• 제목/요약/키워드: Ischemic Stroke

검색결과 588건 처리시간 0.027초

치매환자(患者) 32례(例)에 대(對)한 임상적(臨床的) 고찰(考察) (The Clinical Analysis on 32 Cases of Dementia)

  • 이영욱;강화정;조명래;진천식;홍석;김종석
    • 대한한방내과학회지
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    • 제19권1호
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    • pp.301-317
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    • 1998
  • A clinical analysis was carried out for 32 patients who were treated in Dept. of Dong-shin Oriental Medicine Hospital from 10st January to 16st May in 1998 and ruled out as dememtia. The results were summarized as follows. 1. In the distribution of sex, female was more than male. And the age of seventies(17 cases, 53.125%) was highest in the frequency of age. 2. In the distribution of having history of drinking and smoking were each 4 cases(12.5%) and 7 cases(21.875%). 3. In the distribution of seasons, the ratio of spring and winter were each 16 cases(50.0%), 15 cases(46.875%), that of summer and fall were comparatively low. 4. In the period from onset to admission, the period within a week had 20 cases(62.5%) as top, and the most period of treatment was 2 and 3 weeks(28.125%). 5. The number of cases that had preceding disease was 35 cases(71.875%), a major portion of preceding diseases were hypertension, diabetes mellitus, stroke. 6. The most common symptom was disorientation(78.125%), and the next common symptom was motor desability(71.875%), and memory disturbance, verbal disturbance was each 59.375 and 47.1%. 7. In the distribution of the CT scan films, 15 cases(46.875%) showed cerebral infarction and that of another 5cases (15.625%) showed cerebral hemorrhage, that of another 2 cases(6.25%) showed brain atrophy. 8. In the lipid density of blood, T-Cholesterol, TG, HDL-Cholesterol, LDL- Cholesterol was within normal limit. 9. In the MMSE-K, the most score was from 16 point to 20 point, and second only was from 11 point to 15 point, and the next was from 6 point to 10 point. 10. In the Ischemic score, 20 cases(62.5%) was diagnosed as brain vascular type dementia, and mixed type dementia was 9 cases(28.125%), Alzheimer type dementia was 3 cases(9.375%). 11. The most used recipes were a sort of recipes to activate of flow the vital energy and the blood, to remove the phlegm(41 cases 33.9%), especially DODAMHOALHEL TANG (12 cases, 9.9%), ANSINCHUNGNOITANG (8 case, 6.6%) was the most used recipe. 12. In the judgement of efficacy, 17 cases(53.125%) showed excellent efficacy, 10 cases(31.25%) showed good efficacy, 5 cases(15.625%) showed no change and that according to MMSE-K, 4 case(18.18%) showed excellent efficacy, 15 cases(68.18%) showed good efficacy, 15 cases(68.18%) showed no change.

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Impact of Lifestyle Diseases on Postoperative Complications and Survival in Elderly Patients with Stage I Non-Small Cell Lung Cancer

  • Jeong, Sang Seok;Choi, Pil Jo;Yi, Jung Hoon;Yoon, Sung Sil
    • Journal of Chest Surgery
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    • 제50권2호
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    • pp.86-93
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    • 2017
  • Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

Associations between Morphological Characteristics of Intracranial Arteries and Atherosclerosis Risk Factors in Subjects with Less Than 50% Intracranial Arterial Stenosis

