• Title/Summary/Keyword: vascular accident

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Acoustic parameter delta of an aspirated voice in stroke patients (뇌졸중 환자 대상 흡인 음성의 음향변수 변동)

  • Kang, Young Ae;Jee, Sung Ju;Koo, Bon Seok;Jo, Cheolwoo
    • Phonetics and Speech Sciences
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    • v.9 no.3
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    • pp.85-91
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    • 2017
  • The present study aimed to investigate the changes of acoustic parameters of the aspirated voice in stroke patients. The eighty-eight subjects diagnosed with cerebro-vascular accident were divided into 32 penetration/aspiration (P/A) and 56 Non-P/A groups according to the videofluroscopic swallowing study (VFSS) results, and 26 control subjects participated. All subjects preformed VFSS and vowel /a/ was recorded three times pre- and post VFSS. Since the variation in the acoustic parameters within a single phonation has been observed, we proposed a delta formula for the acoustic parameters which can reflect the temporal changes of the each parameter in an utterance. We measured from the voice data eight acoustic parameters: fundamental frequency (F0), standard deviation of F0 (F0_SD), Jitter, relative average perturbation (RAP), Shimmer, amplitude perturbation quotient (APQ), harmonic to noise ration (HNR), noise to harmonic ratio (NHR). Then we found parameters which show the meaningful biggest temporal change in an utterance using the suggested delta parameter. Among them, the deltas of shimmer and APQ were significantly different pre- and post VFSS. These deltas of the P/A and the control group were increased after VFSS, while those of the Non-P/A group was descended. The variation patterns of the P/A and the control group were similar but the change width of the P/A group was larger. The large variations in an aspirated phonation of the P/A group are thought to be caused by irregular changes in air resistance due to residual food on the vocal cords.

Pulmonary Arteriovenous Fistula with Hemothorax - A case report- (혈흉을 동반한 폐동정맥루에 대한 치험 - 1예 보고 -)

  • 김인섭;정성철;김우식;신용철;유환국;김병열;안재범
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.702-706
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    • 2004
  • Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4${\times}$4${\times}$3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

A Study on Plasma Renin Activity in Essential Hypertension (본태성고혈압(本態性高血壓)에서의 혈장(血漿) Renin 활성(活性)에 관(關)한 연구(硏究))

  • Choe, Kang-Won;Lee, Jung-Sang;Cho, Bo-Yeon;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.9 no.1
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    • pp.21-29
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    • 1975
  • Radioimmunoassay for the measurement of plasma renin activity (PRA) was performed in 43 normal Koreans and 45 patients with essential hypertension. Plasma samples were drawn in supine position in the morning and after upright posture for 4 hours. Urinary sodium excretion rates were measured in the concurrent 24 hour urine samples, as an index of their sodium balance. The results were as follows: 1. There was an inverse correlation between 24hr sodium excretion and PRA. The normal values of PRA in supine position ranged from 1.0 to 7.0 ng/ml/hr. when 24 hour sodium excretion were between 50 to 150 mEq. PRA in elderly tended to be low. 2. When stimulated by 4 hour upright posture, PRA increased by 2.6 times from the baseline value. 3. Of the 45 patients with essential hypertension, PRA was low in 10 cases (22.2%), normal in 28 cases (62.2%), and high in 7 cases (15.6%). 4. In the normal and high renin groups, who tended to be younger in ages, mean diastolic blood pressure and BUN were higher than in low renin group. Though hypertensive retinopathy and left ventricular hypertrophy in ECG were more prevalent in the former, no significant differences were noted as in the case of serum cholesterol. 5. There were 8 cases of cardiovascular complications (7 with cerebral vascular accident, 1 with myocardial infarction); 3 in low renin group (30%), 2 in normal renin (7.1%) and 3 in high renin group (42.9%). This figure indicated higher rate of cardiovascular complications in high renin groups, and lower rate in normal renin group. But the incidence of the complication was not significantly low in low renin group.

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Reconstruction of the Extremities with Lateral Arm Free Flap (외측 상완 유리 판을 이용한 사지 재건술)

  • Lee, Jun-Mo;Lee, Ju-Hong;Kim, Hak-Ji
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.51-57
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    • 2004
  • Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.

