• 제목/요약/키워드: Acute and Subacute

검색결과 221건 처리시간 0.036초

급성심근경색 후 발생한 아급성형 좌심실파열에서 Fibrin Glue를 이용한 치료 (Repair of Postinfarct Subacute Left Ventricular Free Wall Rupture Using Fibrin Glue)

  • 이재훈;노동섭;김재범;박남희;금동윤;최세영
    • Journal of Chest Surgery
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    • 제40권6호
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    • pp.448-450
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    • 2007
  • 급성심근경색에 의한 좌심실파열은 사망률이 높은 질환이나, 아급성형인 경우 심초음파를 통한 신속한 진단과 대동맥 풍선펌프를 사용하여 수술 전후 추가적인 심실벽 파열을 예방할 수 있고, 수술 시 fibrin glue와 여러 가지 형태의 패취를 사용함으로써 지혈이 가능하다. 저자들은 급성심근경색 후 발생한 아급성형 좌심실파열 환자에서 fibrin glue를 이용한 비봉합적인 방법으로 만족할 만한 결과를 얻었기에 문헌과 함께 보고한다.

A Case of Widespread Cavernous Malformations of the Central Nervous System Associated with Acute Neurologic Deficit

  • Noh, Kyung Chul;Chung, Sung Eun;Lee, Dokyung
    • Investigative Magnetic Resonance Imaging
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    • 제21권1호
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    • pp.34-37
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    • 2017
  • A 45-year-old female visited our clinic due to sudden right leg weakness and sensory loss. Brain and spinal cord magnetic resonance imaging showed widespread cavernous malformations. Cavernous malformation in L1 spine area was accompanied by a subacute stage hematoma with perilesional edema. Sensory loss subsided after corticosteroid therapy. Usually, neurologic deficit by spinal cavernous malformation appears more chronically in the adults compared to children. Treatment options are difficult to establish in a case with multiple cavernous malformations. Identifying hemorrhagic lesions by extensive neuroimaging evaluation could be helpful to select the treatment target for cavernous malformation.

사람 적혈구 조혈인자 DA-3585의 토끼에 대한 단회 및 4주 반복투여 독성시험 (Single and 4-Week Repeated Dose Toxicity Studies of DA-3585, a Recombinant Human Erythropoietin, in Rabbits)

  • 조현;김동환;강경구;백남기;김원배
    • Biomolecules & Therapeutics
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    • 제6권2호
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    • pp.171-181
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    • 1998
  • DA-3585, a biosynthetic recombinant human erythropoietin has been developed as a treatment for anemia associated with chronic renal failure in Dong-A pharmaceutical Co. Ltd. This study was carried out to assess its acute and subacute toxicities in rabbits. DA-3585 was intravenously administered to rabbits at dose levels of 6250, 12500 or 25000 lU/kg for single dose toxicity study and at dose levels of 100, 500 or 2500 lU/kg/day for 4-week repeated dose toxicity study. In the acute toxicity study, dose up to 25000 lU/kg had no adverse effect on the behavior or body weight gain. Pathological examinations revealed no abnormal gross lesions related to DA-3585. In the subacute toxicity study, all animals survived until termination of treatment. DA-3585 had no influence on clinical signs, food and water intake or on body weight changes. Hematological examination showed increases in the number of RBC, hemoglobin contents and hematocrit values with a dose dependent manner in the animals treated with DA-3585. Histopathological examination revealed erythroid hyperplasia in the bone marrow and extramedullary hematopoiesis in the liver. The changes detected in the hematological and histopathological examination presumably represent exaggerated pharmacological effects of erythropoietin. The NOAEL (no-observed-adverse-effect-level) of DA-3585 was estimated to be 100 lU/kg/ day under this study condition.

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초기 중풍 환자에 있어서 맥상(脈象)과 NIHSS과의 상관성 연구;다기관 임상연구 (The Relationship between Pulse Pattern and NIHSS Score in Early Stroke Patient;Multi Center Trials)

  • 마미진;강아미;최동준;한창호;이원철;전찬용;조기호;최선미
    • 대한한방내과학회지
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    • 제28권4호
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    • pp.727-732
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    • 2007
  • Objectives : This study investigated using National Institutes of Health Strokes Scale in acute and subacute stroke patients and evaluated relativity of pulse pattern to NIHSS. Methods : 104 acute and subacute stroke patients were selected from 4 oriental medical hospitals from April 2007 to May 2007. The patients were admitted to hospital within 1 month after stroke. Pulse feeling diagnosis was done by oriental medical doctor and classified into 7 subtypes. Results : There were significant results statistically between slow/rapid pulse and NIHSS score in the male group; in the female group, there were no significant results statistically but the results showed that slow pulse has lower NIHSS score than rapid pulse. Patients with surging pulse had lower NIHSS score than the other patients. Another pulse pattern had no relativity to NIHSS score.

