• Title/Summary/Keyword: acute hemorrhagic

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Effects of Korean value incentive program on the in-hospital mortality in acute hemorrhagic stroke patients (가감지급사업 실행 후 급성기 출혈성 뇌졸중의 원내 사망률 변화 분석)

  • Seol, Jin-Ju;Yoo, Ki-Bong;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.27 no.1
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    • pp.20-30
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    • 2022
  • Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke. Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data. Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful. Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

Atypical Manifestation of Acute Hemorrhagic Leukoencephalitis (Hurst's Disease) (비전형적인 중상으로 발현한 급성 출혈성 백질뇌염)

  • Min, Ju-Hong;Lee, Su-Ho;Cho, Joong-Yang;Park, Sung-Hye;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.7 no.1
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    • pp.37-42
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    • 2005
  • Acute disseminated encephalomyelitis (ADEM) and acute hemorrhagic leukoencephalitis (Hurst's disease) are rare autoimmune demyelinating disorders, which show a monophasic illness with preceding infection. We report a 42-year-old woman presented with multiphasic and progressive neurologic deterioration without definite evidences of infection. She developed hypesthetic ataxia, followed by ipsilateral weakness after a weak, and finally encephalopathy after a month. In contrast to the first MRI showing a small longitudinal lesion, the next images revealed massive bilateral frontal lesions with hemorrhagic necrosis and biopsy unveiled inflammatory demyelination.

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The Osteoporotic Condition as a Predictive Factor for Hemorrhagic Transformation in Acute Cardioembolic Stroke

  • Won, Yu Deok;Kim, Jae-Min;Ryu, Je-Il;Koh, Seong-Ho;Han, Myung-Hoon;Cheong, Jin-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.763-775
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    • 2021
  • Objective : Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke. Methods : As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke. Results : This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13-3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically. Conclusion : The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.

The Prognostic Values of Acute Physiological Parameters in Hemorrhagic Stroke Patients: Differences Between Patients with High and Low Glasgow Coma Scale Scores on Admission (출혈성 뇌졸중 환자의 생리적 예측 인자에 대한 연구: 입원시 Glasgow Coma Scale 점수에 따른 비교)

  • Seo, Wha Sook;Oh, Hyun Soo
    • Korean Journal of Adult Nursing
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    • v.19 no.1
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    • pp.45-54
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    • 2007
  • Purpose: This study was to identify the significant acute physiological predictors of mortality and of functional and cognitive recovery in hemorrhagic stroke patients. Methods: The subjects were 108 hemorrhagic stroke patients admitted to Neurological Intensive Care Unit of a university hospital. Results: The significant physiological predictors of mortality and of functional and cognitive recovery were quite different upon admission Glasgow Coma Scale scores: respiratory rate, hematocrit, serum pH, osmolality, and $PaCO_2$ were the predictors in the subjects with a high Glasgow Coma Scale scores while blood pressure, $PaO_2$, respiratory rate, and hematocrit in the subjects with a low Glasgow coma scale scores. Conclusion: The physiological derangements induced by acute stroke are undoubtedly influence clinical outcome. More study is required to determine their diverse impacts on clinical outcomes.

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Study for Safety of Oriental Medical Therapy and Continuous Intravenous Urokinase combined Therapy in Acute Cerebral Infarction. (급성기 뇌경색 환자에서 한방치료와 지속적 유로키나제 정주요법 병용시 안전성에 대한 임상적 고찰)

  • Kim, Sung-keun;Lim, Chang-sun;Yim, Jun-hyok;Yang, Dong-ho;Shin, Hyon-seung;Park, Joon-ha;Jeong, Seung-cheol
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.1-7
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    • 2009
  • Objectives : This Study was prepared for investigating the safety of oriental medicine and continuous intravenous urokinase combined therapy in acute cerebral infarction. Methods : We prospectively estimate safety of hemorrhagic transformation occurred in oriental medical therapy and continuous intravenous urokinase combined therapy. We estimate National Institute of Health Stroke Scale Score and Modified Barthel Index. Results : Hemorrhagic transformation was not noted. and Others are not fatal complication. Conclusions : oriental medical therapy and continuous intravenous urokinase combined therapy are safety method in treatment of acute cerebral infarction. We think this can be a good model of Oriental and western cooperative therapy.

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The Effects of Urinary Trypsin Inhibitor on Hemorrhagic Shock (오줌 유래 Trypsin 억제제가 출혈성쇼크에 미치는 영향)

  • 권오경;김종민;이희천;정언승;양한석;변종환;송동호;조명행
    • Biomolecules & Therapeutics
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    • v.5 no.3
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    • pp.223-227
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    • 1997
  • The protective effect of human urinary trypsin inhibitor(UTI) on acute hemorrhagic shock in beagle dog was studied. Hemorrhagic shock was experimentally induced in thoracotomized beagle dogs by removing blood and maintaining low arterial blood pressure for 30 min, and then blood removed was entirely transfused back into the dogs within one hour. When the blood was transfused, UTI was administered together to check the potential protective effect of UTI on hemorrhagic shock. The arterial blood pressure recovery was accelerated slightly by UTI treatment. Blood pH and $P_{a co2}$ returned to normal level in shorter time in the UTI treatment group. These data suggest that UTI may have protective effects on experimentally induced hemorrhagic shock.

