급한 의학서적 일부분 영어번역입니다. 내공팍팍드려요 부탁드립니다ㅠㅠ...

급한 의학서적 일부분 영어번역입니다. 내공팍팍드려요 부탁드립니다ㅠㅠ...

작성일 2011.12.14댓글 1건
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 영어 고수님들 해석 좀 부탁드립니다.ㅠㅠ

간단한 그래프는 해석하겠는데 이런 통문장은 너무 어렵네요

뇌경색 관련 의학 서적 내용인데 고수님들 번역 좀 부탁드려요!!!!내공 팍팍 쏴드립니다!!!!ㅠㅠㅠㅠㅠ

11.8 conclusion

Based on the currently available data, three conclusions can be drawn; (1) time from symptom onset remains critical in cases of IV thrombolysis, (2) better patient selection and triage criteria can be used to reduce risk, increase efficacy, and expand the therapeutic window, and (3) centers must develop an organized response to acute ischemic stroke with clinical protocols and quality of care assessment tools.

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Future research should focus on reducing the risks of hemorrhage through better patient selection and developing individualized drug delivery and dosing strategies, Rapid diagnostic imaging tools that identify the site of vascular occlusion, exclude nonischemic etiologies that mimic acute stroke, and characterize the energy state and perfusion status of brain parenchyma will help ensure appropriate patient selection, As demonstrated in other chapters in this book, CTA, CT perfusion, and diffusion and perfusion MRI may provide this detailed information in a clinically meaningful manner. MR imaging can also identify patients with occult hemorrhage due to diseases such as amyloid angiopathy who may be at increased risk of intracerebral lobar hemorrhage when given thrombolytic therapy.

 

Alternatively, promising results of intra-arterial recanalization trials have demonstrated benefit up to and beyond 8 h after stroke onset, Unfortunately, special expertise and technology are needed to support IA recanalization, and this is unlikely to be available to most community hospitals. However, a regional approach to acute stroke care might connect community hospitals with tertiary centers that are equipped for IA thrombolysis. In this context, rapid noninvasive diagnostic testing would facilitate optimal patient selection and guide therapeutic decisions. Because of its ability to rapidly identify or exclude proximal vessel occlusion, CTA may facilitate patient selection for IV vs. IA thrombolytic therapy and trigger a system for rapid evacuation of those patients requiring IA therapy to an affiliated institution. For centers that do not have ready access to neuroendovascular specialists, IV t-PA is still superior to conventional therapy (e.g., heparin or antiplatelet agents) and should be initiated immediately in appropriate cases.



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11.8 conclusion

11.8 결론

Based on the currently available data, three conclusions can be drawn; (1) time from symptom onset remains critical in cases of IV thrombolysis, (2) better patient selection and triage criteria can be used to reduce risk, increase efficacy, and expand the therapeutic window, and (3) centers must develop an organized response to acute ischemic stroke with clinical protocols and quality of care assessment tools.

현재까지의 데이터들로 결론을 짓자면, 3가지에 이를수 있다. (1) 처음 증상이 시작되고부터의 시간이 경정맥 혈전용해술의 경우 아주 중요한 요소이다 (2) 더 세심한 환자 선정과, 3가지 결정론에 의해 리스크가 줄어들수 있으며, 치료 효과역시 증가하게되며, 치료가능 시간을 늘릴수 있다. (3) 치료기관들은 반드시 급성 뇌허혈성 졸중 환자에 대한 응급 치료 프로토콜을 개발하여야하며, 관리 평가 방법을 개발하여야 한다는 것이다.

 

 

  1

Future research should focus on reducing the risks of hemorrhage through better patient selection and developing individualized drug delivery and dosing strategies, Rapid diagnostic imaging tools that identify the site of vascular occlusion, exclude nonischemic etiologies that mimic acute stroke, and characterize the energy state and perfusion status of brain parenchyma will help ensure appropriate patient selection, As demonstrated in other chapters in this book, CTA, CT perfusion, and diffusion and perfusion MRI may provide this detailed information in a clinically meaningful manner. MR imaging can also identify patients with occult hemorrhage due to diseases such as amyloid angiopathy who may be at increased risk of intracerebral lobar hemorrhage when given thrombolytic therapy.

 1

앞으로의 연구방향에서는 반드시 더욱 올바른 환자선정, 약물 투입경로및 방법에대한 개인화된 발전 방안의 연구를 통해 뇌출혈의 위험을 줄일수 있는 연구가 이루어져야만 한다. 혈관이 막힌 곳을 빠르게 알아낼수 있는, 그리고 급성 뇌졸중과 비슷한 비허혈성 병인을 제외할수 있는, 그리고 뇌 실질의 에너지, 관류상태를 빠르게 알아낼수 있는 진단 툴이 환자선정에 도움이 될수 있을것이다. MRI 역시 아밀로이드 혈관병증 같은 병으로인한 잠재성 뇌출혈의 진단에 도움될수 있다.

 

 

Alternatively, promising results of intra-arterial recanalization trials have demonstrated benefit up to and beyond 8 h after stroke onset, Unfortunately, special expertise and technology are needed to support IA recanalization, and this is unlikely to be available to most community hospitals. However, a regional approach to acute stroke care might connect community hospitals with tertiary centers that are equipped for IA thrombolysis. In this context, rapid noninvasive diagnostic testing would facilitate optimal patient selection and guide therapeutic decisions.

동맥내 혈관개통술이 증상 발생후 최대 8시간까지 희망적인 결과를 가져올수 있다는 것을 보여주었으나, 불행하게도 이러한 동맥내 혈관개통술에는 아주 특수한 기술과, 매우 숙련된 의사의 능력이 필요하다는 단점이 있다. 대부분의 일반 동네병원에서는 이러한 조건이 충족될 수가 없다. 하지만 일부 지역에서는 동네 병원과 3차급 대병원간의 환자 이송체계가 시도되고 있으며, 이러한 관점에서 응급 비침습적 진단기술이 최적의 환자 선정과 치료 선택에 도움이 될것이다

 

Because of its ability to rapidly identify or exclude proximal vessel occlusion, CTA may facilitate patient selection for IV vs. IA thrombolytic therapy and trigger a system for rapid evacuation of those patients requiring IA therapy to an affiliated institution. For centers that do not have ready access to neuroendovascular specialists, IV t-PA is still superior to conventional therapy (e.g., heparin or antiplatelet agents) and should be initiated immediately in appropriate cases.

CT동맥조영술은 근위혈관폐쇄여부를 빠르게 알아낼수 있는 능력이 있기때문에 경정맥, 경동맥적 혈전용해술 선정에 있어 환자 선택을 용이하게 해준다. 뇌혈관시술을 할수 있는 의사를 갖추지 못한 병원들에 있어서 경정맥 t-PA 약물의 사용은 일반적인 약물치료(헤파린 또는 항혈소판약제)보다 우수한 효능을 보이고 있으며, 적합한 케이스 에 있어서는 즉시 시작되어야할 치료법이다.