• 제목/요약/키워드: the edema rate

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저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 - (Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model)

  • 김원곤;임청;문현종;전이경;지제근;원태희;이영탁;지현근;김준우
    • Journal of Chest Surgery
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    • 제30권5호
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    • pp.471-478
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    • 1997
  • 토끼는 심폐바이패스(CPB) 실험동물로서 많은 장점을 가지고 있음에도 불구하고 토끼에서 CPB운용법의 확립은 기술적으로 대단히 어려운 것으로 알려져 있다. 한편 저체온 순환정지법은 심장수술에서 유용하게 사용되고 있으나 뇌 보호상의 문제점이 지적되고 있다. 스테로이드는 일반적으로 뇌부종 치료에 효과가 있는 것으로 알려져 있으나 순환정지시 뇌보호에 미치는 영향에 관해서는 아직 명확하게 규명되지 못하고 있다. 이런 관점에서 본 연구는 첫째 토끼에서 CPB운용법을 확립하고 둘째 이를 바탕으로 순환정지시 스테로이드에 의한 뇌보호 효과를 분석할 목적으로 시행하였다. 흰 토끼 15마리(평균 체중 3,5kg)를 3군의 실험군에 각각 5마리씩 사용하였다. 제 1실험군(대조군)은 순환 정지시 토끼를 수술대와 평행된 자세로 유지하였으며, 제 2실험군에서는 대조군과 다른 실험방법은 동일하나 순환정지시 토끼를 트렌델렌부르그 자세로 유지하였다. 제 3실험군에서는 트렌델렌부르그 자세와 함께 순환정지전 스테로이드(methylprednisolone 30 mg/kg)를 투여하였다. 실험방법은 토끼를 마취시킨후 정중흉골절 개술로 심장을 노출시키고 상행대동맥 및 \ulcorner심방부속지에 각각 3.3mm 동맥캐늘라 및 14 Fr 단일 정맥캐늘라를 삽관하였다. CPB 회로에는 롤러 펌프와 기포형 산화기를 사용하였다. 충전액은 토끼혈액 120-150cc를 포함하여 약 450cc를 사용하였다. 전체 실험시간은 70분으로 심폐바이패스 시작후 10일 동안 관류 및 표면냉각법으로 체온을 20도(직장)까지 감소시킨뒤 40분 동안 순환정지를 시켰다. 순환정지후 관류를 재개하여 20분 동안 재가온으로 체온을 정상화시키면서 심장 박동이 되돌아오는 것을 확인하였다. 관류 유속은 80~ 90mg/min 으로 시작하였고 체온 하강에 따라 유속을 조절하였다. 실험후 토끼를 희생시킨뒤 바로 부검을 시행하여 뇌, 척수, 신장, 십이지장, 폐, 심장, 간장, 비장, 췌장, 위장의 일부를 채취하여 수분함유량을 조사하였다. 각 실험군간의 수분양 비교는 Kruskal-Wallis 비모수 검정법에 의해 분석하였다. CPB 중 관류 유속 변화는 60~l00ml/kg/min 이었다. 동맥압은 대부분 35-55mmhg 사이에서 유지되었다. 재가온후 심장은 전례에서 박동을 재개하였다. 동맥혈가스분석 결과 심한 조직 허혈을 의미하는 정도의 대사 성 산증은 발견되지 않았다. 각 실험군별 조직수분양 측정 결\ulcorner 뇌를 포함한 각 장기들에서 실험군간체 유의 한 차이는 발견되지 않았다. 이러한 실험결과를 통하여 저자들은 (1) 적절한 기법하에서는 토끼에서도 정상 적인 심폐바이패스 운용이 가능하다는 것과, (2) 본 실험 범주에서는 저체온 순환정지시 트렌델렌부르그 자 세에 의한 뇌부종 발현에 대한 스테로이드의 예방효과를 검정할 수없다는 결론을 얻었다.

