• Investigative Magnetic Resonance Imaging
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• 제15권2호
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• pp.165-169
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• 2011

심장점액종은 심장의 가장 흔한 양성 종양이다. 하지만 국소전이와 원격전이의 증례들이 낮은 빈도로 보고되어 있다. 뇌경색을 주소로 내원한 49세 여자 환자의 심장초음파에서 심장 점액종이 발견되었으며 수술로 절제 1년 후에 구음장애가 발생하여 촬영한 자기공명영상에서 여러개의 조영증강이 되는 출혈성뇌전이 병변들이 관찰되었다. 방사선치료 후 추적 자기공명영상에서 병변의 크기들이 작아지는 것을 확인할 수 있었다. 양성 종양이지만 심장 점액종은 드물게 지연되어 전이를 보일 수 있다. 저자들은 심장 점액종을 수술로 완전히 절제 후 지연되어 나타난 뇌전이를 경험하여 증례 및 문헌고찰을 하는 바이다.

• The Journal of Korean Physical Therapy
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• 제13권1호
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• pp.33-40
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• 2001

Objectives: This study was to identify the effect of physical therapy and related factors on depression in stroke patients. Methods: Questionnaires were completed by 46 stroke patients at physical therapy room in Busan Dongeui Medical Center from September 1999 to April 2001. The self·rating depression scale(SDS)was used to assess the differences for depression score in patients who had suffered a stroke. The design of this study was follow-up study between initial physical therapy and one month after initial. Results: A little decreased score(-0.17) was seen in patients treated with physical therapy in difference of depress between initial physical therapy and one month after initial, but there was no significant difference. In gender, male had -0.42 decreased score, female. on the contrary, had +0.09 increased score. Depress score for 50 years group was decreased(-2.08), but below 50 years and above 60 were increased in age (+1.25 and +0.27, respectively). There were no significant difference in weight, educational level, religion, side of paresis, and diabetes. Significant variables related to difference of depress in multiple regression analysis were weight(p=0.0082)and diagnosis(cerebral infarction, hemorrhage)(p=0.0473, R2=0.4241). Conclusions: This study was indicated that the more weight was a higher, the higher difference of depress score was. Difference of hemorrhage patients was smaller than that of infarction patients.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.128-135
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• 2001

Background : Tremor is uncommon manifestation of stroke. Therefore a few cases have been reported until now. There is still uncertainty about the characteristics of post-stroke tremor. Furthermore the pathogenesis and responsible structures of post-stroke tremor are not precisely known. We have recently experienced 34 cases of post-stroke tremor for the past 6 years. We analysed the clinical features and electrophysiologic findings of post-stroke tremor to evaluate the general characteristics and to analogize the possible pathogenetic mechanisms of post-stroke tremor. Methods : The clinical characteristics of post-stroke tremor were summarized in according to the onset time, involved body parts, types, tremor frequencies, neuroradiologic findings, and associated symptoms. The tremor frequencies were recorded by using a gyroscope. The spectral analysis of tremor frequencies were done automatically with Motus I soft ware. Results : Tremor onset were remarkably varied. Some patients showed a tremor appearing at the onset of a stroke and other patients showed delayed-onset tremor 10 years after a stroke. Tremor frequencies were also much varied. The range of hand tremor frequencies were from 1.5 to 12 Hz. Lesions were found in 31 cases(infarction 27, hemorrhage 4) on neuroimaging. In the cases of cerebral infarctions, 7 cases showed multiple small vessel diseases and 20 cases showed cerebral vessel lesions. The most commonly involved cerebral vessel lesion was the middle cerebral artery territory Several different clinical patterns of post-stroke tremor were identified. Conclusions : There are some evidences from the data summarized here to suggest that several pathogenetic mechanisms including central oscillators could be involved for the development of tremors and that tremor generating neural circuits could be more complex than previously suggested neural circuits.

