• 제목/요약/키워드: Aggravation

검색결과 300건 처리시간 0.029초

Radiation-Induced Intratumoral Necrosis and Peritumoral Edema after Gamma Knife Radiosurgery for Intracranial Meningiomas

  • Lee, Sang-Ryul;Yang, Kyung-Ah;Kim, Sung-Kyu;Kim, Se-Hyuk
    • Journal of Korean Neurosurgical Society
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    • 제52권2호
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    • pp.98-102
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    • 2012
  • Objective : To study the clinical significance and relevant factors of radiation-induced intratumoral necrosis (RIN) and peritumoral edema (PTE) after Gamma knife radiosurgery (GKRS) for intracranial meningiomas. Methods : We retrospectively analyzed the data of 64 patients who underwent GKRS for intracranial meningioma. The mean lesion volume was 4.9 cc (range, 0.3-20), and the mean prescription dose of 13.4 Gy (range, 11-18) was delivered to the mean 49.9% (range, 45-50) isodose line. RIN was defined as newly developed or enlarged intratumoral necrosis after GKRS. Results : RIN and new development or aggravation of PTE were observed in 21 (32.8%) and 18 (28.1%) cases of meningioma, respectively during the median follow-up duration of $19.9{\pm}1.0$ months. Among various factors, maximum dose (>25 Gy) and target volume (>4.5 cc) were significantly related to RIN, and RIN and maximum dose (>24 Gy) were significantly related to the development or aggravation of PTE. In 21 meningiomas with development of RIN after GKRS, there was no significant change of the tumor volume itself between the times of GKRS and RIN. However, the PTE volume increased significantly compared to that at the time of GKRS (p=0.013). The median interval to RIN after GKRS was $6.5{\pm}0.4$ months and the median interval to new or aggravated PTE was $7.0{\pm}0.7$ months. Conclusion : A close observation is required for meningiomas treated with a maximum dose >24 Gy and showing RIN after GKRS, since following or accompanying PTE may deteriorate neurological conditions especially when the location involves adjacent critical structures.

우즈베키스탄 국립응급병원에 내원한 낙상환자들의 임상적인 특성 (Features of Patients Associated with Falls from Heights Admitted to Republican Research Center of Emergency Medicine)

  • ;;김훈
    • Journal of Trauma and Injury
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    • 제28권4호
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    • pp.248-255
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    • 2015
  • Purpose: study of the mutual influence of the individual anatomical regions damage in patients associated with falls from heights. Methods: 561 medical reports of patients associated with falls from heights admitted to Republican Research Center of Emergency Medicine (RRCEM), in period of 2010-2013 yy, were analyzed retrospectively. Patient's age range was from 15 to 89. Treatment of these patients held in three stages: period of acute disorders of vital functions; relative stabilization period; stabilization of vital functions. The scope and content of medical diagnostic procedures performed on pre-hospital and intensive care stages. The severity of each injury was scored according to the AIS scale, the total severity of lesions was scored by points due to ISS. Digital material is treated by methods of mathematical statistics. Results: Falls from heights leads to associated injuries for 4 times more than isolated trauma, and increases according to height of fall and falling surface. Patients with TBI+chest trauma, are most serious contingent that has highest mortality and complications (36.8%). TBI+musculoskeletal system trauma are characterized by high blood loss, traumatic shock and fat embolism, forming a vicious circle. Conclusion: in patients associated with falls from heights clinical manifestations of injuries mutual aggravation syndrome will be seen. TBI leads to complication of chest trauma, delayed diagnostics of abdominal and chest trauma, aggravation of coma condition. Developing of high blood loss and fat embolism in musculoskeletal system trauma leads to shock and pulmonary embolism, which increases probability of death in the presence of abdominal or chest trauma, but abdominal trauma or chest trauma has no significant effect on the severity of the musculoskeletal system trauma.