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동의보감(東醫寶鑑)중 망면색(望面色)에 대한 연구(硏究) (A study on the diagnosis of observing face color by Dongeuibogam)

  • 김민정;박원환
    • 대한한의진단학회지
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    • 제17권2호
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    • pp.131-155
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    • 2013
  • Objectives A study on the importance of observing face color in the Dongeuibogam and the other things to know when we observe face color. Methods We used Deyuk Dongeuibogam of Dongeuibogam publishing company from original photographic edition. Results (1) In all section(ex. Naekyungpyeon, Oehyeongpyeon and Japbyoungpyeon), the chapters related with observing face color were fifty-one. In Naekyungpyeon, the chapters related with observing face color were nineteen(37%). In Oehyeongpyeon, the chapters related with observing face color were ten(20%). In Japbyoungpyeon, the chapters related with observing face color were twenty-two(43%). In all section(ex. Naekyungpyeon, Oehyeongpyeon and Japbyoungpyeon), the statements related with observing face color were three-hundred and nine. In Naekyungpyeon, the statements related with observing face color were sixty-four(21%). In Oehyeongpyeon, the statements related with observing face color were fifty-two(17%). In Japbyoungpyeon, the statements related with observing face color were one hundred ninety-three(62%). (2) In each chapter, the number of statement related with observing face color was studied. Pediatric Chapter (75) were the most common, followed by The way of finding the cause of a disease (27) Face (26) Cold (24) Weak&Fatigue (12) Phlegm, Jaundice (8) Nose, Worm, Chronic indigestion (7) Mouth&Tongue, Woman, Stool (6) Bodyshape, Liver, Heart, Kidney, Cough (5) Eye, Carbunculosis (4) Blood, Voice, Spleen, Lung, Chest, Fire, Edema, Detoxification (3) in order. (3) In each section(ex. Naekyungpyeon, Oehyeongpyeon and Japbyoungpyeon), the rate of chapter related with observing face color was studied. Naekyungpyeon(73%) was the highest. Japbyoungpyeon(61%). Oehyeongpyeon(38%) was the lowest. Conclusions The importance of each chapter for observing face color in the Dongeuibogam was studied. In addition, the entire ocular inspection, the part ocular inspection, moisture and the difference of skin according to the personal constitution should be considered. There are not only the important parts of the past that does not mean but also the unimportant parts of the past that are meaningful now. Additional studies will be needed for the latter.

목과(木瓜) 약침(藥鍼)이 Collagen-induced Arthritis 억제 및 면역조절에 미치는 영향 (Effect of Herbal-acupuncture with Chaenomelis Fructus Solution at the Joksamni($ST_{36}$) of Mice with Collagen-induced Aarthritis)

  • 신동수;김영일;이현
    • Journal of Acupuncture Research
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    • 제24권3호
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    • pp.127-143
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    • 2007
  • Objectives : The purpose of this study was to observe the effects of Chaenomelis Fructus herbal-acupuncture solution (ChF-HAS) at the Joksamni ($ST_{36}$) on arthritis induced by Collagen II in mice. Methods : The author performed several experimental items. The severity of arthritis, changes of mouse weight, size of the spleen and the degree of stenosis, changes of cytokine level, IgG, IgM and anti-collagen II, changes of immunocyte count, histological changes of the CIA mouse joint were analyzed and the conclusions are as follows. Results: 1. In the ChF-HA, the arthritis index, the incidence of arthritis, the degree of joint edema was significantly decreased. 2. In the ChF-HA, weight, spleen size and stenosis rate was low and maintained as the normal group was. 3. In the ChF-HA, cytokine level, IgG, IgM and anti-collagen II were significantly decreased. 4. In the ChF-HA, on changes of immunocyte count were maintained to the levels of normal group. 5. In histological changes of the CIA mouse joint, the cartilage destruction and synovial cell proliferation were decreased. Conclusions: These results suggest that ChF-HA at the $ST_{36}$ has an important role to control the immune reactions and suppress inflammatory response on the collagen induced rheumatoid arthritis. This study can be a significant supporting evidence that ChF-HA is chosen to be the principal therapy for clinical practice of the rheumatoid arthritis in the future.

