• Title/Summary/Keyword: Hemorrhagic

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A Case Report of Traditional Korean Medicine for Left Anterior Cerebral Artery (ACA) Infarction and Hemorrhagic Transformation with Hemiplegia and Urinary Disturbance (한방치료로 호전된 반신부전마비, 배뇨장애를 동반한 좌측 앞대뇌동맥 출혈성 뇌경색 환자의 치험 1례)

  • Yang, Jee-yun;Kim, Min-sung;Jeong, Taek-su;Bang, Chan-hyuck;Mo, Min-ju;Kwon, Do-ick;Choi, Min-gi
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.786-795
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    • 2016
  • Objective: To evaluate the effectiveness of traditional Korean medicine treatment (TKM) on a patient with ACA infarction and hemorrhagic transformation with hemiplegia and urinary disturbance. Methods: A patient diagnosed with left anterior cerebral artery (ACA) infarction and hemorrhagic transformation was treated with electroacupuncture, moxibustion, and herbal medicine. Results: Improvements in the Manual Muscle Test (MMT), modified Barthel Index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), and K-MMSE were observed following the TKM treatment [MMT Gr. (3/0)→Gr. (4+/4+), MBI 20→89, NIHSS 8→2, mRS 5→1, MMSE-K 21→28]. Conclusion: TKM treatment could help improve the symptoms of patients with ACA infarction and hemorrhagic transformation.

A clinical Report on two cases of Hemorrhagic infarction patients (출혈성 뇌경색 환자 2례에 대한 임상적 고찰)

  • Jung, Soo-Mi;Kim, Sung-Jin;Kim, Bang-Ul;Jun, Sang-Yun;Hong, Seok;Kim, Haeng-Jin
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.177-185
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    • 2004
  • This study was designed to analyze the effectiveness of the diagnosis and treatments of hemorrhagic infarction patients in oriental medicine. In this study the clinical symptoms of two hemorrhagic infarction patients improved after diagnosis and treatment of oriental medicine. Though improvement was seen after diagnosis and treatment of both hemorrhagic infarction patients, the early stage of hemorrhagic infarction required western fluid therapy treatments. Study of more cases will be needed in order to varify efficacy for these oriental treatments to be generally applied.

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Comparative Analysis of Specific Factors for Hemorrhagic and Ischemic Stroke (출혈성 뇌졸중과 허혈성 뇌졸중의 특정인자 비교분석)

  • Yoo, Young-Dae;Kim, Yong-Nam
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.19-29
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    • 2002
  • This study questionnaires 166 inpatients and outpatients with stroke in 8 hospitals, including Wonkwang University Gwangju Korean Hospital from July 2 to 31, 2001 in order to find out the influence of general nature, smoking, drinking, obesity, and perception of saltness of patients with stork on the outbreak of stroke and to examine important factors by dividing into hemorrhagic and ischemic stroke. Finally, collected data is analyzed statistically, using SPSS 7.5 statistics package. This study reaches a conclusion as follows. 1. For general nature, 86(51.8%) patients have hemorrhagic stroke and 80(48.2%), ischemic stroke in the rate of 1.59:1(male:female), suggesting that male's outbreak is more than female's. Outbreak age is ranged from 20 years to 90 years in order of 60's, 50's, and 40's. 50's-60's accounts for more than half percentage. 2. For smoking, 73(71.6%) of male patients has smoking experience and their 562% has ischemic stroke. Their cross-analysis for hemorrhagic and ischemic stroke shows significant difference with $x^2=3.90$(p<0.05). 48.6% of patients with smoking experience is ranged from 1 to 10 a day in smoking quantity. 3. For drinking, 90(88.2%) of male patients has drinking experience and their 53.3% has hemorrhagicstroke. Their cross-analysis for hemorrhagic and ischemic stroke shows no significant difference with x2=3.40(p<0.1). 59.3% of patients with drinking experience is classified as a overdrinking group. 4. For obesity, low weight is 8(4.8%): normal, 111(66.9%): excessive, 40(24.1%), and obesity, 7(4.2%). In patients with hemorrhagic stroke, excessive weight and obesity are somewhat high(33.7%). The cross-analysis for male's hemorrhagic and ischemic stork by dividing BMI into more and less than 25 shows no significant difference with x=3.52(p<0.1). 5. For perception of saltness, 21(12.7%) patients eat flat: 76(45.8%) normally, and 69(41.5%), saltily. Many patients with ischemic stroke are classified as a group who eat saltily. The cross-analysis for male's hemorrhagic and ischemic stroke shows signifiant difference with x2=10.99(p<0.05). As this study has small sample and selects inpatient and outpatient in certain local hospital, it is difficult to generalize. But the cross-analysis of male's hemorrhagic and ischemic stroke shows signifiant difference in smoking and perception of saltness. Drinking and obesity are more important factors in hemorrhagic stroke and smoking and perception of saltness in ischemic stroke.

