• Title/Summary/Keyword: cerebrovascular

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Usefulness analysis of radial non-cartesian trajectory in the high-resolution MRA (고해상도 MRA 시 방사형 비직각좌표계 k-space 주사방식의 유용성 분석)

  • Lee, Ho-Beom;Choi, Kwan-Woo;Son, Soon-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.12
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    • pp.6284-6289
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    • 2013
  • With the application of k-space trajectory in a different manner and analyzing the influence of noise and its direction, this study was conducted to obtain high-quality images with minimal influence of noise during an MRI examination for cerebrovascular disease, which has a low signal for imaging. To evaluate influence of the noise of different k-space trajectories, a linear Cartesian coordination trajectory and non-Cartesian coordination trajectory were applied to 38 people who had received a high-resolution MRI examination for the early detection of cerebrovascular disease. As a result, the non-Cartesian coordination trajectory showed a 43.32% lower signal of lumens in the internal carotid artery than a linear Cartesian coordination trajectory, and the noise level was also 50.19% lower in a non-Cartesian coordination trajectory. This result shows that noise occurs less in a non-Cartesian coordination trajectory than a linear Cartesian coordination trajectory, and a non-Cartesian coordination trajectory is more effective in low-signal and low-resolution MRI examination. Therefore, when performing high-resolution MRI examination with a low-signal cerebrovascular system, the use of non-Cartesian coordination k-space trajectory will minimize the influence of noise and provide good images.

The Effectiveness of Cognitive Rehabilitation Program using Virtual reality content on Cognition, Activities of daily living, and Upper extremity functions in Cerebrovascular disease (가상현실 콘텐츠를 활용한 인지재활프로그램 훈련이 뇌혈관질환 환자의 인지, 일상생활활동, 상지기능에 미치는 영향)

  • Cho, Young-Seok;Kim, Keum Sook;Kim, Young-June;Park, Jin-Hong;Lee, Geon-Ho;Baek, So-Young;Hwang, Do-Yeon;Kwon, Ki-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.537-545
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    • 2020
  • This study was undertaken to investigate the effect of cognitive rehabilitation program (CRP) using virtual content, for recovering patients with cerebrovascular disease (CVD). A total of 34 patients with CVD were divided into a control group and an experimental group, and subsequently subjected to a virtual content based CRP, followed by cognition, ADLs, and upper limbs. The control group completed a universal rehabilitation program (URP), and the experimental group was provided a URP and a virtual content based cognitive rehabilitation program. For both groups, respective programs were conducted twice a day, 5 times a week for 4 weeks. Both groups showed significant improvement in ADLs (p<0.05); but the amount of change in the experimental group 5 point improved significantly (p<0.05). Cognition was significantly different for both groups (p<0.05). However, the experimental group showed a greater change (2 point) than the control group when considering the amount of change (p<0.05). Comparing the amount of change in the upper extremity, the experimental group showed a significant change (0.7 point) than the control group (p<0.05). This study confirms that compared to URP, CRP using virtual content significantly improves ADLs and cognition.

Prescribing Patterns of Antihypertensive Drugs by Outpatients with Hypertension in 2007 (고혈압 환자의 혈압강하제 처방양상 - 외래 처방전을 중심으로 -)