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임신중 경증불편감 호소율과 영향 요인에 관한 연구 (The Complaints Rates of Minor Discomforts and Its Influencing Factors.)

  • 이미라;조정호;김은경;송미승
    • 모자간호학회지
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    • 제1권
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    • pp.16-22
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    • 1991
  • Various minor discomforts are reported to be complained by the pregnant women. but what were and how much were they complained has not been revealed until recently. So, These lack of knowledge have given nurses difficulties in planning of care to promote the health during the pregnancy. Objectives of this study were to identify the rate of complaints in each minor discomforts and to explore the influencing factor on reduction of complaints of minor discomforts. The subjects were 120 mothers, who delivered their babies in hospital, from September to December 1990 and the reason why the postpartum mothers were selected as the subjects were minor discomforts could develope during the entire period of pregnancy. Data were gathered by the questionnares and analized statistically using SAS and SPSS program. Results were as follows. 1. More than one third of the subjects complained frequent urination, fatigue, increase of the vaginal discharge, morning sickness, the increased urination at night, pain in leg, backache, edema in leg, constipation, dyspnea, varicose vein, flatulence, headache. 2. Minor discomforts complained to be severe in more than one third of the subjects were frequent urination and increased urination at night. 3. The influencing factor to reduce the complaints of minor discomfort was revealed to be the perceived family support (r=0.030431, t=0.0007). We suggest that nurses should emphasize the importance of the family support to the pregnant women and their family, and to explore the relationships among the locus of control, the perceived family support and the complaints of minor discomforts.

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족삼리(足三里) 천궁(川芎) 약침(藥鍼)이 Collagen-induced Arthritis에 미치는 영향 (Effect of Herbal-acupuncture with Cnidii Rhizoma Solution at the Joksamni($ST_{36}$) of Mice with Collagen-induced Arthritis)

  • 황영진;임윤경;이현
    • Journal of Acupuncture Research
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    • 제24권4호
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    • pp.81-97
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    • 2007
  • Objective: The purpose of this study was to observe the effects of Cnidii Rhizoma herbal-acupuncture solution(CR-HAS) at Joksamni($ST_{36}$) on arthritis induced by Collagen II in mice. Methods : The author performed several experimental items. The severity of arthritis, changes of mouse weight, size of the spleen and the degree of stenosis, changes of cytokine level, IgG, IgM and anti-collagen II, changes of immunocyte count, histological changes of the CIA mouse joint were analyzed. Results: 1. In the CR-HA, the arthritis index, the incidence of arthritis, the degree of joint edema was significantly decreased. 2. In the CR-HA, weight, spleen size and stenosis rate was low and maintained as the normal group was. 3. In the CR-HA, cytokine level, IgG, IgM and anti-collagen II were significantly decreased. 4. In the CR-HA, on changes of immunocyte count were maintained to the levels of normal group. 5. In histological changes of the CIA mouse joint, the cartilage destruction and synovial cell proliferation were decreased. Conclusions : These results suggest that CR-HA at the $ST_{36}$ has an important role to control the immune reactions and suppress inflammatory response on the collagen induced rheumatoid arthritis. This study can be a significant supporting evidence that CR-HA will be chosen to be the principal therapy for clinical practice of the rheumatoid arthritis in the future.

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태열(胎熱)에 관한 문헌적(文獻的) 고찰(考察) (Literatural Study on Tae-yeul)

