• Title/Summary/Keyword: Mild stroke

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Hypertensive Retinopathy and the Risk of Hemorrhagic Stroke

  • Thiagarajah, Ramani;Kandasamy, Regunath;Sellamuthu, Pulivendhan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.543-551
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    • 2021
  • Objective : Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. Methods : A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. Results : Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9-15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. Conclusion : Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.

A Case Study of A Patient Complaining of Disequilibrium Due to Proprioceptive Disorder (고유수용감각이상으로 인한 균형장애를 호소하는 환자 치험 1례)

  • Kyeong-Hwa Lee;Hye-Min Heo;Dong-Ju Kim;Hye-Jin Lee;Seung-Yeon Cho;Seong-Uk Park;Jung-Mi Park;Chang-Nam Ko
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.24 no.1
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    • pp.1-12
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    • 2023
  • ■Objectives This work reports the case of a patient complaining of disequilibrium due to proprioceptive disorder whose condition improved following Korean medicine treatment. ■Methods The patient was hospitalized for 15 days and treated with herbal medicine, mainly doinseunggi-tang-gami, and acupuncture, electroacupuncture, and moxibustion. Disequilibrium was clinically estimated using Korean dizziness handicap inventory(K-DHI) and the patient's subjective discomfort in this regard was also checked by numeral rating scale. The degree of improvement in blood stasis syndrome was evaluated using modified Blood Stasis Questionnaire II(modified BSQ-II) to assess the clinical effects of the treatment. ■Results After treatment, the K-DHI classification improved from severe to mild, and the patient's subjective discomfort was greatly improved from NRS 6 to NRS1. In addition, the degree of improvement in blood stasis syndrome improved from blood stasis group to blood stasis risk group compared to time of admission. ■Conclusion These results suggest that Korean medicine is effective in treating disequilibrium caused by proprioceptive disorder.

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Antihypertensive Activities of Diterpenoid (16,17-dihydroxy-16-${\beta}-(-)$-kaurane-19-oic acid) in Siegesbeckiae pubescens Against Okamoto-Spontaneously Hypertensive Rats (희첨 성분중 디터핀 물질이 오까모토 고혈압 모델 쥐에 미치는 혈압 강하작용)

  • Kim, Jae-Hoon;Yu, Jae-Chun;Chang, Il-Moo;Lee, Jong-Heun;Kim, Joong-Soo
    • Korean Journal of Pharmacognosy
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    • v.11 no.2
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    • pp.61-65
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    • 1980
  • As a folkloric medicine, Siegesbeckia pubescens has been used for treatment of brain stroke and hypertension. Diterpene compound, 16,17-dihydroxy 16-${\beta}-(-)$ kaurane-19-oic acid, was isolated from the plant. Its potential antihypertensive activity was evaluated againstan animal model of hypertension, Okamoto-SHR. When diterpene compound with dose of 50mg/kg/day was orally administered, it exhibited mild antihypertensive activity comparable with propranolol administration dose of 75mg/kg/day.

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Sleep-Related Breathing Disorders in the Elderly (노인에서의 수면 호흡 장애)

  • Shin, Chol
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.11-17
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    • 2001
  • In 2000, the number of people aged 65 and over increased to 3.37 million, accounting for 7.1% of the total population of South Korea. The elderly population will increase up to 19.3% in 2030. Sleep disordered breathing (SDB) seems to increase with age. More than 50-60% of old people complain of SDB-related signs and symptoms including awakening headache, excessive daytime sleepiness, fatigue, cognitive dysfunction, memory loss, personality changes, and depression. The influence of a mild degree of SDB upon the elderly is unclear, but moderate to severe SDB is well known to be associated with many diseases including hypertension, arrhythmia, myocardial infarction, stroke, dementia, and sudden death. Therefore, physicians should pay attention to elderly patients who complain of SDB related symptoms and signs that may not be normal signs of aging. Physicians need to become more sensitive to treat SDB in the elderly.

