• Title/Summary/Keyword: Ischemic attack

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Significant Reperfusion on $^{99m}Tc-HMPAO$ SPECT in a Case of Subacute MCA Infarction (한의학적 치료로 $^{99m}Tc-HMPAO$ SPECT상 현저한 재관류를 보인 아급성기 중대뇌동맥경색 환자 1례)

  • Park, Jung-Mi;Jung, Woo-Sang;Seo, Al-An
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.437-442
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    • 2001
  • For ischemic cerebrovascular disease, it is well known that early luxury perfusion is related to a good clinical outcome and single photon emission computed tomography(SPECT) has the potential for providing useful information about regional cerebral blood flow. We report one case of Rt. MCA infarction mainly treated by oriental medicine and revealed luxury perfusion without thrombolysis. In acute stage, neurological deficits of the patient were very severe. 99mTc-HMPAO SPECT images obtained 10days after the attack showed large perfusion defect in the Rt. MCA territory. We followed up 99mTc-HMPAO SPECT 40days after the ictus. Despite of the poor early perfusion, we found considerably improved perfusion and neurological improvement.

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Primary Aldosteronism and Cerebrovascular Diseases

  • Chen, Zheng-Wei;Hung, Chi-Sheng;Wu, Vin-Cent;Lin, Yen-Hung;TAIPAI study group
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.429-434
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    • 2018
  • As diagnostic techniques have advanced, primary aldosteronism (PA) has emerged as the most common cause of secondary hypertension. The excess of aldosterone caused by PA resulted in not only cardiovascular complications, including coronary artery disease, myocardial infarction, arrhythmia, and heart failure, but also cerebrovascular complications, such as stroke and transient ischemic attack. Moreover, PA is associated more closely with these conditions than is essential hypertension. In this review, we present up-to-date findings on the association between PA and cerebrovascular diseases.

The Case-Control study on the Risk Factors of Stroke (뇌졸중의 위험요인에 대한 환자-대조군 연구)

  • Baek, In-Kyoung;Kim, Yoon-Sik
    • Journal of Haehwa Medicine
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    • v.22 no.1
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    • pp.201-216
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    • 2013
  • The purpose of this case-control study was to show the relationship between risk factor(Sex, Age, Martial Status, Educational Periods, Family history, Variables of Obesity, Smoking Status, Drinking Status, Past History, Blood Test) and the incidence of stroke. Methods: 788 stroke patients were enrolled as the case group and 450 non-stroke patients as control group from Sep.2006 to Dec.2010. Patients were hospitalized within 30 days after the onset of stroke. Risk factors and warning signs were obtained from personal interview by oriental medicine doctors who used CRF. Results: 1. Age was found to have significant relation with stroke(p<.0001). 2. Martial status(p<.0001, OR=0.44) and educational periods(p<.0001) were both significant risk factor for stroke. 3. As a result of reviewing the influence of family history, it was found to have no significant relation with stroke. Stroke was found to have significant relation with stroke(OR=1.50). 4. Female waist circumference(WC, p<.0001) and female waist-hip circumference ratio(WHR, p<.0001) were risk factors for stroke. On the other hand, male WC and male WHR showed no significant influence on stroke occurrence as an independent risk factor. 5. Both smoking status(p<.0001, current smoker OR=8.95) and drinking status(p<.0001, current drinker OR=2.50, former drinker OR=2.82) were significant risk factors for stroke. 6. As a result of reviewing the influence of past history, transient ischemic attack(p<.0001, OR=8.46), hypertension(p<.0001, OR=4.72), hyperlipidemia(0.0064), diabetes mellitus(p<.0001, OR=3.34), stroke(p<.0001, OR=50.26) were significant risk factors. On the other hand, ischemic heart disease(p=0.2332) was found to have no significant relation with stroke. 7. Increase of WBC, RBC, Platelet, TG, FBS and Cl- level were significant risk factor of stroke, On the other hand, decrease of Hgb, Hct, AST, HDL-chol, LDH, Na+ and K+ level were significant risk factor of stroke. T-chol and ALT level showed no significant influence on stroke occurrence.

