• Title/Summary/Keyword: cerebrovascular disease

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Study of the Factors affecting Unmet Medical Needs in Patients with Cerebrovascular Diseases (뇌혈관질환자의 미 충족 의료에 미치는 영향요인 연구)

  • Lee, Jeong Wook
    • Journal of Digital Convergence
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    • v.16 no.9
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    • pp.279-291
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    • 2018
  • This study is designed to demonstrate risk factors of unmet medical care for people with cerebrovascular disease. To do this, statistical analysis was performed by using hierarchical logistic regression analysis with SPSS/WIN24.0 program using Korean Medical Panel data in 2014. In the final model of the hierarchical logistic regression analysis, which is based on Anderson's Model, adjusted for the factors of the predisposing and enabling factors, the explanatory variables affecting the unmet medical development are gender, economic activity, income level, the experience of lying in a sickbed, restriction on activity, subjective health condition, and the number of chronic diseases. Based on the results of this study, the practical and policy implications for the effective management and treatment of cerebrovascular disease should be included in the countermeasures for cerebrovascular disease, a strategy to reduce the unmet medical incidence of cerebrovascular disease, in order to meet the medical needs, the necessity of comprehensive measures considering various dimensions of variables and the influential variables of unmet medical emergence have been suggested for the necessity of making a detailed service manual that can improve accessibility to medical services.

Hepatic/Renal Safety Evaluation of Cheongsimyeonja-tang (Qīngxīn Liánzǎo Tāng), Dodam-tang (Táodàn Tāng), Hyeolbuchukso-tang (Xuè Fǔ Zhú Yū Tāng), and Boshiniknai-tang (Bǔ Shèn Yì Nǎo Tāng) for Cerebrovascular Diseases : A Retrospective Study (뇌혈관질환 환자에 대한 청심연자탕(淸心連子湯), 도담탕(導痰湯), 혈부축어탕(血府逐瘀湯), 보신익뇌탕(補腎益腦湯)의 간기능과 신기능 안전성 평가 : 후향적 연구)

  • Min-hwa Kim;Im-hak Cho;I-rang Nam;Maria Kim;Ki-beom Ku;Se-yeon Lee;Jung-nam Kwon;In Lee;Jin-woo Hong;Young-ju Yun;So-yeon Kim;Chang-woo Han;So-jung Park;Jun-yong Choi;Hyeun-kyoo Shin
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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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.

Differential Activation of Ras/Raf/MAPK Pathway between Heart and Cerebral Artery in Isoproterenol-induced Cardiac Hypertrophy

  • Kim, Hyun-Ju;Kim, Na-Ri;Joo, Hyun;Youm, Jae-Boum;Park, Won-Sun;Warda, Mohamed;Kang, Sung-Hyun;Thu, Vu-Thi;Khoa, Tran-Minh;Han, Jin
    • The Korean Journal of Physiology and Pharmacology
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    • v.9 no.5
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    • pp.299-304
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    • 2005
  • Cardiac hypertrophy contributes an increased risk to major cerebrovascular events. However, the molecular mechanisms underlying cerebrovascular dysfunction during cardiac hypertrophy have not yet been characterized. In the present study, we examined the molecular mechanism of isoproterenol (ISO)-evoked activation of Ras/Raf/MAPK pathways as well as PKA activity in cerebral artery of rabbits, and we also studied whether the activations of these signaling pathways were altered in cerebral artery, during ISO-induced cardiac hypertrophy compared to heart itself. The results show that the mRNA level of c-fos (not c-jun and c-myc) in heart and these genes in cerebral artery were considerably increased during cardiac hypertrophy. These results that the PKA activity and activations of Ras/Raf/ERK cascade as well as c-fos expression in rabbit heart during cardiac hypertrophy were consistent with previous reports. Interestingly, however, we also showed a novel finding that the decreased PKA activity might have differential effects on Ras and Raf expression in cerebral artery during cardiac hypertrophy. In conclusion, there are differences in molecular mechanisms between heart and cerebral artery during cardiac hypertrophy when stimulated with β2 adrenoreceptor (AR), suggesting a possible mechanism underlying cerebrovascular dysfunction during cardiac hypertrophy.

