토끼 대뇌 연막혈관에 국소 Nilvadipine 용액이 미치는 영향

정재익,이영우 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.8

The effects of mock CSF, nilvadipine solution of various concentrations and PEG 400 solution on regional cerebral pial vessels in rabbits were studied by topical microapplication to the perivascular evironment through the bilateral cranial windows in a randomized fashion. Physiological parameters(PaO₂. PaCO₂. blood pH. and systolic blood pressure) were not significantly changed during all experiments. The pial vascular diameter was directly determined with the micrometer eyepiece under the operating microscope The results were the followings : 1) Topical applications with mock cerebrospinal fluid(Group I ) and PEG 400(Group 1) on cerebral pial vessels did not significantly change pial vascular diameter in comparison with the resting state(p>0.05) 2) Application of nilvadipine solution of 1×10^(-8)M did not show significant dilatation, and solutions over the range of 1×10^(-7)M to 1×10^(-2)M resulted in significant dilatation of the cerebral pial arteries in a dose-dependent manner. The small arterial segments showed more dilatation than large arterial segments when topical nilvadipine solution were applied. however. the difference was not significant(p>0.05). 3) In venous segments, topical application of the nilvadipine solution induced no significant pial vein dilatation compared with the resting state(p>0.05). except when 10 minutes after the topical application of 1×10^(-2)M nilvadipine solution(p<0.05). It may be suggested that topical application of nilvadipine solution induce the dilatation of pial arteries with dose-dependent manner. Nilvadipine might be used for treatment and prevention of cerebral vasospasm and ischemia.

石菖蒲가 白鼠의 腦軟膜動脈의 直徑에 미치는 機轉硏究

李金洙,鄭鉉雨,康成溶 대한본초학회 2000 大韓本草學會誌 Vol.15 No.2

Acori Graminei Rhizoma(AGR) has been used in Korea for many centuries as a therapeutic agent for cerebral disease. The effect of AGR on the vascular system is not known. The purpose of this study was to determine the effect of AGR on the pial arterial diameter of male Sprague-Dawely rats. The changes in pial arterial diameter were determinated by video microscopy methods and video analyzer. The results were as follows ; 1. Pial arterial diameter was increased by AGR in a dose-dependent manner. 2. Pretreatment with 1H[1,2,4]oxadizolo[4,3-a]quinoxalin-1-one(ODQ, 3μM, i.v.) significantly inhibited AGR induced increased pial arterial diameter. 3. Pretreatment with N^G-nitro-L-argirinine(-NNA, 1㎎/㎏, iv) significantly inhibited AGR induced increased pial arterial diameter. These results suggest that AGR causes a diverse response of pial arterial diameter. The increased in pial arterial diameter is also mediated by nitric oxide synthase and cyclic GMP(guanylyl cyclase).

토끼 뇌연막혈관에서 norepinephrine과 Benzoxathian 국소 미세점적의 효과

정기철,이영우 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.12

The effects of norepinephrine and benzoxathian on the diameters of cerebral pial vessles in rabbits were studied by topical microapplication of the drugs to the perivascular environment. Vascular diameters were determined with the micrometer eyepiece on operating microscope through the craniectomized area. Physiological parameters(PaO₂, PaCO₂, blood pH, and systolic blood pressure) had not significantly changed during all the experiments. The observations were as follows : 1) Application of norepinephrine over the range of 5×10^(-)M to 5×10^(-3)M to the cerebral pial arteries resulted in significant constriction of the vessels, with the exception of 5×10^(-8)M. The dose-response curve showed a maximal constriction of 31.5±3.8% at 5×10^(-3). 2) Benzoxathian produced vasodilatation at dosages over 5×10^(-4)M. But there was little change of vascular diameter between dosages of 5×10^(-8)M to 5×10^(-5)M. The dose-response curve showed a maximal vasodilatation of 26.31±5.1% at 5×10^(-3)M. 3) The vasoconstriction due to microapplication of norepinephrine was prevented by the inclusion of an equimolar concentration of the alpha-1 receptor antagonist, benzoxathian. 4) The vasoconstriction induced by norepinephrine occurred in higher concentration of norepinephrine than that of benzoxathian, and the vasoconstriction was proportional to the concentration of norepinephrine. 5) The pattern of responses of the pial veins corresponded with that of pial arteries. But the amplitudes of the change in the diameters of veins were less than those of the arteries. The results indicate that alpha-adrenergic receptor is present in the smooth muscles of cerebral pial arteries and veins for the sympathetic control of blood flow to the brain, and newly introduced benzoxathian acts as a highly selective alpha-1 receptor antagonist.

