• Title/Summary/Keyword: Multiple infarction

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Case Report of Multiple Cerebral Infarction in Middle Cerebral Artery with Gait Disturbance Treated by Korean Medicine (중대뇌동맥 영역에 발생한 다발성 뇌경색 환자의 보행장애에 대한 한의 복합 치료: 증례보고 1례)

  • Chae, In-cheol;Choi, In-woo;Yang, Ji-hae;Kang, Jie-yoon;Ryu, Ju-young;Jung, Eun-sun;Kim, Yoon-sik;Seol, In-chan;Yoo, Ho-ryong
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.75-85
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    • 2021
  • Objectives: This study reported about a patient with a right middle cerebral artery infarction whose gait disturbance was improved by Korean medicine treatment. Methods: The patient was treated with a Korean herbal medicine (Gami-yukmijihwang-tang) along with acupuncture, electroacupuncture, moxibustion, cupping, and physical therapy. The treatment effect was evaluated with the manual muscle test (MMT) and the Korean version of the modified Barthel index (K-MBI). The gait of the patient was evaluated by a 10-m walk test (10MWT), the timed up and go (TUG) test, the functional ambulation profile (FAP) score, and the functional ambulatory category (FAC) score. Spatiotemporal parameters were evaluated using a walkway system (GAITRite®, CIR Systems, Inc., USA). Results: After 83 days of traditional Korean medicine treatment, the K-MBI and FAC scores improved from 50 to 70 and from 1 to 4, respectively. The 10MWT and TUG tests also improved from 24.86 to 16.66 sec and from 22.35 to 17.62 sec, respectively. GAITRite® measurements reflected gait improvements: the FAP score improved from 55 to 86 sec; the step time improved from 0.72 to 0.669 sec; the step length improved from 31.076 cm to 41.284 cm; the gait velocity improved from 42.8 cm/sec to 64.1 cm/sec; the cadence improved from 93.6 steps/min to 90.8 steps/min. No adverse effects resulting from treatment or evaluation occurred during the admission period. Conclusions: This study suggests that traditional Korean medicine treatment may reduce symptoms and improve the quality of life in patients with cerebral infarction.

Clinical Experience of Multiple Valve Replacement (다중판막치환술에 대한 임상적 연구)

  • 조창훈
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1346-1353
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    • 1992
  • From Febrary 1984 to July 1992, 138 cases of multiple valve replacements were performed at the Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University. There were 81 females and 57 males, and their ages ranged from 19 to 60 years [mean age, 40.1$\pm$10.9 years]. Thirteen of these patients had undergone previous cardiovascular procedures, with an average of 76.3 months between procedures[range, 3 to 180 months]. Mitral and aortic valve replacement were done in 135 patients, 2 underwent triple valve replacement and 1 underwent mitral and tricuspid valve replacement. Associated procedures were necessary in 20 patients[14.5%]. The operative mortality was 5.8% and the most common cause was low cardiac output. Late follow-up of 83% has been accomplished in 130 early survivors, with a late mortality of 5.9%. The late mortality was due to valve thrombosis in 2 patients, cerebral infarction in 1, heart failure in 1, arrhythmia in 1, and bleeding in l. Of those patients who survived, New York Heart Association functional class improved significantly[from 70% class III and IV before to 88% class I and II after]. Actuarial survival rate including all deaths was 88.8% at 8 years. The follow-up studies revealed that thromboembolism, reoperation and bleeding rate were 1.2%/patient-year, 0.85% /patient-year and 0.57%/patient-year at 8 years postoperatively. We concluded that valve thrombosis, embolism, and anticoagulant-related hemorrhage were the main risk factors of longterm survival of patients.

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Factors Influencing Cardiopulmonary Resuscitation Performance on a Stranger (일 지역 주민의 심폐소생술 수행에 미치는 영향요인)

  • Kim, Hyun-Sook;Uhm, Dong-Choon;Hong, Sun-Woo
    • The Journal of Korean Academic Society of Nursing Education
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    • v.16 no.2
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    • pp.339-346
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    • 2010
  • Purpose: Bystander cardiopulmonary resuscitation (CPR) improves survival. However, there have been few studies on the performance of bystander CPR in Korea. This study was done to identify the reasons for being unwilling to perform CPR, and to investigate the factors associated with performing CPR on a stranger in an emergency situation. Method: The participants in this study were 444 local residents. Data were collected by using self-reported questionnaires from May 1 to June 30, 2010. For data analysis, descriptive statistics and multiple logistic regression were performed using SAS version 9.1. Result: Only 32.2% of respondents reported being willing to perform CPR on a stranger. The major reason for not being willing to perform CPR on a stranger was "have no confidence to perform CPR well". From multiple logistic regression analysis, statistically significant predictors of CPR performance on a stranger were found to be a higher educational level (OR=6.11, 95% CI 1.46-25.52), neighbors with angina pectoris or myocardial infarction (OR=6.65, 95% CI 3.93-11.24), and having confidence of performing CPR (OR=3.02, 95% CI1.78-5.14). Conclusion: CPR education (including automatic external defibrillator) should be offered to family members and neighbors. In addition, the Good Samaritan Law must be given wider publicity at the national level.