  • Byun, Hokyun;Jang, Jinhee;Choi, Hyun Seok;Jung, So-Lyung;Ahn, Kook-Jin;Kim, Bum-soo
    • Investigative Magnetic Resonance Imaging
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    • 제22권3호
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    • pp.150-157
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    • 2018
  • Purpose: To assess associations between morphological characteristics of intracranial arteries in time-of-flight MR angiography (TOF-MRA) and atherosclerotic risk factors. Materials and Methods: From January 2014 to October 2015, a total of 129 patients (65 men and 64 women) without intracranial arterial stenosis > 50% were included in this study. All MRIs were performed using a 3T machine with 3D TOF-MRA sequences. We evaluated irregularity, tortuosity, and dilatation of intracranial arteries in maximal intensity projection (MIP) of TOF-MRA. Subjects' risk factors for atherosclerosis including history of hypertension and diabetes were collected by reviewing their medical records. Associations between morphological characteristics and each known atherosclerosis risk factor were examined using univariate regression analysis. Multivariate regression models were built to determine combined association between those risk factors and morphologic changes of intracranial arteries. Results: In multivariate analysis, hypertension (coefficient [95% CI]: 0.162 [0.036, 0.289], P = 0.012) and absence of diabetes (coefficient [95% CI]: -0.159 [-0.296, -0.023], P = 0.022) were associated with large diameter of intracranial arteries. Males (coefficient [95% CI]: 0.11 [-0.006, 0.23], P = 0.062) and higher age (coefficient [95% CI]: 0.003 [-0.001, 0.008], P = 0.138) had marginal association with increased diameter. Tortuosity was associated with old age (OR: 1.04 [1.02, 1.07], P < 0.001). Irregular contour of intracranial arteries was significantly associated with old age (OR: 1.05 [1.02, 1.09], P = 0.004), presence of diabetes (OR: 2.88 [1.36, 6.15], P = 0.0058), and previous ischemic stroke (OR: 3.91 [1.41, 11.16], P = 0.0092). Conclusion: Morphological characteristics (irregularity, tortuosity, dilatation) of intracranial arteries seen in TOF-MRA might be associated with atherosclerotic risk factors in subjects with no or mild stenosis.

한국인의 허혈성 뇌경색 발생과 플라스미노겐 활성 억제인자-1(PAI-1) 유전자 다형성과의 관계 (The Association of the -675 4G/5G and A-844G Polymorphisms of the Plasminogen Activator Inhibitor-1 Gene with a Risk of Ischemic Stroke in Korean Population)

  • 이병철;변상혁;김순일;강기훈;안세영;두호경;서정철;임강현;조성호;;안영민
    • 대한한방내과학회지
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    • 제25권4호
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    • pp.18-24
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    • 2004
  • 연구배경 : 플라스미노겐 활성 억제인자-1 (plasminogen activator inhibitor-1; PAI-1)은 허혈성 뇌경색의 발생의 원인이 되는 섬유소 용해작용의 저하를 매개하는 인자로서, PAI-1의 작용이 촉진되면 섬유소 용해기능이 저하되어 관상동맥 및 뇌혈관질환의 발생을 증가시키게 된다. PAI-1 유전자의 촉진자(promoter) 영역에는 -675 4G/5G (4G/5G)와A -844G (A/G)의 두 개의 유전자 다형성이 존재하며, 이는 PAI-1의 유전자 전사과정에 영향을 미쳐 혈청 PAI-1의 농도를 증가시키고 결과적으로 허혈성 뇌경색의 발생확률을 높이는 작용을 하게 된다. 연구방법 : 허혈성 뇌경색으로 진단 받은 167명의 환자와 173명의 건강인의 말초혈액에서 DNA를 분리한 후 PAI-1의 4G/5G와 A/G 유전자 다형성에 대한 연쇄중합반응 및 제한효소 절편길이 다형성 (polymerase chain reaction-restriction fragment length polymorphism; PCR-RFLP) 방법을 이용하여 허혈성 뇌경색 발생과 유전자 다형성과의 관계를 비교 분석하였다. 결과 : 허혈성 뇌경색 환자에서의 4G/4G의 유전자형의 빈도는 15.0%으로 정상 대조군의 33.5%에 비해 현저하게 낮게 나타났다 (P < 0.0001). 각각의 유전자형과 허혈성 뇌경색의 발생 위험도 (odd ratio ; OR)와의 관계를 분석했을 때 4G/4G 유전자형을 가질 경우 위험도는 0.35배로 현저하게 낮아졌으며, (P < 0.0001), 5G/5G 유전자형을 가질 경우 위험도는 4.49배 로 현저하게 높아졌다 (P < 0.0001). 그러나, A/G 유전자 다형성과 허혈성 뇌경색의 발생과는 유의한 연관성을 발견하지 못하였다. 결론 : 이상의 결과로 볼 때 PAI-1 유전자의 4G/4G 유전자형은 허혈성 뇌경색의 발생 비율을 감소시키는 작용을 하는 것으로 여겨진다.

