• 제목/요약/키워드: therapeutic space

검색결과 126건 처리시간 0.032초

수술 전 뇌조신티그라피에 의해 치료방침을 결정한 경막하 수활액낭종 1례 (Preoperative Cisternoscintigraphy As a Guide to Therapeutic Decision Making for Cystic Subdurnl Hygroma: Case Report)

  • 김성민;범희승;송호천;민정준;정환정;김지열
    • 대한핵의학회지
    • /
    • 제34권4호
    • /
    • pp.366-369
    • /
    • 2000
  • We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of acute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.

  • PDF

개에서 추간판 질환에 대한 침술치료 증례 (Application of Traditional Acupuncture on Canine Intervertebral Disc Disease)

  • 정성목;박수원
    • 한국임상수의학회지
    • /
    • 제21권1호
    • /
    • pp.49-51
    • /
    • 2004
  • A four-year-old female Pekingese dog was presented with intermittent ambulatory hindlimb lameness and severe back pain. The course of the disease was acute and static and 5 days passed by until presentation. In neurological examination, severe back pain and slightly decreased proprioception in right hindlimb were shown. In radiographic examination, radiopacity was increased at T10-11 intervertebral disc space. According to the history taking, neurological examination and radiographic examination, it was tentatively diagnosed as intervertebral disc disease (IVDD). Conservative treatment was performed including cage rest, medication with prednisolone and traditional acupuncture. Acupoints were GV-6, GV-7, BL-18, BL-19. BL-40 and GB-34. Dry needlings rested for 20 minutes. Just after the first acupuncture treatment back pain was significantly decreased. With additional acupuncture treatment, all the clinical signs were not observed. It is considered that conservative therapy including traditional acupuncture, medication and cage rest might be the first choice of therapeutic method for Grade I or II IVDD in dogs.

Light microscopic evidence of in vivo differentiation from the transplanted inferior turbinate-derived stem cell into the rod photoreceptor in degenerating retina of the mouse

  • Yong Soo Park;Yeonji Kim;Sung Won Kim; In-Beom Kim
    • Applied Microscopy
    • /
    • 제50권
    • /
    • pp.11.1-11.3
    • /
    • 2020
  • The human turbinate-derived mesenchymal stem cells (hTMSCs), which were DiI-labeled and transplanted into the subretinal space in degenerating mouse retina, were observed in retinal vertical sections processed for rhodopsin (a marker for rod photoreceptor) by confocal microscope with differential interference contrast (DIC) filters. The images clearly demonstrated that DiI-labeled hTMSCs have rhodopsin-immunoreactive appendages, indicating differentiation of transplanted hTMSC into rod photoreceptor. Conclusively, the finding suggests therapeutic potential of hTMSCs in retinal degeneration.

Rare complication of skin necrosis after endoscopic debridement and cutaneo-fascial suture for a massive Morel-Lavallée lesion in Korea: a case report

  • Youngmin Kim;Jayun Cho;Myung Jin Jang;Kang Kook Choi
    • Journal of Trauma and Injury
    • /
    • 제36권3호
    • /
    • pp.304-309
    • /
    • 2023
  • A Morel-Lavallée lesion (MLL) is a pathologic fluid collection within an abnormally formed space, resulting from an internal degloving injury between the muscle fascia and subcutaneous fat layer. Due to its resistance to conservative treatments such as drainage or compression dressing, various therapeutic methods have been developed for MLL. However, no standardized guidelines currently exist. Recently, endoscopic debridement and cutaneo-fascial suture (EDCS) has been introduced for the treatment of MLL, particularly for large lesions resistant to conservative approaches. While this procedure is known to be effective, limited reports are available on potential complications. The authors present a case of skin necrosis following EDCS for a massive MLL.

Endothelial cell autophagy in the context of disease development

  • Basheer Abdullah Marzoog
    • Anatomy and Cell Biology
    • /
    • 제56권1호
    • /
    • pp.16-24
    • /
    • 2023
  • Endothelial cells (EC) are the anatomical boundaries between the intravascular and extravascular space. Damage to ECs is catastrophic and induces endothelial cell dysfunction. The pathogenesis is multifactorial and involves dysregulation in the signaling pathways, membrane lipids ratio disturbance, cell-cell adhesion disturbance, unfolded protein response, lysosomal and mitochondrial stress, autophagy dysregulation, and oxidative stress. Autophagy is a lysosomal-dependent turnover of intracellular components. Autophagy was recognized early in the pathogenesis of endothelial dysfunction. Autophagy is a remarkable patho (physiological) process in the cell homeostasis regulation including EC. Regulation of autophagy rate is disease-dependent and impaired with aging. Up-regulation of autophagy induces endothelial cell regeneration/differentiation and improves the function of impaired ones. The paper scrutinizes the molecular mechanisms and triggers of EC dysregulation and current perspectives for future therapeutic strategies by autophagy targeting.