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Effect of Therapeutic Hypercapnia on Systemic Inflammatory Responses in Hemorrhagic Shock in Rats (랫드의 출혈성 쇼크 모델에서 치료적 고탄산혈증이 전신적 염증 반응에 미치는 영향)

  • Kang, Kyeong Won;Jo, You Hwan;Kim, Kyuseok;Lee, Jae Hyuk;Rhee, Joong Eui
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.17-24
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    • 2012
  • Purpose: This study was performed to investigate whether therapeutic hypercapnia could attenuate systemic inflammatory responses in hemorrhagic shock in rats. Methods: Male Sprague-Dawley rats were mechanically ventilated and underwent pressure-controlled (mean arterial pressure: $38{\pm}1$ mmHg) hemorrhagic shock. At 10 minutes after the induction of hemorrhagic shock, the rats were divided into the normocapnia ($PaCO_2$=35-45 mmHg, n=10) and the hypercapnia ($PaCO_2$=60-70 mmHg) groups. The $PaCO_2$ concentration was adjusted by using the concentration of inhaled $CO_2$ gas. After 90 minutes of hemorrhagic shock, rats were resuscitated with shed blood for 10 minutes and were observed for 2 hours. The mean arterial pressure (MAP) and the heart rate were monitored continuously, and the results of arterial blood gas analyses, as well as the plasma concentrations of interleukin (IL)-6, IL-10, and nitrite/nitrate were compared between the normocapnia and the hypercapnia groups. Results: The MAP and the heart rate were not different between the two groups. The plasma concentration of IL-6 was significantly lower in the hypercapnia group than in the normocapnia group (p<0.05). The IL-10 concentration was not different and the IL-6 to IL-10 ratio was significantly lower in the hypercapnia group compared to the normocapnia group. The plasma nitrite/nitrate concentration of the hypercapnia group was lower than that of the normocapnia group. Conclusion: Therapeutic hypercapnia attenuates systemic inflammatory responses in hemorrhagic shock.

Rare Form of Schwannoma as a Purely Hemorrhagic Cystic Tumor Located in an Intermuscular Plane

  • Lim, Joo Hee;Shim, Jae-Chan;Yoon, Byung-Ho;Kang, Yun Kyung;Lee, Kyoung Eun;Kim, Ho Kyun;Lee, Ghi Jai;Suh, Jung Ho
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.1
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    • pp.38-42
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    • 2017
  • Schwannomas are mostly solid tumors, some of which may contain cystic degenerations or hemorrhages. However, a schwannoma seen as a purely hemorrhagic cystic tumor is very rare. A 63-year-old woman was referred to the hospital due to a slow-growing mass (present for about 5 years) on her right thigh. She complained about vague pain but without neurologic symptoms such as numbness or tingling sensations. MR images showed an oval lesion with defined margins surrounded by the rectus femoris, vastus lateral, and the vastus intermedius. It was characterized as a multilocular cystic lesion composed of hemorrhagic fluid. In addition, the benign hemorrhagic cystic lesion was differentially diagnosed by radiological techniques as a hemorrhagic ganglion cyst. The lesion was surgically excised and, based on pathological features, was diagnosed as being a schwannoma. We report a purely hemorrhagic cystic schwannoma located in an intermuscular plane.