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외상후 뇌손상 환자에서 Tc-99m-HMPAO 국소뇌혈류 SPECT와 자기공명영상의 비교 (Comparison of Tc-99m-HMPAO SPECT and MRI after Acute and Subacute Closed-Head Injury)

  • 유원종;이상훈;손형선;이한진;박정미;정수교;김춘열;박용휘;신경섭
    • 대한핵의학회지
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    • 제28권3호
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    • pp.301-306
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    • 1994
  • The purpose of this study was to compare Tc-99m-HMPAO SPECT with MRI after acute and subacute closed-head injury. There were thirty two focal lesions in all cases of these. Fifteen lesions(47%) were seen on both MRI and SPECT. Fourteen lesions(44%) were seen only on MRI. Three lesions(9%) were seen only on SPECT. Of the 14 lesions seen only on MRI, one was epidural hematoma, two were subdural hematoma, three were subdural hygroma, one was intracerebral hematoma, four were contusion, and three were diffuse axonal injuries. SPECT detected 52% of the focal lesions found on MRI. For the detection of lesions, MRI was superior to SPECT in fourteen cases, while SPECT was superior to MRI in three cases. In conclusion, there was a tendency that detection rate of the traumatic lesions was higher on MRI, but the SPECT could delineate more wide extent of lesion.

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가와사끼병에서 혈청 VEGF 및 endostatin의 변화가 관상동맥병변의 발생에 미치는 영향 (Influence of vascular endothelial growth factor (VEGF) and endostatin on coronary artery lesions in Kawasaki disease)

  • 김선아;정범석;윤종서;한지환;이준성
    • Clinical and Experimental Pediatrics
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    • 제50권12호
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    • pp.1241-1246
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    • 2007
  • 목 적 : 최근 가와사끼병에서 혈관내피세포에 작용하는 VEGF와 endostatin의 혈청 농도를 측정하여 가와사끼병의 병인을 밝히고 관상동맥합병증과의 연관성을 찾으려는 여러 연구가 있다. 이 연구에 따르면 두 인자가 모두 가와사끼병에서 관상동맥합병증과 연관이 있다고 하였다. 따라서, 저자들은 가와사끼병의 급성기와 아급성기에 혈청 VEGF와 혈청 endostatin의 농도를 측정하여 어떤 변화가 있는지, 관상동맥병변의 발생과 어떤 연관성이 있는지 알아보고자 하였다. 방 법 : 2004년 1월부터 2005년 7월까지 가톨릭대학교 강남성모병원에서 가와사끼병으로 진단받고 입원 치료를 받은 환아 26명을 대상으로 하였다. 관상동맥병변의 발생 유무에 따라 두 군으로 나누었고 각각 급성기와 아급성기에 혈청 VEGF와 혈청 endostatin의 농도를 측정하였으며 건강 대조군 및 질병 대조군과 비교 분석하였다. 결 과 : 가와사끼병 환아군에서 혈청 VEGF 농도는 증가되었으나 급성기와 아급성기의 비교에서 유의한 차이는 없었고, 관상동맥병변의 유무에 따라 나눈 두 군 간에도 유의한 차이는 없었다. 혈청 endostatin 농도는 가와사끼병 환아의 급성기에서 감소되었고, 관상동맥병변의 유무와 관계없이 급성기에 감소하였다가 아급성기에 회복되었다. 가와사끼병 환아군에서 VEGF/endostatin 비는 증가되었고, 관상동맥병변이 없었던 군에서는 급성기에 비하여 아급성기에 VEGF/endostatin 비가 감소하였으나, 관상동맥병변이 있었던 군에서는 아급성기에 VEGF/endostatin 비가 감소하지 않았다. 가와사끼병 환아군에서 급성기의 혈청 VEGF와 백혈구 수 간, 혈청 VEGF와 ESR 치 간, 그리고 VEGF/endostatin 비와 ESR 치 간에는 양의 상관관계가 있었다. 결 론 : VEGF와 endostatin 같은 혈관내피세포에 작용하는 인자를 측정, 비교하는 것은 가와사끼병의 병인과 관상동맥병변 발생의 병태생리를 밝히는데 도움이 될 것이라고 생각된다.