Deciphering Macrophage Phenotypes upon Lipid Uptake and Atherosclerosis

  • Jihye Lee;Jae-Hoon Choi
    • IMMUNE NETWORK
    • /
    • 제20권3호
    • /
    • pp.22.1-22.21
    • /
    • 2020
  • In the progression of atherosclerosis, macrophages are the key immune cells for foam cell formation. During hyperlipidemic condition, phagocytic cells such as monocytes and macrophages uptake oxidized low-density lipoproteins (oxLDLs) accumulated in subintimal space, and lipid droplets are accumulated in their cytosols. In this review, we discussed the characteristics and phenotypic changes of macrophages in atherosclerosis and the effect of cytosolic lipid accumulation on macrophage phenotype. Due to macrophage plasticity, the inflammatory phenotypes triggered by oxLDL can be re-programmed by cytosolic lipid accumulation, showing downregulation of NF-κB activation followed by activation of anti-inflammatory genes, leading to tissue repair and homeostasis. We also discuss about various in vivo and in vitro models for atherosclerosis research and next generation sequencing technologies for foam cell gene expression profiling. Analysis of the phenotypic changes of macrophages during the progression of atherosclerosis with adequate approach may lead to exact understandings of the cellular mechanisms and hint therapeutic targets for the treatment of atherosclerosis.

경막외차단 중 발생된 우발적 경막하 스테로이드 주입에 의한 난치성 요추수술 후 실패증후군의 치료 경험 -증례 보고- (Accidental Subdural Steroid Injection during Intended Epidural Block Relieves Intractable Radiculopathy in Failed Back Surgery Syndrome -A case report-)

  • 정기승;송선옥;조영우
    • The Korean Journal of Pain
    • /
    • 제14권1호
    • /
    • pp.104-109
    • /
    • 2001
  • We describe the accidental injection of local anesthetics containing steroid into the subdural space during an attempted lumbar epidural injection for intractable radiculopathy in a patient with failed back surgery syndrome. A 24-year-old man complained of severe radiating pain to left lower extremity and showed a walking disturbance and severe lumbar scoliosis. The MRI finding was a left paramedian recurred disc herniation on L4-5 in a laminectomy state. Several therapeutic modalities such as epidural steroid injection, transforaminal injection, L2 root block, medication, and exercise therapy, etc failed. Initially, during epidural block at L4-5 under fluoroscopic guidance, a railroad track appearance appeared on epidurogram suggesting the presence of a subdural space. A second epidural block was tried at L5-S1. Following confirmation of epidural space upon epidurogram, 6 ml of 0.5% lidocaine including triamcinolone 40 mg was injected. The patient showed signs of the subdural injection including an unexpectedly high sensory block (T2) and a motor weakness of both lower extremities. Following this event, the severe radiculopathy and lumbar scoliosis were improved. Therefore, we conclude that subdural injection of steroid could be helpful in intractable radiculopathy, especially in the failed back surgery syndrome. However, it must be used cautiously with careful patient selection.

  • PDF

Complication of epiduroscopy: a brief review and case report

  • Marchesini, Maurizio;Flaviano, Edoardo;Bellini, Valentina;Baciarello, Marco;Bignami, Elena Giovanna
    • The Korean Journal of Pain
    • /
    • 제31권4호
    • /
    • pp.296-304
    • /
    • 2018
  • Epiduroscopy is defined as a percutaneous, minimally invasive endoscopic investigation of the epidural space. Periduroscopy is currently used mainly as a diagnostic tool to directly visualize epidural adhesions in patients with failed back surgery syndrome (FBSS), and as a therapeutic action in patients with low back pain by accurately administering drugs, releasing inflammation, washing the epidural space, and mechanically releasing the scars displayed. Considering epiduroscopy a minimally invasive technique should not lead to underestimating its potential complications. The purpose of this review is to summarize and explain the mechanisms of the side effects strictly related to the technique itself, leaving aside complications considered typical for any kind of extradural procedure (e.g. adverse reactions due to the administration of drugs or bleeding) and not fitting the usual concept of epiduroscopy for which the data on its real usefulness are still lacking. The most frequent complications and side effects of epiduroscopy can be summarized as non-persistent post-procedural low back and/or leg discomfort/pain, transient neurological symptoms (headache, hearing impairment, paresthesia), dural puncture with or without post dural puncture headache (PDPH), post-procedural visual impairment with retinal hemorrhage, encephalopathy resulting in rhabdomyolysis due to a dural tear, intradural cyst, as well as neurogenic bladder and seizures. We also report for first time, to our knowledge, a case of symptomatic pneumocephalus after epiduroscopy, and try to explain the reason for this event and the precautions to avoid this complication.

