• 제목/요약/키워드: 20% hemorrhage

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Wernicke's Encephalopathy with Intracranial Hemorrhage

  • Jeon, Sunghee;Kang, Hyunkoo
    • Investigative Magnetic Resonance Imaging
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    • 제20권1호
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    • pp.71-74
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    • 2016
  • Wernicke's encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. Early diagnosis and treatment of WE is important to avoid persistent brain damage. Although histopathologic examination usually demonstrates pin-point hemorrhages in affected brain parenchyma, secondary hemorrhage is a rare but serious complication of WE. We experienced a rare case of intracranial hemorrhage related to WE in a 56-year-old male patient with malnourishment.

대학부속한방병원 및 국립의료원 한방진료부 뇌졸증환자에 대한 한방치료 현황 분석 (Clinical study on C.V.A patients in Hospital attached to college of oriental medicine and N.M.C. department oriental medicine)

  • 신현규
    • 한국한의학연구원논문집
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    • 제1권1호
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    • pp.1-14
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    • 1995
  • The clinical study was carried out on 1737 cases of inpatient and outpatient which have been diagnosed as C.V.A at hospital attached to 8 colleges of oriental medicine in Korea or National Medical Center from January 1st 1994 to December 31st 1994. The results were as follows; 1. In this study, the case of Occlusive C.V.D was 70.1%, Cerebral hemorrhage was 20.5%, Transient ischemic attack (T.I.A) was 5.3%, Subdural hemorrhage was 3.0%, Subarachnoid hemorrhage was 0.8% 2. It was confirmed by C.T (20%), E.K.G. (19%), X-ray (19%), Urinalysis (19%), Hematoscopy (20%). 3. The mean days of hospital treatment was 27.88 days, mean days of ambulation was 70.34 days. The mean days of hospital treatment of Occlusive C.V.D, Cerebral hemorrhage, T.I.A., Subdural hemorrhage, Subarachnoid hemorrhage were 25.79, 39.32, 12.49, 16.23, 23.40 days, respectively. The mean days of ambulation of Occlusive C.V.D, Cerbral hemorrhage, T.I.A., Subdural hemorrhage, Subarachnoid hemorrhage were 74.40, 93.68, 69.10, 29.75, 32.57 days, respectavely. 4. Oriental medical treatment of C.V.A was mainly Acupuncture (25%), Paper of Chinese herbs (22%), Chinese physiotherapy (14%), Extract of Chinese herbs (11%). 5. Oriental medical physiotherapy for C.V.A was mostly E.S.T., Kinesiatrics, electric negative therapy, others Aerohydrotherapy, interferential current therapy (I.C.T.), Carbon, Samhogi, T.E.N.S., Ultra-sound, Infra-red, Microwave, T.D.P., Ultraviolet, S.S.P., Chinese herbs beth, Prarffin bath, Magnetic treatment and tractions.

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The clinical characteristics and prognosis of subgaleal hemorrhage in newborn

  • Lee, Sun Jin;Kim, Jin Kyu;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • 제61권12호
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    • pp.387-391
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    • 2018
  • Purpose: Subgaleal hemorrhage (SGH) is a rare but potentially fatal condition in newborns; however, few studies have reported on this condition. We aimed to identify the clinical characteristics and prognostic factors of SGH. Methods: We retrospectively reviewed the medical records of 20 neonates diagnosed with SGH between January 2000 and June 2017. Enrolled neonates were clinically diagnosed when they had tender fluctuant scalp swelling that crossed the suture lines. Results: Among 20 neonates with SGH, 12 were boys and 7 were girls; median hospitalization duration was $9.7{\pm}6.9days$. Fourteen neonates (70%) were born via vacuum-assisted vaginal delivery, and 4 via vacuum-assisted cesarean section. Of the neonates enrolled, half of them initially showed unstable vital signs, including apnea, desaturation, and cyanosis. Ten neonates had acidosis and 3 had asphyxia (pH<7.0). Intracranial lesions associated with SGH were observed in 15 neonates (75%), including subdural hemorrhage (50%), subarachnoid hemorrhage (15%), intraventricular hemorrhage (5%), cerebral infarct (15%), skull fracture (30%), and cephalohematoma (20%). Twelve neonates (60%) required transfusion, 5 (25%) had seizures, and 3 (15%) died. Eight neonates (40%) had hyperbilirubinemia (mean total bilirubin, $13.1{\pm}7.4$). The mean follow-up period was $8.4{\pm}7.5months$. At follow-up, 10 neonates (58.8%) were healthy with normal development, whereas 7 (41.2%) had neurological deficits. Conclusion: The morbidity rate was 41.2% due to severe metabolic acidosis. Anemia, hyperbilirubinemia, low Apgar scores, and subdural hemorrhage did not affect the prognosis. The long-term outcomes of neonates with SGH are generally good. Only arterial blood pH was significantly associated with death.

