• Title/Summary/Keyword: brain infarction

검색결과 362건 처리시간 0.024초

가압식 비침습적 대뇌 혈류 증가 장치의 구현 (Implementation of Non-Invasive Pressurized Cerebral Perfusion Platform)

  • 이진;유형곤;김영길
    • 한국정보통신학회논문지
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    • 제21권9호
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    • pp.1752-1760
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    • 2017
  • 뇌경색의 대표적인 치료법과 예방법중 하나는 대뇌혈류를 증가시키는 방법이다. 대뇌 부위로 가는 혈류량을 우회적으로 증가시켜 최종대뇌 손상부위를 최소화 하는 것을 목표로 한다. 이와 같은 대뇌 혈류를 증가시키는 방법은 약물에 의한 치료방법과, 수술에 의한 방법 등 칩습적으로 행해져왔다. 하지만 이러한 침습적인 방법은 환자에게 수술의 부담을 주며 합병증 등의 위험에 노출되어 있는 단점이 있다. 본 논문에서는 이러한 침습적인 치료방법의 단점을 보완하고자 비침습적 대뇌 혈류 증가 장치를 제안한다. 기존의 대뇌 혈류 증가 장치의 단점을 보완하기 위해 가압식 측정법을 적용하여 환자의 사지 혈압을 정확하게 측정하고 사지압박을 실시하여 대뇌부위로 가는 혈류량을 우회적으로 증가시켜 혈류증강 치료를 실시한다. 이는 기존의 침습적 대뇌혈류증강 치료와 비교하여 합병증의 우려가 없고 환자에게 부담을 주지 않으며 대뇌혈류량을 의미 있게 증가시키기 때문에 환자에게 선택적으로 사용될 수 있다.

경추부 초음파 유도하 중재술 (Ultrasound-guided Intervention in Cervical Spine)

  • 문상호
    • 대한정형외과 초음파학회지
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    • 제7권1호
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    • pp.49-66
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    • 2014
  • 지금까지 경추부 중재술은 방사선 투시하에 하는 것이 표준화된 방법이었다. 그러나 방사선을 피폭해야 하는 문제가 있으며, 실시간으로 조영제를 이용하여 투시하거나 컴퓨터단층촬영 유도하 시술로써 안전하게 시행하려는 노력에도 불구하고, 특히 경추간공 차단술에서, 예기치 않은 주사제의 동맥내 주입이 발생하여 심각한 합병증인 척수 손상, 소뇌 및 뇌간 경색 등의 증례들이 방사선 투시하 시술에서 보고되는 것이 사실이다. 최근에는 그 대안으로서 경추부 초음파 유도하 중재술이 시행되고 있는데, 초음파는 주요 신경 및 혈관 구조물들의 위치를 관찰하면서 목표 부위 주위로 주사제가 퍼져나가는 양상을 파악할 수 있다는 장점이 있기 때문이다. 또한 초음파는 방사선이 없고 간편하며 주사하는 동안 실시간으로 계속 영상을 제공함으로써 시술의 정확도를 높일 수 있는 술기이다. 결국 초음파 유도하 시술은 주요 신경과 혈관의 위치를 확인하면서 그에 대한 손상 혹은 주사를 피할 수 있기 때문에 이러한 구조물들의 손상 위험이 높은 경추부에서 안전하게 시행할 수 있다는 중요한 장점이 있는 술기이다. 그리하여 저자는 실시간 초음파 유도하라는 술기가 경추부 중재술에서 얼마나 유용한가에 대해 분석하여 기술하였다.

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Classical swine fever disease in Cheolwon

  • Park Yang-Soon;Shin Myung-Kyun;Chong Dong-Soo;Cheong Ki-Soo;Park Young-Nam;Choi Jee-Hee
    • 한국동물위생학회지
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    • 제27권4호
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    • pp.345-354
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    • 2004
  • Two cases of classical swine fever (CSF) disease have broken out in Cheolwon (7 April, 2002). The suspected pig herds were huddled together because of high fever (over $40^{\circ}C$) and showed remarkable decrease of the leukocytes. The staggering gait related to posterior weakness, constipation and lethargy, hyperemia, hemorrhagic lesions (on the skin, muzzle, ears, limbs, tail and inner part of legs) and conjunctivitis with dirty streaks below the eyes were observed. The inflammation in the lung, infarction in the spleen, swelling and hemorrhage in lymph nodes, kidney, intestine, heart and cheese like purulent inflammation of the tonsil were observed. The ulcers of the colon were also detected. Several clinical and laboratory techniques including blood test, histo-pathological examinations, indirect fluorescent antibody (IFA) test and RT-PCR test were applied to diagnose the disease. Inoculation test on PK-15 cell was also performed. The necrosis of the lymphatic cells and infiltration of the vessel circumferential cells in the brain and lymph organs were commonly viewed. The proliferation of the glia cell (gliosis) in the lymph was particular. Cytopathogenic effect (CPE) and specific fluorescent-bright-green areas (with IFA) appeared in PK-15 cells inoculated with suspected blood plasma. The IFA test on the epithelial and mucous membrane cells of tonsil was positive. RT-PCR technique required more working hours and labor than other techniques in this examination but it was useful because of the sensitivity to the CSF viral gene.

