• Title/Summary/Keyword: Clinical recovery pattern

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A Study of Renogram in Korean Hemorrhagic Fever (한국형(韓國型) 출혈열(出血熱)에서의 Renogram에 대(對)한 연구(硏究))

  • Choi, Tae-Kyu;Lee, Jung-Sang;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.8 no.1_2
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    • pp.13-24
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    • 1974
  • The patterns of renogram in patients with Korean hemorrhagic fever were evaluated with clinical course and renal hemodynamic changes in various clinical stages. The renal plasma flow was measured by hippuran blood clearance using $^{131}I$-ortho-iodohippurate and hippuran renogram was analysed by means of quantitative and qualitative methods in 26 patients of Korean hemorr hagic fever. The results obtained with this study were as follows; 1. During the oliguric phase of Korean hemorrhagic fever, the renogram showed non-functioning (flat) or obstructive pattern. The group of patients with non-functioning pattern of renogram had more severe impairement of renal function and grave prognosis than the group with obstructive pattern of renogram. 2. During the diuretic phase, the renogram showed obstructive or dysfunction or normal pattern, which was related with the recovery of renal function. Obstruction pattern of renogram was observed till the 2nd week of diuretic phase. Normal pattern of renogram began to appear by the 2nd week of diuretic phase. 3. During the convalescent phase of Korean hemorrhagic fever, 40% of patients showed dysfunnction pattern of renogram, and the recovery of abnormal renogram in Korean hemorrhagic fever was more delayed than the recovery of clinical features and laboratory findings. 4. The renogram showed normal pattern 6 months after onset of Korean hemorrhagic fever in all cases. 5. There was significant correlationship between the pattern of renogram and the decreace of renal plasma flow in the patients with Korean hemorrhagic fever. The decreace of renal plasma flow was maked in the patients with non-functioning pattern of renogram and was least in the patients with dysfunction pattern of renogram. All above results suggested that the renogram reflects the effective renal plasma flow and degree of renal impairement, and the renogram may be one of the important indexes which could give us a more precise prognosis in Korean hemorrhagic fever.

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Results of Microvascular Decompression in Hemifacial Spasm (편측안면경련에서 미세혈관감압술의 성적)

  • Kwak, Hyoung Jun;Kim, Jae Hyoo;Lee, Jung Kil;Kim, Tae Sun;Jung, Shin;Kim, Soo Han;Kang, Sam Suk;Lee, Je Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.501-508
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    • 2001
  • Objectives : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. Patients and Methods : From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. Results : The ratio of male to female was 1:1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). Conclusion : In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.

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Japanese-B Viral Encephalitis with a Biphasic Illness Pattern and Recovery after Intravenous Immunoglobulin Therapy (이상성 경과를 보이고 정맥면역글로불린 치료 후 호전된 일본뇌염)

  • Lee, Byung-Chan;Jeon, Ji Ye;Moon, Hye-Jin;Lim, Jeong Geun;Cho, Yong Won
    • Annals of Clinical Neurophysiology
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    • v.16 no.1
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    • pp.35-38
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    • 2014
  • Japanese-B viral encephalitis (JE) usually has a monophasic illness pattern. A 45-year-old woman in an altered mentality had improved over 1 month. About 1 week after the initial improvement, the patient became comatose with aggravated EEG and MRI findings. Assays of cerebrospinal fluid and serum were positive for the IgM antibody to Japanese-B virus. After intravenous immunoglobulin (IVIG) infusion, the patient recovered. We report a patient with JE who showed a biphasic illness pattern and recovered after IVIG therapy.

