대뇌반구 뇌손상으로 인한 뇌혈류 및 체성감각 유발전위 변화 및 Mannitol의 효과 : An Experimental Cat Model

강준기,조병일,김문찬,조태훈,박춘근,김달수,하영수,송진언 대한신경외과학회 1984 Journal of Korean neurosurgical society Vol.13 No.1

Since every component of the evoked responses are considered to be related to topographically specific neural structures, it is possible that the location and severity of brain dysfunction could be accurately defined by careful analysis of evoked responses. The main objective of this experiment was to replicate some of the mechanisms involved in human brain injuries in cat and observe the effect of focal hemispheric brain injury on regional cerebral blood flow(rCBF) and somatosensory evoked potential (SEP) and to evaluate the effects of mannitol on them. Thirty adult cats weighing 2.5 to 4.2 ㎏, were used in this study. The animals were divided into 3 groups of 10 cats each: (1) mild injury, (2) severe injury and (3) mannitol treated severe injury group. A mild injury was produced by moving the drill along a predetermined pathway through the right parietal hole at 50 cycle per minute for 2 seconds and a severe injury was produced in a similar fashion at 200 cycle per minute for 3 seconds. A mannitol treated group was produced in a same method as the severe injury group. The rCBF and SEP measurements were performed immediately after injury in each animal, at 30 minutes, 60 minutes and the final flow at 90 minutes by pasztor(1973) hydrogen clearance technique. The results obtained were as follows. 1) After focal cerebral hemispheric injury, there were rapid rise in intracranial pressure, bradycardia, changes in blood pressure and marked alteration in respiration which are neurogenically mediated. 2) Normal control flows(rCBF, ㎖/100g/min) were 30.7±5.9 in right frontal, 35.2±6.7 in right parietal, 27.9±6.8 in left frontal, and 35.2±7.3 in left parietal lobes. 3) Sequential changes of the rCBF after focal cerebral hemispheric injury were as follows. (1) Mild focal hemispheric injury resulted in a reduction of flow to 30% of control flow(RF: 18.8±3.7, RP: 25.0±7.8㎖/100g/min) at injury resulted in a reduction of flow to 30% of control flow(RF: 18.8±3.7, RP: 25.0±7.8㎖/100g/min) at injury site after immediate injury. (2) Severe focal hemispheric injury resulted in a reduction of flow to 50% of control flow (RF: 20.4±10.9, RP: 18.8±7.6 ㎖/100 g/min) at injury site after immediate injury. (3) Mannitol-treated severe injury resulted also in a reduction of flow to 50% of control flow at the injury site after immediate injury, but at 90minutes the flow was 75% of the control flow. 4) A close correlation was found between cortical-evoked potentials and flow, suggesting a threshold relationship both on injury and non-injury areas. (1) The SEP was present shortly after injury though markedly altered in shape and the early components (No, N1) of the SEP were suppressed first. (2) It was also noted that the amplitude of the SEP was much smaller, perhaps due to direct injury on the injured area. (3) The SEP disappeared if the rCBF in either hemisphere fell below 15㎖/100gm/min. 5) It might be inferred from these results that adequate flow was vital for the preservation and return of electrical activity following brain injury.

腦硬塞患者의 血壓·脈搏 및 腦血流에 대하여 水溝-承漿穴 電鍼刺戟이 미치는 影響

박성욱,문상관,고창남,조기호,김영석,배형섭,이경섭 경희대학교 1997 慶熙醫學 Vol.13 No.4

Age-related changes in pial arterial structure and blood flow in mice

Kang, H.M.,Sohn, I.,Jung, J.,Jeong, J.W.,Park, C. PERGAMON PRESS LTD 2016 NEUROBIOLOGY OF AGING Vol. No.

Age-related cerebral blood flow decreases are thought to deteriorate cognition and cause senescence, although the related mechanism is unclear. To investigate the relationships between aging and changes in cerebral blood flow and vasculature, we obtained fluorescence images of young (2-month-old) and old (12-month-old) mice using indocyanine green (ICG). First, we found that the blood flow in old mice's brains is lower than that in young mice and that old mice had more curved pial arteries and fewer pial artery junctions than young mice. Second, using Western blotting, we determined that the ratio of collagen to elastin (related to cerebral vascular wall distensibility) increased with age. Finally, we found that the peak ICG intensity and blood flow index decreased, whereas the mean transit time increased, with age in the middle cerebral artery and superior sagittal sinus. Age-related changes in pial arterial structure and composition, concurrent with the observed changes in the blood flow parameters, suggest that age-related changes in the cerebral vasculature structure and distensibility may induce altered brain blood flow.

