• 제목/요약/키워드: Stroke risk factor

검색결과 144건 처리시간 0.019초

건강한 성인에서 대뇌 백질 변성과 호모시스테인 농도의 연관성 (Relationship between White Matter Changes and Homocysteine Concentration in Healthy Adults)

  • 허욱;강현구
    • 한국산학기술학회논문지
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    • 제19권8호
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    • pp.449-455
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    • 2018
  • 본 연구는 뇌졸중, 치매 병력이 없는 50-75세 건강한 성인을 대상으로 뇌 CT를 통해 대뇌 백질 변성과 뇌혈관 위험인자들이 상관성이 있는지 분석하고자 하였다. 2016년과 2017년에 일개 병원에서 건강 검진을 받은 900명 중 722명을 대상으로 연구를 진행하였으며 의무기록을 토대로 후향적으로 조사하였고, SPPS를 이용하여 카이제곱검정, 독립표본 t검정, 단변량 로지스틱 회귀분석을 이용하여 분석하였다. 대뇌 백질 변성이 있는 집단과 없는 집단으로 나누어 연구 대상자 특성을 확인하였는데, 대뇌 백질 변성이 있는 군이 없는 군보다 평균 연령과 고혈압, 당뇨 유병률이 높았고, 교육 기간은 짧았으며, 호모시스테인 농도가 높았다. 대뇌 백질 변성이 있는 군에서는 호모시스테인 농도가 증가함에 따라 백질 변성군 내에서 차지하는 비율도 증가했다. 호모시스테인 농도를 4분위하여 가장 낮은 집단(Q1)을 기준으로 상대적 위험도를 비교하였을 때, 나이[p<0.001], 고혈압[p<0.001], 고호모시스테인혈증(Q4)[p=0.021]이 대뇌 백질 변성의 위험인자임을 확인하였다. 이는 건강한 사람에게서 고혈압, 고호모시스테인혈증과 같은 대뇌 백질 변성의 조절 가능한 위험 인자를 확인했다는데 임상적으로 의의가 있다. 하지만 지금까지 고호모시스테인혈증의 일으키는 원인별 위험성에 대한 보고가 없고, 고호모시스테인혈증과 대뇌 백질 변성에 대해 한국인을 대상으로 한 연구가 알려지지 않아 대규모 전향적 연구가 필요할 것으로 사료된다.

허혈성 심질환의 치료에서 관동맥우회술의 임상적 고찰 (Clinical Analysis of Coronary Artery Bypass Surgery for Ischemic Heart Disease)

  • 정태은
    • Journal of Yeungnam Medical Science
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    • 제13권2호
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    • pp.225-233
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    • 1996
  • 허혈성 심질환의 치료로서 시행되는 관동맥우회술은 최근 국내에서도 보편적으로 시행되고 있는데 1992년부터 1996까지 영남대학교 의과대학 흉부외과학교실에서 시행한 63례의 관동맥우회술을 대상으로 수술성적 및 술전 위험인자들이 술후 합병증에 미치는 영향을 조사하여 다음과 같은 결론을 얻었다. 환자의 성별 및 연령을 보면 총 63례의 환자 중 남자가 44례, 여자가 19례였으며 연령 분포는 36세에서 71세까지 평균 $58.3{\pm}8.6$세였으며 50대와 60대에서 대부분을 차지하였다. 원위문합수는 환자당 평균 3.5개의 원위부 문합을 하였으며 수술사망은 6례였으며 술후 합병증으로 부정맥이 7례, 창상감염이 5례, 술후 출혈이 4례, 술중 및 술후 심근경색이 4례, 뇌졸증이 4례, 그리고 위장관 및 신장 합병증이 5례에서 발생하였다. 술후 합병증 발생의 요소를 분석해 본 결과 술전 관동맥질환 발생의 위험인자 중 흡연환자에서 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 술전 위험인자로 정맥으로 Nitroglycerin의 투여가 필요했던 경우와 대동맥 차단시간이 2시간 이상인 경우 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 특히 65세 이상의 고령 환자의 경우 수술사망율이 유의하게 증가하였다(p<0.05). 이상의 결과로 흡연, 65세 이상의 고령, 술전 정맥으로 Nitroglycerin의 투여가 필요했던 경우 그리고 이식혈관의 수가 많아 대동맥 차단시간이 긴 경우 술중 및 술후 관리에 더욱 섬세한 주의가 필요함을 알 수 있었다.

