamics, and inhibitive effect on the brain damage by inhibited $IL-1{\beta}$ and $TNF-{\alpha}$ production, and accelerated IL-10 production.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.1
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• pp.194-199
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• 2004

Cheonmabanhwa-tang(CBT) has been used in the Oriental Medicine for many centuries as a therapeutic agent for dizziness due to Poong-Dam. This study was designed to investigate whether CBT has a cytotoxicity in vitro, and affects the cerebral hemodynamics [regional cerebral blood flow(rCBF), pial arterial diameter(PAD), and mean arterial blood pressure(MABP)) in normal and cerebral ischemic rats. The changes of rCBF were determinated by laser-doppler f1owmeter(LDF), and the change of PAD was determinated by video-microscopy. The results in normal rats were as follows: CBT had no cytotoxicity in neuronal cells. CBT significantly increased rCBF. MABP and PAD in a dose-dependent manner, respectively. Both rCBF and PAD were significantly and stably increased by CBT(10 mg/kg, i.p.) during the period of cerebral reperfusion. which contrasted with the findings of rapid and marked increase in control group. In conclusion, it is suggested that CBT causes a diverse effect on cerebral hemodynamics thereby has an anti-ischemic action.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.6
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• pp.1546-1551
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• 2005

This Study was designed to investigate the effects of Nelumbinis Rhizomatis Nodus (NRN) on the change of cerebral hemodynamics [regional cerebral blood flow (rCBF), pial arterial diameter (PAD) and mean arterial blood pressure (MABP)] in normal and cerebral ischemic rats. And, this study was designed to investigate the inhibition of lactate dehydrogenase activity in neuronal cells The results were as follows NRN significantly increased rCBF and PAD in a dose-dependent manner, and NRN increased MABP in a dose-dependent manner. This results suggested that NRN significantly increased rCBF by dilating PAD. Both rCBF and PAD were significantly and stably increased by NRN (10 mg/kg, i.p.) during the period of cerebral reperfusion, which contrasted with the findings of rapid and marked increase in control group. NRN significantly inhibited lactate dehydrogenase activity in neuronal cells. This results suggested that NRN prevented the neuronal death. It is suggested that NRN had an anti-ischemic effect through the improvement of cerebral hemodynamics and inhibitive effect on the brain damage.

• The Korean Journal of Pain
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• v.23 no.2
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• pp.142-146
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• 2010

Background: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation ($rSO_2$). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. Methods: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. Results: The increments of the $rSO_2$ on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The $rSO_2$ on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. Conclusions: We observed an increment of the $rSO_2$ on the block side from the baseline; however, the $rSO_2$ on the non-block side decreased.

• The Korean Journal of Nuclear Medicine
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• v.23 no.2
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• pp.149-154
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• 1989

Transient ischemic attacks (TIAs) is a syndrome resulting from brain ischemia lasting less than 24 hours. The mechanisms of TIAs may be similar to those of cerebral embolism and thrombosis, and thus TIAs may be followed by cerebral infarction. Despite the availability of CT scanning, the diagnosis and management of TIAs continue to be difficult. Recently SPECT has been advocated as a diagnostic imaging modality. We performed Tc-99m-HMPAO regional cerebral blood flow (rCBF) SPECT in 24 patients with the clinical diagnosis of TIAs to assess its ability to detect early changes of rCBF, and determine the diagnostic value. Ten men and fourteen women with an average of 51 years (range; 27-74 years) were included. All but 8 patients had normal brain CT prior to SPECT. The two patients had moderate degree of brain atrophy and the 6 patients nonspecific calcifications. Eighteen of the 24 patients had abnormal Tc-99m-HMPAO rCBF SPECT. Fifteen had unilateral involvement and the other three had bilateral involvements. Seventy-five percents of the defects were found in the left cerebral hemisphere. According to the distribution of the lesions (total number: 34 lesions), fourteen were in the parietal, eight in the temporal, and the remainders were elsewhere. Tc-99m-HMPAO rCBF SPECT is sensitive in detecting rCBF abnormalities in patients with TIAs, and represent the most accurate diagnostic tool available in the diagnosis of TIAs.