• 제목/요약/키워드: cerebrovascular diseases

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

  • 이정욱
    • 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.

한국 경찰관들의 뇌혈관 질환 요인 분석 (Factor Analysis on Cerebrovascular Disease of Korean Police Officers)

  • 전우진;조재환
    • 한국방사선학회논문지
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    • 제7권4호
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    • pp.293-299
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    • 2013
  • 본 연구는 국내 경찰관들을 대상으로 요인별 뇌혈관 질환의 요인을 파악함으로써 추후 경찰관들의 체계적이고 효율적인 자원 관리를 위한 기초자료로 이용하고자 한다. 국립경찰병원을 방문한 경찰관을 대상으로 뇌혈관 질환 진단을 위한 영상의학과 검사 중 자기공명영상검사를 시행한 경찰관을 대상으로 분석을 실시하였다. 연구 결과 나이가 많은 사람이 적은 사람 보다 2.63배 뇌혈관 질환이 높게 나타났다. 고혈압 있는 사람의 경우는 고혈압이 없는 사람 보다 1.63배 뇌혈관 질환이 높게 나타났다. 심혈관 질환이 있는 사람의 경우는 없는 경우 보다 1.95배 높았다. 이외에 음주를 하는 사람이 안 하는 사람 보다 0.54배 뇌혈관 질환이 높게 나타났으며 Homocysteine 수치에서는 비정상인 사람이 정상인 보다 0.32배 뇌혈관 질환이 높게 나타났다.

Extracranial-Intracranial Bypass Surgery Using a Radial Artery Interposition Graft for Cerebrovascular Diseases

  • Roh, Sung-Woo;Ahn, Jae-Sung;Sung, Han-Yoo;Jung, Young-Jin;Kwun, Byung-Duk;Kim, Chang-Jin
    • Journal of Korean Neurosurgical Society
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    • 제50권3호
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    • pp.185-190
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    • 2011
  • Objective : To investigate the efficacy of extracranial-intracranial (EC-IC) bypass surgery using a radial artery interposition graft (RAIG) for surgical management of cerebrovascular diseases. Methods : The study involved a retrospective analysis of 13 patients who underwent EC-IC bypass surgery using RAIG at a single neurosurgical institute between 2003 and 2009. The diseases comprised intracranial aneurysm (n=10), carotid artery occlusive disease (n=2), and delayed stenosis in the donor superficial temporal artery (STA) following previous STA-middle cerebral artery bypass surgery (n=1). Patients were followed clinically and radiographically. Results : Bypass surgery was successful in all patients. At a mean follow-up of 53.4 months, the short-term patency rate was 100%, and the long-term rate was 92.3%. Twelve patients had an excellent clinical outcome of Glasgow Outcome Scale (GOS) 5, and one case had GOS 3. Procedure-related complications were a temporary dysthesia on the graft harvest hand (n=1) and a hematoma at the graft harvest site (n=1), and these were treated successfully with no permanent sequelae. In one case, spasm occurred which was relieved with the introduction of mechanical dilators. Conclusion : EC-IC bypass using a RAIG appears to be an effective treatment for a variety of cerebrovascular diseases requiring proximal occlusion or trapping of the parent artery.

뇌혈관질환을 동반한 진행성 핵상마비 환자의 의식수준저하에 대한 한방복합치료 증례보고 1례 (A Case Report of Complex Korean Medicine Treatments of Decreased Mental Status in a Progressive Supranuclear Palsy Patient with a Cerebrovascular Accident)

  • 강지현;김서현;김준석;장우석
    • 대한한방내과학회지
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    • 제43권5호
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    • pp.881-890
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    • 2022
  • Objectives: This study investigated the effect of complex Korean medicine treatment on decreased mental status in a progressive supranuclear palsy patient with a cerebrovascular accident. Case presentation: The patient was treated with Korean medicine composed of herbal medicine (modified Guibi-tang), acupuncture, moxibustion, and cupping combined with Western medicine (a dopamine precursor and an anticholinergic) and physical therapy. The Glasgow Coma Scale, Mini-Mental State Examination, and Hoehn and Yahr Scale were used to evaluate the effects of the treatments. After treatment, Glasgow Coma Scores increased from 9-10 to 12-13, and Mini-Mental State Examination for dementia screen scores increased from 1 to 2. The Hoehn and Yahr score remained at 5. There were no side effects of the treatment. Conclusion: This study suggests that complex Korean medicine treatments may be effective for the decreased mental status of a progressive supranuclear palsy patient with a cerebrovascular accident, but further studies are needed.

Comparing Korea Occupational Safety & Health Agency and National Health Insurance Service's cardio-cerebrovascular diseases risk-assessment tools using data from one hospital's health checkups

  • Yunrae Cho;Dong Geon Kim;Byung-Chan Park;Seonhee Yang;Sang Kyu Kim
    • Annals of Occupational and Environmental Medicine
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    • 제35권
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    • pp.35.1-35.11
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    • 2023
  • Background: Cardio-cerebrovascular diseases (CVDs) are the most common cause of death worldwide. Various CVD risk assessment tools have been developed. In South Korea, the Korea Occupational Safety & Health Agency (KOSHA) and the National Health Insurance Service (NHIS) have provided CVD risk assessments with health checkups. Since 2018, the KOSHA guide has stated that NHIS CVD risk assessment tool could be used as an alternative of KOSHA assessment tool for evaluating CVD risk of workers. The objective of this study was to determine the correlation and agreement between the KOSHA and the NHIS CVD risk assessment tools. Methods: Subjects of this study were 17,485 examinees aged 20 to 64 years who had undergone medical examinations from January 2021 to December 2021 at a general hospital. We classified subjects into low-risk, moderate-risk, high-risk, and highest-risk groups according to KOSHA and NHIS's CVD risk assessment tools. We then compared them with cross-analysis, Spearman correlation analysis, and linearly weighted kappa coefficient. Results: The correlation between KOSHA and NHIS tools was statistically significant (p-value < 0.001), with a correlation coefficient of 0.403 and a kappa coefficient of 0.203. When we compared risk group distribution using KOSHA and NHIS tools, CVD risk of 6,498 (37.1%) participants showed a concordance. Compared to the NHIS tool, the KOSHA tool classified 9,908 (56.7%) participants into a lower risk category and 1,079 (6.2%) participants into a higher risk category. Conclusions: In this study, KOSHA and NHIS tools showed a moderate correlation with a fair agreement. The NHIS tool showed a tendency to classify participants to higher CVD risk group than the KOSHA tool. To prevent CVD more effectively, a higher estimation tool among verified CVD risk assessment methods should be selected and managements such as early intervention and treatment of risk factors should be performed targeting the high-risk group.