골반 외상 인터벤션 (Interventional Management for Pelvic Trauma)

  • 황정한;김정호;박수영
    • 대한영상의학회지
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    • 제84권4호
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    • pp.835-845
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    • 2023
  • 골반 외상은 대부분 고에너지 손상을 동반하며, 이에 따른 치명률 및 사망률이 높은 편이다. 관련된 출혈은 대부분 골반내 정맥이 손상되거나 해면골이 골절되어 발생하고 혈종에 의해 안정화되지만, 10%-20%에서 동맥 출혈이 동반되며, 골반 용적이 증가된 상태에서 동맥 출혈이 지속된다면 이로 인한 사망률은 36%-54%까지 증가한다. 골반의 해부학적 구조상 다양하고 풍부한 혈관이 분포되어 있고, 골반 외상 환자 대부분이 많은 양의 혈종을 동반하기 때문에, 수술적 치료는 시야 확보의 어려움과 눌림 효과에 따른 지혈효과를 없애 출혈을 더 조장할 수 있어, 1차적으로 인터벤션 치료가 권고되고 있다. 또한 출혈의 위치가 대부분 골절된 부분이기 때문에 CT를 통해 시술 전 출혈 부위를 특정하여 빠른 시간 내에 출혈에 대한 색전술을 시행할 수 있다. 이처럼 올바른 진단과 치료를 동시에 할 수 있다는 장점으로 인해 골반 외상 환자에 있어 인터벤션 치료는 중추적인 역할을 담당하고 있다. 본 연구에서는 문헌고찰을 통해 골반 외상에 대한 올바른 진단 및 인터벤션 치료의 유용성과 고려 사항에 대해 알아보고자 한다.

Post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma

  • Kim, Kyung Su;Kim, Kyubo;Chie, Eui Kyu;Kim, Yoon Jun;Yoon, Jung Hwan;Lee, Hyo-Suk;Ha, Sung W.
    • Radiation Oncology Journal
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    • 제33권1호
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    • pp.36-41
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    • 2015
  • Purpose: To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC). Materials and Methods: Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed. Results: Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause. Conclusion: WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

당뇨망막병증성 유리체출혈 환자 치험 1례 보고 (A Case Report of Diabetic Retinopathy Vitreous Hemorrhage)

  • 이득주;이마음;권강;서형식
    • 한방안이비인후피부과학회지
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    • 제31권2호
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    • pp.152-159
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    • 2018
  • Objectives : The aim of this study is to report the effect of Korean medicine treatment on diabetic retinopathy vitreous hemorrhage. Methods : A 66-year-old female who had diabetes for over 20 years showed vitreous hemorrhage of Grade 4 at initial visit. For about 2 months, acupuncture, moxibustion and herbal medicine treatment were performed. Prognosis was confirmed by funduscopic examination, automatic refractive examination and visual acuity test. Results : In the fundus photographs, we can observe the recovery of turbidity in Grade 4, which decreases to Grade 1, and the result of refraction in the right eye and visual acuity that was not measured when the turbidity is severe. Conclusions : This study was a case of a patient with diabetic retinopathy vitreous hemorrhage complaining of decreased visual acuity. Patients were given herbal medication, acupuncture and moxibustion. Through the funduscopic examination, the treatment effect on the absorption of vitreous hemorrhage was confirmed.

