• Title/Summary/Keyword: cerebrovascular accident patients

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A Study on the Nutrient Intake in Relation to Food Habit and Attitude of Cerebrovascular Accident Patients (뇌졸중환자의 식습관 및 식생활태도가 영양소 섭취량에 미치는 영향)

  • 김성미;정영미
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.2
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    • pp.295-305
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    • 2002
  • This paper, in which whose subjects were 43 cerebrovascular accident patients analysed the effects of flood habits and attitudes on the nutrient intake. In respect to energy intake, the subjects took 106% of RDA. The protein intake was on the average of 119.1 g, which was 187% of RDA. The fat intake by the subjects on the whole was 60.5 g. The fiber intake of the subjects was 9.6 g. Those who like sweets took in significantly less energy and carbohydrate and more fat than those who didn't like sweets. Those who liked salty flood took in 7890 mg of sodium while those who didn't like salty food took in 5579 mg of sodium. The former took in significantly more sodium than the latter (p < 0.05). The examination of the amount of nutrient intake in terms of meal pattern, showed that those who had two meals a day were significantly higher in the level of weight and BMI was significantly higher (p<0.05) and the level of energy, protein, calcium, iron, vitamin A, vitamin C and cholesterol was significantly higher. Those who thought they had heavy meals took significantly more energy, protein, calcium iron, vitamin A vitamin B$_1$and vitamin C than those who thought they had light meals. Rapid eaters took more nutrients than slow eaters. The multiple regression analysis has shown that the effect of the independent variables on the energy intake are in the order of eating speed, eating volume and eating frequency. They can explain 24.6% of the energy intake. As a result, the faster is eating speed, the heavier is eating volume, and the lower is eating frequency, the higher is the energy intake (p <0.01).

Association of advanced chronic kidney disease with diabetic retinopathy severity in older patients with diabetes: a retrospective cross-sectional study

  • Geun Woo Lee;Chul Ho Lee;Seong Gyu Kim
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.146-155
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    • 2023
  • Background: Despite the recent increasing trend in the prevalence of type 2 diabetes among older individuals, the relationship between diabetic retinopathy (DR) and chronic kidney disease (CKD) in these patients remains unclear. This study investigated the severity of renal dysfunction according to the degree of DR in older patients with type 2 diabetes. Methods: A total of 116 patients with diabetes and CKD stage ≥3 who visited both the nephrology and ophthalmology outpatient departments between July 2021 and January 2022 were screened. There were 53 patients in the no DR group, 20 in the nonproliferative DR (NPDR) group, and 43 in the proliferative DR (PDR) group. Results: DR severity was related to the deterioration of renal function. The proportion of patients with advanced CKD significantly increased with DR severity (p for trend <0.001). In the multivariate regression model adjusted for age of ≥80 years, male sex, poorly controlled diabetes, macroalbuminuria, insulin use, diabetes duration of ≥10 years, cerebrovascular accident, hypertension, hyperlipidemia, and cardiovascular disease history, the odds ratio compared with the no DR group was approximately 4.6 for the NPDR group and approximately 11.8 for the PDR group, which were both statistically significant (p=0.025 and p<0.001, respectively). Conclusion: DR severity in older patients with diabetes may be associated with deterioration of renal function and high prevalence of advanced CKD. Therefore, periodic examination for DR in older patients with diabetes is important for predicting renal function deterioration and CKD progression.

The Effects of Agent Orange in Patient with Pneumonia (고엽제 노출이 폐렴의 치료 결과에 미치는 영향)

