• 제목/요약/키워드: acute stroke

검색결과 534건 처리시간 0.025초

척수손상 후 세포이식에 의한 운동기능의 회복증진 (Improvement of Functional Recovery by Cell Transplantation after Spinal Cord Injury)

  • 이배환;이경희;성제경;황세진;김계성
    • 감성과학
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    • 제7권2호
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    • pp.179-186
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    • 2004
  • 중추신경계는 일단 손상이 되면 손상된 세포의 재생, 손상된 수초의 회복, 신경계의 정상적인 연결 등의 제한성 때문에 그 회복이 매우 힘들다. 이러한 중추신경계의 중요한 손상으로는 다발성 경화증, 뇌졸중, 척수손상, 외상, 축삭의 탈수초화 등이 있다. 이전 연구들은 많은 발생빈도를 보이고 있는 척수손상에서 실질적인 척수의 기능적인 회복을 위해 손상된 척수신경의 재생과 축삭의 재수초화가 중요한 요인이라고 전하고 있다. 최근에는 이러한 척수손상에 대한 치료적 접근으로서 세포이식 기술이 하나의 해결책을 열어주고 있다. 따라서 본 논문에서는 척수손상의 특성을 살펴보고, 척수손상에 의한 기능장애에 대해 세포이식이 기능의 회복을 증진시킬 수 있다는 증거를 논의하고자 한다.

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The Effects of Balloon-Guide Catheters on Outcomes after Mechanical Thrombectomy in Acute Ischemic Strokes : A Meta-Analysis

  • Ahn, Jun Hyong;Cho, Steve S.;Kim, Sung-Eun;Kim, Heung Cheol;Jeon, Jin Pyeong
    • Journal of Korean Neurosurgical Society
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    • 제62권4호
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    • pp.389-397
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    • 2019
  • Objective : Mechanical thrombectomies with balloon-guide catheters (BGC) are thought to improve successful recanalization rates and to decrease the incidence of distal emboli compared to thrombectomies without BGC. We aimed to assess the effects of BGC on the outcomes of mechanical thrombectomy in acute ischemic strokes. Methods : Studies from PubMed, EMBASE, and the Cochrane library database from January 2010 to February 2018 were reviewed. Random effect model for meta-analysis was used. Analyses such as meta-regression and the "trim-and-fill" method were additionally carried out. Results : A total of seven articles involving 2223 patients were analyzed. Mechanical thrombectomy with BGC was associated with higher rates of successful recanalization (odds ratio [OR], 1.632; 95% confidence interval [CI], 1.293-2.059). BGC did not significantly decrease distal emboli, both before (OR, 0.404; 95% CI, 0.108-1.505) and after correcting for bias (adjusted OR, 1.165; 95% CI, 0.310-4.382). Good outcomes were observed more frequently in the BGC group (OR, 1.886; 95% CI, 1.564-2.273). Symptomatic intracranial hemorrhage and mortality did not differ significantly with BGC use. Conclusion : Our meta-analysis demonstrates that BGC enhance recanalization rates. However, BGC use did not decrease distal emboli after mechanical thrombectomies. This should be interpreted with caution due to possible publication bias and heterogeneity. Additional meta-analyses based on individual patient data are needed to clarify the role of BGC in mechanical thrombectomies.

Isolated Bilateral Midbrain Infarction in A Healthy Female Adolescent: A Case Report

  • Dong Ho Yoo;Byunghoon Lee;Yong Beom Shin;Myung-Jun Shin;Jin A Yoon;Sang Hun Kim
    • Physical Therapy Rehabilitation Science
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    • 제12권3호
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    • pp.207-213
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    • 2023
  • Objective: The purpose of this study was to understand the complex anatomical structure and function of the midbrain to better understand the patient's symptoms and plan effective treatment including pharmacological and rehabilitation interventions. Design: A single case study Methods: A 17-year-old girl presented with acute onset of drowsiness, gait disturbance, mutism, and ptosis. Physical examination revealed postural instability, rigidity of all limbs, and limitations in extraocular movement. The brain MRI revealed an isolated acute infarction in the bilateral midbrain. Considering the location of the infarction, the presenting symptoms were the result of an impairment of the dopaminergic pathway in addition to lesions in the nuclei of the oculomotor nerve. Levodopa/carbidopa was prescribed. And the intensive and comprehensive rehabilitation program was done. Results: As a result of the study, through comprehensive intervention, which encompassed assessments such as the manual muscle test, Korean Modified Barthel Index score, and Trail-making test, significant enhancements in the patient's condition were observed. These findings provide evidence supporting the effectiveness of the intervention in promoting the patient's physical functioning and overall well-being. Conclusions: The results of this case highlight the significance of comprehending the intricate anatomical structure and functional aspects of the midbrain, which led us to approach appropriate pharmacological and rehabilitation interventions. Through active communication among the medical team, we were able to establish a therapeutic plan, which demonstrated that effective treatment can be achieved.

