• Title/Summary/Keyword: Ischemic

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The Experimental Study on the Effects of Dansamyeum on Hyperlipidemia (단삼음(丹蔘飮)이 고지혈증(高脂血症)에 미치는 영향(影響))

  • Kim, Byeung-Chul;Park, Chi-Sang;Park, Chang-Gook;Lee, Eun-Ju
    • The Journal of Internal Korean Medicine
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    • v.21 no.1
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    • pp.126-134
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    • 2000
  • Objectives : In order to study effects of Dansamyeum on Hyperlipidemia which causes Hypertension, Arteriosclerosis, Cerebral vascular disease and Ischemic heart disease Methods : The changes of serum total lipid, triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol, body weight and organ weight were observed after the liquid extracts of Single-dosage Dansamyeum and Double-dosage Dansamyeum were administered p.o to the Hyperlipidemic rats induced by 1% cholesterol diet for 10, 20 and 30 days. Results : The body weight was significantly decreased in Double-dosage Dansamyeum group for 20 and 30 days compared with control group. The contents of total lipid were significantly decreased in Single-dosage Dansamyeum group for 20 days, but Double-dosage Dansamyeum group did not show any significant change compared with control group. The contents of total cholesterol were significantly decreased in Single-dosage Dansamyeum group for 20 days, and Double-dosage Dansamyeum group showed significant changes for 10 and 20 days compared with control group. The contents of triglyceride were significantly decreased in Single-dosage Dansamyeum group for 30 days, and Double-dosage Dansamyeum group showed significant changes for 10 days compared with control group. The contents of HDL-cholesterol were significantly increased in Single-dosage Dansamyeum group and Double-dosage Dansamyeum group for 10 days compared with control group. The contents of LDL-cholesterol were significantly decreased in Single-dosage Dansamyeum group for 10, 20 and 30 days, and Double-dosage Dansamyeum group showed significant changes for 10, 20 and 30 days compared with control group. The liver weight was significantly decreased in Single-dosage Dansamyeum group and Double-dosage Dansamyeum group compared with control group. The kidney and testis weight was significantly decreased in Single-dosage Dansamyeum group compared with control group. The spleen weight was significantly decreased in Double-dosage Dansamyeum group compared with control group. Conclusions : It was thought that Single-dosage Dansamyeum and Double-dosage Dansamyeum could be applied effectively to the Hyperlipidemia.

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The Clinical Analysis on 32 Cases of Dementia (치매환자(患者) 32례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee, Y.W.;Kang, H.J.;Cho, M.R.;Jin, C.S.;Hong, S.;Kim, J.S.
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.301-317
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    • 1998
  • A clinical analysis was carried out for 32 patients who were treated in Dept. of Dong-shin Oriental Medicine Hospital from 10st January to 16st May in 1998 and ruled out as dememtia. The results were summarized as follows. 1. In the distribution of sex, female was more than male. And the age of seventies(17 cases, 53.125%) was highest in the frequency of age. 2. In the distribution of having history of drinking and smoking were each 4 cases(12.5%) and 7 cases(21.875%). 3. In the distribution of seasons, the ratio of spring and winter were each 16 cases(50.0%), 15 cases(46.875%), that of summer and fall were comparatively low. 4. In the period from onset to admission, the period within a week had 20 cases(62.5%) as top, and the most period of treatment was 2 and 3 weeks(28.125%). 5. The number of cases that had preceding disease was 35 cases(71.875%), a major portion of preceding diseases were hypertension, diabetes mellitus, stroke. 6. The most common symptom was disorientation(78.125%), and the next common symptom was motor desability(71.875%), and memory disturbance, verbal disturbance was each 59.375 and 47.1%. 7. In the distribution of the CT scan films, 15 cases(46.875%) showed cerebral infarction and that of another 5cases (15.625%) showed cerebral hemorrhage, that of another 2 cases(6.25%) showed brain atrophy. 8. In the lipid density of blood, T-Cholesterol, TG, HDL-Cholesterol, LDL- Cholesterol was within normal limit. 9. In the MMSE-K, the most score was from 16 point to 20 point, and second only was from 11 point to 15 point, and the next was from 6 point to 10 point. 10. In the Ischemic score, 20 cases(62.5%) was diagnosed as brain vascular type dementia, and mixed type dementia was 9 cases(28.125%), Alzheimer type dementia was 3 cases(9.375%). 11. The most used recipes were a sort of recipes to activate of flow the vital energy and the blood, to remove the phlegm(41 cases 33.9%), especially DODAMHOALHEL TANG (12 cases, 9.9%), ANSINCHUNGNOITANG (8 case, 6.6%) was the most used recipe. 12. In the judgement of efficacy, 17 cases(53.125%) showed excellent efficacy, 10 cases(31.25%) showed good efficacy, 5 cases(15.625%) showed no change and that according to MMSE-K, 4 case(18.18%) showed excellent efficacy, 15 cases(68.18%) showed good efficacy, 15 cases(68.18%) showed no change.

