• Title/Summary/Keyword: 뇌혈관

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Evaluation of the bioequivalence of Sumatriptan in healthy volunteers (이미그란 정 50 mg에 대한 수마트란 정의 생물학적 동등성 평가)

  • Yun, Hwi-Yeol;Baek, In-Hwan;Kwon, Kwang-Il
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.2
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    • pp.160-164
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    • 2005
  • 수마트립탄은 뇌혈관에 분포되어 있는 5-HT1B/1D수용체에 특이적이고 선택적으로 작용하여 뇌혈관 수축 작용을 나타내어 편두통의 치료에 널리 쓰이는 약물이다. 본 연구는 수마트립탄 제제인 이미그란(50 mg tablet, GSK사)을 대조약으로 하여 시험약인 명인 제약의 수마트란 50mg정의 생물학적 동등성 평가를 하기 위해 22명의 건강한 지원자를 모집하였다. 지원자를 두 군으로 나누어 1정씩 투여하였고 $2{\times}2$ 교차시험을 실시하였다. 수마트립탄의 혈장 중의 농도를 정량하기 위하여 발리데이션된 HPLC/FD를 사용하였다. 채혈 시간은 투약 전 및 투약 후 0.5, 1, 1.5, 2, 2.5, 3,4, 5, 7, 9, 12시간에 걸쳐 총 12시점에 걸쳐 시행하였다. 생물학적 동등성을 판정하기 위한 파라미터로 12시간까지의 혈장 중 농도 곡선 하 면적$(AUC_{12hr})$ 최고 혈중 농도$(C_{max})$를 사용하였다. $AUC_{12hr}$의 평균은 $137.87ng{\cdot}ml/hr$(시험약)과 $130.12ng{\cdot}ml/hr$(대조약)으로 나타났다. $C_{max}$의 경우 각 각 29.30 ng/ml(시험약)과 29.25ng/m1(대조약)으로 관찰되었다. $AUC_{12hr}$의 경우 로그변환 한 평균치 차의 90% 신뢰구간이 log0.95-log1.24이었고, $C_{max}$의 경우 log0.90-log1.149로 계산되 어 두 항목 모두 log0.8-log1.25이어야 한다는 식품의 약품 안전청 과 FDA의 기준을 모두 만족시켰다. 이상의 결과를 종합하면 시험약 수마트란 정 50 mg은 대조약 이미그란 정 50 mg에 대하여 생물학적으로 동등한 것으로 판정되었다.

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Knowledge on Cardio-cerebrovascular Disease and Health Behaviors among Middle-aged Postmenopausal Women at Risk (심뇌혈관질환 위험인자를 가진 폐경 중년여성의 질환예방 지식과 건강행위)

  • Kim, Kyung Ae;Hwang, Seon Young
    • Korean Journal of Adult Nursing
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    • v.28 no.4
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    • pp.424-435
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    • 2016
  • Purpose: This study examined knowledge about cardio-cerebrovascular disease (CVD) and its relationship to health behaviors among middle-aged postmenopausal women with CVD risk factors. Methods: The study was a cross-sectional descriptive study. One hundred and thirty-six postmenopausal women were recruited from outpatient departments of four hospitals. The women were $60.69{\pm}6.5$ years old. Self-reported questionnaires were administered, and waist-hip ratios (WHR) were measured. Results: Among the women, 72.8% reported hypertension, 19.1% reported diabetes, 33.8% reported hypercholesterolemia, and 24.2% reported angina pectoris. Moreover, 73.9% of the women reported not knowing of CVD prevention, and only 26.1% reported exercising regularly. A majority of the women (80.9%) had a WHR > 0.85. Multiple linear regression analysis after adjusting for age and marital status indicated that the risk of myocardial infarction and stroke increased (p<.001). Waist-hip ratio${\leq}0.85$ (p=.022) and living with family members (p=.006) were significant predictors of healthier behaviors ($R^2$=0.21, p<.001). Knowledge of CVD and health behaviors were not correlated. Conclusion: Obese women and women who live alone are no more likely to practice health behaviors aimed at CVD prevention than their counterparts in the sample. Education and exercise interventions are needed, especially for obese women, to promote healthy behaviors among middle-aged postmenopausal women with CVD risk factors.

