• Title/Summary/Keyword: Stroke risk factor

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Neurologic Outcomes of Preoperative Acute Silent Cerebral Infarction in Patients with Cardiac Surgery

  • Sim, Hyung Tae;Kim, Sung Ryong;Beom, Min Sun;Chang, Ji Wook;Kim, Na Rae;Jang, Mi Hee;Ryu, Sang Wan
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.510-516
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    • 2014
  • Background: Acute cerebral infarction is a major risk factor for postoperative neurologic complications in cardiac surgery. However, the outcomes associated with acute silent cerebral infarction (ASCI) have not been not well established. Few studies have reported the postoperative outcomes of these patients in light of preoperative Diffusion-weighted magnetic resonance imaging (DWI). We studied the postoperative neurologic outcomes of patients with preoperative ASCI detected by DWI. Methods: We retrospectively studied 32 patients with preoperative ASCI detected by DWI. None of the patients had preoperative neurologic symptoms. The mean age at operation was $68.8{\pm}9.5$ years. Five patients had previous histories of stroke. Four patients had been diagnosed with infective endocarditis. Single cerebral infarct lesions were detected in 16 patients, double lesions in 13, and multiple lesions (>5) in three. The median size of the infarct lesions was 4 mm (range, 2 to 25 mm). The operations of three of the 32 patients were delayed pending follow-up DWI studies. Results: There were two in-hospital mortalities. Neurologic complications also occurred in two patients. One patient developed extensive cerebral infarction unrelated to preoperative infarct lesions. One patient showed sustained delirium over one week but recovered completely without any neurologic deficits. In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions. Conclusion: Patients with preoperative ASCI showed excellent postoperative neurologic outcomes. Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.

The Hematologic Study on acute stage of Cerebral Infarction Patients and Cerebral Hemorrhage Patients (뇌경색과 뇌출혈의 초기 혈액학적 소견 비교 연구)

  • Kim, Jong-Won;Shim, Jae-Chul;Kim, Jeong-Keun;Kim, Jung-Hyun;Baek, Kyung-Min;Lee, Hyun-Eui;Oh, Byeong-Yeol;Jo, Hyun-Kyung;Yoo, Ho-Rhyong;Kim, Yoon-Sik;Seol, In-Chan
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.6 no.1
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    • pp.17-23
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    • 2005
  • 1. Purpose : The purpose of this study was done to compare the sex, past history, hematologic relationship between the Cerebral infarction patients and the Cerebral hemorrhage patients. 2. Methods : We selected the two study groups. The one is 20 Cerebral infarction patients and the other 20 Cerebral hemorrhage patients with confirmed by Brain CT or MRI. We made an investigation into past history. We examined and made a comparative study of CBC, LFT, Na, K, Cl in the both group. 3. Result & Conclusion : In the Cerebral hemorrhage group, there were many patients with Hypertension and Diabetes mellitus than the Cerebral infarction group. In the Cerebral infarction group, there were many patients with abnormal RBC count with no significant. Also, ESR is higher than the other group. Between the Cerebral infarction and the other group, we discovered significant cases with abnormal triglyceride, ALP in the Cerebral infarction group(p<0.05). Abnormal triglyceride is known one of important risk factor of Cerebral infarction, but this study was significant in the Cerebral hemorrhage group. Also, ALP was significant in the Cerebral hemorrhage group. Therefore more extensive research is needed.

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Association between Serum Cystatin C and Vascular Complications in Type 2 Diabetes Mellitus without Nephropathy

  • Kim, Hye Jeong;Byun, Dong Won;Suh, Kyoil;Yoo, Myung Hi;Park, Hyeong Kyu
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.513-518
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    • 2018
  • Background: Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. Methods: A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ${\leq}0.65mg/L$; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ${\geq}0.95mg/L$). Results: The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. Conclusion: Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

Relationship between health behaviors and high level of low density lipoprotein-cholesterol applying cardiovascular risk factors among Korean adults: based on the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), 2013 ~ 2015 (성인의 심혈관계 위험인자를 적용한 고저밀도지단백-콜레스테롤혈증과 건강행태의 관련성 연구 : 국민건강영양조사 제6기 (2013 ~ 2015) 자료 이용)

