• 제목/요약/키워드: Acute stage

검색결과 585건 처리시간 0.031초

백서 동종이식 심장모델에서 기계적 경심근 혈관재형성의 심근 혈류 개선 효과 : 급성기 모델 (Myocardial Perfusion after Transmyocardial Mechanical Revascularization in Rat Heart Transplant Model, Acute Model)

  • 신성호;정원상;강정호;전양빈
    • Journal of Chest Surgery
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    • 제38권7호
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    • pp.468-475
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    • 2005
  • 말기 허혈성 심질환 환자에서의 경심근 혈관재형성(Transmyocardial revascularization)은 다양한 임상 결과를 보인다. 저자는 백서의 동종 이식 심장 급성 심근 경색 모델에서 다공 정맥 캐뉼라를 이용해 심실-심근간 통로를 개통하여 초기 심근 재관류 효과와 혈관신생에 대해 알아보고자 하였다. 대상 및 방법: 총 30마리의 심장 이식 백서를 대상으로 이식심장의 좌관상동맥 근부를 결찰하여 심근경색을 유발하고, 측면에 구멍을 뚫은 22G정맥 캐뉼라를 좌심실 내로 삽입하여 10분간 관류를 시킨 후 제거하였다. 각 단계에서 도플러 초음파와 심전도를 측정하여 좌관상동맥의 혈류와 심박동수, QRS 크기를 비교하였다. 이후 1주일간 관찰하여 안락사시킨 후 이식 심장에서 심근 내 통로의 개통성과 혈관신생을 관찰하였다. 걸과: 좌관상동맥 결찰 후($239.1\pm61.7$회/분)와 경심근 다공 캐뉼라 삽입후($235.8\pm58.0$회/분) 심박동수는 결찰 전($277.6\pm40.3$회/분)보다 느렸다(각각 P=0.017, 0.007). QRS 크기는 결찰 전 $3.6\pm3.3mm$, 결찰 후 $2.8\pm3.3m$, 다공 캐뉼라 삽입 후 $2.4\pm2.2mm$로 세 군간에 차이가 없었다. 도플러 초음파 검사에서도 좌관상동맥 혈류량의 평균 최고치와 평균 중간치가 결찰전 $2.11\pm0.17kHz$$1.25\pm0.22kHz$에서 결찰 후 $0.83\pm0.15 kHz$$0.38\pm0.11kHz$로 의미 있게 감소하였고 (p<0.05), 캐뉼라 삽입후$0.61\pm0.05kHz$$0.33\pm0.05 kHz$로 결찰 후 값과 비교할 때 큰 차이가 없었다. Hematoxylin-eosin, Masson-Trichrome 염색을 이용한 병리학적 검사상 1예를 제외하고 초기 통로의 개통성을 확인할 수 없었으나, 1예에서 혈관 증식이 관찰되었다. 걸론: 결론적으로 동종이식 심장의 급성 심근경색 모델에서 경심근 혈관재형성은 초기에 경심근 통로를 통한 혈류와 관류 효과를 유발하지 않았지만 일부에서 혈관신생이 일어나 장기적으로 혈관신생의 가능성을 확인할 수 있었다.

The underlying mechanism of calcium toxicity-induced autophagic cell death and lysosomal degradation in early stage of cerebral ischemia

  • Jirakhamon Sengking;Pasuk Mahakkanukrauh
    • Anatomy and Cell Biology
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    • 제57권2호
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    • pp.155-162
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    • 2024
  • Cerebral ischemia is the important cause of worldwide disability and mortality, that is one of the obstruction of blood vessels supplying to the brain. In early stage, glutamate excitotoxicity and high level of intracellular calcium (Ca2+) are the major processes which can promote many downstream signaling involving in neuronal death and brain tissue damaging. Moreover, autophagy, the reusing of damaged cell organelles, is affected in early ischemia. Under ischemic conditions, autophagy plays an important role to maintain energy of the brain and its function. In the other hand, over intracellular Ca2+ accumulation triggers excessive autophagic process and lysosomal degradation leading to autophagic process impairment which finally induce neuronal death. This article reviews the association between intracellular Ca2+ and autophagic process in acute stage of ischemic stroke.