  • Sung, Ye-Na;Jang, Sun-Mee;Lim, Do-Hee;Shin, Suk-Youn;Song, Hyun-Jong;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.167-179
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    • 2009
  • Hypertension is one of the most common chronic diseases and it causes cardiovascular and cerebrovascular disease. While antihypertensive drug use increased, it took 15% of national health insurance drug expenditure. This study aimed to examine the pattern of antihypertensive drug prescription using National Health Insurance claims database and compare it with recommendations of Korea Hypertension Treatment Guidelines. Among the antihypertensive drugs, calcium channel blocker(64.4%) was most commonly prescribed class, and diuretics(44.6%), angiotensin II receptor blocker(33.3%), angiotensin converting enzyme inhibitor(11.7%) was followed. Approximately 81% of antihypertensives prescription were without cardiovascular or cerebrovascular disease, and among the comorbid conditions, diabetes(10.7%) was most common. calcium channel blocker(62.3%) was mostly prescribed class for hypertension with angina pectoris, angiotensin receptor blocker(45.3%) with myocardial infarction, diuretics(70.2%) and calcium channel blocker(49.5%) with congestive heart failure. For Hypertension with cerebrovascular disease, calcium channel blocker(68.0%) and angiotensin receptor blocker(43.3%) were prescribed mainly. When it comes to diabetes, calcium channel blocker(57.2%) was still mostly prescribed and angiotensin receptor blocker(45.9%) followed. But in hospitals and tertiary hospitals, angiotensin receptor blocker(65.7, 66.1%) was mostly prescribed for the patients with diabetes. For Hypertension with chronic renal disease, angiotensin receptor blocker(59.5%), calcium channel blocker(56.5%), diuretics(54.6%) were mainly used. Average number of classes per prescribing was $1.89{\pm}0.89$ class, average days per prescribing was $33{\pm}19$ day. Among the hypertension without comorbidity, 40.5% of prescription was monotherapy and 58.8% of polytherapy included diuretics. Among the outpatient prescriptions, calcium channel blocker was the most commonly used class, and the prescription pattern in clinic did not closely followed recommendations of Hypertension Treatment Guidelines.

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The Relationship between Cerebrovascular Mortality and Community Health Indicators in Gangwon-do (강원도의 뇌혈관질환 사망과 지역사회 건강 지표와 관련성)

  • Sim, Jeoung-Ha;Son, Mi-A
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.1-12
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    • 2009
  • Objectives: The aim of this study was to characterize the community health indicators affecting standardized mortality rate of cerebrovascular diseases(CVD) and to identify the relationship between CVD mortality and community health indicators in Gangwon-do. Methods: The community health indicators included material deprivation index, medical resource, rates of road pavement and local tax. CVD mortality and the material deprivation index were calculated in the registered death data and the 2000 census which were obtained from the Korean National Statistics Office. The community health indicators were measured using 2001 statistical year book of Ganwon-do. Data were analyzed by using Excel 2003, SAS 9.1. CVD mortality and material deprivation index were visualized by Arcview 9.1. Results: CVD mortality varied by region and sex in Gangwon-do. The highest CVD mortality in male and female were noted at Goseong-gun, the lowest CVD mortality in male was at Yangyang-gun as it of female at Pyeongchang-gun. In Taebaek city where material deprivation index was also the highest; in Pyeongchang-gun was the lowest. Also the higher material deprivation index in some regions was the higher CVD mortality was. CVD mortality was not related with community health indicators. Conclusions: The results showed the regional difference of mortality of CVD among counties and cities in Gangwon-do. It is recommended that other community health indicators besides material deprivation index, road pavement rate, medical resources and local tax affecting CVD mortality need to be considered to improve the preventive strategies.

Risk Factors for Cerebrovascular Disorders in Koreans (뇌혈관질환 발생 위험요인 구명을 위한 코호트내 환자-대조군 연구)

  • Park, Jong-Ku;Kim, Ki-Soon;Lee, Tae-Yong;Lee, Duk-Hee;Koh, Kwang-Wook;Lee, Kang-Sook;Jee, Sun-Ha;Suh, Il;Ryu, So-Yeon;Park, Kee-Ho;Kim, Chun-Bae
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.2
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    • pp.157-165
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    • 2001
  • Objectives : To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. Methods : The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (160-168) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. Results : In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. Conclusion : We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.