Intracranial Pial Arteriovenous Fistula Presenting with Hemorrhage: A Case Report

Jin Soo Lee,오창완,Jae Sung Bang,권오기,Gyojun Hwang 대한뇌혈관외과학회 2012 Journal of Cerebrovascular and Endovascular Neuros Vol.14 No.4

Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular malformation, which has a single or multiple arterial connections to a single venous channel without intervening nidus, and is different from arteriovenous malformation (AVM). We report on a case of a surgically treated pial AVF. A 15-year-old girl with an altered mental state was brought to our hospital. Computed tomography (CT) showed a subcortical hematoma of approximately 24 ml in her right temporal lobe. Cerebral angiography showed an AVF supplied by the right middle cerebral artery with early drainage into the Sylvian vein and the vein of Labbe. She underwent surgical treatment with feeding artery obliteration using a clip and hematoma removal. The patient was discharged without neurologic deficits. Despite the rarity of pial AVF, for correct diagnosis and treatment, neurosurgeons should recognize this condition. Pial AVF can be managed simply by disconnection of the shunt by surgery or endovascular treatment, and a good result can be achieved.

Intracranial Pial Arteriovenous Fistulas

Lee, Ji-Yeoun,Son, Young-Je,Kim, Jeong-Eun The Korean Neurosurgical Society 2008 Journal of Korean neurosurgical society Vol.44 No.2

Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion that has only recently been recognized as a distinct pathological entity. A 41-year-old woman (Patient 1) presented with the sudden development of an altered mental state. Brain CT showed an acute subdural hematoma. A red sylvian vein was found intraoperatively. A pial AVF was revealed on postoperative angiography, and surgical disconnection of the AVF was performed. A 10-year-old boy (Patient 2) presented with a 10-day history of paraparesis and urinary incontinence. Brain, spinal MRI and angiography revealed an intracranial pial AVF and a spinal perimedullary AVF. Endovascular embolization was performed for both lesions. The AVFs were completely obliterated in both patients. On follow-up, patient 1 reported having no difficulty in performing activities of daily living. Patient 2 is currently able to walk without assistance and voids into a diaper. Intracranial pial AVF is a rare disease entity that can be treated with surgical disconnection or endovascular embolization. It is important for the appropriate treatment strategy to be selected on the basis of patient-specific and lesion-specific factors in order to achieve good outcomes.

A Case of Pial Arteriovenous Fistula with Giant Venous Aneurysm and Multiple Varices Treated with Coil Embolization

Oh, Hyuk-Jin,Yoon, Seok-Mann,Kim, Sung-Ho,Shim, Jai-Joon The Korean Neurosurgical Society 2011 Journal of Korean neurosurgical society Vol.50 No.3

Intracranial pial arteriovenous fistulas (AVFs) are rare vascular lesions of the brain. These lesions consist of one or more arterial connection to a single venous channel without true intervening nidus. A 24-year-old woman visited to our hospital because of headache, vomiting, dizziness and memory disturbance that persisted for three days. She complained several times of drop attack because of sudden weakness on both leg. Cerebral angiograms demonstrated a giant venous aneurysm on right frontal lobe beyond the genu of corpus callosum, multiple varices on both frontal lobes fed by azygos anterior cerebral artery, and markedly dilated draining vein into superior sagittal sinus, suggesting single channel pial AVF with multiple varices. Transarterial coil embolization of giant aneurysm and fistulous portion resulted in complete disappearance of pial AVF without complication.

Onyx Embolization of Intracranial Pial Arteriovenous Fistula

Hae-Min Kim,조재훈,Ki-Hong Kim 대한뇌혈관외과학회 2016 Journal of Cerebrovascular and Endovascular Neuros Vol.18 No.3

Intracranial pial arteriovenous fistulas (AVFs) are rare cerebrovascular lesions consisting of one or more arterial connections to a single venous channel without an intervening nidus. Because of the location and high flow dynamics of these lesions, neurosurgeons may have a difficulty deciding between endovascular treatment and open surgical treatment. We report on a patient who underwent endovascular treatment with liquid embolic agent. A 50-year-old man with a decreased mental state and a tonic seizure event was brought to our hospital. Computed tomography (CT) of the brain showed a subcortical hematoma in the right temporoparietal lobe. On three-dimensional cerebral artery CT, there was no evidence of definite cerebrovascular abnormality. Cerebral angiography showed a pial AVF supplied by the right middle cerebral artery with early drainage into the right superior cerebral vein. The patient was treated with Onyx embolization for definitive closure of the fistula. The patient was transferred to the department of rehabilitation medicine two weeks later with grade 4 left hemiparesis. The application of advanced equipment, such as the latest angiography and endovascular tools, will facilitate the correct diagnosis and delicate treatment of pial AVF.

