• Title/Summary/Keyword: cerebrovascular diseases

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Analysis of the Factors Affecting Canalith Repositioning Maneuver Treatment of in Posterior Canal Benign Paroxysmal Positional Vertigo of a Dizziness Patient (뒤반고리관 양성발작성 두위현기증 어지럼증 환자 이석정복술 치료에 영향을 주는 인자 분석)

  • Kim, Chul-Seung
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.267-274
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    • 2018
  • Posterior canal benign paroxysmal positional vertigo (PCBPPV) is the most common disease among patients who visited the st. Carollo hospital dizziness center with the head suddenly feeling rolling or rotational dizziness caused by head and body movements. Most patients showed improvements in symptoms after a single treatment. On the other hand, there are more causes requiring multiple treatments. This study examined the factors affecting the canalithiasis repositioning maneuver for symptom recovery of dizziness, which is posterior BPPV. Dizziness patients who visited the dizziness center of PCBPPV were classified. From March 2008 to November 2010, the cure rate of 165 posterior BPPVs patients was investigated. The success rate after the first, second, third, and further treatments was 57.6%, 17.6%, 10.3%, and 14.5%, respectively. The factors affecting treatment of PCBPPVs included traumatic, medical disease, cerebral infarction, small vessel disease, vestbro basilar artery insufficiency (VBI), cerebrovascular disease, brain disease, and vestibuloplasty (P<0.05). Vomiting, nausea, and syncope can be treated easily by considering the factors affecting these treatments. If the related diseases are combined with the treatment of the canalithiasis repositioning maneuver for symptom recovery of dizziness, the results will show an improvement in daily life that is free from painful dizziness.

Characteristics of patients with decreased mental status while staying in an emergency department: Comparative study with alert patients (응급실 체류 중에 의식이 저하된 환자의 특성: 의식명료 환자와의 비교연구)

  • Moon, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.10
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    • pp.222-230
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    • 2018
  • This was a retrospective study that compared the characteristics of patients with decreased mental status (DMS) during their stays in an emergency department (ED) with that of patients with alert mental status (AMS). The participants in this study consisted of 90 patients with DMS who were staying in an ED along with 100 randomly selected patients with AMS. The DMS group contained more instances of cerebrovascular disease, liver disease, diabetes, and hypertension compared to the AMS group (p=0.001, p=0.003, p<0.001, and p=0.002, respectively). With regard to triage, the DMS group had higher severity than the AMS group (p<.001). The final diagnosis for the DMS group was as follows: 64.9% neurological and 63.3% related to the digestive system, which differed from that of the AMS group (p<.001). Fifty-six (62.2%) patients with DMS had their statuses discovered by nurses, while nine patients in the DMS group had received cardiopulmonary resuscitation. These results suggest that ED nurses frequently assess the consciousness of patients who they suspect may have neurologic or digestive diseases and are classified as high severity, even when the patients are alert.

The Stress Perception, Depressive Symptoms and Medical Comorbidity in Healthcare Center (대학병원 건강검진센터 내원자의 스트레스 지각 정도, 우울 증상 및 신체질환 이환율)

  • Shim, In-Bo;Joe, Sook-Haeng;Ham, Byung-Joo;Han, Changsu;Jeong, Hyun-Ghang;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.27-43
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    • 2013
  • Objectives : We surveyed this study for knowing the relation within stress, depression and medical comorbidities, and finding the risk factors of major depression. Methods : 1764 subjects were enrolled from Jan. 2009 to Dec. 2009 who visit Korea University Guro hospital healthcare center. The subjects answered the questionnaire of PSS(Perceived Stress Scale), PHQ-9(Patient Health Questionnaire-9) and the demographic data. We categorized them as the stress group, depressive group, medical comorbidity group and analyzed the correlation analyses and logistic regression analyses. Results : 198 of 1764 subjects(11.8%) were applied to major depression, and the depressive group showed the higher mean stress score(23.19) and mean depression score(12.95) than the normal group. The total PHQ-9 score was increased by perceiving more stress, having more medical comorbidities. The subjects with female, visiting due to recent health problems, irregular exercise, current smoking, history of angina and cerebrovascular disease showed the increased risk of major depression. Conclusions : In this study, we find the PSS, PHQ-9 were valuable for mental health screening in healthcare center. As perceiving more stress and having more medical comorbidity, risk of major depression were increased. Accordingly the individuals with medical diseases or unhealthy lifestyle would need the mental health screen.