An Unusual Form of Progressive Massive Fibrosis In Pneumoconiosis (진폐증에서 비전형적 형태의 진행성 종괴성 섬유증 1예)

  • Ahn, Byoung-Yong;Baak, Young-Mann;Chang, Hwang-Shin;Kim, Jee-Hong;Kim, Kyoung-Ah;Lim, Young
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.255-258
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    • 1999
  • Pneumoconiosis, very popular to coal miners who are exposed to coal dusts dominantly, was introduced in the 19th century to describe lung diseases consequent to the inhalation of mineral dusts. Coal workers' pneumoconiosis(CWP) colloquially called "black lung" in the United States, is a distinct pathologic entity resulting from the tissue reaction to deposits of dust include the coal macule, which associated with focal emphysema constitutes the characteristic lesion of simple CWP and complicated CWP or progressive massive fibrosis(PMF). Coal mining are also associated with chronic bronchitis, chronic airflow limitation, and/or generalized emphysema. Progressive massive fibrosis lesions may imprint on and obliterate airways and vessels, and cavitation is not uncommon, being the consequence of ischemic necrosis or mycobacterial infections. We report a case which is unusual form of progressive massive fibrosis to be differentiated from lung carcinoma. It is a rapid growing PMF with ischemic necrosis. By the studies which are about risk of having progressive massive fibroois, it is predicted to be 1.4%. And the other study shows that simple pneumoconiosis clearly predisposed to PMF, with five year attack rates of 13.9%, 12.5%, 4.4% and 0.2% among men with categories 3, 2, 1, and 0 respectively at the start of the risk periods.

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Left Ventricular Ejection Fraction Predicts Poststroke Cardiovascular Events and Mortality in Patients without Atrial Fibrillation and Coronary Heart Disease

  • Lee, Jeong-Yoon;Sunwoo, Jun-Sang;Kwon, Kyum-Yil;Roh, Hakjae;Ahn, Moo-Young;Lee, Min-Ho;Park, Byoung-Won;Hyon, Min Su;Lee, Kyung Bok
    • Korean Circulation Journal
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    • v.48 no.12
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    • pp.1148-1156
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    • 2018
  • Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

The Case-Control Study on the Risk Factors of Stroke in Korean Adults (중풍 발생 위험인자에 대한 환자-대조군 연구)

  • Kang, Kyung-Won;Kang, Byung-Gab;Cga, Min-Ho;Go, Mi-Mi;Park, Sae-Wook;Bang, Oak-Sun;Cho, Ki-Ho;Kim, Yoon-Sik;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.13 no.2 s.20
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    • pp.65-69
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    • 2007
  • Background and Purpose : The purpose of this case-control study was to show the relationship between risk factors(past medical history, BMI, WHR, smoking, drinking), warning signs(dyscinesia, sightless, dysarthria, sensory disorder, numbness, blephalospasm, facial spasm, tension) and the incidence of stroke in korean adults. Methods : 455 stroke patients were enrolled as the case group and 180 non-stroke patients as control group from Oct. 2005 to Feb. 2006. Patients were hospitalized within 2 weeks after the onset of stroke. Obesity were defined as $BMI{\geq}25kg/m2$, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Risk factors and warning signs were obtained from personal interview. The analysis of the data was done by chi-square test. Fisher's exact test and test-sample t-test. Results : The percentage of current smokers(or current drinkers) of case group is higher significantly than that of control group. The past medical history of risk factors were found to be transient ischemic attack(p=0.0698), facial palsy(p=0.4061), hypertension(p<0.0001), hyperlipidemia(p=0.1484), DM(p<0.0001), ischemic heart disease(p=0.0093), migraine(p=0.0014) and hypochondria(p=0.2370). $WHR{\geq}0.9$ in male had a 6.696 (3.711-12.082) odds ratio, $WHR{\geq}0.8$ in female had a 1.567 (0.659-3.726) odds ratio. $BMI{\geq}25kg/m2$ had a 2.017(1.263-3.222). The dyscinesia and sensory disorder of warning signs were found to be statistical difference between case and control group. Conclusions : According to the above results, it was found that smoking, drinking, BMI, WHR, hypertension, DM, ischemic heart disease, migraine affected to the incidence of stroke.

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The Study about Characteristics Affecting Functional Recovery of Stroke Patients Treated in an Oriental Medical Center (한방병원에 입원한 뇌경색 환자의 기능회복과 관련된 특성에 대한 연구)

  • Kim, Young-Jee;Kim, Mi-Young;Lee, Seung-Yeop;Choi, Won-Woo;Park, Joo-Young;Kwon, Seung-Won;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Park, Sung-Wook;Park, Jung-Mi;Ko, Chang-Nam;Bae, Hyung-Sup;Na, Byong-Jo
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.719-731
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    • 2009
  • Objectives : Stroke is the most common disabling neurological disease of adult life. The treatment and rehabilitation of stroke patients is an important and challenging area in the field of medicine. In Korea, a lot of stroke patients are treated using oriental medicine and there have been reports on their functional recovery. The aim of this study was to prove the therapeutic effect of oriental medicine on ischemic stroke. We also tried to identify characteristics of patients whose functional recovery was prominent and studied whether or not the use of fluids, anticoagulants, antiplatelets and neuroprotective agents increased the functional recovery of patients. Methods : We studied 794 patients within 2 weeks after first attack of ischemic stroke who were admitted to Kyung-Hee Oriental Medical Center from 1999 to 2000. Their maximum admission period was 60 days. Results : Motor power grade, NIHSS and MBI scores of patients improved during hospitalization significantly. Factors affecting functional recovery were admission period, motor power grade, NIHSS and MBI at admission. Age, waist-hip ratio and HDL cholesterol also affected functional recovery of patients. Whether or not fluids, anticoagulants, antiplatelets and neuroprotective agents were administered had nothing to do with functional recovery. Conclusion : Oriental medicine is effective for treatment and rehabilitation of ischemic stroke patients. When we manage stroke, we have to consider some important factors.