A Study on Pattern Recognition to Compute Guidelines Based on Evidence for Ecological Healing Environment at Agha Khan Hospital in Karachi - Focused on Human Thermal Comfort Model (HTCM), for Karachi, using Climate Consultant Program

  • Shaikh, Javaria Manzoor;Park, Jae Seung
    • KIEAE Journal
    • /
    • 제15권2호
    • /
    • pp.27-35
    • /
    • 2015
  • Purpose: Healthcare is on the whole a personal and critical service that consumer's use, whereas hospitalization is as a rule painful, because nature nurtures and Sun Light Luminosity for healthcare settings is considered healing. The performance and design of climate responsive buildings such as AKU requires a detailed study of attributes of climate both at micro as well as macro level. The therapeutic value of contact with nature through window view, greenery and landscape is calculated there. Method: A two prong strategy is been devised for this article, at micro level three typical morphologies are analysed by creating same environment of neighboring building on sun shading chart, radiation and temperature range. Since the analysis of local climate helps to determine the design strategies for hospital Healing Environment which is suitable for Karachi climate; in order to track the macro climatic behaviour, a considerable analysis of psychometrics chart for AKU Karachi are designed on Climate Consultant (CC) and analysed by Machine Learning. Climate Consultant proposes different design strategies suitable for Karachi. And on the other hand time wise illumination sources for clinical area which are then measured on psychrometric chart- according to singular space: multi patient admission, secondly: acute ambulatory ward, and tertiary: multi windowed space according to the mushrabiyah and sky light pattern. Result: Our findings support the hypothesis that windowed wall is 75-80% more healing wall; an accelerated evidence was found for healing at macro level if the form of the hospital is designed according to the climatologically preferences, whereas at micro level: the light resource becomes the staff attentiveness determinant. In Conclusion evidence was provided that the actual form of luminosity results consequently in satisfaction while light entering from several set of windows and other sources might be valued if design according to the healing environment. The data added on the sun shading chart to calculate rays entraining into space in patient room equal to 124416.21 Watts/ meter $m^2$ is calculated as precise healing rate-and is confirmed by questionnaire from patients belonging from each clinical stage having different illnesses.

Subretinal transplantation of putative retinal pigment epithelial cells derived from human embryonic stem cells in rat retinal degeneration model

  • Park, Un-Chul;Cho, Myung-Soo;Park, Jung-Hyun;Kim, Sang-Jin;Ku, Seung-Yup;Choi, Young-Min;Moon, Shin-Yong;Yu, Hyeong-Gon
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제38권4호
    • /
    • pp.216-221
    • /
    • 2011
  • Objective: To differentiate the human embryonic stem cells (hESCs) into the retinal pigment epithelium (RPE) in the defined culture condition and determine its therapeutic potential for the treatment of retinal degenerative diseases. Methods: The embryoid bodies were formed from hESCs and attached on the matrigel coated culture dishes. The neural structures consisting neural precursors were selected and expanded to form rosette structures. The mechanically isolated neural rosettes were differentiated into pigmented cells in the media comprised of N2 and B27. Expression profiles of markers related to RPE development were analyzed by reverse transcription-polymerase chain reaction and immunostaining. Dissociated putative RPE cells ($10^5$ cells/5 ${\mu}L$) were transplanted into the subretinal space of rat retinal degeneration model induced by intravenous sodium iodate injection. Animals were sacrificed at 1, 2, and 4 weeks after transplantation, and immnohistochemistry study was performed to verify the survival of the transplanted cells. Results: The putative RPE cells derived from hESC showed characteristics of the human RPE cells morphologically and expressed molecular markers and associated with RPE fate. Grafted RPE cells were found to survive in the subretinal space up to 4 weeks after transplantation, and the expression of RPE markers was confirmed with immunohistochemistry. Conclusion: Transplanted RPE cells derived from hESC in the defined culture condition successfully survived and migrated within subretinal space of rat retinal degeneration model. These results support the feasibility of the hESC derived RPE cells for cell-based therapies for retinal degenerative disease.