• 제목/요약/키워드: disorder of blood flow

검색결과 57건 처리시간 0.026초

대사증후군 환자군과 정상군의 뇌혈류 측정 비교를 통한 뇌졸중 위험인자에 대한 TCD의 진단적 가치 고찰 (Comparison of Cerebral Blood Flow between Patients with Metabolic Syndrome and Normal Group to Evaluate Diagnostic Value of Transcranial Doppler Ultrasound)

  • 엄은진;박우람;김주성;이범준;나병조
    • 대한한의진단학회지
    • /
    • 제14권2호
    • /
    • pp.85-100
    • /
    • 2010
  • Objectives: The purpose of this study was to evaluate diagnostic value of Transcranial Doppler Ultrasound about risk factor of stroke by comparing blood flow between patients with metabolic syndrome(MS group) and Normal group. Methods: 62 metabolic syndrome patients and 106 healthy adults were selected who had no cerebrovascular diseases, cardiovascular diseases and other systemic diseases. We measured the mean velocity(Vm), peak systolic velocity(Vs) and pulsatility index(PI) of MCA, ACA, PCA, VA, ICA in two groups using TCD. All subjects were divided by gender and age. Results: In comparing Ms group with normal group, Vm in the MCA, ACA, PCA, ICA and Vs in the MCA, ICA were lower in MS group. In all vessels, PI of MS group were higher than that of Normal group. In all vessels, Vm and Vs revealed negative correlation with age and PI revealed positive correlation with age. In 20-39 year olds, there was decrease in the Vs and Vm and increase of PI of MS group in comparison with normal group. There was significant difference in the Vm of PCA, ICA, Vs of MCA, PCA, ICA and PI of MCA, ACA. In 40-59 year olds, Vm in the MCA, ACA, ICA and Vs in the MCA, ACA were lower in MS group. PI in the MCA, ACA, PCA, ICA were higher in MS group. In 60-79 year olds, Vm of MCA, PCA, ICA was decreased in MS group than Normal group with no statistical signification. Vs in the MCA was lower and PI in the PCA was higher in MS group. In male, Vm of PCA and Vs of MCA were lower and PI of MCA, ACA, PCA, ICA were higher in MS group. In female, Vm of MCA, PCA, ICA and Vs of MCA, ICA were lower and PI of ACA, PCA, VA, ICA were higher in MS group. Conclusions: The significant difference in Vm, Vs, PI between MS group and normal group suggests hemodynamic disorder. Screening and prognosing high risk group can be done through TCD and this can be used to prevent stroke. More detailed study will be needed.

불면증의 형상의학적 고찰 (Treatment of Insomnia in Hyungsang Medicine)

  • 박태숙;강경화;김경철;이용태
    • 동의생리병리학회지
    • /
    • 제16권1호
    • /
    • pp.14-22
    • /
    • 2002
  • Insomnia describes not only a state of a lack of sleep but also a causative factor for both psychological and physical disorders. Most people tend to underestimate the effects of insomnia on psychological problems, stroke, Sogal or other life-threatening conditions. insomnia may occur when 1) the flow of Jung(精), Ki(氣), Shin(神) and Hyul(血) is not smooth; 2) the five Jang organs and six Bu organs are in disharmony; 3) Shin(身) and Hyung(形) are inconsistently developed; 4) Young and Wi(衛) do not work in concert; 5) and other factors such as age or exposure to Cold are involved. I observed my patients suffering from insomnia according to Hyungsang medicine, which is based on 'Dongyuibogam'(東醫寶鑑). Insomnia due to the problems with Jung, Ki. Shin and Hyul was found in the Shin type(神科) and the Ki type(氣科). When it comes to the organs, sleep disorder significantly correlates to weakened Spleen, Liver and Kidneys. In terms of the inconsistent development of Shin and Hyung, patients who were shortsighted or experienced surgery showed insomnia. Patients exposed to Cold showed false type agitation. With respect to age, while children showed a weakened Gallbladder, the aged had deficient Blood. Sleep disorder caused by disharmony of Young and Wi occurs at dusk or dawn.

