• Title/Summary/Keyword: Chronic Stroke

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Subjective and Objective Caregiver Burden in Parkinson's Disease

  • Kim, Keum-Soon;Kim, Bog-Ja;Kim, Kyung-Hee;Choe, Myoung-Ae;Yi, Myung-Sun;Hah, Yang-Sook;Chung, Sun-Ju;Kwon, So-Hi
    • Journal of Korean Academy of Nursing
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    • v.37 no.2
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    • pp.242-248
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    • 2007
  • Purpose. Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. Methods. A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology out-patient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. Results. The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion (47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). Conclusion. Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.

Effects of Virtual Reality Based Video game and Rehabilitation Exercise on the Balance and Activities of Daily Living of Chronic Stroke Patients (가상현실기반 비디오게임과 재활운동이 만성기 뇌졸중 환자의 균형 및 일상생활동작에 미치는 영향)

  • Lee, Hyun-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.2
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    • pp.201-207
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    • 2013
  • 연구목적: 닌텐도 위를 이용한 가상현실기반 비디오게임 프로그램을 만성기 뇌졸중 환자에게 적용하여 균형능력 및 일상생활동작에 어떠한 영향을 미치는지 알아보고, 뇌졸중 환자의 재활프로그램으로서 적용 가능성이 있는지 알아보고자 한다. 연구방법: 만성기 뇌졸중 환자를 무작위로 가상현실기반 비디오게임 프로그램을 적용한 실험군(n=7)과 적용하지 않은 대조군(n=10)으로 구분하여 연구를 진행하였다. 연구에 참여한 모든 대상자에게 30분의 Bobath therapy와 15분간의 FES 치료를 기본적으로 실시하였다. 이에 더하여 실험군은 가상현실기반 비디오게임 프로그램을 1일 30분이내, 주 5회, 3주간 실시하였다. 대조군은 자전거 운동과 보행훈련으로 30분간 시행하였다. 실험 전 후 눈뜨고 외발서기(OLST; open leg standing test), Timed Up and Go(TUG) 검사, 10m 걷기 검사, Functional Independence Measure(FIM)를 측정하였다. 실험 전과 실험 후 측정값의 차이를 비교하기 위해 Wilcoxon Signed Ranks Test를 실시하였다. 그리고 각 측정값의 변화량에 대한 실험군과 대조군 사이의 차이를 알아보기 위해 Mann-Whitney U Test를 실시하였다. 연구결과: 실험결과는 다음과 같다. 1) 실험군에서는 FIM의 유의한 증가와 TUG, 10m 걷기 검사의 유의한 감소를(p<.05) 보였다. 대조군에서는 OLST의 증가와 TUG, 10m walking test의 감소가 나타났지만 통계적으로 유의하지 않았다. 오직 FIM에서만 유의한 증가가 나타났다(p<.05). 2) 실험 전 후의 실험군과 대조군의 각 측정값들의 평균차를 비교한 결과 실험군은 대조군보다 실험 전 후 OLST, TUG, 10m walking test 차이의 평균은 컸지만 통계적으로 유의하지 않았다. 결론: 이상의 결과로부터 가상현실기반 비디오게임이 만성기 뇌졸중 환자의 동적균형능력 및 일상생활동작 향상에 효과가 있음을 알 수 있었다.

Neuroprotective Effect of the Water-insoluble fraction of Root Barks of Dictamnus dasycarpus 70% Ethanolic Extract on Glutamate-Induced Oxidative Damage in Mouse Hippocampal HT22 Cells (백선피 70% 에탄올 추출물의 비수용성 분획물의 뇌세포 보호 효과)