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Early & Midterm Results after Redo Coronary Artery Bypass Grafting (관상동맥우회술 후 재수술의 단기 및 증기 성적)

  • 김준성;김홍관;장우익;김기봉
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.146-153
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    • 2004
  • As the experience of coronary artery bypass grafting (CABG) has been accumulated, the number of reoperation after CABG is increasing. We analyzed our clinical experience of redo-CABG. Material and Method: Fourteen patients who underwent redo-CABG between Jan. 1994 and Dec. 2002 were included in this study. The mean period from the first operation to reoperation was 66$\pm$56 (3∼157) months, and the average ages were 62.8$\pm$8.7 (51∼78) years. The survivors were followed up 39$\pm$29 (4∼101) months postoperatively. Indications of reoperation were stenosis or occlusion of previous grafts in 11 patients, progression of native coronary artery disease in one patient, and both etiologies in two patients. Result: There were two in-hospital mortalities (14.3%) resulting from low cardiac output syndrome, Postoperative morbidities were perioperative myocardiac infarction in 2 patients (14.3%), mediastinitis in one patient (7.2%), duodenal perforation in one patient, ischemic necrosis of the lower extremity in one patient, gastric perforation after mesenteric infarct in one patient, delayed brain infarct in one patient, and intraoperative splenic rupture in one patient. There was one late mortality at six months postoperatively during the follow up. There was no angina recurrence during the follow up. Conclusion: Although redo CABG demonstrated relatively high operative mortalities and morbidities, postoperative status and clinical outcome of the survivors were favorable.

The Use of Greater Saphenous Vein In Situ Graft in Arterial Occlusive Disease of Lower Extremity (하지동맥 폐쇄성 질환에서 자가 대복재정맥 정위 이식편의 이용)

  • Shin Yong-Chul;Kim Mi-Jung;Song Chang-Min;Ahn Jae-Bum;Kim In-Sub;Kim Woo-Sik;Kim Byung-Yul
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.456-461
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    • 2006
  • Background: Distal anastomosis using artificial vascular graft is difficult when luminal size mismatch occurred owing to severe occlusion of popliteal artery and its branches. So we reconstructed blood flow to ischemic lower limb by using autologous greater saphenous vein in situ graft (GSVISG) as vascular graft material. Material and Method: From July 2000 to July 2005, 26 patients treated using GSVISG. We analyzed clinical results retrospectively by chart review. Result: There was no in hospital or early postoperative death and 6 late deaths occurred during follow up period. Postoperative complications were 5 cases of early graft obstruction, 2 cases of wound dehiscence, 1 case of graft aneurysmal change, 1 case of seroma formation at inguinal wound and 1 case of graft injury during valvulotomy. Overall patency rate during follow up period was 69.3%. Conclusion: Greater saphenous vein in situ graft is acceptable vascular graft for arterial occlusive disease of lower extremity.