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비정형 결핵성 림프절염의 악화로 오인된 경동맥 가성동맥류 1예 (A Case of Carotid Artery Pseudoaneurysm Misdiagnosed as Aggravation of Non-tuberculous Mycobacterial Lymphadenitis)

  • 노웅재;이형신;김성원;이강대
    • 대한두경부종양학회지
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    • 제33권1호
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    • pp.73-77
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    • 2017
  • 경동맥에서 발생하는 가성동맥류는 비교적 드문 질환으로 주로 외상, 감염, 수술의 합병증 또는 방사선 치료 후에 합병증으로 발생할 수 있다. 비정형 결핵성 림프절염에 의한 경동맥 가성동맥류는 거의 보고된 바 없으며 따라서 비정형 결핵성 림프절염이 동반된 환자에서는 급성악화에 의한 농양형성으로 오인될 수 있다. 비정형 결핵성 림프절염으로 치료중인 81세 남자 환자에서 이러한 경험을 하였기에 문헌고찰과 함께 보고하고자 한다.

외용(外用) 요법(療法)을 병행(幷行)한 아토피 피부염 환자(患者) 20예(例)에 대한 임상적(臨床的) 연구(硏究) (A Clinical study in 20 cases of Atopic Dermatitis (treated with Aroma therapy an Jaungo))

  • 한재경;김윤희
    • 대한한방소아과학회지
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    • 제15권1호
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    • pp.15-37
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    • 2001
  • Objectives : The aim of this study was to investigate the usefulness and the remedical effect of Aroma therapy and Jaungo as a tool for Atopic dermatitis. Methods : We investigated 20 patients suffering from Atopic dermatitis and on the ground of it analyzed the remedical effect of Aroma therapy and Jaungo Results : 1. In distribution of nursing method, 45% was breast milk and formula, 35% was formular, 20% was breast milk. 2. The proportion of Atopic dermatitis concurred of congenital fever was 53.3%, after a disappearance of congenital fever was 46.7%. 3. That the season of symptom aggravation is not defined is 40%, next is summer 25%. The time of symptom aggravation is at night, 65%. 4. In the causes of symptom worsening, common cold and food was the best at each 33.3%. 5. In distribution of the therapeutic method, 65% was treated with oriental after occidental medicine and 30% only oriental medical care. Additional therapy except medical therapy was 60%. 6. In satisfaction degree of Aroma oil and cream therapy, 60% was not changed, 33.4% was very satisfied and satisfied. In aroma cream therapy, 55% was very satisfied and satisfied 40% was not changed. After using Jaungo therapy, 55.6% was very satisfied and satisfied, 44.4% was not changed. 7. After finishing the healing procedure, 65% was very satisfied and satisfied, 35% was not changed. Conclusions : Considering the above results, we have concluded that Aroma therapy and Jaungo have the remedical effect for Atopic dermatitis.

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『동의수세보원』 십조탕(十棗湯)과 관련된 즙즙한출(濈濈汗出)에 대한 고찰 (A Study on the Jeubjeubhanchul(濈濈汗出) Related to Sibjo-tang in Donguisusebowon)

  • 김태영;박성식
    • 사상체질의학회지
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    • 제31권4호
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    • pp.9-17
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    • 2019
  • Objectives The purpose of this study is to understand the intention expressed as Jeubjeubhanchul(濈濈汗出) unlike the aspect of perspiration in 『Sanghanlun(傷寒論)』 and 『Donguibogam(東醫寶鑑)』. Methods We examined Sibjo-tang(十棗湯) and the aspect of perspiration focusing on the Chip(漐) and Jeub(濈) in 『Sanghanlun(傷寒論)』, 『Donguibogam(東醫寶鑑)』, and 『Donguisusebowon(東醫壽世保元)』. Moreover, we examined the connection between the quoted purpose of Sibjo-tang and the aspect of perspiration. Results and Conclusion 1. When Leejema quoted Sibjo-tang to explain the Chestbind disease(結胸) of the Soyang pattern, he used Jeubjeubhanchul (濈濈汗出) instead of Chipchiphanchul(漐漐汗出). 2. About the aspect of perspiration in 『Sanghanlun』 and 『Donguibogam』, the Chip(漐) is used in a situation when the disease progressed from Pyo(表) to Li(裏) and Taeyang-byeong(太陽病) to Yangmyung-byeong(陽明病), and it is expression of physiological perspiration. The Jeub(濈) is used in a situation related to interior(內), Li(裏), and Yangmyung-byeong. 3. Leejema understood Sibjo-tang in relation to the Chestbind disease of the Soyang pattern caused by aggravation of Liyeol (裏熱). Therefore, Leejema used the Jeub(濈) related to interior, Li and Yangmyung-byeong, and it is expression of perspiration caused by aggravation of Liyeol in the Soyang pattern. 4. At first time, Leejema mentioned perspiration and short of breath(短氣) in the symptoms of Sibjo-tang, but he mentioned dry vomiting(乾嘔) and short of breath in 『Sinchukbon(辛丑本)』. Thus, his perspective of perspiration related to Sibjo-tang was appeared in 『Gabobon(甲午本)』, and he paid attention to perspiraion as a major symptom of the Chestbind disease in the early. After clinical experience was built up, It was not that important as the past.

