• Title/Summary/Keyword: Vascular status

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Intraoperative Monitoring of Motor-Evoked Potentials for Supratentorial Tumor Surgery

  • Lee, Jung Jae;Kim, Young Il;Hong, Jae Taek;Sung, Jae Hoon;Lee, Sang Won;Yang, Seung Ho
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.98-102
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    • 2014
  • Objective : The purpose of this study was to assess the feasibility and clinical efficacy of motor evoked potential (MEP) monitoring for supratentorial tumor surgery. Methods : Between 2010 and 2012, to prevent postoperative motor deterioration, MEP recording after transcranial stimulation was performed in 84 patients with supratentorial brain tumors (45 males, 39 females; age range, 24-80 years; median age, 58 years). MEP monitoring results were correlated with postoperative motor outcome compared to preoperative motor status. Results : MEP recordings were stable in amplitude (<50% reduction in amplitude) during surgery in 77 patients (91.7%). No postoperative motor deficit was found in 66 out of 77 patients with stable MEP amplitudes. However, postoperative paresis developed in 11 patients. False negative findings were associated with edema in peri-resectional regions and postoperative bleeding in the tumor bed. MEP decrease in amplitude (>50%) occurred in seven patients (8.3%). However, no deficit occurred postoperatively in four patients following preventive management during the operation. Three patients had permanent paresis, which could have been associated with vascular injury during tumor resection. Conclusions : MEP monitoring during supratentorial tumor surgery is feasible and safe. However, false negative MEP results associated with postoperative events may occur in some patients. To achieve successful monitoring, collaboration between surgeon, anesthesiologist and an experienced technician is mandatory.

Temporal lobe epilepsy surgery in children versus adults: from etiologies to outcomes

  • Lee, Yun-Jin;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.56 no.7
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    • pp.275-281
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    • 2013
  • Temporal lobe epilepsy (TLE) is the most common type of medically intractable epilepsy in adults and children, and mesial temporal sclerosis is the most common underlying cause of TLE. Unlike in the case of adults, TLE in infants and young children often has etiologies other than mesial temporal sclerosis, such as tumors, cortical dysplasia, trauma, and vascular malformations. Differences in seizure semiology have also been reported. Motor manifestations are prominent in infants and young children, but they become less obvious with increasing age. Further, automatisms tend to become increasingly complex with age. However, in childhood and especially in adolescence, the clinical manifestations are similar to those of the adult population. Selective amygdalohippocampectomy can lead to excellent postoperative seizure outcome in adults, but favorable results have been seen in children as well. Anterior temporal lobectomy may prove to be a more successful surgery than amygdalohippocampectomy in children with intractable TLE. The presence of a focal brain lesion on magnetic resonance imaging is one of the most reliable independent predictors of a good postoperative seizure outcome. Seizure-free status is the most important predictor of improved psychosocial outcome with advanced quality of life and a lower proportion of disability among adults and children. Since the brain is more plastic during infancy and early childhood, recovery is promoted. In contrast, long epilepsy duration is an important risk factor for surgically refractory seizures. Therefore, patients with medically intractable TLE should undergo surgery as early as possible.

Gastroepiploic Artery Preservation with Glycerol as a Training Model for Microvascular Anastomosis (미세혈관문합술의 연습 모델로서 글리세롤 처리된 위대망동맥의 활용)

  • Park, Chan Young;Chang, Hak;Chung, Jin Haeng;Heo, Eun Ju;Minn, Kyung Won;Yoo, Moon Won;Yang, Han Kwang
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.626-629
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    • 2008
  • Purpose: We investigate the possibility of vessel preservation with glycerol and evaluate the potential of preserved gastroepiploic artery as a tool for the microsurgical practice. Methods: In 5 early gastric cancer patients, IRB(No. C-0603-040-170), we gained gastroepiploic artery specimens(5 segments, about 10 cm) after gastrectomy. Each segment was rinsed in a normal saline and subsequently placed in a bottle, containing 50 mL anhydrous glycerol (87%). The bottles were refrigerated at $4^{\circ}C$, the longest preservation time being 5 months. Results: At first glance, no fragmentation was detected and the surface of vessel seemed mild sclerotic. In histological examination, vascular structures remained intact though preservation with glycerol led to a mild atrophy of the smooth muscle in the tunica media. Especially, we found out the elastic fibers and endothelial lining of the intima were preserved until 5 months. Adequate status for using microsurgical practice was also maintained and leakage test was performed successfully with gentian violet ink. Conclusion: Based on the results obtained in this study, the gastroepiploic artery preservation with glycerol as a training model for microvascular anastomosis is a technically very simple procedure and useful for the novice microsurgeon.

