• 제목/요약/키워드: Acute and Subacute

검색결과 221건 처리시간 0.036초

Radiological Apoplexy and Its Correlation with Acute Clinical Presentation, Angiogenesis and Tumor Microvascular Density in Pituitary Adenomas

  • Lee, Jung-Sup;Park, Yong-Sook;Kwon, Jeong-Taik;Nam, Taek-Kyun;Lee, Tae-Jin;Kim, Jae-Kyun
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.281-287
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    • 2011
  • Objective : Pituitary apoplexy is life-threatening clinical syndrome caused by the rapid enlargement of a pituitary tumor due to hemorrhage and/or infarction. The pathogenesis of pituitary apoplexy is not completely understood. We analyzed the magnetic resonance imaging (MRI) of pituitary tumors and subsequently correlated the radiological findings with the clinical presentation. Additionally, immunohistochemistry was also performed to determine whether certain biomarkers are related to radiological apoplexy. Methods : Thirty-four cases of pituitary adenoma were enrolled for retrospective analysis. In this study, the radiological apoplexy was defined as cases where hemorrhage, infarction or cysts were identified on MRI. Acute clinical presentation was defined as the presence of any of the following symptoms: severe sudden onset headache, decreased visual acuity and/or visual field deficit, and acute mental status changes. Angiogenesis was quantified by immunohistochemical expression of fetal liver kinase 1 (Flk-1), neuropilin (NRP) and vascular endothelial growth factor (VEGF) expression, while microvascular density (MVD) was assessed using Endoglin and CD31. Results : Clinically, fourteen patients presented with acute symptoms and 20 for mild or none clinical symptoms. Radiologically, fifteen patients met the criteria for radiological apoplexy. Of the fifteen patients with radiologic apoplexy, 9 patients presented acute symptoms whereas of the 19 patient without radiologic apoplexy, 5 patients presented acute symptoms. Of the five biomarkers tracked, only VEGF was found to be positively correlated with both radiological and nonradiological apoplexy. Conclusion : While pituitary apoplexy is currently defined in cases where clinical symptoms can be histologically confirmed, we contend that cases of radiologically identified pituitary hemorrhages that present with mild or no symptoms should be designated subacute or subclinical apoplexy. VEGF is believed to have a positive correlation with pituitary hemorrhage. Considering the high rate of symptomatic or asymptomatic pituitary tumor hemorrhage, additional studies are needed to detect predictors of the pituitary hemorrhage.

Anti-Helicobacter pylori IgY의 안전성 및 임상적 효과 (The Safety and Clinical Test of Anti-Helicobacter pylori IgY)

  • 정순희;김현주;이수원;류영수;박형석;이남형
    • 한국축산식품학회지
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    • 제25권4호
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    • pp.465-471
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    • 2005
  • 본 연구는 H. pylori를 산란계에 과면역시켜서 얻은 anti-H pylori IgY난황 분말의 안전성과 위염 환자에 있어서 H. pylori에 대한 억제 효과를 알아보기 위하여 실시하였다. Anti-H. pylori IgY난황 분말의 안전성 실험은 급성 독성실험과 아급성 독성실험으로 알아보았다. 급성 독성 실험시 식이섭취나 성장 모두 정상적이었고, 마우스의 체중(kg)당 400mg까지 투여했을 때 이상을 관찰할 수 없었다. 아급성 독성실험에서 외관상의 이상현상은 관찰할 수 없었고, 혈청의 CBC 검사에서 백혈구 수치도 정상적이었다. 그리고 소화기관과 간조직의 병리학적 이상은 관찰되지 않았다. 이 결과로 미루어 anti-H pylori IgY난황분말은 독성이 없음이 확인되었다. 임상실험에서는 WSF 분말 급이군의 UBT 수치는 58.65에서 35.33으로 약 23.31 감소하였으며, anti-H pylori IgY 난황분말 혼합 급이군의 UBT 수치는 47.77에서 28.81로 약 17.95 감소 효과를 보였다. WSF 분말 급이군은 anti-H. pylori IgY 난황분말 혼합 급이군보다 UBT 수치의 감소율이 더 크게 나타났다. 이와 같이 임상실험에서 anti-H, pylori IgY는 H. pylori의 억제 효과가 있음이 확인되었다.