• Tuberculosis and Respiratory Diseases
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• 제44권5호
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• pp.1177-1183
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• 1997

저자들은 임상적으로 신장, 비장 그리고 뇌에 다발성 및 재발성 경색이 발생하여 주요 원인 질환으로 폐선암을 진단하였던 1예를 경험하였기에 문헌 고찰과 함께 이에 보고한다. 다발생 경색의 원인기전으로는 비세균성 혈전성 심내막염 또는 파종성 혈관내 응고증에 의한 in situ thrombosis 등이 추정되었다.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1346-1353
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• 1992

From Febrary 1984 to July 1992, 138 cases of multiple valve replacements were performed at the Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University. There were 81 females and 57 males, and their ages ranged from 19 to 60 years [mean age, 40.1$\pm$10.9 years]. Thirteen of these patients had undergone previous cardiovascular procedures, with an average of 76.3 months between procedures[range, 3 to 180 months]. Mitral and aortic valve replacement were done in 135 patients, 2 underwent triple valve replacement and 1 underwent mitral and tricuspid valve replacement. Associated procedures were necessary in 20 patients[14.5%]. The operative mortality was 5.8% and the most common cause was low cardiac output. Late follow-up of 83% has been accomplished in 130 early survivors, with a late mortality of 5.9%. The late mortality was due to valve thrombosis in 2 patients, cerebral infarction in 1, heart failure in 1, arrhythmia in 1, and bleeding in l. Of those patients who survived, New York Heart Association functional class improved significantly[from 70% class III and IV before to 88% class I and II after]. Actuarial survival rate including all deaths was 88.8% at 8 years. The follow-up studies revealed that thromboembolism, reoperation and bleeding rate were 1.2%/patient-year, 0.85% /patient-year and 0.57%/patient-year at 8 years postoperatively. We concluded that valve thrombosis, embolism, and anticoagulant-related hemorrhage were the main risk factors of longterm survival of patients.

• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.213-225
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• 2013

Objectives: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. Methods: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/ company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. Results: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR, 1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR, 1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. Conclusions: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.

• Journal of Korean Biological Nursing Science
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• 제18권1호
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• pp.27-35
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• 2016

Purpose: The purpose of this study was to identify the assertive behavior of asking smokers not to smoke and investigate the factors related to assertive behavior in patients with vascular diseases. Methods: Participants were 203 adult Korean patients with vascular diseases such as cerebral infarction and myocardial infarction. Data were collected using questionnaires that included the characteristics of secondhand smoke (SHS), secondhand smoke-related variables (Health belief model factors, health promotion model factors) and level of assertive behavior. Descriptive statistics, t-test, ANOVA and multiple regression using SPSS/WIN 18.0 were performed. Results: Participants who never ask smokers not to smoke was 39.9%, whereas participants who always ask was 7.4%. There was a weak positive relationship between assertive behavior and susceptibility to disease (r=.18), severity of disease (r=.19), benefit of assertive behavior to SHS exposure (r=.10), barrier of assertive behavior to SHS exposure (r=.24), and self-rated health (r=.21) respectively. There was a moderate positive relationship between assertive behavior and self-efficacy of assertive behavior to SHS exposure (r=.49). Health belief model factors explained 15.7% variance and health promotion model factors explained 27.0% of assertive behavior. Conclusion: The findings of this study suggest that self-efficacy of assertive behavior to SHS exposure is a very important factor. Therefore the development of a program to foster self-efficacy of assertive behavior regarding SHS exposure in patients with vascular diseases is needed.