  • Kim, Dong Sung;Lee, Jungyoup;Kye, Yu Chan;Jung, Euigi;Jeong, Ki Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.1
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    • pp.26-33
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    • 2020
  • Purpose: Agent Orange (AO) is a herbicide and defoliant used by the United States and its military allies during the Vietnam War. Pneumonia is a common cause of death among Vietnam veterans in our hospital. There have been no previous studies researching any association between AO exposure and the prognosis for pneumonia. The primary objective of this study was to investigate associations between AO exposure and 30-day mortality due to pneumonia. The secondary objective was to examine the clinical factors associated with therapeutic outcomes in veterans with pneumonia, and to assess the prevalence of combined diseases in AO-exposed veterans. Methods: This study retrospectively included veteran patients diagnosed with pneumonia in the emergency department and hospitalized between February 2014 and March 2018. The enrolled patients were grouped according to their defoliant exposure history, and the clinical information of defoliant-exposed and non-defoliant-exposed groups were compared. Patients were divided according to 30-day mortality, and significant factors influencing mortality were evaluated by using univariate analysis and multivariate analysis. The final multivariate model revealed the effect of AO exposure on therapeutic outcomes of pneumonia. Results: A total of 1006 patients were analyzed. Of these, 276 patients had a history of AO exposure, whereas 730 patients had not been exposed. Factors positively associated with 30-day mortality were malignancy, respiratory rate, blood urea nitrogen, and albumin which was negatively associated with mortality. Conclusion: Exposure to defoliant is not associated with 30-day mortality in patients with pneumonia. However, veterans with defoliant exposure are associated with a high prevalence of diabetes mellitus, hypertension, cerebrovascular accident, malignancy, and chronic kidney disease.

A Clinical study on the patients of Brain stem infarction (뇌간경색환자에 대한 임상적 고찰)

  • Park, Kyu-Taek;Kim, Young-Kyun;Kwon, Jung-Nam;Park, Sook-Ja
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.729-738
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    • 2000
  • Objective : We examined patients admitted to Dong Eui University Oriental Medical Hospital from 1st January to 31st December in 2000. We studied 110 cases of patients who were diagnosed as Brain stem(pons, mid brain, medullar) infarction with brain CT, MRI scan, MR Angiography. Methods : We analyzed patients into sex, age, onset time, invasion lesion, past and family history, risk factor, abnormal vital sign for early 2 weeks, prodromal symptoms, symptoms at entry, progress and incidental symptoms at acute stage, complications, the state of condition at discharge, demonstrations, herb medications, western and oriental medical cooperation and admission period. Results : Our study was similar to existing studies in the distribution of sex, age, past and family history and risk factors. But there was some differences in the prodromal symptoms, symptoms at entry progress and incidental symptoms at acute stage, and the state of condition at discharge. Conclusions : Our study shows the brain stem infarction patients differed from other cerebrovascular accident patients in the symptoms. We hoped that our study would be further studied in western and oriental medicine.

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Factors Influencing the Hospital Presentation Time of Stroke Patients (뇌졸중 환자의 병원 내원시간에 영향을 미치는 요인)

  • Lee, Sang Hyun;Lee, Young Whee;Kim, Hwa Soon;Lim, Ji Young
    • Korean Journal of Adult Nursing
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    • v.19 no.2
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    • pp.167-177
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    • 2007
  • Purpose: This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. Methods: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. Results: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(${\chi}^2=18.629$, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. Conclusion: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.

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Clinical Validity of the Domestic EEG and EP Mapping System(Neuronics) (국산화 EEG 및 EP Mapping System(Neuronics)의 임상적 타당성 연구)

  • Min, Sung-Kil;Jon, Duk-In;Lee, Sung-Hoon;Ahn, Chang-Beom;Yoo, Sun-Kook
    • Sleep Medicine and Psychophysiology
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    • v.4 no.1
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    • pp.96-106
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    • 1997
  • The clinical validity of a korean EEG and EP mapping system(Neuronics) was evaluated with schizophrenic patients(n=20), normal controls(n=19), and 10 patients with central nervous system disease(8 patients with cerebrovascular accident, 1 patient with brain mass, and 1 patient with periodic paralysis). In the normal control group, the pattern of resting computerized EEG with eyes closed showed normal parieto-occipital dominance of alpha wave. Compared with normal controls, schizophrenic patients had more delta activity in the frontal region, and less alpha activity especially in the parieto-occipital region. In most cases patients with cortical organic lesions(n=5) revealed increased delta and theta activity and decreased alpha activity on the lesion areas. These findings were compatible with their MRI and clinical findings. However in the cases of subcortical lesions(n=5) EEG showed various findings which suggest diverse influences of subcortical abnormalities on cortical activities. The P300 of schizophrenic group was smaller and more delayed than those of normal controls. These results are generally compatible with the previous studies using other EEG and EP mapping systems consequenty and suggest that the this EEG and EP mapping system(Neuronics) has clinical validity.

