• 지역사회간호학회지
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• 제18권4호
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• pp.572-582
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• 2007

Purpose: This study was to evaluate the effects of visiting nursing intervention on self care behavior and blood pressure with high risk of cerebrovascular diseases. Method: A one-group pretest-posttest was designed. Data collection was done in 150 participants from March. 2003 to November, 2003 at a public health center. Self care behavior was assessed by the scores of smoking, alcohol, diet, exercise, stress and medication compliance. The scores of knowledge related cerebrovascular diseases, blood pressure, blood glucose were estimated. The Participants were intervened in with basic assessment, emotional support, education. This program took a period ranging from 3 months to 7 months depending on the cerebrovascular risk level. The mean number of visiting times was 1.67 per month. Result: 1. Knowledge level was improved(t=-2.542, p= .012). 2. Systolic and diastolic pressure were lower(t=5.439, p<.001; t=4.966, p<.001) 3. Self care level was higher (t=-12.981, p=.001) after the intervention. Conclusion: The visiting nursing intervention was found to have an effect on the scores of knowledge, self care behavior and blood pressure with high risk of cerebrovascular diseases. The results provided evidences for the importance of visiting nursing intervention in the high risk factor of cerebrovascular disease for self care.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.40-44
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• 2011

Objective : To evaluate the prevalence and risk factors of clopidogrel resistance, and association between thromboembolic complications and clopidogrel resistance in patient with stent-assisted angioplasty for atherosclerotic cerebrovascular disease. Methods : Between September 2006 and June 2008, clopidogrel resistance test was performed on 41 patients who underwent stent-assisted angioplasty for atherosclerotic cerebrovascular disease. It was performed before drug administration and about 12 hours after drug administration (loading dose : 300 mg, maintain dose : 75 mg). Two patients were excluded, and 41 patients were included (mean : $67.59{\pm}7.10$ years, age range : 41-79). Among 41 patients, 18 patients had intracranial lesions, and 23 had extracranial lesions. We evaluated the prevalence, risk factors and complications related to clopidogrel resistance. Results : Twenty-one patients (51.2%) showed clopidogrel resistance [intracranial : 10 patients (55.6%), extracranial : 11 patients (47.8%)] and no clopidogrel resistance was seen in 20 patients. Hypercholesterolemia was an indepedent risk factor of clopidogrel resistance. Stent-assisted angioplasty was technically successful in all patients, but acute in-stent thrombosis occurred in 5 patients with intracranial lesions (4 patients with clopidogrel resistance and 1 without clopidogrel resistance). Acute thrombi were completely lysed after intra-arterial infusion of abciximab. Conclusion : There was relatively high prevalence of clopidogrel resistance in patients with atherosclerotic cerebrovascular disease. Hypercholesterolemia was an independent predictive factor of clopidogrel resistance. Acute in-stent thrombosis was more frequently seen in the clopidogrel resistant group. Therefore, clopidogrel resistance test should be performed to avoid thromboembolic complications related to stent-assisted angioplasty for atherosclerotic cerebrovascular disease, especially patients with hypercholeterolemia and intracranial lesion.

• 한국콘텐츠학회논문지
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• 제11권5호
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• pp.308-316
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• 2011

혈관 질환 위험인자의 가족력은 이미 잘 알려져 있으며 최근 심혈관 질환의 위험인자를 대상으로 한 연구에서는 가족력 뿐 만 아니라 배우자간의 위험인자 일치성이 있다고 밝혔다. 이는 혈관 질환 위험인자에서의 가족력은 유전적인 이유뿐 만이 아니라 환경적 요인으로 인해서도 발생한 다는 것을 암시한다. 그러나 뇌졸중이 발생한 환자에서 그 배우자간 위험인자의 일치성을 알아본 연구는 없었다. 이 연구는 본 연구를 진행하기 앞서 시행한 연구로서 뇌졸중으로 입원했던 환자를 대상으로 위험인자간의 관련성을 조사해 그 경향성을 파악하고자 하였는데 고혈압의 유무(p=0.025)와 경동맥 내막-중막 두께(r=0.479, p=0.001)에서 의미있는 연관성을 보였으나 나이를 보정하는 경우 의미가 없는 것으로 드러났다. 일반 인구 대상이거나 심혈관질환자가 대상이었던 종전의 연구 결과와는 다른 결과였다. 의미 있는 경향성을 보인 위험인자에 대해서 추후 보다 큰 규모의 연구가 필요할 것이다.

• Journal of Korean Biological Nursing Science
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• 제6권2호
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• pp.31-42
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• 2004

Purpose: This study was undertaken to investigate bio-medical and behavioral risk factor of stroke according to the level of blood pressure among the prospective tele-health users. Method: A descriptive study was conducted using interviews with a structured questionnaire. Of the households in the village, 24 households were selected for inclusion in the study. Among all of the residents from these households, a total of 48 residents who completed all the blood tests as well as the questionnaire. Results: Among bio-medical risk factors including demographic characteristics, physiologic variables, and health history, only triglyceride(TG) was significantly different among normal, prehypertension, and hypertension groups(F=3.78, p<.05). However, regarding behavioral variables, those who were classified as prehypertension and hypertension group reported more frequent drinking, those who were in prehypertension group reported highest scores of stress and lowest frequency of exercise, and those who were in normal and hypertension group showed higher scores of interest on health and lower scores of perceived seriousness of disease and health knowledge than those who were in prehypertension group. Conclusion: Identification and implementation of modifiable risk factors of stroke according to the level of blood pressure are crucial for health care utilizing tele-medicine.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.639-655
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• 1996

Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of these diseases are mostly alike. But some risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group (RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of monarch, and prothrombin time. The factor whose level was higher in AMI than ill RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAM than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAM and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age, uric acid, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.