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Effect of Medical History on the Stroke Incidence in Korean Population (중풍의 질병과거력 요인에 대한 연구)

  • Kang, Kyung-Won;Yu, Byung-Chan;Kang, Byeong-Kab;Kim, No-Soo;Kim, Jeong-Chul;Go, Mi-Mi;Kim, Bo-Young;Cha, Min-Ho;Bang, Oak-Sun;Seol, In-Chan;Jo, Hyun-yung;Kim, Yoon-Sik;Choi, Sun-Ni
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1611-1618
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    • 2007
  • In this study we investigated the effect of medical history on the incidence of stroke in Korean population. 217 stroke patients were enrolled as a case group. 160 non-stroke patients and 146 normal and non-stroke patients were enrolled as a control and a normal group, respectively, from Jul. 2005 to Mar. 2007. Stroke patients were hospitalized within 2 weeks after the onset of stroke. Medical history was gathered by interviewing each patient. Clinical data were analyzed using SAS software (ver 9.1). Hypertension and diabetes mellitus (DM) were statistically significant in a case group when compared with control and normal groups. Other parameters, such as transient ischemic attack, hyperlipidemia, ischemic heart disease, facial palsy, migraine, and hypochondria, did not show any statistical significance. The same association pattern was observed in the ischemic stroke patients of case group. On the other hand, hemorrhagic stroke patients of case group showed a significant difference in DM when compared with other subject groups. More efficient therapeutic strategy should be considered for patients with medical history, especially hypertensin and DM, to reduce the stroke incidence in Korean population.

A Comparison of Combination Therapy with Western and Oriental Medical Treatment versus Mono Therapy with Western Medical Treatment for Functional Recovery in Acute Ischemic Stroke Patients (급성기 뇌경색환자를 대상으로 한양방 병행치료군과 양방 단독치료군간 기능회복도 비교연구)

  • Woo, Su-kyung;Hyun, Sang-ho;Lee, Eun-chan;Kwak, Seung-hyuk;Park, Joo-young;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Kim, Young-suk
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.1-12
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    • 2012
  • Object : This is a study of ischemic stroke patients designed for comparison Combination therapy of western medical treatment and oriental medical treatment. and western medical treatments alone. Methods : 45 patients were diagnosed by Br-MRI scan as having suffered ischemic stroke. They had entered Kyung-Hee Medical hospital within ten days of attack, between March 2011 and October 2012. Patients were divided into two groups; a group treated with Combination therapy of western medical treatment and oriental medical treatment and other group treated with Western medical treatments. Scandinavian stroke scale and Motricity Index score was checked at admission, 2 weeks or 3 weeks later to assess neurologic improvement and motor function recovery. Results : Comparing the Scandinavian stroke scale and Motricity Index score between baseline and 2 or 3 weeks later, the combination therapy group and western medical treatment group had improved but there was no significance. Conclusions : Combination therapy have more beneficial effect on acute stage of stroke.

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Moyamoya syndrome occurred in a girl with an inactive systemic lupus erythematosus

  • Lee, Yun-Jin;Yeon, Gyu Min;Nam, Sang Ook;Kim, Su Yung
    • Clinical and Experimental Pediatrics
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    • v.56 no.12
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    • pp.545-549
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    • 2013
  • We report the case of a 17-year-old Korean girl with systemic lupus erythematosus (SLE) who presented with sudden weakness of the right-sided extremities and dysarthria. Oral prednisolone was being taken to control SLE. Results of clinical and laboratory examinations did not show any evidence of antiphospholipid syndrome or thromboembolic disease nor SLE activity. Cerebral angiography showed stenosis of the left internal carotid artery and right anterior cerebral artery with accompanying collateral circulation (moyamoya vessels). After the patient underwent bypass surgery on the left side, she recovered from the neurological problems and did not experience any additional ischemic attack during the 14-month follow-up period. This case represents an unusual association between moyamoya syndrome and inactive SLE (inactive for a relatively long interval of 2 years) in a young girl.