Agent Orange Exposure and Prevalence of Self-reported Diseases in Korean Vietnam Veterans

  • Yi, Sang-Wook;Ohrr, Heechoul;Hong, Jae-Seok;Yi, Jee-Jeon
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.5
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    • pp.213-225
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    • 2013
  • Objectives: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. Methods: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/ company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. Results: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR, 1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR, 1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. Conclusions: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.

Assertive Behavior in Asking Smokers Not to Smoke among Patients with Vascular Diseases (혈관질환자의 간접흡연 노출 시 흡연중단에 대한 주장행위 관련 요인)

  • Kim, Eun Kyung;Chae, Young Ran;Jung, Yun Hee;Park, Eun Ha
    • Journal of Korean Biological Nursing Science
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    • v.18 no.1
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    • pp.27-35
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    • 2016
  • Purpose: The purpose of this study was to identify the assertive behavior of asking smokers not to smoke and investigate the factors related to assertive behavior in patients with vascular diseases. Methods: Participants were 203 adult Korean patients with vascular diseases such as cerebral infarction and myocardial infarction. Data were collected using questionnaires that included the characteristics of secondhand smoke (SHS), secondhand smoke-related variables (Health belief model factors, health promotion model factors) and level of assertive behavior. Descriptive statistics, t-test, ANOVA and multiple regression using SPSS/WIN 18.0 were performed. Results: Participants who never ask smokers not to smoke was 39.9%, whereas participants who always ask was 7.4%. There was a weak positive relationship between assertive behavior and susceptibility to disease (r=.18), severity of disease (r=.19), benefit of assertive behavior to SHS exposure (r=.10), barrier of assertive behavior to SHS exposure (r=.24), and self-rated health (r=.21) respectively. There was a moderate positive relationship between assertive behavior and self-efficacy of assertive behavior to SHS exposure (r=.49). Health belief model factors explained 15.7% variance and health promotion model factors explained 27.0% of assertive behavior. Conclusion: The findings of this study suggest that self-efficacy of assertive behavior to SHS exposure is a very important factor. Therefore the development of a program to foster self-efficacy of assertive behavior regarding SHS exposure in patients with vascular diseases is needed.

Delayed Diagnosis of Cerebral Infarction after Complete Occlusion of ICA due to Blunt Head Trauma: A Case of Report (두부둔상 후 내경동맥손상으로 인한 뇌경색의 지연진단: 증례보고)

  • Yun, Jung-Ho;Ko, Jung Ho;Cho, Chun-Sung
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.190-194
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    • 2015
  • Blunt cerebrovascular injury is defined as a vertebral or carotid arterial structural wall injury resulting from nonpenetrating trauma. Complete traumatic internal carotid artery occlusion is very rare condition accounting for 0.08~0.4 0f all trauma patients and believed to be associated with the greatest risk of ischemic stroke reported in 50~90% in a few small series. A 55-year-male was admitted with drowsy mentality and severe headache after a fall down accident. Brain computed tomography showed a subdural hematoma at the both frontal area with a fracture of the occipital skull bone. Two days after admission, he suddenly complained with a right side hemiparesis of motor grade 2. Brain magnetic resonance diffusion demonstrated multiple high flow signal changes from the left frontal and parietal lesion. Computed tomographic angiogram (CTA) revealed absence of the left ICA flow. Trans femoral cerebral angiography (TFCA) showed complete occlusion of the left internal carotid artery (ICA) at ophthalmic segment in the left ICA angiogram and flows on the left whole hemispheric lesions through the anterior communicating artery in the right ICA angiogram. We decided to conduct close observations as a treatment for the patient because of acute subdural hematoma and sufficient contralateral cerebral flow by perfusion SPECT scan. Two weeks after the accident, he was treated with heparin anticoagulation within INR 2~4 ranges. He recovered as the motor grade 4 without another neurologic deficit after 3 months.

