• 한국산학기술학회논문지
• /
• 제14권12호
• /
• pp.6284-6289
• /
• 2013

본 연구는 k-space 주사방식을 새롭게 적용하여 noise의 영향과 방향성을 분석함으로써 영상의 신호강도가 낮은 뇌혈관 질환의 고해상도 MRI 검사 시 noise의 영향을 최소화 하여 진단적 가치가 높은 영상을 획득하고자 하였다. 연구방법은 2013년 6월부터 동년7월까지 뇌혈관 질환의 조기 진단을 위해 고해상도 MRI 검사를 받은 38명을 대상으로 k-space 주사방식에 따른 noise의 영향을 평가하기 위해 기존의 선형 직각좌표계 주사방식과 새로운 방사형 직각좌표계 주사방식을 각각 적용한 후, 획득한 영상에서 내경동맥 내강의 신호강도와 noise를 비교 평가하였다. 연구결과, k-space 주사방식에 따른 내경동맥 내강의 신호강도는 방사형 비직각좌표계 주사방식이 기존의 선형 직각좌표계 주사방식 보다 43.32% 낮았고, noise 역시 50.19% 가량 낮게 나타났다. 이는 방사형 비직각좌표계 주사방식이 선형 직각좌표계 주사방식보다 noise가 적게 발생하며, 영상의 신호강도가 낮은 고해상도 MRI에서는 방사형 비직각좌표계 주사방식이 더 유용하다는 것을 의미한다. 그러므로 영상의 신호강도가 낮은 고해상도 뇌혈관 MRI 검사 시 방사형 비직각좌표계 k-space 주사방식을 이용한다면 noise의 영향을 최소화하여 양질의 영상을 획득할 수 있으리라 사료된다.

• 한국산학기술학회논문지
• /
• 제21권8호
• /
• pp.537-545
• /
• 2020

본 연구는 회복기 단계에 있는 뇌혈관 질환자를 대상으로 가상현실 콘텐츠를 활용한 인지재활프로그램의 임상적 적용 효과를 알아보았다. 연구방법은 회복기 단계의 뇌혈관 질환자 34명을 대상으로 대조군(16명)과 실험군(18명)으로 나눈 후에 가상현실 콘텐츠 기반의 인지재활프로그램을 적용한 후, 인지기능과 일상생활활동 능력, 상지기능에서의 효과를 비교하고자 하였다. 대조군에는 보편적인 재활치료 프로그램을 실시하고, 실험군에서는 보편적인 재활치료 프로그램과 가상현실 콘텐츠 기반의 인지재활프로그램을 제공하였다. 두 집단 모두 하루 2회(1회 30분씩)씩, 주 5회, 4주간(총 20회기) 실시하였다. 중재 결과, 두 집단 모두 일상생활활동 능력이 모두 유의미하게 향상되었지만(p<.05), 실험군에서의 변화량이 대조군보다 5점정도 더 향상되었다(p<.05). 인지기능에서도 실험군과 대조군이 유의미한 차이를 보였고(p<.05), 변화량에서 실험군이 대조군보다 2점정도의 변화 수치를 보였다(p<.05). 상지기능에서는 대조군과 실험군 간의 유의마한 차이는 없었고(p>.05), 전후 변화량을 비교한 결과 실험군이 대조군보다 0.7점정도 유의미한 변화폭을 보였다(p<.05). 가상현실 콘텐츠를 활용한 인지재활프로그램이 일반적인 재활치료 프로그램에 비해서 일상생활활동 능력과 인지기능에서의 유의미한 향상 폭의 차이가 있다는 것을 확인하는 연구였다.

• 한국임상약학회지
• /
• 제19권2호
• /
• pp.167-179
• /
• 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.

• 농촌의학ㆍ지역보건
• /
• 제34권1호
• /
• pp.1-12
• /
• 2009

본 연구는 뇌혈관질환 사망에 영향을 미치는 지역의 건강상태 지표를 파악하기 위해 시도되었으며, 연구방법은 2000년 사망 원인 통계를 활용하여 뇌혈관질환으로 인한 사망자 수와 2000년 인구센서스 자료를 이용하여 인구수를 산출하여 뇌혈관질환 표준화 사망률을 산출하였다. 또한 지역사회 건강지표로 지역의 물질적 결핍 지수와 보건의료자원, 도로 포장율, 지방세를 지표로 하였다. 자료는 Excel 2003과 SAS 9.1을 활용하여 분석하였다. GIS 프로그램인 Arcview 9.1을 이용하여 뇌혈관질환 사망률과 지역의 물질적 결핍지수를 시각화하였다. 본 연구의 결과는 다음과 같다. 1. 강원지역에서 뇌혈관질환의 표준화 사망률은 지역, 성별에 따라 차이가 있었다. 남자의 사망률이 가장 높은 지역은 고성군이었고, 가장 낮은 지역은 평창군으로 나타났다. 여자의 사망률이 가장 높은 지역은 고성군이었고, 가장 낮은 지역은 양양군이었다. 2. 강원도의 지역의 물질적 결핍지수는 태백시가 가장 높게 박탈된 지역으로 나타났고, 가장 적게 박탈된 지역은 평창군이었다. 3. 병 의원의 수, 지역의 물질적 결핍지수, 도로포장율. 지방세와 남녀 표준화 사망률과는 관계가 없었다. 본 연구의 의의는 지역의 여러 건강상태를 나타내는 자원들을 지표로 산출하여 뇌혈관질환 사망과 관련지어 분석하고, 또한 소지역인 시 군별 사망률의 차이와 지역사회 건강 지표인 물질적 결핍지수와의 관계를 시각화하였다는 점이다.

• Journal of Preventive Medicine and Public Health
• /
• 제34권2호
• /
• pp.157-165
• /
• 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.

• 대한한방내과학회지
• /
• 제28권1호
• /
• pp.25-33
• /
• 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.

• Korean Journal of Radiology
• /
• 제23권7호
• /
• pp.742-751
• /
• 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 (GP_QSM) and CT (GP_CT) 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 GP_QSM and GP_CT. The relationship between GP grades and cerebrovascular risk factors and SVD imaging markers was assessed using univariable and multivariable linear regression analyses. Results: GP_CT and GP_QSM were significantly associated (p < 0.001) but were not identical. Higher GP_CT and GP_QSM 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 GP_CT (p = 0.006) and brain atrophy was significantly associated with GP_QSM (p = 0.032) in at univariable analysis. In multivariable analysis, the normalized volume of the GP was independently positively associated with GP_CT (p < 0.001) and GP_QSM (p = 0.002), while the normalized volume of the GM was independently negatively associated with GP_CT (p = 0.040) and GP_QSM (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.

• Korean Journal of Radiology
• /
• 제23권8호
• /
• pp.828-834
• /
• 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.

• 대한한의학회지
• /
• 제44권4호
• /
• pp.87-103
• /
• 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.

• 대한예방의학회:학술대회논문집
• /
• 대한예방의학회 2001년도 제53차 추계 학술대회 연제집
• /
• pp.350-352
• /
• 2001