• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.73-83
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• 2024

Objective : The Act on Life-Sustaining Treatment (LST) decisions for end-of-life patients has been effective since February 2018. An increasing number of patients and their families want to withhold or withdraw from LST when medical futility is expected. This study aimed to investigate the status of the Act on LST decisions for patients with acute cerebrovascular disease at a single hospital. Methods : Between January 2017 and December 2021, 227 patients with acute cerebrovascular diseases, including hemorrhagic stroke (n=184) and ischemic stroke (n=43), died at the hospital. The study period was divided into the periods before and after the Act. Results : The duration of hospitalization decreased after the Act was implemented compared to before (15.9±16.1 vs. 11.2±18.6 days, p=0.127). The rate of obtaining consent for the LST plan tended to increase after the Act (139/183 [76.0%] vs. 27/44 [61.4%], p=0.077). Notably, none of the patients made an LST decision independently. Ventilator withdrawal was more frequently performed after the Act than before (52/183 [28.4%] vs. 0/44 [0%], p<0.001). Conversely, the rate of organ donation decreased after the Act was implemented (5/183 [2.7%] vs. 6/44 [13.6%], p=0.008). Refusal to undergo surgery was more common after the Act was implemented than before (87/149 [58.4%] vs. 15/41 [36.6%], p=0.021) among the 190 patients who required surgery. Conclusion : After the Act on LST decisions was implemented, the rate of LST withdrawal increased in patients with acute cerebrovascular disease. However, the decision to withdraw LST was made by the patient's family rather than the patient themselves. After the execution of the Act, we also observed an increased rate of refusal to undergo surgery and a decreased rate of organ donation. The Act on LST decisions may reduce unnecessary treatments that prolong end-of-life processes without a curative effect. However, the widespread application of this law may also reduce beneficial treatments and contribute to a decline in organ donation.

• Research in Community and Public Health Nursing
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• v.24 no.2
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• pp.111-122
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• 2013

Purpose: This study was conducted to evaluate effects of a comprehensive lifestyle improvement program for middle-aged women with cardio-cerebrovascular disease (CVD)-related risk factors. Methods: The research adopted a non-equivalent control group pretest-posttest design. The number of participants was 18 in the experimental group and 16 in the control group sampled among middle-aged women who had CVD-related risk factors residing in a community. The experimental group participated in a four-session comprehensive lifestyle promotion program, which consisted of lectures, demonstrations, small-group meetings and telephone-counseling. The effects of the program were evaluated by measuring knowledge, attitude, health behavior, and self-efficacy for CVD prevention. Results: The experimental group showed a significant increase in self-efficacy for CVD prevention compared to the control group. There was no significant increase in knowledge, attitude, and health behavior. Conclusion: The results suggest that the comprehensive lifestyle improvement program was effective in improving self-efficacy for CVD prevention. There is a need to develop more effective lifestyle improvement programs designed to improve knowledge, attitude, and health behavior for CVD prevention. In further research, a follow-up evaluation is also needed to investigate any delayed effects on targeted variables among which no significant differences emerged immediately after the completion of the program.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.44-52
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• 2016

Background: This study investigates the perception of the general public regarding the concentration to metropolitan, hospitals of cardiac and cerebrovascular surgeries, and the perceived public need for government policies to resolve this issue. Methods: A total of 800 participants were recruited for our telephone interview survey. Quota sampling was performed, adjusting for age and sex, to select by various geographic regions. Sampling with random digit dialing was performed; we called the randomly generated telephone numbers and made three attempts for non-responders before moving on to a different telephone number. Results: Our sample population was 818 participants, 401 men (49.0%) and 417 women (51.0%). Our data showed that 85.5% of participants thought that cardiac surgery and neurosurgery patients are concentrated in large hospitals in Seoul. The principle reason for regional patients to want to receive surgery at major hospitals in Seoul was because of poor medical standards associated with regional hospitals (87.7%). We found that a vast majority of participants (97.5%) felt that government policies are needed to even out the clustering of cardiac surgery and neurosurgery patients, and that this clustering may be alleviated if policies that can specifically enhance the quality and the capacity of regional hospitals to carry out surgeries are adopted (98.3%). Conclusion: Government policy making must reflect public desiderata, and we suggest that these public health needs may be partially resolved through government-designated cardiac and neurosurgery specialist hospitals in regional areas.

