• Title/Summary/Keyword: Cerebrovascular disorder

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Sleep-Disordered Breathing and Metabolic Dysfunction (수면호흡장애와 대사적 기능장애)

  • Joo, Soon-Jae;Shin, Chol
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.17-22
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    • 2005
  • Sleep-disordered breathing (SDB) is associated with increased cardiovascular and cerebrovascular morbidity. Epidemiological and clinic-based studies have shown that SDB is related to impaired glucose tolerance and increased insulin resistance, independent of obesity. Despite of a consistent association between SDB and impaired glucose-insulin metabolism, the mechanism underlying this relationship has not been fully elucidated. It is recognized that hypoxemia and hypercapnia that occur in SDB provoke sympathetic nervous activity and catecholamine, epinephrine and norepinephrine, and cortisol are released. Sympathetic hyperactivity and increased catecholamines can impair glucose homeostasis by increasing glycogenolysis and gluconeogenesis, which can result in increased circulating insulin levels and increased risk of insulin resistance. A prospective study is needed to investigate the causal relationship between SDB and impaired glucose-insulin metabolism in a healthy population without diabetes, hypertension and obesity as etiologic risk factors.

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Which Diseases were Incurable by Authors of the Huangdineijing? -A Study on Incurables Diseases of the Huangdineijing- (황제내경의 저자들은 어떤 질병을 고칠 수 없었는가 - 황제내경의 불치증에 대한 고찰 -)

  • Kim, Kiwang
    • Journal of Korean Medical classics
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    • v.34 no.1
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    • pp.89-102
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    • 2021
  • Objectives : This paper aims to examine situations that were conceived as incurable at the time of publication of the 『Huangdineijing』. Methods : The texts of the 『Huangdineijing』 were searched for contents which included 'cannot be cured.' Next, the verses were examined within their context, after which those that specifically indicated 'incurability' were selected. These were categorized according to content, then organized to better show the situations that were seen as incurable to the authors of the 『Huangdineijing』. Results : The conditions deemed incurable in the 『Huangdineijing』 were bloody and purulent stool, ascites, tumors, some purulent inflammation, some infectious diseases with fever, wasting thirst, chronic kidney disorder, some diseases of the connective tissue, epilepsy, cardiac infarction, and cerebrovascular diseases. Internal damage due to acupuncture and poor patient attitude could also contribute to incurability. Conclusions : The authors of the 『Huangdineijing』 were unable to cure some conditions that are currently being cured by Korean Medicine.

A Case of Moyamoya Disease with Neurofibromatosis Type I (제 1형 신경섬유종증에 합병된 모야모야병 1례)

  • Lee, Mi A;Eom, Joo Pil;Lee, Hae Young;Cha, Byung Ho
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.93-96
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    • 2005
  • Neurofibromatosis type I is an autosomal dominant disorder with varied manifestations in bone, soft tissue, the nervous system and skin. This is characterized by cafe-au-lait spots, neurofibromas, Lisch nodules, optic glioma, bony displasia, and intertriginous freckling. One of the more serious aspect of the disease relates to the arterial involvement. Vascular changes in neurofibromatosis may occur in any arterial tree from the proximal aorta to the small arteries but these changes are most common in the renal arteries, aorta, celiac arteries and mesenteric arteries. Of the many complications observed in neurofibromatosis type I, cerebrovascular lesions may be the least appreciated. About 40 cases of neurofibromatosis type I associated with occlusive cerebrovascular disorders have been reported in the literature, but MRI and angiographic findings typical of moyamoya disease are rarely described. We experienced a case of moyamoya disease associated with neurofibromatosis type I in a 3-year-old girl who of complained gait disturbance and paraparesis and showed findings typical of moyamoya disease on MRI and carotid angiogram.

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 Statistical Study of Patients Came to Seoul Veterans Hospital (서울보훈병원 한방진료과 내원환자에 대한 통계적 고찰)

  • Han, Eul-Joo;Lee, Myeong-Jong
    • Journal of Korean Medicine Rehabilitation
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    • v.15 no.1
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    • pp.143-161
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    • 2005
  • Objectives : Among the patients at Seoul Veterans Hospital, there is a great demand for oriental medical treatments, and the number of patients of oriental medical part is on the increase. The purpose of this study is to show patients inclination statistically. Methods : The study was carried out on the 1045 patients came to Seoul veterans hospital from April 2003 to May 2004. Results & Conclusions : 1. Most of men patients were veterans. They had neurological disorder or cerebrovascular disease that was ongoing for 1~5 years before diagnosis and they were treated less than 10 times. 2. Most of women patients were nursing their family. They had musculoskeletal disease that was ongoing 1 week before diagnosis and they were treated less than 10 times. 3. Under the current system, only acupuncture and other limited treatments are provided to patients due to the limited funding from the government. There were few patients who had an internal disease because they needed to be herbal treated. If the government funding were provided, they would be able to be treated.

