• 월간산업보건
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• s.253
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• pp.34-40
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• 2009

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.5-9
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• 1985

• 월간산업보건
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• s.191
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• pp.27-31
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• 2004

• 대한핵의학회:학술대회논문집
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• 1995.05a
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• pp.185-185
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• 1995

• Journal of The Korean Radiological Technologist Association
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• v.28 no.1
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• pp.311-312
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• 2002

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.241-250
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• 2001

Purpose: Vasospasm is a complication of aneurysmal subarachnoid hemorrhage (aSAH). We assessed the role of acetazolamide-enhanced brain perfusion SPECT (ACZ-SPECT) with Tc-99m ECD for predicting the prognosis of patients with aSAH. Materials and methods: Two SPECT studios (baseline with 740 MBq and ACZ-SPECT with 1480 MBq) with image subtraction were performed in 21 patients with aSAH. All patients had brain CT and angiogram. Vasoreactivity on ACZ-SPECT, perfusion defect on baseline SPECT, and vasospasm on angiogram were correlated with Hunt-Hess grading, extent of SAH (unilateral or bilateral) on CT, and clinical outcome. Vasoreactivity was considered decreased when cerebral/cerebellar uptake ratio difference from baseline SPECT to ACZ-SPECT was greater than 2SD of normal control values. Results: Decreased vasoreactivity was observed in 38% (8/21), perfusion defect in 81% (17/21), and vasospasm in 38% (8/21). The preserved vasoreactivity group showed better outcome scale (92%, 12/13) and the decreased vasoreactivity group showed poorer outcome scale (62.5%, 5/8) (p=0.014). Extensive SAH was more frequently seen in the decreased vasoreactlvlty group (87.5%, 7/8) than in the preserved vasoreactivity group (30.7%, 4/13)(p=0.017). The perfusion defect and vasospasm did not show good correlation with outcome scale, extent of SAH, and Hunt-Hess grading (p=ns). Vasoreactivity represented the patient's outcome better than the vasospasm in all of the vasoreactivity/vasospasm-mismatched cases (6 cases). Conclusions: Our data show that decreased vasoreactivity on ACZ-SPECT does not always represent vasospastic condition. But patients with decreased vasoreactivity reveal poorer outcome than patients with angiographic vasospasm do. Therefore ACZ-SPECT is a valuable, noninvasive test for predicting the prognosis of patients with aSAH.

• Korean Journal of Adult Nursing
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• v.15 no.4
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• pp.628-638
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• 2003

Purpose: The purpose of this study was to develope a evaluation tool of the quality of nursing care for aneurysmal subarachnoid hemorrhage patients at Hunt & Hess Grade I~III. Method: The data was gathered from April 15, 2002 to June 14, 2002. The tool proceeded in six steps according to Bloch's framework. Result: The results of this study are as follows: 1) The quality evaluation tool for neurosurgery ICU consisted of 25 standards and 138 criteria. The quality evaluation tool for ward consisted of 27 standards and 144 criteria.; 2) The content validities of the tools for neurosurgery ICU and ward were 0.96 and 0.98, respectively.; 3) The Pearson coefficients for evaluating the interrated reliability of the tools for neurosurgery ICU and ward were r=0.9106 (p<0.1) and r=0.8807 (p<0.1), respectively.; 4) The ranges of corrected item-total correlations for evaluating the construct validity of the tools for neurosurgery ICU and ward were 0.0279~0.9354 and 0.0174~0.9682, respectively.; And 5) The ranges of Cronbach's ${\alpha}$ reliabilities for evaluating the internal consistency reliability of the tools for neurosurgery ICU and ward were 0.6040~0.8554 and 0.6212~0.9584, respectively. Conclusion: The tools developed in this study seem useful in evaluating the quality of nursing care for aneurismal subarachnoid hemorrhage patients at Hunt & Hess Grade I-III.

• 월간산업보건
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• s.179
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• pp.23-25
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• 2003

산업재해보상보험법(법률 제4826호) 4조 1항에 의하면 '업무상 재해라 함은 업무상의 사유에 의한 근로자의 부상, 질병, 신체장애 또는 사망을 말한다'로 규정되어 있습니다. 질병을 포함한 재해가 업무상 사유에 의한 것인가의 여부를 판단하는 것은 쉬운 일이 아니며 더욱이 국가의 사회적.경제적 여건에 따라 시대적으로 업무관련성의 범위나 인정기준등 개념이 변화되고 있기 때문에 산업보건분야 관련 종사자들은 관심을 갖고 항시 그 흐름을 파악하는 것이 바람직합니다. 본 란에서는 관계자 분들의 이해를 돕기 위해 근로복지공단에서 발행되는 '산재보험법판례속보'에 게재된 내용을 선별하여 업무상 재해 인정에 관한 최근의 법원 사례를 소개합니다.

• 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.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.426-429
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• 2000

Arare case of bilateral abducens nerve paralyses after rupture of a left posterior communicating artery(PcomA) aneurysm with multiple unruptured aneurysms in a 46-year-old female is presented. Sudden left abducens nerve paralysis followed by progressive right abducens nerve paralysis were present without additional neuroophthalmological signs. Postoperatively, bilateral abducens nerve paralyses gradually recovered and disappeared in 2 weeks. The authors reviewed and discussed the possible mechanisms involved in this uncommon neuro-ophthalmological manifestation.