• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.146-155
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• 2023

Background: Despite the recent increasing trend in the prevalence of type 2 diabetes among older individuals, the relationship between diabetic retinopathy (DR) and chronic kidney disease (CKD) in these patients remains unclear. This study investigated the severity of renal dysfunction according to the degree of DR in older patients with type 2 diabetes. Methods: A total of 116 patients with diabetes and CKD stage ≥3 who visited both the nephrology and ophthalmology outpatient departments between July 2021 and January 2022 were screened. There were 53 patients in the no DR group, 20 in the nonproliferative DR (NPDR) group, and 43 in the proliferative DR (PDR) group. Results: DR severity was related to the deterioration of renal function. The proportion of patients with advanced CKD significantly increased with DR severity (p for trend <0.001). In the multivariate regression model adjusted for age of ≥80 years, male sex, poorly controlled diabetes, macroalbuminuria, insulin use, diabetes duration of ≥10 years, cerebrovascular accident, hypertension, hyperlipidemia, and cardiovascular disease history, the odds ratio compared with the no DR group was approximately 4.6 for the NPDR group and approximately 11.8 for the PDR group, which were both statistically significant (p=0.025 and p<0.001, respectively). Conclusion: DR severity in older patients with diabetes may be associated with deterioration of renal function and high prevalence of advanced CKD. Therefore, periodic examination for DR in older patients with diabetes is important for predicting renal function deterioration and CKD progression.

• The Journal of Korean Medicine
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• v.44 no.2
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• pp.201-201
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• 2023

Objectives: Cupping therapy (CT) has been widely used in traditional medicine worldwide for various indications, including stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.809-817
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• 2023

Single source and dual source measurements using anthropomorphic phantoms in which the phantoms are lined up in human body equivalents use OSLD (Optically Stimulated Luminescence Dosimeter), so the effective dose is calculated using OSLD. For hospital images, SNR (Signal to Noise Ratio) and CNR (Contrast to Noise Ratio) were measured in MCA (Middle Cerebral Artery) for single source and dual source, and for phantom images, SNR and CNR were measured for brain parenchyma of single source and dual source. For hospital imaging, SNR and CNR were measured in MCA for both single-source and dual-source, and for phantom images, SNR and CNR were measured for brain parenchyma from single-source and dual-source. As a result of comparing the SNR and CNR of the hospital image and the phantom image, there was no statistical difference. Comparing patient doses in hospital images, the effective dose of the dual source was 53.53% less and the effective dose of the dual energy phantom was 57.94% less. The dose can be increased in other areas, but the cerebrovascular area is useful because the dose is small.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.735-742
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• 2023

Nephrotic syndrome (NS) is associated with cerebral venous sinus thrombosis (CVST), which is a rare cerebrovascular disorder in children. Systemic anticoagulation with heparin is the standard therapy for CVST, and mechanical thrombectomy (MT) has been described as a salvage treatment for adult anticoagulant refractory CVST, However, it has never been reported in children. We describe a case of MT for refractory CVST in a child with NS. A 13-year-old boy with newly diagnosed NS presented to an emergency department with acute headache. A head computed tomography showed acute thrombus in the superior sagittal sinus, straight sinus and transverse sinus. The child was started on heparin therapy, but clinically deteriorated and became unresponsive. In view of the rapid deterioration of the condition after anticoagulation treatment, the patient received intravascular treatment. Several endovascular technologies, such as stent retriever and large bore suction catheter have been adopted. After endovascular treatment, the patient's neurological condition was improved within 24 hours, and magnetic resonance venography of the head demonstrated that the CVST was reduced. The child recovered with normal neurological function at discharge. This case highlights the importance of considering MT for refractory CVST, and we suggest that MT may be considered for refractory CVST with NS in children.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.712-718
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• 2022

Diploic arteriovenous fistulas (AVFs) or intraosseous dural AVFs are rare arteriovenous shunts. A diploic AVF is formed between a meningeal artery and an intraosseous diploic vein or the transosseous emissary vein, and the nidus is located exclusively within the bone. Currently, endovascular embolization with a transvenous approach is considered the treatment of choice for most dural AVFs. However, in the absence of an accessible venous channel, an alternate treatment approach should be considered. Herein, we report a case of a diploic AVF that was treated using embolization with transosseous direct cannulation.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.261-266
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• 2021

Ischemic stroke is one of the manifestations of reversible cerebral vasoconstriction syndrome (RCVS). Many precipitants and associated disorders of RCVS have been suggested. However, few case reports have indicated an association between anemia and RCVS. Here, we report a case of a 66-year-old female with severe iron deficiency anemia (IDA), who presented with ischemic stroke and cerebral vasoconstriction, which gradually improved with conservative treatment. High-resolution vessel wall magnetic resonance imaging findings and reversibility suggested the possibility of RCVS. In patients with RCVS and ischemic stroke, IDA should be considered. Prompt management should be delivered to prevent disease progression and recurrence.

• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.158-165
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• 2024

Objective : Superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis is conducted for flow augmentation. In this study, we measured the STA cut flow of a Korean population and evaluated the relationship between STA cut flow and long-term patency of the bypass. Methods : A retrospective study was conducted. Intraoperative measurement of STA flow was conducted using a microvascular flow meter on patients who underwent STA-MCA. After cutting the distal end, the STA flow rate was measured with no resistance and recorded. After finishing anastomosis, STA flow was measured and recorded. The cut flow index was calculated by dividing post anastomosis flow by cut flow in intracranial atherosclerotic stenosis patients. Results : The median STA cut flow was 35.0 mL/min and the post anastomosis flow was 24.0 mL/min. The cut flow of STA decreased with aging (p=0.027) and increased with diameter (p=0.004). The cut flow showed no correlation with history of hypertension or diabetes mellitus (p=0.713 and p=0.786), but did correlate a positively with history of hyperlipidemia (p=0.004). There were no statistical differences in cut flow, STA diameter, and post anastomosis flow between the frontal and parietal branches (p=0.081, p=0.853, and p=0.990, respectively). Conclusion : The median STA cut flow of a Korean population was 35 mL/min. Upon reviewing previous articles, it appears that there are differences in the STA cut flow between Western and Asian patients.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1140-1145
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• 2023

Cerebral amyloid angiopathy-related inflammation (CAA-RI) is an encephalopathy caused by inflammation of β-amyloid peptide deposition in cerebrovascular vessels. It is a rare disease that mainly occurs in the elderly and is characterized by rapidly progressive dementia, headache, seizures, and focal neurologic deficits. CAA-RI can demonstrate characteristic brain MRI findings and can be reversed by steroids or other immunosuppressive therapies. Here, we report a case of CAA-RI, which was initially misdiagnosed as a subacute infarction but was diagnosed while reviewing follow-up brain MRI images, and spontaneous remission was achieved.

• Journal of the East Asian Society of Dietary Life
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• v.18 no.4
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• pp.436-445
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• 2008

Stroke is a serious disease despite recent improvements in the medical treatments available. Thirty-six stroke patients were interviewed as case and 36 non-stroke patients were interviewed as controls between February 2005 and August 2005 at Daegu S Medical Center. Information regarding the subjects' food habits was collected using the recall method from 5 years before the onset of stroke. Using interview techniques, we investigated how dietary habits and attitude influence nutrient intake. These results were analyzed by the $X^2$, Student's t-test and Chi-square test using the SPSS 12.0 program. This case-control study was performed to demonstrate the relationships among general quality factors (BMI, WHR, and family history of stroke) and lifestyle factors (smoking, exercise and alcohol drinking). The results were as follows. Analysis of the percentage of nutrient intake in terms of meal pattern showed that WHR was significantly higher in the case group than in the control group. Hypertension and diabetes were the most common preceding diseases associated with the risk of stroke. The frequencies of smoking, alcohol consumption (p<0.001) and exercise (p<0.05) were higher in the cases than in the controls. Thus, the findings of this study are consistent with those of previous studies and suggest that people should be advised to control hypertension, smoking, alcohol drinking and obesity in order to prevent the occurrence of stroke as these factors are major risk factors for stroke.

• Journal of Internet Computing and Services
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• v.17 no.1
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• pp.101-107
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• 2016

Due to the recent advancement in digital imaging technology, development of intervention equipment has become generalize. Video arbitration procedure is a process to insert a tiny catheter and a guide wire in the body, so in order to enhance the effectiveness and safety of this treatment, the high-quality of x-ray of image should be used. However, the increasing of radiation has become the problem. Therefore, the studies to improve the performance of x-ray detectors are being actively processed. Moreover, this intervention is based on the reference of the angiographic imaging and 3D medical image processing. In this paper, we propose a guidance system to support this intervention. Through this intervention, it can solve the problem of the existing 2D medical images based vessel that has a formation of cerebrovascular disease, and guide the real-time tracking and optimal route to the target lesion by intervention catheter and guide wire tool. As a result, the system was completely composed for medical image acquisition unit and image processing unit as well as a display device. The experimental environment, guide services which are provided by the proposed system Brain Phantom (complete intracranial model with aneurysms, ref H+N-S-A-010) was taken with x-ray and testing. To generate a reference image based on the Laplacian algorithm for the image processing which derived from the cerebral blood vessel model was applied to DICOM by Volume ray casting technique. $A^*$ algorithm was used to provide the catheter with a guide wire tracking path. Finally, the result does show the location of the catheter and guide wire providing in the proposed system especially, it is expected to provide a useful guide for future intervention service.