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도홍사물탕(桃紅四物湯)이 광화학적 뇌경색 마우스의 유전자 발현에 미치는 영향 (Effects of Dohongsamul-Tang on the Gene Expression of Photothrombotic Ischemia Mouse Model)

  • 조권일;김혜윤;고석재;이성근;신선호;문병순
    • 동의생리병리학회지
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    • 제23권3호
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    • pp.645-661
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    • 2009
  • The water extract of Dohongsamul-Tang(DHSMT) has been traditionally used to stroke and brain injuries in Oriental Medicine. The present study was designed to investigate the effects of DHSMT on the gene expression profile of cerebral infarction by cDNA microarray in photothrombotic ischemia mouse model. Photothrombotic ischemia was induced in stereotactically held male BALB/c mice using rose bengal and cold light. MRI was performed 24 hours after inducing photothrombosis using 1.5 T MRI and 47 mm surface coil to obtain T2-weighted, and contrast-enhanced images. After MRI test, animal was sacrificed and the brain sections were stained for hematoxylin and eosin and immunohistochemistry. MRI and histological analysis revealed that lesion of thrombotic ischemia was well induced in the cortex with the evidence of biological courses of infarction. The target area of thrombotic infarction was 1 mm anterior to bregma and 3 mm lateral to midline with 2 mm in diameter, which were decreased by administration of DHSMT. To assess gene expression pattern of cerebral infarction, mRNA was isolated and reacted with microarray chip(Agilant's DNA Microarray 44K). Scatter and MA plot analysis were performed to clustering of each functional genes. M value [M=log2(R/G), A={log2(R ${\times}$ G)}/2] was between -0.5 and +0.5 with 40% difference. After pretreatment with DHSMT, the expression levels of mRNA of many genes involved in various signaling pathway such as apoptosis, cell cycle, cell proliferation, response to oxidative stress, immune response, angiogenesis, and inflammatory cytokine were markedly inhibited in photothrombotic ischemia lesion compared to the control group. These results suggest that DHSMT prevent ischemic death of brain on photothrombotic ischemia model of mice through modulation of gene expression at the transcriptional level.

최근 중의학에서 시스템생물학의 발전 현황 - 한의학에 미치는 영향 및 시사점을 중심으로 - (Current Status of Systems Biology in Traditional Chinese medicine - in regards to influences to Korean Medicine)