마취유도 시 경두개 도플러를 이용한 Rocuronium과 Succinylcholine 투여 후 뇌혈류속도 비교

정순호,김영환,김세용,이근무,최영균,김영재,박진우,신치만,박주열 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

Background: In intravenous administration of a depolarizing of a depolarizing neuromuscular blocker, succinylcholine is reported to produce activation of the electroencephalogram and increase cerebral blood flow and intracranial pressure. In this point, rocuronium was recently introduced as a non-depolarizing relaxant, and recommended as a safe alternative to succinylcholine. The purpose of this study was to evaluate the effects of rocuronium and succinylcholine on cerebral blood flow velocities during anesthetic induction. Methods: Forty patients were randomly assigned into two groups. Group 1 was administrated rocuronium 0.6 mg/kg and group 2 was administrated succinylcholine 1 mg/kg for tracheal intubation after each group had intravenous administration of thiopental 5 mg/kg. The author observed changes of mean arterial pressure, arterial carbon dioxide tension, and middle cerebral arterial blood flow velocities at 5 times: before induction (control), 30 sec after thiopental administration, 30 sec, 60 sec and 90 sec after muscle relaxant administration. Results: Mean arterial pressure decreased more at 30 sec after thiopental administration compared with the control (P < 0.05). Middle cerebral arterial blood flow velocities were reduced at 30 sec after thiopental administration and 60 sec after rocuronium administration compared with the control (P < 0.05). Middle cerebral arterial blood flow velocities were reduced at 30, 60, 90 sec after rocuronium administration compared with succinylcholine administration (P < 0.05). Conclusions: We conclude that rocuronium gas little effects on increasing cerebral blood flow. These result suggest that rocutonium have a less effect on increase in cerebral blood flow during neurosurgical anesthesia. (Korean J Anesthesiol 2002; 43: 575~580)

뇌혈류변화를 동반한 뇌혈관 질환에서의 혈관 크기의 변화

조용준,김창현,곽동근,박세혁,이규호 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.4

It has been known that the size of arterial diameter during growth in primates is closely dependent on blood flow. Flow induced arterial size can be influenced by contractile or structual characters of vascular smooth muscle cells. Furthermore it had been confirmed through experimental study that vascular endothelium releases vasoactive substances which adjust smooth muscle tone, and could detect shear stress on the vascular wall by its direct contact with luminal flow. The authors tried to prove it through the angiographic measurement of the major vessel sizes in cerebrovascular diseases with changed blood flow. We measured the major vessel sizes of 36 cases of cerebrovascular diseases : arteriovenous malformation in 14 cases, cerebral infarction in 8, cerebral hemiatrophy in 6, moyamoya disease 5, occlusion of the internal carotid artery in 2, and carotid-cavernous fistula in 1, which may influence cerebral, blood flow, on angiography under the same circumstances. Results are as the followings : 1) In the cases of arteriovenous malformation and carotid-cavernous fistula, all of the major vessel sizes of the lesion site were increased and all became decreased postoperatively. 2) In the cases of major vessel occlusion and cerebral hemiatrophy, the major vessel size of the lesion site was smaller than that of the normal site. 3) In the cases of moyamoya disease, there was no definite size difference between both ICA sizes. In conclusion, the change in cerebral blood flow is a determinant factor of the major vessel sizes in the cases of cerebrovascular disorders which can influence cerebral blood flow.

경두개 초음파를 이용한 혈액투석중 뇌혈류량의 변화측정

김용수(Yong Soo Kim),방병기(Byung Kee Bang),양철우(Chul Woo Yang),박정희(Jung Hee Park),박주현(Joo Hyun Park),이광수(Kwang Soo Lee),최영빈(Young Bin Choi),한시령(Si Ryung Han),김영인(Yeong In Kim) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.3

N/A Hemodialysis is a safe and effective treatment for uremic patients but hemodynamic changes during he-modialysis is suggested to be the possible cause of encephalopathy. However, few studies have evaluated the cerebral circulation of and the effects of hemo-dialysis. Therefore, this study was performed to evaluate the cerebral blood flow by transcranial doppler. The study populations were 12 male patients who ranged in age from 28 to 58 years(mean:57) and were receiving maintenance hernodialysis for 3.8 years(0.5-11.5 years). Mean blood flow velocity(MFV), pulsatility index(PI) and resistance index(RI) were measured in carotid artery(CA), middle cerebral artery(MCA), anterior cerebral artery(ACA) and pos-terior cerebral artery(PCA) before, during and after hemodialysis. Simultaneously, we also checked vari- ables(body weight, blood pressure, arterial blood gases, hematocrits, and other biochemical parame-ters) which might affect cerebral blood flow. MFV during(70.5±20.3 vs. 60.0±211cm/sec) and after(vs. 60.6±13.7cm/sec, p<0.01) hemodialysis in CA showed significant reduction as compared to the that of before hemodialysis, but other vessels(MCA, ACA and PCA) showed no significant changes. There were no significant changes in PI and RI before, during and after hemodialysis. Body weight, PaCO₂, blood urea nitrogen and hematocrit changed significantly during and after hemodialysis as compared to those of before hemodialysis, but correlation between changes of MFV and these variables was not observed. Hemodialysis and its associated physiologic changes are not associated with cerebral blood flow, and this result suggests the well-preservation of autoregulation of cerebral blood flow during and after hemodialysis.