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무증상성 열공성 뇌경색 환자에서 호모시스테인과 대사증후군의 상관관계에 대한 연구 (Correlation between Metabolic Syndrome and Plasma Homocysteine Level in Patients with Silent Lacunar Infarction)

  • 신윤리;이재욱;이승연;윤용재;정현윤;김경민;김영균
    • 대한한방내과학회지
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    • 제33권3호
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    • pp.243-256
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    • 2012
  • Objectives : This clinical study was done to examine metabolic syndrome (MS) and plasma homocysteine (HCY) level in patients with silent lacunar infarction (SLI) and in normal controls. Methods : A total of 154 patients, who were over 20 years of age and visited the stroke prevention check-up center of a university hospital from December 2006 to December 2010, were examined by brain CT or brain MRI, and classified into two groups. We compared the components of MS and HCY levels between patients with SLI (n=74) and normal controls (n=80). Modified ATP III definition was used for diagnosis of MS while Korean standard for waist circumference was used. Results : Prevalence of MS was significantly higher in the SLI group than the normal group. HCY was also significantly higher in the SLI group than the noraml, and the odds ratio (OR) for SLI, comparing high HCY level (${\geq}10{\mu}mol/L$) with low HCY level ($<10{\mu}mol/L$), was 3.64 (95% confidence interval (CI); 1.81-7.29, p<.0001). However, there was no correlation between MS and HCY in the SLI group. Prevalence of diabetes and hypertension (HT) was higher in the SLI group than the normal group, but there was no significant difference in blood lipids level between the SLI and normal groups. Of note, HT itself was enough to be an independent risk factor for SLI (OR; 4.58, 95% CI; 1.91-11.01, p=0.001). Body mass index, waist circumference, waist-hip ratio and visceral fat area were significantly higher in the SLI than normal group, and visceral fat area was enough to be an independent risk factor for SLI (OR; 2.41, 95% CI; 1.04-5.59, p=0.040). Conclusions : SLI is shown to have significant correlation with HCY and prevalence of MS, however there is no relationship between HCY and prevalence of MS in patients with SLI.

Angiographic and Clinical Factors Related with Good Functional Outcome after Mechanical Thrombectomy in Acute Cerebral Artery Occlusion

  • Park, Jong Hyuk;Han, Young Min;Jang, Kyeong Sool;Yoon, Wan Soo;Jang, Dong Kyu;Park, Sang Kyu
    • Journal of Korean Neurosurgical Society
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    • 제58권3호
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    • pp.192-196
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    • 2015
  • Objective : The aim of this study is to investigate good prognostic factors for an acute occlusion of a major cerebral artery using mechanical thrombectomy. Methods : Between January 2013 to December 2014, 37 consecutive patients with acute occlusion of a major cerebral artery treated by mechanical thrombectomy with stent retrievers were conducted. We analyzed clinical and angiographic factors retrospectively. The collateral flow and the result of recanalization were sorted by grading systems. Outcome was assessed by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at 90 days. We compared the various parameters between good and poor angiographic and clinical results. Results : Twenty seven patients demonstrated good recanalization [Thrombolysis in Cerebral Infarction (TICI) 2b or 3] after thrombectomy. At the 90-day follow up, 19 patients had good (mRS, 0-2), 14 had moderate (3-4) and four had poor outcomes (5-6). The mRS of older patients (${\geq}75years$) were poor than younger patients. Early recanalization, high Thrombolysis in Myocardial Infarction risk score, and low baseline NIHSS were closely related to 90-day mRS, whereas high TICI was related to both mRS and the decrease in the NIHSS. Conclusion : NIHSS decreased markedly only when recanalization was successful. A good mRS was related to low initial NIHSS, good collateral, and early successful recanalization.

뇌경색 후유증 환자의 고지혈증과 변비에 대한 함초환(鹹草丸) 호전 1례 (A Case Report of Hyperlipidemia and Constipation in a Patient with Cerebral Infarction Treated with Herbal Prescription.)