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Effects of Ovarian Cycle on Hemodynamic Responses during Dynamic Exercise in Sedentary Women

  • Choi, Hyun-Min;Stebbins, Charles L.;Nho, Hosung;Kim, Mi-Song;Chang, Myoung-Jei;Kim, Jong-Kyung
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.6
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    • pp.499-503
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    • 2013
  • This study tested the hypothesis that effects of the menstrual cycle on resting blood pressure carry over to dynamic exercise. Eleven healthy females were studied during the early (EP; low estrogen, low progesterone) and late follicular (LP; high estrogen, low progesterone) menstrual phases. Stroke volume (SV), heart rate (HR), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), and total vascular conductance (TVC) were assessed at rest and in response to mild and moderate cycling exercise during EP and LP. During EP, compared to LP, baseline SBP ($111{\pm}1$ vs. $103{\pm}2$ mmHg), DBP ($71{\pm}2$ vs. $65{\pm}2$ mmHg) and mean arterial pressure (MAP) ($84{\pm}2$ vs. $78{\pm}1$ mmHg) were higher and TVC ($47.0{\pm}1.5$ vs. $54.9{\pm}4.2$ ml/min/mmHg) was lower (p<0.05). During exercise, absolute values of SBP (Mild: $142{\pm}4$ vs. $127{\pm}5$ mmHg; Moderate: $157{\pm}4$ vs. $144{\pm}5$ mmHg) and MAP (Mild: $100{\pm}3$ vs. $91{\pm}3$ mmHg; Moderate: $110{\pm}3$ vs. $101{\pm}3$ mmHg) were also higher, while TVC was lower (Mild: $90.9{\pm}5.1$ vs. $105.4{\pm}5.2$ ml/min/mmHg; Moderate: $105.4{\pm}5.3$ vs. $123.9{\pm}8.1$ ml/min/mmHg) during EP (p<0.05). However, exercise-induced increases in SBP, MAP and TVC at both work intensities were similar between the two menstrual phases, even though norepinephrine concentrations were higher during LP. Results indicate that blood pressure during dynamic exercise fluctuates during the menstrual cycle. It is higher during EP than LP and appears to be due to additive effects of simultaneous increases in baseline blood pressure and reductions in baseline TVC.

The Effect of Constraint-Induced Movement Therapy(CIMT) With Cognitive-Perceptual Training on Upper Extremity Function of Stroke Patients With Mild Cognitive Impairment (경도 인지손상을 가진 뇌졸중 환자의 상지 기능에 미치는 강제유도운동치료(CIMT)와 인지-지각 훈련의 병행 효과)

  • Kim, Hun-Ju;Shin, Joong-Il;Kam, Kyung-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5684-5691
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    • 2011
  • The purpose of this study is to examine effects of constraint-induced movement therapy(CIMT) and/or cognitive-perceptual training(CPT) on the change of hand function in cerebrovascular accident(CVA) patients and to evaluate the change in the amount and quality of use of the affected upper extremity in performing daily living tasks. The subjects of study were 10 patients who had been under rehabilitation for more than three months after CVA onset. They were all determined as mild cognition impairment according to NCSE or MVPT test. For CIMT group, to restrict the movement of the unaffected hand the subjects had been worn modified resting arm-splint in daytime for 4 weeks. For CIMT+CPT group, the subjects were performed CPT with CIMT and control group had been under conventional occupational therapy for the same period. CIMT+CPT group showed significant improvement in simulated feeding, lifting large light objects, and lifting large heavy objects of Jebsen-Taylor Hand Function Test. CIMT group also showed significant improvement compared with control group. The mean changes of the amount of use(AOU) of the affected arm had a statistically significant difference among groups (p<.05). While CIMT+CPT group had the biggest change in the quality of movement(QOM) of upper extremity of the affected side, CTL group showed the smallest change. Both CIMT and CIMT+CPT groups had statistically significant difference in the change in the quality of movement in upper extremity of affected side with CTL group(p<.05), but there was not significant difference between CIMT group and CIMT+CPT group. CIMT performed to the patients of stroke, with mild impairment in cognitive perceptual abilities showed the improvement in hand movement and AOU and QOM of upper extremity in the affected side and the combination of CIMT with CPT showed synergic effects.

A game-type rehabilitation system that can be helpful for exercise and cognitive rehabilitation for the elderly or patients with mild brain disease (노인 또는 경증 뇌질환 환자들의 운동 및 인지재활에 도움이 될 수 있는 게임형 재활 시스템)

  • Choi, Goon-Ho
    • Journal of Convergence for Information Technology
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    • v.11 no.2
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    • pp.229-237
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    • 2021
  • Among the elderly and patients with mild brain diseases (such as dementia and stroke), when there is a certain degree of self-acting ability and cognitive ability, exercise and cognitive rehabilitation are often required. However, since most of the existing rehabilitation systems are separated or specialized in exercise or cognitive rehabilitation, there is a need for a form linking both. In this paper, we propose a game-type rehabilitation system that enables both exercise and cognitive rehabilitation using CAN communication protocol, one of ICT technologies. This system uses the CAN BUS structure to separate and combine each individual module constituting the rehabilitation system in various forms. A prototype of the proposed system was actually produced to show that various types of rehabilitation environments can be implemented according to the degree of cognitive ability and motor ability of the patient (or the elderly). In addition, through several experiments using this system, it is possible to implement exercise/cognitive parallel rehabilitation applicable to various environments.

