• Title/Summary/Keyword: Acute and Subacute

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Findings Regarding an Intracranial Hemorrhage on the Phase Image of a Susceptibility-Weighted Image (SWI), According to the Stage, Location, and Size

  • Lee, Yoon Jung;Lee, Song;Jang, Jinhee;Choi, Hyun Seok;Jung, So Lyung;Ahn, Kook-Jin;Kim, Bum-soo;Lee, Kang Hoon
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.2
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    • pp.107-113
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    • 2015
  • Purpose: Susceptibility weighted imaging (SWI) is a new magnetic resonance technique that can exploit the magnetic susceptibility differences of various tissues. Intracranial hemorrhage (ICH) looks a dark blooming on the magnitude images of SWI. However, the pattern of ICH on phase images is not well known. The purpose of this study is to characterize hemorrhagic lesions on the phase images of SWI. Materials and Methods: We retrospectively enrolled patients with ICH, who underwent both SWI and precontrast CT, between 2012 and 2013 (n = 95). An SWI was taken, using the 3-tesla system. A phase map was generated after postprocessing. Cases with an intracranial hemorrhage were reviewed by an experienced neuroradiologist and a trainee radiologist, with 10 years and 3 years of experience, respectively. The types and stages of the hemorrhages were determined in correlation with the precontrast CT, the T1- and T2-weighted images, and the FLAIR images. The size of the hemorrhage was measured by a one- directional axis on a magnitude image of SWI. The phase values of the ICH were qualitatively evaluated: hypo-, iso-, and hyper-intensity. We summarized the imaging features of the intracranial hemorrhage on the phase map of the SWI. Results: Four types of hemorrhage are observed: subdural and epidural; subarachnoid; parenchymal hemorrhage; and microbleed. The stages of the ICH were classified into 4 groups: acute (n = 34); early subacute (n = 11); late subacute (n = 15); chronic (n = 8); stage-unknown microbleeds (n = 27). The acute and early subacute hemorrhage showed heterogeneous mixed hyper-, iso-, and hypo-signal intensity; the late subacute hemorrhage showed homogeneous hyper-intensity, and the chronic hemorrhage showed a shrunken iso-signal intensity with the hyper-signal rim. All acute subarachnoid hemorrhages showed a homogeneous hyper-signal intensity. All parenchymal hemorrhages (> 3 mm) showed a dipole artifact on the phase images; however, microbleeds of less than 3 mm showed no dipole artifact. Larger hematomas showed a heterogeneous mixture of hyper-, iso-, and hypo-signal intensities. Conclusion: The pattern of the phase value of the SWI showed difference, according to the type, stage, and size.

Systematic Review of Occupational Therapy Programs for Upper Extremity Functions in Subacute Stroke Patients (아급성기 뇌졸중 환자의 팔 기능을 위한 작업치료프로그램에 대한 체계적 고찰)

  • Yo-Soon Bang;Eun-Sol Ju
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.4
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    • pp.105-114
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    • 2023
  • Purpose : This study systematically reviewed occupational therapy programs for upper extremity functions in subacute patients implemented over the last decade at home and abroad to utilize the findings as the basis for intervention protocols. Methods : This study was conducted with domestic and foreign randomized controlled experimental studies published from January 2013 to May 2023. Acute or subacute, CVA or stroke, upper extremity function, and program or therapy were used as search keywords in the search databases Scopus, PubMed, Riss, and DBpia. A total of 3,723 documents were retrieved, and 1,007 duplicate papers were excluded. In addition, 2,640 papers that did not meet the inclusion and exclusion criteria were excluded by the researcher examining the titles and abstracts. Thereafter, the full texts were checked. Consequently, 67 documents were excluded, and nine documents were finally used for analysis. Results : Due to the evaluation of the quality of the documents of nine studies, five items were rated "low," and two items were rated "unclear" in many studies. Males predominated the genders, and infarction predominated the types. The average age was over 50 but under 60 years, and the number of days after onset was predominantly fewer than one month. Occupational therapy programs were classified into mental programs, mirror therapy, music programs, and virtual reality programs, and virtual reality programs were frequently used. The intervention periods were predominantly 15-30 sessions for less than 30 minutes, and the Fugl-Meyer assessment-upper extremity was predominantly applied as an evaluation tool. Conclusion : This study is significant because it attempted to present the direction of intervention protocols for upper extremity functions in subacute stroke patients in clinical settings. Studies should be conducted with an expanded scope for a literature review.