Impact of Lifestyle Diseases on Postoperative Complications and Survival in Elderly Patients with Stage I Non-Small Cell Lung Cancer

  • Jeong, Sang Seok;Choi, Pil Jo;Yi, Jung Hoon;Yoon, Sung Sil
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.86-93
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    • 2017
  • Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

A Case of Continuous Positive Airway Pressure Therapy in a Patient with Central Sleep Apnea and Heart Failure (중추성 수면 무호흡이 동반된 심부전 환자에서 지속적 상기도 양압술 적용 1례)

  • An, Jee Young;Kim, Shin Bum;Kang, Hyeon Hui
    • Sleep Medicine and Psychophysiology
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    • v.24 no.2
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    • pp.118-123
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    • 2017
  • Central sleep apnea (CSA) is a highly prevalent comorbidity in patients with heart failure and may present in 25 to 40 percent of heart failure patients. Continuous positive airway pressure (CPAP) is the primary therapeutic option and effective in treatment of obstructive sleep apnea (OSA). In heart failure patients with CSA, several trials of CPAP showed a number of positive effects in heart failure treatment. A 58-year-old male visited the hospital because of dyspnea and he was diagnosed as heart failure with ischemic heart disease. He underwent coronary angiography and received percutaneous coronary intervention due to stenosis at the middle of left anterior descending coronary artery. However, dyspnea was not completely improved after treatment with percutaneous coronary intervention. The patient also experienced snoring and sleep apnea which worsened with symptom of dyspnea in the recent year. We suspected CSA and the patient underwent polysomnography to confirm whether sleep apnea was present. During the polysomnography, CSA with Cheyne-Stokes respiration (CSR) was observed and apnea-hypopnea index was 45.9/hr. The patient was treated with CPAP. After CPAP treatment, hypoxemia and CSA were resolved and dyspnea was improved with reducing NYHA class. We report a case successfully treated with clinical improvement by presuming CSA in a patient with heart failure.

Delayed Enhancement Magnetic Resonance Imaging Findings in Cardiac Amyloidosis (심장 아밀로이드증의 지연 조영증강 MR 영상소견)

  • Song, Jin Hwa;Park, Eun-Ah;Lee, Whal;Chung, Jin Wook;Park, Jae Hyung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.33-40
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    • 2013
  • Purpose : To evaluate late gadolinium enhancement (LGE) pattern of left ventricular (LV) myocardium and presence or absence of LGE in other regions of the heart on cardiac magnetic resonance (CMR) imaging in patients diagnosed with cardiac amyloidosis. Materials and Methods: From 2009 to 2011, 9 patients who were suspected cardiac amyloidosis underwent CMR. We retrospectively analyzed the presence or absence of LGE and enhancement pattern in LV myocardium, and the presence or absence of LGE in other chambers as well. Also we measured interatrial septal thickness (IST), relative signal intensities of atrial septum and epicardial fat over the left atrial (LA) cavity on delayed enhanced images. MRI parameters in these patients were compared to those of control group of patients with ischemic heart disease by Wilcoxon rank sum test. Results: Of nine patients, LGE were found in 8; subendocardial circumferential pattern in 4 and diffuse pattern in 4. LGE in right ventricle was observed in 7. IST was significantly increased in patients with cardiac amyloidosis (P = 0.02). Ratio of atrial septum to LA cavity and ratio of epicardial fat to LA cavity showed a significant difference (P = 0.0002 and P = 0.0006, respectively). Conclusion: In LGE CMR, subendocardial or diffuse enhancement pattern is a typical finding for patients with cardiac amyloidosis. Atrial septum and epicardial fat show relatively increased signal intensities over LA blood cavity.

'Clinical Observation on the 290 cases of Cerebrovascular Accident' (뇌졸중환자(腦卒中患者) 290례(例)에 대(對)한 임상(臨床) 고찰(考察) (III))

  • Kang, Kwan-Ho;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.223-244
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    • 1997
  • Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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Review of pediatric cerebrovascular accident in terms of insurance medicine (소아뇌졸중의 보험의학적 고찰)