  • Choi, Hyun-Gyu;Lee, Dong-Sung;Li, Bin;Jun, Ki-Yong;Jeong, Gil-Saeng;Kim, Youn-Chul
    • Korean Journal of Pharmacognosy
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    • v.42 no.2
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    • pp.175-181
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    • 2011
  • Oxidative stress or accumulation of reactive oxygen species (ROS) leads neuronal cellular death and dysfunction, and it contributes to neuronal degenerative disease such as Alzheimer's disease, Parkinson's disease and stroke. Glutamate is one of the major excitatory neurotransmitter in the central nervous system (CNS). Glutamate contributes to fast synaptic transmission, neuronal plasticity, outgrowth and survival, behavior, learning and memory. In spite of these physiological functions, high concentration of glutamate causes neuronal cell damage, acute insults and chronic neuronal neurodegenerative diseases. Heme oxygenase-1 (HO-1) enzyme plays an important role of cellular antioxidant system against oxidant injury. NNMBS020, the water-insoluble fraction of the 70% EtOH extract of root barks of Dictamnus dasycarpus, showed dominant neuroprotective effects on glutamate-induced neurotoxicity in mouse hippocampal HT22 cells by induced the expression of HO-1 and increased HO activity. In mouse hippocampal HT22 cells, NNMBS020 makes the nuclear accumulation of Nrf2 and stimulates extracellular signal-regulated kinase (ERK) pathway. The ERK MAPK pathway inhibitor significantly reduced NNMBS020-induced HO-1 expression, whereas the JNK and p38 inhibitors did not. In conclusion, the water-insoluble fraction of the 70% EtOH extract of root barks of D. dasycarpus (NNMBS020) significantly protect glutamate-induced oxidative damage by induction of HO-1 via Nrf2 and ERK pathway in mouse hippocampal HT22 cells.

Ischemic Infarcion Model by Middle Cerebral Artery Occlusion using Allogenic Blood Clot in Beagle Dogs (비글견에서 동종혈전 색전술을 이용한 중간대뇌동맥의 허혈성 뇌경색 모델)

  • Kim, Younghwan;Choi, Sooyoung;Lee, Kija;Han, Woosok;Choi, Hojung;Lee, Youngwon
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.10-15
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    • 2016
  • The purpose of this study was to establish reproducible ischemic infarction model using allogenic blood clot in beagle dogs and identify induced ischemic lesion after middle cerebral artery occlusion using magnetic resonance imaging (MRI) and histopathologic findings. Twenty eight male beagle dogs with no evidence of neurologic disease were experimented. Allogenic embolus was made using a healthy beagle dog. After internal carotid artery (ICA) was exposure, 16G catheter was introduced through the ICA. The dog was administered 0.3 ml blood clot for 15 seconds followed by 3 ml of saline for 15 seconds. MRI scans were performed with 1.5T to evaluate ischemic lesion at 7 days after middle cerebral artery occlusion procedure. Evaluation parameters of MRI include location, distribution, infarction type, margin, shape, mass effect and intensity of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid attenuated inversion recovery (FLAIR) sequence, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC). On MRI, all dogs (28/28) showed focal or multifocal lesion including telencephalon and thalamus lesions, especially caudate nucleus (24/28). These lesions had well-defined margin from adjacent brain parenchyma, none or mild mass effect and various shape. Most of dogs appeared hyperintensity on T1WI, T2WI, FLAIR, and DWI/ADC, corresponding to chronic infarction. These lesions were histopathologically confirmed atrophic changes and unstained lesion. In conclusion, MRI is the useful method to provide information about ischemic infarction in dogs and the best reproducible ischemic infarction model was developed by using allogenic blood clot.

The effect of a hospital-based smoking cessation intervention on the continuous abstinence rate from smoking over 12 months in patients with cerebral infarction (병원기반 금연중재가 뇌경색 환자의 퇴원 후 12개월 지속 금연율에 미치는 효과)