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A Study on the Complications of Acute Ischemic Cerebrovascular Disease Patients (급성기 허혈성 뇌중풍(중풍)의 합병증에 관한 연구)

  • Hsia, Yu-Chun;Jung, Ki-Yong;Go, Ho-Yeon;Jung, Seung-Min;Jung, Hee;Ko, Mi-Mi;Kang, Mi-Suk;Choi, You-Kyung;Kim, Dong-Woo;Han, Chang-Ho;Cho, Ki-Ho;Park, Jong-Hyung;Ko, Seung-Gyu;Jun, Chan-Yong
    • The Journal of Internal Korean Medicine
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    • v.28 no.1
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    • pp.25-33
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    • 2007
  • Background and Purpose : This study was to survey complication according to the TOAST classification and Sasangconstitution in first-ever AICD (acute ischemic cerebrovascular disease) patients. Methods : From 1 Oct. 2005 to 31 Oct. 2006. 97 patients with a first-ever stroke were included in the study. patients were hospitalized within 14 days after the onset of stroke at Kyungwon University Incheon Oriental Hospital. We recorded patient's complications according to the standard operation procedure of 'A stroke study for standardization and science on Korean Medicine' Results : Complications were recorded in 23 cases (24%). The most common complication was upper respiration infection in 11 cases (11%). No statistical significance was shown between complications of AICD and Sasangconstitutions, but complications rate of LAA was higher than SVO in AICD patients (odds ratio 4.17 95% CI 1.127${\sim}$7.307). Conclusions : To acquire more concrete data on this theme. we need further and larger scale research.

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Clinical Implications of Focal Mineral Deposition in the Globus Pallidus on CT and Quantitative Susceptibility Mapping of MRI

  • Hyojin Kim;Jinhee Jang;Junghwa Kang;Seungun Jang;Yoonho Nam;Yangsean Choi;Na-young Shin;Kook-Jin Ahn;Bum-soo Kim
    • Korean Journal of Radiology
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    • v.23 no.7
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    • pp.742-751
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    • 2022
  • Objective: To assess focal mineral deposition in the globus pallidus (GP) by CT and quantitative susceptibility mapping (QSM) of MRI scans and evaluate its clinical significance, particularly cerebrovascular degeneration. Materials and Methods: This study included 105 patients (66.1 ± 13.7 years; 40 male and 65 female) who underwent both CT and MRI with available QSM data between January 2017 and December 2019. The presence of focal mineral deposition in the GP on QSM (GPQSM) and CT (GPCT) was assessed visually using a three-point scale. Cerebrovascular risk factors and small vessel disease (SVD) imaging markers were also assessed. The clinical and radiological findings were compared between the different grades of GPQSM and GPCT. The relationship between GP grades and cerebrovascular risk factors and SVD imaging markers was assessed using univariable and multivariable linear regression analyses. Results: GPCT and GPQSM were significantly associated (p < 0.001) but were not identical. Higher GPCT and GPQSM grades showed smaller gray matter (p = 0.030 and p = 0.025, respectively) and white matter (p = 0.013 and p = 0.019, respectively) volumes, as well as larger GP volumes (p < 0.001 for both). Among SVD markers, white matter hyperintensity was significantly associated with GPCT (p = 0.006) and brain atrophy was significantly associated with GPQSM (p = 0.032) in at univariable analysis. In multivariable analysis, the normalized volume of the GP was independently positively associated with GPCT (p < 0.001) and GPQSM (p = 0.002), while the normalized volume of the GM was independently negatively associated with GPCT (p = 0.040) and GPQSM (p = 0.035). Conclusion: Focal mineral deposition in the GP on CT and QSM might be a potential imaging marker of cerebral vascular degeneration. Both were associated with increased GP volume.