Differences in Clinical Characteristics and Surgical Outcomes of Patients with Ischemic and Hemorrhagic Pituitary Adenomas

  • Jingpeng, Liu;Peng, Huang;Xiaoqing, Zhang;Yong, Chen;Xin, Zheng;Rufei, Shen;Xuefeng, Tang;Hui, Yang;Song, Li
    • Journal of Korean Neurosurgical Society
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    • v.66 no.1
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    • pp.72-81
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    • 2023
  • Objective : Ischemia and hemorrhage of pituitary adenomas (PA) caused important clinical syndrome. However, the differences on clinical characteristics and surgical outcomes between these two kinds apoplexy were less reported. Methods : A retrospective analysis was made of patients with pituitary apoplexy between January 2013 and June 2018. Baseline and clinical characteristics before surgery were reviewed. All patients underwent transsphenoidal surgery and were followed up at least 1 year. Results : Total 67 cases (5.8%) among 1147 pituitary tumor patients were enrolled, which consisted of 28 (~2.4%) ischemic PA and 39 (~3.4%) hemorrhagic PA. There were more male patients in the ischemic group compared with hemorrhagic group (78.6% vs 53.8%, p=0.043). However, the mean age, tumor size and functional tumor ratio were significant higher in the hemorrhagic group. Headache was more common in ischemic PA (82.1%) than that of hemorrhagic PA (51.3%, p=0.011). Magnetic resonance imaging findings found that mucosal thickening and enhancement of the sphenoid sinus was observed in 15 ischemic PA patients (n=27, 55.6%), but none in patients with hemorrhagic PA (n=38, p<0.0001). It was worth noting that the rate of pre-surgical hypopituitarism in ischemic PA patients were seemed higher than that in hemorrhagic PA patients, but not significant. The two groups got a total tumor resection rate at 94.1% and 92.9%, independently. No significant difference on the operative time, blood loss in operation and complications in perioperative period was observed in two groups. After operation, cranial nerve symptoms recovered to normal at 81.8% of ischemic PA patients and 82.6% of hemorrhagic PA patients. Importantly, the incidence of postoperative hypopituitarism partially decreased in both groups, among which the rate of hypothyroidism in ischemic PA patients significantly decreased from 46.4% to 18.5% (p=0.044). Conclusion : Patients with ischemic PA presented different clinical characteristics to the hemorrhagic ones. Transsphenoidal surgery should be considered for the patients with neuro-ophthalmic deficits and might benefit for pituitary function recovery of the apoplectic adenoma patients, especially pituitary thyroid axis in ischemic PA patients.

Clostridium perfringens Type A Infection in a Hippopotamus amphibius Cub (새끼 하마에서 Clostridium perfringens Type A 감염 증례)

  • Kim, Young-Seob;Lim, Suk-Kyung;Shin, Nam-Shik
    • Journal of Veterinary Clinics
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    • v.25 no.4
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    • pp.310-313
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    • 2008
  • C. perfringens is the most important enteric clostridial pathogen of animals. C. perfringens type A has been associated with hemorrhagic enteritis in a wide lange of domestic and wild mammals. But all types of C. perfringens can be normal inhabitants of the intestine of most mammals. We have a special case that showed C. perfringens type A infection in a hippopotamus (Hippopotamus amphibius) cub at Seoul Grand Park Zoo. Male, hippopotamus cub died in 3 days after birth. Clinical features of the hippopotamus cub have showed lethargy and anorexia before death. Gross post-mortem findings of the hippopotamus were hemorrhagic enteritis of intestine. Histopathologically, ruminant stomach and intestine showed hemorrhagic lesions and the lumen of the small intestine was filled with mucoid and hemorrhagic fluid. Also, intestine and stomach of hippopotamus were distended with gas and hemorrhagic fluid. C. perfringens was isolated in culture of small intestine and the presence of C. perfringens type A was confirmed by PCR. This case indicated that C. perfringens type A could be considered as a virulence factor responsible for causing death of a newborn hippopotamus.

