• Title/Summary/Keyword: Cerebrovascular and cardiovascular disease

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Attitude towards Traditional Korean Medicine Use among Hemiplegic Patients after Cerebrovascular Accident (재활치료 중인 뇌졸중환자의 한의약의료에 대한 태도)

  • Han, Dong-Woon;An, Taek-Soo;Choi, Soo-Jeong;Kim, Ji-Woo
    • Journal of Society of Preventive Korean Medicine
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    • v.15 no.3
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    • pp.67-81
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    • 2011
  • Background : Complementary and alternative medicine has bee used to cardiovascular diseases. In recent years, many hospitals have tried to integrate complementary and alternative medicine(CAM) with conventional medical approaches for patients with chronic diseases. Recently, the prevalence of the use of traditional Korean medicine(TKM) among patients with chronic diseases, expecially, hemiplegia patients after cerebrovascular accident is increasing in Korea. To date, however, there were only few studies addressing the patients' attitudes, and utilization of TKM, compared to the well-documented escalating use of TKM among consumers in Korea. Objectives : The objective of this study was to analyze the prevalence of TKM use among hemiplegia patients after cerebrovascular accident and to determine what factors affect to use CAM among the patients. The study also aims to provide information on TKM and assist therapy selection among various CAM therapies for hemiplegia patients after cerebrovascular accident within health care system in which both practitioners of TKM and practitioners of modern Western medicine coexisted. Methods : The design of the study was descriptive cross-sectional, and data were collected using a 32-items questionnaire. The subjects were one hundred fifty nine patients with chronic diseases who visited or admitted to health care facilities in a hospital in Seoul Metropolitan city, Korea. Data were analyzed using 'SPSS Statistics 18.0 Network Version(on release 18.0.1 of PASW Statistics)' program. Various statistical methods were used to obtain a profile for participants and the therapies most frequently used by hemiplegia patients of TKM. Logistic regression analysis was employed in order to determine the predicting variables of TKM use. Results : The prevalence of the use of TKM was 51.6%. The most common TKM therapies used by the patients included acupuncture(93.2%), herbal medicine(64.8%), and cupping(37.5%). Results of logistic regression analysis revealed that the variables significantly related with TKM use were gender, marital status, job, No. of visiting health care facilities/week. Conclusions : This study shows that the use of TKM among the hemiplegia patients is relatively high in Korea, this topic should be taken into account in the development of a holistic approach for patients with chronic diseases and an efficient chronic disease management system in Korea.

Current Guidelines on the Management of Dyslipidemia (이상지질혈증의 국내 및 국외 치료 가이드라인 비교)

  • Choi, Yunjeong;Lee, Song;Kim, Ju Young;Lee, Kyung Eun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.276-283
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    • 2017
  • Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

Brain Hypoxia Imaging (뇌 저산소증 영상)

  • Song, Ho-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.91-96
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    • 2007
  • The measurement of pathologically low levels of tissue $pO_2$ is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowaday have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. $^{18}F-MISO$ PET and $^{99}mTc-EC-metronidazole$ SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using $^{123}I-IAZA$ in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.

Clinical Study of Sogunjung-tang Granules in 30 Cases of Heartburm (가슴쓰림 환자 30례에 대한 소건중탕 과립제의 임상적 고찰)

