• 제목/요약/키워드: acute hemorrhagic

검색결과 157건 처리시간 0.028초

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

  • 설진주;유기봉;이광수
    • 한국병원경영학회지
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    • 제27권1호
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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.

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

  • 민주홍;이수호;조중양;박성혜;이광우
    • Annals of Clinical Neurophysiology
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    • 제7권1호
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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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    • 제64권5호
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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.

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

  • 서화숙;오현수
    • 성인간호학회지
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    • 제19권1호
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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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급성기 뇌경색 환자에서 한방치료와 지속적 유로키나제 정주요법 병용시 안전성에 대한 임상적 고찰 (Study for Safety of Oriental Medical Therapy and Continuous Intravenous Urokinase combined Therapy in Acute Cerebral Infarction.)

  • 김성근;임창선;임준혁;양동호;신현승;박준하;정승철
    • 대한중풍순환신경학회지
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    • 제10권1호
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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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오줌 유래 Trypsin 억제제가 출혈성쇼크에 미치는 영향 (The Effects of Urinary Trypsin Inhibitor on Hemorrhagic Shock)

  • 권오경;김종민;이희천;정언승;양한석;변종환;송동호;조명행
    • Biomolecules & Therapeutics
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    • 제5권3호
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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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헤노호-쉔라인 자반증으로 오인된 영아 급성 출혈성 부종 1례 (Acute hemorrhagic edema in an infant mimicking Henoch-Schönlein purpura: a case study)

  • 이향모;강은영;김한욱;황평한
    • Clinical and Experimental Pediatrics
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    • 제49권12호
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    • pp.1354-1357
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    • 2006
  • 영아 급성 출혈성 부종은 2세 이전에 발생하는 드문 혈관염의 일종이다. 영아 급성 출혈성 부종은 현저한 말단부 부종과 발열을 보이며 특징적으로 얼굴, 귀, 사지에 두드러지게 헤노호-쉔라인 자반증과 유사한 피부 병변이 발생한다. 이러한 피부 병변은 1주일에서 3주일 사이에 저절로 소실되며 헤노호-쉔라인 자반증과 달리 내부 장기의 침범은 거의 없다. 처음 헤노호-쉔라인 자반증으로 생각하였으나 특징적인 발진의 분포와 전신 증상의 부재 등의 차이로 영아 급성 출혈성 부종으로 진단하게 된 23개월 남아의 증례를 보고하는 바이다.

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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    • 제30권3호
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    • pp.188-192
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    • 2023
  • 영아기 급성 출혈성 부종(acute hemorrhagic edema of infancy, AHEI)은 주로 영아에서 발생하는 드문 혈관염으로 호흡기 바이러스 감염과 연관되어 발생할 수 있다. 저자들은 coronavirus disease 2019 (COVID-19) 감염 후 발생한 AHEI 단일 사례를 보고한다. 재태주수 38주에 3.5kg으로 출생한 건강했던 생후 47일된 환아는 동반증상 없는 발열을 주소로 내원하였고 COVID-19 reverse transcription polymerase chain reaction 검사결과 양성이 확인되었다. 입원 이틀째부터 손과 발에 비창백성(non-blanching) 홍반성 반점(macule)과 반(patch)이 발생했고 압통을 동반한 부종이 관찰되었다. 발열은 호전되었고 전신 컨디션과 경구 섭취는 정상적인 모습을 보였다. 정맥 덱사메타손 투약 후 발진과 부종은 호전되었다. AHEI를 적시에 진단하는 것은 불필요한 검사나 치료를 피하고 드물지만 발생 가능한 심각한 합병증을 신속하게 발견하는데 중요하다.

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) (Studies on the rabbit viral hepatitis I. Electron microscopic observation of the acute hepatic lesions in experimentally infected rabbit)

  • 이차수;박청규
    • 대한수의학회지
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    • 제29권4호
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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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동종말초조혈모세포이식 후 발생한 BK 바이러스 출혈성 방광염의 Cidofovir 방광 내 주입 치험 1례 (A Case of Intravesical Cidofovir Treatment of BK Virus-Associated Hemorrhagic Cystitis after Allogeneic Peripheral Blood Stem Cell Transplantation)

  • 강성훈;이화정;장예수;지준호;이선아;이원식;이정림;이경희
    • Journal of Yeungnam Medical Science
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    • 제26권2호
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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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