• Title/Summary/Keyword: Acute stage

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Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication

  • Lee, Min Young;Son, Hye Ran;Rah, Yoon Chan;Jung, Jae Yun;Suh, Myung-Whan
    • Journal of Audiology & Otology
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    • v.23 no.1
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    • pp.33-38
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    • 2019
  • Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication

  • Lee, Min Young;Son, Hye Ran;Rah, Yoon Chan;Jung, Jae Yun;Suh, Myung-Whan
    • Korean Journal of Audiology
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    • v.23 no.1
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    • pp.33-38
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    • 2019
  • Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

Experimental Production of Canine Pyometra by Inoculation with Escherichia coli into the Uterus (대양균 자궁내 접종에 의한 개의 자궁축농증 발증시험)

  • Kang Byong-kyu;Park In-chul;Park Nam-yong
    • Journal of Veterinary Clinics
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    • v.12 no.1
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    • pp.819-827
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    • 1995
  • An attempt to reproduce pyometra by means of experimental uterine infection was conducted with the 10 mongrel hitches of the anestrus, proestrus, metestrus, and postpartum uterine involution stages. Organism used was hemoltic E. coli. origially isolated from uterine pus of a bitch that had the canine pyometra. One ml of broth culture containing $2{\times}10^6$ CFU was inoculated into the uterine horn with the uterine cervix ligated. Aか bitches were ovariohysterectomized at the 7th or 14th day after inoculation and the uterus was provided for macroscopic and microscopic observations. An experimental production of pyometra was successful in 7(70%) of 10 mongrel bitches, and the incidence of pyometra was seen 100% in the stage of anestrus, 100% in the stage of metestrus, 50.0% in the stage of pyomestrus, and 33.359 in the stage of uterine involution. Histologically, these uteri were characterized by the presence of cystic. endomeetrial hyperplasia(CEH) and acute endometritis superimposed on the cystic hyperplasia. And the pyometra with CEH could be seen 66.7% in metestrus 50% in anestrus, 33.3% in involution and in 0% in proestrus stage. Blood progesterone concentrations were showed as a normal range of the each stage of sexual cycle and any relationships between the progesterone concentrations and the incidence of pyometra were not observed.

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A Clinical Study of Combined Eastern and Western Treatment of Acute Stage Stroke (급성기 뇌졸중 환자의 한양방 협진치료에 대한 임상적 고찰)

  • Kim, Jong-Hwan;Sin, Woo-Jin;Jang, Ja-Won;Kim, Ji-Yun;Min, Sung-Soon;Hwang, Won-Duek
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.65-74
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    • 2004
  • Object : This is a study of acute stage stroke patients designed for comparison of combined Eastern and Western medical treatments and Oriental treatments alone. Methods : 51 patients were diagnosed by Brain-CT and Brain-MRI scan as having suffered stroke. They had entered Dong-eui hospital within seven days of attack, and remained over seven days, all between November 2002 and August 2003. Patients were divided into two groups: a group treated with both Eastern and Western medical treatments, and a group treated only with Oriental medical treatments (but examinations were done and medications were given in hypertension, Diabetes Mellitus and so on). Results : The Eastern-Western medical treatment group showed significant changes in NIHSS. A rate of improvement figure of 24.94% was obtained for the Eastern-Western medical treatment group, and for the Oriental medical group a figure of 7.84% was obtained. Conclusion : The East-West medical treatment group had significant rate of development that measure for NIHSS by treated comparatively dependent patients. And oriental medical treatment group had significant rate of development that measure for NIHSS by treated comparatively independent patients. The NIHSS measure for the Eastern-Western medical treatment group shows a significant rate of improvement for relatively dependent patients, and the NIHSS measure for the Oriental medical treatment group shows a significant rate of development for relatively independent patients.

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Performance Costumes and Stage Direction Characteristics Shown in the Nouvelle Danse Work - Focused on the Philippe Decouflé's choreography work and costume design of Philippe Guillotel - (누벨당스 작품에 나타난 퍼포먼스 의상의 미적 특성 연구 - 필립 드쿠플레(Philippe Decouflé)의 안무작품과 필립 기요텔(Philippe Guillotel)의 의상디자인을 중심으로 -)