The Clinical Efficacy of Yangkyuksanwha-tang on Acute Stroke (급성기 중풍 환자에 대한 양격산화탕의 임상적 효능)

  • 최동준;류순현;정우상;문상관;조기호;김영석;배형섭
    • The Journal of Korean Medicine
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    • v.25 no.1
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    • pp.111-116
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    • 2004
  • Objective : To assess the clinical efficacy of Yangkyuksanwha-tang on acute stroke Methods : We prescribed Yangkyuksanwha-tang to 83 acute stroke patients without thrombolytic treatment. Results : The rate of progressive stroke type was 1.2%, it was remarkably lower than previous reports. 3.6% felt an itching sensation, 3.6% complained headache, dizziness and powerless, 2.4% complained indigestion and diarrhea, 1.2% appeared hematuria and G-I bleeding. Yangkyuksanwha-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale(NIHSS), and increased Modified Barthel Index(MBI). So we could suggest that this medicine have desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, all results were within the normal value, which showed no hepatic or renal toxicity. Conclusion : We could suggest that Yangkyuksanwha-tang is a useful medicine which has clinical efficacy for acute stroke, but further investigation for an administration of more than 2 weeks is necessary.

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Factors Influencing Visual Field Recovery after Transsphenoidal Resection of a Pituitary Adenoma

  • Lee, Dong Kyu;Sung, Mi Sun;Park, Sang Woo
    • Korean Journal of Ophthalmology
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    • v.32 no.6
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    • pp.488-496
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    • 2018
  • Purpose: This study aimed to analyze the factors influencing visual field recovery after transsphenoidal approach-tumor resection (TSA-TR) in pituitary adenoma patients with visual field defects (VFDs). Methods: We retrospectively evaluated 102 eyes of 102 patients with VFDs induced by pituitary adenomas who underwent TSA-TR between January 2010 and December 2015. All patients had been observed for more than one year. The severity of the VFD in each patient was evaluated using the mean deviation (MD) and pattern standard deviation in the most-affected eye. Clinical and demographic data such as preoperative visual acuity and visual field, age, sex, tumor volume, neurological symptoms at diagnosis, duration of symptoms, patterns of the preoperative VFD, and preoperative central VFD were investigated and analyzed for association with recovery of the visual field. Results: Recovery from VFDs occurred in 71 (69.6%) eyes after a mean period of $18.36{\pm}5.21$ months. The recovery group was younger (p = 0.003), had higher preoperative MD values (p = 0.016), and had better preoperative visual acuity (p = 0.03), compared with the non-recovery group. Preoperative central VFD (p = 0.006) and preoperative bilateral VFD (p = 0.016) were significantly less frequent in the recovery group. Multivariate logistic regression revealed that age at diagnosis (odds ratio [OR], 0.962; p = 0.022), preoperative MD (OR, 1.069; p = 0.046), preoperative central VFD (OR, 0.212; p = 0.039), and preoperative bilateral VFD (OR, 0.212; p = 0.035) were associated with visual field recovery after TSA-TR. Conclusions: Younger age, higher preoperative MD, and the preoperative abscence of central VFD or bilateral VFD were favorable factors influencing visual field recovery after TSA-TR in patients with pituitary adenomas. An understanding of the associated clinical factors may help predict visual outcomes after TSA-TR in pituitary adenoma patients with VFDs.

Characteristics of Gait and Motor Function Recovery in Quadriplegia Patients with Cerebellar Injury (소뇌 손상에 의한 사지 마비 환자의 보행 및 운동 기능 회복 양상 연구)

  • Sang-Seok Yeo
    • PNF and Movement
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    • v.21 no.3
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    • pp.327-335
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    • 2023
  • Purpose: Cerebellar injury can be caused by a variety of factors, including trauma, stroke, and tumor. Cerebellar injury can manifest in different clinical symptoms and signs depending on the size and location of the injury. The purpose of this study was to examine and compare the recovery patterns of each motor function by tracking the motor levels of patients with cerebellar injury. Methods: This study recruited 11 patients with quadriplegia resulting from cerebellar injury. The motricity index (MI), modified Brunnstrom classification (MBC), and functional ambulation category (FAC) methods were used to evaluate motor levels. The motor function evaluation was performed immediately after the onset of the condition and at intervals of one month, two months, and six months after onset. Results: The MI values of the upper and lower extremities and hand function (MBC) indicated severe paralysis in the early stages of onset. Compared to the onset time, significant motor function recovery was observed after 1, 2, and 6 months (p < 0.05). In contrast, there was no significant pattern of recovery between 1, 2, and 6 months after onset (p > 0.05). FAC indicated showed significant recovery at one month compared to onset (p<0.05), and there was also a significant difference between 1 and 2 months (p < 0.05). On the other hand, there was no significant difference in FAC between 2 and 6 months (p > 0.05). Conclusion: Patients with cerebellar injury showed significant recovery in functions related to muscle strength and voluntary muscle control one month after onset and gradually recovered further over the next six months. On the other hand, gait function, which is closely related to balance, showed a relatively slow recovery pattern from the beginning of the disease to the six month follow-up.

