• Title/Summary/Keyword: Hemorrhagic transformation

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A Case Report of Traditional Korean Medicine for Left Anterior Cerebral Artery (ACA) Infarction and Hemorrhagic Transformation with Hemiplegia and Urinary Disturbance (한방치료로 호전된 반신부전마비, 배뇨장애를 동반한 좌측 앞대뇌동맥 출혈성 뇌경색 환자의 치험 1례)

  • Yang, Jee-yun;Kim, Min-sung;Jeong, Taek-su;Bang, Chan-hyuck;Mo, Min-ju;Kwon, Do-ick;Choi, Min-gi
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.786-795
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    • 2016
  • Objective: To evaluate the effectiveness of traditional Korean medicine treatment (TKM) on a patient with ACA infarction and hemorrhagic transformation with hemiplegia and urinary disturbance. Methods: A patient diagnosed with left anterior cerebral artery (ACA) infarction and hemorrhagic transformation was treated with electroacupuncture, moxibustion, and herbal medicine. Results: Improvements in the Manual Muscle Test (MMT), modified Barthel Index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), and K-MMSE were observed following the TKM treatment [MMT Gr. (3/0)→Gr. (4+/4+), MBI 20→89, NIHSS 8→2, mRS 5→1, MMSE-K 21→28]. Conclusion: TKM treatment could help improve the symptoms of patients with ACA infarction and hemorrhagic transformation.

The Effect of Korean Medicine Treatment for Hemorrhagic Transformation after Interventional Reperfusion Therapy of an Anterior Circulation Infarction in a Patient with Hemiplegia and Conscious and Cognitive Disorders: A Case Report (전방순환 뇌경색의 중재적 재관류 치료 이후 출혈 변환으로 의식 및 인지장애를 동반한 편마비환자의 한방치험 1례)

  • Chae-eun Kim;Ji-hyeon Kang;Seo-hyun Kim;Jun-seok Kim;Kyung-min Baek
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1274-1288
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    • 2022
  • Objectives: The study investigated the effect of Korean medicine treatment on a hemiplegic patient with conscious and cognitive disorders due to hemorrhagic transformation after interventional reperfusion therapy of anterior circulation infarction. Case presentation: The patient was treated with acupuncture, moxibustion, cupping, and herbal medicine in combination with Western medicine and physical therapy. The effects on clinical symptoms were evaluated using the Manual Muscle Test (MMT), Glasgow Coma Scale (GCS), Korean Mini-Mental State Examination (K-MMSE), Korean Nursing Delirium Screening Scale (Korean Nu-DESC), and Modified Bathel Index (MBI). After the treatment, the MMT grade increased from Gr.0-1 to Gr.0-3, the GCS score increased from 10 to 15, the K-MMSE score increased from 8 to 15, the Korean Nu-DESC score decreased from 3 to 1, night delirium disappeared, and the MBI score increased from 13 to 26. Conclusions: Complex Korean medicine treatments were effective for improving the clinical symptoms of hemorrhagic transformation after interventional reperfusion therapy for anterior circulation infarction in a patient with hemiplegia and conscious and cognitive disorders. However, further studies are needed.

The Osteoporotic Condition as a Predictive Factor for Hemorrhagic Transformation in Acute Cardioembolic Stroke

  • Won, Yu Deok;Kim, Jae-Min;Ryu, Je-Il;Koh, Seong-Ho;Han, Myung-Hoon;Cheong, Jin-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.763-775
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    • 2021
  • Objective : Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke. Methods : As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke. Results : This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13-3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically. Conclusion : The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.

Study for Safety of Oriental Medical Therapy and Continuous Intravenous Urokinase combined Therapy in Acute Cerebral Infarction. (급성기 뇌경색 환자에서 한방치료와 지속적 유로키나제 정주요법 병용시 안전성에 대한 임상적 고찰)

  • Kim, Sung-keun;Lim, Chang-sun;Yim, Jun-hyok;Yang, Dong-ho;Shin, Hyon-seung;Park, Joon-ha;Jeong, Seung-cheol
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.1-7
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    • 2009
  • Objectives : This Study was prepared for investigating the safety of oriental medicine and continuous intravenous urokinase combined therapy in acute cerebral infarction. Methods : We prospectively estimate safety of hemorrhagic transformation occurred in oriental medical therapy and continuous intravenous urokinase combined therapy. We estimate National Institute of Health Stroke Scale Score and Modified Barthel Index. Results : Hemorrhagic transformation was not noted. and Others are not fatal complication. Conclusions : oriental medical therapy and continuous intravenous urokinase combined therapy are safety method in treatment of acute cerebral infarction. We think this can be a good model of Oriental and western cooperative therapy.