  • 우성호;김병철;김진원;정병주;나유진;심효주;김용호;서호석;이원희
    • 대한한방내과학회지
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    • 제27권4호
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    • pp.945-953
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    • 2006
  • Hyperlipidemia is one of the major factors causing the atherosclerosis of coronary arteries and a well-documented modifiable risk factor for stroke, especially of the ischemic type. Constipation is the condition of being unable to empty the bowels frequently enough or effectively. However, it is usually temporary and not a serious disease. Salicornia herbacea is a sea coast plant that grows on the western and southern coastal beaches and salt flats of the Korean peninsula. Belonging to Chenopodiaceae by biological classification. Salicornia herbacea is not known from research except that it contains plenty of minerals. The purpose of this study was to evaluate the effect of treatment with Hamcho-hwanand to observe changes in total cholesterol (T-Chol) high-density lipoprotein cholesterol (HDL), triglyceride (TG) and constipation. After treatment, total cholesterol decreased from 273mg/dl to 235mg/dl. Triglyceride decreased from 201mg/dl to 126mg/dl. HDL cholesterol increased from 30mg/dl to 40mg/dl. Constipation changed for the better. These results support a role for oriental medical therapy in treating hyperlipidemia and constipation. Further case studies of herbal treatment of this ailment are needed.

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물리치료사의 작업관련 근골격계 통증과 부담작업 유해요인 평가: 성인 신경계 손상 치료를 중심으로 (Work-Related Musculoskeletal Pain and Workload Evaluation of Physical Therapists: Focused on Neurological Injury Treatment of Adults)

  • 이중호;최영철;김진상
    • 한국전문물리치료학회지
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    • 제19권2호
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    • pp.69-79
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    • 2012
  • Importance of the work-related musculoskeletal disorders (WMSDs) has been increasing in the hospital industry such as health care industry and financial industry. This study investigated in order to identify the factors like general, occupational and ergonomically characteristics of the subjects related to musculoskeletal disorders (MSDs) of physical therapists (PTs). Ergonomic tools of rapid upper limb assessment (RULA) were used for evaluation workload of the tasks. Prevalence of MSDs were 13 PTs (26.0%) for neck, 31 PTs (62.0%) for shoulder, 9 PTs (18.0%) for arm/elbow, 27 PTs (54.0%) for hand/wrist, 28 PTs (56.0%) for back, 14 PTs (28.0%) for leg/foot. The analysis of the rate of the pain intensity showed that 53.5% subjects experience moderate pain and 14.0% subjects experience severe pain. Factors which were general characteristics, for example, height, ergonomically characteristics such as 'Posture Score A' were related musculoskeletal subjective symptoms in logistic analysis (p<.05). Among physical therapists, action level of RULA were action level 2 (6.0%), action level 3 (52.0%), action level 4 (42.0%). Physical therapists were estimated one of the highest risk factor in this study. This study suggested that the need of preventive education and program for PTs (physical therapists). Comprehensive and systematic management plans should be established to include both ergonomic and sociopsychological aspects.

Is the diagnosis of calcified laryngeal cartilages on panoramic radiographs possible?

  • Cagirankaya, Leyla Berna;Akkaya, Nursel;Akcicek, Gokcen;Dogru, Hatice Boyacioglu
    • Imaging Science in Dentistry
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    • 제48권2호
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    • pp.121-125
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    • 2018
  • Purpose: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: A total of 312 regions(142 bilateral, 10 left, 18 right) in 170 patients(140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient(${\kappa}$) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators(sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. Results: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (${\kappa}=0.684$ and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. Conclusion: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

태음인(太陰人) 한다열소탕(寒多熱少湯)이 비만유도(肥滿誘導) 백서(白鼠)의 체중(體重) 및 지질대사(脂質代謝)에 미치는 영향(影響) (Effects of Handayulso-tang for Taeum-in on the Body Weight and Lipid Metabolism of induced Obesity Rats)

