• 제목/요약/키워드: Stroke Treatment

검색결과 1,246건 처리시간 0.049초

갑상선기능항진증(甲狀線機能亢進症)에서 좌심실용적(左心室容積) 및 기능변화(機能變化)에 관한 연구(硏究) (Effects of Thyroid Hormone on Left Ventricular Volume and Function in Hyperthyroidism)

  • 이명철;고창순
    • 대한핵의학회지
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    • 제17권2호
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    • pp.1-17
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    • 1983
  • The purpose of this study is to investigate the effects of thyroid hormone on the left ventricular(LV) volume arid function in man with untreated hyperthyroidism and to determine the effects of successful therapy for thyrotoxicosis on the ventricular pathophysiology. In the present study, equilibrium radionuclide cardiac angiography was performed and LV volume index, ejection phase indexes of LV performance, serum thyroid hormone levels and other hemodynamic parameters were measured in 28 normal subjects and 39 patients with hyperthyroidism before treatment and again every 4 weeks for the first 2 months after the initiation of effective therapy. The results obtained were as follows; 1) In the untreated hyperthyroid state heart rate, blood volume, cardiac index and stroke volume index($97{\pm}14$ beats/min, $73.5{\pm}11.8ml/kg,\;6.9{\pm}1.4\;l/min/m^2$ and $77.6{\pm}13.8ml/m^2$, respectively) were increased significantly compared to those in normal control($74{\pm}12beats/min$, $66.6{\pm}14.8ml/kg,\;3.8{\pm}1.2\;l/min/m^2$ and $56.6{\pm}13.2ml/m^2$ respectively). $(Mean{\pm}SD)$ 2) There was a significant increase in LV end-diastolic volume index in patients with hyperthyroidism ($30.5{\pm}7.5$ for hyperthyroid group compared to a normal control of $22.2{\pm}6.5$; p<0.001), whereas end-systolic volume index remained unchanged $9.6{\pm}3.6\;and\;8.8{\pm}3.3$ respectively).3) In patients with hyperthyroidism, LV ejection fraction was $70.0{\pm}5.6%$, fractional shortening $32.9{\pm}5.1%$, mean velocity of circumferential fiber shortening(mean Vcf) $1.34{\pm}0.31$ circ/sec and maximum ejection rate $3.47{\pm}0.80$. All the ejection phase indexes were significantly greater than those in normal control($65.2{\pm}5.7%,\;28.8{\pm}3.2%,\;0.88{\pm}0.37$ circ/see and $2.27{\pm}0.50$, respectively; p<0.001). 4) Effective therapy produced significant decrease in all the values of serum thyroid hormone concentrations(p<0.00l), hemodynamic parameters(p<0.001), end-diastolic volume index(p<0.01) and ejection phase indexes of LV contractility in patients with hyperthyroidism and after one to two months, when the patients were euthyroid, these measurements were in the range of normal. 5) A significant linear correlation between mean Vcf and serum thyroxine level(r=0.63, p<0.001) as well as between mean Vcf and serum triiodothyronine level(r=0.62, p<0.001) was found. The lesser degree of correlation was also noted between other ejection phase indexes and serum thyroid hormone concentrations. The results indicate that the major effects of excess thyroid hormone on the LV in human beings with hyperthyroidism are an enhancement of LV function and an increase in LV enddiastolic volume and that these effects cause predictable reversible cardiac alteration which are changed dramatically and immediately after effective therapy.

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청국장 에탄올 추출물의 혈관내피세포 증식과 이동 촉진효과 (Ethanol Extracts of Chungkookjang Stimulate the Proliferation and Migration of Human Umbilical Vascular Endothelial Cells)