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Cerebral Venous Thrombosis Complicated by Hemorrhagic Infarction Secondary to Ventriculoperitoneal Shunting

  • Son, Won-Soo;Park, Jae-chan
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.357-359
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    • 2010
  • While a delayed intracerebral hemorrhage at the site of a ventricular catheter has occasionally been reported in literature, a delayed hemorrhage caused by venous infarction secondary to ventriculoperitoneal shunting has not been previously reported. In the present case, a 68-year-old woman underwent ventriculoperitoneal shunting through a frontal burr hole, and developed a hemorrhagic transformation of venous infarction on the second postoperative day. This massive venous infarction was caused by bipolar coagulation and occlusion of a large paramedian cortical vein in association with atresia of the rostral superior sagittal sinus. Thus, to eliminate the risk of postoperative venous infarction, technical precautions to avoid damaging surface vessels in a burr hole are required under loupe magnification in ventriculoperitoneal shunting.

Immortalization of Swine Umbilical Vein Endothelial Cells with Human Telomerase Reverse Transcriptase

  • Hong, Hai Xia;Zhang, Yan Ming;Xu, Hao;Su, Zheng Yuan;Sun, Pei
    • Molecules and Cells
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    • v.24 no.3
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    • pp.358-363
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    • 2007
  • Swine endothelial cells are commonly used as an in vitro model for studying features of the blood-brain barrier and some hemorrhagic diseases. However, primary cultures of swine cells have finite lifespans. To establish immortalized swine umbilical vein endothelial cells (SUVECs) using human telomerase reverse transcriptase (hTERT), the plasmid pCI-neo-hTERT was transfected into SUVECs by lipofection. Clones were selected for G418 resistance, and positive clones were amplified. One of the clones was cultured for up to 50 passages. Factor VIII-related antigen and CD34 were detected. The immortalized cells shared the properties of normal cells, such as contact inhibition, serum requirement and anchorage dependence. Karyotype analysis revealed that the immortalized cells were in the diploid range. In addition, both in vivo and in vitro assays of tumorigenicity showed no neoplastic transformation. Furthermore, NO, $PGI_2$, and ET-1 concentrations in the transfected cells were normal. These results suggest that the SUVECs immortalized by hTERT retain their original characteristics.

Hypointensity on Susceptibility-Weighted Images Prior to Signal Change on Diffusion-Weighted Images in a Hyperacute Ischemic Infarction: a Case Study

  • Kim, Dajung;Lee, Hyeonbin;Jung, Jin-Man;Lee, Young Hen;Seo, Hyung Suk
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.2
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    • pp.131-134
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    • 2018
  • Susceptibility-weighted imaging (SWI) is well known for detecting the presence of hemorrhagic transformation, microbleeds and the susceptibility of vessel signs in acute ischemic stroke. But in some cases, it can provide the tissue perfusion state as well. We describe a case of a patient with hyperacute ischemic infarction that had a slightly hypodense, patchy lesion at the left thalamus on the initial SWI, with a left proximal posterior cerebral artery occlusion on a magnetic resonance (MR) angiography and delayed time-to-peak on an MR perfusion performed two hours after symptom onset. No obvious abnormal signals at any intensity were found on the initial diffusion-weighted imaging (DWI). On a follow-up MR image (MRI), an acute ischemic infarction was seen on DWI, which is the same location as the lesion on SWI. The hypointensity on the initial SWI reflects the susceptibility artifact caused by an increased deoxyhemoglobin in the affected tissue and vessels, which reflects the hypoperfusion state due to decreasing arterial flow. It precedes the signal change on DWI that reflects a cytotoxic edema. This case highlights that, in some hyperacute stages of ischemic stroke, hypointensity on an SWI may be a finding before the hyperintensity is seen on a DWI.