Outpatient Day-Care Management of Unruptured Intracranial Aneurysm: A Retrospective Cohort Study

  • Dae Chul Suh;Yun Hyeok Choi;Sang Ik Park;Suyoung Yun;So Yeong Jeong;Soo Jeong;Boseong Kwon;Yunsun Song
    • Korean Journal of Radiology
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    • v.23 no.8
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    • pp.828-834
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    • 2022
  • Objective: This study aimed to assess the outcomes of outpatient day-care management of unruptured intracranial aneurysm (UIA), and to present the risks associated with different management strategies by comparing the outcomes and adverse events between outpatient day-care management and management with longer admission periods. Materials and Methods: This retrospective cohort study used prospectively registered data and was approved by a local institutional review board. We enrolled 956 UIAs from 811 consecutive patients (mean age ± standard deviation, 57 ± 10.7 years; male:female = 247:564) from 2017 to 2020. We compared the outcomes after embolization among the different admission-length groups (1, 2, and ≥ 3 days). The outcomes included pre- and post-modified Rankin Scale (mRS) scores and rates of adverse events, cure, recurrence, and reprocedure. Events were defined as any cerebrovascular problems, including minor and major stroke, death, or hemorrhage. Results: The mean admission period was 2 days, and 175 patients (191 aneurysms), 551 patients (664 aneurysms), and 85 patients (101 aneurysms) were discharged on the day of the procedure, day 2, and day 3 or later, respectively. During the mean 17-month follow-up period (range 6-53 months; 2757 patient years), no change in post-mRS was observed compared to pre-mRS in 99.6% of patients. Cure was achieved in 95.6% patients; minimal recurrence that did not require re-procedure occurred in 3.5% patients, and re-procedure was required in 2.3% (22 of 956) patients due to progressive enlargement of the recurrent sac during follow up (mean 17 months, range, 6-53 months). There were eight adverse events (0.8%), including five cerebrovascular (two major stroke, two minor strokes and one transient ischemic stroke), and three non-cerebrovascular events. Statistical comparison between groups with different admission lengths (1, 2, and ≥ 3 days) revealed no difference in the outcomes. Conclusion: This study revealed no difference in outcomes and adverse events according to the admission period, and suggested that UIA could be managed by outpatient day-care embolization.

Effects of Cardiotonic Pills® on Cerebrovascular CO2 Reactivity and Erythrocyte Deformability in Normal Subjects: A Pilot Study

  • Sang-Kwan Moon;Han-Gyul Lee;Seungwon Kwon;Seung-Yeon Cho;Seong-Uk Park;Woo-Sang Jung;Jung-Mi Park;Chang-Nam Ko;Ki-Ho Cho
    • The Journal of Korean Medicine
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    • v.44 no.4
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    • pp.87-103
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    • 2023
  • Backgrounds and objectives: Cardiotonic Pills® (CP) are used for vascular diseases such as coronary diseases, atherosclerosis, and cerebral infarction. This study aimed to determine the transient effects of CP on cerebrovascular CO2 reactivity (CVR) and erythrocyte deformability in normal subjects. Methods: This study had a crossover design and included 10 participants who were randomly allocated to 2 groups. The experimental group was given CP with water, while the control group was given only water. CVR was measured by hyperventilation-induced CVR of the middle cerebral artery (MCA) using transcranial Doppler (TCD). Erythrocyte deformability was measured using a Rheoscan-D microfluidic ektacytometer. All measurements were performed prior to and 1, 2, and 3 hours after CP or water administration. Blood pressure and heart rate were also measured before and after administration. Results: CP significantly improved CVR 3 hours after administration in the experimental group compared to the control group (p = 0.042). The corrected blood flow velocity at partial pressure of end-tidal carbon dioxide (PETCO2) = 40mmHg (CV40) was also significantly improved 2 and 3 hours after administration in the CP group compared to the control group (p = 0.036 and p = 0.021, respectively). CP significantly improved erythrocyte deformability 3 hours after administration in the experimental group compared to the control group (p = 0.027). Mean heart rate and mean blood pressure showed no change. Conclusions: This study demonstrated that CP increases CVR and erythrocyte deformability. These results suggested that CP improves cerebral microcirculation which provide evidence for the future use of CP for prevention of ischemic stroke and neurodegenerative diseases.