99mTc - HMPAO 뇌혈류 SPECT 영상의 부위별 체적 혈류 평가에 관한 기초 연구

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),최창운(Chang Woon Choi),박석건(Seok Gun Park),이경한(Kyung Han Lee),곽철은(Cheol Eun Kwark),양형인(Hyung In Yang) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2

N/A The quantitative methods for the assessment of the cerebral blood flow using Tc-99m- HMPAO brain SPECT utilize the measured count distribution in some specific reconstructed tomographic slice or in algebraic summation of a few neighboring slices, rather than the true volumetric distribution, to estimate the relative regional cerebral blood flow, and consequently produce the biased estimates of the true regional cerebral blood flow. This kind of biases are thought to originate mainly from the arbitrarily irregular shape of the cerebral region of interest(ROI) which are analyzed. In this study, a semi-automated method for the direct quantification of the volumetric regional cerebral blood flow estimate is proposed, and the results are compared to those calculated by the previous planar approaches. Bias factors due to the partial volume effect and the uncertainty in ROI determination are not considered presently for the methodological comparison of planar/volumetric assessment protocol.

Cerebral blood flow change during volatile induction in large-dose sevoflurane versus intravenous propofol induction: transcranial Doppler study

정화성,성태윤,강현,김진선,김태엽 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.5

Background: The impact of volatile induction using large-dose sevoflurane (VI-S) on cerebral blood flow has not beenwell investigated. The present study compared the changes in cerebral blood flow of middle cerebral artery using transcranialDoppler (TCD) during VI-S and conventional induction using propofol. Methods: Patients undergoing elective lumbar discectomy were randomly allocated to receive either sevoflurane (8%,Group VI-S, n = 11) or target-controlled infusion of propofol (effect site concentration, 3.0 μg/ml; Group P, n = 11) forinduction of anesthesia. The following data were recorded before and at 1, 2, and 3 min after commencement of anestheticinduction (T0, T1, T2, and T3, respectively): mean velocity of the middle cerebral artery (VMCA) by TCD, meanblood pressure (MBP), heart rate, bispectral index score (BIS) and end-tidal CO2 (ETCO2). Changes in VMCA and MBPfrom their values at T0 (ΔVMCA and ΔMBP) at T1, T2, and T3 were also determined. Results: BISs at T1, T2 and T3 were significantly less than that at T0 in both groups (P < 0.05). ΔVMCA in Group VI-Sat T2 and T3 (18.1% and 12.4%, respectively) were significantly greater than those in Group P (-7.6% and -19.8%, P =0.006 and P < 0.001, respectively), whereas ETCO2 and ΔMBP showed no significant intergroup difference. Conclusions: VI-S using large-dose sevoflurane increases cerebral blood flow resulting in luxury cerebral flow-metabolismmismatch, while conventional propofol induction maintains cerebral flow-metabolism coupling. This mismatch inVI-S may have to be considered in clinical application of VI-S.

뇌동맥류 혈액유입 저감을 위한 스텐트 형상에 관한 전산유체해석

여동현(Dong-Hyeon Yeo),박동규(Dong-Gyu Park),변상민(Sang-Min Byon) 한국기계가공학회 2017 한국기계가공학회지 Vol.16 No.1

A cerebral aneurysm is a ballooning arising from a weakened area in the wall of a blood vessel in the brain. In this study, the flow analysis of the blood vessel, including the cerebral aneurysm and the stent, was conducted to investigate the effect of the stent shape on reduction of blood flowing into the cerebral aneurysm. We used the Carreau model to describe Non-Newtonian behaviors of blood flow. Two kinds of stents, which had different cross angles were modelled by the commercial CAD program and the geometries of those stents were reflected in the analysis domain of the blood vessel. From the results of the flow analysis, we found that the blood flowing into the cerebral aneurysm was decreased as the cross angle of the stent was decreased.

운동형태 및 valsalva maneuver가 뇌혈류에 미치는 영향

정일규(Il Gyu Jeong),오명진(Myung Jin Oh),윤재석(Jae Suk Yoon),김종오(Jong Oh Kim),이일우(Il Woo Lee),김명기(Myung Ki Kim),강금숙(Geum Sook Kang) 한국사회체육학회 2005 한국사회체육학회지 Vol.0 No.23

This study investigated the effects of exercise types and valsalva maneuver on brain blood flow. Eleven subjects were participated in this experiment. Brain blood flow was tested by TCD through 5 sessions: valsalva maneuver, resting, arm ergometer exercise at 15watts, arm ergometer exercise at 30watts, and curling the dumbbell of 15 kg. The values of mean cerebral arterial blood flow at valsalva maneuver and curling the dumbbell were decreased significantly compared to resting value(p<.05). The arm ergometer exercise at 15w and 30w increased significantly the cerebral arterial blood flow compared to resting state(p<.00). There was no significant difference of heart rate among exercise types regardless of brain blood flow velocity. Present results suggest that performing valsalva maneuver during weight lifting might lead to cerebral blood flow dysfunction such as fainting by reducing blood flood to brain whereas rhythmical exercise(arm ergometer) actually increases blood flood to brain.