Production of virus-like particles of nervous necrosis virus displaying partial VHSV's glycoprotein at surface and encapsulating DNA vaccine plasmids

  • Yang, Jeong In;Bessaid, Mariem;Kim, Ki Hong
    • Journal of fish pathology
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    • v.33 no.2
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    • pp.103-109
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    • 2020
  • In order to use nervous necrosis virus (NNV) virus-like particles (VLPs) as a delivery tool for heterologous antigens or plasmids, we attempted to produce red-spotted grouper nervous necrosis virus (RGNNV) VLPs displaying a partial region of viral hemorrhagic septicemia virus (VHSV) glycoprotein at the surface and VLPs that are harboring DNA vaccine plasmids within the VLP. A peptide encoding 105 amino acids of VHSV glycoprotein was genetically inserted in the loop region of NNV capsid gene, and VLPs expressing the partial part of VHSV glycoprotein were successfully produced. However, in the transmission electron microscope analysis, the shape and size of the partial VHSV glycoprotein-expressing NNV VLPs were irregular and variable, respectively, indicating that the normal assembly of capsid proteins was inhibited by the relatively long foreign peptide (105 aa) on the loop region. To encapsulate by simultaneous transformation with both NNV capsid gene expressing plasmids and DNA vaccine plasmids (having an eGFP expressing cassette under the CMV promoter), NNV VLPs containing plasmids were produced. The encapsulation of plasmids in the NNV VLPs was demonstrated by PCR and cells exposed to the VLPs encapsulating DNA vaccine plasmids showed fluorescence. These results suggest that the encapsulation of plasmids in NNV VLPs can be done with a simple one-step process, excluding the process of disassembly-reassembly of VLPs, and NNV VLPs can be used as a delivery tool for DNA vaccine vectors.

A Clinical Survey of Patients of the 3rd Intensive Care Unit in Kyung-Hee Medical Center (경희의료원 제3중환자실 입원 환자에 대한 임상적 고찰)

  • So, Hyung-jin;Heo, Hong;Lee, Beom-Joon;Rho, Byoung-Wan;Ryu, Jae-Hwan;Son, Yoon-Jung
    • The Journal of Korean Oriental Chronic Disease
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    • v.10 no.1
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    • pp.21-31
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    • 2005
  • We have analyzed 247 patients who were admitted to the 3rd ICU for intensive care between January 2003 and December 2003 to investigate characteristics of ICU patients and obtain better guidance and management in the ICU. The results are as follows: 1) The total number of patients was 247. The proportion of males was 59.1 %, of females was 40.9%, and the ratio of male to female was about 1.45:1. 2) The most prevalent age group is those in their seventies, the proportion is 33.6%. 3) The total admission days was 3,438days, and mean patient stay being 13.9days. 4) The total number of expired patients was 26, the mortality rate was 10.5%. The mortality in distribution by disease was higest in Cerebral infarction, rate was 53.8%. the proportion of raised intracranial pressure was 42.3%, of hemorrhagic transformation was 11.5%. 5) In distribution by admission channel, Oriental hospital E.R. was 60.7%, Oriental hospital ward was 38.5%, and etc. was 0.8%. 6) The number of patients of Cerebral infarction was 146(59.1%), being the highest in distribution by chief disease and the proportion of MCA territory infarction is highest in the Cerebral infarction(61.6%). 7) In distribution by Oriental Medicine therapy, the proportion of Acupuncture treatment was 15.8%, of Acupuncture treatment combination Herb medication was 78.5%, and of Acupuncture, Herb medication plus subcutaneous Acupuncture treatment was 5.7%.

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NECROSIS OF A PAROTID GLAND PLEOMORPHIC ADENOMA : A CASE REPORT (이하선 다형성 선종의 괴사)

  • Ryu, Sun-Youl;Baek, Sung;Park, Hong-Ju;Choi, Hong-Ran
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.165-169
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    • 2004
  • Pleomorphic adenoma is the most common neoplasm of the parotid gland, generally presenting as a slowly growing, firm, well-circumscribed, painless nodule. It is often difficult to separate into benign and malignant categories because its bland histomorphologic and cytologic features. This tumor can be rarely associated with cystic change, hemorrhagic necrosis, or spontaneous infarction. Necrosis of lesional tissue may be associated with malignant transformation, particularly in a pleomorphic adenoma. We report a case of 50-year-old woman presented with a enlarging right parotid mass. Computed tomographic scan demonstrated a right superficial lobe mass with ill-defined border. The preoperative fine needle aspiration yielded necrotic debris and atypical squamous elements that were thought to be compatible with high degree of mucoepidermoid carcinoma. A total parotidectomy with intraoperative frozen section revealed extensive necrosis and diagnosed as malignant tumor. This tumor was finally diagnosed as a pleomorphic adenoma with necrosis on permanent sections. Caution should be exercised in evaluation of the parotid neoplasms with central necrosis to avoid misdiagnosis of such lesions as malignancy.