A Case of Henoch-Schonlein Purpura Nephritis Complicating Encephalopathy Accompanied by Hypertension and Cerebral Vasculitis (고혈압과 뇌혈관염이 동반된 상태에서 뇌증을 보인 Henoch-Schonlein Purpura Nephritis 1례)

  • Choi, Hee Ra;Kim, Eo Jin;Choi, Myoung Bum;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Sang
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1040-1043
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    • 2003
  • Henoch-Shonlein purpura(HSP) is a systemic small-vessel vasculitis that primarily affects the skin, gastrointestinal tract, joints, and kidneys. The nervous system may be involved, less commonly than other organs. When the central nervous system(CNS) was involved, headache, changes in mental status, seizures, and focal neurologic deficits have been reported. Hypertension, uremic encephalopathy, metabolic abnomalities, electrolyte abnormalities, or cerebral vasculitis were suggested as possible causes of the neurologic manifestation. Diagnosis of vasculitic involvement of CNS is difficult. Magnetic resonance imaging of the brain is the modality of choice for the evaluation of the CNS disease. Steroid or plasmapheresis are used in treatment of cerebral vasculitis. We experienced a case of 9-year-old boy who had presented with Henoch-Schonlein purpura nephritis complicating encephalopathy accompanied by hypertension and cerebral vasculitis. Brain MRI showed multiple small nodular-linear pattern enhancing lesions in whole cerebral hemispheres and focal increased T2 signal in the right basal ganglia. We used intravenous immunoglobulin in treatment of cerebral vasculitis. We report this case with a brief review of related literature.

Is There Any Spousal Concordance of Cerebrovascular Risk Factors in Stroke Patients? : A Preliminary Study (뇌졸중 환자에서 배우자 사이에 뇌혈관 질환의 위험요인 일치성이 있는가? : 예비 연구)

  • Lee, Hyung-Suk;Ko, Young-Chai;Baek, Shin-Hye;Shin, Kyeong-Seob;Kim, Ji-Sun;Han, Hyun-Jeong;Shin, Dong-Ick
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.308-316
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    • 2011
  • Familial concordance of vascular risk factors is well understood and there are many studies about inter-spouse concordance of the risk factors for coronary heart disease. However, there are no studies for inter-spousal relation of the risk factors in cerebrovascular disease patients. We analysed inter-spouse correlation of cerebrovascular risk factors in patients admitted our hospital due to stroke and their spouses. There was statistically significant inter-spouse concordance in the presence of hypertension(p=0.025) and carotid IMT(r=0.479, p=0.001). However, the further age-adjusted analysis revealed no significant result. Differently from the results of previous studie,, the present study shows no significant spousal concordance. Althought there are tendencies of spousal concordance in some risk factors, the age is major determinant.

Job Analysis of Coordinator Working in the Regional Cardiocerebrovascular Center (권역별 심뇌혈관질환센터 코디네이터 직무분석)

  • Cho, Kyung-Sook;Kwon, Sung-Bok;Lee, Kun Sei;Son, Haeng-Mi
    • Journal of muscle and joint health
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    • v.21 no.2
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    • pp.153-163
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    • 2014
  • Purpose: This study was to analyze the job of coordinators working in the regional cardiocerebrovascular center. Methods: Using Developing a Curriculum (DACUM) method, the role of coordinators was defined and their duties and tasks were identified. The developed duties and tasks were classified and validated according to importance, difficulty, and frequency of the job. Results: A coordinator is defined as a clinical nurse specialist affiliated in a cardiocerebrovascular center. The coordinator is responsible for managing the major critical pathway to provide adequate medical service and providing education to the patient with myocardial infarction and cerebrovascular attack admitted via emergency room for prevention and management of disease. Ten duties and sixty-nine tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks showed as A, B, C respectively. Based on determinant coefficient of the task, the highest ranked task was 'analysis for variation of CP' and the lowest was'investing the articles in stock'. Conclusion: The results of study showed that coordinators were doing various duties and tasks and they felt burden from their work and were in confusion. The results of this study can be used to develop training programs for coordinators and evaluation-scale of the coordinators' job performance as the basic data.