  • Ahn, Gye-Hoon
    • The Journal of the Korean life insurance medical association
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    • v.29 no.2
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    • pp.29-32
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    • 2010
  • Moyamoya disease (MMD) is a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. MMD is one of cerebrovacular accident,which is treated with sugical maeuver in pediatic neurosurgery. Moyamoya (ie, Japanese for "puff of smoke") characterizes the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but unilateral involvement does not exclude the diagnosis. The exact etiology of moyamoya disease is unknown. Some genetic predisposition is apparent because it is familial 10% of the time. The disease may be hereditary and multifactorial. It may occur by itself in a previously healthy individual. However, many disease states have been reported in association with moyamoya disease, including the following: 1) Immunological - Graves disease/thyrotoxicosis 2) Infections - Leptospirosis and tuberculosis 3) Hematologic disorders - Aplastic anemia, Fanconi anemia, sickle cell anemia, and lupus 4) Congenital syndromes - Apert syndrome, Down syndrome, Marfan syndrome, tuberous sclerosis, Turner syndrome, von Recklinghausen disease, and Hirschsprung disease 5) Vascular diseases - Atherosclerotic disease, coarctation of the aorta and fibromuscular dysplasia, 6)cranial trauma, radiation injury, parasellar tumors, and hypertension etc. These associations may not necessarily be causative but do warrant consideration due to impact on treatment.(Mainly neurosurgical operation.) The incidence of moyamoya disease is highest in Japan. The prevalence of MMD is 1 person per 100,000 population. The prevalence and incidence of moyamoya disease in Japan has been reported to be 3.16 cases and 0.35 case per 100,000 people, respectively. With regard to sex, the female-to-male ratio is 1.4:1. A bimodal peak of incidence is noted, with symptoms occurring either in the first decade(5-10yr) or in the third and fourth decades (30-40yr)of life. Mortality rates of moyamoya disease are approximately 10% in adults and 4.3% in children. Death is usually from hemorrhage. In aspect of life insurance, MR is 1700%, EDR is 16 per 1000 persons. Children and adults with moyamoya disease (MMD) may have different clinical presentations. The symptoms and clinical course vary widely from asymptomatic to transient events to severe neurologic deficits. Adults experience hemorrhage more commonly; cerebral ischemic events are more common in children. Children may have hemiparesis, monoparesis, sensory impairment, involuntary movements, headaches, dizziness, or seizures. Mental retardation or persistent neurologic deficits may be present. Adults may have symptoms and signs similar to those in children, but intraventricular, subarachnoid, or intracerebral hemorrhage of sudden onset is more common in adults. Recently increasing diagnosis of MMD with MRI, followed by surgical operation is noted. MMD needs to be considered as the "CI" state now in life insurance fields.

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Diffus ion-Weighted MR Imaging of Spinal Cord Infarction (척수경색의 확산강조자기공명영상)

  • 김윤정;서정진;임남열;정태웅;김윤현;박진균;정광우;강형근
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.166-172
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    • 2002
  • Purpose : To evaluate the usefulness of diffusion-weighted imaging(DWI) and quantitative apparent diffusion coefficient (ADC) maps in the patients with spinal cord infarction. Materials and methods : We studied 6 patients presented symptoms with spinal cord infarction, retrospectively (3 men and 3 women). We obtained multi-shot echo planar-based, DWI using 1.5T MR scanner at 5.4 mean days after the onset of ischemic symptoms. In six patients, signal intensity was acquired at conventional b value $1000s/\textrm{mm}^2$). The ADC value for the normal spinal cord and for infarcted lesions was measured from the trace ADC maps by using regions of interest positioned over the spinal cord. We analyzed signal intensity of lesion on MRI and DWI, and compared with ADC values in infarcted lesions and normal site. Results : T1-weighted MR image showed isosignal intensity in four of six patients and low signal intensity in two of six. T2-weighted MR image demonstrated high signal intensity in all of six. All DWI were considered to be diagnostic. All of six depicted a bright signal intensity on DWI. ADC values of infarcted lesion were measured lower than that of normal spinal cord on ADC map. The differences in ADC values between infarcted and normal spinal cord were significantly different (p<0.05). Conclusion : It is possible to obtain DWI and ADC map of the spinal cord and DWI may be useful in the early diagnosis and localization of lesion site in patients with spinal cord infarction.

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