• Title/Summary/Keyword: 2-Stroke

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The Effect of Physical Therapy on Functional Change and Related Factors in Stroke Patients (뇌졸중환자의 물리치료경과에 따른 기능변화와 관련요인)

  • Lee Seung-Ju;Yeh Min-Hae;Chun Byung-Yeol
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.7-21
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    • 1998
  • An analysis of 101 stroke patients who were enrolled in 10 hospitals of Cities of Pusan, Taegu, and Andong from November 1, 1996 to April 31. 3997 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals: Initial assessment, one month after initial. at discharge, and one month after discharge. The mean BI score of patients initial assessment was 27.18, and that of PS was 17.54. There were statistically significant between initial score and one month after initial (21.39: p<0.001), at discharge(37.47: p<0.001), one month after discharge(46.49: p<0.001). PS scores were also improved .significantly(-2.62, -4.52. and -6.26(p<0.001). And the score between dischange and one month after discharge was significant (9.01: p<0.001) and in PS score(-1.73: p<0.001). Age and BE score were significantly associated with the improved in BI score between initial and discharge(T3-T1)(p<0.05). Below age forty the Bower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial Bl score, patients' attitude for physical therapy after discharge, age, and surgical operation were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, patients' positive attitude for physical therapy after discharge, below age forty. and no surgical operation showed significantly higher improvement(p<0.05). BI score at discharge, side of hemiparesis and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3) (p<0.05). The lower BI score at discharge. left aide of hemiparesis, with religion showed significantly higher improvement (p<0.05). Age, initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score and below age forty showed significantly higher improvement(T3-T1)(p<0.05). Initial PS score, patient' attitude for physical therapy after discharge, age, educational level, physical therapy hour after discharge, and surgical operation were significantly associated with the improvement of PS score between initial and one month after discharge(T4-T1)(p<0.05). The higher initial PS score, patients' positive attitude for physical therapy after discharge, below age forty, higher education, the shorter physical therapy hour, and no surgical operation showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, educational level, patient' attitude far physical therapy after discharge, physical therapy hour after discharge, and gender were significantly associated with the improvement of PS score between discharge and une month after discharge(T4-T3) (p<0.05), The higher PS non at discharge, higher education, patients' positive attitude for Physical therapy after discharge, the shorter physical therapy hour, and male showed significantly higher improvement (T4-T3)(p<0.05). In conclusion, initial BI score and age were significantly associated with BI score improvement and initial PS score, age, and educational level were also significantly associated with PS score improvement in stoke patients.

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Antioxidative Effects of Korean Bamboo Trees, Wang-dae, Som-dae, Maengjong-juk, Jolit-dae and O-juk (한국산 왕대, 솜대, 맹종죽, 조릿대 및 오죽의 항산화 효과)

  • Lee, Min-Ja;Moon, Gap-Soon
    • Korean Journal of Food Science and Technology
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    • v.35 no.6
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    • pp.1226-1232
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    • 2003
  • Bamboo trees have been used for a long time as folk remedies for treatment of hypertension and stroke symptoms in Oriental regions. These pharmaceutical effects of bamboos look like to be related to its antioxidant capacity and phytochemicals in bamboos. To evaluate the antioxidative effects of bamboo trees, five kinds of bamboo varieties dominant in Korean peninsular were chosen and determined its total antioxidaive activities, free radical scavenging activities and nitrite scavenging activities by TEAC (Trolox Equivalent Antioxidant Capacity) assay, DPPH and Griess reagent assay using in vitro system, respectively. To evaluate the correlation between antioxidative activities and Maillard reaction during hot water extraction, contents of reducing sugar and total nitrogen and brown color intensity at 420 nm were determined. When total antioxidative activities, free radical scavenging activities and nitrite scavenging activities of five kinds of bamboo trees were compared, wang-dae (Phyllostachys bambusoides S. et Z.) showed the strongest effect among samples, although all kinds of extracts showed relatively strong effects against oxidation. The bamboo culms extract showed stronger antioxidative effects than that of bamboo leaves. In each fraction obtained from 70% ethanol extract, antioxidative effect were increased in order of dichloromethane>ethyl acetate>butanol>water>hexane fraction. In reducing sugar analysis of extracts, reducing sugar contents of water extracts were higher than that of 70% ethanol extracts and wang-dae water extract showed the highest level which was 708.92 mg/g. Total nitrogen contents of the extracts were $1.785{\sim}2.605\;mg%$ and contents in water extracts were lower than that in 70% ethanol extracts. Brown color intensity at 420 nm showed similar tendency with results in reducing sugar contents.