급성 중독으로 응급실에 내원하여 사망한 환자의 원인물질 및 시간 분포 (Causative Substance and Time of Mortality Presented to Emergency Department Following Acute Poisoning: 2014-2018 National Emergency Department Information System (NEDIS))

  • 이현재;좌민홍;한은아;고동률;고재욱;공태영;조준호;정성필
    • 대한임상독성학회지
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    • 제19권2호
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    • pp.65-71
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    • 2021
  • Purpose: The purpose of this study was to investigate the cause of acute fatal poisoning and the time of death by analyzing the National Emergency Department Information System (NEDIS) of South Korea. Methods: The NEDIS data from 2014 to 2018 excluding non-medical visits were used for this study. The patients with acute poisoning were extracted using diagnostic codes. The toxic substances were classified into pharmaceuticals, pesticides, gases, artificial poisonous substances, and natural toxic substances. Patients were classified according to the time of death, place of death, and region. In each case, the most causative substances of poisoning were identified. Results: There were 380,531 patients including poisoning-related diagnoses, of which 4,148 (1.1%) died, and the WHO age-standardized mortality rate was 4.8 per 100,000. Analysis of 2,702 death patients whose primary diagnosis was acute poisoning, the most common cause of poisoning death was pesticides (62%), followed by therapeutic drugs, gas, and artificial toxic substances. Herbicides were the most common pesticides at 64.5%. The proportion of mortality by time, hyperacute (<6 h) 27.9%, acute (6-24 h) 32.6%, subacute (1-7 d) 29.7%, and delayed period (>7 d) were 9.8%. Conclusion: This study suggests that the most common cause of poisoning death was pesticides, and 60% of deaths occurred within 24 hours. The 71% of mortality from pesticides occurred within 6-24 hours, but mortality from gas was mostly within 6 hours. According to the geographic region, the primary cause of poisoning death was varied to pesticides or pharmaceuticals.

한국형 재활환자분류체계 버전 1.0 개발 (The Development of Korean Rehabilitation Patient Group Version 1.0)

  • 황수진;김애련;문선혜;김지희;김진휘;하영혜;양옥영
    • 보건행정학회지
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    • 제26권4호
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    • pp.289-304
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    • 2016
  • Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

교도소에서 의뢰된 급성 하악 지치 주위염의 보존적 감염관리: 증례보고 (Conservative infection control on acute pericoronitis in mandibular third molar patients referred from the prison)

  • 이천의;유재하;최병호;설성한;김하랑;모동엽;김종배
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권1호
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    • pp.57-61
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    • 2010
  • In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.

Effect of Treadmill Training with Ankle Joint Taping on Gait Function and Balance Ability in Patients with Subacute Stroke: A Randomized, Controlled, Preliminary Trial

  • Gill, Yeong-Jin;Oh, Se-Jung;Cha, Yong-Jun
    • 대한물리의학회지
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    • 제17권1호
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    • pp.21-30
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    • 2022
  • PURPOSE: This study examined the effects of treadmill training with taping on the affected ankle joint on the gait and balancing ability in patients with sub-acute stroke. METHODS: Nineteen patients with sub-acute hemiplegic stroke in a rehabilitation hospital were assigned randomly to either the experimental group (n = 10), who received treadmill training with taping on the affected ankle joint or the control group (n = 9), who received general treadmill training. All participants performed 60 min of comprehensive rehabilitation therapy (five sessions per week for four weeks). Each group received treadmill training with or without taping on the affected ankle joint for 20 min (three sessions per week for four weeks). The gait and balancing ability were measured before and after the four-week training. RESULTS: Post-training scores of 10-meter walk test (10 MWT), timed up and go (TUG) test, and center of pressure (COP) path length and velocity for the experimental group increased significantly compared to that pre-training (p < .05). The experimental group showed a larger decrease in the 10 MWT and TUG test than the control group (-3.5 s vs. -1.01 s, p < .05; -4.9 s vs. -1.7 s, p < .05; respectively) CONCLUSION: Treadmill training with taping on the affected ankle joint might improve the gait and balancing ability of stroke patients and is considered a more effective method for improving gait and balancing ability than the method of general treadmill training.