Cerebrovascular Reservoir and Arterial Transit Time Changes Assessed by Acetazolamide-Challenged Multi-Phase Arterial Spin Labeling Perfusion MRI in Chronic Cerebrovascular Steno-Occlusive Disease (만성 뇌혈관 협착폐색증에서 아세타졸아미드 부하 다상 동맥스핀표지 자기공명관류영상으로 평가한 뇌혈류 예비능과 동맥 통과 시간의 변화)

  • Inpyeong Hwang;Chul-Ho Sohn;Keun-Hwa Jung;Eung Koo Yeon;Ji Ye Lee;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Seung Hong Choi;Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.626-637
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    • 2021
  • Purpose To explore cerebrovascular reservoir (CVR) and arterial transit time (ATT) changes using acetazolamide-challenged multi-phase arterial spin labeling (MP-ASL) perfusion-weighted MRI in chronic cerebrovascular steno-occlusive disease. Materials and Methods This retrospective study enrolled patients with chronic steno-occlusion who underwent acetazolamide-challenged MP-ASL between June 2019 and October 2020. Cerebral blood flow, CVR, basal ATT, and ATT changes associated with severe stenosis, total occlusion, and chronic infarction lesions were compared. Results There were 32 patients (5 with bilateral steno-occlusion) in our study sample. The CVR was significantly reduced during total occlusion compared with severe stenosis (26.2% ± 28.8% vs. 41.4% ± 34.1%, respectively, p = 0.004). The ATT changes were not significantly different (p = 0.717). The CVR was marginally lower in patients with chronic infarction (29.6% ± 39.1% vs. 38.9% ± 28.7%, respectively, p = 0.076). However, the ATT was less shortened in patients with chronic infarction (-54 ± 135 vs. -117 ± 128 ms, respectively, p = 0.013). Conclusion Acetazolamide-challenged MP-ASL provides an MRI-based CVR evaluation tool for chronic steno-occlusive disease.

Primary Aldosteronism and Cerebrovascular Diseases

  • Chen, Zheng-Wei;Hung, Chi-Sheng;Wu, Vin-Cent;Lin, Yen-Hung;TAIPAI study group
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.429-434
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    • 2018
  • As diagnostic techniques have advanced, primary aldosteronism (PA) has emerged as the most common cause of secondary hypertension. The excess of aldosterone caused by PA resulted in not only cardiovascular complications, including coronary artery disease, myocardial infarction, arrhythmia, and heart failure, but also cerebrovascular complications, such as stroke and transient ischemic attack. Moreover, PA is associated more closely with these conditions than is essential hypertension. In this review, we present up-to-date findings on the association between PA and cerebrovascular diseases.

A Study on Using EAV (MERIDIAN) by Analysis of Cerebrovascular Disease Risk Factors (뇌혈관질환 위험요인과의 분석을 통한 EAV(MERIDIAN)활용에 관한 연구)

  • Kim, Young-Eun;Kim, Il-Wha;Moon, A-Ji;Kim, Nam-Kwen;Lee, Seung-Geun;Lee, Key-Sang
    • The Journal of Korean Medicine
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    • v.31 no.5
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    • pp.136-145
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    • 2010
  • Objectives: Electroacupuncture according to Voll (EAV) has been used to quantify the skin's electrical resistance and conductance over acupuncture points that, based on traditional Chinese medicine, represent the state of health or disease of the organ or tissue. However, it doesn't have enough objective data yet, so the purpose of this study was to aid in the use of EAV in analysis of cerebrovascular disease risk factors. Methods: This study researched the clinical statistics of 216 cases: cerebrovascular attack (CVA) group 43, control group 173. We measured control meridian points (CMP) on hands and feet and the cardio ankle vascular index (CAVI) which represents atherosclerosis severity, and sex, age, hypertension, diabetes, dyslipidemia, and obesity. The data were then analyzed by t-test, chi-square test and logistic regression. Results: Between the CVA and control groups, there were not statistically significant differences in CMP. However, logistic regression analysis of the presence of CVA, mean of CMP heart and lung, sex, age, DBP (diastolic blood pressure), and HDL (high density lipoprotein) cholesterol showed that the risk of CVA was 1.1 times increased with CMP heart (p=0.002), in men was 4.12 times higher than in women (p=0.001), 1.09 times higher with age (p=0.000), 1.04 times higher with DBP (p=0.045), while was lower by 0.924 times with CMP lung (p=0.005) and 0.957 times with HDL cholesterol (p=0.006). Conclusion: Although there were not clear evidence or mechanisms about EAV, this study showed that if we study EAV further, we may be able to apply EAV as an objective instrument of oriental medicine in cerebrovascular disease.