Coronary Artery Bypass Grafting in Elderly Patients Older Than 75 Years (75세 이상 고령환자의 관상동맥우회로술)

  • Yoo Dong Gon;Kim Chong Wook;Park Chong Bin;Choo Suk Jung;Lee Jae Won;Song Meong Gun;Song Hyun
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.123-131
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    • 2005
  • Background: The number of elderly patients undergoing coronary artery bypass grafting (CABG) is increasing. Elderly patients are at increased risk for a variety of perioperative complications and mortality. We identified determinants of operative complications and mortality in elderly patients undergoing CABG. Material and Method: Between January 1995 and July 2003, 91 patients older than 75 years underwent isolated CABG at Asan Medical Center. There were 67 men and 24 women with mean age of $77.0\pm2.4$ years. Thirty clinical or hemodynamic variables hypothesized as predictors of operative mortality were evaluated. Result: CABG was performed under emergency conditions in 5 patients. The internal thoracic artery was used in 85 patients and 10 patients received both internal thoracic arteries. The mean number of distal anastomosis was 3.7 per patient. Operative mortality was $3.3\%$. Twenty-two patients had at least one major postoperative complication. Low cardiac output syndrome was the most common complication, followed by reoperation for bleeding, pulmonary dysfunction, perioperative myocardial infarction, stroke, acute renal failure, ventricular arrhythmia, upper gastrointestinal bleeding, infection, and delayed sternal closure. None were the predictors of mortality. Renal failure, peripheral vascular disease, emergency operation, recent myocardial infarction, congestive heart failure, New York Heart Association (HYHA) class III or IV, Canadian Cardiovascular Society (CCS) angina scale III or IV, and low left ventricle ejection fraction below $40\%$ were univariate predictors of overall complications. Actuarial probability of survival was $94.9\%,\;89.8\%,\;and\;83.5\%$ at postoperative 1, 3 and 5 years respectively. During the follow-up period $93.3\%$ of patients were in NYHA class I, or II and $91.1\%$ were free from angina. Conclusion: Although operative complication is increased, CABG can be performed with an acceptable operative mortality and excellent late results in patients older than 75 years.

Efficacy Assessment of Endovascular Stenting in Patients with Unilateral Middle Cerebral Artery Stenosis Using Statistical Probabilistic Anatomical Mapping Analysis of Basal/Acetazolamide Brain Perfusion SPECT (기저/아세타졸아미드 국소뇌혈류 SPECT의 확률 뇌지도 분석을 이용한 일측 중대뇌동맥 협착환자에서 시행한 스텐트 삽입술의 효용성 평가)

  • Kim, Hae-Won;Won, Kyoung-Sook;Zeon, Seok-Kil;Lee, Chang-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.280-286
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    • 2009
  • Purpose: The aim of this study was to evaluate the hemodynamic changes after endovascular stenting in patients with unilateral middle cerebral artery (MCA) stenosis using statistical probabilistic anatomical mapping (SPAM) analysis of basal/acetazolamide (ACZ) Tc-99m ECD brain perfusion SPECT. Materials and Methods: Eight patients (3 men and 5 women, 64.8$\pm$10.5 years) who underwent endovascular stenting for unilateral MCA stenosis were enrolled. Basal/ACZ Tc-99m ECD brain perfusion SPECT studies were performed by one-day protocol before and after stenting. Using SPAM analysis, we compared basal cerebral perfusion (BCP) counts and cerebrovascular reserve (CVR) index of the MCA territory before stenting with those after stenting. Results: After stenting, no patient had any complication nor additional stroke. In SPAM analysis, 7 out of the 8 patients had improved BCP counts of the MCA territory and 7 out of the 8 patients had improved CVR index of the MCA territory after stenting. Before stenting, the mean BCP counts and CVR index in the affected MCA territory were 47.1$\pm$2.2 ml/min/100 g and -2.1$\pm$2.9%, respectively. After stenting, the mean BCP counts and CVR index in the affected MCA territory were improved significantly (48.3$\pm$2.9 ml/min/100 g, p =0.025 and 0.1$\pm$1.3%, p =0.036). Conclusion: This study revealed that SPAM analysis of basal/ACZ brain perfusion SPEG would be helpful to evaluate hemodynamic efficacy of endovascular stenting in unilateral MCA stenosis.

