• Journal of Korean Neurosurgical Society
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• v.63 no.1
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• pp.56-68
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• 2020

Objective : To analyze the incidence and treatment trends of hemorrhagic stroke (HS), according to HS subtypes, using nationwide data in Korea from January 2008 to December 2016. Methods : We used data from the national health-claim database provided by the National Health Insurance Service for 2008-2016 using the International Classification of Diseases. The crude incidence and age-standardized incidence of each disease associated with HS, which included intracranial aneurysm (IA), hypertensive intracerebral hemorrhage (ICH), and arteriovenous malformation (AVM), were calculated and additional analysis was conducted according to age and sex. Changes in trends in treatment methods and number of treatments were analyzed for each cerebrovascular disease using the Korean Classification of Diseases procedure codes. Results : In 2016, the total number of newly diagnosed adult patients with HS was 24169, showing a decrease by 7.0% since 2008; the age-standardized incidence of HS was 46.2 per 100000 person-years. The age-standardized incidence of unruptured IA (UIA) in adults was 71.4 per 100000 person-years-increased by 2.6-fold since 2008-while that of ruptured IA (RIA) was 12.6 per 100000 person-years, which had decreased at a rate of 20.3% since 2008. The number of coil embolization (CE) for UIA increased by 3.4-fold over 9 years and exceeded that of clipping since 2008. With respect to RIA, CE increased by 2.0-fold over 9 years and exceeded that of clipping from 2014. As for spontaneous ICH in adults, the age-standardized incidence was 31.3 per 100000 person-years in 2016-decreased by 34.7% since 2008-and 14.6% of patients diagnosed with ICH were treated in 2016, which was not significantly different from the proportion of patients treated since 2008. The age-standardized incidence of unruptured AVM (UAVM) was 2.0 per 100000 person-year in 2016, while that of ruptured AVM (RAVM) was 2.4 per 100000 person-years in 2016, showing a decreasing rate of 17.2% from 2008. The total number of treated patients with AVM declined since 2014. Conclusion : In Korea, age-related cerebral vascular diseases, such as RIA, ICH, and RAVM, demonstrated a declining trend in age-standardized incidence; meanwhile, UIA and UAVM demonstrated an increased trend in both crude incidence and age-standardized incidence for 9 years. The increase in the elderly population, management of hypertension, and development of diagnostic and endovascular techniques appear to have influenced this trend.

• Health Policy and Management
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• v.30 no.2
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• pp.231-244
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• 2020

Background: As the population is aging, chronic diseases and depression are becoming the main problems in a country's healthcare system. In this study, we aimed to explore the associations between chronic diseases and depression among the elderly in South Korea. Methods: We analyzed 9,975 (men, 4,147; women, 5,828) respondents obtained from the 2014 National Survey of Living Conditions and Welfare Needs of Korean Older Persons. Our dependent variable was either 1 or 0 according to whether a respondent had depression or not, where depression was defined when the Short Form of Geriatric Depression Scale score was 8 or more points. Variables of interest were 24 types of chronic diseases and covariates included various socio-demographic and health behavior characteristics. We performed Rao-Scott chi-square tests and hierarchal logistic regression analyses by gender, reflecting the characteristics of the survey. Results: A significant difference was found in the proportion of having depression between genders (men 18.9% vs. women 23.4%). According to fully adjusted, multivariable analyses, for elderly men, relative to those without any chronic disease, the odds ratio of depression was 1.56 (95% confidence interval [CI], 1.10-2.22) in the stroke patients group and 1.82 (95% CI, 1.01-3.25) in the osteoporosis patients group. For elderly women, the odds ratio was 1.96 (95% CI, 1.28-3.00) in the fracture/dislocation and aftereffects patients group and 1.30 (95% CI, 1.03-1.64) in the group of patients with other diseases. Conclusion: Even after being adjusted for diverse characteristics, some chronic diseases were significantly associated with depression in the elderly and the association differed between genders. Therefore, public health and medical interventions are needed to manage such chronic diseases together with curing depression symptoms.

• Journal of Applied Biological Chemistry
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• v.66
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• pp.250-257
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• 2023

Glutamate is an excitatory neurotransmitter distributed in the central nervous system of mammals. However, high concentrations of glutamate are known to cause neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and stroke by causing nerve cell death. In this study, the antioxidant activity and neuroprotective effect of subtropical natural products were analyzed. Among 11 subtropical plant extracts mainly tested, Sallacca wallichiana extract (SE) showed the greatest free radical scavenging activity. Then, we confirmed through WST-1 assay that SE protected HT22 cells against glutamate-induced cell death in a concentration-dependent manner. The protective effects of SE against glutamate-induced apoptosis in HT22 cells were also confirmed by flow cytometry analysis using Annexin V/PI double staining. We also confirmed using H₂DCF-DA single staining that SE inhibits glutamate-induced intracellular reactive oxygen species. And we were confirmed through that SE inhibited glutamate-induced phosphorylation of Mitogen-activated Protein kinases. Consequently, our results propose that SE may contribute to the development of therapeutics to prevent neurodegenerative diseases.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.302-328
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• 1996

