• Title/Summary/Keyword: cerebrovascular

검색결과 827건 처리시간 0.029초

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

  • 탁명림;강나루;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제24권1호
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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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    • 제51권4호
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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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    • 제29권3호
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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.

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

  • 김종배;정원균;노희진;장선옥;유재하;한상권;정재형;김병욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권5호
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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.

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

  • 김상아;허영혜;박웅섭
    • 농촌의학ㆍ지역보건
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    • 제34권1호
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    • pp.34-46
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    • 2009
  • 이 연구는 비교적 간단하면서도 객관성과 타당성이 높다고 평가되는 자료와 산출방식을 적용하여 보건사업의 가중치를 산출함으로써 지방자치단체 보건사업의 자원 배분과 평가에 용이하게 활용할 수 있는 계량적 기준을 제시하고자 하는 목적으로 수행되었다. 이를 위해 먼저 HP 2010에서 제시한 중점과제를 기초로 선행연구의 결과와 보건복지부 사업담당자들의 의견을 반영하여 분류안을 구성하였다. 다음으로 선행연구 결과들을 검토하여 각 보건사업과 관련된 질병부담 자료를 수집하였고, 전문가 의견 조사를 실시하여 각 보건사업과 관련된 문제의 심각도와 사업의 추정 효과를 파악하였다. 그리고 이와 같은 과정을 통해 수집된 자료들을 BPRS 방식에 적용하여 보건사업의 가중치를 산출하였다. 수집된 자료들을 BPRS 공식에 대입하여 가중치를 산출한 결과 전염성질환이 58.97%로 가장 높았고, 금연이 14.07%로 두 번째로 높았다. 그 다음은 고혈압(3.87%), 당뇨(3.40%), 암(2.90%), 심 뇌혈관질환(2.86%), 운동(2.10%), 절주(2.07%), 건강검진(1.92%), 정신건강증진(1.72%), 중증정신질환(1.62%), 영양(1.52%), 구강위생관리(1.15%), 구강질환(1.10%), 중독(0.73%) 순으로 나타났다. 이 연구의 결과는 중앙정부가 지방자치단체 보건사업에 자원을 배분할 때 계량적 기준으로 활용할 수 있으며, 평가점수 산정 시 상대적으로 더 중요한 사업에 더 높은 점수를 부여하여 사업의 효과성을 정책적으로 향상시킬 수 있을 것으로 기대된다.

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

  • 고성규;전찬용;박종형;한창호;고호연;윤유식;최선미;김중길;정우상;문상관;김영석;배형섭;조기호
    • 대한한의학회지
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    • 제27권1호
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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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단삼통맥탕(丹蔘通脈湯)과 단삼생맥산(丹蔘生脈散)이 고지혈증 및 Hypoxia로 유발된 뇌손상과 세포손상에 미치는 영향 (The Effect of Dansamtongmek-tang and Dansamsengmek-san on Hyperlipidemia and Brain & Cell Damage by Hypoxia)

  • 김용진;유병남;김윤식;설인찬
    • 대한한의학회지
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    • 제27권3호
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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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직업 및 교육수준에 따른 사망원인별 비례사망비의 연도별 추이: 1993-2004년 우리나라 사망등록자료의 분석 (The Proportional Mortality Ratios of Specific-cause Mortality by Occupation and Education among Men Aged 20-64 in Korea (1993-2004))

  • 김기혜;이경학;이상민;이승연;이예승;임경리;장지은;조상원;최은혜;정성태;진은정;손미아
    • Journal of Preventive Medicine and Public Health
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    • 제40권1호
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    • pp.7-15
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    • 2007
  • Objectives : This study investigated the relationship of occupational class and educational background with proportional mortality ratios in Korea. Methods : Mortality was investigated using the entire registered death data from 1993 to 2004, obtained from the Korean National Statistics Office. Proportional mortality ratios (PMRs) for specific diseases were calculated according to the occupational class and educational background of men aged 20-64. Results : Manual workers were found to have higher PMRs for liver disease and traffic accidents, as did the lower educated group. Especially, this study showed trends of an increasing of the wide gap between lower and higher socioeconomic stati for liver disease, traffic accidents, diabetes mellitus and cerebral vascular disease. The mortality for cerebrovascular disease, diabetes mellitus, heart disease, traffic accident and liver disease showed increasing trends according to the calendar year for the lower than the higher social class. Conclusions : The specific conditions that had higher PMRs in the Korean lower social class were liver disease and traffic accidents. Especially, there was an increasing trend for a widening of the gap between manual and non-manual groups in relation to mortality from liver disease, diabetes mellitus and traffic accidents.