A study of the Nursing Interventions performed by the ICU nurses to the patients with Cerebrovascular disorders (중환자실 뇌혈관질환자에게 수행된 간호중재분석)

  • Park, Young-Rye;Choi, Kyung-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.1
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    • pp.94-104
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    • 2001
  • The purpose of this study was to analysis of nursing interventions performed by the ICU nurses to the patients with cerebrovascular disorder practically from one university hospital in Seoul. The data were collected from 15 nurses with 86 cerebrovascular disorder cases from one ICU with the questionaire to write frequency of nursing care done by the surveyee from May, 2, 2000 to July, 3, 2000 and the list of 66 nursing interventions selected out of 433 NIC(Nursing Interventions Classification) of Iowa University which were translated into Korean (44 items) and core nursing interventions by ICU nurses (22 items; KIm, Su-Jin, 1997). The data were analysed with SPSS program. The results are as follow : 1. The most frequently used nursing interventions were vital sign monitoring, fall prevention, cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care, communication enhancement, technology management, bed rest care, respiratory monitoring in rank. 2. The most frequently used nursing intervention domains were 'Physiological : Complex', 'Physiological : basic', 'Behavior', 'Safty', 'Health system' in rank. In the domain of physiological : basic, the most frequently used nursing interventions were bed rest care, urinary elimination management, tube care : urinary, physical restraints in rank. In the domain of physiological : complex, the most frequently used nursing interventions were cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care in rank. In the domain of behavior, the most frequently used nursing interventions were communication enhancement, touch, active listening in rank. In the domain of safty, the most frequently used nursing interventions were vital sign monitoring, fall prevention in rank. In the domain of health system, the most frequently used nursing interventions were technology management, specimen management in rank. 3. some difference of the frequency practicing the nursing interventions according to the shift of duties was found. For example, medication administration was common at day duty, touch was practiced at evening duty, temperature regulation was performed.

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A Case of Tuberculous Meningoencephalitis Presenting as Prominent Psychotic Features (현저한 정신증상으로 발현된 결핵성 뇌수막뇌염 1예)

  • Yu, Hyun-Jung;Oh, Jee-Young;Kim, Jee-Hyun;Kim, Jung-Eun;Park, Kee-Duk
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.603-608
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    • 2001
  • Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressive behavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proximal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.

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Analysis on Home Care Services and Home Health Care Cost of CVA Patients in Korea (뇌혈관질환자의 가정간호 서비스 및 진료비 분석)

  • Kim, Eun-Kyung;Shin, Suk-Youn;Hwang, Jeong-Hae
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.2
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    • pp.225-232
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    • 2006
  • Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

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The Effects of Visiting Nursing Intervention on Self Care Behavior and Blood Pressure in Persons with High Risk of Cerebrovascular Diseases (방문간호 중재가 뇌혈관질환 고위험자의 자가간호행위 및 혈압에 미치는 효과)

  • Park, Jeong-Mo;Lee, Suk-Jeong
    • Research in Community and Public Health Nursing
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    • v.18 no.4
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    • pp.572-582
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    • 2007
  • Purpose: This study was to evaluate the effects of visiting nursing intervention on self care behavior and blood pressure with high risk of cerebrovascular diseases. Method: A one-group pretest-posttest was designed. Data collection was done in 150 participants from March. 2003 to November, 2003 at a public health center. Self care behavior was assessed by the scores of smoking, alcohol, diet, exercise, stress and medication compliance. The scores of knowledge related cerebrovascular diseases, blood pressure, blood glucose were estimated. The Participants were intervened in with basic assessment, emotional support, education. This program took a period ranging from 3 months to 7 months depending on the cerebrovascular risk level. The mean number of visiting times was 1.67 per month. Result: 1. Knowledge level was improved(t=-2.542, p= .012). 2. Systolic and diastolic pressure were lower(t=5.439, p<.001; t=4.966, p<.001) 3. Self care level was higher (t=-12.981, p=.001) after the intervention. Conclusion: The visiting nursing intervention was found to have an effect on the scores of knowledge, self care behavior and blood pressure with high risk of cerebrovascular diseases. The results provided evidences for the importance of visiting nursing intervention in the high risk factor of cerebrovascular disease for self care.

