• 제목/요약/키워드: cerebrovascular

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The Stress Perception, Depressive Symptoms and Medical Comorbidity in Healthcare Center (대학병원 건강검진센터 내원자의 스트레스 지각 정도, 우울 증상 및 신체질환 이환율)

  • Shim, In-Bo;Joe, Sook-Haeng;Ham, Byung-Joo;Han, Changsu;Jeong, Hyun-Ghang;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.27-43
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    • 2013
  • Objectives : We surveyed this study for knowing the relation within stress, depression and medical comorbidities, and finding the risk factors of major depression. Methods : 1764 subjects were enrolled from Jan. 2009 to Dec. 2009 who visit Korea University Guro hospital healthcare center. The subjects answered the questionnaire of PSS(Perceived Stress Scale), PHQ-9(Patient Health Questionnaire-9) and the demographic data. We categorized them as the stress group, depressive group, medical comorbidity group and analyzed the correlation analyses and logistic regression analyses. Results : 198 of 1764 subjects(11.8%) were applied to major depression, and the depressive group showed the higher mean stress score(23.19) and mean depression score(12.95) than the normal group. The total PHQ-9 score was increased by perceiving more stress, having more medical comorbidities. The subjects with female, visiting due to recent health problems, irregular exercise, current smoking, history of angina and cerebrovascular disease showed the increased risk of major depression. Conclusions : In this study, we find the PSS, PHQ-9 were valuable for mental health screening in healthcare center. As perceiving more stress and having more medical comorbidity, risk of major depression were increased. Accordingly the individuals with medical diseases or unhealthy lifestyle would need the mental health screen.

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Covered Stenting Is an Effective Option for Traumatic Carotid Pseudoaneurysm with Promising Long-Term Outcome

  • Wang, Kai;Peng, Xiao-xin;Liu, Ao-fei;Zhang, Ying-ying;Lv, Jin;Xiang, Li;Liu, Yun-e;Jiang, Wei-jian
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.590-597
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    • 2020
  • Objective : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Long-term outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.

Effects of Physical Activity Practice Rates and Knowledge Related to Cardiocerebrovascular Disease Prevention on Health Behavior Case Study Focusing on Middle Aged Women with Risk of Central Obesity (중심비만 위험인자를 가진 중년여성의 신체활동 실천율, 심뇌혈관질환 예방관련 지식이 건강행위에 미치는 영향)

  • Lee, Byeong-Ju;Hwang, Seon-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.342-352
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    • 2018
  • This study was conducted to evaluate the effects of physical activity practice rates and knowledge related to cardiocerebrovascular disease prevention on the health behavior of middle aged women. Data were collected from Oct to Nov 2017 from 142 middle-aged women living in 24 Eup, Myeon, and Dong areas in North Gyeongsangbuk-do Province using a structured questionnaire. The obtained data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation, and stepwise multiple regression analysis. The major factors influencing health behavior were found to be alcohol consumption (${\beta}=0.15$, p=0.009), diet (${\beta}=0.16$, p=0.003), vigorous intensity (${\beta}=0.14$, p=0.011), marriage (${\beta}=0.19$, p<0.001), interest in one's own health (${\beta}=0.23$, p<0.001), and health recognition (ill: ${\beta}=0.31$, p<0.001). Alcohol consumption and diet were factors of cardiocerebrovascular knowledge, vigorous intensity was a factor of physical activity practice rate, marriage and interest in one's own health were factors of general characteristics, and health recognition was a factor in health-related characteristics. Health-promotion activity was positively correlated with knowledge regarding cardiocerebrovascular disease prevention (r=0.41, p<0.001) and physical activity practice rate (r=0.44, p<0.001). It will be necessary to develop and apply practical intervention programs based on disease prevention knowledge and physical activity to enhance the health behavior of middle aged women.

A Study on the Dizziness of Huangdi's Internal Classic $\ll$黃帝內經$\gg$ ($\ll$소문.영추(素問.靈樞)$\gg$에 나타난 현훈(眩暈)에 대한 연구(硏究))