  • 황재성;성대일;이환명;정영신;김한복
    • 미생물학회지
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    • 제50권3호
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    • pp.223-226
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    • 2014
  • 청국장은 대두발효식품으로 대두 단백질이 발효 중 분해되면서 다양한 생리활성물질이 만들어진다. 혈관내피세포는 혈관의 기능은 물론 신생혈관 생성을 주도하는 세포이다. 뇌졸중이나 심근경색, 뇌경색 등의 혈관관련 질병들은 신생혈관 생성을 촉진하는 치료법이 필요하다. Vascular Endothelial Growth Factor (VEGF)는 새로운 혈관 형성을 촉진하는 역할을 한다. 본 연구에서는 청국장 에탄올추출물(CEE)이 HUVEC (혈관 내피세포) 증식에 미치는 영향을 조사하여 보았다. 청국장 추출물(100, $1000{\mu}g/ml$)을 HUVEC에 처리했을 때, VEGF (10 ng/ml)를 처리한 대조군과 같은 정도로 세포를 증식시켰다. 열처리한 청국장추출물을 혈관 내피세포에 처리해도 세포 증식효과는 마찬가지였다. 청국장이 세포 증식뿐 아니라 HUVEC이동에도 영향을 주는지 sprout 분석법으로 확인하였다. 청국장 추출물($100{\mu}g/ml$)을 처리했을 때, VEGF (10 ng/ml)와 비슷할 정도로 HUVEC 이동이 일어났다. 청국장 추출물에서 HUVEC 증식과 이동에 영향을 미치는 특정 peptide의 분리가 필요할 것이다.

Cilostazol에 의한 뇌혈관내피세포의 세포이동 증진 효과연구 (Cilostazol Promotes the Migration of Brain Microvascular Endothelial Cells)

  • 이세원;박정화;신화경
    • 생명과학회지
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    • 제26권12호
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    • pp.1367-1375
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    • 2016
  • Cilostazol은 phosphodiesterase III의 선택적 저해제로 알려져 있으며, 뇌졸중 치료에 일반적으로 사용되고 있다. Cilostazol을 처리한 경우, 국소 뇌허혈이 발생한 후에 혈관신생을 통해서 혈관형성이 향상된다는 것을 본 연구자들이 발표하였다. 혈관신생은 조직의 허혈상태를 극복하기 위해서 혈관재생을 촉진하는 중요한 과정으로써, 혈관내피세포의 증식, 이동, 모세관구조 형성의 다단계 과정으로 구성되어 있다. 이에 본 연구에서는 인간 뇌혈관내피세포를 이용하여 cilostazol이 혈관신생의 각 단계들에 어떤 영향을 미치는지 조사하였다. Cilostazol은 농도의존적으로 뇌혈관내피세포의 이동성을 촉진하였으나, 뇌혈관내피세포의 증식과 모세관구조 형성에는 영향을 미치지 않았다. Cilostazol이 세포이동을 조절하는 기전을 분석하기 위해서 cDNA microarray를 수행하였고, 세포이동에 관련성이 있는 5종의 후보 유전자들을 선택하여 real-time PCR을 통해 해당 유전자의 발현을 검증하였다. Cilostazol에 의해서 발현양이 조절되는 유전자들로써, phosphoserine aminotransferase 1 (PSAT1)와 CCAAT/enhancer binding protein ${\beta}$ ($C/EBP{\beta}$)은 발현이 증가하였고, tissue factor pathway inhibitor 2 (TFPI2), retinoic acid receptor responder 1 (RARRES1), RARRES3는 발현이 감소하였다. 이상의 결과를 통해서 cilostazol이 혈관내피세포의 이동을 촉진하여 혈관신생을 향상시킬 수 있음을 제안할 수 있으며, 뇌혈관내피세포에 대한 cilostazol의 조절기전에 대해서 더욱 상세히 규명을 한다면 혈관형성을 통하여 허혈성 질환을 치료할 수 있는 유용한 정보가 될 것으로 기대한다.

우울증 치료의 중의학 최신 임상연구 동향-무작위 대조군 임상연구와 체계적 문헌 고찰을 중심으로- (Review of Recent Clinical Trials for Depression in Traditional Chinese Medicine-Based on Randomized Controlled Trials and Systematic Reviews-)