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

  • Ko Seong-Gyu;Jun Chan-Yong;Park Jong-Hyeong;Han Chang-Ho;Ko Ho-Yeon;Yoon Yoo-Sik;Choi Seon-Mi;Kim Jung-Gil;Jung Woo-Sang;Moon Sang-Kwan;Kim Yeung-Suk;Bae Hyung-Sup;Cho Ki-Ho
    • The Journal of Korean Medicine
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    • v.27 no.1 s.65
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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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The Proportional Mortality Ratios of Specific-cause Mortality by Occupation and Education among Men Aged 20-64 in Korea (1993-2004) (직업 및 교육수준에 따른 사망원인별 비례사망비의 연도별 추이: 1993-2004년 우리나라 사망등록자료의 분석)

  • Kim, Ki-Hye;Lee, Kyung-Hak;Lee, Sang-Min;Lee, Seung-Yeon;Lee, Ye-Seung;Lim, Kyoung-Ree;Chang, Jee-Eun;Cho, Sang-Won;Choi, Eun-Hye;Chung, Sung-Tae;Jin, Eun-Jeong;Son, Mi-A
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.1
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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.

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

  • Kim, Ki-Soon;Park, Jong
    • Journal of agricultural medicine and community health
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    • v.18 no.1
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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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A Panel Study on Determinants of Catastrophic Health Expenditure of the Middle- and Old-Aged Households (중·고령 가구의 과부담 의료비 발생의 결정요인에 관한 패널연구)

  • Park, Jin Yeung;Jung, Kee Taig;Kim, Yong Min
    • Health Policy and Management
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    • v.24 no.1
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    • pp.56-70
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    • 2014
  • Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.

A Study on Knowledge, Educational Needs and Educational Experience for Indwelling Catheter Management in the Families of Home Care Clients (유치도뇨관 삽입 가정간호대상자 가족의 유치도뇨관 관리에 관한 지식, 교육요구 및 교육경험)

  • Kim, Jung-Soon;Lee, Sang-Ju;Kang, In-Soon
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.12 no.1
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    • pp.92-116
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    • 2005
  • Purpose: This study was a predicative survey to provide home care clients with indwelling urinary catheters for furnishing basic educational material to their families by analyzing the family members' knowledge, educational needs and educational experience about indwelling catheter management. Method : The subjects consisted of 108 family members who cared for home care clients with indwelling catheters. Data were collected by home care nurses in nine hospitals in Pusan, who directly interviewed with them through questionnaires from Sep. 6th to 30th in 2004. The questionnaires for data collection were developed through pre-survey and reference review. The collected data was analyzed by using frequency, percentile, mean, variation, t-test, ANOVA on SPSS 10.1 package. Results : There were characters of home care clients with indwelling catheters: women(67.6%) were more than men; the average age of them was $69.60{\pm}14.99$ years old; neurogenic and cerebrovascular diseases(80.0%) were the most common disease group; 81.5% of them were totally dependent on others in terms of level of activity. Home care clients' families had these characters: women(76.9%) were more than men; the average age was $54.5{\pm}13.70$ years old; 46.3% of them were parents or sons or daughters in terms of relation with patient; tl1e average care period was $39.8{pm}34.20$ months. Level of knowledge about indwelling catheter management of the family members were 69.8% and its mean were $20.24{\pm}4.53$. Educational needs were 90.9% and its mean were $14.55{\pm}3.56$. Educational experience were 53.3% and its mean were $8.53{\pm}4.30$. 'Complications in using an indwelling catheter', 'Symptoms to call for a home care nurse' and 'Method to attach an indwelling catheter' were high ranked in both educational needs and educational experience. 'Anatomy of urinary tract', 'Functions of urinary tract' and 'Catheter placement' were low ranked in both educational needs and educational experience Level of knowledge about indwelling catheter management of the families showed a significant difference according to their age(F=5.35, p=0.01). Educational needs showed a significant difference according to care period(F=3.06, p=0.04). Conclusion: the family members' level of knowledge and educational experience about indwelling catheter management and their educational were not sufficient while their educational needs were high. In other words although the family members were acknowledged education needs, but the care for the patients with indwelling catheter weren't performed well because of their lack of related knowledge. Therefore systematic educational programs about indwelling catheter management for home care clients and their families should be made on the base of this study.

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Liver Cancer Mortality Trends during the Last 30 Years in Hebei province: Comparison Results from Provincial Death Surveys Conducted in the 1970's, 1980's, 1990's and 2004-2005