Estimation of Home Care Nursing Cost to the Patient with Cerebrovascular Disease based on a Bundle of Home Care Nursing Service (뇌혈관질환 환자군의 가정간호 행위묶음 수가연구)

  • Hong, Jin-Ui;Yun, Soon-Nyoung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.7 no.1
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    • pp.26-38
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    • 2000
  • The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

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Association of Body Mass Index with Medical Care Use and Costs - Cerebrovascular Diseases, Ischemic Heart Disease, Hypertension and Diabetes Mellitus -

  • Kim, Kyung-Ha;Noh, Jin-Won
    • International Journal of Contents
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    • v.13 no.2
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    • pp.14-20
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    • 2017
  • The purpose of this study was to investigate the association of obesity with medical care use and costs according to overall diseases, cerebrovascular diseases (CVD), ischemic heart disease (IHD), hypertension (HTN) and diabetes mellitus (DM). The final sample was a group of persons who were free of diseases mentioned above and were not underweight. Their baseline screening program data and health insurance contribution data were connected with a 7-year medical claim database. The participants were classified according to their baseline BMI into normal, overweight, obese, and severely obese groups. Given the disease type, the total costs of DM showed the largest difference in each obesity group in both males and females. Also, the pharmacy costs for DM were more relevant than any other type of service to the obesity level. Considering the high prevalence of obesity and the relevantly increased medical care use and costs, there is a need for reduction in medical costs through obesity prevention efforts.

Dietary Habits and Serum Lipid Composition in Patients with Cerebrovascular Disease in Korean (정상인과 뇌졸중 환자에서 혈청 지질조성과 식습관의 비교에 관한 연구)

  • 정현희
    • Journal of Nutrition and Health
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    • v.20 no.6
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    • pp.422-431
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    • 1987
  • Dietary habits and serum lipid composition of 80 hospitalized patients with cerebrovascular disease (CVD) were compared to those of normal subjects. CVD patients were significantly higher in BP, serum cholesterol and triglyceride levels and low4r in HDL-choelsterol which resulted in the higher ratio of serum chol/HDL-chol than normal. Patients were also lower in the relative amount of HDL fraction by electrophoresis but were higher in LDL fraction and the ratio of LDL/HDL . In Korean, the high levels of serum chol, TG and LDL with low level of HDL as well as high BP could be one of the important causing factors of CVD. However, dietary habits of patients were not significantly different from those of normal . There is a possibility that patients might have controlled their dietary habits after they realized the severeness of disease.

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Analysis on Ischemic Cerebrovascular of Middle Age and Oldest-Old Age by Using Magnetic Resonance Imaging (자기공명영상을 이용한 중년 및 초고령의 허혈성 뇌혈관 호발 부위에 대한 분석)

  • Seoung, Youl-Hun
    • Journal of Digital Convergence
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    • v.10 no.9
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    • pp.391-396
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    • 2012
  • The purpose of this study was to present basic research data to utilize magnetic resonance imaging (MRI) with analyzing intracerebral regional distributions of ischemic cerebrovascular disease of middle aged and oldest-old aged people. We retrospectively analyzed middle-aged group (average age of 44.2 year-old, 43 males, 26 females) and oldest-old aged group (average age of 84.7 year-old, 58 males, 71 females) who taken MRI screening for ischemic cerebrovascular disease from May 2006 year to January 2008 year. The intracerebral vascular were classified into 8 vessels, which anterior communication artery (ACoA), posterior communication artery (PCoA), anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), internal carotid artery (ICA), common carotid artery(CCA), and basilar artery (BA). The result of middle-aged group showed that more ischemic cerebrovascular diseases appeared in men than women, and it affected in MCA mostly. In oldest-old aged group, ischemic cerebrovascular diseases occurred evenly spaced in intracerebral region of right, left, and both vessels, and women have more than men. For men, the most occurred in ICA and for women the most occurred in MCA. Specially middle-aged group in men showed that more ischemic cerebrovascular diseases in MCA appeared than oldest-old aged group in men. It is suggested that the analysis on ischemic cerebrovascular could be helpful in the clinical diagnosis and treatment.