구치부 치관삭제가 생쥐 해마복합체에 미치는 영향에 관한 조직학적 연구 (Influence of Molarless Condition on the Hippocampal Formation in Mouse: a Histological Study)

  • 김용철;강동완
    • 구강회복응용과학지
    • /
    • 제23권2호
    • /
    • pp.179-186
    • /
    • 2007
  • The decrease of masticatory function caused by tooth loss leads to a decrease of cerebral blood flow volume resulting in impairment of cognitive function and learning memory disorder. However, the reduced mastication-mediated morphological alteration in the central nervous system (CNS) responsible for senile deficit of cognition, learning and memory has not been well documented. In this study, the effect of the loss of the molar teeth (molarless condition) on the hippocampal expression of glial fibrillary acidic protein (GFAP) protein was studied by immunohistochemical techniques. The results were as follows : 1. The molarless mice showed a lower density of pyramidal cells in the cornu ammonis 1 (CA1) and dentate gyrus (DG) region of the hippocampus than control mice. 2. Immunohistochemical analysis showed that the molarless condition enhanced the time-dependent increase in the cell density and hypertrophy of GFAP immunoreactivity in the CA1 region of the hippocampus. The molarless condition enhanced an time-dependent decrease in the number of neurons in the hippocampal formation and the time-dependent increase in the number and hypertrophy of GFAP-labeled cells in the same region. The data suggest a possible link between reduced mastication and histological changes in hippocampal formation that may be one risk factor for senile impairment of cognitive function and spatial learning memory.

Review of Genetic Diagnostic Approaches for Glanzmann Thrombasthenia in Korea

  • Shim, Ye Jee
    • Journal of Interdisciplinary Genomics
    • /
    • 제3권2호
    • /
    • pp.41-46
    • /
    • 2021
  • Inherited platelet function disorders (IPFDs) are a disease group of heterogeneous bleeding disorders associated with congenital defects of platelet functions. Normal platelets essential role for primary hemostasis by adhesion, activation, secretion of granules, aggregation, and procoagulant activity of platelets. The accurate diagnosis of IPFDs is challenging due to unavailability of important testing methods, including light transmission aggregometry and flow cytometry, in several medical centers in Korea. Among several IPFDs, Glanzmann thrombasthenia (GT) is a most representative IPFD and is relatively frequently found compare to the other types of rarer IPFDs. GT is an autosomal recessive disorder caused by mutations of ITGA2B or ITGB3. There are quantitative or qualitative defects of the GPIIb/IIIa complex in platelet, which is the binding receptor for fibrinogen, von Willbrand factor, and fibronectin in GT patients. Therefore, patients with GT have normal platelet count and normal platelet morphology, but they have severely decreased platelet aggregation. Thus, GT patients have a very severe hemorrhagic phenotypes that begins at a very early age and persists throughout life. In this article, the general contents about platelet functions and respective IPFDs, the overall contents of GT, and the current status of genetic diagnosis of GT in Korea will be reviewed.

공황장애 환자에서 $^{99m}Tc-ECD$ 뇌관류 SPECT를 이용한 인지행동치료 효과 평가 (Evaluation of Therapeutic Effects of Cognitive-Behavioral Therapy in Patients with Panic Disorder using Serial $^{99m}Tc-ECD$ Brain Perfusion)

  • 김정희;송호천;양종철;이병일;허영준;범희승;박태진;민정준
    • Nuclear Medicine and Molecular Imaging
    • /
    • 제40권6호
    • /
    • pp.302-308
    • /
    • 2006
  • 목적: 공황장애에 대한 다양한 신경해부학적 모델들이 제안되었으나, 인지행동치료와 관련된 뇌 신경학적 기전에 대한 해석은 불명확하다. 본 연구에서는 공황장애 환자에서 CBT 전과 후에 뇌관류 변화를 평가하고 이에 따른 신경해부학적 연관성을 평가하고자 한다. 대상 및 방법: DSM-IV 기준으로 진단된 공황장애 환자 7명(남자 5명, 여자 2명, 평균연령 $45{\pm}11.0$세)을 대상으로 8주 동안 인지행동치료를 했으며, 건강한 정상인 12명(남자6명, 여자 6명, 평균연령 $42{\pm}9.5$세)을 대조군으로 사용하였다. 모든 환자들에게 인지행동치료 전과후에 $^{99m}Tc-ECD$ 뇌관류 SPECT, PDSS-SR과 ACQ점수를 각각 평가하였다. 인지행동치료 도중에는 약물치료를 실시하지 않았다. 모든 영상은 공간적으로 평준화와 편평화를 하여 SPM2를 이용하여 통계적으로 분석하였다. 결과: 공황장애 환자에서 인지행동치료 후 자각적인 증상들이 개선되고, 인지행동 평가 척도와 인지적 불안점수가 유의미하게 감소하였다(p<0.05). CBT치료 전에 띠이랑, 시상, 중간뇌와 전두엽과 측두엽에서 뇌관류가 증가하고, 우측 아래 전두엽에서 뇌관류가 감소함을 관찰하였다. 그리고 8주간의 CBT후 임상 소견의 호전과 함께 좌반구의 해마이랑, 우반구의 띠이랑와 도, 그리고 좌우 전두엽과 측두엽에서 뇌관류가 감소를 하였고 후두엽, 두정엽과 전두엽 일부에서 뇌관류가 증가한 소견을 관찰할 수 있었다. 결론: 공황장애 환자에서 약물치료 없이 인지행동치료만으로도 그 증상을 감소시키는 효과를 보였고, 이는 공포와 관련된 뇌영역에서 뇌활성도의 완화 및 안정화로 인해 치료 효과가 나타남을 알 수 있었다.

