• Title/Summary/Keyword: cerebrovascular accident patients

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The Analysis on Research in the Korean Journal of Rehabilitation Nursing (재활간호학회지 논문 분석 - 창간호부터 2004년까지 -)

  • Lim, Nan-Young;Kim, Jeong-Hwa;Cho, Bok-Hee;So, Hee-Young;Park, Song-Ja;Cho, Nam-Ok;Yoo, Kyung-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.8 no.2
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    • pp.119-128
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    • 2005
  • Purpose: The purpose of this study was to analyze research in the Korean Journal of Rehabilitation Nursing and to suggest further perspective for rehabilitation nursing research. Method: In this study we reviewed the contents of 134 articles published in this journal from its beginning year 1998 to 2004. Results: The majority of subjects were adult patients. The type of disease were Cerebrovascular Accident, Neuromuscular disease, Cancer patients, Urogenital disease such as Chronic Renal Failure, Spinal cord injury. Domain of research almost was client, type of research were survey(34.3%), quasi experimental study(20.9%), correlation study(19.4%). Nursing intervention of experimental study was exercise(39.0%), education(17.1%). Place of data collection was hospital (58.2%), position of researcher was professor(67.2%), method of data collection was questionnaire(50.7%). Conclusion: There has been a lack of written consent, child rehabilitation, measurement tool development, qualitative research. More studies about rehabilitation nursing are needed to extend the role and fields for professional nursing.

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Development of the Bedside Neurocognitive Function Localization Test(BNLT) I : A Design (간이 신경 인지기능 국재화 검사의 개발 I : 고안)

  • Lee, Young-Ho;Jung, Hyo-Kyung;Hoe, Si-Young;Koh, Young-Taek;Park, Byung-Kwan
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.133-142
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    • 1999
  • Recently, with increasing the number of patients with head injury and cerebrovascular accident, there has been an increasing need for the useful assessment tools of brain dysfunction and it's localization. With the advances in the neuroscience since the mid-1970s, particularly in the areas of neuroanatomical tracing, neuroimaging, and improved behavioraltest design, it has been possible to develop a more precise understanding and localization of brain dysfunction. However, these equipments are not readily available in the private clinics and too expensive to use as a screening tool to all suspected patients with brain dysfunction. Although several screening tests such as Mini-Mental States Examination(MMSE) or Brief Cognitive Rating Scale(BCRS) are simple in use and useful for the brief assessment of brain dysfunction, these are also limited in using for localization of brain dysfunction because of their simplicity. With increasing need of the assessment tool which is able to localize the dysfunction more precisely in the clinical practice, we planned to develop the new assessment tool, the Bedside Neurocognitive Function Localization Test(BNLT) which is suitable for this purpose. The BNLT was designed to be utilized for localizing brain dysfunction effectively and readily in the clinical practice. We introduced the whole process of designing the BNLT in this manuscript.

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Aortoplasty with Using Gore-Tex Conduit in Dissecting Aneurysms of Descending Thoracic Aorta - Two Cases Report - (GoreTex$^{\circledR}$ 인조혈관을 이용한 해리성 하행 흉부대동맥류 성형술 - 수술치험 2례 -)

  • 정진용
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.816-822
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    • 1989
  • Aneurysms of the descending thoracic aorta can be caused by various etiologies. So, its abrupt rupture leads life-threatening state, it must be operated as soon as possible. Surgical treatment of the descending thoracic aortic aneurysm requires temporary cross-clamping of major artery. The obligatory occlusion of the descending thoracic aorta during management causes proximal arterial hypertension and distal arterial hypotension. The former may leads to left ventricular failure, or cerebrovascular accident, whereas the latter may leads to spinal cord ischemia or renal injury. Some have recommended insertion of temporary shunt around the occluded descending aorta to prevent above problems. Still others would favor expeditious operation employing simple aortic occlusion during the repair of the descending aorta. Recently we had experienced two cases of dissecting aneurysms of descending thoracic aorta which performed aortoplasty with Gore-Tex conduit under simple aortic occlusion. The one was 34-year-old female patient with traumatic dissecting aortic aneurysm [5 em X 5 cm] on the descending thoracic aorta distal to the origin of the left subclavian artery and the other was 58-year-old female patient with atherosclerotic dissecting descending thoracic aortic aneurysm [6 cmX7 cm] and diffuse abdominal aortic aneurysms [3X5 cm]. Both patients performed standard left posterolateral thoracotomy. After the aneurysmal sac was mobilized, occluding vascular clamps were placed on the transverse aorta proximal to the origin of the left subclavian artery, and on the distal descending aorta without adjuvant bypass procedures for 31 and 32 minutes, respectively, and the aneurysmal sac was repaired with 18 mm ringed Gore-Tex conduit graft. Both patients postoperative courses were uneventful.

