• Title/Summary/Keyword: cerebrovascular accidents patients

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Aortic Arch Endarterectomy Associated with On-Pump Cardiac Surgery in Patients with a Mobile Arch Atheroma

  • Song, Joon Young;Choi, Jong Bum;Kim, Jong Hun;Kim, Kyung Hwa;Kim, Tae Yun
    • Journal of Chest Surgery
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    • v.52 no.2
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    • pp.112-115
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    • 2019
  • We describe aortic arch endarterectomy performed concomitantly with on-pump cardiac surgery in 2 patients with grade V arch atherosclerosis. In both patients, transesophageal echocardiographic findings led to the diagnosis of severe arch atherosclerosis associated with a mobile atheromatous plaque in the aortic arch. The severe arch atherosclerosis was managed with endarterectomy under deep hypothermic circulatory arrest. In patients with severe grade V atherosclerosis in the aortic arch, performing endarterectomy simultaneously with primary cardiac surgery may be justified as a way to reduce the risk of peripheral embolism, including cerebrovascular accidents, with minimal additional surgical risk.

Stroke Following Cervical Chuna Treatment by Nonprofessional Therapist : A Case Report (경추 추나치료 후 발생한 뇌졸중 1례)

  • 이상호;이종립;김성수
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.264-270
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    • 2000
  • The occurrence of neurologic symptoms after cervical manipulation(Chuna treatment) seems to be an uncommon event considering the large number of manipulations performed. The precise incidence is unknown, for only patients with serious complications seek medical care. We recently experienced a 3D-year-old woman who developed sudden neurologic complications after cervical Chuna treatment by a nonprofessional therapist. Whether the manipulation is the major causative factor in the subsequent stroke can be disputable and must be considered in each case. Physicians and patients, however, should be aware that cerebrovascular accidents may occur as a result of cervical manipulation.

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Clinical Study of Composite Valve Graft Replacement of the Aortic Root (대동맥 근부 복합 인공 판막 도관 치환술에 관한 임상적 고찰)

  • Park, Kwon-Jae;Woo, Jong-Soo;Cho, Gwang-Jo;Bang, Jung-Hee;Jeong, Sang-Seok
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.260-265
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    • 2010
  • Background: A composite valve graft replacement has been used for a variety of aortic root diseases. The aim of this study was to evaluate the mid-term results of this technique. Material and Method: We conducted a retrospective analysis of aortic root composite valve graft replacements in 39 patients and these procedures were done at our institution between 1992 and 2009. The mean age of the patients was $49.2{\pm}16.4$ years. The mean follow-up was $64.2{\pm}53.4$ months (maximum: 176 months). Result: There were 4 hospital deaths (8.6%) due to emergency aortic dissection and 4 late deaths owing to several causes. The causes of late death were 2 ruptures of a remnant aneurysm, 1 subdural hemorrhage and 1 paravalvular leakage. The calculated survival rate was 93.5%, 85.0% and 85.0% at 1, 5 and 10 years, respectively. There were 3 cerebrovascular accidents during the follow up period. The rate of freedom from cerebrovascular accidents was 97.0%, 92.0% and 80.0% at 1, 5 and 10 years, respectively. All of these brain accidents were hemorrhage-related complications. Conclusion: A composite valve graft replacement of the aortic root was associated with favorable results. So, this technique seems to be a good method to treat various aortic root diseases.

Analisis of chief influencing factor on aged man's cerebrovascular accidents - case control study - (노인 중풍 발생에 미치는 요인 분석)

  • Choi, Young-Mi;Ryu, Tae-Sik;Lee, Jong-Sub
    • Journal of agricultural medicine and community health
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    • v.23 no.1
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    • pp.51-64
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    • 1998
  • This study was carried out during 3 years from March 1992 to March 1995, 140 healthy people and 140 C.V.A patients were investigated, at an oriental clinic in Taejon. The data collected was analysed using a SAS. The results are as follows. 1. The Relationships between patients who have undergone one or more abortion procedures and C.V.A occurrence. A statistical significant difference was recorded between the control group and the outpatients group of P<0.05 2. Number of years after initial C.V.A diagnosis before C.V.A symptom onset. within 1 years 52% (2-3 years, 3-4 years, 4-5 years, 5 years and over) 3. Additional diseases occurring after initial stroke 1 disease 50.7% (2, 3, 4, 5 or more) 4. Alcohol Consumption "A statistical significant difference was recorded between the control group and the outpatients group of" P<0.01 5. Previous Treatment Experience for stoke outpatients Oriental Hospital, clinic 64.3% (General Hospital, clinic, a public health center drug store, home remedies, etc) 6. Exercise Frequency Outpatients Regular 28.6%, Irregular 71.4% Control sample Regular 27%, Irregular 72.9% 7. Degree of Appetite "A statistical significant difference was recorded between the control group and the outpatients group of" P<0.01 8. People who include fish in their diet "A statistical difference was recorded between the control group and the outpatients group of" P<0.01.