  • 우정아;남유진;박윤진;권영규
    • 동의생리병리학회지
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    • 제29권6호
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    • pp.458-466
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    • 2015
  • The purpose of this study was to review the research on treating depression in Traditional Chinese Medicine(TCM) over the last 5 years to set the foundation for further studies. We searched for and analyzed articles about depression in CNKI(China National Knowledge Infrastructure) from January 2010 to December 2014. The results were as follows : The most frequently used diagnostic criteria was CCMD-3(The Chinese Classification of Mental Disorders-3), and the most used evaluation criteria was HAMD(Hamilton Depression Rating Scale). Prescription of decoction of medical herbs was most frequently used as a therapeutic method. Acupuncture, traditional Chinese psychotherapy, and music therapy were also used for some studies. The most frequent TCM Syndrome Differentiation Type was stagnation of liver-QI. For decoction of Chinese herbs, Soyo-san(Xiaoyao-san) and Sihosogan-san(Chaihushugan-san) were most often prescribed, and Bupleuri Radix, Paeoniae Radix Alba, Curcumae Radix, Poria cocos wolf, Angelicae Gigantis Radix, Atractylodis Rhizoma Alba were mainly used for medical herbs. BaekHoi(GV20) and Yindang(Ex-HN3) were often used as acupuncture sites. Post-Stroke Depression was the most common case of intercurrent or secondary depression. According to the Jadad Quality Assessment Scale, the quality of the reports was not high as most of the reports had a score of 3 or below. Most systematic reviews on depression were conducted by Chinese researchers. The problem with Clinical research on depression, according to those reviews, was that there were no standardized criteria for the diagnosis and treatment and the trials were usually not randomized nor controlled. We found out there are various clinical methods for treating depression in TCM, and hope that this research could provide the preliminary data for designing and conducting clinical trials for depression.

Clinical Features, Response to Treatment, Prognosis, and Molecular Characterization in Korean Patients with Inherited Urea Cycle Defects

  • Yoo, Han-Wook;Kim, Gu-Hwan;Seo, Eul-Ju
    • 대한유전성대사질환학회지
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    • 제2권1호
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    • pp.77-79
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    • 2002
  • The urea cycle, consisting of a series of six enzymatic reactions, plays key roles to prevent the accumulation of toxic nitrogenous compound and synthesize arginine de novo. Five well characterized diseases have been described, resulting from an enzymatic defect in the biosynthesis of one of the normally expressed enzyme. This presentation will focus on two representative diseases; ornithine transcarbamylase(OTC) deficiency and citrullinemia(argininosuccinate synthetase deficiency). OTC deficiency is one of the most common inborn error of urea cycle, which is inherited in X-linked manner. We identified 17 different mutations in 20 unrelated Korean patients with OTC deficiency; L9X, R26P, R26X, T44I, R92X, G100R, R141Q, G195R, M205T, H214Y, D249G, R277W, F281S, 853 del C, R320X, V323M and 10 bp del at nt. 796-805. These mutations occur at well conserved nucleotide sequences across species or CpG hot spot. The L9X and R26X lead to the disruption of leader sequences, required for directing mitochondrial localization of the OTC precursor. Their phenotypes are severe, and neonatal onset. The G100R, R277W and V323M mutations were uniquely identified in patients with late onset OTC deficiency. The other genotypes are associated with neonatal onset. Out of 20 patients with OTC deficiency, only 6 patients are alive; two were liver transplanted, and normal in growth and development at 2, 4 years after transplantation respectively. Citrullinemia is an autosomal recessive disease, caused by the mutations in the argininosuccinate synthetase(ASS) gene. We identified in 3 major mutations in 11 unrelated Korean patients with citrullinemia; G324S, $IVS6^{-2}$ A to G, and 67 bp ins at nt 1125-1126. Among these, the 67 base pair insertion mutation is novel. The allele frequency of each mutation is; G324S(45%), IVS6-2 A to G(32%), and 67 base pair insertion(14%). All patients are diagnosed at neonatal or infantile age. Interestingly, two patients presented with stroke like episode. Out of 11 patients, 5 patients died. Among 6 patients alive, one patient was successfully liver transplanted.