가와사끼병에서 Matrix metalloproteinase 9과 Tissue inhibitor of metalloproteinase 1, 2의 임상적 중요성 (Clinical significance of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 and 2 in Kawasaki disease)

  • 윤기욱;윤신원;이정주;채수안;임인석;최응상;유병훈;이미경
    • Clinical and Experimental Pediatrics
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    • 제53권4호
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    • pp.510-518
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    • 2010
  • 목 적: 가와사끼병은 급성 전신성 미세혈관염으로서, 소아의 후천성 심질환의 가장 흔한 원인이다. 가와사끼병의 관상동맥병변에 대한 조직병리학적 소견은 미만성 혈관염에 의한 관상동맥벽의 파괴를 시사하는데, matrix metalloproteinase (MMP)와 그 내인성 억제인자인 tissue inhibitor of metalloproteinases (TIMP)가 이러한 과정에 주요한 역할을 할 것으로 생각되고 있으며, 그 중에도 MMP-9이 최근 가장 주목을 받고 있다. 따라서 본 연구에서는, 한국의 가와사끼병 환아들에서 MMP-9과 그 억제인자들인 TIMP-1, TIMP-2가 갖는 임상적 중요성을 평가하고자 하였다. 방 법: 가와사끼병 환아 47명을 연구대상으로 하였고, 급성열성 세균감염 환아 14명을 대조군으로 하였다. 혈중 MMP-9, TIMP-1, TIMP-2의 농도를 kit를 통한 효소 면역법을 이용하여 측정하였고, 각 임상 단계 및 관상동맥병변의 유무에 따라 비교분석하였다. 결 과: 급성기에 MMP-9과 TIMP-1은 가와사끼군에서 대조군에 비해 유의하게 높았고, TIMP-2는 오히려 낮았다($P$<0.05). 급성기에 증가한 MMP-9은 아급성기와 회복기에 유의하게 감소하였다($P$<0.05). 관상동맥 확장군과 비확장군의 비교에서는, 확장군에서 급성기 MMP-9과 TIMP-1, MMP-9/TIMP-2가 낮았으며, 아급성기로 가면서 통계적으로 유의하게 증가하였다가 다시 회복기로 가면서 감소하는 양상을 보였다($P$<0.05). MMP-9은 급성기와 아급성기에 TIMP-1과 통계적으로 유의한 양의 상관관계를 보였고, TIMP-2와는 아급성기와 회복기에 음의 상관관계를 보였다($P$<0.05). 결 론: 이러한 결과들은 MMP-9과 TIMP-1의 증가, 그리고 MMP-9과 TIMP-2의 불균형이 가와사끼병, 특히 그 관상동맥병변의 병태생리에 핵심적인 역할을 한다는 사실을 시사한다 하겠다. 더 종합적이고 심도 깊은 연구를 위해서 좀 더 많은 대상자를 포함하는 큰 규모의 연구들이 향후 이루어져야 할 것이다.

호흡운동 프로그램과 수중운동 프로그램이 아급성기 뇌졸중 환자의 폐기능에 미치는 영향 비교 (Comparison between the Effects of Combined Conventional Exercise Therapy Plus Respiratory Exercise Program with Combined Conventional Exercise Therapy Plus Aqua Exercise Program on the Pulmonary Function of Subacute Stroke Patients )