뇌졸중에 의한 핵간 안운동 마비 6례 : 자기공명영상 소견을 중심으로 (MR Imaging of Internuclear Ophthalmoplegia due to Cerebrovascular Diseases)

  • 김숙희;이영기;하정상;변영주;박충서;김선용
    • Journal of Yeungnam Medical Science
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    • 제8권1호
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    • pp.220-230
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    • 1991
  • Internuclear ophthalmoplegia is a conjugated gaze disorder characterized by impaired adduction on the side of a lesion involving the medial longitudinal fasciculus with dissociated nystagmus of the other abducting eye. Six patients with INO(who had clinical cerebrovascular diseases) underwent MR imaging and the results were as follows : 1. The MLF lesions were identified by MR imaging in 5 cases 2. The ratio of unilateral INO to bilateral INO was 5:1 3. The nature of lesions was infarction in 4 cases and hemorrhage in 1 case 4. The sites of MLF lesion were in the midbrain in 4 cases and in the pons in 1 case 5. All 5 cases of INO identified by MR imaging had other lesion sites in addition to MLF lesion.

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지역거주 노인의 낙상에 대한 두려움과 일상활동, 신체기능간의 관계 (Fear of Falling, ADL and Physical Functioning among Senior Citizens)

  • 박지원;유혜라
    • 재활간호학회지
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    • 제9권2호
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    • pp.117-125
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    • 2006
  • Purpose: The objectives of this study were to explore the relationships between the fear of falling and daily activities, and physical functioning of older people in community. Method: A descriptive study design was used in this study. 295 people aged over 65 and living in community participated. Data of demographic characteristics, fear of falling, activity daily living, physical functioning were collected. Result: 13.2% of the participants reported that they have falling accident last one year. 75.6% of participants reported fear of falling. 67.7% of them expressed restricting activity because of fear of falling. There were no significant relationship between fear of falling and BADL(Basic Activity Daily Living) but fear of falling and IADL(Instrumental Activity Daily Living) were related. It was also found that older people with higher fear of falling expressed more pain and uncomfortable feelings especially on their lower body and had higher scores of morbidity of neurologic diseases such as neuralgia and cerebrovascular diseases. Conclusion: There were significant relationships between fear of falling and IADL, and physical functioning on lower body, and morbidity of neurologic diseases such as neuralgia and cerebrovascular diseases.

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CADASIL 동물모델의 생리학적 접근 및 연구적 가치의 예측 (Physiological approach of CADASIL animal model and its predictable implication)

  • 정성철;고은아
    • Journal of Medicine and Life Science
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    • 제16권3호
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    • pp.55-59
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    • 2019
  • Cerebral vessels are functionally and structurally specialized to provide adequate blood flow to brain which shows high metabolic rates. Cerebral hemorrhage or ischemic infarction due to cerebrovascular injury or occlusion can cause the immediate brain damage, and if not treated rapidly, can lead to serious or permanent brain damages, and sometimes life-threatening. Unlike these popular cerebrovascular diseases, there are diseases caused by genetic problems. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is one of them. CADASIL does not show the high incidence, but it is considered to be significantly affected by regional obstructiveness such as islands and therefore, to be an important genetic disease in Jeju. This paper aims to summarize the possibility of animal model research that can provide preclinical data for CADASIL disease research and to evaluate its applicability in future research plans.

Hutchison-Gilford 조로증 증후군 환아에서의 뇌 자기공명 혈관조영술 소견: 증례 보고 (Detection of Cerebrovascular Disease in a Child with Hutchinson-Gilford Progeria Syndrome Using MR Angiography: A Case Report)

  • 이재호;이하영;임명관;강영혜
    • 대한영상의학회지
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    • 제83권6호
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    • pp.1360-1365
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    • 2022
  • Hutchinson-Gilford progeria 증후군(syndrome) (이하 HGPS)은 심혈관 및 뇌혈관 질환의 조기 이환율을 갖는 드문 진행성 조기 노화 증후군이다. 임상증상은 매우 다양하여 성장 부진, 경피증, 탈모증, 골다공증과 같은 비특이적 증상 외에도 가속화된 혈관 노화에 의해 유년기 및 청소년기에 발생하는 고혈압과 심뇌혈관 질환을 포함한다. HGPS 환자에게 자기공명 혈관조영술은 무증상 뇌졸중 또는 혈관 변화를 조기에 진단하고 뇌혈관 질환의 위험성 증가를 평가하기 위해 권장된다. 이 증례 보고는 전형적인 임상 특징을 보인 5세 환아에서 유전자분석으로 확진된 국내 두 번째 HGPS이며, 뇌 자기공명 혈관조영술 소견을 제시한 국내 최초 영문 증례 보고이다.