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동의보감(東醫寶鑑) 중(中) 당귀(當歸)와 천궁(川芎)이 등분(等分) 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察) (Applications of Prescriptions Including Angelicae Gigantis Radix and Cnidii Rhizoma in Dongeuibogam)

  • 국윤범
    • 대한한의학방제학회지
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    • 제18권2호
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    • pp.25-51
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    • 2010
  • This report describes 214 prescriptions including Angelicae Gigantis Radix and Cnidii Rhizoma in Dongeuibogam. Angelicae Gigantis Radix and Cnidii Rhizoma have been used separately or concurrently in Oriental Medicine for a long time as a treatment for various diseases. The following conclusions are reached through investigations on the applications of prescriptions including Angelicae Gigantis Radix and Cnidii Rhizoma in Dongeuibogam. 1. 34 times(15.9%) prescriptions are recorded in women chapter, 24 times(11.2%) in wind chapter, 13 times(6.1%) in children chapter and 12 times(5.6%) in intumescence chapter, which are arranged in order of frequency. 2. Treating blood, stroke and fetal movement are ranked top, regulating blood, headache, cataract, carbunculosis, pregnancy, abortion, underdevelopment, etc, among 137 symptoms in prescriptions including Angelicae Gigantis Radix and Cnidii Rhizoma. 3. The dosages of Angelicae Gigantis Radix and Cnidii Rhizoma are ranged from 2.5 pun~6 nyang. 1 jeon is recorded 54 times(25.2%), 7 pun is 29 times(13.6%), 5 pun is 24 times(11.2%), 1 nyang is 21 times(9.8%), same amount is 11 times(5.1%), 5 pun is 10 times(4.7%), 8 pun is 9 times(4.2%) used among 187 prescriptions including Angelicae Gigantis Radix and Cnidii Rhizoma. 4. The dosages of Angelicae Gigantis Radix and Cnidii Rhizoma are ranged from 2.5 pun~6 nyang. 2.5 pun~1.5 jeon, 2 jeon~6 nyang, same amount which are recorded by percent(decoction groups: the other groups) are 69.0%(98.0:2.0%), 25.5%(18.5:81.5%), 5.1%(18.2:81.8%) respectively. The less using dosage of Angelicae Gigantis Radix and Cnidii Rhizoma has a more percentage of decoctions groups, The more using dosage of Angelicae Gigantis Radix and Cnidii Rhizoma has a more percentage of the other groups except decoctions. The less using prescriptions have an effects of controling menstrual pain, enhancing blood and chi, etc, as a whole. The more using prescriptions as a form of compound powder have an effects in epilepsy, chronic diseases, etc. 5. The 214 prescriptions including Angelicae Gigantis Radix and Cnidii Rhizoma in Dongeuibogam are mainly composed of Goongguitang, Samooltang, Sagoonjatang and Gobangpoongtang, etc.

한방물리요법에 대한 문헌적 고찰 (A Literatural Study on the Traditional Korean Medical Physiotherapy)

  • 최보미;홍서영
    • 한방재활의학과학회지
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    • 제21권2호
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    • pp.211-226
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    • 2011
  • Objectives : The purpose of this study is to establish literatural evidence about traditional Korean medical physiotherapy through literatural review. Methods : Applicable paragraphs which were related to the traditional Korean medical physiotherapy were phrased from in "Hwang-je-nae-gyung(黃帝內經)", "Yumun-sa-chin(儒門事親)", "Geum-guei-yo-ryack(金匱要略)", "Eui-hack-ip-mun(醫學入門)", "Gyung-ack-jeon-seo(景岳全書)", "Eui-hack-gang-mock(醫學綱目)", "Dong-eui-bo-gam(東醫寶鑑)" where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of Korean medical physiotherapy. Results : 1. Theromtherapy is originated from yu(熨), hot hand, warm, water bath, warm earth, fumigation, lamp, torchlight and brazier. Matching indications are various musculoskeletal pain and diseases, skin diseases such as chronic inflammation, frostbite, gynecological and urogenital diseases such as uterine myoma, lower abdominal pain, metrorrhagia, breast diseases, digestive tract diseases such as vomiting, diarrhea, stomachache and also it treats cardiovascular disease. Other matching indications are sunstroke, rhinorrhea, psycosis and anal pain. And it used helping acupuncture therapy. 2. Cryotherapy is originated from lengfu(冷敷), lengtie(冷貼), cold stone and cold water. Matching indications are various fever disease, skin diseases such as acute inflammation, wound, fever skin disease, otorhinolaryngological diseases such as acute sore throat, otitis, stomatitis, nasal bleeding and contusions, abrasions, burn and dysuria. In addition, it treats extremity coldness, chillness, stomachache caused to accumulate fever. 3. Physiotherapy by circulating meridian system is originated from manipulation such as pushing, massage and beating to therapy point. Matching indications are musculoskeletal diseases such as various muscular pain, heavy sensation, convulsion, urogenital diseases such as dysuria, lower abdomen pain, digestive tract diseases such as stomachache, and paralysis due to blocked meridian system. And other matching indications are psycosis, leprosy, hypoesthesia, acute stroke. In addition it helps other therapy methods. In addition, the power of manipulation classify to strengthen and reduce. 4. Physiotherapy by balancing meridian system is originated from sunshine, magnet, horn, bamboo and tube. Sunshine helps improving self's care and cure inflammatory skin disease. Magnet's matching indications are paralysis, various injuries, abscess, fever and eye disease. Cupping therapy treats to skin diseases and internal diseases such as tuberculosis. Conclusions : Traditional Korean medical physiotherapy was widely used in traditional Korean medicine since ancient time based on the traditional Korean medical principle and anatomical knowledge. With modern physiotherapy and traditional Korean medicine together, effects of treatment are enhanced. And traditional Korean medical physiotherapy is appropriated to world physiotherapy's expectation.