  • Lee, Young-Hoon;Oh, Gyung-Jae;Han, Mi-Hee;Kim, Gue-Jin;Park, Hyun Young;Kim, Hee-Sook;Lee, Kun Sei
    • Korean Journal of Health Education and Promotion
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    • v.33 no.3
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    • pp.61-70
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    • 2016
  • Objectives: The aim of this study was to investigate the effectiveness of a hospital-based smoking cessation intervention for increasing continuous abstinence rate from smoking in patients with cerebral infarction. Methods: One-hundred and two smokers with cerebral infarction who decided to quit smoking were enrolled in the smoking cessation intervention from December 2012 to February 2015. The smokers underwent six consecutive times of individual intervention with nurse specialist on smoking cessation including education on behavioral modification, counseling for withdrawal symptoms, and anti-smoking advice over a 12-month period. Results: Among the total participants, the continuous abstinence rate from smoking changed from 79.4% at 1 month to 60.8% at 12 months after discharge. The continuous abstinence rate from smoking after 12 months was 88.5% in participants who completed the entire program (6 times), while 51.3% in participants who did not complete the entire program (${\leq}5$ times) (P=0.001). After adjustment for general and smoking-related characteristics, complete implementation of hospital-based smoking cessation intervention was significantly associated with continuous abstinence from smoking after 12 months (odds ratio: 5.93; 95% confidence interval: 1.45-24.22). Conclusions: The hospital-based smoking cessation intervention might be effective for smoking cessation in patients with cerebral infarction, especially when the intervention was implemented thoroughly.

Anti-stress and Anti-nociceptive Effects of the Aqueous Extracts of Chungsimyeonja-eum against Immobilization Stress and Incision Pain in Rats (청심포자음(淸心蒲子飮)의 구속 스트레스 및 절개 통증에 대한 항스트레스 작용과 진통효과)

  • Yoon, Jeong-Hwan;Ko, Il-Gyu;Shin, Mal-Soon;Kim, Chang-Ju;Lee, Chung-Yeol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.4
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    • pp.874-883
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    • 2007
  • The aqueous extract of Chungsimyeonja-eum has been used to treat palpitation, anemia, chronic fatigue, hypertension, and stroke. It also possesses various pharmacological effects including hypotensive, blood circulating, sedative, anti-inflammatory, diuretic, and anti-stress activities. In the present results, the latency time of plantar test was decreased in the immobilization stress and incusion pain-induction group. However the paw withdrawal latency values were increased in the immobilization stress and incision pain-induction groups after treatment with the aqueous extract of Chungsimyeonja-eum. The c-Fos expression in the paraventricular nucleus (PVN), and 5-hydroxytryptamine (5-HT) and tryptophan hydroxylase (TPH) in the dorsal raphe were enhanced in the immobilization stress and incision pain-induction groups. However, the treatment with the aqueous extract of Chungsimyeonja-eum suppressed the immobilization stress and incision pain-induced increase of c-Fos, 5-HT, and TPH expressions. Here in this study, we have demonstrated the protective effects of Chungsimyeonja-eum on immobilization and incision pain-induced stress. The present study revealed that Chungsimyeonja-eum treatment diminishes immobilization and pain stress.

Food therapy analysis of the primary ailments from the 『ShikLyoChanYo(食療纂要)』 (『식료찬요(食療纂要)』에 기재(記載)된 7개 병증(病證)의 식약요법(食藥療法)에 관한 소고(小考))

  • Yeo, Min-Kyung;Yin, Lin;Hwang, Su-Jung;Lee, Byung-Wook;Kim, Ki-Wook
    • The Journal of Korean Medical History
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    • v.27 no.1
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    • pp.61-76
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    • 2014
  • The "ShikLyoChanYo", written in 1460 by JunSoonYi (全循義), master court doctor in JoSeon (朝鮮) Dynasty, is the very first specialty publication of Korean dietary treatment existing today. Both Chinese and Korean scholars have assumed that this book had been lost long time ago. In November 2003, however, a Korean philologist found a version of the book, Yangyang (襄陽, a district name in Korea), and this book has attracted a lot of interest of Korean traditional medical science and agricultural science since then. This paper is to dissert the document of food therapy from the book with profound document study and statistical analysis in the fields of traditional Chinese medicine and traditional Korean medicine on dietetics. It completes the study of the application of all the dietetic treatments according to symptoms of diseases and all the plants and medication applied to cure chronic conditions that are clinically examined for the purpose of food therapy. A general survey on sundry records related to this food therapy of the "ShikLyoChanYo" has been done to make this dissertation and it carried out a statistic analysis of all the dietetic mixing technique of all plants and medication. Among other symptoms of illnesses from the book, there are 7 frequently addressed ailments chosen from the aspect of food therapy - a stroke, a disease diagnosed by thirst, a serious cough, an ache resulting from numbness, a disease relating to stomach, blurry vision and weak hearing, and a drinking related disease. This part is to discuss these illnesses and how to cure them with food based on its characteristics and rules of application.