  • 구진숙;김장현
    • 대한한방소아과학회지
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    • 제15권1호
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    • pp.235-253
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    • 2001
  • Tae-yeul is the baby's disorder inheritted by its mother during fregnancy. This is due to its mother's overeating hot, fatty food and taking harmful medicine. So internal physical fever is accumulated in mother's body, and it heats up the placenta and the umbilical cord. Generally, this disorder means the skin disease that is occurred from $2{\sim}5$ months to 1 year after birth. It is specialized by the dirty oozing, a severe itching and the rash at its head and face. It is similar in its symptoms such as atopic dermatitis in western medicine. Recently, this disease has the increasing tendency of prevalence rate because of the bad atmosphere and the invironmental pollution. The results were summerised as follows; 1, 2, 3, 4 1. The causes of Tae-yeul are summarized by fragnat woman's contacting a cool air, overating a hot and toxic food and taking emotional shock. 2. The symptoms of Tae-yeul are the edema on upper eyelids, stifling convulsions, flush, the fever of one side body, the asthma of sputum increase, the yawing of the tired mind, the bowl complaint, the red urine and urination disturbance. 3. In the treatment method of Tae-yeul, its mother feed her milk after taking a madicine. So one must expect to be treated slowly. If one tries to treat it with a cool madicine quickly, it can cause vomitting or a serious disorder. 4. In the prescription of Tae-yeul, they used a Moktongsan, a Chiwhnagtang, an Yangyoubang, a Tojuksan, a Whangyunsan, a Juryungtang and a Kamdutang, etc.. For the method of cleaning face or bathing, they used Sasungsan, Whanbaekpijuntang. 5. Tae-yeul including Naesun, Taelyumchang, yousun, etc. is similar to the atopic dermatitis of western medicine in its symptoms.

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지연성 외상성 뇌실질내 출혈 환자의 치료를 결정하는 임상적, 영상학적 예후인자에 대한 평가 (Assessment of the Clinical and the Radiological Prognostic Factors that Determine the Management of a Delayed, Traumatic, Intraparenchymal Hemorrhage (DTIPH))

  • 류제일;김충현;김재민;정진환
    • Journal of Trauma and Injury
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    • 제28권4호
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    • pp.223-231
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    • 2015
  • Purpose: Delayed, traumatic, intraparenchymal hemorrhage (DTIPH) is a well-known contributing factor to secondary brain damage that evokes severe brain edema and intracranial hypertension. Once it has occurred, it adversely affects the patient's outcome. The aim of this study was to evaluate the prognosis factors for DTIPH by comparing clinical, radiological and hematologic results between two groups of patients according to whether surgical treatment was given or not. Methods: The author investigated 26 patients who suffered DTIPH during the recent consecutive five-year period. The 26 patients were divided according to their having undergone either a decompressive craniectomy (n=20) or continuous conservative treatment (n=6). A retrospective investigation was done by reviewing their admission records and radiological findings. Results: This incidence of DTIPH was 6.6% among the total number of patients admitted with head injuries. The clinical outcome of DTIPH was favorable in 9 of the 26 patients (34.6%) whereas it was unfavorable in 17 patients (65.4%). The patients with coagulopathy had an unexceptionally high rate of mortality. Among the variables, whether the patient had undergone a decompressive craniectomy, the patient's preoperative clinical status, and the degree of midline shift had significant correlations with the ultimate outcome. Conclusion: In patients with DTIPH, proper evaluation of preoperative clinical grading and radiological findings can hamper deleterious secondary events because it can lead to a swift and proper decompressive craniectomy to reduce the intracranial pressure. Surgical decompression should be carefully selected, paying attention to the patient's accompanying injury and hematology results, especially thrombocytopenia, in order to improve the patient's neurologic outcomes.

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기도확보가 어려운 상황에서 Miller blade와 Macintosh blade를 이용한 기관내삽관의 비교 : 숙련되지 않은 인턴을 대상으로 한 마네킨 연구 (Comparison of tracheal intubation using the Miller blade versus Macintosh blade in difficult airway: A manikin study among novice intern doctors)