${\ll}$소문(素問).거통론(擧痛論)${\gg}$에 나타난 구기(九氣)에 대(對)한 고찰(考察) (Bibliographical study on the Jiu Qi(九氣) shown at Ju Tong Lun(擧痛論) in Shao Wen(素問) Huang Ti Nei Ching(黃帝內經))

  • 김보경;이상용
    • 동의신경정신과학회지
    • /
    • 제11권1호
    • /
    • pp.145-167
    • /
    • 2000
  • Jiu Qi(九氣) was shown at Ju Tong Lun(擧痛論) in Shao Wen(素問) Huang Ti Nei Ching(黃帝內經), and is nine important factors that affect the function of human body. Jiu Qi concludes endogenous, exogenous, non-endo-exogenous factors. I do the bibliographical study on the Jiu Qi, the results were as follows; 1. The Qi of Jiu Qi has two opposite meanings. one is genuine vital energy(正氣), and the other is the factors causing abnormal state in vital energy. Jiu Qi is nine factors concluding coldness-heat(exogenous factors). six emotional factors(endogenous factor), overworking(non -endo-exogenous factor). 2. Anger may lead to abnormal rising of vital energy. Anger causes Qi of the liver to go perversely upward, and perverted flow of exuberant Qi of the liver lead to dysfunction of the spleen, so resulted in hematemesis, diarrhea, indigestion. 3. Joy can promote the harmony of vital energy and blood, so do the circulation of nutrient and defensive energy in physiological state. But an excessive joy may lead to the sluggishness of vital energy. 4. The lung keeps the pathway of air unconstructed, disseminates vital energy, cleanses the inspired air and keeps vital energy flowing downward. Sorrow affects on the function of the lung and the heart, so could result in obstruction of the circulation of nutrient and defensive energy. An excessive sorrow after stagnation may lead to the consumption of vital energy. 5. Fear makes vital energy and essence of the kidney sink to inward and downside, makes Yang-Qi can't go upward, so causes obstruction of triple wanner. An excessive fear can obstructs the ascending of Yang-Qi, so may lead to the abnormal falling of vital energy. 6. Coldness makes the sweat pore be contracted, so obstructs the circulation of triple warmer, causes sluggishness of defensive energy or Qi of the internal organ. 7. Heat makes the sweat pore be open, much amount of sweat is excreted with Yang-Qi, defensive energy, vital energy. Heat may consume vital energy. 8. Sudden fright affects on spirits of the heart and liver, causes disorder of the mental faculties and separation of blood and vital energy. Fright may lead to disorder of Qi. 9. Overwork concludes overfatigue and exhaustion caused by intemperance in sexual life. Overwork renders vital energy consumed, and hence results in lassitude and listlessness. 10. Thinking affects on the function of the heart and the spleen. Over thinking may lead to depression of vital energy. Through the bibliographical study on Jiu Qi, I got smallest amount of it, and this must be more investigated correlating with clinical study.