Effect of NMDA Receptor Antagonist on Local Cerebral Glucose Metabolic Rate in Focal Cerebral Ischemia (국소뇌허혈에서 NMDA 수용체 길항제가 국소 뇌포도당 대사율에 미치는 영향)

  • Kim, Sang-Eun;Hong, Seung-Bong;Yoon, Byung-Woo;Bae, Sang-Kyun;Choi, Chang-Woon;Lee, Dong-Soo;Chung, June-Key;Roh, Jae-Kyu;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.3
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    • pp.294-306
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    • 1995
  • There has recently been increasing interest in the use of NMDA receptor antagonists as potential neuroprotective agents for the treatment of ischemic stroke. To evaluate the neuroprotective effect of the selective non-competitive NMDA receptor antagonist MK-801 in focal cerebral ischemia, local cerebral glucose utilization (ICGU) was examined in 15 neuroanatomically discrete regions of the conscious rat brain using the 2-deoxy-D[$^{14}C$] glucose quantitative autoradiographic technique 24 hr after left middle cerebral artery occlusion (MCAO). Animals received MK-801 (5 mg/kg i.v.) or saline vehicle before (20-30 min) or after (30 min) MCAO. Both pretreatment and posttreatment of MK-801 increased occluded/non-occluded ICGU ratio in 7 and 5 of the 15 regions measured, respectively (most notably in cortical structures). Following MK-801 pretreatment, there was evidence of widespread increases in ICGU not only in the non-occluded hemisphere (12 of the 15 areas studied) but also in the occluded hemisphere (13 of the 15 areas studied), while MK-801 postreatment did not significantly increase ICGU both in the normal and occluded hemispheres. These data indicate that MK-801 has a neuroprotective effect in focal cerebral ischemia and demonstrate that MK-801 provides widespread alterations of glucose utilization in conscious animals.

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Clinical Results of 100 Cases of Coronary Artery Bypass Grafting without Cardiopulmonary Bypass (심폐바이패스 없이 시행한 관상동맥 우회술 100예의 임상적 고찰)

  • 방정희;우종수
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.322-327
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    • 2004
  • Coronary artery bypass grafting on the beating heart is no longer a new methods for any cardiac surgeon. We evaluated the application of the off-pump coronary artery bypass procedure relative to safety and efficiency as measured by postoperative complication and operative mortality. Material and Method: We used our retrospective database to compare the patients having off-pump coronary surgery (n=100) with those having on-pump coronary surgery (n=100) between June, 1999 and August, 2002. Patients whom underwent associated valvular or aortic aneurysmal operation were excluded. Result: Neither groups showed any differences in the patient's risk factors and extent of coronary disease. Off-pump CABG group did not have significantly less mean operation time (295$\pm$73 min vs 323$\pm$83 min, p=ns) and mean hospital day (15.34$\pm$6.02 day vs 13.80$\pm$4.95 day, p=ns). However, off-pump CABG group had significantly shorter mean ventilation time (17.3$\pm$11.27 hour vs 24.98$\pm$16.1 hour, p<0.05). No patients were converted to on-pump CABG in off-pump CABG. Intraoperative hemodynamic instability in off-pump CABG were 6 cases, of whom 2 cases were in lateral wall approach and 4 cases in right coronary anastomosis. Postoperative mortality was 1 case in off-pump CABG and 2 cases in on-pump CABG. Intra-aortic ballon pump (IABP) was applied in 1 case with off-pump CABG and in 2 cases with on-pump CABG. No patients presented postoperative cerebral infarction & stroke in off-pump CABG but 2 patients in on-pump CABG. Postoperative arrhythmia presented in 4 cases with off-pump CABG and in 6 cases with on-pump CABG. Acute renal failure (ARF) was complicated in 3 cases with off-pump CABG and in 2 cases with on-pump CABG. Conclusion: This study documented the immediate safety and efficiency of the off-pump CABG procedure.