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An Analysis on Korean Mortality Structure (한국인의 사망력 구조분석)

  • 이상식
    • Korea journal of population studies
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    • v.13 no.1
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    • pp.51-80
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    • 1990
  • 한국의 사망력은 높은 수준의 성별 사망력 차이와 중년 남성의 급격한 사망력 상승을 그 구조적 특성으로 하고 있는데, 이러한 한국인 사망력 구조의 특이성은 직접적으로는 사망원인의 성별, 년령별 차별적 역활에 기인하며 간접적으로는 이들 원인의 차별성을 초래하는것으로 추정되는 경제개발기간동안의 사회, 경제 및 공공정책상의 변화 및 생활습관의 차이에서 기인된다고 보아진다. 본 연구에서는 이들 차이를 결과짓는 여러 요인들을 중심으로 한국인의 사망력 구조상에서 나타난 년령별 및 성별특성을 분석하는데 그 주요점을 두었다. 1985년 경제기획원 조사통계과에 의해 집계된 사망원인통계자료는를 활용하여 한국인의 사망력 구조의 특성을 사망원인과 관련시켜 연구분석한 결과는 다음과 같이 종합될수 있다. 첫째, 40대 이후 남성의 높은 사망력에 의거한 요인들은 뇌혈관질환, 고혈압성질환, 암질환 및 기지 심질환 및 간의 악성신생물 순으로 중요하게 나타났다. 둘째, 0세에서의 남녀간의 기득개념의 차이는 차이는 초년 또는 청년층에서의 남녀간의 사망력 차이에서 보다는 40대 이상의 중장년층에서의 남녀간의 사망력 차이에서 비롯되었으며, 뇌혈관 질환, 악성간질환 및 고혈압성 질환, 간의 악성 신생물,및 기타 심질환 및 간의 악성 신생물 질환들이 중장년층에서의 남녀간의 사망력 차이를 결정하는데 주역활을 하고 있는 것으로 나타났다. 세째, 위의 년령간의 및 남녀간의 사망력 수준의 차이를 결정짓는 주요한 사회적 간접요인들로는 첫째, 사회.경제개발과 함께 이어 병행되어온 보건정책들이 즈로 어린이 또는 여성에 편향된 결과 였으며, 둘째,환경적 요소로서 중년 남성들의 Social stress, 운동부족과 관련된 질병들과 공해, 먼지, 유해화학물 가스 등 산업재회와 관련된 질병들에 의한 사망률이 높으며, 세째, 행위적 요소로서 음주와 흡연과 관련된 질병들에 의한 중년 남성의 사망률이 높은것들로 요약될수 있다. 중년 남성의 높은 사망률은 기술적,사회적 경험이 축적된 노동력의 상실로서 국가적 손실이 크며, 고 년령층 인구의 구조적 측면에서도 성의 불균등을 초래하여 미혼 여성의 증가등 사회적인 기반문제의 주요한 요인이 되므로서 그 중요성은 지대하다고 할수 있겠다. 그러므로 이 문제는 국가적 사회적 차원에서 해결이 시급하며 그 해결책으로는 지금 까지 도외시 되어 왔던 중년 남성의 건강을 위한 프로젝트의 실지와 함께 이들에게 노출되어 왔던 운동 부족, 사회적 스트레스 및 산업재회의 해소 내지 제거에 대한 방안들이 연구 되어야 하겠다. 한편 음주 및 흡연등의 개인행위적 습관의 개선을 위한 사회 계몽활동의 추진 및 건전한 스트레스 해결책의 개발이 중요하다고 하겠다.

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