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The Effect of Yangkyuksanhoa-tang Extracts on the Changes of the Immunoreactive Nerve Fiber in the Rat Basilar Artery after Subarachnoid Hemorrhage (지주막하출혈 후 뇌기저동맥벽에 존재하는 면역양성 신경섬유의 변화에 미치는 양격산화탕(凉膈散火湯)의 효과)

  • Lee, Dong-Weon;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.1
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    • pp.117-131
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    • 1999
  • Yangkyuksanhoa-tang is frequently used for cerebrovascular accident(CVA). The present study was performed to investigate the effect of Yangkyuksanhoa-tang on the peri vascular immunoreactive nerve fiber of the basilar artery after experimentally induced subarachnoid hemorrhage(SAH). Sprague Dawley rats weighing between 350-400g were used. The SAH induced by injection of the fresh autologus heart blood(0.3-0.4ml) into the cisterna magna through the posterior atlanto-occipital membrane. Sample group was given a $3.3m{\ell}/kg/day$ of Yangkyuksanhoa-tang extracts for 2 days after SAH. The experimental animals divided into 48hrs after SAH. The changes of perivascular immunoreactive nerve fiber was examined by using indirect immunofluorescence method. The meshlike perivascular nerve fiber appeared in the basilar artery of normal rats. In basilar artery of SAH elicitated rat, the distribution of calcitonin gene-related peptide (CGRP)-immunoreactivity(IR) and vasoactive intestinal polypeptide(VIP)-IR of the perivascular nerve fiber were remarkably diminished, also dopamine beta hydroxylase(DBH)-IR, neuropeptide Y(NPY)-IR and serotonin-IR were diminished. In SAH elicitated rat with Yangkyuksanhoa-tang treatment, the CGRP-IR and VIP-IR degree were repaired as well as normal rat's, but DBH-IR, NPY-IR and serotonin-IR had no changes. These results provide the basic data to investigate the effect of Yangkyuksanhoa-tang on the vasospasm after SAH.

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Effects of Action-observational training Program on Gait and Balance of Patients with Hemiplegia (동작관찰훈련프로그램이 편마비환자의 보행 및 균형에 미치는 영향)

  • Kim, Haeri;Woo, Sunghee;Lee, Hyojeong
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2017.10a
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    • pp.594-597
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    • 2017
  • The purpose of this study is to evaluate the effects of Action-observational training program on gait and balance of patients with hemiplegia. Subjects of this study, among the patients who received the diagnosis cerebral vascular accident, for patients total of 4 people have agreed to research. Experimental group 2 people, control group 2 people, was a total of 4 people. Group-specific arbitration method, was applied to Action-observational training program(experimental group) and general Task-oriented training program(control group). Each training courses 30 minutes for 4 weeks, examined the changes in 10 Meter Walk Test(10MWT), gait speed, Berg Balance Scale(BBS) and time up and go(TUG) ability to examine a total of 4-week course effectively. The intervention were compared by measuring before and after. There were significant improvements in the subscales of the gait and balance test of those who practiced with the Action-observational training program, while the control group showed no significant changes. Therefore, Action-observational training program is effective in improvement of to improve the gait and balance in patients with hemiplegia.

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Aortoplasty with Using Gore-Tex Conduit in Dissecting Aneurysms of Descending Thoracic Aorta - Two Cases Report - (GoreTex$^{\circledR}$ 인조혈관을 이용한 해리성 하행 흉부대동맥류 성형술 - 수술치험 2례 -)

  • 정진용
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.816-822
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    • 1989
  • Aneurysms of the descending thoracic aorta can be caused by various etiologies. So, its abrupt rupture leads life-threatening state, it must be operated as soon as possible. Surgical treatment of the descending thoracic aortic aneurysm requires temporary cross-clamping of major artery. The obligatory occlusion of the descending thoracic aorta during management causes proximal arterial hypertension and distal arterial hypotension. The former may leads to left ventricular failure, or cerebrovascular accident, whereas the latter may leads to spinal cord ischemia or renal injury. Some have recommended insertion of temporary shunt around the occluded descending aorta to prevent above problems. Still others would favor expeditious operation employing simple aortic occlusion during the repair of the descending aorta. Recently we had experienced two cases of dissecting aneurysms of descending thoracic aorta which performed aortoplasty with Gore-Tex conduit under simple aortic occlusion. The one was 34-year-old female patient with traumatic dissecting aortic aneurysm [5 em X 5 cm] on the descending thoracic aorta distal to the origin of the left subclavian artery and the other was 58-year-old female patient with atherosclerotic dissecting descending thoracic aortic aneurysm [6 cmX7 cm] and diffuse abdominal aortic aneurysms [3X5 cm]. Both patients performed standard left posterolateral thoracotomy. After the aneurysmal sac was mobilized, occluding vascular clamps were placed on the transverse aorta proximal to the origin of the left subclavian artery, and on the distal descending aorta without adjuvant bypass procedures for 31 and 32 minutes, respectively, and the aneurysmal sac was repaired with 18 mm ringed Gore-Tex conduit graft. Both patients postoperative courses were uneventful.