  • 이승은;이선동
    • 대한예방한의학회지
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    • 제21권2호
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    • pp.1-13
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    • 2017
  • Objectives : This paper serves to explore current trends of systems biology in Traditional Chinese Medicine (TCM) and examine how it may influence the Traditional Korean medicine. Methods : Literature review method was collectively used to classify Introduction to systems biology, diagnosis and syndrome classification of systems biology in TCM perspective, physiotherapy including acupuncture, herbs and formula functions, TCM systems biology, and directions of academic development. Results : The term 'Systems biology' is coined as a combination of systems science and biology. It is a field of study that tries to understand living organism by establishing a theory based on an ideal model that analyzes and predicts the desired output with understanding of interrelationships and dynamics between variables. Systems biology has an integrated and multi-dimensional nature that observes the interaction among the elements constructing the network. The current state of systems biology in TCM is categorized into 4 parts: diagnosis and syndrome, physical therapy, herbs and formulas and academic development of TCM systems biology and its technology. Diagnosis and syndrome field is focusing on developing TCM into personalized medicine by clarifying Kidney yin deficiency patterns and metabolic differences among five patterns of diabetes and analyzing plasma metabolism and biomarkers of coronary heart disease patients. In the field of physical therapy such as acupuncture and moxibustion, researchers discovered the effect of stimulating acupoint ST40 on gene expression and the effects of acupuncture on treating functional dyspepsia and acute ischemic stroke. Herbs and formulas were analyzed with TCM network pharmacology. The therapeutic mechanisms of Si Wu Tang and its series formulas are explained by identifying potential active substances, targets and mechanism of action, including metabolic pathways of amino acid and fatty acid. For the academic development of TCM systems biology and its technology, it is necessary to integrate massive database, integrate pharmacokinetics and pharmacodynamics, as well as systems biology. It is also essential to establish a platform to maximize herbal treatment through accumulation of research data and diseases-specific, or drug-specific network combined with clinical experiences, and identify functions and roles of molecules in herbs and conduct animal-based studies within TCM frame. So far, few literature reviews exist for systems biology in traditional Korean medicine and they merely re-examine known efficacies of simple substances, herbs and formulas. For the future, it is necessary to identify specific mechanisms of working agents and targets to maximize the effects of traditional medicine modalities. Conclusions : Systems biology is widely accepted and studied in TCM and already advanced into a field known as 'TCM systems biology', which calls for the study of incorporating TCM and systems biology. It is time for traditional Korean medicine to acknowledge the importance of systems biology and present scientific basis of traditional medicine and establish the principles of diagnosis, prevention and treatment of diseases. By doing so, traditional Korean medicine would be innovated and further developed into a personalized medicine.

자기공명 확산강조영상검사 시 영상왜곡 감소에 관한 연구 (The Study on Reduction of Image Distortion by using Single-Shot Turbo Spin Echo in Brain Stem Diffusion MRI)

  • 최관우;이호범;나사라;유병규;손순룡
    • 한국방사선학회논문지
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    • 제10권4호
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    • pp.279-284
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    • 2016
  • 본 연구는 DWI 검사 시 자화율 차이로 인해 뇌줄기에 발생하는 영상의 왜곡을 새로운 SS-TSE를 적용하여 감소시키고자 하였다. 연구방법은 2015년 7월부터 동년 9월까지 DWI 검사를 검사한 30명을 대상으로, 기존의 SS-EPI 기법과 새로운 SS-TSE를 적용하여 기법에 따른 뇌줄기의 왜곡과 오차율을 비교평가 하였다. 연구결과, 새로운 SS-TSE 적용 시 왜곡이 감소된 것을 볼 수 있으며, 오차율 또한 b0 영상은 2.4%(11.1%에서 8.7%), b1000 영상은 1.2%(11.4%에서 10.1%) 감소하는 것을 볼 수 있었다. 결론적으로, 뇌줄기의 DWI 검사 시 본 연구의 SS-TSE를 이용하면 기존 기법 사용 시 발생하는 영상의 왜곡을 감소시킬 수 있어 진단적 가치가 높은 영상을 획득할 수 있다.

뇌경색 환자의 당뇨병성 고지혈증에 대한 오적산가감방(五積散加減方) 호전 1례 (A Case Report of Diabetic Hyperlipidemia in a Patient with Cerebral Infarction Treated with Ojeok-san)