A Study on Major Health Components of National Health Examination Survey in Korea (국민건강진단조사(National Health Examination Survey) 내용선정에 관한 연구)

  • Lee, Soon-Young;Kim, Hae-Kyung;Park, Ju-Won;Shin, Seung-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.2 s.61
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    • pp.167-182
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    • 1998
  • The purpose of this study was to identify the major health components and measurements to be conducted in National Health Examination Survey(KNHES). The prevalence and severity of disease, acceptability of population and the possibility of standardization of measurement were considered as guideline for selecting the components. On the base of magnitude and severity of disease, chronic liver disease, hepatic cancer, gastric ulcer, stomach cancer, essential hypertension, cerebrovascular disease, ischemic heart disease, pulmonary tuberculosis, lung cancer, DM, breast cancer, cervical cancer, arthritis and intervertebral disc disorder were selected as the preliminary target diseases. Questionnaire survey for 648 persons in 'K' city and medical specialists in five clinical societies were conducted for evaluation the acceptability of general population for the measurements and the possibility of standardization for the procedures. In conclusion, the major target diseases were chronic liver disease, hypertension and DM and the total cholesterol, high density lipoprotein, triglyceride, total protein, albumin, hemoglobulin, hematocrit, platlet count, anti-HBs, HBsAg, height and weight were selected for basic physical components.

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Wisdom teeth extraction in a patient with moyamoya disease

  • Seto, Mika;Aoyagi, Naoko;Koga, Sayo;Kikuta, Toshihiro
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.6
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    • pp.289-291
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    • 2013
  • Moyamoya disease is a rare neurovascular disorder that involves constriction of certain arteries in the brain. In patients with moyamoya disease, it is very important to prevent cerebral ischemic attacks and intracerebral bleeding caused by fluctuating blood pressure and increased respiration. A 40-year-old woman with moyamoya disease was scheduled for extraction of her right upper and lower impacted wisdom teeth. Her lower impacted wisdom tooth was situated close to the inferior alveolar nerve. We decided to continue her oral antiplatelet therapy and planned intravenous sedation with analgesic agents administered approximately five minutes prior to extraction of the root of the mandibular wisdom tooth. Oral analgesic medications were regularly administered postoperatively to alleviate pain and anxiety. During the perioperative period, no cerebrovascular event occurred, and the wisdom teeth were successfully extracted as per the planned procedure. It is thought that the perioperative risks of wisdom tooth extraction in patients with moyamoya disease can be minimized with the use of our protocols.

Cardiometabolic Effects of Obstructive Sleep Apnea and Treatment Effects of Oral Appliance: An Updated Review for Dentists

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.43 no.3
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    • pp.61-69
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    • 2018
  • Obstructive sleep apnea (OSA) is a relatively common, but greatly underdiagnosed sleep-related breathing disorder, characterized by recurrent collapse of the upper airway during sleep. OSA has been associated with a variety of cardiometabolic disease, such as hypertension, coronary artery disease, cardiac arrhythmia, cerebrovascular disease and metabolic dysfunction. Neurocognitive impairment, including excessive daytime sleepiness, increased risk of motor vehicle accidents, is also related to OSA. Sleep fragmentation and related arousals during sleep lead to intermittent hypoxia, sympathetic activation, oxidative stress, systemic inflammation and metabolic dysregulation which provide biological plausibility to this pathologic mechanism. Extensive studies demonstrated that OSA is a modifiable risk factor for the above mentioned diseases and oral appliances (OAs), although continuous positive air pressure (CPAP) is a first-line therapy of OSA, are not inferior to CPAP at least in mild OSA, and may be an alternative to CPAP in CPAP-intolerant subjects with OSA. The goal of this article is to provide a current knowledge of pathologic link between OSA and cardiovascular disease, focusing on intermittent hypoxia, sympathetic activation, oxidative stress and metabolic dysregulation. Then, previous epidemiologic studies will be reviewed to understand the causal relationship between OSA and cardiovascular disease. Finally, the effects of OAs will be updated via recent metaanalyses compared to CPAP.

Three Cases of Stroke Patients with Dysphagia with Dong-Si Acupuncture Therapy (동씨침법(董氏鍼法)을 이용한 중풍(中風) 환자의 연하장애(嚥下障碍) 치험 3례(例))

  • Lim, Woong-Kyoung;Park, Soo-Eun;Kim, Chang-Hwan;Jung, Kyung-Suk;Ock, Min-Keun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.18 no.3
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    • pp.114-120
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    • 2005
  • Objective: This study was performed to evaluate the effect of Dong-Si acupuncture therapy, on the stroke patients with dysphagia. Method: We studied three selected stroke patients with dysphagia who could follow instructions. The patients were treated with Dong-Si acupuncture (Jokch'eonkeum, Jokokeum) with Dong-Qi therapy for two weeks. We evaluated the effects by AHSA scale, VAS and MBI. Results & conclusion: Dysphagia was improved in all of three cases after treatment. But more clinical & scientific trials are expected to follow this study.

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Acute Respiratory Distress during Impression Taking in a TMJ Dislocation Patient with Pneumonia (폐렴을 동반한 턱관절 탈구환자에서 인상채득 중 유발된 급성 호흡장애)

  • Son, Jeong-Seog;Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.119-126
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    • 2014
  • Difficulty in breathing can be very disconcerting to a patient who is conscious yet unable to breath normally. The common causes of acute respiratory distress include hyperventilation, vasodepressor syncope, asthma, heart failure, and hypoglycemia. In most of these situations, the patient does not exhibit respiratory distress unless an underlying medical disorder becomes acutely exacerbated. Examples of this include acute myocardial infarction, anaphylaxis, cerebrovascular accident, hyperglycemia, and hypoglycemia. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Therefore, the most dental patient should be cared gently as the stress reduction protocol. This is a case report of acute respiratory distress with vasodepressor syncope during alginate impression taking of mandibular teeth in a long-standing temporomandibular joint dislocated 93-years-old pneumonic patient.