가미우슬탕의 요통치료효과 및 신기능에 미치는 영향에 대한 임상적 고찰 (A Clinical Study of the Effects of KamiWooseul-tang on Low Back Pain and Kidney Function)

  • 양재훈;한상철;오로사;오명진;김형균;이언정
    • 대한한의학회지
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    • 제21권4호
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    • pp.216-226
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    • 2000
  • Objectives : The aim of this clinical experiment was to investigate the effect of KamiWooseul-tang on low back pain and kidney function. Methods: We investigated 64 low back pain patients. We treated the patients with acupuncture, bed rest, herbal medicine, physical therapy. The patients were divided into two groups as follows, 32 patients (with normal renal function) were treated with only KamiWooseul-tang. Another 32 patients were treated with a commonly used herbal medicine. Results : The obtained results are summarized as follows. The patients were 43.8% male and 56.2% female. Their age were 20s 15.6%, 30s 25%, 40s 17.2%, 50s 9.3%, 60s 18.8% 70s 12.5% and 80s1.6%. Duration is most common in the most acute stage (< 1 week), next was chronic stage ( >6 months ), acute stage (1 week ~ 1 month) and subacute stage(l months ~ 6 months) in turn. Cure rate increased step by step after herb-medicine administration. Duration of patients had no relation with cure rate(P>0.05). The KamiWooseul-tang was more effective than the commonly used herbal medicine after 3 weeks therapy (P<0.05). Serum BUN and Creatinine level in KamiWooseul-tang group changed from $14.69{\pm}4.0,{\;}0.76{\pm}0.19(mg/dl)$ before adminstration to $13.64{\pm}3.92{\;}0.77{\pm}0.19,{\;}13.48{\pm}3.00{\;}0.82{\pm}0.21,{\;}13.26{\pm}3.73{\;}0.87{\pm}0.21(mg/dl)$ at 7th, 14th, and 21st days of administration respectively. Urinalysis showed no specific change in the KamiWooseul-tang group. During medication serum-electrolyte was within normal range. Conclusion : Therefore KamiWooseul-tang was more effective than the commonly used herbal medicine and there was no clinically remarkable difference in the serum BUN, Creatinine level, urinalysis and serum electrolyte between pre-medication and post-medication in the KamiWooseul-tang group.

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요추추간판탈출증환자 49례의 탈출양상에 따른 한방치료에 대한 임상적 고찰 (The clinical study on difference of sex, age, medical history, part, or type in patients with lumbar spine herniation of nucleus pulpous)

  • 이기하;김기역;김우영;김창연;이현종;엄태웅
    • 척추신경추나의학회지
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    • 제3권1호
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    • pp.37-48
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    • 2008
  • Objective : In treatment of lumbar spine herniation of nucleus pulpous, the different result in accordance with difference of sex, age, medical history, part, or type. Methods : After 49 patients who were diagnosed as HNP of L-spine were grouped by sex, age, medical history, part, or type, they were compared and analyzed on the basis of difference between measuring VAS and ODI as they were hospitalized and as they were discharged. Results : 1. In terms of differences by gender, males' average degree of VAS improvement was 63.92 and females' average degree of VAS improvement was 59.8. Also, Males' average ODI improvement index was 12.36 and females' average ODI improvement index was 12.5. 2. In terms of differences by age, Teens recorded highest degree of VAS improvement and ODI improvement index. 3. In terms of differences by medical history, Most acute or acute patients showed higher degree of VAS improvement and ODI improvement index than subacute or chronic patients. 4. There were no significant distinguishing markscomparing between one diseased part and other. 5. As the research that focused on different type, Extrusion type had better improvement by medical treatment than Protrusion type. Conclusion : This research drew the result as above, but recognizable statistical relation could not be found in the result. Therefore there needs much sustainable research to deduce meaningful result.

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영지(靈芝)의 안전성(安全性)에 관한 연구(硏究) (Studies on Safety of Ganoderma lucidum)

  • 김명자;김하원;이영순;심미자;최응칠;김병각
    • 한국균학회지
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    • 제14권1호
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    • pp.49-59
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    • 1986
  • 국내에서 재배된 영지의 안전성을 검토하기 위하여 크게 급성 독성 실험과 아급성 독성 실험으로 나누어 실험하여본 결과, 급성 독성 실험에서는 투여 가능한 최대 투여량(5,000 mg/kg)에서 암, 수 모두에서 치사 예는 관찰할 수 없었으며, 아급성 독성 실험에서는 체중 측정, 혈액학적 검사, 장기 중량, 장기 조직의 병리학적 조직 검사, 뇨 검사를 실시하여 본 바, 대조군과 비교할만한 통계학적 유의차를 발견할 수 없었다.

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Optimal examination for traumatic nerve/muscle injuries in earthquake survivors: a retrospective observational study

  • Berkay Yalcinkaya;Busranur Tuten Sag;Mahmud Fazil Aksakal;Pelin Analay;Hasan Ocak;Murat Kara;Bayram Kaymak;Levent Ozcakar
    • Journal of Yeungnam Medical Science
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    • 제41권2호
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    • pp.120-127
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    • 2024
  • Background: Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered. Methods: Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated. Results: Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14). Conclusion: The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.