  • Tark, Myoung-Rim;Kang, Na-Ru;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.24 no.1
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    • pp.142-170
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    • 2011
  • Objective : The purpose of this study is to investigate dizziness of Plain Questions $\ll$素問$\gg$ and Miraculous Pivot $\ll$靈樞$\gg$. Methods : We conducted a study on the original text paragraphs of Internal Classic $\ll$內經$\gg$ containing the dizziness and analysis of Yang, Ma, Zhang, Wang etc. We drew a parallel between dizziness from Internal Classic $\ll$內經$\gg$and matching diagnoses from western medicine. Results : The results were as follows. 1. Dizziness in Ok Ki Jin Jiang Ron <玉機眞藏論> and Pyo Bon Byeong Jeon Ron <標本病傳論> had relation to liver and was similar to dizziness caused by tension, hypertension, anemia and cerebrovascular accident etc. in western medicine. 2. Dizziness in Ja Yeol<刺熱>, O Sa<五邪> and Hai Ron<海論> had relation to kidney and was similar to dizziness caused by aging and peripheral vertigo concurrent with tinnitus and difficulty in hearing in western medicine. 3. Dizziness in O Sa<五邪> had relation to heart(pericardium) and was similar to dizziness caused by cardiac output loss and psychogenic dizziness in western medicine. 4. In Internal Classic $\ll$內經$\gg$ the main etiology of dizziness was infirmity(虛), which were Qi(氣) of the upper portion of the body being insufficient(上氣不足), blood depletion(血枯), deficiency of marrow-reservoir(髓海不足) etc. 5. In Dae Hok Ron<大惑論> etiology and pathogenesis of dizziness were mentioned and dizziness was similar to dizziness caused by eye disorder, psychogenic dizziness and central dizziness in western medicine. 6. In Internal Classic $\ll$內經$\gg$ the meridian of acupuncture points which was used much for dizziness was Bladder Meridian. Aqupunture points used in treatment of dizziness were Ch'onju(天柱), Kollyun(崑崙), Taejo, Chok-t'ongkok(足通谷) etc. Conclusion : We found out etiology, pathogenesis, treatments of dizziness in Internal Classic $\ll$內經$\gg$. Further we compared with western medicine to develop better understanding of dizziness.

Comparison of Radiofrequency Ablation and Cryoablation for the Recovery of Atrial Contractility and Survival

  • Kim, Kang Min;Chung, Suryeun;Kim, Sang Yoon;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.266-272
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    • 2018
  • Background: Limited comparative data are available on the efficacy of cryoablation versus radiofrequency ablation in patients with atrial fibrillation. This study aimed to compare radiofrequency ablation and cryoablation with regard to clinical outcomes and the restoration of sinus rhythm or atrial contractility. Methods: A total of 239 patients who underwent surgical ablation between August 2003 and December 2016 at our institution were included. The patients were divided into 2 groups according to the energy device that was used (group A: n=140, radiofrequency ablator; group B: n=99, cryoablator). Echocardiographic data, overall survival, and major cardiovascular and cerebrovascular event (MACCE)-free survival were compared between the 2 groups. Results: At 1 year of follow-up, the atrial contractility recovery rate was 32.2% (19 of 59) in group A and 48.8% (21 of 44) in group B. In addition, cryoablation was found to be a predictive factor for the recovery of atrial contractility (cryoablation vs. radiofrequency ablation: odds ratio, 2.540; 95% confidence interval, 1.063-6.071; p=0.036). The left ventricular ejection fraction was significantly higher in group B ($53.1%{\pm}11.5%$ vs. $59.1%{\pm}6.3%$, p=0.001). The median follow-up duration was 36 months. The 5-year overall survival rate was $80.1%{\pm}3.6%$ in group A and $92.1%{\pm}2.9%$ in group B (p=0.400). The 5-year MACCE-free survival rate was $70.3%{\pm}4.0%$ in group A and $70.9%{\pm}5.6%$ in group B (p=0.818). Conclusion: Cryoablation was associated with a higher atrial contractility restoration rate and better left ventricular function than radiofrequency ablation. However, no significant relationship was observed between the energy source and overall or MACCE-free survival.

Radiotherapy for pituitary adenomas: long-term outcome and complications

  • Rim, Chai-Hong;Yang, Dae-Sik;Park, Young-Je;Yoon, Won-Sup;Lee, Jung-Ae;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.29 no.3
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    • pp.156-163
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    • 2011
  • Purpose: To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. Materials and Methods: We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-five patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Results: Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing's disease). Amenorrhea was abated in 7 of 10 patients, galactorrhea in 8 of 8 patients, acromegaly in 7 of 11 patients, Cushing's disease in 4 of 4 patients. Long-term complication was observed in 4 patients; 3 patients with cerebrovascular accident, 1 patient developed dementia. Of these patients, 3 of 4 received more than 60 Gy of irradiation. Conclusion: EBRT is highly effective in preventing recurrence and reducing mass effect of non-secreting adenoma. Effort to improve tumor control of secreting adenoma is required. Careful long-term follow-up is required when relatively high dose is applied. Modern radiosurgery or proton RT may be options to decrease late complications.

A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE PATIENTS WITH MAJOR BLEEDING DISORDERS (주요 출혈성 질환자에서 치성감염 관리에 관한 임상적 연구)

  • Kim, Jong-Bae;Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok;Yoo, Jae-Ha;Han, Sang-Kwon;Chung, Jae-Hyung;Kim, Byung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.330-337
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    • 2003
  • This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.