목단피(牧丹皮)가 손상된 성상신경세포의 CD81 및 GFAP의 발현에 미치는 영향 (The Effect of the Moutan Radicis Cortex on Expression of CD81 and GFAP in Injured Astrocyte)

  • 문성진;성기문;임진영;송봉근
    • 대한한방내과학회지
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    • 제30권1호
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    • pp.24-35
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    • 2009
  • Object : In conditions of brain infarction, irreversible axon damage occurs in the central nerve system (CNS), because gliosis makes physical and mechanical barriers. If gliosis formation could be suppressed, irreversible axon damage would be reduced. This could mean that an injured CNS could be regenerated. CD81 and GFAP have close relationships to gliosis. The increase in glial cells at CNS injury gives rise to the expression of CD81 and GFAP. CD81 was postulated to play a central role in the process of CNS scar formation. Method : In this study, the author investigated the effect of the water extract of the Moutan Radicis Cortex on regulation of CD81 and GFAP expression in injured CNS cells. MTT assay was used to examine cell viability, while RT-PCR and ELISA methods were carried out to measure the expression of CD81 and GFAP in the astrocyte. Results : We observed that water extract of the Moutan Radicis Cortex increased cell viability under hypoxia induced by $CoCl_2$ and suppressed the expression of CD81 and GFAP up-regulated by hypoxia. Conclusion : These results suggest that the Moutan Redicis Cortex could promote neural regeneration as a consequence of protecting CNS cells from hypoxia and suppressing the reactive gliosis following CNS injury.

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전침자극과 운동치료가 허혈성 뇌졸중 백서모델의 신경계에 미치는 영향 (Effects of Electro-acupuncture and Therapeutic Exercise on Nervous system in the Ischemic Stroke Rats)

  • 유영대;김기도;천진성;정현우;김계엽
    • 동의생리병리학회지
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    • 제20권4호
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    • pp.1014-1020
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    • 2006
  • This study was intended to examine the effects of electroacupuncture(EA) and therapeutic exercise on the improvement of exercise function, BNDF, and HSP70 protein expression in an ischemic stroke model induced by MCA occlusion. Experiments were conducted for 1, 3 days, 1, 8 weeks respectively. Group I was a group of EA and therapeutic exercise; Group II was a group of therapeutic exercise; Group III was a group of EA; Group IV was a sham group of EA; Group V was a control group; and Group VI was a sham group without ischemic stroke. In each group, neurologic motor behavior test, histologic observations, BDNF, and HSP70 expression were observed and analyzed. The following results were obtained. The results of behavior test suggest that 8 weeks after ischemic stroke was induced, Group I improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group VI. In immunohistochemical observations, Group I showed increase in BDNF and decrease in HSP70. Based on these results, EA and therapeutic exercise may improve muscle atrophy and change in BDNF and HSP70 expression of ischemic stroke rats and contribute to the improvement of exercise function.

사상체질집단의 ADPRT gene 3'UTR region의 단일염기다형성 연구 (Genetic Polymorphism of ADPRT Gene 3'UTR Region and Sasang Constitution)

  • 이성진;송일병;이수경
    • 사상체질의학회지
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    • 제14권2호
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    • pp.90-97
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    • 2002
  • Sasang Constitutional Medicine is based on the diversity of human being and medically developed the variation of response to diseases and medicines. The diversity is categorized as four groups Taeyangin, Taeumin, Soyangin, Soeumin according to morphology, physiology, pathology, and pharmacology. The phenotypes of Sasang constitutions represent that constitutions may be possessed of the different genetic backgrounds. To clarify the genetic difference among the Sasang constitutions, we performed a genetic analysis with the 3'-UTR polymorphism of ADPRT (rs=8679) as a pooled DNA sequencing method. ADPRT modulates various nuclear proteins by poly(ADP-ribosy)lation and is involved in the regulation of various cellular processes such as differentiation, proliferation, and tumor transformation. This gene is also involved in the recovery of cell from DNA damage and the brain infarction. The allele frequencies of [T/C] polymorphism of ADPRT of Soeumin and Soyangin groups were (T: 0.94/C: 0.06) and that of Taeumin and Taeyangin groups were (T: l.00/C: 0.00). The allele frequency was not showed the difference between constitution groups. This result represented that the [T/C] polymorphism of ADPRT 3' UTR region was not suitable to classify the constitutions. However, this study is the first trial of Sasang classification according to genetic polymorphism and further analysis will be necessarily to classify the genetic difference of Sasang constitution.

