• 제목/요약/키워드: subacute stage

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Pituitary Hemorrhage : Classification and Related Factors

  • Kim, Dae-Jin;Song, Young-Jin;Kim, Su-Jin;Park, Mi-Kyoung;Choi, Sun-Seob;Kim, Ki-Uk
    • Journal of Korean Neurosurgical Society
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    • 제46권1호
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    • pp.23-30
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    • 2009
  • Objective : Clinical features of pituitary hemorrhage vary from asymptomatic to catastrophic. The purpose of this study was to evaluate the factors related to severity of hemorrhage of pituitary adenoma. Methods : Pituitary hemorrhage was noted in 32 of 88 patients who underwent operations between January 2000 and December 2007. Clinical status was classified into group I (no hemorrhage symptoms), II (mild to moderate symptoms without neurological deficit), and III (with neurological deficit), and was compared to radiological, pathological, and operative findings. All patients were operated by transsphenoidal approach, and hemorrhage-related symptoms were relieved. Results : Groups I, II,and III comprised 15, 10 and 7 patients, respectively. In group I, hemorrhage volume was under 1 mL in 11 (73.3%), but, it was above 1 mL in 7 (70%) of group II and in all cases of group III. Hemorrhage stage based on MRI findings was chronic or subacute in 11 (73.3%) of group I, acute in 6 (60%) of group II, and acute or hyperacute in 6 (85.7%) of group III. Pathological examination revealed chronic-stage hematomas in 5 (50%) group II patients. Functioning adenomas were found in 5 (33.3%) group I patients but none in group II or III patients. Silent adenomas were found in 4 (26.7%), 8 (80%), and 3 (42.9%) in groups I, II,and III, respectively. Conclusion : Clinical features of pituitary hemorrhage may differ with the radiological and immunohistopathlogical findings. Persistent symptoms are related to the chronic stage of hematoma requiring surgery for symptom relief. Neurological deficits are caused by large amount of acute hemorrhage requiring emergency operation. Silent adenoma is related to the severity of pituitary hemorrhage.

요추추간판탈출증의 동·서의학적 협진연구 (Collaborative Study of Oriental-Western Medicine on HIVD)

  • 이건목;이강창;황유진
    • Journal of Acupuncture Research
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    • 제17권2호
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    • pp.1-10
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    • 2000
  • Herniated lumbar intervertebral disc(HIVD) is the most common reason causing low back pain and leg radiating pain. The purpose of this study is to see the good of Oriental-Western medicine on HIVD. In order to this syudy, HIVD patients divided into two groups: Group with Oriental medicine(GOM) and Group with Oriental-Westem medicine(GOWM). The results of treatments were summarized as follows. 1. If We investigate a state of patients, GrIII type is 17 cases in GOM and is 16 cases in GOWM. In the GOM, Gr II shows better than the others and in the GOWM, GrI, III shows better than the others. 2. The results of treatments in GOM and GOWM is the good in a general way. It shows excellent type at 10 cases in the GOM, and shows excellent type at 14 cases in GOWM. 3. In Acute stage(in one month), subacute stage(one month~six months) and chronic stage(over six months), the therapic point of GOM and GOWM is 2.9~3.5 on the average. 4. If we notice the effect point of HIVD, in GOM, the point of bulging type is 3, protruded type is 3.5 extruded type is 3. But in GOWM, the point of bulging type is 3.7, protruded type is 3.5 extruded type is 2.7.

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뇌졸중으로 인한 운동 관련 후유증의 한의 치료 연구에서 뇌졸중 시기 및 평가 척도에 대한 국내 문헌 고찰 (A Review of the Stroke Stage and Outcome Measures in Stroke Motor Sequelae Clinical Studies in Korea)