I . Objective and significance of the study To design a data acquisition chart, which facilitates data collection and analysis. The chart is also useful for solving problems that arise from personal variations in clinical symptoms and filling the knowledge base of an expert system. II. Content and scope 1. Collect the diagnosis knowledge of cerebrovacular diseases from doctors and analyze it. 2. Design a data acquisition chart. 3. Compare ODS and doctors with respect to their diagnosis results 4. Select patients who are determined to suffer from cerebrovascular diseases using CT(computed tomographic) scan, collect clinical data from them. III. Results and Application The chart be used for data collection and analysis in different medical hospitals, The results of data analysis facilitates collecting clinical data about other diseases and implementing the knowledge base. Also, the collected data serves as a tool for medical education, and cooperative diagnosis of oriental and western medical doctors.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.38-45
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• 2017

Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

• 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.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.790-798
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• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.313-323
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• 2009

Diffusion-weighted imaging (DWI) has been demonstrated to be a practical method for the diagnosis of various brain diseases such as acute infarction, brain tumor, and white matter disease. In this study, we used two techniques to examine the average signal intensity (SI) and apparent diffusion coefficient (ADC) of the brains of patients who ranged in age from 10 to 60 years. Our results indicated that the average SI was the highest in amygdala (as derived from DWI), whereas that in the cerebrospinal fluid was the lowest. The average ADC was the highest in the cerebrospinal fluid, whereas the lowest measurement was derived from the pons. The average SI and ADC were higher in $T_2^*$-DW-EPI than in FLAIR-DW-EPI. The higher the b-value, the smaller the average difference in both imaging techniques; the lower the b-value, the greater the average difference. Also, comparative analysis of the brains of patients who had experienced cerebral infarction showed no distinct lesion in the general MR image over time. However, there was a high SI in apparent weighted images. Analysis of other brain diseases (e.g., bleeding, acute, subacute, chronic infarction) indicated SI variance in accordance with characteristics of the two techniques. The higher the SI, the lower the ADC. Taken together, the value of SI and ADC in accordance with frequently occurring areas and various brain disease varies based on the b-value and imaging technique. Because they provide additional useful information in the diagnosis and treatment of patients with various brain diseases through signal recognition, the proper imaging technique and b-value are important for the detection and interpretation of subacute stroke and other brain diseases.

• Journal of Digital Convergence
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• v.11 no.9
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• pp.229-238
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• 2013

Out-of-hospital cardiac arrest is a major public health problem in Korea. The survival rate to discharge remains at approximately 3.5% and only 1% have good neurological function. To increase the survival rate, prehospital care should restore spontaneous circulation. The purpose of this study was to analyze the factors associated with return of spontaneous circulation(ROSC) after out-of-hospital cardiac arrest. Data used for this study were collected from KCDC Out-of-Hospital Cardiac Arrest Surveillance 2009. As for the results of decision tree analysis, it is clear that prehospital CPR, cardiac arrest witness, activity, past history(cancer/heart disease/stroke), place, bystander CPR, response time, age, etc are significant contributing factors in ROSC. Among 16 cardiac arrest types from decision tree classification, the ROSC rate of type 1 is the highest(29.6%). Also notable is the fact that bystander CPR was strongly correlated with ROSC of patents with cardiac arrest occurring in non-public places. Community resources should be concentrated on increasing bystander CPR and early prehospital emergency care.

• Korean Journal of Clinical Pharmacy
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• v.12 no.1
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• pp.29-38
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• 2002

Hypertension is an important public health problem because it increases the risk of stroke, angina, myocardial infarction, heart failure, and end-stage renal disease. If it is not actively treated, morbidity and mortality increase with hypertension-induced complications and quality of life decreases. This study was to evaluate the use of antihypertensive drugs and blood pressure changes and to compare algorithms chosen (or the 1st and 2nd line therapy of hypertension based on the JNC VI recommendations. The medical charts of 222 patients with essential hypertension at St. Vincent's Hospital in Suwon from January 1997 to January 2000 were reviewed retrospectively. Data collection and analysis included baseline BP underlying diseases and complications, administered antihypertensives, BP changes, changes of antihypertensive regimen, and adverse effects with treatments. As results, the higher BP the patients had, the more frequent they had target organ damages and clinical cardiovascular diseases. Mean duration to reduce blood pressure less than 140/90 mmHg was 8 weeks in $85.3\%$ of the patients. The rate of control in BP was $82.4\%$ at 6 months. The major antihypertensive drugs prescribed were calcium channel blockers $(61.8\%)$ , ACE inhibitors $(19.1\%),\;\beta-blockers\;(13.7\%)$ and diuretics $(5.3\%)$ as the 1st-line monotherapy. The methods of treatment used as the 1st-line therapy were monotherapy$(59\%)$ and combination therapy $(41\%)$. Blood pressure change was significantly greater for combination therapy than monotherapy$(-26.2\pm21.4\;vs.\;-18.56\pm16.7$ mmHg for systolic blood pressure; P<0.003, $-16.9\pm13.2\;vs.\;-9.2\pm12.8$ mmHg for diastolic blood pressure; p<0.001). When blood pressure was not completely controlled with the first antihypertensive selected, the 2nd line therapy had 4 options: addition of 2nd agent from different class; $66.2\%$, substitution with another drug, $21.9\%$ increase dose $11.9\%$ continue first regimen $27.9\%$ Calcium channel blockers were the most frequently prescribed agents. This was not comparable to the JNC VI guideline which recommended diuretics and $\beta-blockers$ for the 1st-line therapy. Most of patients achieved the goal BP and maintained it until 6 months, but the remaining patients should be controlled more tightly to improve their BP with combination of life style modification, patient education, and pharmacotherapy.