• 대한물리치료과학회지
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• 제9권4호
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• pp.95-104
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• 2002

This study investigated effect to injure cerebrovascular accident patients who divided cerebral hemorrhage and cerebral infarction of sex the distinct on as a result of body composition. cerebral infarction patients of cerebrovascular accidents were observed the higher ratio than cerebrovascular hemorrhage patients. Experimental group were sixteen subjects who had received. we used assessment instruments such as in body to assess body composition. The result were as follows; 1. Change in body composition according to the come of onset, there were not differenced significantly between two groups. 2. Change in body composition according to the sex, the soft lean mass were differenced significantly(p<.05). but the other variations were not differenced significantly between two groups. 3. Change in body composition according to the region of paralysis, the soft lean mass were differenced significantly(p<.05). but the other variations were not differenced significantly between two groups.

• 디지털융복합연구
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• 제16권9호
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• pp.279-291
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• 2018

본 연구는 뇌혈관질환자의 미 충족 의료 발생의 위험요인을 실증하기 위한 연구이다. 이를 위해 2014년 한국의료패널 데이터를 활용해 SPSS/WIN24.0 프로그램으로 위계적 로지스틱 회귀분석을 적용하여 통계 분석을 실시하였다. Anderson 모형에 따라 소인 요인과 가능 요인을 보정해 필요 요인을 투입한 위계적 로지스틱 회귀분석의 최종 모델에서 미 충족 의료 발생에 영향을 미치는 설명변수로서 성별, 경제활동 여부, 소득, 와병 경험, 활동제한 여부, 주관적 건강상태, 만성질환 개수가 유의한 영향변수로 검증되었다. 이러한 연구 결과를 토대로 뇌혈관질환의 효과적인 관리와 치료에 필요한 실무적 정책적 시사점으로서 뇌혈관질환자의 미 충족 의료 발생률을 감소시키기 위한 전략적 방안을 뇌혈관질환 관리 대책에 포함시켜야 할 필요성, 뇌혈관질환자의 의료적 필요 충족을 위해 다양한 차원의 변수들을 고려한 포괄적 대책 마련의 필요성, 미 충족 의료 발생의 유의한 영향변수들을 중심으로 의료서비스에 대한 접근성을 높일 수 있는 구체화된 서비스 매뉴얼 제작의 필요성에 대해 제언하였다.

• Journal of Preventive Medicine and Public Health
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• 제28권2호
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• pp.473-486
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• 1995

본 연구는 뇌혈관질환의 위험요인을 규명하고, 특히 혈청 콜레스테롤 값 및 코골음과 뇌혈관질환과의 관련성을 검정하기 위하여 시도된 짝지은 병원 환자-대조군 연구이다. 환자군인 뇌혈관질환군은 1993년 12월부터 1995년 3월까지(16개월간) 경상대학교 병원 신경과에 처음 입원하는 환자로 뇌전산화 단층촬영으로 확진되는 뇌경색 74명, 뇌출혈 53명 총 127명으로 하였다. 대조군은 환자군과 비슷한 시기에 입원하는 경상대학교 병원의 신경과 이외 병동의 입원 환자중 환자군과 성(性)이 같고 연령이 5세 이내인 대상자를 환자군과 1:1 개별 짝짓기(individual matching)하여 127명을 선정하였다. 대조군은 과거에 뇌혈관질환의 병력이 없고 원칙적으로 뇌혈관질환의 잠재적 위험요인과 관계없는 질병으로 입원한 경우로만 하였다. 본 연구결과 논란이 있는 코골음과 저콜레스테롤혈증이 뇌혈관질환의 위험요인이라고 할 수 없었다. 유의한 위험요인은 심전도의 이상(좌심실비대 및 심방세동)이 가장 중요하였고, 그 외에도 뇌혈관질환의 가족력, 안저검사의 이상소견, 과거 일과성 허혈성 발작의 경험 및 혈청 콜레스테롤치의 상승이었다. 뇌경색의 위험요인은 역시 심전도의 이상이 가장 중요하였고, 그외에도 안저검사의 이상소견, 흡연 및 혈청 콜레스테롤치의 상승이었다. 이상의 위험요인을 고려할 때 뇌혈관질환을 예방하기 위해서는 고혈압의 치료가 중요하며, 특히 안저검사와 심전도 검사에서 이상소견이 나타나지 않도록 철저히 관리해야 한다. 가족력이 있는 사람들과 과거 일과성 허혈성 발작 경험자는 특히 고위험군으로서 다른 위험요인을 가지지 않도록 교육해야 한다. 또한 흡연과 고콜레스테롤 혈증의 건강에 대한 위해성도 다시 한번 강조되어야 한다. 이렇게 함으로써 보건당국은 단일 사망원인으로 우리나라에서 제1의 사망원인인 뇌혈관질환을 예방하기 위하여 더욱 노력해야 할 것이다.