  • 이동협;유경태
    • 대한물리의학회지
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    • 제18권2호
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    • pp.115-123
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    • 2023
  • PURPOSE: This study examined the effects of combined conventional exercise therapy plus respiratory exercise program with combined conventional exercise therapy plus aqua exercise program in the pulmonary function of subacute stroke patients. METHODS: The respiratory exercise program group underwent inspiration and expiration training using the Threshold IMT and Threshold PEP three days per week for four weeks. The aquatic exercise program group had aquatic aerobics, halliwick, and bad ragaz ring training three days per week for four weeks. Before and after the experiment, Pony fx was used to examine the FVC, FEV1, FEV1/FVC, VC, and MVV. RESULTS: Significant improvement was found after the experiment in the FVC. FEV1, VC, MVV, excepting FEV1/FVC, of the pulmonary function in the aquatic exercise program group. After the experiment, significant improvement was found in FVC, FEV1, FEV1/FVC, VC, and MVV of pulmonary function in the respiratory rehabilitation therapy group. No significant difference in FVC, FEV1, FEV1/FVC, VC, and MVV of pulmonary function was observed in the inter-group comparison. CONCLUSION: Significant improvement was found after the experiment in both the aquatic exercise program group and the respiratory exercise program group. No difference in pulmonary function was noted in the inter-group comparison. Therefore, combining general exercise therapy and an aquatic or respiratory exercise program is expected to be effective for the pulmonary function of acute stroke patients. These results are expected to provide basic data to help research intervention of aquatic and respiratory exercise programs for subacute stroke patients.

Subacute Nicotine Exposure in Cultured Cerebellar Cells Increased the Release and Uptake of Glutamate

  • Lim, Dong-Koo;Park, Sun-Hee;Choi, Woo-Jeoung
    • Archives of Pharmacal Research
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    • 제23권5호
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    • pp.488-494
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    • 2000
  • Cerebellar granule and glial cells prepared from 7 day-old rat pups were used to investigate the effects of sub-acute nicotine exposure on the glutamatergic nervous system. These cells were exposed to nicotine in various concentrations for 2 to 10 days in situ. Nicotine-exposure did not result in any changes in cerebellar granule and glial cell viability at concentrations of up to 500 $\mu\textrm{M}$. In cerebellar granule cells, the basal extracellular levels of glutamate, aspartate and glycine were enhanced in the nicotine-exposed granule cells. In addition, the responses of N-methyl-D-aspartate (NMDA)-induced glutamate release were enhanced at low NMDA concentrations in the nicotine-exposed granule cells. However, this decreased at higher NMDA concentrations. The glutaminase activity was increased after nicotine exposure. In cerebellar glial cells, glutamate uptake in the nicotine-exposed glial cells were either increased at low nicotine exposure levels or decreased at higher levels. The inhibition of glutamate uptake by L-trans-pyrollidine-2,4-dicarboxylic acid (PDC) was lower in glial cells exposed to 50 $\mu\textrm{M}$ nicotine. Glutamine synthetase activity was lower in glial cells exposed to 100 or 500 $\mu\textrm{M}$ of nicotine. These results indicate that the properties of cerebellar granule and glial cells may alter after subacute nicotine exposure. Furthermore, they suggest that nicotine exposure during development may modulate glutamatergic nervous activity.

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Comparison of the Results of Balloon Kyphoplasty Performed at Different Times after Injury

  • Oh, Gun-Soek;Kim, Hyeun-Sung;Ju, Chang-Il;Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • 제47권3호
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    • pp.199-202
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    • 2010
  • Objective : Balloon kyphoplasty is a minimally invasive procedure that is mainly performed for refractory pain due to osteoporotic compression fractures. The purpose of this study was to evaluate the results of balloon kyphoplasty performed at different times after an injury. Methods : In this retrospective study, the records of 99 patients who underwent one level of balloon kyphoplasty between January 2005 and December 2007 were reviewed. The patients were divided into three groups : 21 patients treated within 3 weeks of an injury (the acute group), 49 treated within 3 weeks to 2 months of an injury (the subacute group), and 29 patients treated at more than 2 months after an injury (the chronic group). Clinical outcomes were assessed using a visual analogue scale (VAS). In addition, modified MacNab's grading criteria was used to assess the subjective patient outcome. The radiology findings, including vertebral height restoration and procedure related complications, were analyzed based on the different time intervals after the injury. Results : Patients in all three groups achieved marked pain relief in terms of the VAS within 7 days of the procedure. Good or excellent results were achieved by most patients in all three groups. However, the height restoration, the main advantage to performing a balloon kyphoplasty, was not achieved in the chronic group. Moreover, evidence of complications including cement leakage was observed significantly less frequently in the subacute group compared to the other two groups. Conclusion : Although balloon kyphoplasty is an effective treatment for osteoporotic compression fractures, with regard to pain relief, the subacute stage appears to be optimal for treating patients with a balloon kyphoplasty in terms of achieving the best outcomes with minimal complications.