順氣導痰湯이 白鼠 의 腦血流力學에 미치는 기전 연구

정현우,송정석,김천중 대한동의병리학회 2001 동의생리병리학회지 Vol.15 No.3

Sunkidodam-tang(SDT) have been used in oriental medicine for many centuries as a therapeutic agent for fullness sensation due to accumulation of phlegm. The effects of SDT on the vascular system is net known. The purpose of this Study was to investigate the effects of SDT on the pial arterial diameter, action mechanism of SDT on the cerebral hemodynamics. The changes in regional cerebral blood flow(rCBF), mean arterial blood pressure(BP) and cardiac muscle contractile force(CMF) were determinated by Laser-Doppler Flowmetry(LDF), and the changes in pial arterial diameter were determinated by video microscopy methods and video analyzer. The results were as follows ; Pial arterial diameter was significantly increased by SDT in a dose-dependent manner. Pretreatment with L-NNA significantly inhibited SDT induced increased rCBF. Pretreatment with L-NNA significantly inhibited SDT induced increased BP. Pretreatment with methylene blue inhibited SDT induced increased rCBF Pretreatment with methylene blue significantly inhibited SDT induced increased BP. Pretreatment with indomethacin significantly inhibited SDT induced increased rCBF. Pretreatment with indomethacin inhibited SDT induced increased BP. These results suggest that SDT causes a diverse response of blood vessle movement(rCBF, BP, CMF and pial arterial diameter). The blood vessle movement(rCBF, BP, CMF) is also mediated by nitric oxide synthase, cyclic GMP(guanylyl cyclase) and prostaglandin(cyclooxygenase).

토끼 척수 연막동맥의 Norepinephrine에 의한 α-receptor자극과 Benoxathian에 의한 봉쇄효과

김환종,이영우 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.4

The effect of norepinephrine and benoxathian on the diameter of spinal pial arteries in rabbits was studied by topical microapplication of the drug to the perivascular environment. Arterial diameter was determined with the micrometer eyepiece on operating microscope through laminectomized area. Physioiogical parameters(PaO_(2). Pac0_(2) blood pH. and systolic blood pressure) were not significantly changed during all experiments. The results of this study are summerized as follow. 1) Application of norepinephrine over the range of 5xIO^(-8) M to 5x10^(-3) M to spinal pial arteries resulted in significant constriction which were shown to be proportional to concentration, with exception of 5x10^(-8) M. The dose-response curve showed constriction of 30 5±7 1% at 5x^(-3) M. 2) Benoxathian produced the vasodilatation which were shown to be proportional to concentration. The dose-response curve showed vasodilatation of 21 4±4.4% at 5x10^(-3) M. 3) The vasoconstriction due to microapplication of norepinephrine was prevented by the inclusion of an equimolar concentration of the a-adrenergic receptor blocker benoxathian. 4) The vasoconstriction due to norepinephrine was present in the concentration of norepinephrine more than that of benoxathian, and the vasoconstriction was proportional to the concentration of norepinephrine. The results indicate that a-adrenergic receptor is present in the smooth muscle of spinal pial arteries for the sympathetic control of blood flow to the spinal cord.

토끼 척수 연막동맥에 Norepinephrine과 Phentolamine 국소 도포의 효과

박인석,이영우 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.10

토끼 척수 연막동맥에 norepinephrine과 phentolamine 용액을 구소 도포하여 동맥직경의 변화(효과)를 관찰하였다. 추궁절제술후 수술현미경하에서 micrometer eyepiece를 사용하여 동맥직경의 변화를 측정하였다. 생리적 변수(PaO_(2) PaCO(2) 혈액 ? 및 수축기 혈압)는 전 실험중 의의있는 변화는 없었다. 1) 5×10^(-8)M에서 5×10(-3)M norepinephrine을 척수동맥에 처치한 결과 5×10^(-8)M을 제외하고 동맥 수축을 보였고, 최대 수축은 5×10(-3)M에서 30.5±7.1%였다. 2) Phentolamine만을 처치한 경우 의의있는 동맥 직경의 변화는 없었다. 3) Norepinephrine과 phentolamine의 동일 농도 처치시에는 현저한 혈관 수축은 없었다. 4) Norepinephrine의 농도가 phentolamine 농도보다 높은 경우에 혈관 수축이 있있고, 그 수축은 norepinephrine 농도에 비례하였다. 이상의 결과로 α-adrenergic receptor가 척수혈류의 교감신경조절을 위하여 척수연막동맥 평활근에 존재한다고 생각되었다. The effect of norepinephrine and phentolamine on the diameter of spinal pial arteries in rabbits was studied by topical microapplication of the drug to the perivascular environment. Arterial diameter was determined with the micrometer eyepiece on operating microscope through laminectomized area. Changes of physiological parameters (PaO₂, PaCO₂, blood pH, and systolic blood pressure) were not significant during all of the experiments. 1) Application of norepinephrine over thr range of 5×10^(8)M to 5×10￣³M to the spinal pial arteries resulted in significant constriction of the vessels, with the exception of 5x10^(-8)M. The dose-response curve showed a maximal constriction of 30.5±7.1% at 5x10￣³M. 2) Phentolamine produced no significant vasodilatation. 3) The vasoconstriction due to microapplication of norepinephrine was prevented by the inclusion of an equimolar concentration of the α-adrenergic blocker, phentolamine. 4) The vasoconstriction due to norepinephrine was evident while the concentration of norepinephrine was more than that of phentolamine. Furthermore the degree of vasoconstriction was proportional to the concentration of norepinephrine. The results indicate that α-adrenergic receptors are present in the smooth muscle of spinal pial arteries for the sympathetic control of blood flow to the spinal cord.