Natural Course of Initially Non-Operated Cases of Acute Subdural Hematoma : The Risk Factors of Hematoma Progression

  • Son, Seong;Yoo, Chan Jong;Lee, Sang Gu;Kim, Eun Young;Park, Chan Woo;Kim, Woo Kyung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.211-219
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    • 2013
  • Objective : The objectives of the present study were to characterize the natural course of initially non-operated traumatic acute subdural hematoma (ASDH) and to identify the risk factors of hematoma progression. Methods : Retrospective analysis was performed using sequential computed tomography (CT) images maintained in a prospective observational database containing 177 ASDH cases treated from 2005 to 2011. Patients were allocated to four groups as followings; 136 (76.8%) patients to the spontaneous resolution group, 12 (6.8%) who underwent operation between 4 hours and 7 days to the rapid worsening group (RWG), 24 (13.6%) who experienced an increase of hematoma and that underwent operation between 7 and 28 days to the subacute worsening group (SWG), and 5 (2.8%) who developed delayed aggravation requiring surgery from one month after onset to the delayed worsening group (DWG). Groups were compared with respect to various factors. Results : No significant intergroup difference was found with respect to age, mechanism of injury, or initial Glasgow Coma Scale. The presence of combined cerebral contusion or subarachnoid hemorrhage was found to be a significant prognostic factor. Regarding CT findings, mixed density was common in the RWG and the SWG. Midline shifting, hematoma thickness, and numbers of CT slices containing hematoma were significant prognostic factors of the RWG and the SWG. Brain atrophy was more severe in the SWG and the DWG. Conclusion : A large proportion of initially non-operated ASDHs worsen in the acute or subacute phase. Patients with risk factors should be monitored carefully for progression by repeat CT imaging.

Differential Diagnosis of Brain Diseases Using In Vivo Proton Magnetic Resonance Spectroscopy at 3 Tesla: A Preliminary Study

  • Shen, Yu-Lan;Kang, Heoung-Keun;Kim, Tae-Hoon;Sundaram, Thirunavukkarasu;Kim, Hyeong-Jung;Jeong, Gwang-Woo
    • Journal of the Korean Magnetic Resonance Society
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    • v.13 no.2
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    • pp.64-83
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    • 2009
  • The purpose of this study was to evaluate the usefulness of in vivo 3T $^1H$ MRS with short TE for prescreening various brain diseases. Together with ten normal volunteers, 12 brain tumor patients(2 lymphomas, 5 malignant gliomas) and 5(benign meningiomas) and 10 brain ischemic disease patients(6 acute and 4 subacute infarctions) participated. Lymphomas showed increased intensities of Cho and Lac. Likewise, gliomas showed increased Cho and Lac, but with decreased NAA and ${\beta}\;{\gamma}$-Glx; in higher grade of gliomas, Lac, Cho, mI and Lip predominantly increased with decrease of NAA. Benign meningiomas showed increased Cho, Lac and ${\beta}\;{\gamma}$-Glx; with decreased of NAA. The alanine peak at 1.47 ppm is a neuronal marker for meningiomas. Infarctions showed increased Lac and Lip and decreased NAA, ${\alpha}$-Glx and ${\beta}\;{\gamma}$-Glx where Lac increased with decreased of ${\alpha}$-Glx in acute, and Cho, Lac and Lip increased with decrease of NAA in subacute. Elevated Lac and decreased NAA levels were more aggravated in subacute. Clinical application of the $^1H$ MRS with short TE at 3T is able to povide valuable spectral information for prescreening various brain diseases by monitoring the changes of disease-specific cerebral metabolite concentrations in vivo, and consequently, it can be applicable to assessment of differential diagnosis and malignancy as well.