• 디지털융복합연구
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• 제12권7호
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• pp.327-336
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• 2014

본 연구는 심뇌혈관 환자의 정기적 의료이용에 영향을 미치는 요인을 살펴보는 데 목적이 있다. 2010년 한국의료패널조사 자료를 이용하였으며, 설문에 응답한 응답자 중 심뇌혈관질환자 770명을 대상자로 하였다. 분석대상자의 의료이용 현황을 파악하기 위하여 기술통계를 실시하였으며, 심뇌혈관 환자의 정기적 의료이용에 영향을 미치는 요인을 파악하기 위하여 로지스틱회귀분석을 실시하였다. 연구 결과, 심뇌혈관 환자의 정기적 의료이용에 영향을 미치는 요인은 연령, 교육수준, 가구소득수준, 동반상병지수(CCI), 고위험음주 유무, 비만 유무로 나타났다. 연령별로는 60-69세, 교육수준별로는 고등학교 이상, 가구소득수준별로는 중위수 이상, 동반상병지수(CCI)가 높을수록, 고위험 음주 무, 비만인 환자가 정기적으로 의료를 이용할 확률이 높게 나타났다. 이는 정기적 의료이용이 낮은 중위수 미만 환자와 고위험 음주 유인 환자 등 문제의 원인과 대상에 맞는 구체적인 관리방안을 모색하는 노력이 필요할 것으로 보인다. 이러한 결과들은 향후 보건의료정책 수립에 기초 자료로 의미 있게 활용되어질 수 있으리라 여겨진다.

• 대한한방내과학회지
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• 제25권3호
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• pp.440-450
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• 2004

Objectives: Uwhangchungsim-won(UC) has been used in the treatment of a wide variety of conditions including stroke, hypertension, arterosclerosis, autonomic imbalance, and mental instability, in Korean traditional hospitals. The aim of this study was to evaluate the effect of DC on cerebral hemodynamics and to determine the appropriate dosage. Methods: We studied changes in hyperventilation-induced cerebrovascular reactivity and mean blood flow velocity of the middle cerebral arteries(MCAs) were studied by means of transcranial Doppler ultrasound. Changes in mean blood pressure, pulse rate and expiratory CO2(PECO2) were observed using Cardiocap TM/5. Six healthy young volunteers who were administrated with full doses of DC for group A, and half doses for group B. Six other healthy subjects comprised the control group. The evaluation was performed during basal condition, and repeated at 20, 40, 60, 120, and 180 minutes after administration. Results: Increases of cerebrovascular reactivity and mean blood flow velocity in the middle cerebral artery in group A were significantly different compared with group B and the control group (p<0.1). Mean blood pressure, pulse rate and expiratory CO2 did not change during the observation and were not different among these three groups. We observed that in cerebrovascular reactivity induced hyperventilation, group A was most effective at 40 minutes after administration, and its effectiveness lasted for 120 minutes. Conclusions: This study provides evidence for UC, in full doses, as an agent for dilation of the cerebral arteriols to increase hyperventilation-induced cerebrovascular reactivity as a consequence of faster recovery of blood flow velocity.