  • Xu, Hong;He, Yu-Tong;Zhu, Jun-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1895-1899
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    • 2012
  • Background and Aims: Liver cancer is a major health problem in low-resource countries. Approximately 55% of all liver cancer occurs in China. Hebei Province is one of the important covering nearly 6% of the population of China. The aim of this paper was to explore liver cancer mortality trends during past 30 years, and provide basic information on prevention strategies. Methods: Hebei was covered covered all the three national surveys during 1973-1975, 1990-1992, and 2004-2005 and one provincial survey during 1984-1986. Subjects included all cases dying from liver cancer in Hebei Province. Liver cancer mortality trend and geographic differences across cities and counties were analyzed. Results: There were 82,878 deaths in Hebei Province during 2004-2005 with an average mortality rate was 600.9/10,000, and an age-adjusted rate of 552.3/10,000. Those dying of cancer were 18,424 cases, accounting for 22.2% of all deaths, second only to cerebrovascular disease as a cause of death. Cancer mortality was 133.6/100,000 (age-adjusted rate was 119.2/100,000). Liver cancer ranked fourth in this survey with a mortality rate of 21.0/100,000, 28.4/100,000 in males and 13.35/10,000 in females, accounting for 15.7%, 17.1% and 13.4% of the total number of cancer deaths and in males and females, respectively. The sex ratio was 2.13. Since the 1970s, liver cancer deaths of Hebei province have been increasing slightly. The crude mortality rates in the four surveys were 11.3, 16.0, 17.4, 21.0 per 100,000, respectively, with age-adjusted rates fluctuating during the past 30 years, but the trend also being upwards. There is a tendency for the mortality rates to be higher in coastal than mountain areas, and is relative lower in the plain area, with crude mortality rates of 25.3, 22.1, and 19.1 per 100,000, respectively. There were no notable differences in cride data between urban and rural, but the age-adjusted mortality rate in rural was much higher. Conclusion: Our study indicated that the mortality of liver cancer in Hebei Province is lower than the national average level. There is a slightly increase trend, especially in some counties. Liver cancer is a major health problem and it is necessary to further promote prevention strategies in Hebei province.

Effects of Ramulus Uncariae Cum Uncis' Herbal Acupuncture on Transient Forebrain Ischemic Injury in Rats (흰쥐의 일과성 전뇌 허혈 손상에 대한 조구등 약침의 효과)

  • 고정수;김재효;최동옥;김경식;손인철
    • The Journal of Korean Medicine
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    • v.24 no.2
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    • pp.66-80
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    • 2003
  • Objectives : Recently, herbal acupuncture has been developed in the Korea since the earlier 1960' applied to various diseases including the cerebrovascular accident. The main characteristics of herbal acupuncture are a combination the merit of acupuncture and herbal medicine. It was not well known the therapeutic effect and the mechanism of herbal acupuncture on transient forebrain ischemic injury, although it has been used frequently in clinics. Ramulus Uncariae Cum Uncis (釣鉤藤) has been claimed to possess sedative, anti-spasmodic actions, and treat childhood epilepsy in oriental medical preparation. Also, it has been stated that Ramulus Uncariae Cum Uncis was antioxidatvie effect and neuroprotection against glutamateinduced neuronal death. Methods : In this study, effects of Ramulus Uncariae Cum Uncis' herbal acupuncture on the $GV_{20}{\;}or{\;}LR_3$, named Baek-hue or Tae-chung, on neuroprotection after the transient forebrain ischemia were investigated in Sprague-Dawely rats. Expressions of cFos, FosB and BDNF protein in the hippocampus and cortex were observed at 2 hrs and 48 hrs after transient forebrain ischemia by immunohistochemistry and ELISA technique. Results : Expression of cFos protein was increased slightly in the hippocampus and cortex at 2 hrs after transient forebrain ischemia, but FosB protein was increased highly comparing to cFos protein. However, pretreatment with Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ significantly increased expression of cFos protein and significantly decreased expression of FosB protein compared to control group, respectively. These features were observed in the motor cortex and retrosplenial granular cortex as well as the hippocampus. Especially, cFos expression was more increased at the herbal acupuncture on $GV_{20}{\;}than{\;}LR_3$, but FosB expression was more decreased in $LR_3$ group than $GV_{20}$ group. Also, pretreatment with Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ significantly increased the expression of BDNF protein in the hippocampus ($254.88{\pm}12{\;}pg/ml{\;}in{\;}GV_{20}$ group, $245.93{\pm}44.4{\;}pg/ml{\;}in{\;}LR_3$ group) and the cortex ($85.81{\pm}3.45{\;}pg/ml{\;}in{\;}GV_{20}$ group, $111.51{\pm}15.79{\;}pg/ml{\;}in{\;}LR_3$, group) compared to the hippocampus ($134.07{\pm}2.96{\;}pg/ml$) and the cortex ($61.16{\pm}4.11{\;}pg/ml$) in control group at 48 hrs after transient forebrain ischemia. Conclusion : These results suggest that pretreatment with Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ has neuroprotective effect on transient forebrain ischemia and the herbal acupunture on $GV_{20}{\;}or{\;}LR_3$ may be related to antioxidative effect and calcium channel block of Ramulus Uncariae Cum Uncis. Also, it could be mentioned there is specificity of acupoints treating ischemic injury through the difference between the herbal acupuncture of $GV_{20}{\;}and{\;}LR_3$.

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