Objective : Transfemoral catheter angiography (TFCA) is a basic procedure in neurovascular surgery with increasing importance in surgical and non-invasive treatments. Unfortunately, resident neurosurgeons have relatively few opportunities to perform TFCA in most institutions. We report a method developed in our hospital for training resident neurosurgeons to perform TFCA and evaluate the efficacy of this training. Methods : From May 2011 to September 2011, a total of 112 consecutive patients underwent TFCA by one resident neurosurgeon supervised by two neuroendovascular specialists. Patients who underwent elective diagnostic procedures were included in this study. Patients who underwent endovascular treatment were excluded. Demographic data, indications for TFCA, side of approach, number of selected arteries, and complications were analyzed. Results : This study included 64 males and 48 females with a mean age of 51.6 (12-81) years. All procedures were performed in the angiography suite. Common indications for procedures were as follows : stroke-induced symptoms in 61 patients (54.5%), Moyamoya disease and arteriovenous malformation in 13 patients (11.6%), and unruptured intracranial aneurysm in eight patients (7.1%). Right and left femoral puncture was performed in 98.2% and 1.8% of patients, respectively. A total of 465 selective angiographies were performed without complications. Angiographic examination was performed on 4.15 vessels per patient. Conclusion : TFCA can be performed safely by resident neurosurgeons based on anatomical study and a meticulous protocol under the careful supervision of neuroendovascular specialists.
Kim, Dae-Sik;Sung, Hyun-Ho;Cho, Eun-kyung;Lee, Jong-Woo
Korean Journal of Clinical Laboratory Science
/
v.47
no.4
/
pp.188-193
/
2015
Carotid Intima-Media Thickness (CIMT) testing is a test that precisely assesses cerebrovascular and coronary heart diseases. According to many previous studies, CIMT predicts atherosclerosis and is highly correlated to cardiovascular disease risk factors. It has also been reported that CIMT is an independent predictor of risk factors for myocardial infarction and stroke. Therefore, the purpose of this study is to investigate CIMT and other independent factors through a correlation study with the clinical laboratory test results of a blood test. As a result, this study could not prove the correlation between CIMT and risk factors of cardiovascular disease (TC, TG, LDL cholesterol, and HDL cholesterol) due to an insufficient number of subjects. Nevertheless, a positive correlation was demonstrated between CIMT and ALT (p<0.05), GGT (p<0.05), Uric acid (p<0.05), and CEA (p<0.05) at a statistically significant level, suggesting a continuation of the study.
Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.
Objectives : A traditional herbal prescription, Kyung-Ok-Ko (KOK), has long been used in oriental medicine as an invigorant for age-related diseases, such as amnesia and stroke. However, the beneficial value of KOK for immune responses is largely unknown. Based on the above mentioned effects of KOK, other previous reports, and its use in traditional medicine, we hypothesized that KOK displays beneficial effects against methotrexate (MTX)-induced immune suppression. Methods : We investigated the effects of KOK (0.6 g/kg/day, oral (p.o.)) on deteriorated immunity caused by MTX (2 mg/kg/day, p.o.) in an immune suppression mouse model. MTX was fed to mice once a day for 7 days. After the immune responses of the mice deteriorated by MTX treatment, KOK in water was fed to the mice once a day for 14 days. We then measured the expression levels of various cytokines, such as T helper cell (Th1, Th2) cytokines, and the number of immune cells, such as spleen T cells, B cells, and macrophages. Results : The data showed that MTX decreased Th1 profiles (interferon $(IFN)-{\gamma}$, interleukin (IL)-2, IL-12) and the number of immune cells, and increased Th2 profiles (IL-4, IL-5, IL-13), which were normalized significantly by post-administration of KOK. However, there was no significant difference in body-weight gain between MTX- and KOK-treated mice. Conclusion : These results indicate that KOK has immune-enhancing functions and reduces immunotoxicity of MTX, suggesting that supplementation with KOK will improve immune responses clinically and be useful for the prevention of immune-related diseases.
Han Ha-Na;Song Eun-Beom;Kim Chul-Seung;Heo Ji-Un;Eom Gwang-Moon
Science of Emotion and Sensibility
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v.9
no.2
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pp.93-100
/
2006
This paper aims at the development and clinical evaluation of the wireless gyro-mouse system. The wireless gyro-mouse system is a computer interface with gyro-sensor and wireless communication, for the patients with upper-extremity disabled from the traffic accident or stroke to use the computer software i.e. internet browser. In the development, we focused on, firstly, to make the system wireless for the patients to manipulate the mouse easily even on the bed or wheelchair, secondly, to insert the gyro-sensor into a headband for easy don-and-doff and aesthetic appearance, thirdly, to devise a click switch in case of $C5{\sim}C6$ patients and a head nodding detection in case of C4 patients for sending click message to computer operating system. We performed evaluation experiment for patients with upper-extremities disabled from spinal cord injury. The results show that the displacement error of the cursor position against the target position during linear (vertical/horizontal) movement manipulation decreased with trial number. The click rate per minute also increased with trial number. This indicates the developed wireless gyro-mouse system would be more useful to the patients with repetitive use.