  • PDF

전환장애(轉換障碍)로 입원(入院)한 환자(患者) 41례(例)에 대(對)한 임상적(臨床的) 고찰(考察) (Clinical Study for Conversion Disorder in 41 Admission Cases)

  • 김명진;최병만;이상룡
    • 동의신경정신과학회지
    • /
    • 제11권2호
    • /
    • pp.131-140
    • /
    • 2000
  • The clinical study was carried out the 41 patients with conversion disorder who were treated in Dae Jeon University Oriental Hospital from 26 september 1998 to 21 september 2000.The results were summarized as follows.1. The ratio of male and female was 4:37 and in the age distribution, the highest frequence was 40s, in descending order over 50s, 30s, 20s, 10s and mental attack was the most inducing factor.2. In distribution of the period of the clinical history. within one day was the highest percentage and in admission period most of the patients were from four days to seven days.3. In symptoms and signs, physical symptoms were more than mental symptoms, physical symptoms had many muscle-skeleton-system symptoms and they were in descending order general body weakness. headache, anorexia, chest discomfort, dyspepsia, dizziness, four extremities numbness, insomnia, dysarthria, anxiety, four extremities tremor. palpitation. nausea, vomiting, facial numbness.4. In classification of Four Human coporeal constitution the number of patients, Sho-Eum-In(少陰人) was remarked mostly and most of female patients had no past history of the conversion disorder.5. In distribution of the prescription, drugs of regulating gi such as BUNSIMGIEUM(分心氣飮) were many, in descending order drugs of growing heart and warming gall bladder such as ONDAMTANGGAMI(溫膽湯加味), drugs of maintaining patency for the flow of gi such as CHUNGGANSOYOSAN(淸肝逍遙散), drugs of decomposing food and asending gi such as PYUNGJINGUNBITANG(平陳健脾湯), drugs of storing blood and relaxing the mind such as SAMULGUIBITANG(四物歸脾湯). drugs of removing sputum and cooling heart such as CHUNGSIMDODAMTANG 淸心導痰湯).6. In distribution of the treatments, the group of drug and acupuncture and aroma-therapy was many, in acup uncture TAEGUKCHIMBUP(太極針法) was mainly used. in therapy inhalation type of Lavender and Rosewood was many and the type of Peppermint and Rosemary massaging epigastric-chest, and neck was many.7. In distribution of the treatment result, in 15 patients(36.6%) symptoms were eliminated from four to seven days, in 13 patients(31.7%) symptoms were not changed. in 12 patients(29.3%) symptoms were eliminated from two to three days. in 1 patients(2.4%) symptoms were eliminated whin one day.

  • PDF

발달성언어장애아(發達性言語障碍兒)의 단일광자방출전산화단층촬영(單一光子防出電算化斷層撮影) 소견(所見)에 관한 연구 (THE SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY FINDINGS IN DEVELOPMENTAL LANGUAGE DISORDERS)

  • 박진생;조수철;이명철
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • 제3권1호
    • /
    • pp.46-55
    • /
    • 1992
  • 발달성언어장애는 학령기 아동에서 약 $3{\sim}10%의$ 높은 빈도로 발견이 되며 그대로 방치할 경우 열등감, 좌절감, 우울증 등의 정서적인 문제를 일으키며 이차적인 학습장애를 동반한다. 이러한 발달성언어장애의 원인으로서는 사회환경적인 영향, 언어발달시기에 생긴 전도성청음장애로 인한 청각자극의 결핍, 유전적인 영향, 국소적인 뇌의 손상 등 때문으로 주장되지만 아직까지 정확한 기전은 밝혀지지 않고 있다. 이에 본 연구는 뇌전산화단층촬영이나 뇌파검사 등에는 나타나지 않는 국소적인 기질적인 병변이 존재하기 때문이라는 가설을 세우고, 뇌의 기능적인 이상을 알 수 있는 '단일광자방출전산화단층촬영'을 시행한 결과, 61.9%(26/42)에서 혈류의 감소가 있음을 발견하였다. 이상소견이 발견된 뇌의 부위가운데에서 대뇌피질이 47.6%(20/42)로서 가장 많았고, 그 다음으로는 시상부위가 33.3%(14/42)로 많았다. 이러한 결과로 미루어 볼 때 발달성언어장애가 뇌혈류의 이상소견과 관련된 뇌기능장애와 관련되어 나타날 가능성이 있음을 알 수 있었다. 향후 동일한 대상 환아군들을 추적 조사하여 증상이 호전된 후에 다시 단일광자방출전산화단층촬영을 실시하여 본 연구결과와 비교연구를 시행한다면 보다 정확한 원인 규명이 가능할 것으로 판단된다.