  • Kim, Hyang-ja;Kim, Young-sam
    • Journal of the Korean Society of Costume
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    • v.65 no.5
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    • pp.126-141
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    • 2015
  • The purpose of this study is to examine the works of choreographer Philippe $Decoufl{\acute{e}}$ and the performance costumes designer Philippe Guillotel, and identify the intrinsic values shown in the formative characteristics in their works. And it proposes a vision and a direction for the development and performance of modern fashion phenomenon of media convergence performing arts complex. The results were as follows. First, the performance characteristics shown in Philippe $Decoufl{\acute{e}}$'s art pattern applies dynamic improvisation, decategorization reflected in the media interactivity, time and space of a variable scalability, complex artistic genres and transcends cultural boundaries. Second, the characteristics of the performance costume can be described as a co-existence between dynamics of aesthetic layers, 'Media body' represented by the interaction of the compounds with the technology, and integrated variable expandability. And aesthetic values inherent in the performance costumes are summarized as abstraction, playfulness, reproducibility, and theatricality. Modern fashion performance and limited production of the center 'costumes' in the fashion images can be used in diverse ways, and innovative marketing has gone through a change in image production. Metaphysical text of the advanced performance genre can be presented in a new perspective to fashion derivatives 'Media body'. And the aesthetics of popular culture kitsch, the grotesque, and surrealism in theater will produce creative stage direction.

PaCO2 at Early Stage is Associated with Adverse Cardiovascular Events in Acute Carbon Monoxide Poisoning (급성 일산화탄소 중독 환자에서 응급실 내원 초기 동맥혈 이산화탄소 분압의 임상적 의미)

  • Yang, Keun Mo;Chun, Byeong Jo;Moon, Jeong Mi;Cho, Young Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.86-93
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    • 2019
  • Purpose: The objective was to determine the association between PaCO2 and adverse cardiovascular events (ACVEs) in carbon monoxide (CO)-poisoned patients. Methods: This retrospective study included 194 self-breathing patients after CO poisoning with an indication for hyperbaric oxygen therapy and available arterial blood gas analysis at presentation and 6 hours later. The baseline characteristics and clinical course during hospitalization were collected and compared. The mean PaCO2 during the first 6 hours after presentation was calculated. Results: The incidence rates of moderate (30 mmHg< PaCO2 <35 mmHg) or severe (PaCO2 ≤30 mmHg) hypocapnia at presentation after acute CO poisoning were 40.7% and 26.8%, respectively. The mean PaCO2 during the first 6 hours was 33 (31-36.7) mmHg. The incidence of ACVEs during hospitalization was 50.5%. A significant linear trend in the incidence of ACVEs was observed across the total ranges of PaCO2 variables. In multivariate regression analysis, mean PaCO2 was independently associated with ACVEs (OR 0.798 (95% CI 0.641-0.997)). Conclusion: Mean PaCO2 during the first 6 hours was associated with increased ACVEs. Given the high incidence of ACVEs and PaCO2 derangement and the observed association between PaCO2 and ACVEs, this study suggests that 1) PaCO2 should be monitored at the acute stage to predict and/or prevent ACVEs; and 2) further study is needed to validate this result and investigate early manipulation of PaCO2 as treatment.

Sequential 1H MR Spectroscopy(MRS) Studies of Kaolin-Induced Hydrocephalic Cat Brain (Kaolin 유발 고양이 수두증 모델에서 양자 자기공명 분광상의 경시적 변화)

  • Kim, Myung Jin;Hwang, Sung Kyoo;Hwang, Jeong Hyun;Chang, Yongmin;Kim, Yong Sun;Kim, Seung Lae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1421-1428
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    • 2000
  • Objectives : The aim of this study is to evaluate the sequential metabolic changes in experimental hydrocephalus and the clinical applicability to the diagnosis and prognosis of hydrocephalus using proton MR spectroscopy. Methods : Hydrocephalus was experimentally induced in 30 cats(2-3kg body weight) by injecting 1ml of sterile kaolin suspension(250mg/ml) into the cisterna magna. Proton MRS was performed with a 1.5 T MRI/MRS unit (Vision Plus, Siemens) at pre-treatment and at 1, 3, 7, 14, 21, and 28 days after the kaolin injection. PRESS(TR/TE=1500/270msec) technique was employed. The major metabolites which include N-acetyl aspartate (NAA), creatine(Cr), choline(Cho), and lactate(Lac) were quantitatively analyzed and the relative concentrations ratios were evaluated. Multislice $T_2$-weighted images were also obtained using fast spin echo sequence(TR/TE= 2500/96msec) to monitor the morphologic changes along with progression of hydrocephalus. Results : Hydrocephalus was successfully induced in all 30 cats. Twenty five cats died within 3 days and one at the end of the second week. In all animals, the NAA/Cr ratios initially decreased during the acute stage. In 4 surviving cats, the NAA/Cr ratios initially decreased during the acute stage(<14 days) and then gradually increased to the prekaolin level as follows : pre-kaolin($1.49{\pm}0.04$), day 1($1.11{\pm}0.07$), day 7($1.17{\pm}0.04$), day 14($1.40{\pm}0.03$), day 21 ($1.46{\pm}0.06$), day 28($1.43{\pm}0.03$). These levels were relatively well correlated with the symptomatologic improvement. Lactate peak, which reflects the evidence of ischemia, did not appear throughout the entire period except in one case which expired at the end of the second week. Conclusions : The NAA/Cr ratio of the sequential proton MRS in kaolin-induced hydrocephalic cats reflects a metabolic aspect of the hydrocephalus at each stage. A decreased NAA level at the early stage is from both neuronal and axonal damage which may provide diagnostic information in the acute stage of hydrocephalus. In addition, the initial fall of NAA/Cr ratio and recovery in the late stage, when no lactate peak emerges, may suggest that the main insult of the parenchyma is not to the neuron itself but to the axon, which may be related to a good prognosis. However, emergence of the lactate peak and unrecoverable NAA/Cr at the end of the acute phase may be a poor prognostic factor. In the chronic stage, recovery of NAA/Cr ratio may provide a diagnostic clue for the differentiation between hydrocephalus and cortical atrophy.