뇌졸중환자(腦卒中患者) 290례(例)에 대(對)한 임상(臨床) 고찰(考察) (III) ('Clinical Observation on the 290 cases of Cerebrovascular Accident')

  • 강관호;전찬용;박종형
    • 대한한의학회지
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    • 제18권2호
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    • pp.223-244
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    • 1997
  • Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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기능적 전기 자극을 이용한 생체되먹임 융합 자세조절 훈련이 뇌졸중 환자의 근활성도와 균형 능력에 미치는 영향 (The Effects of Biofeedback Fusion Postural Control Training using Functional Electrical Stimulation on the Muscle Activity and Balance Ability of the Stroke Patient)

  • 김제호;엄요한
    • 디지털융복합연구
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    • 제17권12호
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    • pp.319-327
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    • 2019
  • 본 연구에서는 기능적 전기 자극을 이용한 생체되먹임 융합 자세조절 훈련을 중재하여 급성기 뇌졸중 환자들의 다리 근활성도와 균형 능력에 미치는 효과에 대하여 알아보고자 하였다. 뇌졸중 환자는 기능적 전기 자극을 이용한 생체 되먹임 융합 자세조절 실험군 15명과 일반적인 생체되먹임 융합 자세조절 대조군 15명으로 나누어 8주간 주 5회, 30분간 시행하였고, 다리 근활성도를 평가하기 위해 근전도를 이용하여 가쪽넓은근, 안쪽넓은근, 넙다리곧은근, 넙다리두갈래근를 측정하였다. 균형 능력을 측정하기 위해 Biorecue를 이용하여 균형 능력을 측정하였다. 다리 근활성도 비교에서는 가쪽넓은근, 안쪽넓은근, 넙다리곧은근, 넙다리두갈래근에서 통계적으로 유의한 차이를 보였고, 균형 능력 비교에서는 신체 중심 이동면적, 총 궤적 길이, 안정선한계에서 통계적으로 유의한 차이를 보였다. 이에 따라 기능적 전지 자극을 이용한 생체되먹임 자세조절 훈련이 일반적인 생체되먹임 자세조절 훈련 보다 다리 근활성도와 균형 능력을 향상시키는데 효과적임을 알 수 있었다.

편마비 환자의 밀기증후군 발생빈도와 신경정신학적 증상과의 관계 (Correlation of Neuropsychological Symptoms and Incidence for Hemiplegia with Pusher Syndrome)

  • 박이수;이강노;장기우;박성일
    • 대한물리치료과학회지
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    • 제6권3호
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    • pp.1-7
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    • 1999
  • The objectives of this study was to investigate the incidence and any correction between hemiplegia with pusher syndrome and neuropsychological symptoms such as hemineglect and anosognosia. Pusher syndrome defines that the patient leans toward the hemiplegic side regardless of the position that patient was placed on and resists any attempt for passive correction of posture that would move his weight toward the midline of the body. The subjects of this study were 69 acute hemiplegia who had been rehabilitated at department of rehabilitation medicine, Asan Medical Center from May 1. 1999 through July 31. 1999. The data were analyzed by researchers who were trained for assessment of anosognosia and hemineglect. 12 subjects were excluded for confusion. The method of statistical analysis used for our study was Fisher's exact test. Results of the study disclosed 21 hemiplegia(38.6%) with pusher syndrome. In conclusion, these hemiplegic patients with pusher syndrome did not have any correlation with hemineglect and anosognosia and also had no preference of stroke side.

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바이오휘드백을 이용한 운동훈련이 재가 편 마비 환자의 상지둘레, 악력, 근육강도, 관절운동범위, 일상생활활동에 미치는 효과 (Effects of Biofeedback Exercise Training in Hemiplegic Patients after Stroke)

  • 김금순;이소우;최명애;이명선;김은정
    • 대한간호학회지
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    • 제31권3호
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    • pp.432-442
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    • 2001
  • Purpose: The purpose of this study was to investigate the effects of biofeedback exercise training on muscle activity and activities of daily livings (ADL) in hemiplegic patients. An experimental group consisting of 17 people, was given biofeedback exercise training for 30- 60 minutes per week for 5 weeks, while a control group consisting of 18 people, was given normal exercise with quasi-experimental design. Result: The results of the study show that biofeedback exercise is effective for improving muscle activity in hemiplegic patients, especially in the hemiplegic limbs. However, this study found no significant differences in ADL and IADL between the experimental and the control groups. It implies that ADL and IADL may not be improved for a short period of time, such as 5 weeks, for people with more than five years of hemiplegia. The study suggests that the effect of biofeedback exercise on ADL and IADL should be determined in hemiplegic patients in acute stage.