Concurrent Chemoradiation with Weekly Cisplatin for the Treatment of Head and Neck Cancers: an Institutional Study on Acute Toxicity and Response to Treatment

  • Ghosh, Saptarshi;Rao, Pamidimukkala Brahmananda;Kumar, P Ravindra;Manam, Surendra
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권16호
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    • pp.7331-7335
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    • 2015
  • Background: Concurrent chemoradiation with three weekly high dose cisplatin is the non-surgical standard of care for the treatment of locally advanced head and neck cancers. Although this treatment regime is efficacious, it has high acute toxicity, which leads not only to increased treatment cost, but also to increased overall treatment time. Hence, the current study was undertaken to evaluate the acute toxicity and tumor response in head and neck cancer patients treated with concurrent chemoradiation using $40mg/m^2$ weekly cisplatin, which has been our institutional practice. Materials and Methods: This single institution retrospective study included data for 287 head and neck cancer patients treated with concurrent chemoradiation from 2012 to 2014. Results: The mean age of the patients was 48.8 years. The most common site of involvement was oral cavity. Most of the study patients presented with advanced stage disease. The mean overall treatment time was 56.9 days. Some 67.2% had overall complete response to treatment as documented till 90 days from the start of treatment. According to the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria, mucositis was seen in 95.1% of the patients. Dermatitis and emesis were observed in 81.9% and 98.6%, respectively. Regarding haematological toxicity, 48.8% and 29.6% suffered from anaemia and leukopenia, respectively, during treatment. Acute kidney injury was assessed using the Common Terminology Criteria for Adverse Events (CTCAE), and was found in 18.8% of the patients. Conclusions: Concurrent chemoradiotherapy with weekly cisplatin is an effective treatment regime for head and neck cancers with reasonable toxicity which can be used in developing countries, where cost of treatment is so important.

음주 주종과 급성 위해 유발 음주 위험도 (Type of Alcoholic Beverage and High Risk Drinking for Acute Harm)

  • 유태우;이선미;정우진
    • Journal of Preventive Medicine and Public Health
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    • 제36권4호
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    • pp.383-389
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    • 2003
  • Objective : Studies have suggested that beer is associated with a high risk of mortality and morbidity. The purpose of this study was to investigate how types of alcoholic beverage are related to high risk acute harm. Methods : Data from the 1997 Korea's Behavioral Risk Factor Surveillance System Survey, collected through telephone questionings, were analyzed based on multi-stage stratified random sampling(N=1,045). Among those who had drunk at least one type of alcoholic beverage in the last month, one episode where the drinker had consumed the highest level of ethanol was selected, and the alcohol consumption per drinking day categorized into four risk levels of short-term, 'acute' harm, according to the WHO guidelines. Employing ordered logistic regression analyses, as the explanatory variables, types of alcoholic beverage, with and without socioeconomic characteristics, were considered. Results : Spirits and soju were more than ten and three times, respectively, more likely than beer, while makkolli and wine were almost as likely as beer, to involve high risk drinking, irrespective of controlling for the socioeconomic characteristics. Conclusions : Unlike most Western countries, in Korea, beer, rather than spirits or soju, is generally less likely to be associated with high risk drinking for acute harm, The influence of beverage types on high risk drinking for acute harm appears to vary between countries.

급성 수부 손상시 즉시 족지 전이술 (Immediate Toe-to-Hand Transfer in Acute Hand Injuries)