  • Lee, Da-eun;Jang, Hye-yeon;Lee, Yu-lim;Lee, Young-su
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1193-1201
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    • 2019
  • Objectives: This study aimed to assess the clinical characteristics of patients who complained of heartburn and to report the effects of Sogunjung-tang granules on heartburn. Methods: Observation was carried out on 30 patients with heartburn who were treated in Dongshin University Oriental Medicine Hospital from 1 October 2018 to 3 July 2019. For relieving heartburn, an oriental medical therapy of Sogunjung-tang granules was administered. To evaluate the effect of treatment, the visual analog scale (VAS) was used. Results: Females predominated among the patients (86.7% of the total). The patients were mostly aged in their 50s and the average age was 56.8 years. In the medical histories of the patients, other diseases (neuropsychiatric disease, cardiovascular disease, cerebrovascular disease, urologic disease, uterine disease etc.) were the most common (34.7%) and gastrointestinal disease was the second most common (22.4%). The patients took Sosiho-tang granules plus Sogunjung-tang granules for a maximum of 282 days. The number of patients who took medication within 10 days of experiencing heartburn was the highest and the number of patients who took medication more than 30 days of experiencing heartburn was the lowest. The scores on the visual analog scale (VAS) were significantly improved after treatment, the average decreasing from 7.0 to 3.1. Before taking the granules, the average rate of improvement for patients who recorded less than VAS 6 was 80%. Six out of seven inpatients showed more than two VAS changes on 3.8 day of taking medicine, and 23 outpatients showed more than two VAS changes on the second visit. Conclusions: This study suggests that Sogunjung-tang granules is probably effective in the treatment of heartburn.

Factors Affecting Adherence to Antihypertensive Medication

  • Choi, Hyo Yoon;Oh, Im Jung;Lee, Jung Ah;Lim, Jisun;Kim, Young Sik;Jeon, Tae-Hee;Cheong, Yoo-Seock;Kim, Dae-Hyun;Kim, Moon-Chan;Lee, Sang Yeoup
    • Korean Journal of Family Medicine
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    • v.39 no.6
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    • pp.325-332
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    • 2018
  • Background: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ${\geq}65$ years, exercise, treatment in a metropolitan-located hospital, being on ${\geq}2$ classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.

Blood Glucose Change and the Impact of Participation in Diabetes Mellitus Class of a Public Health Center (일개 보건소 당뇨교실 이용 환자의 참가율이 혈당변화에 미치는 영향)

  • Hwang, YS;Kam, S;Park, KS
    • Journal of agricultural medicine and community health
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    • v.33 no.1
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    • pp.71-81
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    • 2008
  • Objectives: Recently the care of cerebrovascular and cardiovascular disease is important as much as that of cancer care in public health, so the control of diabetes mellitus(DM) which is a risk factor of cerebrovascular and cardiovascular disease has been also important consideration.class(DM class) of a health center. Methods: Study subjects were 54 participants of DM class in a health center that had been held once a month, from January 2005 to March 2006.Results: Among the DM class participants, 67.3% participated by 50% or over in the DM clas.participants(p<0.05). In a comparison betwen more than 50% participation group and les than 50% participation group, more than 50% participation group got decreased level of blood sugar from 182mg/dl to 155mg/dl and less than 50% participation group also got decreased level from 172mg/dl to 156mg/dl. But Conclusion: DM clas of health center was effective program to manage diabetes mellitus patients in comunity.

A Study on the Relationship between Carotid Artery Intima-Media Thickness and Clinical Chemistry Tests (경동맥 초음파 결과와 임상화학 검사의 상관성 연구)

  • Kim, Dae-Sik;Sung, Hyun-Ho;Cho, Eun-kyung;Lee, Jong-Woo
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.188-193
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    • 2015
  • Carotid Intima-Media Thickness (CIMT) testing is a test that precisely assesses cerebrovascular and coronary heart diseases. According to many previous studies, CIMT predicts atherosclerosis and is highly correlated to cardiovascular disease risk factors. It has also been reported that CIMT is an independent predictor of risk factors for myocardial infarction and stroke. Therefore, the purpose of this study is to investigate CIMT and other independent factors through a correlation study with the clinical laboratory test results of a blood test. As a result, this study could not prove the correlation between CIMT and risk factors of cardiovascular disease (TC, TG, LDL cholesterol, and HDL cholesterol) due to an insufficient number of subjects. Nevertheless, a positive correlation was demonstrated between CIMT and ALT (p<0.05), GGT (p<0.05), Uric acid (p<0.05), and CEA (p<0.05) at a statistically significant level, suggesting a continuation of the study.