  • Cha, Bo-Kyoung
    • Journal of Nutrition and Health
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    • v.51 no.6
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    • pp.556-566
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    • 2018
  • Purpose: This study was designed to determine the relationship between health behaviors and high levels of low-density lipoprotein-cholesterol (LDL-cholesterol) according to cardiovascular risk factors among Korean adults. Methods: This cross-sectional study was based on the sixth Korea national health and nutrition examination survey (KNHANES VI). Participants were 13,841 adults aged 19 years and older. Cardiovascular risk factors were stroke, myocardial infarction or angina, diabetes mellitus, smoking, hypertension, aging, high density lipoprotein-cholesterol (HDL-cholesterol) under 40 mg/dL and HDL-cholesterol over 60 mg/dL. Cardiovascular risk groups were classified as very high risk (stroke, myocardial infarction or angina), high risk (diabetes mellitus), moderate risk (over 2 risk factors), and low risk (below 1 risk factor). The prevalence of high LDL-cholesterol was calculated using the LDL-cholesterol target level according to cardiovascular risk group. Results: The prevalence of high LDL-cholesterol was 25.5% in males and 21.7% in females. Complex sample cross tabulation demonstrated that the high LDL-cholesterol and normal groups differed significantly according to age, education, body mass index, percentage of energy from carbohydrate, fat, saturated fat and n-6 in males and females. These two groups were also significantly different according to smoking in males and the percentage of energy from n-3 in females. Complex sample multiple logistic regression analysis adjusted for multiple confounding factors demonstrated that the probability of high LDL-cholesterol was significantly associated with current smoking (OR: 1.66, 95% CI: 1.40-1.99), obesity (OR: 1.95, 95% CI: 1.64-2.31) in males, and current smoking (OR: 1.73, 95% CI: 1.19-2.52), obesity (OR: 1.63, 95% CI: 1.39-1.90), percentage of energy from n-3 (quartile 1 vs. quartile 2; OR: 0.77, 95% CI: 0.62-0.96; quartile 1 vs. quartile 3; OR: 0.73, 95% CI: 0.56-0.94; quartile 1 vs. quartile 4: OR: 0.67, 95% CI: 0.51-0.87) in females. Conclusion: This study reveals the impact of smoking, obesity, energy percentage of nutrient intake on LDL-cholesterol.

Association between cardiovascular disease and periodontal disease prevalence (치주질환에 의한 심장질환 발생의 관련성)

  • Jeong, Mi-Ae;Kim, Jee-Hee
    • Journal of the Korea Convergence Society
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    • v.2 no.4
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    • pp.47-52
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    • 2011
  • Periodontal disease is a common inflammatory disorder that is being considered as a risk factor for atherosclerotic complication. Recent epidemiological evidence also supports that its potential association with increased blood pressure levels and hypertensive prevalence. Data from cross-sectional studies suggest that in hypertensive patients periodontal disease may enhance the risk and degree of target organ damage. So dental infections have been associated with cardiovascular diseases. There are potential pathophysiologic links between hypertension and periodontits. The role of the inflammatory pathway include C-reactive protein(CRP). CRP is an inflammatory mediator that has been shown to predict the development of hypertension independently of baseline BP and traditional risk factors, has been consistently reported as at least mildly elevated in patients with periodontal disease. Reactive oxygen species produced by locally infiltrating neutrophils participate in periodontal tissue destruction. Periodontits can lead to inflammatory responses in the atrial myocardium, which disturbs the structural and electrophysiologic properties of the atrium and facilitates atrial fibrillation in the animal experiment.

Anti-apoptotic effect of fermented Citrus sunki peel extract on chemical hypoxia-induced neuronal injury (화학적 저산소증이 유도하는 뇌신경세포 손상에 있어서 미성숙 진귤 과피 발효 추출물의 보호 효과)

