• Journal of Preventive Medicine and Public Health
• /
• 제54권2호
• /
• pp.103-109
• /
• 2021

Objectives: The aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017. Methods: Incidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs). Results: The burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively. Conclusions: The burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.

• 대한한의학회지
• /
• 제40권3호
• /
• pp.1-20
• /
• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

• Journal of Audiology & Otology
• /
• 제25권3호
• /
• pp.163-170
• /
• 2021

Cortical deafness is a clinical rarity whereby a patient is unresponsive to all types of sounds despite the preserved integrity of the peripheral hearing organs. In this study, we present a patient who suddenly lost his hearing following ischaemic infarcts in both temporal lobes with no other neurological deficits. The CT confirmed damage to the primary auditory cortex (Heschl's gyrus) of both hemispheres. Initially, the patient was unresponsive to all sounds, however, he regained some of the auditory abilities during 10 months follow up. Pure tone threshold improvement from complete deafness to the level of moderate hearing loss in the right ear and severe in the left was observed in pure tone audiometry. Otoacoustic emissions, auditory brainstem responses, and acoustic reflex findings showed normal results. The middle and late latency potential results confirmed objectively the improvement of the patient's hearing, however, after 10 months still, they were somewhat compromised on both sides. In speech audiometry, there was no comprehension of spoken words neither at 3 nor at 10 months. The absent mismatch negativity confirmed above mentioned comprehension deficit. The extensive auditory electrophysiological testing presented in this study contributes to the understanding of the neural and functional changes in cortical deafness. It presents the evolution of changes after ischaemic cerebrovascular event expressed as auditory evoked potentials starting from short through middle and long latency and ending with event-related potentials and supported by neuroimaging.

• 대한청각학회지
• /
• 제25권3호
• /
• pp.163-170
• /
• 2021

Cortical deafness is a clinical rarity whereby a patient is unresponsive to all types of sounds despite the preserved integrity of the peripheral hearing organs. In this study, we present a patient who suddenly lost his hearing following ischaemic infarcts in both temporal lobes with no other neurological deficits. The CT confirmed damage to the primary auditory cortex (Heschl's gyrus) of both hemispheres. Initially, the patient was unresponsive to all sounds, however, he regained some of the auditory abilities during 10 months follow up. Pure tone threshold improvement from complete deafness to the level of moderate hearing loss in the right ear and severe in the left was observed in pure tone audiometry. Otoacoustic emissions, auditory brainstem responses, and acoustic reflex findings showed normal results. The middle and late latency potential results confirmed objectively the improvement of the patient's hearing, however, after 10 months still, they were somewhat compromised on both sides. In speech audiometry, there was no comprehension of spoken words neither at 3 nor at 10 months. The absent mismatch negativity confirmed above mentioned comprehension deficit. The extensive auditory electrophysiological testing presented in this study contributes to the understanding of the neural and functional changes in cortical deafness. It presents the evolution of changes after ischaemic cerebrovascular event expressed as auditory evoked potentials starting from short through middle and long latency and ending with event-related potentials and supported by neuroimaging.

• Journal of Yeungnam Medical Science
• /
• 제21권2호
• /
• pp.143-150
• /
• 2004

A thromboembolic stroke is believed to be precipitated by a rupture of vulnerable atheromatous plaques. Until recently the assessment of a further risk of stroke in high-risk patients in whom atherosclerosis has presented with a transient ischaemic attack (TIA), has been confined to a quantitative assessment of the luminal patency of the internal carotid artery. These traditional stratification parameters are no longer believed to be the most accurate predictors of a thrombo-embolism. This is because the process of vessel wall remodeling can maintain a luminal patency, and consequently, quite large friable plaques may remain unidentified. Accordingly, there is a need for an improved risk assessment. The fibrous cap of a vulnerable plaque is thinner, and an intraplaque hemorrhage and inflammation can occur during the development of atherosclerotic plaque. Several imaging methods for identifying vulnerable plaques have been developed. Recently, high resolution magnetic resonance (MR) imaging has emerged as an accurate non-invasive tool that can characterize the carotid plaque components in vivo. A High resolution carotid magnetic resonance is capable of distinguishing an intact, thick fibrous cap from a thin and ruptured cap in carotid plaque. In addition, a plaque MR can identify the active inflammation and detect a hemorrhage. High resolution carotid MR imaging is a valuable noninvasive method for quantifying the plaque components and identifying vulnerable plaque.

• 대한의생명과학회지
• /
• 제8권4호
• /
• pp.275-282
• /
• 2002

This study was carried out to investigate the effect of fibrinogen genotype and other characteristics on the plasma fibrinogen levels. Many studies have conformed that high plasma fibrinogen levels are associated with the increased risk of ischaemic heart disease, stroke and arterial disease. And fibrinogen levels are related with age, obesity, cholesterol and alcohol consumption, genotypes. For this study the blood samples were collected from 93 healthy Koreans (66 males and 27 females). The blood samples were individually analyzed by smoking status, cholesterol levels, genotype, age, and gender. The plasma fibrinogen was assayed by clotting method (modified Clauss assay) and cholesterol was assayed by cholesterol oxidase method. Subjects were classified by current smokers, ex-smokers (<6 month), or nonsmokers. The $\beta$-fibrinogen genotype was detected by PCR of relevant region and digestion with HaeIII, with the H$_1$H$_1$ allele allowing cleavage by this restriction enzyme and H$_2$H$_2$ allele being refractory. In conclusion, the study shows that the factor of the increasement in the fibrinogen level was closely related with the cholesterol level, smoking status and genotype (H$_1$H$_2$); but there was no significant difference by gender, Especially, among the people over 50 years of age, fibrinogen level was higher with the increasement of cholesterol level (<200 mg/dl), current smoker, and genotype H$_1$H$_2$.

• 보건행정학회지
• /
• 제19권3호
• /
• pp.1-26
• /
• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• 미생물학회지
• /
• 제50권3호
• /
• pp.223-226
• /
• 2014

청국장은 대두발효식품으로 대두 단백질이 발효 중 분해되면서 다양한 생리활성물질이 만들어진다. 혈관내피세포는 혈관의 기능은 물론 신생혈관 생성을 주도하는 세포이다. 뇌졸중이나 심근경색, 뇌경색 등의 혈관관련 질병들은 신생혈관 생성을 촉진하는 치료법이 필요하다. Vascular Endothelial Growth Factor (VEGF)는 새로운 혈관 형성을 촉진하는 역할을 한다. 본 연구에서는 청국장 에탄올추출물(CEE)이 HUVEC (혈관 내피세포) 증식에 미치는 영향을 조사하여 보았다. 청국장 추출물(100, $1000{\mu}g/ml$)을 HUVEC에 처리했을 때, VEGF (10 ng/ml)를 처리한 대조군과 같은 정도로 세포를 증식시켰다. 열처리한 청국장추출물을 혈관 내피세포에 처리해도 세포 증식효과는 마찬가지였다. 청국장이 세포 증식뿐 아니라 HUVEC이동에도 영향을 주는지 sprout 분석법으로 확인하였다. 청국장 추출물($100{\mu}g/ml$)을 처리했을 때, VEGF (10 ng/ml)와 비슷할 정도로 HUVEC 이동이 일어났다. 청국장 추출물에서 HUVEC 증식과 이동에 영향을 미치는 특정 peptide의 분리가 필요할 것이다.