Risk Assessment for Cardiocerebrovascular Disease in Middle Age Women Workers (중년여성 근로자의 뇌심혈관질환 발병위험도 평가)

  • Choi, Jun-Young;Jeon, Mi-Yang;Seo, Yeong-Mi;Choi, So-Young
    • Journal of the Korea Convergence Society
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    • v.8 no.8
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    • pp.137-145
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    • 2017
  • The purposed of this study was to identify cardiocerebrovascular disease risk assessment and the factors that affect cardiocerebrovascular disease risk. The subjects of this study were 1340 middle age women worker in one shipyard. This study was base on worker health check up data. Data were analyzed using SPSS18.0 program. "healthy group" were 1078(80.4%), "low risk group" were 45(3.4%), "moderate risk group" were 150(11.2%), "high risk group" were 67(5.0%). Age, HDL, LDL, smoking, family history of stroke, hypertension were the factors that affected the risk cardiocerebrovascular disease. Results of this study can be used as fundamental data for developing cardiocerebrovascular disease preventive program in middle aged women.

Standards for recognition and approval rate of occupational cerebro-cardiovascular diseases in Korea

  • Ui-Jin Kim;Won-Jun Choi;Seong-Kyu Kang;Wanhyung Lee;Seunghon Ham;Junhyeong Lee;Yongho Lee;Eunseun Han;Sanghyuk Lee;Yongkyu Kim;Inah Kim
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.30.1-30.13
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    • 2022
  • Background: Although working hours have decreased in Korea, they are still high compared to that of other countries. In Korea, cardiovascular and cerebrovascular diseases (CCVDs) related to overwork in Korea continually occur, and the social burden from overwork is estimated to be high. This study investigated the amendment of regulations affecting the approval rate of occupational CCVDs. Methods: The change in approval rate of occupational CCVDs and related regulations were investigated using the Act and public notice on the standards for recognition of occupational CCVDs and the yearbooks of the Ministry of Employment and Labor. The CCVD mortality was estimated using data on the number of deaths according to the cause of death, the number of employed people, and resident registration population aged 15-64 years. The cumulative mortality of CCVDs was estimated using the Kaplan-Meier method. Results: Since the establishment of the standards for recognition in Korea in 1982, the scope of occupational diseases has been expanded to include intracerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, myocardial infarction, and aortic dissection. In 2013, the concept of working hours was introduced in chronic overwork. The approval rate of occupational CCVDs was 44.7% in 2006, which decreased to 12.9% in 2011. After the improvement of related regulations, the approval rate increased to 41.3% in 2018. From 2000 to 2017, the CCVD mortality of both the unemployed and employed tended to decrease, and their cumulative CCVD mortalities were 549.3 and 319.7 per 100,000 people, respectively. Conclusions: CCVDs are recognized as occupational diseases in Korea. The amendments to the standards for recognition, the introduction of the Occupational Disease Adjudication Committee, the principle of presumption, and the reduction of working hours have changed the approval rate of occupational CCVDs. A strategic approach is needed to further reduce the incidence of CCVDs.

Cardiac Surgery Using CPB in Moyamoya Disease - A Case Report- (모야모야 환자에게서의 인공심폐기를 이용한 개심술 -1예 보고-)

  • 이기복;김응중;신윤철;박종운;이원진;박진흥;손정환;지현근
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.772-775
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    • 2003
  • Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries, but the etiology remains unclear. Angiographic characteristics include bilateral stenosis or occlusion of the terminal portions of the intracranial internal carotid arteries and bilateral development of fine collateral vessels at the base of the brain known as ‘Moyamoya vessels’. Cardiac surgery using cardiopulmonary bypass due to coronary artery disease and others among patients with moyamoya disease is very rare, and cardiac surgery for such patients has a potential risk of intraoperative and perioperative brain ischemia. We successfully treated a patient who underwent artrial septal defect closure and coronary artery bypass graft using the cardiopulmonary bypass, so we report this case with a brief literature review.