  • 이미림;김철태;이효철
    • 한국응급구조학회지
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    • 제22권3호
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    • pp.35-45
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    • 2018
  • Purpose: The purpose of this study was to compare laryngoscopic views and ease of use and success of intubation, via the percentage of glottic opening (POGO) scale when using the Miller blade and Macintosh blade in paraglossal approach. Methods: Forty intern doctors were randomized for laryngoscopy to be performed in a crossover manner. They performed endotracheal intubation with Miller blade and Macintosh blade in two airway scenarios: normal airway and difficult airway with edema. We observed the rate of successful intubation, time required for visualizing the glottis, time to complete endotracheal intubation, ease of intubation, and the POGO scale. Results: In the normal airway, there was no difference in intubation between the two endoscopes. In the difficult airway, the time for visualizing the glottis (7.80 versus 10.24 sec; p=.006), the time to tube passage (19.38 versus 23.03 sec; p=.038) and the time to complete endotracheal intubation (21.84 versus 28.54 sec; p=.022) with Miller blade was shorter than with Macintosh blade. The POGO scale(%) of the Miller blade was higher than that of the Macintosh blade's (62.25 versus 56.32; p=.030). Conclusion: Compared to the Macintosh blade, Miller blade provided better visualization of the glottis and POGO scale, and faster time to completion of endotracheal intubation.

Clinicopathological Findings and Five Year Survival Rates for Patients with Central Nervous System Tumors in Yazd, Iran

  • Zahir, Shokouh Taghipour;Vakili, Mahmood;Navabii, Hossein;Rahmani, Koorosh
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10319-10323
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    • 2015
  • Background: The incidence rate of brain tumors has increased more than 40% in the past 20 years, especially in adults. We aimed to study the clinical and pathological findings of central nervous system (CNS) tumor patients and to evaluate their 5 year survival rates. Materials and Methods: The archives of all patients with CNS tumors in 6 health care centers in Yazd, Iran, from 2006 to 2013, were studied. Patients data were extracted using a checklist which included age, sex, date of reference and diagnosis, date of death, clinical signs, radiography findings, pathology report, size and location of tumor, patient treatment and grade of tumor. Results: A total of 306 patient records were studied in the 8 year period. The most prevalent type of tumor was astrocytoma (n=113, 36.9%). The frequency of almost all tumor types was statistically higher in male patients (p=0.025). In most cases surgery with radiotherapy was the treatment of choice (49.3%). The most frequent symptom reported was headache (in 60.8% of patients) followed by convulsions (15.7%). Most of the tumors were located in the right hemisphere (46.1%) and the frontal and parietal lobe (26% and 12%, respectively). Radiography findings displayed edema with a nonhomogeneous lesion in majority of the patients (87%). The survival fraction of the patients with malignant tumors decreased over time (0.807 in the first year and 0.358 at the end of the $5^{th}$ year). Conclusions: Astrocytoma was the more common CNS tumor with male predominance. Overall survival rates of malignant tumors decreased over time and this was in relation with tumor grade.

Magnetic Resonance Image Manifestations of the Atypical Meningioma

  • Wu, Qing-Wu;Yan, Rui-Fang;Li, Qiang;Hu, Ying;Zhou, Feng-Mei;Ren, Ji-Peng;Yang, Rui-Min;Zhang, Yan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6337-6340
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    • 2013
  • Through retrospective analysis of 13 cases of magnetic resonance image (MRI) manifestations of atypical meningiomas confirmed by operation and pathology in the First Affiliated Hospital of Xinxiang Medical University, the objective of this study was to evaluate the diagnostic value of MRI in order to improve the accuracy rate of preoperative diagnosis. In this retrospective analysis of MRI findings for atypical meningiomas in First Affiliated Hospital of Xinxiang Medical University from January to July in 2012, the location, morphology and tumor signals and other tumor imaging characteristics were covered. In 13 cases of atypical meningioma patients of this group, most tumors were located at typical sites (10/13), mainly the falx cerebri, parasagittal, convexity, saddle area. Only two cases were at atypical locations, 1 in the cerebellar hemisphere and 1 in a lateral ventricle. Most of the tumors showed T1 and T2 isointensity signals, and necrosis, calcification, and peritumoral edema were always featured. DWI showed isointensity in 11 cases (11/13), and hyperintensity in 2. Some 9 cases had dural tail signs, 12 had accurate positioning (12/13), and 2 were postoperative recurrences. MRI has high value in the diagnosis of atypical meningiomas, with important roles in early clinical diagnosis, treatment and prognosis evaluation.