Home Healthcare Service Awareness Survey for Korean Medicine Doctors: a survey study

  • Hye In Jeong;Taegwang Nam;Minhui Hong;Kyeong Han Kim
    • Journal of Pharmacopuncture
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    • v.26 no.1
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    • pp.60-66
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    • 2023
  • Objectives: Discussions regarding "medical blind spots" in Korea's "aging society" are continuously rising. In addition, the demand for medical attention and care for the elderly and vulnerable populations continues to increase. Given this, the government is promoting the "home healthcare service" project. This study aims to lay the foundation for promoting this project by investigating the perception of clinical Korean Medicine (KM) doctors in the "community health care" project. Methods: With the cooperation of the Association of Korean Medicine, we sent a questionnaire to all KM doctors through e-mail. The survey included personal information, awareness, appropriate disease and intervention, proper visit location, and pros and cons. Results: A total of 602 responses were collected and analyzed. Approximately 20% of the doctors answered that they were well aware of the service, while 55% responded that they did not know about it. For a visit, a KM doctor selected the appropriate diseases in the order of stroke, dementia and Parkinson's disease, osteoarthritis, and chronic diseases. Among treatments, acupuncture, moxibustion, and herbal medicine exhibited similar results. The most common opinion was that KM doctors should schedule their visits once a week for 6-12 months, which was the most prolonged period among the given options. More than 80% (84.1%) of the doctors replied that care projects were highly essential, and about 63.8% expressed their willingness to participate in these projects. Conclusion: To provide appropriate home health care, we must raise awareness among Korean medicine doctors. In addition, the healthcare budget must be increased to provide the required support.

Percutaneous Dilatational Tracheostomy in a Cardiac Surgical Intensive Care Unit: A Single-Center Experience

  • Vignesh Vudatha;Yahya Alwatari;George Ibrahim;Tayler Jacobs;Kyle Alexander;Carlos Puig-Gilbert;Walker Julliard;Rachit Dilip Shah
    • Journal of Chest Surgery
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    • v.56 no.5
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    • pp.346-352
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    • 2023
  • Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08-0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.

Current Status and Application Prospects of Anti-Atherosclerotic Active Biomaterials (항동맥경화 활성 바이오소재 개발 연구 동향 및 활용 전망)

  • Seunghee Kim;Jeongho Lee;Hah Young Yoo
    • Korean Chemical Engineering Research
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    • v.62 no.2
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    • pp.133-141
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    • 2024
  • Atherosclerosis, a disease with high morbidity and mortality worldwide, is a chronic inflammatory disease that is a major cause of cardiovascular diseases such as stroke and myocardial infarction. Atherosclerosis is characterized by the accumulation of lipid deposits in the arteries, forming atheromas. This leads to the narrowing of the arteries and thrombosis. Recently, the need to develop bio-derived anti-atherosclerotic materials has been highlighted with concerns about the side effects of synthetic therapeutics. Accordingly, related research (such as the discovery of biomaterials for the improvement and treatment of atherosclerosis and the identification of mechanisms) has been actively conducted. Biomaterials including polysaccharides, polyphenols, and coenzyme Q10 have been reported to inhibit or delay symptoms by modulating factors involved in the development of atherosclerosis. For biomaterials with superior activity, in vivo anti-atherosclerotic activity has been confirmed. In this review, the pathogenesis of atherosclerosis was investigated, and the current status and application prospects of biomaterials with anti-atherosclerotic activity were proposed.