The Clinical Efficacy of Chungpyesagan-tang on Acute Stroke (급성기 중풍 환자에 대한 청폐사간탕의 임상적 효능)

  • 최동준;정우상;문상관;조기호;김영석;배형섭
    • The Journal of Korean Medicine
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    • v.23 no.4
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    • pp.9-14
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    • 2002
  • To assess the clinical efficacy of Chungpyesagan-tang on acute stroke, we prescribed this medicine to 88 acute stroke patients without thrombolytic treatment. The rate of progressive stroke type was 2.3%, remarkably lower than in previous reports. 1.1 % felt an itching sensation, and 17.0% complaxined of loose stool and diarrhea. Chungpyesagan-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale (NIHSS), and increased Modified Barthel Index (MBI). Thus, we could suggest that this medicine has a desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, ALT had anupward tendency and increased over normal value in 16 cases (18.2%). However, the mean serum level 2 weeks later was within the normal value and the other hepatic enzymes did not increase.

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Clinical Course according to Antipsychotics Prescription Pattern in Delirium (섬망 환자에서 항정신병약물 처방 유형에 따른 임상 경과의 차이)

  • Park, Jaesub;Kim, Jae-Jin;Park, Sungjong;Kim, Sungmin;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.120-128
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    • 2017
  • Objectives : Although antipsychotics are commonly used to control symptoms of delirium, there is a lack of research on the prescription pattern and its clinical effects. The purpose of this study was to investigate the effect of antipsychotics prescription pattern on clinical course of delirious patients consulted to psychiatry. Methods : During the period from July 2016 to February 2017, 212 patients who were referred for delirium were reviewed for their medical records. The duration of delirium was monitored using CAM-ICU, and duration of admission, mortality, and delirium at discharge were reviewed. Clinical course was compared among three groups according to the antipsychotic drug administration pattern: Continuous use group, optimal use group and PRN use group. Results : The pattern of taking antipsychotic medication longer than duration of delirium did not associated with better clinical course compared with the pattern of adapting to the period of delirium and rather increased the risk of taking antipsychotic medication at discharge. When used for a shorter period than the delirium period, it was associated with poor clinical course. Conclusions : The results of this study suggest that a strategy to administer antipsychotics for a minimum period, according to periods of delirium, is appropriate. Also, efforts are needed to minimize the use of antipsychotic drugs after recovery from delirium.

The Clinical Observation of Digital Infrared Thermographic Imaging on Bell`s palsy (DITI 진단을 통한 Bell`s palsy의 임상적 고찰)