• 대한물리의학회지
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• 제8권3호
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• pp.337-342
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• 2013

PURPOSE: The Unilateral neglect is characterized by difficulty shifting attention to the side of space opposite the brain lesion and frequently reducing use of contralesional extremities. This study was to identify whether the visual deprivation was responsible for head position on unilateral neglect patient after stroke. METHODS: A patient with left middle cerebral artery infarction participated in the study. We assessed neglect using line bisection and star cancellation test. Patient was instructed to maintain correct alignment of trunk and head in a sit position. We evaluated degree of head lateral tilting and rotation. Then, patient was blocked visual input. Also, we evaluated head position in the same way. RESULTS: He scored 3 points in the line bisection test and 9 points star cancellation test. In postural evaluation, he had deviated posture such as lateral head tilting and rotation. After visual cue deprivation, patient showed different head position which was decreased degree of head tilting and rotation. CONCLUSION: For vertical body orientation, it was used multiple sensory references including the vestibular, somatosensory, and visual system. This finding suggested that abnormal posture of neglect patient could be related to the visual input. It has important clinical implications in terms of understanding the neglect.

• Tuberculosis and Respiratory Diseases
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• 제77권1호
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• pp.34-37
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• 2014

Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.

• 핵의학기술
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• 제16권1호
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• pp.17-26
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• 2012

[목적] 본 연구는 화학적으로 안정된 $^{99m}Tc$-HMPAO (d, l-hexamethylpropylene amine oxime) 방사성 의약품을 사용한 환자 가운데 뇌조직 추출률이 떨어져 영상의 질이 저하되었던 환자를 대상으로 $^{99m}Tc$-HMPAO 방사성 의약품 외의 요인으로 뇌조직 추출률에 변화가 일어나는 요인을 알아보고자 한다. [대상 및 방법] 2010년 1월부터 2010년 12월까지 대뇌경색(Cerebral infarction, CI)에 의한 $^{99m}Tc$-HMPAO 뇌혈류 SPECT 검사를 시행한 환자 272명 가운데 뇌조직 추출률이 떨어졌던 환자 23명(연령 $55.3{\pm}9$세, 남 21명, 여 3명)을 대상으로 하였다. 대상환자는 정상 뇌조직 추출률을 보인 환자와 검사를 동시에 진행하여 같은 $^{99m}Tc$-HMPAO 방사성의약품을 사용함으로써 화학적 안전성을 확인하였다. 대상환자의 연령, 성별, 혈압, 당뇨 수치, 검사 시 사용 약물, 검사시 환자상태, 과거 검사 시 CT/MRI 조영제 부작용 이력, 과거 SPECT 검사를 시행한 환자의 전과 후 검사 영상을 비교하여 뇌조직 추출률에 영향을 미치는 요인과의 상관관계를 분석하였다. [결과] 다중선형회귀분석(Multiple Linear Regression)의 결과, 성별 및 전, 후 검사 영상을 제외한 6가지 사항에서는 특이한 상관관계를 발견할 수 없었다($p$>0.05). 남성 91.3%, 여성 8.7%로 남성이 여성보다 뇌조직 추출률이 떨어졌다고 보인다. 비모수 검증을 이용한 전과 후 검사 영상에서는 유의미한 차이를 나타내지 않았다($p$>0.05). 결과적으로 전과 후 검사 영상에서 비슷한 뇌조직 추출률을 나타냈으며 환자 개인에 따라 뇌조직 추출률에 변화가 있음을 확인하였다. [결론] 화학적으로 안정된 $^{99m}Tc$-HMPAO 방사성 의약품의 사용도 환자의 개인적인 특성 및 체질에 따라서 뇌조직 추출률이 떨어지는 유의한 요인임을 확인하였다. 앞선 $^{99m}Tc$-HMPAO 뇌혈류 SPECT 관련 논문을 참고할 때 뇌혈관 질환 중 측부 순환로에 의한 요인이 추측되지만, 환자에 따라 뇌조직 추출률이 떨어지는 정확한 요인은 알 수 없었다. 그러나 $^{99m}Tc$-HMPAO SPECT 검사가 뇌질환에 따른 경과 추적에 유용한 검사이며 추적 검사 시 뇌조직 추출률이 떨어지는 환자에 대한 정보를 검사에 반영하여 정확한 검사와 판독에 도움을 줄 것으로 생각한다.