Na 섭취제한, K 투여 및 이뇨 기간중 실혈성 Aldosterone 반응의 변동 (Alteration of Hemorrhagic Aldosterone Response During Sodium Restriction, Potassium Supplement and Diuresis)

  • 성호경;유용운;고주환;박귀원;이장규
    • 대한핵의학회지
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    • 제11권1호
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    • pp.3-8
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    • 1977
  • Effect of sodium restriction with or without potassium supplement and furosemide diuresis on plasma aldosterone response to mild hemorrhage were studied in normotensive young volunteers. After an overnight fast, blood were drawn just before and 10, 20, 30, 50, 70, 90, and 120 minutes after the $^3H$-aldosterone injection. The sum of blood delivered reached over 100ml(during two hours). Plasma aldosterone and renin were measured by means of radioimmunoassay. The results were as followed; 1. Hemorrhage resulted in a moderate increase in plasma aldosterone level of volunteers with normal diet. 2. The mean figures of plasma aldosterone in subjects with sodium restriction and diuresis were likewise significantly increased by hemorrhage, however, the figure of the subjects with potassium supplement who already shown higher plasma level was without effect on hemorrhage. 3. Hemorrhage produced slight decrease in serum sodium concentration in every experimental conditions, although the changes were not significant. 4. Plasma renin activities after the hemorrhage followed a similar pattern with that of aldosterone, increased during sodium restriction or diuresis and unaffected during potassium supplement.

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Acute and Chronic Effects of Ethanol on the Cardiovascular and Hormonal Responses to Hemorrhage in Conscious Normotensive and Spontaneously Hypertensive Rats

  • Park, Yoon-Yub;Lee, Joong-Hee;Park, Jae-Sik;Yang, Eun-Kyoung;Ahn, Dong-Kuk;Kim, Hyeong-Jin;Lee, Won-Jung
    • The Korean Journal of Physiology
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    • 제27권1호
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    • pp.67-77
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    • 1993
  • Acute and chronic effects of ethanol (EOH) administration on the cardiovascular and hormonal responses to repeated hemorrhage were investigated in conscious normotensive Wistar rats and spontaneously hypertensive rats (SHR). The chronic EOH treated group received 5% EOH (vol/vol) ad libitum in the drinking water far the first week,10% for the last 2 weeks, and 20% for the last 5 weeks from the age of 6 weeks. The EOH free group received tap water. Chronic EOH and EOH free groups were randomly subdivided into acute EOH infusion and control groups. Under ether anesthesia, catheters were inserted into the femoral vein and both femoral arteries. After rats regained consciousness and their blood pressure was stabilized, responses to quick hemorrhage (5 ml/kg BW) were tested. In the acute EOH infusion group, hemorrhage was induced 20 min after EOH infusion (1.0 g/kg BW), Baroreceptor reflex sensitivity was assessed by the ratio of changes in hen.1 rate and mean arterial pressure (${\Delta}HR/{\Delta}MAP$) immediately after the hemorrhage. Chronic EOH administration elevated MAP in Wistar rats. During acute EOH infusion, MAP do- creased and HR increased in all groups. In comparison to EOH free control rats, acute or chronic EOH treated rats showed a greater reduction in MAP and a smaller elevation in heart rate in response to a hemorrhage. The degree of MAP reduction was significantly greater in SHR than in Wistar rats. Both the acute and chronic EOH administration attenuated the baroreceptor reflex and retarded MAP recovery, again the trend being much more prominent in SHR. The increase in plasma vasopressin and lenin concentrations after hemorrhage were intensified by the chronic EOH administration. SHR showed a greater vasopressin response but a smaller lenin response than Wistar rats. These results indicate that the EOH treated rats, particularly SHB, are prone to shock by a hemorrhage, which may be partly attributed to an impaired baroreceptor reflex function.