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Estrogen Regulate Neuroprotection and PDI Gene Expression in Ischemic Rat Brain

  • Yu, Seong-Jin;Kim, Do-Rim;Kim, Jee-Yun;Youm, Mi-Young;Lee, Chae-Kwan;Kang, Sung-Goo
    • 한국발생생물학회:학술대회논문집
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    • 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
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    • pp.69-69
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    • 2003
  • Neuroprotective strategies have been appeared to be effective in a variety of stroke models. One of the major focuses has been related to the activities of estrogen. $17\beta$-estradiol valerate(EV) has been reported to exert neuroprotective effects when administered before an ischemic insult. The purpose of this study was to determine whether EV can protect against brain injury via estrogen receptor. Chronic and acute pretreatment can reduce the ischemic damage of focal cerebral ischemia in OVX rat, indicating that EV may be a new therapeutic class of drugs to prevent neuronal damage associated with cerebral ischemia. RNAs were extracted from the hippocampus of ovariectomized female rat with or without EV. Differential gene expression profiles were revealed(Bone morphogenetic protein type 1A receptor, Protein disulphide isomerase, cytochrome bc-1 complex core P, thiol-specific antioxidant protein). RT-PCR and in situ hybridization were used to validate the relative expression pattern obtained by the cDNA array. This Study was supported by the Korea Science and Engineering Foundation(KOSEF) through the Biohealth Products Research Center(BPRC), Inje University, Korea

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Transcranial Doppler를 이용(利用)한 급성기뇌경색(急性期腦硬塞)이 추골기저동맥계(椎骨基底動脈係) 혈관(血管)의 혈류속도(血流速度)에 미치는 영향(影響) (The Transcranial Doppler(TCD) Assesment of Vertebrobasal Vascular Blood Flow in Cerebral Infarction)

  • 안탁원;김윤식
    • 대한한방내과학회지
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    • 제21권5호
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    • pp.805-811
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    • 2000
  • Objectives : To determine the effects on blood flow of vertebrobasal vascular system in cerebral infarction, Methods : We altered 33 normal patients and 12 patients who were diagnosed cerebral infarction on Rt. middle cerebral artery(MCA) region and 8 patients who were diagnosed cerebral infarction on Lt, MCA region, and measured the mean velocity, systolic to diastolic rate(SD rate), asymmetrical index(A/I) by TCD. Results : The mean velocity of posterior cerebral artery(PCA), vertebral artery was increased in same direction as infarcted site and the mean velocity of basal artery was more increased than control, and the SD rate of PCA, vertebral artery, basal artery was larger than control. The A/l of PCA, vertebral artery was revealed that mean velocity of vertebrobasal vascular system is increase the same direction as infarcted area. Conclusion : TCD examination within 7 days(acute stage) after stroke can help to predict the infarcted direction.

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Sphingosine 1-Phosphate Receptor Modulators and Drug Discovery

  • Park, Soo-Jin;Im, Dong-Soon
    • Biomolecules & Therapeutics
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    • 제25권1호
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    • pp.80-90
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    • 2017
  • Initial discovery on sphingosine 1-phosphate (S1P) as an intracellular second messenger was faced unexpectedly with roles of S1P as a first messenger, which subsequently resulted in cloning of its G protein-coupled receptors, $S1P_{1-5}$. The molecular identification of S1P receptors opened up a new avenue for pathophysiological research on this lipid mediator. Cellular and molecular in vitro studies and in vivo studies on gene deficient mice have elucidated cellular signaling pathways and the pathophysiological meanings of S1P receptors. Another unexpected finding that fingolimod (FTY720) modulates S1P receptors accelerated drug discovery in this field. Fingolimod was approved as a first-in-class, orally active drug for relapsing multiple sclerosis in 2010, and its applications in other disease conditions are currently under clinical trials. In addition, more selective S1P receptor modulators with better pharmacokinetic profiles and fewer side effects are under development. Some of them are being clinically tested in the contexts of multiple sclerosis and other autoimmune and inflammatory disorders, such as, psoriasis, Crohn's disease, ulcerative colitis, polymyositis, dermatomyositis, liver failure, renal failure, acute stroke, and transplant rejection. In this review, the authors discuss the state of the art regarding the status of drug discovery efforts targeting S1P receptors and place emphasis on potential clinical applications.