Hypertension is the major factor of most death and high blood pressure (BP) can lead to stroke, myocardial infarction and cardiac failure. Moreover, hypertension is strongly correlated with body mass index (BMI). Although the exact causes of hypertension are still unclear, some of genetic loci were discovered from genome-wide association study (GWAS). Therefore, it is essential to study genetic variation for finding more genetic factor affecting hypertension. The purpose of our study is to conduct a CNV association study for hypertension-related traits, BP and BMI, in Korean individuals. We identified 2,206 CNV regions from 3,274 community-based Korean participants using the Affymetrix Genome-Wide Human SNP Array 6.0 platform and performed a logistic regression analysis of CNVs with two hypertension-related traits, BP and BMI. Moreover, the 4,692 participants in an independent cohort were selected for respective replication analyses. GWAS of CNV identified two loci encompassing previously known hypertension-related genes: LPA (lipoprotein) on 6q26, and JAK2 (Janus kinase 2) on 9p24, with suggestive p-values (0.0334 for LPA and 0.0305 for JAK2 ). These two positive findings, however, were not evaluated in the replication stage. Our result confirmed the conclusion of CNV study from the WTCCC suggesting weak association with common diseases. This is the first study of CNV association study with BP and BMI in Korean population and it provides a state of CNV association study with common human diseases using SNP array.
Brain perfusion CT scanning is often employed usefully in clinical conditions as it accurately and promptly provides information about the perfusion state of patients having acute ischemic stroke with a lot of time constraints and allows them to receive proper treatment. Despite those strengths of it, it also has a serious weakness that Lens may be exposed to a lot of dose of radiation in it. In this study, as a way to reduce the dose of radiation to Lens in brain perfusion CT scanning, this researcher conducted an experiment with Bismuth shielding and change of patients' position. TLD (TLD-100) was placed on both lens using the phantom (PBU-50), and then, in total 4 positions, parallel to IOML, parallel to IOML (Bismuth shielding), parallel to SOML, and parallel to SOML (Bismuth shielding), brain perfusion scanning was done 5 times for each position, and dose to Lens were measured. Also, to examine how the picture quality changed in different positions, 4 areas of interest were designated in 4 spots, and then, CT number and noise changes were measured and compared. According to the results of conducting one-way ANOVA on the doses measured, as the significance probability was found to be 0.000, so there was difference found in the doses of radiation to crystalline lenses. According to the results of Duncan's post-hoc test, with the scanning of being parallel to IOML as the reference, the reduction of 89.16% and 89.66% was observed in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding) respectively, so the doses to Lens reduced significantly. Next, in the scanning of being parallel to IOML (Bismuth shielding), the reduction of 37.12% was found. According to the results, reduction in the doses of radiation was found the most significantly both in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding). With the limit of the equivalent dose to Lens as the reference, this researcher conducted comparison with the dose to occupational exposure and dose to Public exposure in the scanning of being parallel to IOML and found 39.47% and 394.73% respectively; however in the scanning of being parallel to SOML (Bismuth shielding), considerable reduction was found as 4.08% and 40.8% respectively. According to the results of evaluation on picture quality, every image was found to meet the evaluative standards of phantom scanning in terms of the measurement of CT numbers and noise. In conclusion, it would be the most useful way to reduce the dose of radiation to Lens to use shields in brain perfusion CT scanning and adjust patients' position so that their lens will not be in the field of radiation.
An author is bound to reflect his or her own thinking and inclination in his or her works. The previous studies on Changam(蒼巖), however, mostly discussed the aesthetics in the forms of his introductions and works, hardly addressing his thinking reflected in his works. Recognizing that he had the "reactionism tendency" unlike the Bukhak-School(北學派), which was the cultural mainstream of the days, this study examined the specific patterns of the reactionism calligraphy style in his learning and calligraphy processes and works. He loved to write xing-cao-shu(行草書) with a focus on the materials written in one's own calligraphy, but he also emphasized that one should obtain the force of his or her calligraphy style by mastering kai shu before calligraphy xing cao shu. He thus left a lot of works in the xiao kai(小楷) of the Wang Xzhi(王羲之) calligraphy style throughout his life, which is attributed to the influences of the calligraphers of dong-guk-jin-che(東國眞體) in the latter half of Joseon(朝鮮) and those of Lee Gwang-sa(李匡師), his master in spirit. He is distinguished from the other calligraphers of the times in that he made lifelong efforts to compensate for the lacking stroke of the pen in the model calligraphy of Wang Xzhi. In the calligraphy theory, he put importance on the traditional method of Han-Wei(漢魏) and took Cai Yong(蔡邕) and Zhong Yao(鍾繇) as the fundamentals. For da kai(大楷), he constantly practiced the with the stroke of the pen by added to it, the letters of Wei(魏) Wudi(武帝), by Yan Zhenqing(顔眞卿), and letters of Kim Saeng(金生). His late works using the intended conception of and , in particular, present his unique calligraphy style that added the crooked forms of to the shapes of characters of that were in the kai-shu(楷書) style. It is a limitation that a considerable number of calligraphy materials Changam studied or consulted were either reprint copy or block book rather than original rubbing edition due to time and space restrictions. However, it is also true that those restrictions made an important contribution to his creation of his unique calligraphy style with deep local colors at the result of his constant efforts.
Clinical observation was made on 161 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1994. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, hypertensive encephalopathy, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through western medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission, the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 11.4 days and with cerebral hemorrhage 22.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. The next was pneumonia. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.
This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.
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