Geographical distribution range and growth environmental characteristics of Deutzia paniculata Nakai, a Korean Endemic Plant (한반도 특산식물 꼬리말발도리의 분포와 생육환경특성)

  • Jung, Ji-young;An, Jong-Bin;Yun, Ho-Geun;Jung, Su-Young;Shin, Hyun-Tak;Son, Sung-won
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.23 no.2
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    • pp.1-16
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    • 2020
  • The current status of geographical distribution range of Deutzia paniculata, one of the korean endemic plants, was investigated based on the species distribution information. The information of the geographical range used for analysis includes all the published references to the distribution of D. paniculata, herbarium specimens in Korea National Arboretum (KH) including its online database: http://www.nature.go.kr, and field research. Although, D. paniculata was firstly recorded in Wonsan, Hamgyeongnam-do, North Korea, this research revelaved that D. paniculata is mainly distributed in Gyeongsangbuk-do and Gyeongsangnam-do, southern regions of the Korean Peninsula. According to the distribution map, this species was estimated on distribution edge of in Anyang region of Gyeonggi-do, Mt. Naejang of Jeollabuk-do and Mt. Taebaek of Gwangwon-do on the distribution edge. However, it was made use of intensive field survey to identify the natural population of the species in these regions. D. paniculata habitat was mainly distributed between 290 meters and 491 meters in altitude, but it was also found ranged from 936 to 959 meters in Gun-wi, Gyeongsangbuk-do, South Korea. The distribution slope was 5° to 35° and the north, N, NE and NW in the aspect. The flora of vascular plants in D. paniculata habitats was listed in 137 taxa: 54 families, 103 genera, 120 species, 2 subspecies, 12 varieties and 3 forms while Korean endemic plants were found in three taxa, Stewartia koreana, Weigela subsessilis and D. Paniculata. Based on a collection of non-biological environment and biological environment data, D. paniculata population were discussed to make strategy and basic research methods for sustainable preservation.

High glucose and palmitate increases bone morphogenic protein 4 expression in human endothelial cells

  • Hong, Oak-Kee;Yoo, Soon-Jib;Son, Jang-Won;Kim, Mee-Kyoung;Baek, Ki-Hyun;Song, Ki-Ho;Cha, Bong-Yun;Jo, Hanjoong;Kwon, Hyuk-Sang
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.2
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    • pp.169-175
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    • 2016
  • Here, we investigated whether hyperglycemia and/or free fatty acids (palmitate, PAL) affect the expression level of bone morphogenic protein 4 (BMP4), a proatherogenic marker, in endothelial cells and the potential role of BMP4 in diabetic vascular complications. To measure BMP4 expression, human umbilical vein endothelial cells (HUVECs) were exposed to high glucose concentrations and/or PAL for 24 or 72 h, and the effects of these treatments on the expression levels of adhesion molecules and reactive oxygen species (ROS) were examined. BMP4 loss-of-function status was achieved via transfection of a BMP4-specific siRNA. High glucose levels increased BMP4 expression in HUVECs in a dose-dependent manner. PAL potentiated such expression. The levels of adhesion molecules and ROS production increased upon treatment with high glucose and/or PAL, but this eff ect was negated when BMP4 was knocked down via siRNA. Signaling of BMP4, a pro-inflammatory and pro-atherogenic cytokine marker, was increased by hyperglycemia and PAL. BMP4 induced the expression of inflammatory adhesion molecules and ROS production. Our work suggests that BMP4 plays a role in atherogenesis induced by high glucose levels and/or PAL.