최근 4년간 울릉군 지역의 헬리콥터를 이용한 응급 환자 이송의 고찰 (Study of Emergency Medical Transport by Helicopter in Ulleung Island during 4 Years)

  • 배정민;정만진;정기훈;배성한
    • 농촌의학ㆍ지역보건
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    • 제30권3호
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    • pp.255-262
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    • 2005
  • 도서 지역이라는 울릉도의 특성상 응급 환자의 이송 수단으로 헬리콥터는 필수적이다. 울릉도 지역의 인구 분포의 변화가 고령화가 심화됨에 따라 헬리콥터의 이송 빈도는 더욱 증가될 것으로 예상된다. 그러나, 응급 환자 이송용 헬리콥터가 없어 이송 시간동안의 응급처치 등에 장애가 있으므로, 동해안에 환자 이송의 역할을 가진 헬리콥터의 배치가 필요하다고 생각된다. 아울러 최근 감소세에 들어섰던 울릉군 지역의 인구가 증가하고 있고, 독도 열풍에 따른 관광객의 증가가 현저하므로 그에 따른 울릉군의 적절한 보건 정책이 필요하다고 생각된다

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일부 농촌지역 고혈압자의 사망에 미치는 요인 -12년 추적 연구- (A 12 Year Follow-up Study on the Factors Related with the Death of Hypertensives in a Korean Rural Area)

  • 김기순;박종
    • 농촌의학ㆍ지역보건
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    • 제18권1호
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    • pp.43-54
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    • 1993
  • In order to find the factors associated with the death of hypertensives, 12 year follow-up study for 267 hypertensives whose average blood pressure were 140/90 mmHg or above during their first health screening in 1979-1980 at YongJin Township, Wanju Country, North Cholla Province by the Community Health Team of Chonju Presbyterian Medical Center. The study results are as follows : 1. Initial general characteristics of hypertensives were studied. The age distribution of studied hypertensives showed 27.3% in 40-49 years, 25.8% in 50-59 years, 29.6% in 60-69 years and 17.2% In 70 + years old group. Marital status showed that 82.8% of hypertensives had their wife or husband. 74. 5% were employed on agriculture. 56.5% of hypertensives were illiterate. 2. Among the hypertensives, 91.6% of male and 22.8% of female reported that they were smokers. 82.6% of hypertensives had body mass index lower than 25 Kg/$m^2$. 46.8% of average systolic blood pressure were 160mmHg or above and 54.3% of average diastolic blood pressure were 95mmHg or above. 3. Twenty percent of hypertensives reported that they were treating hypertension at the beginning of follow up, while 68.5% reported that they were not treated. 28.1% reported that they were treating hypertension within 6 months before last follow-up. but 69.3% reported that they were not treated for hypertension within Ii months before last follow up. So 50.6% were classified as never treated group and 41.2% as treated group. 4. Average blood pressure for initial 3 years were calculated. The change of average systolic blood pressure was observed as $161.3{\pm}19.4mmHg$ at the first year, $145.6{\pm}28.0mmHg$ at the second year and $141.4{\pm}37.2mmHg$ at the third year. Average diastolic blood pressure were changed from $96.2{\pm}14.4mmHg$ at the first year to $90.6{\pm}18.6mmHg$ at the second year and $86.4{\pm}22.9mmHg$ at the third year. 5. By the follow-up of hypertensives, 54 hypertensives (46.2%) among 117 male hypertensives and 50 hypertensives (33.3%) among 150 female hypertensives died for 12 years. 42.6% of male death and 52.0% of female death were caused by cerebrovascular diseases. 6. Through univariate statistical test about the association between general characteristics or cardiovascular risk factors of hypertensives and mortality for 12 years, age variable among male and among female age, marital status, occupation. educational level. systolic blood pressure and treatment status were shown as significant variable to influence upon the mortality. 7. By multiple logistic regression analysis, among male age and systolic blood pressure were selected as significant variable to be associated with the total mortality for 12 years. Among female age, systolic blood pressure and treatment status were selected as statistically significant variable to be associated with the total mortality for 12 years.

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