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Changes in Blood Pressure and Heart Rate during Decompressive Craniectomy

  • Jo, Kwang Wook;Jung, Hyun-Ju;Yoo, Do Sung;Park, Hae-Kwan
    • Journal of Korean Neurosurgical Society
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    • 제64권6호
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    • pp.957-965
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    • 2021
  • Objective : Rapid increase in intracranial pressure (ICP) can result in hypertension, bradycardia and apnea, referred to as the Cushing phenomenon. During decompressive craniectomy (DC), rapid ICP decreases can cause changes in mean atrial blood pressure (mABP) and heart rate (HR), which may be an indicator of intact autoregulation and vasomotor reflex. Methods : A total of 82 patients who underwent DC due to traumatic brain injury (42 cases), hypertensive intracerebral hematoma (19 cases), or major infarction (21 cases) were included in this prospective study. Simultaneous ICP, mABP, and HR changes were monitored in one minute intervals during, prior to and 5-10 minutes following the DC. Results : After DC, the ICP decreased from 38.1±16.3 mmHg to 9.5±14.2 mmHg (p<0.001) and the mABP decreased from 86.4±14.5 mmHg to 72.5±11.4 mmHg (p<0.001). Conversly, overall HR was no significantly changed in HR, which was 100.1±19.7 rate/min prior to DC and 99.7±18.2 rate/min (p=0.848) after DC. Notably when the HR increased after DC, it correlated with a favorable outcome (p<0.001), however mortality was increased (p=0.032) when the HR decreased or remained unchanged. Conclusion : In this study, ICP was decreased in all patients after DC. Changes in HR were an indicator of preserved autoregulation and vasomotor reflex. The clinical outcome was improved in patients with increased HR after DC.

침치료와 Open Wet Dressing Therapy로 완치된 3,4단계 욕창환자 9례에 대한 증례보고 (9 Cases of Pressure Ulcers Cured by Acupuncture Treatment and Open Wet Dressing Therapy)

  • 서정복;이태종;이지원;김경아;윤정제
    • 동의생리병리학회지
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    • 제34권5호
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    • pp.269-278
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    • 2020
  • The purpose of this study is to report the effect of the Korean acupuncture treatment and Open Wet Dressing Therapy(OPWT) for pressure ulcer. From November 2015 to January 2020, 9 patients with 3rd or 4th graded pressure ulcer over 70 years of age who were admitted to a care hospital with underlying diseases such as cerebral infarction, brain hemorrhage, and Parkinson's disease were treated by acupuncture and OPWT. Photographs of lesions were used to evaluate the changes in condition of pressure ulcer. Acupuncture was performed 4 times a week along the border between the normal epidermal region and the pressure ulcer granulation tissue in contact with the pressure ulcer interface. OPWT to create a wet environment for wounds by washing the wounds 1-2 times a day with normal saline solution and covering them with food wrap was combined. In addition, for objective treatment progress evaluation, size, stage and condition of pressure ulcer were regularly monitored using the classification method of The National Pressure Ulcer Advisory Panel (NPUAP) according to the condition and depth of the damaged tissue and The Pressure Ulcer Scale for Healing(PUSH tool 3.0). After acupuncture treatment and OPWT, the pressure ulcer of patients was cured in as short as 66 days and as long as 274 days (average 170 days). This study shows that acupuncture treatment and OPWT were effective to treat pressure ulcer.

열다한소탕(熱多寒少湯) 가감방(加減方)을 이용한 태음인(太陰人) 시상통증증후군 치험 1례 (A Case report of Thalamic pain Syndrome Patient who were Constitutionally Typed as Taeeumin improved by Yeoldahanso-tang(熱多寒少湯))

  • 엄태민;백인경;박혜진;조현경;김윤식;유호룡;설인찬
    • 대한중풍순환신경학회지
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    • 제14권1호
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    • pp.115-121
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    • 2013
  • 2013년 2월 19일부터 2013년 3월 16일까지 대전대학교 둔산한방병원에서 입원치료를 받은 시상통증증후군 환자 1례를 태음인(太陰人) 간조열증(肝燥熱證)으로 인한 중풍(中風)으로 판단하고 열다한소탕(熱多寒少湯) 가감방(加減方)을 투여하고 침구(鍼灸)치료, 부항요법(附缸療法), 물리치료, 재활 및 운동치료 등을 병행하면서 환자의 시상통증증후군 증상을 면밀히 관찰한 결과 유의한 효과를 얻었는바 이에 보고하는 바이나 향후 더 많은 증례를 통한 지속적인 연구가 필요할 것으로 사료된다.

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대뇌반구의 병변과 동측에 반신마비 발생한 중풍 환자의 1례 (A Case Report of a patient with hemiplegia ipsilateral to affected cerebral hemisphere)

  • 조승연;곽자영;홍진우;나병조;박성욱;정우상;문상관;박정미;고창남
    • 대한중풍순환신경학회지
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    • 제8권1호
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    • pp.48-57
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    • 2007
  • Stroke is a disease which results in impairment of body functions and affects everyday life. The ability of cerebral neurons to become reorganized and restore function after damage is called plasticity. Motor impairment typically appears contralateral to the affected cerebral hemisphere in patients with cerebral lesions. The authors report a case of a patient with hemiplegia ipsilateral to affected cerebral hemisphere, along with its conjectured mechanism.

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