  • Ko, Woon Chul;Lee, Sun Ryung
    • Journal of Nutrition and Health
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    • v.48 no.5
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    • pp.451-456
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    • 2015
  • Purpose: Neuronal apoptotic events induced by aging and hypoxic/ischemic conditions is an important risk factor in neurodegenerative diseases such as ischemia stroke and Alzheimer's disease. The peel of Citrus sunki Hort. ex Tanaka has long been used as a traditional medicine, based on multiple biological activities including anti-oxidant, anti-inflammation, and anti-obesity. In the current study, we examined the actions of fermented C. sunki peel extract against cobalt chloride ($CoCl_2$)-mediated hypoxic death in human neuroblastoma SH-SY5Y cells. Methods: Cell viability was measured by trypan blue exclusion. Expression of apoptosis related proteins and release of cytochrome c were detected by western blot. Production of intracellular reactive oxygen species (ROS) and apoptotic morphology were examined using 2',7'-dichlorofluorescin diacetate (DCF-DA) and 4',6-diamidino-2-phenylindole (DAPI) staining. Results: Exposure to $CoCl_2$, a well-known mimetic agent of hypoxic/ischemic condition, resulted in neuronal cell death via caspase-3 dependent pathway. Extract of fermented C. sunki peel significantly rescued the $CoCl_2$-induced neuronal toxicity with the cell viability and appearance of apoptotic morphology. Cytoprotection with fermented C. sunki peel extract was associated with a decrease in activities of caspase-3 and cleavage of poly (ADP ribose) polymerase (PARP). In addition, increase in the intracellular ROS and release of cytochrome c from mitochondria to the cytosol were inhibited by treatment with extract of fermented C. sunki peel. Conclusion: Based on these data, fermented C. sunki peel extract might have a protective effect against $CoCl_2$-induced neuronal injury partly through generation of ROS and effectors involved in mitochondrial mediated apoptosis.

A Study on the Improvement of Reliability of Safety Instrumented Function of Hydrodesulfurization Reactor Heater (수소화 탈황 반응기 히터의 안전계장기능 신뢰도 향상에 관한 연구)

  • Kwak, Heung Sik;Park, Dal Jae
    • Journal of the Korean Society of Safety
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    • v.32 no.4
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    • pp.7-15
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    • 2017
  • International standards such as IEC-61508 and IEC-61511 require Safety Integrity Levels (SILs) for Safety Instrumented Functions (SIFs) in process industries. SIL verification is one of the methods for process safety description. Results of the SIL verification in some cases indicated that several Safety Instrumented Functions (SIFs) do not satisfy the required SIL. This results in some problems in terms of cost and risks to the industries. This study has been performed to improve the reliability of a safety instrumented function (SIF) installed in hydrodesulfurization reactor heater using Partial Stroke Testing (PST). Emergency shutdown system was chosen as an SIF in this study. SIL verification has been performed for cases chosen through the layer of protection analysis method. The probability of failure on demands (PFDs) for SIFs in fault tree analysis was $4.82{\times}10^{-3}$. As a result, the SIFs were unsuitable for the needed RRF, although they were capable of satisfying their target SIL 2. So, different PST intervals from 1 to 4 years were applied to the SIFs. It was found that the PFD of SIFs was $2.13{\times}10^{-3}$ and the RRF was 469 at the PST interval of one year, and this satisfies the RRF requirements in this case. It was also found that shorter interval of PST caused higher reliability of the SIF.

A Case Report of the Beneficial Effects of Chunghyul-Plus in Dyslipidemia Patients (청혈플러스로 호전된 이상지질혈증 환자 4례 보고)

  • Jung, Eun Sun;Kim, Hyun Tae;Choi, Koh Eun;Oh, Jeong Min;Cho, Hyun Kyoung;Yoo, Ho Ryong;Kim, Yoon Sik;Seol, In Chan
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.17 no.1
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    • pp.55-66
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    • 2016
  • Dyslipidemia is a major risk factor for cardiovascular accidents (CVA) and heart disease, especially the ischemic type. Lowering of serum low-density lipoprotein cholesterol (LDL-C) levels is a primary measure for preventing atherosclerosis. Many medications are available for the treatment of dyslipidemia; however, these drugs have some side effects. Therefore, we treated dyslipidemia patients with Chunghyul-plus. Before treatment, patients' levels of total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), and LDL-C were measured on an empty stomach. Thereafter, patients were administered 1000 mg (2 capsules) of Chunghyul-plus two or three times a day for 2 weeks. After treatment with Chunghyul-plus, patients' serum triglyceride, LDL-C, and total cholesterol levels decreased. The results of this study suggest that Chunghyul-plus might be useful in the treatment of dyslipidemia.

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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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    • v.22 no.3
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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.

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.