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The Relationship between Tongue Diagnosis and National Institute of Health Stroke Scale in Acute Stroke Patients - Multi Center Trials (급성기 중풍환자의 설진(舌診)과 National Institute of Health Stroke Scale과의 상관성 연구 - 다기관 임상연구)

  • Lee, In-Whan;Shin, Ae-Sook;Gwak, Ja-Young;Cho, Seung-Yeon;Park, Seong-Uk;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.9 no.1
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    • pp.1-7
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    • 2008
  • Objectives : We questioned whether the tongue diagnosis is effective for judging seriousness of cerebrovascular accidents. This study is about the relationship between tongue diagnosis and National Institute of Health Stroke Scale(NIHSS) in acute stroke patients. Methods : 738 subjects were recruited from the patients admitted to the department of internal medicine at Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center from April 2007 to August 2008. We looked at the tongue as in three dimensions of tongue color, tongue fur color and tongue body. And, we calculated NIHSS means according to the subtypes of three dimensions. Results : 1. In the Tongue color, from the most commom to least common colors were pale red, red, pale, bluish purple, and ect. The NIHSS mean score of red is significantly higher than pale and pale red. 2. In the Tongue fur color, white fur was the most common, and then yellow fur, etc. There is no significant difference among three subtypes in the NIHSS mean score. 3. In the Tongue body, etc. is the most common, followed by teeth-marked tongue, enlarged tongue, blood patchy tongue, and mirror tongue. The NIHSS mean score of teeth-marked tongue is significantly lower than blood patchy tongue and mirror tongue. Conclusions : The tongue color and the tongue body are useful indexes for judging seriousness of cerebrovascular accidents presented by NIHSS. But in our study, the tongue fur color was not useful. Further study is necessary on the tongue fur.

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Effects of Venesection at the Sybsun-points on Blood Pressure and Body Temperature in Patients with Stroke (중풍환자에 있어 십선용사혈이 혈압 및 체온에 미치는 영향)

  • 이경진;구본수;김영석;강준권;문상관;고창남;조기호;배형섭;이경섭
    • The Journal of Korean Medicine
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    • v.21 no.1
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    • pp.62-67
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    • 2000
  • Background and Purpose: Sybsun-points are located at the tips of all fingers, 0.1chon from the finger nails, totaling 10 points on both hands. These points have been used for emergency care, fainting, epilepsy, cerebrovascular accidents, hypertension, unconsciousness, high fever etc. The most common technique is bleeding with a needle at these points. Hypertension and fever are the main factors for stroke patients’progress. We investigated whether venesection at Sybsun-points has effects on blood pressure and body temperature in stroke patients. Materials and Methods: 79 stroke patients were enrolled in this study from 1 Jan. 1999 to 30 Sep. 1999. All of them were admitted in Kyunghee University, Hospital of Oriental Medicine. Among them, 62 patients were hypertensive people, 17 were normal. Among the hypertensive patients, 27 were stage 1,20 were stage 2, 15 were stage 3 by classification of JNC 1997. All of the hypertensive patients had been taking drugs, while the normal group did not. From 2pm to 3pm, every 30 minutes we checked patients' blood pressure and body temperature by 24ABPM and tympanic thermometer. After 30 minutes passed, we phlebotomized patients Sybsun-points with Samneung needle 2-3cc of blood. Right after the bleeding, we checked blood pressure and body temperature. After the bleeding, for the next hour and a half, we checked each patient’s blood pressure and body temperature every thirty minutes, or a total of three times. We compared the blood pressure and the body temperature before and after treatment(p<0.05). Results: 1. Venesection at Sybsun-points significantly decreased systolic blood pressure on stage 3 hypertensive patients(p<0.0l). 2. Venesection at Sybsun-points significantly decreased diastolic blood pressure on stage 3 hypertensive patients(p<0.05) 3. Venesection at Sybsun-points had no effect on the change of body temperature. Conclusions: Though further study is needed, our findings suggest that Venesection at Sybsun-points may alleviate hypertension in stroke patients.