• Korean Journal of Acupuncture
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• v.21 no.1
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• pp.15-27
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• 2004

Objectives : Acupuncture has been used to prevent and treat the cerebrovascular accident, such as a stroke, and many studies of acupuncture and moxibustion concerning to the stroke have been undertaken in the human and various animals. Also, herbal acupuncture, namely aqua acupuncture has been applied and developed to various diseases including the cerebrovascular accident. FOLIUM ARTEMISIAE ARGYI is the dry leaf of Artemisia argyi Levl. et Vant. collected in summer before the plant blooms and used to moxibustion and has been recommended for use as an analgesic and hemostatic. In this study, effects of FOLIUM ARTEMISIAE ARGYI (艾葉)' herbal acupuncture on the $LR_3$, namely Taechung on neuroprotection after the transient forebrain ischemia were investigated in Sprague-Dawely rats. Methods : Expressions of neuronal nitric oxide synthase (nNOS) protein in the hippocampus and cortex were observed at 2 hrs after transient forebrain ischemia by immunohistochemistry. Results : Expression of nNOS protein was increased in the hippocampus and cortex at 2 hrs after transient forebrain ischemia. However, pretreatment with FOLIUM ARTEMISIAE ARGYI' herbal acupuncture on $LR_3$ significantly decreased expression of nNOS protein protein compared to ischemia group. These features were observed in the motor cortex and the hippocampus. Conclusions : These results suggest that pretreatment with FOLIUM ARTEMISIAE ARGYI' herbal acupuncture on $LR_3$ inhibits the expression of nNOS protein induced by transient forebrain ischemia and may modulate excitatory toxicity of neuron related to neuronal cell death.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.302-328
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• 1996

I . Objective and significance of the study To design a data acquisition chart, which facilitates data collection and analysis. The chart is also useful for solving problems that arise from personal variations in clinical symptoms and filling the knowledge base of an expert system. II. Content and scope 1. Collect the diagnosis knowledge of cerebrovacular diseases from doctors and analyze it. 2. Design a data acquisition chart. 3. Compare ODS and doctors with respect to their diagnosis results 4. Select patients who are determined to suffer from cerebrovascular diseases using CT(computed tomographic) scan, collect clinical data from them. III. Results and Application The chart be used for data collection and analysis in different medical hospitals, The results of data analysis facilitates collecting clinical data about other diseases and implementing the knowledge base. Also, the collected data serves as a tool for medical education, and cooperative diagnosis of oriental and western medical doctors.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.705-713
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• 2020

Arteriosclerosis is a disease in which blood circulation is impaired due to loss of elasticity as blood vessels become narrower, and is a potential cause of recently increasing cardiovascular and cerebrovascular diseases. Carotid ultrasound is used as a predictor of cardiovascular and cerebrovascular diseases by evaluating the degree of atherosclerosis. Therefore, this paper attempted to investigate the correlation between the increase in the thickness of the inner media and various clinical variables in carotid ultrasound. Patients with carotid ultrasound findings were classified into three stages: mild intima thickening, sclerosis, and significant stenosis. CAVI (Carotid Ankle Vascular Index: vascular age) data measured in the degree and physical characteristics of the carotid artery(gender, age, body mass index, blood pressure), blood test(total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, creatine phosphokinase, fasting blood sugar), and arteriosclerosis test were collected. It was confirmed that the carotid intima thickness was correlated with variables such as hypertension, hyperlipidemia, and BMI, and also correlated with the risk factors of cardiovascular disease as CAVI increased.