Intracranial Hemorrhage Developed from Patient Who Had Been Preeclampsia at Five Days Postpartum - A Case Report - (전자간이 있던 산모에서 분만 5일후 발생한 뇌실질내 출혈 - 증례보고 -)

  • Lee, Chang-Woo;Kim, Yong-Seog;Park, Moon-Sun;Ha, Ho-Guyn;Lee, Jong-Sun;Jung, Ho;Kim, Joo-Seung
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.371-375
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    • 2001
  • Intracranial hemorrhage due to preeclampsia in the postpartum woman is rarely documented. Generally, the incidence of stroke is increased during pregnancy and early postpartum. Preeclampsia is considered a main cause of both nonhemorrhagic and hemorrhagic stroke. We present a 32-year-old woman who had intracranial hemorrhage at 5 days postpartum. At admission, her consciousness was semicomatose with elevated blood pressure. Computerized tomography revealed intracranial hemorrhage on right frontal lobe. Additional angiography did not reveal abnormal vascular lesion. Emergency craniectomy with hematoma removal was done. However, the patient showed no recovery and died 2 weeks later. We conclude that postpartum care of preeclampsia is important to prevent intraparenchymal hemorrhage. Relative high risk of stroke during the postpartum period suggests a causal roles for the large decrease in blood volume or the rapid changes in hormonal status that follow a live birth or stillbirth, perhaps by means of hemodynamics, coagulative, or vessel wall changes.

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Effects of daily quercetin-rich supplementation on cardiometabolic risks in male smokers

  • Lee, Kyung-Hea;Park, Eun-Ju;Lee, Hye-Jin;Kim, Myeong-Ok;Cha, Yong-Jun;Kim, Jung-Mi;Lee, Hye-Ran;Shin, Min-Jeong
    • Nutrition Research and Practice
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    • v.5 no.1
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    • pp.28-33
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    • 2011
  • Limited information from human studies indicates that dietary quercetin supplementation influences blood lipid profiles, glycemic response, and inflammatory status, collectively termed cardiometabolic risks. We tested the hypothesis that quercetin-rich supplementation, derived from onion peel extract, improves cardiometabolic risk components in healthy male smokers in a randomized, double blinded, placebo-controlled parallel design. Randomly assigned subjects were instructed to take either the placebo (n=43) or 100 mg quercetin capsules each day (n=49) for 10 weeks. Anthropometric parameters and blood pressure were measured, and blood lipids, glucose, interleukin-6, and soluble vascular cell adhesion molecule-1 (sVCAM-1) were determined at baseline and after 10 weeks of quercetin supplementation. Quercetin-rich supplementation significantly reduced serum concentrations of total cholesterol (P<0.05) and LDL-cholesterol (P<0.01), whereas these effects were not shown in the placebo group. Furthermore, significant increases were observed in serum concentrations of HDL-cholesterol both in the placebo (P<0.005) and quercetin-rich supplementation group (P<0.001); however, changes in HDL-cholesterol were significantly greater in subjects receiving quercetin-rich supplementation than the placebo. Both systolic (P<0.05) and diastolic blood pressure (P<0.01) decreased significantly in the quercetin-rich supplementation group. Glucose concentrations decreased significantly after 10 weeks of quercetin-rich supplementation (P<0.05). In contrast, no effects of quercetin-rich supplementation were observed for the inflammatory markers-IL-6 and sVCAM-1. Daily quercetin-rich supplementation from onion peel extract improved blood lipid profiles, glucose, and blood pressure, suggesting a beneficial role for quercetin as a preventive measure against cardiovascular risk.

Current Status and Future Perspective of Nuclear Cardiology (심장핵의학의 현황과 전망)