  • 이지은;천세은;전민결;신용진;임정태;신선호
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.656-679
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    • 2022
  • Objectives: The aims of this study were to evaluate the fidelity of stroke stage reporting, the timeliness of the outcome measures, and the use of the core outcome set. Methods: We searched the literature using 6 domestic databases. We selected studies that used Korean medicine interventions and targeted stroke patients with motor sequelae. We examined whether the included studies reported the stroke stage and whether they used the outcome measures in the appropriate period based on the recommendations of the "Stroke Evidence Database to Guide Effectiveness". We also confirmed the use of the essential assessment tools suggested by the core outcome set. Results: Overall, 77 studies were finally selected, with 16 (21%), 55 (71%), and 6 (8%) published on the acute, subacute, and chronic phases, respectively. Only 11 of the studies directly mentioned the stroke stage. The most commonly used assessments were the National Institutes of Health Stroke Scale, Modified Barthel Index, and Manual Muscle Testing. Only 5 studies failed to apply the stage-related outcome measures at the recommended period. The outcome variables used inadequately were the National Institutes of Health Stroke Scale, Functional Ambulation Categories, 36-Item Short Form Health Survey, and Mini-Mental State Examination. Among the core outcome set items, some studies used liver and renal function tests, but no herbal medicine safety reporting was conducted. Conclusions: In future studies, we propose to ensure accurate reporting of the stroke stage with reliable outcome measures to deliver better clinical and research outcomes. Furthermore, in future clinical studies on stroke, a standard protocol that reflects the core outcome set should be developed.

가와사끼병에서 Matrix metalloproteinase 9과 Tissue inhibitor of metalloproteinase 1, 2의 임상적 중요성 (Clinical significance of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 and 2 in Kawasaki disease)

  • 윤기욱;윤신원;이정주;채수안;임인석;최응상;유병훈;이미경
    • Clinical and Experimental Pediatrics
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    • 제53권4호
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    • pp.510-518
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    • 2010
  • 목 적: 가와사끼병은 급성 전신성 미세혈관염으로서, 소아의 후천성 심질환의 가장 흔한 원인이다. 가와사끼병의 관상동맥병변에 대한 조직병리학적 소견은 미만성 혈관염에 의한 관상동맥벽의 파괴를 시사하는데, matrix metalloproteinase (MMP)와 그 내인성 억제인자인 tissue inhibitor of metalloproteinases (TIMP)가 이러한 과정에 주요한 역할을 할 것으로 생각되고 있으며, 그 중에도 MMP-9이 최근 가장 주목을 받고 있다. 따라서 본 연구에서는, 한국의 가와사끼병 환아들에서 MMP-9과 그 억제인자들인 TIMP-1, TIMP-2가 갖는 임상적 중요성을 평가하고자 하였다. 방 법: 가와사끼병 환아 47명을 연구대상으로 하였고, 급성열성 세균감염 환아 14명을 대조군으로 하였다. 혈중 MMP-9, TIMP-1, TIMP-2의 농도를 kit를 통한 효소 면역법을 이용하여 측정하였고, 각 임상 단계 및 관상동맥병변의 유무에 따라 비교분석하였다. 결 과: 급성기에 MMP-9과 TIMP-1은 가와사끼군에서 대조군에 비해 유의하게 높았고, TIMP-2는 오히려 낮았다($P$<0.05). 급성기에 증가한 MMP-9은 아급성기와 회복기에 유의하게 감소하였다($P$<0.05). 관상동맥 확장군과 비확장군의 비교에서는, 확장군에서 급성기 MMP-9과 TIMP-1, MMP-9/TIMP-2가 낮았으며, 아급성기로 가면서 통계적으로 유의하게 증가하였다가 다시 회복기로 가면서 감소하는 양상을 보였다($P$<0.05). MMP-9은 급성기와 아급성기에 TIMP-1과 통계적으로 유의한 양의 상관관계를 보였고, TIMP-2와는 아급성기와 회복기에 음의 상관관계를 보였다($P$<0.05). 결 론: 이러한 결과들은 MMP-9과 TIMP-1의 증가, 그리고 MMP-9과 TIMP-2의 불균형이 가와사끼병, 특히 그 관상동맥병변의 병태생리에 핵심적인 역할을 한다는 사실을 시사한다 하겠다. 더 종합적이고 심도 깊은 연구를 위해서 좀 더 많은 대상자를 포함하는 큰 규모의 연구들이 향후 이루어져야 할 것이다.