심정격(心正格)의 보혈(補穴), 신정격(腎正格)의 보혈(補穴), 심정격(心正格)의 보혈(補穴) 배신정격(配腎正格)의 보혈(補穴) 및 심정격(心正格) 자침(刺鍼)이 실험적(實驗的) 뇌허혈(腦虛血)에 미치는 영향(影響) (The Effects of Reinforcing Acupoint of Heart JEONGGYEOK, Reinforcing Acupoint of Kidney JEONGGYEOK, Combination of Reinforcing Acupoint of Heart JEONGGYEOK and Kidney JEONGGYEOK, Reinforcing and Reducing Acupoint of Heart JEONGGYEOK on Focal Ischemia Induced by Inserted Intraluminal Filament in MCA of Rats)

  • 황문현;윤대환;나창수
    • Korean Journal of Acupuncture
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    • 제22권4호
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    • pp.43-56
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    • 2005
  • Objectives : The acupuncture has been used as treatment of disease in the oriental medicine. In this study, it was investigated at had an effects of Heart JEONGGYEOK(心正格) of SAAM five evolutive phase acupuncture techniques(舍岩五行鑛法) for appling deficiency in the heart induced by experimental focal ischemia. Materials and methods : The focal ischemia was induced by middle cerebral artery occlusion for 2hours. The groups divided into 6 groups, normal(intactness group), control(no therapy group after ischemia-induced), AT1(reinforcing acupoint of Heart JEONGGYEOK : acupuncture therapy group at LR1, HT9 after ischemia-induced), AT2(reinforcing acupoint of Kidney JEONGGYEOK : acupuncture therapy group at LU8, KI7 after ischemia-induced) AT3(combination of reinforcing acupoint of Heart JEONGGYEOK and Kidney JEONGGYEOK : acupuncture therapy group at LR1, HT9, LU8, KI7 after ischemia-induced) AT4(reinforcing and reducing acupoint of Heart JEONGGYEOK : acupuncture therapy group at LR1, HT9, HT3, KI10 after ischemia-induced), AT4(reinforcing and reducing acupoint of Heart JEONGGYEOK : acupuncture therapy group at LRI, HT9, HT3, KI10 after ischemia-induced). Acupuncture therapy was carried out during 3 weeks after focal ischemia-induced. Eight-arm radial maze was used for the behavioral task and neuropretective effect of acupuncture therapy was observed by Cresyl violet, AchE, ChAT-stain. Results : The error rate in the eight-arm radial maze task was significantly decreased in AT3 group on 3days, in AT1 and AT4 groups on 4days, in AT3 and AT4 groups on 5days compared to the control group. The rate of correct choice was significantly increased AT4 group compared to the control group. The density of neurons in the hippocampal CA1 were significantly increased in all experiment groups, AT1, AT2, AT3 and AT4 groups compared to the control group. The density of AchE in the hippocampal CA1 was significantly increased in AT4 group compared to the control group. The density of ChAT in the hippocampal CA1 were significantly increased in AT1 and AT3 group compared to the control group. Conclusions : These results suggest that reinforcing and reducing acupoint of Heart JEONGGYEOK could be used as a medication for controlling the stroke by deficiency in the heart.

