• 제목/요약/키워드: Clinical Manifestation

검색결과 472건 처리시간 0.032초

고압산소치료를 받은 급성 일산화탄소 중독 환자들에서 발생한 지연성 신경정신과학적 후유증 발생과 관계된 인자 (Factors Associated with Delayed Neuropsychological Sequelae in Acute Carbon Monoxide Poisoning Patients Treated by Hyperbaric Oxygen)

  • 이동하;최우익
    • 대한임상독성학회지
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    • 제9권2호
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    • pp.88-94
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    • 2011
  • Purpose: Delayed neuropsychological sequelae (DNS) commonly occurs after recovery from acute carbon monoxide poisoning. The aim of this article is to identify the factors associated with DNS development. Methods: We retrospectively evaluated patients, admitted to the medical center emergency department from June 2005 to March 2011, who were suffering from acute carbon monoxide (CO) poisoning. We categorized the patients into two groups - those with DNS, and those without DNS. Multiple regression analysis was performed to identify the factors related to manifestation of DNS. Results: Of the total one hundred fifty seven patients (157) recruited for the study, twenty two (22) developed DNS. Longer CO exposure times and lower GCS scores were positively associated with development of DNS symptoms. Conclusion: Our study identified two potential factors which are predictive of DNS development in CO intoxication, however, more studies are needed. Adequate follow-up after hospital discharge to monitor for and accurately identify manifestation of DNS, is also important.

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방사선치료 후 전신적증세의 발현을 나타낸 Midline Malignant Reticulosis 환자군에 대한 재고 (Reevaluation of Midline Malignant Reticulosis with Systemic Manifestation after Irradiation)

  • 김귀언;서창옥;김병수;홍원표
    • Radiation Oncology Journal
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    • 제2권1호
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    • pp.71-79
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    • 1984
  • During a 10 year periods, 42 patients with well-documented Midline Malignant Reticulosis were treated with local irradiation and followed for extended periods of time. 13 cases with systemic manifestation after irradiation illustrate the protean features of this disease. Although it commonly Presents in upper airway tracts such as nasal cavity and/or septum, soft palate and palatine tonsil, the lesion may be localized as well as diffuse. 2 cases among them showed systemic relapse on lung, pancreas and scrotum probably from either a multifocal or metastatic deposits. Another 3 eases were associated with systemic diseases such as stomach carcinoma, typhoid enteritis and CNI of fat tissue. Remained cases were diagnosed by clinical or radiological examination. Possibility of close relation to lymphoma with Midline Malignant Reticulosis are also suggested in 1 case. In Midline Malignant Reticulosis, the best results of treatment are obtained in localized lesion of the upper airway treated early with irradiation: A poorer outcome is associated with multifocal systemic involvement, which necessitates a systemic therapy.

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혀통증으로 나타난 비타민 B12 결핍증 -증례보고- (Glossodynia as an Unusual Manifestation of Vitamin B12 Deficiency -A case report-)

  • 이정훈;정일만;서원구;우철호;배종석;문성하;곽인숙;김광민
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.275-277
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    • 2006
  • A 58-year old male patient, with a history of gastrectomy, came to our department for recently aggravated glossodynia. A delicate physical examination revealed gait ataxia and a positive Rhomberg test. He was diagnosed as having vitamin B12 deficiency using a combination of the laboratory results, such as macrocytic anemia. It was thought that the tongue pain might have been a main clinical manifestation of vitamin B12 deficiency.

가미소요산(加味逍遙散)의 항산화 효과와 serotonin 대사과정에 미치는 영향 (The Effect of Gamisoyo-san(Jiaweixiaoyaosan) on Serotonin Metabolism)

  • 심태경;정인철;이상룡
    • 동의신경정신과학회지
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    • 제22권1호
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    • pp.37-51
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    • 2011
  • Objectives : This experiment was designed to investigate the effect of Gamisoyo-san(Jiaweixiaoyaosan, SYS) on serotonin activity of P815 Mast Cell. Methods : The effects of SYS on activation of TPH-1 mRNA and AAADC mRNA in P815 mast cell were investigated. The effect of SYS on content of serotonin in P815 mast cell was investigated. The effects of SYS on activation of DPPH and SOD in P815 mast cell were investigated. Results : 1. The SYS increased the activation of SOD and DPPH in P815 mast cell. 2. The SYS decreased the manifestation TPH-1 mRNA in P815 mast cell. 3. The SYS decreased the manifestation AAADC mRNA in P815 mast cell. Conclusions : This experiment shows that Gamisoyo-san might not be effective for treating depression in terms of biogenic amine theory. However, Gamisoyo-san showed significant anti-oxidative effect and it can not yet be ruled out for treating depression. Therefore, pathogenesis of depression and clinical research of Gamisoyo-san is suggested for future research.