Frequency and Causes of Life-long Labour Force Loss in Rural Population of Korea (한국농촌인구(韓國農村人口)의 종신적(終身的) 노동능력상실(勞動能力喪失) 빈도(頻度)와 원인(原因))

  • Loh, In-Kyu
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.1-10
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    • 1976
  • This study was conducted in order to observe some descriptive epidemiological findings and causes of life-long labour force loss in the rural population of Korea, and to consider, on the basis of these observations, some principles of the necessary control measures. The total number of subjects in the study was 27,172, all family members of 4,174 households. The study population was located in the 81 counties, out of a total of 138 counties, where the college students conducted service activities during the summer of 1974. In each village area where these service activities were conducted, one household per student interviewer was randomly selected. Student interviewers were instructed on the contents of the questionnaire prior to the survey. The main contents of the questionnaire form included address, name, sex and age of each family members, and present life-long labour force loss, if any, of each family member. In cases of current labour force loss, the age of onset and causes were recorded. Of the total households surveyed, 8.9% had family members (1-4 in number) with life-long labour force loss. Of the total persons surveyed, the crude prevalence rate for life-long labour force loss was 15.1 per 1,000; and the age-standardized prevalence rates for male and female were 16.3 per 1,000 and 13.4 per 1,000, respectively. The rates, in both sexes, were gradually increased as the ages were increased. The prevalence rates per 1,000, in order, for life-long labour force loss by the causes were 10.2 for senility, 2.4 for impairment of extremities, 1.2 for chronic diseases of internal organs, 0.5 for other conditions of muosculoskeletal system, 0.4 for blindness in both eyes, 0.2 for impairment of spine, 0.2 for psychoses, and 0.1 for epilepsy. Among them the causes of impairment of extremities were stroke, poliomyelitis, accidents, arthritis and injury due to war operation, in that order of higher relative frequency. The frequency ratios by age of onset were also observed by the causes and sex.

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A Study on the Dynamic Behavior Characteristics of a Small Fishing Crane (소형 어로 크레인의 동적 거동 특성에 관한 연구)

  • 이원섭;이대재
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.37 no.3
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    • pp.163-173
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    • 2001
  • The dynamic behavior characteristics of a small fishing crane for inshore and coastal fishing vessels was experimentally analyzed in order to improve the fishing operation and to reduce considerably manual work of fisherman. The small fishing crane was designed to be controlled electro-hydraulically by means of proportional valves and solenoid valves, and also to be controlled the speed of each operation. The dynamic behavior characteristics was investigated by measuring the changes of parameters such as oil pressure, swing angle of load, load tension, the lifting angle and the swing angle of crane arm when the arms extended in a side way was given a test load. The results obtained are summarized as follows: 1. The designed small fishing crane can be proportionally controlled by means of proportional valves and rapidly by operating the solenoid valves, respectively. The capacity, turning angle, maximum reach of crane were 2 T-M, $180^\circ$, 3.7m, respectively. 2. The vertical change of crane arm on the extension of lifting cylinder was $1.2^\circ$/cm, and the swing speed of crane arm due to the extension of swing cylinder by on/off operations of solenoid valves was $15^\circ$/sec, with the swing period of 1.4 sec and the angle fluctuation of $\pm$11.0$^{\circ}$. 3. When changing simultaneously the horizontal and vertical positions of the lifting load by on/off operations of solenoid valves, the swing and lifting speeds of crane arm were $4.46^\circ$/sec and $6.4^\circ$/sec, respectively. 4. The movements of the designed crane were particularly smooth as they are controlled with the aid of proportional valves than by means of solenoid valves.