Surgical Results of Monocusp Implantation with Transannular Patch Angioplasty in Tetralogy of Fallot Repair

  • Jang, Woo Sung;Cho, Joon Yong;Lee, Jong Uk;Lee, Youngok
    • Journal of Chest Surgery
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    • 제49권5호
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    • pp.344-349
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    • 2016
  • Background: Monocusp reconstruction with a transannular patch (TAP) results in early improvement because it relieves residual volume hypertension during the immediate postoperative period. However, few reports have assessed the long-term surgical outcomes of this procedure. The purpose of the present study was to evaluate the mid-term surgical outcomes of tetralogy of Fallot (TOF) repair using monocusp reconstruction with a TAP. Methods: Between March 2000 and March 2009, 36 patients with a TOF received a TAP. A TAP with monocusp reconstruction (group I) was used in 25 patients and a TAP without monocusp reconstruction (group II) was used in 11 patients. We evaluated hemodynamic parameters using echocardiography during the follow-up period in both groups. Results: At the most recent follow-up echocardiography (mean follow-up, 8.2 years), the mean pulmonary valve velocities of the patients in group I and group II were $2.1{\pm}1.0m/sec$ and $0.9{\pm}0.9m/sec$, respectively (p=0.001). Although the incidence of grade 3-4 pulmonary regurgitation (PR) was not significantly different between the two groups (group I: 16 patients, 64.0%; group II: 7 patients, 70.0%; p=0.735) during the follow-up period, the interval between the treatment and the incidence of PR aggravation was longer in group I than in group II (group I: $6.5{\pm}3.4years$; group II: $3.8{\pm}2.2years$; p=0.037). Conclusion: Monocusp reconstruction with a TAP prolonged the interval between the initial treatment and grade 3-4 PR aggravation. Patients who received a TAP with monocusp reconstruction to repair TOF were not to progress to pulmonary stenosis during the follow-up period as those who received a TAP without monocusp reconstruction.

Acute kidney injury in childhood-onset nephrotic syndrome: Incidence and risk factors in hospitalized patients

  • Kim, Mi Young;Cho, Myung Hyun;Kim, Ji Hyun;Ahn, Yo Han;Choi, Hyun Jin;Ha, Il Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Kidney Research and Clinical Practice
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    • 제37권4호
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    • pp.347-355
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    • 2018
  • Background: Nephrotic syndrome (NS) is the most common glomerulopathy in children. Acute kidney injury (AKI) is a common complication of NS, caused by severe intravascular volume depletion, acute tubular necrosis, interstitial nephritis, or progression of NS. However, the incidence and risk factors of childhood-onset NS in Korea are unclear. Therefore, we studied the incidence, causes, and risk factors of AKI in hospitalized Korean patients with childhood-onset NS. Methods: We conducted a retrospective review of patients with childhood-onset NS who were admitted to our center from January 2015 to July 2017. Patients with decreased renal function or hereditary/secondary NS, as well as those admitted for management of other conditions unrelated to NS, were excluded. Results: During the study period, 65 patients with idiopathic, childhood-onset NS were hospitalized 90 times for management of NS or its complications. Of these 90 cases, 29 met the Kidney Disease Improving Global Outcomes criteria for AKI (32.2%). They developed AKI in association with infection (n = 12), NS aggravation (n = 11), dehydration (n = 3), and intravenous methylprednisolone administration (n = 3). Age ${\geq}9$ years at admission and combined use of cyclosporine and renin-angiotensin system inhibitors were risk factors for AKI. Conclusion: AKI occurred in one-third of the total hospitalizations related to childhood-onset NS, owing to infection, aggravation of NS, dehydration, and possibly high-dose methylprednisolone treatment. Age at admission and use of nephrotoxic agents were associated with AKI. As the AKI incidence is high, AKI should be considered during management of high-risk patients.