  • Chung, June-Key
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.159-164
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    • 2009
  • Coronary artery disease is on the rise over the world. Myocardial perfusion SPECT is a well established technique to detect coronary artery disease and to assess left ventricular function. In addition, it has the unique ability to predict the prognosis of the patients. Moreover, the application of ECC-gated images provided the quantitatve data and improved the accuracy. This approach has been proved to be cost-effective and suitable for the emerging economies as well as developed countries. However, the utilization of nuclear cardiology procedures vary widely considering the different countries and region of the world. Korea exits 2-3 times less utilization than Japan, and 20 times than the United States. Recently, with the emerging of new technology, namely cardiac CT, cardiac MR and stress echocardiography, the clinical usefulness of nuclear cardiology has been called in question and its role has been redefined. For the proper promotion of nuclear cardiology, special educations should be conducted since the nuclear cardiology has the contact points between nuclear medicine and cardiology. Several innovations are in horizon which will impact the diagnostic accuracy as well as imaging time and cost savings. Development of new tracers, gamma camera technology and hybrid systems will open the new avenue in cardiac imaging. The future of nuclear cardiology based on molecular imaging is very exciting. The newly defined biologic targets involving atherosclerosis and vascular vulnerability will allow the answers for the key clinical questions. Hybrid techniques including SPECT/CT indicate the direction in which clinical nuclear cardiology may be headed in the immediate future. To what extent nuclear cardiology will be passively absorbed by other modalities, or will actively incorporate other modalities, is up to the present and next generation of nuclear cardiologists.

Prognosis and Clinicopathology of CXCR4 in Colorectal Cancer Patients: a Meta-analysis

  • Li, Lu-Ning;Jiang, Kai-Tong;Tan, Peng;Wang, Ai-Hua;Kong, Qing-Yin;Wang, Cui-Yue;Lu, Hua-Rong;Wang, Jing
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4077-4080
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    • 2015
  • The chemokine receptor 4 (CXCR4) has been widely used in diagnosis and prognosis of colorectal cancer (CRC). However, there is no current consensus on the impact of CXCR4 on CRC patients. The purpose of this study was to evaluate the prognostic and clinicopathological importance of CXCR4 in CRC patients. Databases, such as PubMed, Cochrane library, CBM and EMBASE updated to 2014 were searched to include eligible articles. We analysed correlations between CXCR4 expression and clinicopathological features and overall survival (OS). A total of 1, 055 CRC patients from twelve studies were included in the study. The pooled odds ratios (ORs) which indicated CXCR4 expression was likely to be associated with TNM stage (OR=0.43, CI=0.34-0.55, P<0.00001), lymph node status (OR=2.23, CI=1.23-4.05, P=0.008) and vascular invasion (OR=2.21, CI=1.11-4.39, P=0.02). Poor overall survival of CRC cancer was found to be significantly related to CXCR4 overexpression (hazard ratio (HR) 1.36 CI=1.17-1.59, P<0.0001), whereas combined ORs revealed that CXCR4 expression had no correlation with gender or differentiation. Based on the published studies, CXCR4 overexpression in patients w ith CRC indicates poor survival outcome and clinicopathological factors.

Prognostic Value of Serum AFP, AFP-L3, and GP73 in Monitoring Short-term Treatment Response and Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

  • Wang, Nan-Ya;Wang, Cong;Li, Wei;Wang, Guan-Jun;Cui, Guo-Zhen;He, Hua;Zhao, Heng-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1539-1544
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    • 2014
  • Purpose: Alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and Golgi protein 73 (GP73) levels have been widely used as tumor markers for the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to investigate whether these tumor markers could be used to monitor short-term treatment response and recurrence of HCC in patients undergoing radiofrequency ablation (RFA). Methods: Between July 2012 and July 2013, 53 consecutive patients with newly diagnosed HCC were prospectively enrolled in this study. Among these, 32 patients underwent RFA, after which they were followed up prospectively at the First Hospital of Jilin University in China. Results: AFP, AFP-L3, and GP-73 values pre-RFA were not associated with tumor size, whereas AFP and GP-73 levels tended to be associated with tumor number, the presence of vascular invasion, deterioration of liver function, advanced-stage disease, and a poor performance status. GP-73 levels were dramatically elevated in the patients with hepatitis C-associated HCC. Neither pre-RFA nor 1-month post-RFA tumor marker values were associated with short-term outcome. The short-term recurrence rate of AFP-positive patients measured 1 month post-RFA was obviously higher than that of AFP-negative patients. Conclusions: AFP and GP-73 values were associated with clinical variables representing tumor growth and invasiveness, and the AFP value measured 1 month post-RFA was a strong predictor of short-term recurrence in patients with HCC.