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Short-term Coexisting Intracerebral Hemorrhage and Cerebral Infarctions

  • Song, Kwan-Su;Moon, Jae-Gon;Lee, Ho-Kook;Kim, Chang-Hyun;Hwang, Do-Yun
    • Journal of Korean Neurosurgical Society
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    • 제38권6호
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    • pp.419-424
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    • 2005
  • Objective : Short-term coexisting intracerebral hemorrhage and cerebral infarctions defined as the recurrent stroke presented with different type within three weeks. Despite the high recurrence rate of stroke, little attention and insufficient clinical data had been given to short-term coexisting intracerebral hemorrhage and cerebral infarction's features. This study aims to estimate the risk factors and present the clinical features of short-term coexisting intracerebral hemorrhage and cerebral infarctions. Methods : We investigated 18 patients with short-term coexisting intracerebral hemorrhage and cerebral infarctions who were admitted to our hospital between January 1995 and January 2005. They were subdivided by the recurrence interval such as a group of within one week and another of between one and three weeks as hyperacute and acute respectively. Results : The mean interval between strokes was 6.64 days. Lesional analysis showed that short-term coexisting intracerebral hemorrhage and cerebral infarctions in this study occurred at the other side in 12 cases [66.7%]. The abnormality on the electrocardiographic feature [23.5%] and long-term history of hypertension [20.5%] were the most common risk factors. However, short-term history of diabetes was more common in hyperacute group than in acute group [P<0.05]. The mean number of risk factors was three in acute group. It is larger than that of hyperacute group [P<0.05]. Conclusion : If the patients who experienced cerebrovascular attack have many risk factors, they tend to be the cases of acute coexisting intracerebral hemorrhage and cerebral infarctions than hyperacute. Therefore, that cases are required to be vigilant to the change of patients' state up to three weeks in the treatment.

출혈성 쇼크로 인한 급성 폐손상의 발병기전과 아스피린의 효과 (Effects of Aspirin on the Pathogenesis of Acute Lung Injury in Rats Subjected to Hemorrhage)

  • 박윤엽;이영만
    • Tuberculosis and Respiratory Diseases
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    • 제60권1호
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    • pp.83-91
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    • 2006
  • 연구배경 : 아스피린이 출혈성 쇼크시 나타나는 급성 폐손상에 미치는 효과와 혈장 및 폐세척액 내 ferritin 농도변화를 알아보고자 본 연구를 시행하였다. 방 법 : 실험동물은 체중 350g 내외의 Sprague-Dawley 종 흰쥐를 사용하였고, 혈압측정 및 출혈을 시키기 위하여 catheter를 양쪽 대퇴동맥에 삽입하였다. 수술 후 polygraph를 이용하여 평균동맥압을 기록하였으며, 출혈은 withdrawal pump를 이용하여 5분간 체중 kg당 20 ml의 혈액을 출혈시켰다. 실험군은 대조군, 출혈군과 아스피린 처치군으로 분류하였다. 대조군은 출혈군과 동일하게 수술하고 출혈은 시키지 않았으며 나머지 과정은 출혈군과 동일하게 처리하였다. 아스피린 처치군은 출혈 30분 전 대퇴정맥으로 아스피린(10mg/kg)을 주입하였고, 출혈군은 체중 당 동일한 양의 생리식염수를 주입하였다. 출혈 2시간 후의 폐손상 정도와 아스피린이 이에 미치는 효과를 알아보기 위하여 폐장내 myeloperoxidase 활성도와 폐세척액 내의 단백함량과 백혈구 수 및 혈장 ferritin 농도와 폐세척액 내 ferritin 농도를 측정하였다. 결 과 : 폐장내 myeloperoxidase 활성도와 폐세척액 내의 단백함량과 백혈구수는 출혈 후 대조군에 비해 유의하게 증가하였다. 이러한 반응은 아스피린 전처치에 의하여 효과적으로 차단되었다. 혈장 및 폐세척액 내 ferritin 농도는 출혈 후 크게 증가하였는데, 아스피린 전처치로 반응이 억제되었다. 결 론 : 심한 출혈 후에 생기는 급성 폐손상은 아스피린 전처치로 효과적으로 예방될 수 있으며, 출혈 후 증가하는 혈장 및 폐세척액 내 ferritin 농도는 급성폐손상이 나타날 수 있는 환자에서 조기진단을 위한 생체지표 로 활용될 수 있다고 생각된다.