• 가정간호학회지
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• 제2권
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• pp.35-51
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• 1995

This study was done to define nursing diagnose and to test the validity of the characteristics for patients with cerebrovascular accidents being seen at home by home health care nurses. This study was a descriptive study. The sample consisted of 10 experts(professors and home health care nurses) who had had a variety of experience using nursing diagnoses in clinical practice, and 336 nurse progress notes for 18 patients with cerebrovascular accidents. First, 32 nursing diagnoses were defined by the analysis of 336 nurse progress notes, and ten nursing diagnoses were selected according to a criteria of frequency and four nursing diagnoses from home health care clinical practice. Second, content validity was examined by an expert group which considered the sign / symtoms of the fourteen nursing diagnoses. The instrument used for this was a checklist for sign / symtoms based on the nurse progress notes and literature : Carpenito(1993), Kim Cho Ja et al (1994), Lee Sun Ok et al.(1994), Kim Mae Ja et al. (1992), Seoul University Hospital (1993) , Kim Mi Ja et al. (1991). The data were collected from March 1995 to April 1995. Data were analyzed using Content Validity Incidence where if 80% or more of the expert group agreed, characteristics were defined as a major sign/symtoms, if between 50% and 79% of the expert group agreed with the characteristic it was defined as a minor sign / symtoms. The results of this study are summarized as follows : 1. Thirty-two nursing diagnoses related to patients with cerebrovascular accidents were defined. There was a high frequency for the following : 'Potential for disuse syndrome (61%)', 'Impaired physical mobility(50%)', 'Impaired skin integrity (44.4%)', Potential for aspiration(33.3%)', 'Potential for infection: respiration(33.3%)', 'Self-care deficit : bathing /hygine(27.8%)', 'Ineffective family coping(22.2%)', 'Potential for trauma(22.2%)', 'Alteration in nutrition: less than body requirements(22.2%)'. The following diagnoses were also used in home health care clinical practice : 'Anxiety in family (50%)', 'Caregiver fatigue(27.8%)', 'Ineffective treatment behavior (22.2%)', 'Ineffective Levin tube management and Levin tube feeding(22.2%)'. Fourteen nursing diagnoses were selected. 2. Ten of the nursing diagnoses for patients with cerebrovascular accident were listed as nursing diagnoses by NANDA but four nursing diagnoses were new nursing diagnoses used in home health care clinical practice. 3. Characteristics of the ten Nursing Diagnoses from NANDA were developed from the sign /symtoms in the literature and in the nurse progress notes. These characteristics was verified as major or minor sign / symtoms by the expert group. 4. Characteristics of the four nursing diagnoses used in home health care were not defined by the literature but only by the nurse progress notes and verified as major or minor signs /symtoms by the expert group. On the basis of the findings of this study, the following recommendations are made : 1. Continual study is necessary to identify other signs /symtoms not verified in this study. 2. It is necessary to use verified signs /symtoms in home health care clinical practice. 3. It is necessary to define related factors which define each diagnoses in this study. 4. It is necessary to develop of standardized nursing are plans which include defined signs and symtoms. 5. It is necessary to study the outcomes of the standardized nursing care plans.

• 대한한방내과학회지
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• 제44권3호
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• pp.439-454
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• 2023

Objectives: As Korea transitions into an aging society, the incidence of cerebrovascular disease is expected to increase. Herbal medicine is commonly used in Oriental medicine to treat cerebrovascular disease. However, there is insufficient clinical evidence to actively support the safety of herbal medicine in clinical practice. Therefore, the aim of this study was to determine the toxicity and safety of four herbal medicines (Cheongsimyeonja-tang, Dodam-tang, Hyeolbuchukso-tang, and Boshiniknai-tang) in patients with cerebrovascular disease. Methods: This study used electronic medical records to analyze patients admitted to an oriental medicine hospital from April 1, 2017, to December 31, 2020. Liver and renal function values at the time of admission and discharge were compared. Results: A total of 25 patients were included in this study. We found no significant differences in various variables, such as complete blood count, liver-renal function test, and urine, before and after the administration of the four herbal medicines. Additionally, no significant adverse events related to herbal medicine were observed. Conclusions: This study confirmed the safety of the four herbal medicines in patients with cerebrovascular disease who were hospitalized in a single Oriental medicine hospital.