  • 한승혜;정병주;우성호;김병철;김용호;서호석;황규동;조철준;남효익;김진원
    • 대한한방내과학회지
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    • 제26권1호
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    • pp.275-280
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    • 2005
  • Hyperlipidemia is one of the major factors causing the atherosclerosis of coronary arteries and well-documented modifiable risk factors of stroke, especially of the ischemic type. For Insulin-Dependent Diabetes Mellitus sufferers, if blood sugar is appropriately maintained, lipid and lipoprotein are normal, but if blood sugar is inappropriately maintained or clinical Diabetic nephropathy induces metabolic disorder of lipid, then Total cholesterol, low density lipoprotein cholesterol, triglyceride and very low density lipoprotein cholesterol levels go up and high density lipoprotein levels go down. The purpose of this study is to evaluate the effect of treatment with Ojeok-san and to observe the changes in Fasting Blood Sugar(FBS), 2 Hours Postprandial Blood Sugar(PP2h), Haemoglobin A1c(HbA1c), Total Cholesterol(T-Chol) and Triglyceride(TG). After the treatment, Fasting Blood Sugar decreased from 149mg/dl to 89mg/dl. 2 Hours Postprandial Blood Sugar decreased from l85mg/dl to 110mg/dl. Haemoglobin A1c decreased from 6.3% to 5.7%. Total Cholesterol decreased from 268mg/dl to 217mg/dl. And Triglyceride decreased from 438mg/dl to 265mg/dl. These results support a role for oriental medical therapy in treating Diabetic Hyperlipidemia. Further case studies of herbal treatment of this ailment are needed.

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Transduced Human Copper Chaperone for Cu,Zn-SOD (PEP-1-CCS) Protects Against Neuronal Cell Death

  • Choi, Soo Hyun;Kim, Dae Won;Kim, So Young;An, Jae Jin;Lee, Sun Hwa;Choi, Hee Soon;Sohn, Eun Jung;Hwang, Seok-Il;Won, Moo Ho;Kang, Tae-Cheon;Kwon, Hyung Joo;Kang, Jung Hoon;Cho, Sung-Woo;Park, Jinseu;Eum, Won Sik;Choi, Soo Young
    • Molecules and Cells
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    • 제20권3호
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    • pp.401-408
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    • 2005
  • Reactive oxygen species (ROS) contribute to the development of various human diseases. Cu,Zn-superoxide dismutase (SOD) is one of the major means by which cells counteract the deleterious effects of ROS. SOD activity is dependent upon bound copper ions supplied by its partner metallochaperone protein, copper chaperone for SOD (CCS). In the present study, we investigated the protective effects of PEP-1-CCS against neuronal cell death and ischemic insults. When PEP-1-CCS was added to the culture medium of neuronal cells, it rapidly entered the cells and protected them against paraquat-induced cell death. Moreover, transduced PEP-1-CCS markedly increased endogenous SOD activity in the cells. Immunohistochemical analysis revealed that it prevented neuronal cell death in the hippocampus in response to transient forebrain ischemia. These results suggest that CCS is essential to activate SOD, and that transduction of PEP-1-CCS provides a potential strategy for therapeutic delivery in various human diseases including stroke related to SOD or ROS.

뇌 관류 CT검사에서 BolusTracking기법을 적용한 피폭선량 저감화에 관한 연구 (A Study on the Mitigation of the Exposure Dose Applying Bolus Tracking in Brain Perfusion CT Scan)

  • 김기정;정홍량;임청환;홍동희;심재구;유인규
    • 디지털융복합연구
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    • 제12권3호
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    • pp.353-358
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    • 2014
  • 급성기 허혈성 뇌졸중 증상이 있는 뇌 관류 CT 검사를 시행한 환자를 대상으로 장비사가 제시한 고정 시간 기법(Fixed time technique)과 조영제 추적 기법(Bolus tracking technique)을 비교하여 환자의 피폭선량을 분석하고자 하였으며, 조영제 추적 기법의 유용성과 최적의 조영증강 구간을 구현하는 Time graph를 알아보기 위한 것이다. 환자에서는 PCT의 $CTDI_{VOL}$은 고정시간기법에서 431.72mGy, Bolus tracking에서 323.61mGy로 측정되었고, DLP값은 고정시간기법에서 $1243.47mGy{\cdot}cm$, Bolus tracking에서 $932mGy{\cdot}cm$로 측정되었다. Time graph는 고정시간기법에서 다양하게 나타났으나, Bolus tracking 기법에서는 최적의 Time graph를 얻을 수 있었으며, 뇌 관류 CT검사 시 Bolus tracking기법을 적용하여 피폭선량을 25% 정도 감소시킬 수 있었다.