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Factors influences on early and late results of modified fontan operation (변형 Fontan수술의 수술결과 및 장기결과에 미치는 영향에 관한 연구)

  • Jang, Byeong-Cheol;Park, Yeong-Hwan;Jo, Beom-Gu
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.569-577
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    • 1986
  • Between October 1979 and June 1986, modified Fontan procedures have been performed on 22 patients by the Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine. Twelve patients had tricuspid atresia; one, congenital tricuspid stenosis; five, single ventricle; two, I-transposition of the great vessels; one, double outlet right ventricle, and one, pulmonary atresia with an intact ventricular septum. There were 9 operative deaths [mortality; 40.9%]. The causes of death were right heart failure in six patients and pulmonary venous hypertension in one who misdiagnosed preoperatively. Another two were deceased due to sepsis and cerebrovascular accident at postoperative 35 and 34 days in each. There were 7 patients below 4 years of age at the time of operation and among them 4 patients were deceased. The operative death was not related with patients` age above and below 4[p=0.211]. The relation between operative death of tricuspid anomaly and another cardiac malformations was statistically significant [p=0.048]. The operative procedures with or without valved conduit [woven dacron] was related significantly [p=0.043] in the case of the 21 of the patients, but the modified Fontan operation with a valved conduit was performed early stage in this series. Since 1982, we operated on 4 patients, doing a right atrium-right ventricle anastomosis without a conduit. All survived and remained in functional class I [NYHA]. The right atrial pressure [RAP] was elevated significantly after operation [mean 9.9$\pm$4.8 ~16.9$\pm$3.6 mmHg, p<0.001]. The relation between the postoperative RAP of the survival group [16.5$\pm$4.3 mmHg] and the group who died [17.4$\pm$2.2 mmHg] was statistically significant [p=0.047]. There was no relation between any operative death and any previous palliation. All patients were followed for 4 months to 80 months, except one who was lost to follow up at 2 months following surgery [mean 11.4 months, 238 patient. months]. All were in functional class I with 5 on medications and 7 not. One was reoperated at 70 months following the first operation, due to conduit stenosis. She was moderately impaired in activity, with hepatomegaly after the second operation.

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A Study on the Food Habits and Attitudes of Cerebrovascular Accident Patients in Daegu S Medical Center (대구 S병원 뇌졸중 환자의 생활 습관 및 식습관에 관한 조사 연구)

  • Lee, Seung-A;Jeon, Seon-Min;Kim, Hye-Jin;Do, Gyeong-Min;Jung, You-Mi;Choi, Myoung-Sook
    • Journal of the East Asian Society of Dietary Life
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    • v.18 no.4
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    • pp.436-445
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    • 2008
  • Stroke is a serious disease despite recent improvements in the medical treatments available. Thirty-six stroke patients were interviewed as case and 36 non-stroke patients were interviewed as controls between February 2005 and August 2005 at Daegu S Medical Center. Information regarding the subjects' food habits was collected using the recall method from 5 years before the onset of stroke. Using interview techniques, we investigated how dietary habits and attitude influence nutrient intake. These results were analyzed by the $X^2$, Student's t-test and Chi-square test using the SPSS 12.0 program. This case-control study was performed to demonstrate the relationships among general quality factors (BMI, WHR, and family history of stroke) and lifestyle factors (smoking, exercise and alcohol drinking). The results were as follows. Analysis of the percentage of nutrient intake in terms of meal pattern showed that WHR was significantly higher in the case group than in the control group. Hypertension and diabetes were the most common preceding diseases associated with the risk of stroke. The frequencies of smoking, alcohol consumption (p<0.001) and exercise (p<0.05) were higher in the cases than in the controls. Thus, the findings of this study are consistent with those of previous studies and suggest that people should be advised to control hypertension, smoking, alcohol drinking and obesity in order to prevent the occurrence of stroke as these factors are major risk factors for stroke.