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Surgical Outcomes of a Modified Infarct Exclusion Technique for Post-Infarction Ventricular Septal Defects

  • Kim, In Sook;Lee, Jung Hee;Lee, Dae-Sang;Cho, Yang Hyun;Kim, Wook Sung;Jeong, Dong Seop;Lee, Young Tak
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.381-386
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    • 2015
  • Background: Postinfarction ventricular septal defects (pVSDs) are a serious complication of acute myocardial infarctions. The aim of this study was to analyze the clinical outcomes of the surgical treatment of pVSDs. Methods: The medical records of 23 patients who underwent operations (infarct exclusion in 21 patients and patch closure in two patients) to treat acute pVSDs from 2001 to 2011 were analyzed. Intra-aortic balloon counterpulsation was performed in 19 patients (82.6%), one of whom required extracorporeal membrane support due to cardiogenic shock. The mean follow-up duration was $26.2{\pm}18.6months$. Results: The in-hospital mortality rate was 4.3% (1/23). Residual shunts were found in seven patients and three patients required reoperation. One patient needed reoperation due to the transformation of an intracardiac hematoma into an abscess. No patients required reoperation due to recurrence of a ventricular septal defect during the follow-up period. The cumulative survival rate was 95.5% at one year, 82.0% at five years, and 65.6% at seven years. Conclusion: The use of a multiple-patch technique with sealants appears to be a reliable method of reducing early mortality and the risk of significant residual shunting in patients with pVSDs.

Expression and Significance of MicroRNA155 in Serum of Patients with Cerebral Small Vessel Disease

  • Guo, Ying;Li, Dongxue;Li, Jiapei;Yang, Nan;Wang, Deyun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.463-469
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    • 2020
  • Objective : This study aimed to investigate the changes and significance of microRNA155 levels in serum of patients with cerebral small vessel disease (CSVD). Methods : Thirty patients with CSVD who met the inclusion criteria were selected and divided into eight patients with lacunar infarction (LI) group and 22 patients with multiple lacunar infarction (MLI) combined with white matter lesions (WML) group according to the results of head magnetic resonance imaging (MRI). Thirty samples from healthy volunteers without abnormalities after head MRI examination were selected as the control group. The levels of serum microRNA155 in each group were determined by real-time polymerase chain reaction, and the correlation between microRNA155 in the serum of patients with CSVD and the increase of imaging lesions was analyzed by Spearman correlation analysis. Results : Compared with the control group, the serum microRNA155 level in the LI group, MLI combined with WML group increased, the difference was statistically significant (p<0.05); serum microRNA155 level was positively correlated with the increase of imaging lesions (p<0.05). Conclusion : The change of serum microRNA155 level in patients with CSVD may be one of its self-protection mechanisms, and the intensity of this self-protection mechanism is positively correlated with the number of CSVD lesions.

Various Renal Manifestations in Children with Tuberous Sclerosis Complex (소아 결절성 경화증에서 나타나는 다양한 신증상들)

  • Lim, Ja Hyun;Park, Moon Sung;Pai, Ki Soo;Kim, Sung Hwan;Shin, Jae Il;Park, Se Jin
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.132-136
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    • 2014
  • Tuberous sclerosis complex (TSC) is a genetic disorder that affects multiple organ systems and causes tumors. It is important that physicians are aware of the manifestations of TSC, and that they follow the recommendations for screening and evaluation. Several types of renal abnormalities may develop in individuals with TSC. Individuals with TSC may require ongoing treatment that can be adapted for each arising manifestation of renal disease. Herein, we report 4 patients with TSC who presented with a range of different renal manifestations, including angiomyolipoma, renal cell carcinoma, renal infarction, renal cyst, and nephrolithiasis.

Implementation of Non-Invasive Cerebral blood Increasing Platform using PI (혈류지수를 이용한 비침습적 대뇌혈류증가 장치의 구현)

  • Kwon, Seong-tae;Lee, Jean;Kim, Young-kil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.9
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    • pp.1761-1770
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    • 2017
  • Treatment for cerebral blood flows is one of the most important treatments for cerebral infarction. There is a concern that the increasing number of cerebral blood flow treatments can cause multiple complications as it is invasive. To compensate for these problems, recently non-invasive cerebral blood flow increases have emerged. However, the current implementation of the non-invasive cerebral blood flow sensor raises the question of speed and accuracy. In this theses, the system aims to minimize the final cortical damage to the cerebrum by implementing a system in a completely different manner to complement the disadvantages of the existing non-invasive cerebral blood flow device. The system measure the PI of the limbs while simultaneously pressing limbs. Blood flow rate is carried out indirectly by increasing blood flow to peer pressure through the limbs in which the PI eips below a certain level. This can be used selectively in patients to increase blood flow.