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Clinical Effect of Pyungjingunbitanggagam-bang on CVA Patients with Hyperlipidemia (뇌졸중환자의 고지혈증에 대한 평진건비탕가감방의 임상적 효과)

  • Park, Sang-Eun;Hong, Su-Hyun;Kwon, O-Sun;Seo, Chang-Woon;Min, Sung-Soon;Hong, Sang-Hoon
    • The Journal of Internal Korean Medicine
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    • v.27 no.3
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    • pp.561-571
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    • 2006
  • Objectives : This study was aimed at examining significant curative effects of Pyungjingunbitanggagam-bang on CVA(Cerebral Vascular Accident) patients with hyperlipidemia. Methods : The subjects in this study were sixteen patients admitted to Dong-Eui University Oriental Hospital who broke out with CVA from November 2004 through August 2005, with high total cholesterol (240mg/ dl above) or high TG (200mg/dl above). Before prescription. they were tested for total cholesterol, ALT. AST. BUN. and creatinine with fasting and were then prescribed the herbs(Pyungjingnnbitanggagam-bang) for 2 weeks. after which they were retested for total cholesterol. ALT. AST. BUN. and creatinine every 2 weeks. Conclusions : In the whole treatment group, hypertension & DM group. and cerebral infarction group.statistical significance of total cholesterol changes was recognized before and after the treatment.. Pyungjingunbitanggagam-bang decreased total cholesterol in HT. DM. and cerebral infarction groups. In the whole treatment. HT. and DM groups. statistical significance of TG changes was not recognized before and after the treatment. Hepatotoxicity and nephrotoxicity did not appeared when a stroke patient was given Pyungjingunbitanggagam-bang.

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Latissimus Dorsi Transfer in Brachial Plexus Injury for the Elbow Flexion (상완 신경총 손상후 주관절 근력 회복을 위한 광배근 전이술)

  • Han, Chung-Soo;Chung, Duke-Whan;Soh, Jae-Ho
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.35-40
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    • 1998
  • The incidence of brachial plexus injury is increasing because of the development of motor vehicle but the the results of treatment was reported poor due to its complex anatomical structure and changes of function and sensory during the recovery after trauma. But the results of treatment has been improved by the recently introduced high sensitive diagnostic method that can evaluate accurately the site and extent of the injury and treatment method. Restoration of the elbow flexion is the most important goal of treatment after brachial plexus injury and nerve graft, neurotization and muscle transfer were used for methods of treatment. From December 1992 to May 1994, the author performed 6 cases of latissimus dorsi transfer at the same side for the improvement of elbow flexion in the patients of brachial plexus injury. There were 5 cases of male, one case of female and average age was 22 years old. The causes of injury were traffic accident in 3 cases, gun shot injury, falldown and birth injury in each one case and in all cases, the type of injury were upper arm type. The average follow up period were 1 year 5 months ranging from 12 months to 4 years 5 months. In all cases, active elbow flexion was impossible before operation and average muscle power was grade I. We analysed the active range of motion, muscle power and the functional results. At the last follow up, range of active elbow flexion was average $124^{\circ}$ and flexion contracture was average 11 degrees and the average of muscle power was grade IV. In the functional analysis, there were two cases of excellent, three cases of good and 1 case of fair. There was no complications including wound infection, vascular compromise and donor site problem. The results of latissimus dorsi transfer for improvement elbow flexion in the patients of brachial plexus injury is one of the useful mettled for the restoration of elbow flexion.

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Pre-Hospital and In-Hospital Management of an Abdominal Impalement Injury Caused by a Tree Branch

  • Ahn, So Ra;Lee, Joo Hyun;Kim, Keun Young;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.288-293
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    • 2021
  • In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.