• Annals of Clinical Neurophysiology
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• 제14권1호
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• pp.20-24
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• 2012

Background: Migraine patients can be sensitive to external or internal stimuli, such as light, noise, or hormonal changes. Using transcranial Doppler ultrasonography (TCD) with breath-holding method, we evaluated the changes of cerebrovascular reactivity (CVR) to hypercapnia in women with migraine without aura between fasting and postprandial period. Methods: Twelve women with migraine without aura and the same number of age and sex-matched healthy controls with no significant history of headache participated in this study. Using TCD examinations, we studied mean flow velocity in middle cerebral artery with better temporal window. Each subject was examined consecutively before and after a standard meal, together with serum glucose level and blood pressure. CVR was evaluated with breath-holding index (BHI). Results: Postprandial-BHI (mean+SD) was significantly higher than fasting-BHI (mean+SD) in patients group but not in controls (in patient group; postprandial-BHI=1.38, fasting-BHI=1.08, in control group; postprandial-BHI=1.25, fasting-BHI=1.18, P=0.021 and 0.239, respectively). After meal, serum glucose level was significantly enhanced but blood pressure was not in both groups. Serum glucose level of patients showed a tendency of mild positive correlation with BHIs (${\gamma}$=0.448, P=0.032). Conclusions: Although exact mechanisms are unclear, cerebrovascular reactivity of some women with migraine without aura may be influenced by prandial state.

• 한국응급구조학회지
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• 제24권1호
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• pp.37-55
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• 2020

Purpose: The purpose of this study was to provide basic data for improving the response capacity of 119 EMS systems by analyzing the effects of particulate matter on cardio-cerebrovascular and respiratory symptoms in the pre-hospital stage. Methods: We examined 46,389 patients who transferred to the hospital with complaints of cardiopulmonary arrest and cardio-cerebrovascular and respiratory symptoms by 119 ambulances in Incheon from 2016 to 2018. Results: The probability of 119 emergency dispatch for patients with cardiopulmonary arrest increased 2.8-4.0% from the day of symptom onset until two days before hospital presentation as particulate matter 10㎛ or less in diameter(PM₁₀) increased by 10㎍/㎥ (OR=1.028; 95% CI=1.014-1.041, p=0.000, lag 0), (OR=1.040; 95% CI=1.024-1.056, p=0.000, lag 1), (OR=1.032; 95% CI=1.016-1.049, p=0.000, lag 2). Meanwhile, emergency dispatch increased 3.6-6.1% for PM_2.5 in creased by 10㎍/㎥ (OR=1.046; 95% CI=1.024-1.068, p=0.000, lag 0), (OR=1.061; 95% CI=1.035-1.088, p=.000, lag 1), and (OR=1.036; 95% CI=1.010-1.063, p=0.006, lag 2). Conclusion: Emergency medical technicians (EMTs) who respond to 119 calls should rapidly and accurately evaluate patients and provide professional emergency care by identifying the characteristics of the vulnerable groups relative to particulate matter size. To prevent the occurrence and exacerbation of symptoms caused by particulate matter, EMTs should be prepared and equipped with a response system for high particulate matter in the EMS system.

• Journal of Korean Neurosurgical Society
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• 제49권1호
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• pp.20-25
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• 2011

Objective: Due to longer life spans, patients newly diagnosed with unruptured intracranial aneurysms (UIAs) are increasing in number. This study aimed to evaluate how management of UIAs in patients age 65 years and older affects the clinical outcomes and post-procedural morbidity rates in these patients. Methods: We retrospectively reviewed 109 patients harboring 136 aneurysms across 12 years, between 1997 and 2009, at our institute. We obtained the following data from all patients: age, sex, location and size of the aneurysm(s), presence of symptoms, risk factors for stroke, treatment modality, and postoperative 1-year morbidity and mortality. We classified these patients into three groups: Group A (surgical clipping), Group B (coil embolization), and Group C (observation only). Results: Among the 109 patients, 56 (51.4%) underwent clipping treatment, 25 (23%) patients were treated with coiling, and 28 observation only. The overall morbidity and mortality rates were 2.46% and 0%, respectively. The morbidity rate was 1.78% for Clipping and 4% for coiling. Factors such as hypertension, diabetes mellitus, hypercholesterolemia, smoking, and family history of stroke were correlated with unfavorable outcomes. Two in the observation group refused follow-up and died of intracranial ruptured aneurysms. The observation group had a 7% mortality rate. Conclusion: Our results show acceptable favorable outcome of treatment-related morbidity comparing with the natural history of unruptured cerebral aneurysm. Surgical clipping did not lead to inferior outcomes in our study, although coil embolization is generally more popular for treating elderly patients, In the treatment of patients more than 65 years old, age is not the limiting factor.