  • 우상현;김학수
    • Archives of Reconstructive Microsurgery
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    • 제11권1호
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    • pp.19-28
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    • 2002
  • From 1994-2001, 25 mutilated digits were reconstructed with immediate toe-to-hand transfer in acute hand injury in 21 patients. There were 15 cases of great toe-to-hand transfer(partial great toe transfer 8 cases, modified wrap-around procedure 2 cases, and trimmed great toe transfer 2 cases) for thumb reconstruction, 2 cases of second toe transfer for index reconstruction, and 4 cases of simultaneous two toe-to-hand transfer(great toe & second toe transfer 1 case, bilateral second-toe transfer 2 cases, combined second & third toe transfer 1 case) for reconstruction of multiple digit amputations. Two cases of emergency exploration(2/25, 8%) were successfully salvaged. The incidence of emergency exploration and postoperative infection was not significantly different from that of the elective toe-to-hand transfer cases. Duration of industrial insurance coverage was 225 days, which is much shorter than that of elective cases. Among 43% of patients maintained their original job even after injury and immediate toe-to-hand transfer. The subjective satisfaction self- assessment scores of aesthetic appearance and function on the new reconstructed thumb were 80 and 88 in average, respectively, over a total score of 100. These were higher than those of reconstruction of other digits, but lower than those of elective reconstruction. The donor site after harvest of the great toe was mostly unsatisfied in a view of appearance. Immediate toe-to-hand transfer provides many advantages over elective procedure in acute hand injuries such as single stage reconstruction, shortened convalescent period, early return to work and efficient socio-economic factor. Furthermore because there were no significant differences in success rate, frequency of complications or ultimate functional result, immediate toe-to-hand transfer is a safe and reliable procedure in case of limited indications for acute digits loss.

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급성기 중풍 환자의 설태색(舌苔色)에 따른 특성 비교 (Comparison Study on the General Characteristics of Acute Stroke Patients according to Tongue Fur Color)

  • 박수경;김미영;최원우;임정태;박성욱;정우상;조기호
    • 대한한방내과학회지
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    • 제30권4호
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    • pp.806-812
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    • 2009
  • Objective : The aim of this study was to provide basic background information on stroke by evaluation various etiological factors on the basis that the Tongue fur color of acute stroke patients. Method : We studied patients hospitalized within 4 weeks after their ictus who were admitted at Kyunghee University Oriental Medical Center, Dongguk University Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center, and Kyungwon University Incheon Oriental Medical Center from April 2008 to August 2009. We compared the general characteristics of acute stroke patients according to tongue fur color. Result : Tongue fur color showed significant difference for past history of hypertension, hyperlipidemia, stroke, HDL-chol, BUN, Hg, and pulse pattern. Conclusion : The above results show that the overall tendency of acute stage cerebral infarction patients varies according to their tongue fur color. Further studies will be needed to better understand the difference between yellow fur group and white fur among acute stroke patients.

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The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia

  • Doo, A Ram;Choi, Jin-Wook;Lee, Ju-Hyung;Kim, Ye Sull;Ki, Min-Jong;Han, Young Jin;Son, Ji-Seon
    • The Korean Journal of Pain
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    • 제32권3호
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    • pp.215-222
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    • 2019
  • Background: Several nerve blocks can reduce the incidence of postherpetic neuralgia (PHN) as well as relieve acute zoster-related pain, but the long-term outcome of PHN has not been clearly determined. This study investigated the efficacy of selective nerve root block (SNRB) for herpes zoster (HZ) on the long-term outcome of PHN. Methods: We prospectively conducted an interview of patients who had undergone an SNRB for HZ from January 2006 to December 2016 to evaluate their long-term PHN status. The relationship between the time from HZ onset to the first SNRB and the long-term outcome of PHN was investigated. Results: The data of 67 patients were collected. The patients were allocated to acute ($SNRB{\leq}14days$, n = 16) or subacute (SNRB > 14 days, n = 51) groups. The proportions of cured patients were 62.5% and 25.5% in the acute and subacute groups (P = 0.007), respectively. In logistic regression, an SNRB >14 days was the significant predictor of PHN (adjusted odd ratio, 3.89; 95% confidence interval, 1.02-14.93; P = 0.047). Kaplan-Meier analysis revealed that time from the SNRB to the cure of PHN was significantly shorter in the acute group ($2.4{\pm}0.7yr$) than in the subacute group ($5.0{\pm}0.4yr$; P = 0.003). Conclusions: An early SNRB during the acute stage of HZ (within 14 days) appears to decrease the incidence and shorten the duration of PHN, with a median of 5.0 years of follow-up.