  • PDF

Fontan 수술을 받은 정신지체 소아에서 인상채득을 위해 시행한 깊은 진정 (Deep Sedation for Palate Alginate Impression Procedure in a Post-Fontan Procedure Patient with Mental Retardation)

  • 이정만;서광석;김현정;신순영;신터전
    • 대한치과마취과학회지
    • /
    • 제12권1호
    • /
    • pp.45-50
    • /
    • 2012
  • The Fontan operation is a heart operation used to treat complex congenital heart defects like tricuspid atresia, hypoplastic left heart syndrome, pulmonary atresia and single ventricle. A single ventricle is dedicated to pumping oxygenated blood to the systemic circulation and the entire systemic venous return reaches the pulmonary arterial system without the direct influence of a pumping chamber. In the patient with Fontan operation, it is important to achieve adequate pulmonary blood flow and cardiac output in anesthetic management. In this case, a 10-year-old boy (19.6 kg, 114 cm) with cleft palate, cerebral palsy and severe mental retardation, who underwent a Fontan operation when he was 4 years old, was presented for deep sedation. Because he was suffering from eating disorder with cleft palate, the orthodontist and the plastic surgeon planned to insert intraoral orthodontic device before cleft palate repair. But it was impossible to open his mouth for alginate impression procedure. After careful pre-anesthesia evaluation we planned to administer deep sedation with propofol infusion. After Intravenous catheter insertion, we started propofol intravenous infusion with the formula of a loading dose of 1.0 mg/kg followed by an infusion rate of 6.0 mg/kg/hr with syringe pump. His blood pressure was remained around 80/40 mmHg after loss of consciousness, but he could not maintain his airway patent. So we lowered the infusion rate to 3.0 mg/kg/hr, immediately. The oxygen saturation was maintained above 95% with nasal oxygen supply, and blood pressure was maintained around 100-80/60-40 mmHg. After the sedation of 110 minutes with propofol (the infusion rate to 3.0-5.0 mg/kg/hr), he fully regained consciousness, and was discharged without complication after 1 hour observation. In case of post-Fontan patient, intravenous deep sedation with propofol was safe and effective method of behavioral management during dental treatment.

주 우울증 환자의 국소 뇌혈류 변화 연구 (Alterations of Regional Cerebral Blood Flow in Major Depressive Disorder)

  • 이원형;정용안;서예영;유익동;나세정;정현석;김기준
    • Nuclear Medicine and Molecular Imaging
    • /
    • 제43권2호
    • /
    • pp.107-111
    • /
    • 2009
  • 목적: 저자 들은 주 우울증 환자들의 뇌 혈류 SPECT을 정상 대조군과 비교하여, 기존에 보고된 주 우울증 환자들의 소견과 어떤 차이가 있는 지 알아보고자 하였다. 대상과 방법: DSM-IV criteria로 주 우울증인 환자들 중에서 4주 이상 모든 정신과적 약물을 중지시킨 12명(남: 7, 녀: 5, 나이 범위: $19{\sim}52$세, 평균 나이: $29.3{\pm}9.9$세)과 자발적으로 지원한 정상 대조군 14명(남: 8, 녀: 6, 나이 범위: $19{\sim}53$세, 평균 나이: $31.4{\pm}9.2$세)을 대상으로 하였다. Tc-99m ECD 주사 후 SPECT 영상을 얻은 후, 주 우울증 환자군과 정상 대조군에서의 국소 뇌 혈류 패턴을 비교하였다. 결과: 정상인 대조군에 비해서, 주 우울증 환자들은 우측 후두엽의 설상 회와 방추상 회, 좌측 후두엽의 설상 회와 설전부, 그리고 좌측 측두엽의 상측두 회의 국소 뇌 혈류가 의미있게 증가하였다. 또한 우측 뇌교, 좌측 전두엽의 내측 전두회, 좌측 변연계의 대상 회, 우측 전두엽의 대상 회, 우측 변연계의 대상 회에서는 대조군에 비해 주 우울증 환자에서 국소 뇌 혈류가 의미있게 감소하였다. 결론: 주 우울증 환자군의 Tc-99m ECD뇌 혈류 SPECT 소견은 기존의 보고와 큰 차이가 없었으며, 우측 뇌교와 대상 회 그리고 좌측 내측 전두 회에서 특정적인 국소 뇌 혈류 감소 소견이 있었다.