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수면과 관련된 호흡장애가 심혈관계의 기능 변화에 미치는 영향 (Influence of Sleep-Related Breathing Disorders on Changes of Cardiovascular Function)

  • 문화식
    • 수면정신생리
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    • 제4권2호
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    • pp.129-139
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    • 1997
  • 수면 무호흡을 포함한 다양한 원인의 수면과 관련된 호흡장애를 동반한 환자들에서는 여러가지 심혈관계 기능부전이 초래되어 이들 환자의 임상경과에 중대한 영향을 미친다. 수면 무호흡증후군, 특히 폐쇄성 수면 무호흡증후군은 수면장애의 여러 가지 원인 중 임상영역에서 가장 흔히 볼수 있는 질환으로 전신성 고혈압, 심부정맥, 폐동맥 고혈압 및 우심실 부전, 협심증 및 심근경색증, 뇌졸증등의 발병률이 정상인에 비하여 현저히 높은 것으로 알려져 있다. 폐쇄성 수면 무호흡과 달리 중추성 수면 무호흡은 수면중에 호흡중추를 불안정하게 하는 다양한 원인에 의해 발생하며 역시 심혈관계의 기능에 영향을 미칠 수 있다. 수면중에 환기장애가 더욱 악화될 수 있는 호흡기계 질환이 있는 환자들은 수면 무호흡증후군과 달리 만성적인 저산소증과 고탄산증이 동반되며 이로 인해 심부정맥, 폐동맥 고혈압, 우심실 부전(폐성심) 등의 심혈관계 이상이 초래될 수 있다. 따라서 수면 무호흡을 포함한 수면과 관련된 호홉 장애의 진단과 치료에 있어서는 호흡기계 질환에 대한 정확한 평가와 더불어 동반될 수 있는 심혈관계의 기능부전에 대한 정밀한 분석이 반드시 필요하며, 이들 자료를 바탕으로 기관절개술, 기계적 호흡, 지속적 양압공급치료, 적절한 산소요법 등의 적극적이고도 효과적인 치료법을 적용함으로서 심혈관계 합병증의 발생과 이로 인한 사망률을 감소시킬 수 있을 것으로 생각된다.

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배양대뇌신경세포 저산소증모델에서 반하여 의한 유전자표현의 변화 (Microarray Analysis of Gene Expression Affected by Water-extracts of Pinelliae rhizoma in a Hypoxic Model of Cultured Rat Cortical Cells)

  • 권건록;정현정;신길조;문일수;이원철;정승현
    • 생명과학회지
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    • 제19권7호
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    • pp.905-916
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    • 2009
  • 본 연구는 저산소증에서 반하가 대뇌신경세포의 유전자 표현에 미치는 영향을 알아보기 위하여 배양한 $E_{18}$의 흰쥐 대뇌 신경세포를 반하로 처리하고, 저산소증을 유도한 후 microarray 기법으로 유전자 표현 변화를 조사하였다. Microarray 결과 tubb5, tgfa, ptpn11, n-ras, pdgfa 등 세포의 성장 분화에 관여하는 유전자들의 표현이 증가하였으며, 세포 자연사를 억제하는 mcl-1 유전자의 표현 또한 증가하였다. 한편 세포 자연사를 유도하는 tieg 유전자는 표현이 감소하였다(Fig. 3). 반하에 의하여 수많은 유전자의 표현이 변화되었고, 세포사를 촉진하는 유전자의 표현이 크게 증가되는 경우(예, alox12, faf1)도 있어 본 연구결과만으로 일반적인 결론을 유도하기는 어려웠다. 그러나 대략적으로 반하는 저산소증에서 주로 세포의 성장과 분화를 유지하고, 세포 자연사를 방지하는 유전자들의 표현을 증가시켜 신경 세포사를 보호하는 것으로 이해된다.