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Organic Acidopathies as Etiologic Diseases of Seizure Disorders in Korean Childhood and Adolescent Age Group (한국인 소아청소년기 발작의 원인질환으로서의 유기산대사이상질환)

  • Kim, Hui Kwon;Lee, Jong Yoon;Lee, Ye Seung;Bae, Eun Joo;Oh, Phil Soo;Park, Won Il;Lee, Hong Jin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.1
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    • pp.23-34
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    • 2012
  • Purpose: Acute symptomatic seizures are caused by structural changes, inflammation or metabolic changes of brain, such as tumor, stroke, meningitis, encephalitis and metabolic disorders. Inherited metabolic disorders that can cause seizures are organic acidopathies, lysosomal storage disorders, peroxisomal disorders and mineral disorders. We have done this study to find out the importance of organic acidopathies causing seizure disorders in Korean childhood and adolescent patients. Method: Retrograde analysis for 1,306 patients with seizure disorders whose clinical informations are available and have done urine organic acid analysis for 5 years period, between Jan. 1st 2007 to Dec. 31th 2011. Statistical analysis was done with Student's t test using SPSS. Result: Out of 1,306 patients, 665 patients (51%) showed abnormalities on urine organic acid analysis. The most frequent disease was mitochondrial respiratory chain disorders (394, 30.1%), followed by mandelic aciduria (127, 9.7%), ketolytic defects (81, 6.2%), 3-hydroxyisobutyric aciduria (19, 1.4%), glutaric aciduria type II (10, 0.8%), ethylmalonic aciduria (4), propionic aciduria (4), methylmalonic aciduria (3), glutaric aciduria type I (3), pyruvate dehydrogenase deficiency (3), pyruvate carboxylase deficiency (3), isovaleric aciduria (2), HMG-CoA lyase deficiency (2), 3-methylcrotonylglycinuria (2), fatty acid oxidation disorders (2), fumaric aciduria (1), citrullinemia (1), CPS deficiency (1), MCAD deficiency (1). Conclusion: On neonatal period, mandelic aciduria due to infection was found relatively frequently. Mitochondrial disorders are most frequent etiologic disease on all age group, followed by ketolytic defects and various organic acidopathies. The number and diversities of organic acidopathies emphasize meticulous evaluation of basic routine laboratory examinations and organic acid analysis with initial sample on every seizure patient.

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The Combined Therapy of Inhaled Nitric Oxide and Prone Positioning Has an Additive Effect on Gas Exchange and Oxygen Transport in Patients with Acute Respiratory Distress Syndrome (급성호흡곤란증후군 환자에서 복와위(prone position)와 산화질소흡입(nitric oxide inhalation) 병용 치료의 효과)

  • Koh, Youn-Suck;Lim, Chae-Man;Lee, Ki-Man;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1223-1235
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    • 1998
  • Background and Objective : Although prone positioning has been reported to improve gas exchange, prone positioning alone does not seem to be sufficient to increase systemic oxygen transport in an acute lung injury. The objective of this study was to investigate whether the combined therapy of low dose nitric oxide (NO) inhalation and prone positioning has an additive effect on the oxygenation and hemodynamics in patients with severe ARDS. Patients and Methods : Twelve patients with ARDS were included. Prone positioning alone, later combined with nitric oxide inhalation (5~10 ppm) from the supine position (baseline) were performed with serial measurement of gas exchange, respiratory mechanics and hemodynamic at sequential time points. The patient was regarded as a responder to prone positioning if an increase in $PaO_2/FiO_2$ of more than 20 mm Hg at 30 min or 120 min intervals after prone positioning was observed compared to that of the baseline. The same criterion was applied during nitric oxide inhalation. Results : Eight patients (66.5%) responded to prone positioning and ten patients (83.3%) including the eight just mentioned responded to the addition of NO inhalation. The $AaDO_2$ level also decreased promptly with the combination of prone positioning and NO inhalation compared to that of prone positioning alone ($191{\pm}109$ mm Hg vs. $256{\pm}137$ mm Hg, P<0.05). Hemodynamic parameters and lung compliance did not change significantly during prone positioning only. Following the addition of NO inhalation to prone positioning, the mean pulmonary artery pressure and pulmonary artery occlusion pressure decreased and cardiac output, stroke volume and oxygen delivery increased (P < 0.05) compared to those of prone 120 min. Conclusion : These findings indicate that NO inhalation would provide additional improvement in oxygenation and oxygen transport to mechanically ventilated patients with ARDS who are in a prone position.

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