Development of Health Service Weight for Resource Allocation and Performance Monitoring (자원 배분과 성과 모니터링을 위한 보건사업 가중치 개발)

  • Kim, Sang-A.;Hur, Young-Hye;Park, Woong-Sub
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.34-46
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    • 2009
  • Objectives: This study was conducted to estimate health service weight for resource allocation and performance monitoring using Basic Priority Rating System. Methods: The Health service would be classified according to New Health Plan 2010, and Burden of disease collected from preceding studies. The data of severity of health problem and effectiveness of intervention were collected through the survey of experts' suggestion. The health service weight was estimated in the formula which is Basic Priority Rating System. Results: In the result of analysis, the health service weight of Infectious disease was ranked highest at 58.97% followed by Anti-smoking campaign(14.07%), Hypertension(3.87%), Diabetes mellitus(3.40%), Cancer(2.90%), Cardiovascular-Cerebrovascular diseases(2.86%), Physical activity(2.10%), Moderate drinking(2.07%), Medical examination(1.92%), Mental health promotion(1.72%), Serious mental illnesses(1.62%), Nutrition(1.52%), Oral health promotion(1.15%), Oral diseases(1.10%), Addiction(0.73%). Conclusions: We think the result of this study provides a rational basis for resource allocation and performance monitoring of health service.

Development of CRF and SOPs for the Identification of Risk Factors of the Cerebrovascular Diseases in the East and West Medicine (뇌혈관질환의 한양방적인 위험요인 규명 및 진단 표준화 연구를 위한 CRF 및 SOP 개발)

  • Ko Seong-Gyu;Jun Chan-Yong;Park Jong-Hyeong;Han Chang-Ho;Ko Ho-Yeon;Yoon Yoo-Sik;Choi Seon-Mi;Kim Jung-Gil;Jung Woo-Sang;Moon Sang-Kwan;Kim Yeung-Suk;Bae Hyung-Sup;Cho Ki-Ho
    • The Journal of Korean Medicine
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    • v.27 no.1 s.65
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    • pp.204-219
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    • 2006
  • Objectives : This study is to report the proceeding of the project sponsored by the ministry of science and technology of Korea for the stroke study titled as 'fundamental study for standardization and objectification of differentiation and pattern identification of symptoms of Oriental Medicine in stroke'. Methods and Results : We works for clinical research and molecular epidemiology center and we are in charge of the development of case report form, education of the investigators, data entry, data validation, and analysis. In the process of this project, we need to development of standard operating procedures for development and education for the case report form. Conclusions : This study is to let researchers for Traditional Korean Medicine and clinical research know how to develop of case report form and standard operating procedures in clinical researches and maintain the resource document and data.

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The Effect of Dansamtongmek-tang and Dansamsengmek-san on Hyperlipidemia and Brain & Cell Damage by Hypoxia (단삼통맥탕(丹蔘通脈湯)과 단삼생맥산(丹蔘生脈散)이 고지혈증 및 Hypoxia로 유발된 뇌손상과 세포손상에 미치는 영향)

  • Kim, Yong-Jin;Yu, Byeong-Chan;Kim, Yoon-Sik;Seol, In-Chan
    • The Journal of Korean Medicine
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    • v.27 no.3 s.67
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    • pp.107-131
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    • 2006
  • Background and Aims: Dansamtongmek-tang (DSTMT) and Dansamsengmek-san (DSSMS) have been used for many years as therapeutic agents for the acute stage of cerebrovascular disease, hypertension and hyperlipidemia in Oriental medicine, but the effects of DSTMT and DSSMS on hyperlipidemia and safety for cell damage are not yet well-known. This study was done to investigate the effects of DSTMT and DSSMS on hyperlipidemia. Methods: In vivo test: after administering DSTMT and DSSMS to SHR and ICR occurred hyperlipidemia for 3 weeks, we analyzed body weight, cholesterol levels. TG, HDL-chol, LDL-chol, LDH in plasma, brain, liver and kidney tissue, and DNA by RT-PCR. In vitro test: after administering DSTMT and DSSMS to human hepatocellular carcinoma in hypoxia, we observed cell cohesion by light microscope, analyzed the inflow of Ca2+ by confocal laser scanning microscope and DNA by RT-PCR. Results: DSTMT significantly decreased the levels of triglyceride and increased the levels of HDL-cholesterol in SHR, and significantly decreased the levels of LDL-cholesterol and body weight and increased the levels of HDL-cholesterol in ICR. DSSMS significantly decreased body weight, total cholesterol levels, LDL-cholesterol, LDH and cardiac risk factor (CRE) in SHR and significantly decreased the levels of total cholesterol, triglyceride, LDL-cholesterol, LDH and CRF in ICR. DSTMT had an effect on protecting cells from damage by inhibiting production of p53 mRNA, and in DSSMS, by inhibiting production of p53 mRNA and p21 mRNA after hypoxia. DSTMT effectively blocked off Ca2+ at low density, but DSSMS effectively blocked off Ca2+ at high density. Both DSTMT and DSSMS had an effect on inhibiting lipid metabolism by blocking off production of apo B mRNA. Conclusions: These results suggest that DSTMT and DSSMS might be usefully applied for treatment of hyperlipidemia and suppression of brain damage.

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