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Clinical characteristics and treatment plan for patients with snoring and obstructive sleep apnea (코골이와 수면무호흡증 환자의 임상적 특징과 치료계획)

  • Jung, Jae-Kwang;Kim, Ki-Rim;Byun, Jin-Seok;Choi, Jae-Kap
    • The Journal of the Korean dental association
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    • v.53 no.4
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    • pp.249-258
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    • 2015
  • Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.

Mid-Term Results of Using the Seal Thoracic Stent Graft in Cases of Aortopathy: A Single-Institution Experience

  • Cho, Jun Woo;Jang, Jae Seok;Lee, Chul Ho;Hwang, Sun Hyun
    • Journal of Chest Surgery
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    • v.52 no.5
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    • pp.335-341
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    • 2019
  • Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. Results: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was $37.86{\pm}30.73$ months (range, 0-124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. Conclusion: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.

Radiological Accident and Acute Radiation Syndrome (방사선 사고와 급성 방사선 증후군)

  • Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.39-48
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    • 2011
  • In mass casualty situation due to radiological accidents, it is important to start aggressive management with rapid triage decisions. External contamination needs immediate decontamination and internal contamination should be treated with special expertise and equipment to prevent the rapid uptake of radionuclides by target organs. Acute radiation syndrome shows a sequence of events that varies with the severity of the exposure. More severe exposures generally lead to more rapid onset of symptoms and severe clinical findings. After the massive exposure, various systems of the body reflect their severe damages that can lead to death within hours or up to several months. The disease progression has classically been divided into four stages: prodromal, latent, manifest illness, and recovery or death. Three characteristic clusters of symptoms including the hematopoietic syndrome, the gastrointestinal syndrome and the cerebrovascular syndrome are all associated with the acute radiation syndrome. The standard medical management of the patients with a potentially survivable radiation exposure includes good medical, surgical and supportive measures. Specific treatment with cytokines and bone marrow transplantation should be considered. The management of internal contamination is much the same as the treatment of poisoning. The standard decontamination should be applied to reduce uptake, and the chelating agents can be administered to enhance the clearance of radioisotopes. Radioactive iodine ($^{131}I$) as one of the nuclear fission products can increase the incidence of thyroid cancer in children. Potential benefit of potassium iodide prophylaxis is greater especially in neonates, infants and small children.

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General Characteristics of CVA and Epidemic Survey of the Cause Related CVA (CVA환자의 일반적 특성 및 CVA와 관계되는 원인들의 역학적 조사)

  • Kim Woong-Gak
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.31-44
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    • 1998
  • This observation was made on 163 cases of CVA that were confirmed through survey. They were treated in the Bulgyo Oriental Hospital in Taegu from February to March 1998. The results was as follows, 1. The ration of male to female was 1:1:36 in whole groups. 2. Onset time was occurred $37.4\%$ at 06:00-12:00. $20.0\%$, 00:00-16:00. 3. Of 157 cases of cerebrovascular accidents cerebral infarction (included cerebral thrombosis & cerebral embolism) was presented in $47.4\%$, cerebral hemorrhage in $38.2\%$, subarachnoid hemorrhage in $5.1\%$, and others in $8.9\%$. 4. The most ordinary preceding disease was hypertension. 5. The family history was appeared as $12.9\%$ of the mother, $9.7\%$ of the father.(This observation was made on 155 cases) 6. The body weight of CAV patients was appeared $37.4\%$ in 51-60kg, $30.7\%$ in 61-70kg, $17.8\%$ in below 50kg, and $9.8\%$ in 71-80kg, $4.3\%$ in above 80kg. 7. Of 161 cases, $46.6\%$ did not exercise. 8. Of 163 cases, $65.6\%$ of them did not drink alcohol. 9. Of 162 cases, $63\%$ did not smoke cigarettes. 10. The food taste (food habit) of stroke patients was that they comprised a fancy as $38.0\%$ of salty food, $33.8\%$ of fresh food, and $24.7\%$ of hot food, $3.5\%$ of sweet food.(This observation was made on 143 cases) According to the above result, We must restrain salty food and control positively hypertension and in terms of CVA prevention.

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