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Clinical Analysis of the Arterial Bypass Surgery for Chronic Ischemia of the Lower Extremities (하지 만성 허혈에 대한 동맥 우회술의 임상적 고찰)

  • 안정태
    • Journal of Chest Surgery
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    • v.28 no.7
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    • pp.678-683
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    • 1995
  • Arterial bypass for the chronic ischemia of the lower extremities underlying atherosclerotic obliterans has been performed with a number of alternative conduits from 1941 by Kunlin. It is indicated for the limb salvage of patients with threatened limb loss despite of several controversies in surgical treatment of atherosclerotic obliterans. From March 1991 to January 1995, 26 arterial bypasses were performed in 23 patients with the chronic ischemia of the lower extremities in our hospital. Their mean follow up period is 18.9 months ranging from 4 months to 44 months. Mean age is 60.9 years ranging 47 years to 76 years and the most prevalent incidence is the 6th decade. 21 patients are male and 2 patients are female. 19 of 23 patients are smokers. Clinical classifications by Fontaine are class II[21.7% , class III[34.8% and class IV[43.5% .Diabetes mellitus[47.8% , hypertension[43.5% , hyperlipid-emia[26% , tuberculosis[21.7% , cerebrovascular accident[13.0% and cardiac diseases[8.7% are associated. Aorto-single femoral bypass in 4 cases, aorto-bifemoral bypass in 5 cases, aortofemoral & femoropopliteal bypass in 2 cases, femoropopliteal bypass in 10 cases, popliteotibial bypass in 3 cases, femoropedal bypass[composite graft bypass in 2 cases were surgically approached. There are complicated early thrombosis in 4 cases those are required immediately reoperation, wound infection in 3 cases, hematoma in 3 cases, and so on. Postoperative complication rate is 53.8%.Postoperative patency rates are 84.6% at 6 months, 75.0% at 1 year, 70.0% at 2 years and 66.7% at 3 years. We usually used 6 mm & 8 mm graft for bypass, and the rate of thrombosis formation is 28.6%[2/7 in 6 mm graft and 12.5%[2/16 in 8 mm separately. In according to the graft materials, the rate of thrombosis formation is higher in the group using artificial graft than in that using autologous saphenous vein[16.6% vs 12.5% . Limb salvage rate is 76.9%. Postoperative mortality rate is zero %.

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Clinical Studies on 56 Cases of Having Treated patients suffering from Ischemic Stroke through both Urokinase and Therapeutics of Oriental Medicine (Urokinase와 동의학적요법(東醫學的療法)으로 동시치료(同時治療)한 허혈성뇌졸중환자(虛血性腦卒中患者) 56례(例)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Kim, In-Sup
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.46-91
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    • 1994
  • l. Backgrounds of Studies Cerebrovascular accident. one of the three major causes of death among audults with cardiopathy and malignancy, has been on the increase in korea while it is on the decrease in European countries and Japan. Types of stroke undergo changes caused by prolongment of life expectancy. and social and economic variety. More patients of ischemic stroke show a tendency to increase now than those of hemorrhagic stroke in the past. Many clinical studies on medical cerebrovascular and oriental stroke of paralysis have been published. but few clinical studies on therapeutics of integrated oriental and western medicine are to be found. So I have made an attempt to study clinical observations and therapeutic responses of ischemic stroke under integrated oriental and western medicine. 2.Methods. Among the patients admitted into the clinic of Joong-Poong, Woo-Suk University Hospital from May 1. 1993 until April 30. 1994 those 56 patients who were diagnosed as ischemic stroke on Computed Tomography(CT) and showed no dubious symptom after examination of coagulation and bleeding time were classified into the following six steps and treated: l)diagnosis 2)emergency treatment 3)basic treatment 4)treatment of risk and provoking factors. and preceeding disease 5)complications and conservative therapy 6)rehabilitation. For a period of basic treatment both herb medication and urokinase therapy were applied at the same time. Intravenous injection has been given at a unit of 300.000 dosage a day as urokinase therapy during basic treatment. If they showed any dubious symptom in glucose tolerance test. fructose 500ml and urokinase 300.000 dosage were mixed and injected. In case of no symptom 5% DW 500ml was mixed with urokinase 300.000 unit. and injected at a speed of 15gtt per minute. 3. Results and Conclusions 1) The level of ambulation has been improved from 42.9% when admitted to 73.2% when discharged in the degree of recovery. The level of severe function disorder has been remarkably decreased from 55.4% when admitted to 19.6% when discharged. 2) The treatment effect on the basis of therapeutic response of clinical and subjective symptom shows as follows: 7.1% Excellent. 35.7% Good. 37.5% Effective. 10.7% Stationary. and 8.9% Aggravated. The total recovery above effective shows 80.3%. Judging from the above results I think it proper to develop the model of better preventing and treating ischemic stroke through effective therapeutic and clinical studies of integrated oriental and western medicine.