가미귀비탕(加味歸脾湯)이 P815세포의 serotonin 대사 과정에 미치는 영향 (Study on Effect to Serotonin Metabolism of Gamiguibi-tang on P815 Cell)

  • 노동진;정인철
    • 동의신경정신과학회지
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    • 제21권1호
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    • pp.1-11
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    • 2010
  • Objectives: This study was perfomed to investigate the antioxidant activity and serotonin activity of Gami-guibi-tang on P815 Mast Cell. Methods: The effects of Gami-guibi-tang on activation of TPH-1 mRNA and AAADC mRNA in P815 mast cell were investigated. The effect of Gami-guibi-tang on content of serotonin in P815 mast cell was investigated. The effects of Gami-guibi-tang on activation of DPPH radical scavenging and SOD in P815 mast cell were investigated. Results: 1. The Gami-guibi-tang increased SOD activity and DPPH radical scavenging activity. 2. The Gami-guibi-tang increased the intracellular concentration of serotoninin 60 ${\mu}g/ml$, 80 ${\mu}g/ml$ experiment group. 3. The Gami-guibi-tang increased menaingful the manifestation TPH mRNA. 4. The manifestation of AAADC and MAO mRNA have not made menaingful changes on Gami-guibi-tang. Conclusions: This experiment shows that Gami-guibi-tang had significant anti-oxidative effect. And Gami-guibi-tang increased the intracellular concentration of serotonin. Therefore, Gami-guibi-tang can be used by the medication of major depression disorder. But Study on mechanism of increased serotonin and clinical research of Gami-guibi-tang is suggested for future research.

성인 활로 4징증에 대한 개심술 (Surgical correction of adult tetralogy : Results of repair in 123 patients)

  • 안혁;서경필;이영우
    • Journal of Chest Surgery
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    • 제19권4호
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    • pp.627-632
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    • 1986
  • This report describes our 17-years experience with intracardiac repair in 123 patients older than 15 years with tetralogy of Fallot. Major clinical manifestation was cyanosis and clubbing [102 Pts], but other minor associated manifestation were infective endocarditis, pulmonary tuberculosis, brain abscess, congestive heart failure, nephrotic syndrome, and tuberculous spondylitis. Prior palliative shunts had been performed in 10 patients. Preoperative hemoglobin ranged from 9.7 gm/dl to 25 gm/dl [mean 19 gm/dl]. The type of ventricular septal defect were typical perimembranous type, and total canal defect [13%]. The right ventricular outflow tract obstruction was due to combined [58.5%], infundibular [35%], and valvular stenosis [6.5%]. Transannular patch was used in 17% of patients. Hospital mortality was 9.8% in overall, but decreased to 1.7% since 1982. There was two late death [12 year actuarial survival [97%] due to fulminant hepatitis, residual abnormalities [PS, VSD]. Ninety two percent of survivors at follow-up are asymptomatic and leading an active normal life. Residual ventricular septal defect was detected with radionuclide single pass study in 15.3% of patients but almost cases were Qp/Qs less than 1.5, and only two patients had been candidates for reoperation.

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Hemorrhagic Moyamoya Disease : A Recent Update

  • Fujimura, Miki;Tominaga, Teiji
    • Journal of Korean Neurosurgical Society
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    • 제62권2호
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    • pp.136-143
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    • 2019
  • Moyamoya disease (MMD) is a progressive cerebrovascular disease with unknown etiology, characterized by bilateral steno-occlusive changes at the terminal portion of the internal carotid artery and an abnormal vascular network formation at the base of the brain. MMD has an intrinsic nature to convert the vascular supply for the brain from internal carotid (IC) system to the external carotid (EC) system, as indicated by Suzuki's angiographic staging. Insufficiency of this 'IC-EC conversion system' could result not only in cerebral ischemia, but also in intracranial hemorrhage from inadequate collateral anastomosis, both of which represent the clinical manifestation of MMD. Surgical revascularization prevents cerebral ischemic attack by improving cerebral blood flow, and recent evidence further suggests that extracranial-intracranial bypass could powerfully reduce the risk of re-bleeding in MMD patients with posterior hemorrhage, who were known to have extremely high re-bleeding risk. Although the exact mechanism underlying the hemorrhagic presentation in MMD is undetermined, most recent angiographic analysis revealed the characteristic angio-architecture related to high re-bleeding risk, such as the extension and dilatation of choroidal collaterals and posterior cerebral artery involvement. We sought to update the current management strategy for hemorrhagic MMD, including the outcome of surgical revascularization for hemorrhagic MMD in our institute. Further investigations will clarify the optimal surgical strategy to prevent hemorrhagic manifestation in patients with MMD.