편측 뇌손상 환자의 동측 운동 결함에 대한 고찰 (Ipsilateral Motor Deficit in Patients with Unilateral Brain Damage)

  • 김중선;김경;권용현
    • The Journal of Korean Physical Therapy
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    • 제18권4호
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    • pp.1-9
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    • 2006
  • Recently, several investigations revealed that after unilateral brain damage, movement abnormalities were exposed on the ipsilateral side as well as the upper extremity contralateral to the damaged hemisphere. Even the motor abilities had significantly recovered from ipsilateral motor deficits on not only simple sensoriomotor function, also clinical assessments since subacute stage, although could not completely returned. Such motor deficits were detected in a diversity of motor tasks depending on the interhemispheric specialization, further in clinical evaluation and a daily of activities. In the clinical features, muscular weakness, sensory loss and impaired manual dexterity were observed. In a laboratory experiment, there were increasing evidences that the kinematic processing deficits was founded in various-specific motor tasks, which ranged from simple basic element to complex tasks, such as tapping task, step-tracking, goal directional aiming task, and iso(and non-)directional interlimb coordination. In the point of view, the manifest understanding in related to ipsilateral deficits provide the clinicians with an important information for scientific management about brain injured patient's prognosis and therapeutic guidelines.

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A case of Hashimoto's encephalopathy presenting with seizures and psychosis

  • Lee, Min-Joo;Lee, Hae-Sang;Hwang, Jin-Soon;Jung, Da-Eun
    • Clinical and Experimental Pediatrics
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    • 제55권3호
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    • pp.111-113
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    • 2012
  • Hashimoto's encephalopathy (HE) is a rare, poorly understood, autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. Here, we report a case of a 14-year-old girl with HE and briefly review the literature. The patient presented with acute mental changes and seizures, but no evidence of infectious encephalitis. In the acute stage, the seizures did not respond to conventional antiepileptic drugs, including valproic acid, phenytoin, and topiramate. The clinical course was complicated by the development of acute psychosis, including bipolar mood, insomnia, agitation, and hallucinations. The diagnosis of HE was supported by positive results for antithyroperoxidase and antithyroglobulin antibodies. Treatment with methylprednisolone was effective; her psychosis improved and the number of seizures decreased. HE is a serious but curable, condition, which might be underdiagnosed if not suspected. Anti-thyroid antibodies must be measured for the diagnosis. HE should be considered in patients with diverse neuropsychiatric manifestations.

뇌졸중 환자의 건측억제유도와 자기효능에 대한 이해 (Understanding the constraint induced movement and Self-efficacy in Stroke Patients)

  • 신형수;김중선
    • PNF and Movement
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    • 제3권1호
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    • pp.35-45
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    • 2005
  • Objectives : The purpose of this study was to understanding the constraint induced movement and Self-efficacy with arm training on upper motor function in Stroke Patients. Methods : Stroke, the leading cause of functional disability, causes a variety of impairments that compromise quality of life. Upper limb hemiparesis, a commonly seen impairment, is particularly problematic given its impact on activities of daily living. Because stroke was a disease to correspond to the first during domestic cause of death, and was accompanied by a lot of side aftereffects after a survival, stroke rehabilitation bought a patient and a family and a physical therapist, and it was main concern of. Results : Looks into upper extremity excrise of a subacute stroke patient estranged a acute convalescence later by a rehabilitation treatment in this consideration, and evaluates an effect to wind up constraint induced movement for an early treatment of stroke and Self efficacy, and help is one to an early rehabilitation of an stroke patient. Conclusions : Overuse sound tends after the stroke occurrence in the early stage in order to recompense for stroke, and at the time of a new aspect called learned nonuse syndrome by a movement of a paralysis part dusting off wealth with this step thing later. Constraint induced movement using self efficacy could be an effective for improving function of stroke.

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Evaluating the Influence of Side Stream Cigarette Smoke at an Early Stage of Non-Alcoholic Steatohepatitis Progression in Mice