Surgical Outcomes of Centrifugal Continuous-Flow Implantable Left Ventricular Assist Devices: Heartmate 3 versus Heartware Ventricular Assist Device

  • Kinam Shin;Won Chul Cho;Nara Shin;Hong Rae Kim;Min-Seok Kim;Cheol Hyun Chung;Sung-Ho Jung
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.184-194
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    • 2024
  • Background: Left ventricular assist devices (LVADs) are widely employed as a therapeutic option for end-stage heart failure. We evaluated the outcomes associated with centrifugal-flow LVAD implantation, comparing 2 device models: the Heartmate 3 (HM3) and the Heartware Ventricular Assist Device (HVAD). Methods: Data were collected from patients who underwent LVAD implantation between June 1, 2015 and December 31, 2022. We analyzed overall survival, first rehospitalization, and early, late, and LVAD-related complications. Results: In total, 74 patients underwent LVAD implantation, with 42 receiving the HM3 and 32 the HVAD. A mild Interagency Registry for Mechanically Assisted Circulatory Support score was more common among HM3 than HVAD recipients (p=0.006), and patients receiving the HM3 exhibited lower rates of preoperative ventilator use (p=0.010) and extracorporeal membrane oxygenation (p=0.039). The overall early mortality rate was 5.4% (4 of 74 patients), with no significant difference between groups. Regarding early right ventricular (RV) failure, HM3 implantation was associated with a lower rate (13 of 42 [31.0%]) than HVAD implantation (18 of 32 [56.2%], p=0.051). The median rehospitalization-free period was longer for HM3 recipients (16.9 months) than HVAD recipients (5.3 months, p=0.013). Furthermore, HM3 recipients displayed a lower incidence of late hemorrhagic stroke (p=0.016). In the multivariable analysis, preoperative use of continuous renal replacement therapy (odds ratio, 22.31; p=0.002) was the only significant predictor of postoperative RV failure. Conclusion: The LVAD models (HM3 and HVAD) demonstrated comparable overall survival rates. However, the HM3 was associated with a lower risk of late hemorrhagic stroke.

Left Ventricular Hypertrophy and Prelude to Hypertensive Cardiovascular Diseases: from the Pediatric Cardiologist's Point of View (좌심실 비대와 고혈압성 심혈관 합병증: 소아 심장 의사의 관점)

  • Cho, Min-Jung
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.14-21
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    • 2011
  • Although left Left ventricular hypertrophy (LVH) is not only an adaptive response of the heart to increased cardiac workload in hypertension, it surelybut also is the most potent risk factor of overt cardiovascular complications such as coronary heart disease, heart failure, arrhythmia and stroke in the hypertensive population. Also it has become generally accepted that subclinical cardiovascular disease begins in childhood and LVH is the most readily assessed marker for that. As LVH can be seen in children and adolescents with even mild blood pressure elevation with the reported prevalence of 10 to 47%, aggressive antihypertensive treatment is critical in preventing the development of hypertensive heart disease in that those cases.

Revaluation of manufacturing process of Bambusae Caulis in Liquamen Based on Traditional Medical Texts (죽력(竹瀝)의 올바른 제법 고찰)

  • Hong, Sae Young
    • Journal of Korean Medical classics
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    • v.26 no.2
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    • pp.121-132
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    • 2013
  • Objective : Bambusae Caulis in Liquamen has been used by East Asian doctors who approved efficient clinical effects of it since the early stage of medical history. It is commonly used for lifestyle related diseases including stroke in recent days thanks to the increasing number of manufacturers. However, products from pharmaceutical companies as well as food companies are not classified as Bambusae Caulis in Liquamen but Bamboo vinegar. This study aims to discern disparate manufacturing process. Methods : In this study, original texts were searched to corroborate the correct method to produce Bambusae Caulis in Liquamen. It is essential to inspect the original texts thoroughly in the course of modernizing traditional knowledge. Result : Discrimination between the two substances starts from manufacturing process; Bambusae Caulis in Liquamen is made under the temperature of less then $170^{\circ}C$, containing mild fragrance and sweet taste, and the Bamboo vinegar over $170^{\circ}C$ upto $400^{\circ}C$, carrying strong smoky scent and acidness. Although some researches show conforming clinical actions of both products, still there is a possibility that closer clinical study would reveal their discrepancy. Conclusion : Current use of Bambusae vinegar needs speculation. Authenticity in proper manufacturing process can be attained through passed-on medical texts.