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Acute hemorrhagic edema in an infant mimicking Henoch-Schönlein purpura: a case study (헤노호-쉔라인 자반증으로 오인된 영아 급성 출혈성 부종 1례)

  • Lee, Hyang Mo;Kang, Eun Young;Kim, Han Uk;Hwang, Pyoung Han
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1354-1357
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    • 2006
  • Acute hemorrhagic edema of infancy (AHEI) is an uncommon form of cutaneous leukocytoclastic vasculitis that occurs in infants and children younger than 2 years. AHEI is characterized clinically by marked peripheral edema and fever as well as large palpable purpuric and ecchymotic skin lesions in a target-like pattern, mainly on the face, ears and extremities, similar to the skin findings of $Henoch-Sch{\ddot{o}}nlein$ purpura (HSP). The skin lesions heal spontaneously within one to three weeks and internal organs are rarely affected. We report a case of AHEI occurring in a 23-month-old boy who was initially misdiagnosed as HSP, and was later diagnosed according to his clinical symptoms and histochemical characteristics.

Acute Hemorrhagic Edema of Infancy Associated With Coronavirus Disease 2019

  • Jong Ki Jung;Young June Choe; Hwa Jung Ryu;Won-Hee Seo
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.188-192
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    • 2023
  • Acute hemorrhagic edema of infancy (AHEI) is a rare, benign, vascular condition that primarily affects infants, and is possibly associated with respiratory viral infections. A case involving a 47-day-old male infant, who was admitted with a 1-day history of fever, is presented. Initially, the patient developed an erythematous macular rash and patches on the hands and feet, along with swelling. The fever subsided after the first day of hospitalization, and the patient remained in generally good condition with normal oral intake. Timely recognition of AHEI is crucial to avoid unnecessary medical investigations or therapies, and to promptly identify any rare but potentially severe complications that may arise.

Studies on the rabbit viral hepatitis I. Electron microscopic observation of the acute hepatic lesions in experimentally infected rabbit (토끼의 바이러스성(性) 간염(肝炎)에 관(關)한 연구(硏究) I. 실험적(實驗的) 감염토(感染兎)의 급성간염조직(急性肝炎組織)의 전자현미경적(電子顯微鏡的) 관찰(觀察))

  • Lee, Cha-soo;Park, Cheong-kyu
    • Korean Journal of Veterinary Research
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    • v.29 no.4
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    • pp.531-540
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    • 1989
  • A new sudden death in rabbits appeared in China and Korea in 1984 and 1985, respectively, and was recognized to be an acute infectious disease caused by a virus. The disease was reported as a "new viral disease," and thereafter, a tentative name of "viral hemorrhagic disease", "hemorrhagic pneumonia" or "viral hemorrhagic pneumonia" has been described in the case reports. But authors had called the viral disease "rabbit viral hepatitis" due to picornavirus infection, because the principal lesion of the disease was an acute hepatitis. The purpose of this report is to describe the electron microscopic findings on the livers in experimentally infected rabbits. All the livers of the affected rabbits were shown to have degenerative changes of a type that is characteristic of acute hepatitis. In the liver cells, there were dilation of rER and mitochondria, vacuole formation of various sizes, and appearances of many virus-like particles in the vicinity of rER, granular bodies and crystalline arrays of viral particles in the cytoplasm with necrotic changes of the nucleus. Clusters of virus-like particles and viral crystals appeared in the cytoplasm of sinusoid endothelial cells and Kupffer's cells with morphological changes of organelles. Also viral crystals were demonstrated in the cytoplasm of macrophages among the liver cells. On the whole, the liver cells had many virus-like particles and a few crystalline arrays of viral particles. Therefore, this implies that the liver cells are the main site of the viral replication in inducing the viremia. It was concluded that the liver was the primary target organ of this viral disease, and the pathological and the ultrastructural evidence suggest that the virus may be belong to genus enterovirus.

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A Case of Intravesical Cidofovir Treatment of BK Virus-Associated Hemorrhagic Cystitis after Allogeneic Peripheral Blood Stem Cell Transplantation (동종말초조혈모세포이식 후 발생한 BK 바이러스 출혈성 방광염의 Cidofovir 방광 내 주입 치험 1례)

  • Kang, Seong-Hun;Lee, Hwa-Jeong;Jang, Ye-Su;Ji, Jun-Ho;Lee, Sun-Ah;Lee, Won-Sik;Lee, Jung-Lim;Lee, Kyung-Hee
    • Journal of Yeungnam Medical Science
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    • v.26 no.2
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    • pp.143-147
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    • 2009
  • Hemorrhagic cystitis (HC) is a common complication after allogeneic transplantation. Early posttransplant HC occurs in association with cyclophosphamide, while later on HC results from viral infections such as polyomavirus BK (BKV) and adenovirus. We report here the case of a 57-year-old woman who received an instillation of cidofovir into the bladder for the treatment of hemorrhagic cystitis after allogeneic peripheral stem cell transplantation for her acute myeloid leukemia. Cyclophosphamide and busulfan were used as conditioning treatments. Cyclosporin was administered daily. On the 71st day after transplantation, the patient developed acute severe hemorrhagic cystitis, and BK virus was demonstrated in the urine samples using polymerase chain reaction. Her urinary symptoms did not improve in spite of palliative treatment, but a response was evident after intravesical cidofovir treatment.

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