  • Park, Kyung-hwa;Kim, Jong-han;Hwang, Choong-yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.11 no.1
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    • pp.23-39
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    • 1998
  • The clinical data and thermographic imaging were analyzed on the 100 cases of Bell's palsy who were treated in the Kwang-Ju Oriental Medical Hospita! of Wonkwang University from February to October 1997. All the cases were taken Digital Infrared Thermograph Imaging(DITI) before treatment and 30 cases of them were taken follow up imaging again after recovery. And the following results were obtained. 1. Of 100 cases, under teenager occupied $1\%,\;teenager\;8\%,\;2nd\;decade\;14\%,\;3rd\;decade\;11\%,\;4th\;decade\;16\%,\;5th\;decade\;26\%,\;6th\;decade\;16\%,\;7th\;decade\;7\%\;and\;over\;80\;occupied\;1\%$. 2. Male occupied $48\%$ and female occupied $52\%$. 3. $42\%\;of\;male\;and\;23\%$ of female had the affected side at left side. And right facial nerve palsy occured at $29\%\;of\;male\;and\;29\%$ of female. 4. The most common cause of Bell's palsy was cold wind $18\%$, and the next were excessive labor $15\%,\;stress\;12\%,drinking\;2\%\;and\;cold\;food\;1\%$. 5. Thermal pattern were present as hyperthermal pattern in $44\%$ and hypothermal pattern in $22\%$. 6. The DITI showed hyperthermal pattern as close as to the onset day and changes to hypothermal pattern as times passed. 7. The DITI pattern and post-auricular pain, the most common prodomal syndrome, showed no significant relationship. 8. The relationship between the grade of paralysis and thermal patttern of DITI showed no significance. 9. Mean temperature of loci in affected side indicrtted $30.27^{\circ}C\;at\;Yang\;baek,\;30.02^{\circ}C\;at\;Taeyang,\;29.25^{\circ}C\;at\;Geoyo,\;29.62^{\circ}C\;at\;Jichang,\;29.78^{\circ}C\;at\;Hakwan,\;29.61^{\circ}C\;at\;Hyupgeo,\;and\;30.59^{\circ}C$at Yeopoong. 10. Mean temperature of loci in unaffected side showed $30.16^{\circ}C\;at\;Yang\;baek,\;30.02^{\circ}C\;at\;Taeyang,\;29.61^{\circ}C\;at\;Geoyo,\;29.68^{\circ}C\;at\;Jichang,\;29.70^{\circ}C\;at\;Hakwan,\;29.57^{\circ}C\;at\;Hyupgeo,\;and\;29.89^{\circ}C$at Yeopoong. 11. Of 30 cases who were taken follow up imaging again after recovery, the relationship between delta T at loci and symptoms showed no significance. It should be needed further investigation in order to apply them for clinical evaluation.

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Study on Clinical Diseases of Yang Deficiency Pattern (양허증(陽虛證)의 임상적 질환 범위에 대한 고찰)

  • Park, Mi Sun;Ki, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.2
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    • pp.153-166
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    • 2013
  • Yang deficiency pattern is a representative syndrome differentiation. This article is a study on to which categories of modern diseases yang deficiency is assigned by reference to modern clinical papers and the meaning of yang deficiency interpreted with a perspective of Korean Medicine and a modern perspective. Yang deficiency, yang qi deficiency, lack of yang qi and yang qi debilitation are the words found in "Nei Ching" and yang qi can be interpreted as something to warm, drive and arouse. Zhangzhongjing considered recovery or loss of Yang as the key to life in "Shanghanlun". Danxi proposed "Yang being liable to hyperactivity, Yin being insufficient" and emphasized pathological ministerial fire of Yang exuberance rather than physiological ministerial fire of Yang deficiency. Zhangjingyue proposed "Yang not being in excess, Yin being often deficient" and understood growth and decline of yin qi are all led by yang qi and put emphasis on true yin in addition to yang qi. Diseases of yang deficiency pattern are related with decline of metabolic level, hypofunction of internal secretion, disorder of immune function, disorder of automatic nerve system, sympathetic nerve inhibition, metabolic disorder of microelements, increase of cGMP, change of microcirculation, low speed of blood stream, kidney malfunction. Diseases related with kidney are sterility, polycystic ovary syndrome, spinal stenosis, edema, renal failure, IgA nephropathy, erectile dysfunction, nephritis, prostatitis, benign prostatic hyperplasia, decrease of adrenal cortical hormone by nephrotic syndrome, myelodysplastic syndrome. Disease related with heart are heart failure, arrhythmia, cardiomyopathy, atherosclerosis heart disease, hypertension, hyperlipidemia, pulmonary heart disease. Diseases related with spleen are irritable bowel syndrome, ulcerative colitis. Diseases related with liver are hypothyroidism, liver cirrhosis ascites, hepatitis B, chronic hepatitis, hepatic diabetes. Diseases related with lung are allergic rhinitis, cough variant asthma, bronchial asthma, pulmonary emphysema. And diabetes mellitus, metabolic syndrome, aplastic anemia, headache, encephalatrophy, Alzheimer's disease are also related with yang deficiency.