• Journal of Preventive Medicine and Public Health
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• v.40 no.5
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• pp.397-403
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• 2007

Objectives: The prevalence of metabolic syndrome has recently increased, Payments from the Korea Labor Welfare Corporation for compensation for mortality in workers caused by cardiovascular and cerebrovascular diseases have also increased in Korea in recent years. The association of metabolic syndrome and cardiocerebrovascular disease has been investigated by several researchers in recent studies, This study was conducted in an attempt to characterize the relationship between metabolic syndrome and Korean cardiocerebrovascular disease risk assessment, and to provide basic data to group health practices for the prevention of cardiocerebrovascular disease. Methods: Health examinations were previously conducted for 1526 male researchers at a private laboratory. The prevalence by age and the odds ratio of metabolic syndrome scores into the "cardiocerebrovascular risk group" (sum of low, intermediate, and high risk groups) of the Korean cardiocerebrovascular disease risk assessment were assessed, in an effort to elucidate the associations between metabolic syndrome and cardiocere brovascular disease risk assessment. Results: The prevalence of metabolic syndrome and inclusion in the cardiocerebrovascular risk group was 11,7% and 22.1% respectively. The severity of metabolic syndrome and cardiocerebrovascular risk assessment showed that individuals in their 40's and 50's were at higher risk than those in their 30's (p<0,001). The age-adjusted odds ratio of metabolic syndrome to cardiocere brovascular risk group inclusion was 5.6. Conclusions: An active prevention program for cardiocerebrovascular disease needs to begin in the 40's, as the prevalence of metabolic syndrome and the risk group of cardiocerebrovascular risk assessment peak in the 40's age group. The odds ratio between metabolic syndrome and the cardiocerebrovascular risk group was high, which indicates that metabolic syndrome scores should be utilized as guidelines during the consultation and behavioral modification program for the workplace prevention of cardiocerebrovascular diseases in group health practices.

• Journal of radiological science and technology
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• v.26 no.4
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• pp.33-38
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• 2003

The purpose of this study was to examine how lacunar infarction developed and what its characteristics were. As this disease had little noticeable clinical symptoms and is likely to draw less attention than other types of cerebrovascular diseases like panhemispheric infarction, it‘s difficult to make an early diagnosis of it or treat it successfully. The subjects in this study were 196 people who showed no clinical symptoms and took a MRI test. When the MRI test data were analyzed, signal intensity and the part where that disease was detected were primarily taken into account. As a result, it's found that 116 people had no lacunar infarction and 80 people suffered from that disease, including 13 with very mild lacunar infarction, 41 with mild lacunar infarction and 26 with lacunar infarction. However, very mild and mild lacunar infarction could not be viewed as clinically significant cases, and only 26 people, which accounted for 13 percent of the subjects, should be considered to be diagnosed with lacuanr infarction. The most common part where that disease was found was white matter and basal ganglia, regardless of gender. Accordingly, those who are exposed to health hazards such as hypertension or diabetes should take a MRI test to prevent cerebrovascular diseases that might be caused by those illnesses.

• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1193-1203
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• 2006

Purpose: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. Method: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. Result: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequoia of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (${\fallingdotseq}$ 48 $, 1 $=960 Won). The costs ranged from 74,523 Won (${\fallingdotseq}$78 $, loss of chronic kidney function, N18) to 32,270 Won (${\fallingdotseq}$34 $, other cerebrovascular diseases, 167). Conclusion: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

• Toxicological Research
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• v.23 no.4
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• pp.311-319
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• 2007

Elevated blood levels of homocysteine (a sulfur-containing amino acid) have been linked to increased risk of cerebrovascular disease including Alzheimer's disease. A recent study suggests that elevated homocysteine levels may lead to replicative senescence in vitro called 'permanent arrest of cell cycle' caused by oxidative stress. In this study, serum homocysteine level in rat was reduced by Lentinus edodes-powder diet, resulting in the reduced level of oxidative stress in rat brain. In addition, homocysteine-induced replicative senescence treated with or without Lentinus edodes-powder was analyzed by population doubling in vitro. The Lentinus edodes-powder induced a increased number of population doubling in primary neuron cell isolated from rat-cerebral cortex. This indicates that Lentinus edodes-powder would delay a homocysteine-induced aging of neuron cells in brain, showing a possible role in preventing cerebrovascular diseases including Alzheimer's disease.