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The Study of IgG subclasses in Acute stage of Kawasaki Disease (급성기 가와사끼병 환아의 IgG 아형항체에 대한 연구)

  • Kim, Minshik;Kim, Youngsook;Cho, Namji;Kim, Kyungsook
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.140-149
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    • 1997
  • Purpose : Kawasaki Disease(KD) is a febrile disease with acute multisystemic vasculitis which is seen commonly in early childhood. The cause and etiologic agents are still unknown to identify using ordinary bacterial and viral culture, but the clinical labaratory studies suggest that KD is one of autoimmune disorder caused by infectious agents, but that is not proved yet. The study was performed to investigate the IgG subclasses in acute stage of KB before treatment of IVIG(Intravenous immunoglobulin). Method : The 35 cases in acute stage of KD before treatment of IVIG who were hospitalized from jan. 1995 to dec. 1996. The obtained sera were measured level of total IgG, IgM, IgA, IgE and IgG subclasses IgGl, IgG2, IgG3, IgG4 by using EIA and SRID method. Results : 1) The sex ratio is male to female is 1.5: 1.0, and male is prone to infected. 2) Total IgG, IgM, IgA and IgE level is normal range with age adjusted, but few cases are shown slight high level of total IgG compare to normal range of age adjusted. 3) acute phage reactants such as CRP, C3, ESR are all increased in acute stage of cases. 4) IgG subclasses IgGl, IgG2, IgG3 are shown normal range of age adjusted, but remarkably low level of IgG4 in all of cases. Conclusions : The low level of IgG4 is able to increasing the incidence of KD, and may use early diagnostic tools combine with other clinical symptoms and signs. But the resulsts of reported studies are different to each other, so it needs more times and cases to get final evaluation of changes of serum immnunoglobulin levels correlate to increase the incidence of high risk group of KD patients.

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

  • Shinn Sung Ho;Chung Won Sand;Kang Jung Ho;Jeon Yang-Bin
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.468-475
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    • 2005
  • Transmyocardial revascularization (TMR) in end stage ischemic heart disease results in variable clinical responses. We investigated the acute effect of early reperfusion and the angiogenesis after formation of the transmyocardial channel in a transplanted rat heart model with acute myocardial infarction. Material and Method: In the 30 transplanted hearts we induced acute myocardial infarction by ligating the proximal left coronary artery and inserted a porous 22G intravenous cannula into the left ventricle. After ten minutes of reperfusion, we removed the cannula. At every stage, we recorded the heart rate, QRS size, and left coronary arterial blood flow using the electrocardiogram and Doppler. One week later the rats were sacrificed and evaluated for the patency of intramyocardial channels and the angiogenesis. Result: The heart rates after ligation and after cannula insertion were $239.1\pm61.7,\;235.8\pm58.0bpm$ respectively, and they were statistically significantly slower than that of before ligation, $277.6\pm40.3bpm\;(p=0.017,\;p=0.007\;respectively)$. QRS sizes before ligation, after ligation, and after cannula insertion were $3.6\pm3.3mm,\;2.8\pm3.3 mm,\;and\;2.4\pm2.2mm,$respectively, and there was no significant difference in the three groups. Doppler findings after ligation showed that average peak and mean values of coronary perfusion were significantly decreased from $2.11\pm0.17kHz,\;1.25\pm0.22kHz\;to\;0.83\pm0.15kHz,\;0.38\pm0.11kHz$(p<0.05 respectively). After insertion of the porous cannula, the average peak and mean values of coronary perfusion were $0.61\pm0.05kHz\;and\;0.33\pm0.05 kHz$ respectively, but there was no statistically significant change compared to values after ligation. In all cases except one, pathologic findings showed no patent channels in the acute stage, however, one case showed the angiogenesis. Conclusion: We confirmed that TMR in a rat heart transplant model did not show blood flow through the channel in the acute stage. However, reperfusion effect in some cases had a potential for angiogenesis.

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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    • v.16 no.16
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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.