  • 임형호;김재중
    • 한방비만학회지
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    • 제2권1호
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    • pp.95-104
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    • 2002
  • Objects. There was an increase in obese population due to eating habits resulted in modernization of lifestyle and the change of the tendency to conduct the physical activity, in order words, the reduction in the range of kinetic energy. Obesity is viewed as a major risk factor for serious health problems, including heart disease, high blood pressure, stroke, diabetes, and certain forms of cancer as well as for psychological and social problems owing to our fat-phobic society. In the present study, we investigate the weight loss thanks to giving Handayulso-tang(HD) medication of Taeum-in to induced obesity rats and its effects on lipid metabolism, given that their behavior patterns are changed according to their constitution. Methods: The extracts of Handayulso-tang was orally administered to the rats of HD group 200mg/200g of rats weight every day for 6 weeks, and the control group were fed with equal amount of saline. And measured the body weight and total cholesterol, triglyceride, free fatty acid and total lipid contents in serum in obese rats. Results: 1. The body weight in HD group were decreased. 2. The contents of serum total cholesterol and triglyceride in HD group were decreased and statistically showed the significant difference compared with the control group. 3. The contents of serum free fatty acid and total lipid in HD group were decreased, but did not statistically show the significant difference compared with the control group. Conclusion: Based on the above results, we know that Handayulso-tang have effects on the decrease of the body weight and the contents of serum total cholesterol, triglyceride, free fatty acid and total lipid So it could be concluded that Handayulso-tang can help the treatment of obesity.

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Anti-Obesity and Inhibitory Effect of Lipid Accumulation of The Cone of Pinus rigida × Pinus taeda in 3T3-L1 Cells

  • Da-Yoon Lee;Tae-Won Jang;So-Yeon Han;Seo-Yoon Park;Woo-Jin Oh;Jae-Ho Park
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2023년도 임시총회 및 춘계학술대회
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    • pp.55-55
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    • 2023
  • With the COVID-19 pandemic, there is increasing interest in anti-obesity strategies. According to the National Statistical Office, the obesity rate in Korea was 38.3% in 2020 and 37.1% in 2021. Obesity is a risk factor for several severe diseases, including stroke, heart disease, type 2 diabetes, and certain types of cancer. Pinus rigida × Pinus taeda is a hybrid of Pinus rigida Mill and Pinus taeda Linn, and its cones are considered a by-product. Although previous studies have investigated their pharmacological effects on antioxidant activity and protection against oxidative DNA damage, few researchers have explored their potential as functional natural materials. Therefore, we evaluated the anti-obesity effects of the cone of ethyl acetate fraction of P. rigida × P. taeda (ERT), specifically its ability to inhibit lipid accumulation. Our analysis showed that ERT contains phytochemicals (catechin and caffeic acid) which are known to improve immune function and inhibit cell damage. ERT inhibited lipid droplet accumulation at the cellular levels through Oil Red O staining. Furthermore, ERT suppressed the expression of adipogenic transcription factors (PPARγ and CEBP/α) as well as downstream lipogenic target genes (FAS and SREBP-1) thereby inhibiting adipogenesis. ERT also down-regulated key adipogenic markers, including aP2α, while inducing the phosphorylation of AMPK. It has been reported that PPARγ and CEBP/α are expressed in the early stages of adipose differentiation, while SREBP-1 is expressed in the late stage. Therefore, our findings suggest that ERT activates AMPK signaling pathways, which inhibits adipogenic transcription factors (PPARγ, C/EBPα, and SREBP1) and lipogenic genes (FAS and aP2α), thereby blocking lipid accumulation and preventing obesity and related disorders. ERT showed potential as a new resource for developing a functional material for anti-obesity agents.

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A Prognostic Factor for Prolonged Mechanical Ventilator-Dependent Respiratory Failure after Cervical Spinal Cord Injury : Maximal Canal Compromise on Magnetic Resonance Imaging

  • Lee, Subum;Roh, Sung Woo;Jeon, Sang Ryong;Park, Jin Hoon;Kim, Kyoung-Tae;Lee, Young-Seok;Cho, Dae-Chul
    • Journal of Korean Neurosurgical Society
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    • 제64권5호
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    • pp.791-798
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    • 2021
  • Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.