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Selected Characteristics and Degree of Physical Disability of Stroke Survivors at Discharge from Five General Hospitals in Seoul, 1975 (중추 신경계 혈관질환(C. V. A)환자 중 퇴원환자의 신체기능장애정도와 그 특성에 관한 고찰)

  • 이선옥
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.23-28
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    • 1976
  • This study was undertaken to obtain information about selected characteristics and the degree of physical disability of patients with a diagnosis of cerebrovascular accident upon their discharge from a general hospital. It was hoped that this information would contribute to the assessment of their needs for follow-up nursing care. Nurse's and Physician's Progress Notes of all stroke patients discharged from five general hospitals in Seoul from January to December 1975 were analysed using a prepared check list. Patients with other complicating diagnosis such as diabetes, tuberculosis or heart disease were excluded from the sample. According to six factors used to grade the total sample of 334 stroke victims degree of physical ability at discharge, 144 (43%) of the Survivors had good functional ability, 72 (22%) fair, 62 (18%) poor, and 57(17%) very Poor. Certain clinical diagnosis correlated with the degree of physical ability. Intra cranial Hemorrhage and Subarachnoid Hemorrhage tended to be related to poor and very poor outcome categories. There was no significant correlation between nae and ability outcome, women had revealed a significantly positive correlation with poor and very poor ability outcomes. The hospitalization period was less than three days for 37.5% of the total group, and more than one month for 4.7%. Those patients with less than three days hospitalization accounted for the highest relationship with poor and very poor ability outcomes. Of the total groups 175(50.99%), were discharged with a diagnosis of condition improved (though not necessarily with good physical ability). The results suggest serious need for comprehensive follow- up nursing care for stroke survivors discharged a from general hospitals in Seoul.

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A Review of Falls in the Elderly and Exercise Intervention (지팡이의 형태가 뇌졸중 환자의 보행 시 근활성도에 미치는 영향)

  • Choi, Young-Won;Jeong, Dae-Geun;Han, Jin-Tae;Lee, Myung-Hee;Kweon, Oh-Hyun;Bae, Sung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.2
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    • pp.125-134
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    • 2007
  • Purpose : This study is to determine effects of cane-shape which influenced on the change of muscle activation, gait component in hemiplegic patients caused by cerebrovascular accident. Methods : Twenty one stroke patients using T-shape cane(TCG) and twenty one stroke patients using I-shape cane(ICG) participated in this study. Surface electromyography(SEMG) of erector spinae, transvers abdominis, tibialis anterior, soleus of both side were measured during walking without cane and walking with cane. Results : The activation of tibialis anterior was significantly increased in affected side of ICG. The activation of tibialis anterior was significantly decreased in affected side of TCG. The activation of soleus was significantly increased in affected side of ICG. The activation of soleus was significantly decreased in affected side of TCG. The activation of erector spinae was significantly increased in nonaffected side of ICG and TCG. The activation of transvers abdominis was significantly increased in nonaffected side of ICG and TCG. Conclusion : From the finding of this study, it was suggested that I-shape cane increase weight bearing of affected side in hemiplegic patient. Therefore, I-shape cane can be applied to improve gait asymmetry of hemiplegic patients.

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