  • Kim, Jong Won;Yun, Hyejin;Choi, Seong-Jin;Lee, Sang-Hyub;Park, Surim;Lim, Chae Woong;Lee, Kyuhong;Kim, Bumseok
    • Toxicological Research
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    • 제33권1호
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    • pp.31-41
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    • 2017
  • Side stream cigarette smoke (SSCS) is known to be as harmful and hazardous to human health as is active smoking. In this study, we investigated the relationship between the exposure to SSCS and its stimulatory and subacute effects on the progression of non-alcoholic steatohepatitis (NASH). A methionine and choline-deficient plus high fat (MCDHF) diet was administered to C57BL/6 mice for 6 weeks. During the first three weeks of MCDHF diet feeding, each diet group was exposed to SSCS (0, 20, $40{\mu}g/L$) or fresh air for 2 hrs per day and 5 days per week. Additional experiments were performed by increasing the concentration (0, 30, $60{\mu}g/L$) and exposure time (6 hours per day) of SSCS. According to histopathologic analysis and serum levels of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST), there were no differences in hepatic fat deposition, fibrosis, apoptosis or liver damage in MCDHF-fed mice based on SSCS exposure. There were also no differences in the expression of inflammation-, oxidative stress- or fibrosis-related genes between MCDHF-fed mice with or without SSCS exposure. Therefore, it is concluded that SSCS with current exposure amounts does not have additive detrimental effects on the early stage of NASH.

실험적 돼지 삼출성 표피염에 관한 병리학적 연구 I. 육안적 및 병리조직학적 관찰 (Pathological studies on exudative epidermitis in experimentally infected pigs I. Macroscopical and histopathological observations)

  • 오규실;이차수
    • 대한수의학회지
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    • 제34권4호
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    • pp.787-799
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    • 1994
  • To elucidate morphologic lesion of porcine exudative epidermitis which is occurred sporadically in Korea, Staphylococcus hyicus subsp. hyicus isolated from the naturally affected pigs was inoculated to suckling pigs. The infected piglets were observed grossly and histopathologically. Although affected piglets were taking acute, subacute, or chronic course, some piglets suffered from chronic disease showed poor prognosis and marked growth depression. Affected peglets had erythematous skin on the face, ear, and abdomen and these localized lesions appear as brownish spots of exudative epidermitis and fromed crust in the early stage. But, after this stage, the skin were covered by viscous greasy exudate and formed blackish brown crust and appeared fissures and hypertrophy. Grossly, there has been hemorrhage with the removal of crust-like materials of epidermis and edematous subcutis. The superficial lymph nodes were edematous and swollen or congested and hemorrhagic. Some piglets had swollen ureters, cysts in the renal cortex, or polyarthritis. A few cases had mild edematous swelling of kidney, intestinal catarrh and congestion of brain. Microscopically, skin lesions had detachment of keralinized layer and parakeratosis of epidermis, hydropic degeneration of epidermal cell, and retrogressive degeneration of hair root sheath. Dermis had edema, and infiltration of neutrophils and mononuclear cells. As the disease was proceeded, there was marked perivasculitis with lots of mononuclear inflammatory cells. More chronic lesions formed granuloma-like bodies(nodules) due to more mononuclear, perivascular inflammatory cell infiltration and proliferation of fibroblast. Lots of plasma cells and eosinophils were also present in dermis. Epidermis was hyperplastic by proliferation of basal cells stratum germinativum and epidermal pegs often extended into the dermis. In secondary infection, lots of neutrophils could be seen in epidermis and derms. Kidney had neutrophilic infiltration, necrotic and cystic glomeruli, and dilation of renal tubules and ureters. Purulent arthritis was sometimes observed in joints. Three days old mice administrated Staphylococcus hyicus subsp hyicus subcutaneously before had focal congestion and hemorrhage, necrosis, and subcutaneous edema of the skin. This observation was also seen in the study of mice administrated exfoliatin toxin of Staphylococcus which evoked human staphylococcal scalded skin syndrome.

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뇌졸중환자(腦卒中患者)에 대한 연례보고(年例報告)(IV) (Yearly Report on CVA patients (IV))

  • 심문기;전찬용;박종형
    • 대한한의학회지
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    • 제19권2호
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    • pp.59-74
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    • 1998
  • Clinical observation was done on 272 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 1997. 1. The cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage. and transient ischemic attack. The most case of them was the cerebral 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 cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 7. The common symptoms were motor disability and verbal disturbance. 8 The average time to start physical therapy was 1l.3rd day after stroke in cerebral infarction and it was 15.2th day after stroke in cerebral hemorrhage. 9. The common complications were urinary tract infection, pneumonia, myocardial infarction. 10. Hypercholesterolemia and hypertriglyceridemia are usually found more frequently in cerebral infarction than in hemorrhage. 11. 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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