• Title/Summary/Keyword: cerebrovascular

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Differential Activation of Ras/Raf/MAPK Pathway between Heart and Cerebral Artery in Isoproterenol-induced Cardiac Hypertrophy

  • Kim, Hyun-Ju;Kim, Na-Ri;Joo, Hyun;Youm, Jae-Boum;Park, Won-Sun;Warda, Mohamed;Kang, Sung-Hyun;Thu, Vu-Thi;Khoa, Tran-Minh;Han, Jin
    • The Korean Journal of Physiology and Pharmacology
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    • v.9 no.5
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    • pp.299-304
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    • 2005
  • Cardiac hypertrophy contributes an increased risk to major cerebrovascular events. However, the molecular mechanisms underlying cerebrovascular dysfunction during cardiac hypertrophy have not yet been characterized. In the present study, we examined the molecular mechanism of isoproterenol (ISO)-evoked activation of Ras/Raf/MAPK pathways as well as PKA activity in cerebral artery of rabbits, and we also studied whether the activations of these signaling pathways were altered in cerebral artery, during ISO-induced cardiac hypertrophy compared to heart itself. The results show that the mRNA level of c-fos (not c-jun and c-myc) in heart and these genes in cerebral artery were considerably increased during cardiac hypertrophy. These results that the PKA activity and activations of Ras/Raf/ERK cascade as well as c-fos expression in rabbit heart during cardiac hypertrophy were consistent with previous reports. Interestingly, however, we also showed a novel finding that the decreased PKA activity might have differential effects on Ras and Raf expression in cerebral artery during cardiac hypertrophy. In conclusion, there are differences in molecular mechanisms between heart and cerebral artery during cardiac hypertrophy when stimulated with β2 adrenoreceptor (AR), suggesting a possible mechanism underlying cerebrovascular dysfunction during cardiac hypertrophy.

Magnetic Resonance Angiographic Evaluation as a Screening Test for Patients who are Scheduled for Cardiac Surgery (심장수술 대상자에서 선별 검사로서 두경부 MRA)

  • Suh, Jong-Hui;Choi, Si-Young;Kim, Yong-Hwan
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.718-723
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    • 2008
  • Background: The advances in surgical techniques, anesthesia management, perfusion methodology and postoperative intensive care have markedly decreased the mortality and cardiac morbidity of patients who undergo heart surgery over the past 2 decades. Nevertheless, it is well recognized that cardiac surgery carries a substantial risk for central nervous system complications. This study was conducted to evaluate the prevalence of subclinical cerebrovascular lesions in the head and neck by performing magnetic resonance angiography (MRA), and we investigated the clinical course of patients who had abnormal lesion seen on head and neck MRA. Material and Method: The subjects were 107 patients (71 men and 36 women ranging in age from 21 to 83 years) who were scheduled for cardiac surgery under nonemergency conditions between October 2005 and June 2008. Informed consent was obtained before the MRA. The carotid arteries, intracranial arteries and brain parenchyme were examined for subclinical cerebrovascular lesions by performing MRA. We reviewed the patients' medical records and MR findings to evaluate the prevalence of neurologically high risk patients and their clinical course. Result: The overall prevalence of neurologically high risk patients was 15.7% (17 patients). Among these patients, 11 patients had ischemic heart disease and 6 patients had valvular heart disease. Only 2 patients had a history of cerebrovascular disease. The clinical courses of 14 patients (13.1%) were changed according to their MRI findings. Conclusion: The prevalence of subclinical cerebrovascular disease in patients who were scheduled for cardiac surgery was higher than was expected. MR angiography was of value to identify these patients.

Effects of Periodontal Disease on Cardio-Cerebrovascular Disease: A Focus on Personal Income and Social Deprivation (치주질환이 심뇌혈관질환 발생에 미치는 영향: 지역결핍과 개인소득을 중심으로)

  • Kim, Min-Young;Shin, Hosung
    • Journal of dental hygiene science
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    • v.17 no.4
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    • pp.375-381
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    • 2017
  • The study aimed to investigate the effects of differences between personal income and social deprivation on the association between cardio-cerebrovascular disease (hypertension, stroke) and periodontal disease. This study used 12 years of cohort data from the Korea National Health Insurance Service covering the years 2002 to 2013. Among the patients aged more than 40 years who had received treatment for periodontal disease 224,067 and 284,730 who had not received treatment for hypertension and stroke, respectively, were included in the analysis. The Kaplan-Meier analysis revealed differences in the rate of treatment for cardio-cerebrovascular disease (hypertension, stroke) according to regional differences, the rate of treatment increased as the composite deprivation index value increased. The difference in treatment rates for cardio-cerebrovascular disease (hypertension, stroke) according to income was found to be higher in the treatment group with low income. This study empirically proved that the association between systemic disease and periodontal disease varies depending on personal income and the regional socioeconomic deprivation level. This shows that the clinical influence of periodontal illness on systemic disease differs according to the personal socio-demographic characteristic and residential area and that an individual's characteristic (income and the regional) needs to be considered along with the patient's clinical intervention in the disease treatment process.