Experimental Studies on Antimetastatic and Immunomodulating Effects of Patriniae Radix Herbal-acupuncture (패장약침(敗醬藥鍼)의 암전이 억제 및 면역 조절 효과에 관한 실험적 연구)

  • Park, Hee-Soo;Park, Jai-Young
    • Journal of Acupuncture Research
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    • v.23 no.4
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    • pp.187-203
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    • 2006
  • Objectives : This study was designed to investigate the antimetastatic and immunomodulating effects of Patriniae Radix. Methods : Acute and subacute cytotoxicity experiment of Patriniae Radix was performed. Antimetastatic experiment was administered in vitro and in vivo. To observe the immunomodulating effects of Patriniae Radix, FACS analysis and ELISA assay were performed. Results : There was no acute and subacute toxicity responses in mouse treated with Patriniae Radix. Antimetastatic experiment in vitro and in vivo showed that Patriniae Radix has antimetastatic effects. This research revealed that Patriniae Radix mediate cellular immunity response. As compared with control, the population of total T cell, helper T cell, cytotoxic T cell and macrophage were increased. The production of Th 1 type cytokines from splenocyte and cytokines which is associated with anti-tumor activity form macrophage were increased significantly. Conclusion Patriniae Radix Herbal-acupuncture appears to have considerable activity on the treatment of liver metastasis from colon26-L5 carcinoma cell line, and deserves further evaluation in this setting.

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Single and 13-week Repeated Dose Toxicity Study of DA-3002, An Authentic Recombinant Human Growth Hormone (천연형 인성장호르몬 DA-3002의 단회 및 13주 반복투여독성연구)

  • 김옥진;강경구;안병옥;백남기;이순복;김원배;양중익
    • Biomolecules & Therapeutics
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    • v.2 no.2
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    • pp.161-172
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    • 1994
  • This study was conducted to examine DA-3002, a biosynthetic human growth hormone, for its acute and subacute toxicities in mice and rats. The drug was administered subcutaneously and orally at a dose level of 1.0, 3.0, 8.9, 26.7 or 80.0 lU/kg once for single dose toxicity and given subcutaneously at a dose level of 0.34, 1.7 or 8.4 lU/kg daily for 13 weeks to investigate repeated dose toxicity. In the acute toxicity study, doses up to 80 lU/kg had no adverse effect on the behavior or body weight gain. Pathological examinations revealed no abnormal changes which could be attributed to toxic effect of DA-3002. In the subacute toxicity study, the growth hormone was tolerated well in broth mice and rats. No drug related deaths occurred and all animals appeared to be normal throughout the dosing period. Increases in body weight gain, food utilisation and absolute organ weights were observed in the rats in the high dose group. Mild changes in the blood chemical parameters were also seen in the treated groups. Histopathologically, however, no abnormal changes were observed in any organ. The changes noted during the treatment periods presumably represent exaggerated pharmacological effects of the growth hormone, and no observed adverse effect level (NOAEL) was considered to be more than 8.4 lu/kg/day.

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Effect of acupuncture applied to Naegwan (PC6) and Joksamni (ST36) on the fullness of epigastrium or epigastric pain (내관(PC6).족삼리(ST36) 자침(刺鍼)이 심하통(心下痛) 심하만(心下滿) 등 신경성질환에 미치는 영향)