• 대한한의학회지
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• 제25권4호
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• pp.36-42
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• 2004

Objective : Glutathione S-transferase polymorphism (GST) were examined in 120 cases with ischemic cerebrovascular disease (ICVD) to test the hyperthesis that GST polymorphisms confer a risk to an individual to develop ICVD. Tobacco smoking is a major cause of both cancer and vascular disease. Methods : therefore We were stratified the subjects with ICVD for smoking status, and then examined whether polymorphisms in this detoxification enzyme gene, GST, influence risk of ICVD Results : Neither GSTM1 nor GSTT1 genotypes in the ICVD group was significantly different from the control group (n=207), even in smokers. We attempted the combined analyses for GSTM1 and GSTT1 genotypes in ICVD for smoking status. No significant association observed between the combined genotypes and ICVD Conclusion : Our observation do not confirm the effect of the GSTM1 and GSTT1 genotypes as a risk factor for ICVD, even in smokers.

• 대한한의학회지
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• 제24권4호
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• pp.113-119
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• 2003

The association between apolipoprotein E (apo E) gene polymorphism and ischemic cerebrovascular disease (ICVD) has been controversial. These controversies may be due to inaccurate classification of patients and ethnic differences. We investigated the association between apo E genotypes and ICVD patients by case-control study in a Korean population. The association between apo E polymorphism and ICVD was examined in 121 patients with ICVD and 132 controls without ICVD. The E3/E4 phenotype was more frequent in control subjects (23.8％) than in patients (13.0％) (p<0.05). The E2/E3 phenotype was more frequent in patients (14.8％) than in control subjects (10.8％), but the difference was not statistically significant (p>0.05). These results suggest that the E4 allele may be a protective factor against early vascular morbidity, and the E2 allele may be a risk factor for cerebrovascular morbidity.

• Journal of Preventive Medicine and Public Health
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• 제34권2호
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• pp.157-165
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• 2001

Objectives : To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. Methods : The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (160-168) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. Results : In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. Conclusion : We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.

• Journal of Korean Neurosurgical Society
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• 제49권1호
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• pp.20-25
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• 2011

Objective: Due to longer life spans, patients newly diagnosed with unruptured intracranial aneurysms (UIAs) are increasing in number. This study aimed to evaluate how management of UIAs in patients age 65 years and older affects the clinical outcomes and post-procedural morbidity rates in these patients. Methods: We retrospectively reviewed 109 patients harboring 136 aneurysms across 12 years, between 1997 and 2009, at our institute. We obtained the following data from all patients: age, sex, location and size of the aneurysm(s), presence of symptoms, risk factors for stroke, treatment modality, and postoperative 1-year morbidity and mortality. We classified these patients into three groups: Group A (surgical clipping), Group B (coil embolization), and Group C (observation only). Results: Among the 109 patients, 56 (51.4%) underwent clipping treatment, 25 (23%) patients were treated with coiling, and 28 observation only. The overall morbidity and mortality rates were 2.46% and 0%, respectively. The morbidity rate was 1.78% for Clipping and 4% for coiling. Factors such as hypertension, diabetes mellitus, hypercholesterolemia, smoking, and family history of stroke were correlated with unfavorable outcomes. Two in the observation group refused follow-up and died of intracranial ruptured aneurysms. The observation group had a 7% mortality rate. Conclusion: Our results show acceptable favorable outcome of treatment-related morbidity comparing with the natural history of unruptured cerebral aneurysm. Surgical clipping did not lead to inferior outcomes in our study, although coil embolization is generally more popular for treating elderly patients, In the treatment of patients more than 65 years old, age is not the limiting factor.

• 사상체질의학회지
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• 제14권1호
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• pp.123-131
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• 2002

Glutathione S-transferase polymorphisms (GST) were examined in 98 cases with cerebrovascular disease (CVD) to test the hypothesis that GST polymorphisms confer a risk to an individual to develop CVD. Tobacco smoke is a major cause of both cancer and vascular disease. We therefore were stratified the subjects with CVD for smoking status, and then examined whether polymorphisms in this detoxification enzyme gene, GST, influence risk of CVD. Neither GSTM1 nor GSTT1 genotypes in the CVD group was significantly different from the control group (n=230), even in smokers. We attempted the combined analyses for GSTM1 and GSTT1 genotypes in CVD for smoking status. No significant association observed between the combined genotypes and CVD. We also classified the subjects and control group into four types according to Sasang Constitutional Medicine, Korean Traditional Oriental Medicine, and investigated the association among GST genotypes, CVD, and Sasang constitutional classification. Our observations do not confirm the effect of the GSTM1 and GSTT1 genotypes as a risk factor for CVD, even in smokers. Furthermore, we first attempted to evaluate the efficacy of Sasang Constitutional Medicine, and to find an association with CVD.