Reducing Radiation Exposure Dose on Operator by Using Lateral Protection in Neuro-Intervention (뇌혈관 중재적시술에 있어 측방향 차폐체를 이용한 시술자 피폭 선량 저감화 방법 연구)

  • Kim, Jongdeok;Ahn, ByeoungJu;Lee, Junhaeng
    • Journal of the Korean Society of Radiology
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    • v.8 no.1
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    • pp.1-10
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    • 2014
  • The bi-plane cerebrovascular angiography radiation is done the radiation exposure at the forward and lateral direction as opposed to the one of the source. So, the exposure dose of radiation workers increases further. Therefore, the medical diagnostic radiation workers as well as patients is interested to ways to reduce the dose. The exposure dose of cerebral angiography and interventional radiology must be considered the primary radiation of X-ray tube directly, scattered primary radiation between lateral tube and lateral detector and relatively small secondary scatter radiation in the walls of room. The aim of study is that the exposure dose of primary and scatter radiation reduce as much as possible to install protection device of lateral protection than common shielding of table and ceiling. As a result, the dose of fluoroscopy was reduced approximately 3.64 times the gonads, thyroid approximately 3.13 times, 4.42 times around eyes. And the dose of DSA was reduced approximately 4.98 times the gonads, thyroid approximately 3.00 times, 1.67 times around eyes. Consequently, medical practitioners can be helpful for radiation dose-exposure for the lateral protection of bi-plane cerebrovascular angiography more than the common shield method in cerebrovascular angiography and interventional radiological procedures.

Study on function evaluation tools for stroke patients (뇌졸중(腦卒中) 환자(患者)의 기능평가방법(機能評價方法)에 대(對)한 연구(硏究))

  • Ko, Seong-Gyu;Ko, Chang-Nam;Chox, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Lee, Kyung-Sup
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.48-83
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    • 1996
  • Our conclusions for function evaluation tools of Stroke patients are as follows. 1. Evaluating tools of Activities of Daily Living, Katz Index, Barthel Index, Modified Barthel Index have high validity and reliability because of ease of measuring, high accuracy, consistency, sensitivity and sufficient stastistics, but they mainly measure motor function except sense, mentation, language, and social conception. Therefore cerebrovascular disease and brain injury in trauma patients with lacked acknowledgement and sensation, we are not able to apply these tools. 2. PULSES Profile is a useful scale for measuring the patient's over-all status, upper and lower limb functions, sensory components, excretary functions, and intellectual and emotional adaptabilities. It is recognized as a good, useful tool to evaluate patient's whole function. 3. Motor Assessment Scale was designed to measure the progress of stroke patients. The scale was supplemented with upper arm function items. We believe that the Motor Assessment Scale could be a useful evaluation tool with inter-rater reliability ,test-retest reliability. 4. The existing evaluation tools, Katz Index, Barthel Index, Modified Barthel Index, PULSES Profile, Motor Assessment Scale, mainly measured the rehabilitational motor function of sequela of cerebrovascular patients. On the other hand CNS & INH stroke scale can measure cerebrovascular disease patient's neurologic deficits and over-all stautus, which are recognition ability, speech status, motor function, sensory function, activities of daily living. Those scales have been recognized as useful tools to measure function of cerebrovascular disease patients and have increased in use. 5. Every function evaluation tool was recognized to have some validity and inter-rater, test-retest reliability in items of each evaluation tool and total scores of each evaluation tools, but it is thought that none of these scales have been fully validated and proved reliable. Therefore afterward, the development of a highly reliable rating system may best be accomplished by a careful comparison of several tools, using the same patients and the same observers in order to choose the most reliable items from each. 6. Ideal evaluation tools must have the following conditions; (1) It should show the objective functional statues at the same time. (2) It should be repeated consecutively to know changed function status. (3) It should be easy to observe the treatment program. (4) It should have the same result with another rater to help rater exchange information with treatment team members. (5) It should be practical and simple. (6) The patient should not suffer from the observer.

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Current Status of Costs and Utilizations of Hospital Based Home Health Nursing Care in Korea (전국 의료기관 가정간호이용 및 가정간호비용)

  • Ryu, Ho-Sihn
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1193-1203
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    • 2006
  • Purpose: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. Method: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. Result: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequoia of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (${\fallingdotseq}$ 48 $, 1 $=960 Won). The costs ranged from 74,523 Won (${\fallingdotseq}$78 $, loss of chronic kidney function, N18) to 32,270 Won (${\fallingdotseq}$34 $, other cerebrovascular diseases, 167). Conclusion: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

A Study on Compliance of Hypertensive Workers at a Department Store in Seoul (서울 시내 한 백화점 근로자의 고혈압 치료 순응도에 관한 연구)

  • Jee, Ju-Ok
    • Korean Journal of Occupational Health Nursing
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    • v.12 no.1
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    • pp.19-30
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    • 2003
  • Increasing occupational cerebrovascular & cardiovascular disease, it becomes the most serious problem in the occupational health management. Hypertension is the most important risk factor of cerebrovascular & cardiovascular disease. Although treatment for hypertension has the priority, hypertension has not been managed systematically at the worksite. The objectives of this study were to investigate the actual situation of its treatment, figure out what factors can affect compliance for hypertension treatment and analyze the relations between compliance and employment status. Subjects were 28 workers who have been diagnosed as hypertension at periodic health examination, 20 workers who have been managed for hypertension at dispensary and 22 workers who were diagnosed during the study periods. The results of the study were as follows; 1. More women have been hired as part time workers and had lower education background and income than the full time workers. 2. Among the factors that have been known to affect the treatment compliance, part time workers had less supports from the company than full time workers. 3. We got the comparison of difference between compliance and variables that the factor grade of cure promotion and average ages are high in high compliance. In conclusion there were not the difference of compliance by employment status. But it was hard to rule out the selection vias because the sample size was so small. So it seems difficult to generalized the conclusion that employment status doesn't affect the treatment compliance.

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