Headache related to mask use of healthcare workers in COVID-19 pandemic

  • Toksoy, Cansu Koseoglu;Demirbas, Hayri;Bozkurt, Erhan;Acar, Hakan;Boru, Ulku Turk
    • The Korean Journal of Pain
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    • 제34권2호
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    • pp.241-245
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    • 2021
  • Background: It has been reported that a new type of headache may develop as a result of face mask use during the COVID-19 pandemic. The aim of this study is to investigate the clinical features of face mask-related headache during the COVID-19 pandemic. Methods: This is a cross-sectional study carried out on healthcare workers at the Afyonkarahisar Health Sciences University. The number of workers at our university was established. Sample size was calculated using the G*Power program. A questionnaire consisting of questions relating to pre-existing headache, an aggravation in headache, and de-novo headache was filled out by 3 neurologists with all participants. Results: Data was collected from a total of 375 participants, after the exclusion of 5 individuals who refused to participate. Out of all participants, 26 (6.9%) used a filtering mask, 274 (73.1%) used a surgical mask, 75 (20.0%) participants used a combination of both masks. The number of participants with preexisting headache was 114 (30.4%) had pre-existing headache. Of those with pre-existing headache, 77 (67.5%) healthcare workers had reported an aggravation in their headache after mask use. De-novo headache was observed in 116 (30.9%) of participants. De-novo headache characteristics included throbbing in 17 (14.7%) participants and pressing in 99 (85.3%) participants. In addition, symptoms such as tachypnea, sleep disturbance, and fatigue were found to be significantly higher. Conclusions: This study indicates that healthcare workers develop headaches due to use of masks during the COVID-19 outbreak.

장애인 환자에서의 진정법 (THE PROVISION OF SEDATION FOR BEHAVIORAL CONTROL IN THE SPECIAL NEED PATIENTS)

  • 신터전
    • 대한장애인치과학회지
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    • 제9권1호
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    • pp.1-10
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    • 2013
  • This article discusses the provision of sedation for uncooperative special need dental patients. Most of dental treatments have been performed in these patients with the techniques of behavioral control. However, if this behavioral control fails during treatment, it is nearly impossible to treat them without either sedation or general anesthesia. Sedation is also beneficial for patients because it circumvent the aggravation of negative behaviors related to their stress during the treatment. Also, the morbidity and mortality related to dental sedation is relatively low. In this regard, the provision of sedation for people with special needs can be considered as a safe and necessary techniques for their treatment.

건선(乾癬)환자의 임상(臨床) 치험례(治驗例) 보고 (Report on the Clinical Treatment of Psoriasis Patients)

  • 원영호;장안수;홍요한
    • 한방안이비인후피부과학회지
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    • 제21권2호
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    • pp.165-175
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    • 2008
  • Psoriasis, which is characterized by the covering of silver-white scaliness and various Sizes of redness with clear boundary, is an intractable skin disease that repeats aggravation and remission. The objective of the present clinical report is to demonstrate that oriental medical treatment after differentiation of syndromes is effective in treating psoriasis, an intractable skin disease. For this purpose, we identified the pattern of three psoriasis patients based on blood heat and viscous blood, and applied acupuncture and herbal medicine to them. The effect of treatment was evaluated using PASI (psoriasis area and severity index). In all of the three cases, the results of treatment were satisfactory. Thus, oriental medical treatment after differentiation of syndromes, which is highly effective without side effect, is considered to make a great contribution to the treatment of psoriasis in the future.

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