긴장형(緊張型) 두통(頭痛)의 임상양상(臨床樣相) 및 생체전기 자율반응과의 상관성(相關性) 고찰(考察) (The clinical manifestation of tension-type headache and correlation study with autonomic bioelectric response)

  • 정인태;이상훈;최도영
    • Journal of Acupuncture Research
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    • 제21권2호
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    • pp.183-203
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    • 2004
  • Objective : Tension-type headache is the most common headache. The objective of this study is to find the clinical manifestation of tension-type headache and correlation with autonomic bioelectric response. Methods : This observation was carried out on 60 patients with tension-type headache. We used headache questionnaire and the Autonomic Bioelectric Response recoder(ABR-2000) for this study. Results : 1. Distribution of sex & age : male : female=5 : 7, 50s&60s group (28.3%) 2. Duration of onset : over 5years(50%), over one years(83.4%) 3. Causes of illness : stress(58.3%), severe fatigue(53.5%), tension(33.3%) 4. Time of attack : irregular(56.7%), day time(16.7%) 5. Pattern of pain: heavy(31 people), stiffness of occipital region (27 people) tightening around the head(25 people) 6. Curve : 40%, 56.7%, 35.0% SL(Slope low) at peak 1, 2, 3/ SH&SI not found 7. Regulation : 16.7% RR(Regulation reverse) at peak 1, 25% RH(Regulation high) at peak 2, 15% RR(Regulation reverse) at peak 3 8. Graph : Activity-60.0%, 70.0%, 63.3% lowered reaction(L, LR, L!) at peak 1, 2, 3 Reactivity-83.3%, 95.0%, 93.3% lowered reaction at peak 1, 2, 3 Conclusion : We find tension-type headache has remarkable relativeness with autonomic bioelectric response.

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전신성 홍반성 루푸스 (Systemic lupus erythematosus)

  • 김광남
    • Clinical and Experimental Pediatrics
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    • 제50권12호
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    • pp.1180-1187
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    • 2007
  • Systemic lupus erythematosus (SLE) is an episodic, multi-system, autoimmune disease characterized by widespread inflammation of blood vessels and connective tissues and by the presence of antinuclear antibodies (ANAs), especially antibodies to native (double-stranded) DNA (dsDNA). Its clinical manifestations are extremely variable, and its natural history is unpredictable. Untreated, SLE is often progressive and has a significant fatality rate. The most widely used criteria for the classification of SLE are those of the American College of Rheumatology (ACR), which were revised in 1982 and modified in 1997. The presence of four criteria have been diagnosed as a SLE. Rashes are common at onset and during active disease. The oral mucosa is the site of ulceration with SLE. Arthralgia and arthritis affect most children and these symptoms are short in duration and can be migratory. Lupus nephritis may be more frequent and of greater severity in children than in adults. The initial manifestation of nephritis is microscopic hematuria, followed by proteinuria. The most common neuropsychiatric symptoms are depression, psychosis(hallucination and paranoia) and headache. CNS disease is a major cause of morbidity and mortality. Pericarditis is the most common cardiac manifestation. Libman-Sacks endocarditis is less common in children. The most frequently described pleuropulmonary manifestations are pleural effusions, pleuritis, pneunonitis and pulmonary hemorrhage. During the active phase ESR, CRP, gamma globulin, ferritin and anti-dsDNA are elevated. Antibodies to dsDNA occur in children with active nephritis. Antibodies to the extractable nuclear antigens (Sm, Ro/SS-A, La/SS-B) are strongly associated with SLE. Specific treatment should be individualized and based on the severity of the disease. Sepsis has replaced renal failure as the most common cause of death.

Patterns of ischemic injury on brain images in neonatal group B Streptococcal meningitis

  • Choi, Seo Yeol;Kim, Jong-Wan;Ko, Ji Won;Lee, Young Seok;Chang, Young Pyo
    • Clinical and Experimental Pediatrics
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    • 제61권8호
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    • pp.245-252
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    • 2018
  • Purpose: This study investigated patterns of ischemic injury observed in brain images from patients with neonatal group B Streptococcal (GBS) meningitis. Methods: Clinical findings and brain images from eight term or near-term newborn infants with GBS meningitis were reviewed. Results: GBS meningitis was confirmed in all 8 infants via cerebrospinal fluid (CSF) analysis, and patients tested positive for GBS in both blood and CSF cultures. Six infants (75.0%) showed early onset manifestation of the disease (<7 days); the remaining 2 (25.0%) showed late onset manifestation. In 6 infants (75%), cranial ultrasonography showed focal or diffuse echogenicity, suggesting hypoxic-ischemic injury in the basal ganglia, cerebral hemispheres, and periventricular or subcortical white matter; these findings are compatible with meningitis. Findings from magnetic resonance imaging (MRI) were compatible with bacterial meningitis, showing prominent leptomeningeal enhancement, a widening echogenic interhemisphere, and ventricular wall thickening in all infants. Restrictive ischemic lesions observed through diffusion-weighted imaging were evident in all eight infants. Patterns of ischemic injury as detected through MRI were subdivided into 3 groups: 3 infants (37.5%) predominantly showed multiple punctuate lesions in the basal ganglia, 2 infants (25.0%) showed focal or diffuse cerebral infarcts, and 3 infants (37.5%) predominantly showed focal subcortical or periventricular white matter lesions. Four infants (50%) showed significant developmental delay or cerebral palsy. Conclusion: Certain patterns of ischemic injury are commonly recognized in brain images from patients with neonatal GBS meningitis, and this ischemic complication may modify disease processes and contribute to poor neurologic outcomes.