현훈을 동반한 편타성 손상 환자에 대한 판상근 아시혈 침치료 중심의 한방복합치료 치험 3례 (Patients Treated with Acupuncture on Splenius Muscle and Combined Korean Medicine for Acute Dizziness Caused by Whiplash Injury: Three Case Reports)

  • 류광현;주아라;박미소;추원정;최요섭;문영주;최효정
    • 대한한방내과학회지
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    • 제41권6호
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    • pp.1210-1222
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    • 2020
  • Objective: The purpose of this study was to report the effect of acupuncture on the splenius muscle and the effect of combined Korean medicine treatment on acute dizziness in patients due to whiplash injury. Methods: Three patients with acute dizziness were treated with acupuncture of the splenius muscle and combined Korean medicine. A numeric rating scale (NRS) and the Korean dizziness handicap inventory (K-DHI) were checked every day from admission to discharge to confirm symptom improvements. Results: In the acute stage of dizziness caused by whiplash injury, acupuncture of the splenius muscle and combined Korean medicine improved the NRS and K-DHI scores. Conclusions: For patients with acute dizziness caused by whiplash injury, a combination of acupuncture on the splenius muscle and Korean medicine treatment may be a solution.

Persistent headache and chronic daily headache after COVID-19: a prospective cohort study

  • Larissa Clementino Leite Sa Carvalho;Priscila Aparecida da Silva;Pedro Augusto Sampaio Rocha-Filho
    • The Korean Journal of Pain
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    • 제37권3호
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    • pp.247-255
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    • 2024
  • Background: Little is known about the frequency and impact of the persistent headache and about the incidence of chronic daily headache (CDH) after coronavirus disease 2019 (COVID-19). The aim of this prospective cohort study was to assess the incidence, risk factors, characteristics, and impact of CDH in patients with COVID-19. Methods: In the first stage, 288 patients were interviewed by telephone after the acute phase of COVID-19. Subsequently, 199 patients who presented headache were reinterviewed at least one year after COVID-19. Headaches that persisted beyond the acute phase of COVID-19 for three or more months and presented frequency ≥ 45 days over the first three months were considered to be CDH. Results: One hundred and twenty-three patients were included, 56% were females; median age: 50 years (25th and 75th percentile: 41;58). The headache persisted beyond the acute phase of COVID-19 in 52%, and 20.3% had CDH (95% confidence interval: 13.6-28.2). Individuals who previously had headaches and who had headaches of greater intensity during the acute phase were at higher risk of developing CDH. The group with CDH included more females, greater impact of headache, more persistence of headache beyond the 120th day of COVID-19 and less throbbing headache than did the other individuals whose headache persisted. Conclusions: Patients who had COVID-19 had a high incidence of CDH. Previous headache and greater intensity of headache were associated with higher risk of CDH.

대하의 초기생활사에 있어 아질산, 암모니아 및 황화수소의 급성독성 (Acute Toxicity of Nitrite, Ammonia and Hydrogen Sulfide for Early Developmental Stages of Fenneropenaeus chinensis)

  • 지정훈;강주찬
    • 한국어병학회지
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    • 제17권3호
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    • pp.199-205
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    • 2004
  • 우리나라 갑각류의 대표적인 양식종인 대하의 초기생활사 동안의 아질산, 암모니아 및 황화수소에 대한 급성독성 수준을 파악하여 각 발달단계에 따른 독성차이를 검토하였다. 아질산에 대한 대하의 mysis, post larva 및 juvenile기의 96시간 반수치사 농도는 각각 18.4, 32.3 및 39.8 mg/L이었고, 암모니아에 대한 대하의 mysis, post larva 및 juvenile기의 96시간 반수치사 농도는 각각 1.43, 3.45 및 3.35 mg/L이었다. 황화수소에 대한 대하의 mysis, post larva 및 juvenile기의 96시간 반수치사 농도는 각각 13.5, 22.7 및 28.5 $\mu{g}/L$이었다. 이들 오염물질에 대한 독성순위는 황화수소>암모니아>아질산 순으로 나타났다. Post larva에 대한 mysis기의 독성수준은 모든 오염물질에서 1.5배 이상을 나타냈고, juvenile에 대한 mysis기의 독성수준은 2배 이상을 나타내어 가장 큰 차이를 보였다. 한편 juvenile에 대한 post larva기의 독성차이는 1.5배 이하를 나타내어 가장 작은 차이를 보였다.