  • Sohn, In-Chul
    • Korean Journal of Acupuncture
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    • v.23 no.1
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    • pp.111-118
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    • 2006
  • Objectives : To test the therapeutic efficacy of acupuncture applied to PC6 and ST36 for the relief of fullness of epigastrium or epigastric pain. Subjects and Methods : We enrolled fifty patients in a case series study The patients were mainly female (94 %) with an average age of 55 years $({\pm}15.0)$; the average age of the male patients was 51 years $({\pm}20.0)$. Twenty four percent of patients were in acute phase which epigastric pain had lasted below 1 month. Twenty eight percent of patients were in chronic phase which the pain had lasted over 6 month. The rest were in subacute phase. Acupuncture needles were inserted into PC6 and ST36 bilaterally. The acupuncture treatments were performed 2 times a week for 4 weeks. One treat session was lasted for 30 min. At each visit, overall symptomatic improvement, frequency and intensity of symptoms were checked on a 4 scaled questionnaire. Results : After acupuncture treatment, a progressive improvement of pain intensity was reported in 46 of the 50 patients, including 23 of excellent and 23 of good. The progress of symptom was more superior in subacute phase to acute or chronic phase. The symptom of 22 of 24 patients in subacute phase was improved. No patient experienced minor side-effects during acupuncture treatment. Conclusion : These preliminary data suggest the acupuncture treatment provides good pain relief for most patients presenting with epigastric pain. Randomized trials with appropriate control groups are needed to validate the effectiveness of this therapy in the treatment of epigastric pain.

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Pharmacological Studies on Forsythiae Fructus (연교(連翹)추출물의 일반(一般) 약리작용(藥理作用))

  • Lee, Eun-Bang;Keum, Hye-Jeong
    • Korean Journal of Pharmacognosy
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    • v.19 no.4
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    • pp.262-269
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    • 1988
  • The Forsythiae fructus is described to be used as an antiinflammatory drug, diuretics, antidotes and antibacterials in oriental literatures. In order to investigate the efficacy of Forsythiae viridissima (Oleaceae), the methanol extract and its fraction have been evaluated for the acute toxicity, antiinflammatory, analgesic and spasmolytic action in animals. The methanol extract of Forsythiae fructus was found to have significant antiinflammatory activity in the acute and subacute antiinflammatory model in rats, but have no analgesic action. Furthermore, through fractionation procedure, it was found that the active compounds were easily soluble in chloroform and butanol. It is also noted that the extracts had spasmolytic activities in the rat fundus and uterus and had low acute toxicity in mice.

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A Case Report of Acute Transverse Myelitis Managed in Oriental Medical Hospital (한방치료만을 시행한 급성 횡단성 척수염 2례에 대한 증례보고)

  • Lee, Myeong-Jong;Song, Mi-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.15-25
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    • 2006
  • Objectives : This report is about a case of a patient who improvement in general condition, Infection and bowel after and urinary dysfunction. Methods : We diagnosed that symptoms as Wejeung(?證), and employed oriental medical treatments, herb medication, acupuncture, electro-acupuncture, moxibustion and physical therapy. Results : In the first case, neurologic impairment was aggravated despite of 15 days of treatments. In the second case, motor and defecation was improved. Conclusions : There is no specific treatment for acute transverse myelitis in the Western medicine. Several case reports revealed clinical improvement of subacute or chronic transverse myelitis in the oriental medicine. We anticipated that the researches regarding treatment for acute transverse myelitis in the oriental medicine will be encouraged in the near future.

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Subannular Aortic Aneurysm Accompanied with Subacute Bacterial Endocarditis.- Report of one case - (아급성 심내막염을 동반한 대동맥륜 하부 대동맥류의 수술치험 -1례 보고-)

  • Han, Jae-Jin;Yi, Won-Yong;Chae, Hurn
    • Journal of Chest Surgery
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    • v.22 no.6
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    • pp.1084-1087
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    • 1989
  • Subannular aortic aneurysm is a word-wide rare disease entity occurring predominantly in young black men. In Korea, there has been no report. We report one patient, 46 years old man, who had been operated urgently because of acute aortic insufficiency and aortic valvular vegetation after antibiotics treatment of Subacute bacterial endocarditis for 6wks. At the operative field, We found the bulging aneurysmal mass between the aorta and superior vena cava above the right pulmonary artery, which has subannular communicating opening into the left ventricular cavity, beneath the anterior commissure of the bicuspid aortic valve. Pathologic findings are consistent with "portion of vascular wall with features of aneurysm.* The patients survived aortic valve replacement and patch closure of subannular aneurysm, with no symptoms at one-year postoperative follow-up.w-up.

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