Experimental study on the changes of serum free fatty acid and blood sugar during hemorrhagic shock (출혈성(出血性) Shock 에 출현(出現)되는 유리지방산(遊離脂肪酸) 및 혈당량(血糖量)의 변동(變動)에 관(關)하여)

  • Kim, Hyong-Se
    • The Korean Journal of Pharmacology
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    • v.2 no.1 s.2
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    • pp.99-109
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    • 1966
  • It has been known that the pronounced hypotension resulting from hemorrhage gives rise to compensatory stimulation of the adrenosympathetic system, which leads to an increase of liberation of catecholamines from sympathetic nervous system and adrenal medulla. It is obvious, therefore, that numerous physiological and biochemical changes during the hemorrhagic hypotention might be mediated through the increased liberation of catecholamines. Although an extensive studies have been reported on changes of protein and carbohydrate metabolism in hemorrhagic shock a few studies on the changes of lipid metabolism have been reported. Levenson(1961) observed a marked increase of serum lipids content during hemorrhagic shock and also noticed a marked elevation of serum free fatty acids. He suggested that these effects were due to mobilization and accelerated metabolic breakdown of lipids which might be resulted by sympathetic stimulation as a cause. To elucidate the mechanism of this, author studied the change of serum free fatty acids and blood sugar with relation to catecholamines during experimentally induced hemorrhagic shock in dog. Healthy male mongrel dogs weighing approximately 15kg were used. Under the general anesthesia with pentobarbital, rapid hemorrhage was produced from the femoral artery maintaining blood pressure level of 40 mmHg measured by the manometer connected with the opposite femoral artery throughout the experiment. Serum free fatty acids(FFA) and blood sugar were measured by the methods of Dole(1956) and Folin-wu,(1920) respectively. Tissue catecholamine was measured by Shore and Olin method(1958) using Aminco-Bowman spectrophotofluorometer.

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Studies on the Clostridium perfringens type C infection of pig in Korea (국내(國內) 돼지의 Clostridium perfringens type C 감염증에 관한 연구)

  • Yeh, Jae-gil;Park, Kyoung-yoon;Cho, Soung-kun
    • Korean Journal of Veterinary Research
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    • v.33 no.3
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    • pp.419-427
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    • 1993
  • Thirteen strains of Clostridium perfringens were isolated from the pigs with hemorrhagic enteritis. The characteristics of the outbreaks, clinical signs and lesions were examined. The biochemical properties, type of toxin and susceptibility to antimicrobial agents of the isolates were investigated. The results could be summarized as follows ; 1. Almost of the pigs affected with hemorrhagic enteritis, 17 cases examined from 1989 to 1992, were piglets less than 7 day old. 2. The average mortality rate of piglet less than 7 day old affected with hemorragic and necrotic enteritis was 48.5%. 3. The clinical signs of pigs with hemorrhagic enteritis were depression, hemorrhagic diarrhea, anemia and dehydration. Necropsy of the infected pigs showed typical hemorrhage of upper intestine and necrosis of mucosal membrane. 4. The characteristic biochemical properties of the isolates were 2-band hemolysis, positive reaction of reverse CAMP test and formation of LV precipitate in egg yolk medium. 5. The toxin type of the 13 isolates, investigated by mouse inoculation test, was all type C strains of Clostridium perfringens. 6. In susceptibility test to antimicrobial agents, 13 isolates of Clostridium perfringens were highly sensitive to ampicillin, enrofloxacin(Baytril), cephalothin, penicillin and trimethoprim-sulfamethoxazole.

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Hemorrhagic Moyamoya Disease : A Recent Update

  • Fujimura, Miki;Tominaga, Teiji
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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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.