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Early Postoperative Complications after Heart Transplantation in Adult Recipients: Asan Medical Center Experience

  • Kim, Ho Jin;Jung, Sung-Ho;Kim, Jae Joong;Kim, Joon Bum;Choo, Suk Jung;Yun, Tae-Jin;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.426-432
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    • 2013
  • Background: Heart transplantation has become a widely accepted surgical option for end-stage heart failure in Korea since its first success in 1992. We reviewed early postoperative complications and mortality in 239 patients who underwent heart transplantation using bicaval technique in Asan Medical Center. Methods: Between January 1999 and December 2011, a total of 247 patients aged over 17 received heart transplantation using bicaval technique in Asan Medical Center. After excluding four patients with concomitant kidney transplantation and four with heart-lung transplantation, 239 patients were enrolled in this study. We evaluated their early postoperative complications and mortality. Postoperative complications included primary graft failure, cerebrovascular accident, mediastinal bleeding, renal failure, low cardiac output syndrome requiring intra-aortic balloon pump or extracorporeal membrane oxygenation insertion, pericardial effusion, and inguinal lymphocele. Follow-up was 100% complete with a mean follow-up duration of $58.4{\pm}43.6$ months. Results: Early death occurred in three patients (1.3%). The most common complications were pericardial effusion (61.5%) followed by arrhythmia (41.8%) and mediastinal bleeding (8.4%). Among the patients complicated with pericardial effusion, only 13 (5.4%) required window operation. The incidence of other significant complications was less than 5%: stroke (1.3%), low cardiac output syndrome (2.5%), renal failure requiring renal replacement (3.8%), sternal wound infection (2.0%), and inguinal lymphocele (4.6%). Most of complications did not result in the extended length of hospital stay except mediastinal bleeding (p=0.034). Conclusion: Heart transplantation is a widely accepted option of surgical treatment for end-stage heart failure with good early outcomes and relatively low catastrophic complications.

A Retrospective Review of Tracheobronchial Foreign Bodies (기도 이물의 임상적 고찰)

  • Son, Chang-Young;Wee, Jeong-Ook;Kim, Soo-Ock;Oh, In-Jae;Park, Chang-Min;Kim, Kyu-Sik;Kim, Yu-Il;Lim, Sung-Chul;Lim, Sang-Chul;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.600-606
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    • 2005
  • Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.

The Effect of External-rotation Reducing Exercise on the Gait of Patient with Hemiplegia (편마비 환자의 보행에 대한 외회전 감소운동의 효과)

  • Kim, Ah-Ram;Park, Cheol-Ju;Ryu, In-Jeong;Choi, Jeong-Wook;Hyun, Ju-Hyup;Cho, Nam-Jung;Yoo, Byung-Kook;Jeong, Jong-Hee;Lee, Ho-Jun
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.6 no.1
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    • pp.69-79
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    • 2008
  • In this paper, the effects of the external-rotation exercise on the gait of hemiplegia was investigated. 26 patients with hemiplegia due to cerebrovascular accident participated in this study. Subjects were randomly assigned to experimental group(n=12) and control one(n=14). 12 subjects of the experimental group were received the external rotation reducing exercise on the mat with seating and supine posture after the general therapeutic exercise for hemiplegia. 14 subjects of the control group were received only general therapeutic exercise. The effects of external rotation reducing exercise were evaluated by measurements of gait velocity, cadence, stride length, step length and foot angle using ink-foot prints. The collected data were analyzed statistically based on Wilcoxon, Mann-Whitney and correlation analysis. After treatment of three weeks, it turned out that external rotation reducing exercise has the significant effect on foot angle(p<0.01). However the exercise has no statistically significant direct effect on the gait velocity, cadence, stride length and step length.

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Effects of moving cupping therapy on the edematous hands of three patients with flaccid hemiplegia (뇌졸중 편마비로 인한 수부(手部) 부종(浮腫) 환자 3례에 대한 주관법(走罐法)의 효과)

  • Lee, Hong-Min;Jun, Heung-Jun;Hwang, Uk;Nam, Sang-Su;Kim, Yong-Suk
    • Journal of Acupuncture Research
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    • v.19 no.2
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    • pp.231-237
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    • 2002
  • Objective : This study evaluated the effect of Moving Cupping therapy for the edematous hands of the three person with flaccid hemiplegia. Method : The subjects were from 1 month to 4 month post-cerebrovascular accident with flaccid hemiplegia. Each subjects routine therapy program was maintained throughout Single subject ABA withdrawal design. During the first week, baseline data were gathered, during the second week the intervention was provided(20 minutes of Moving Cupping therapy), during third week data were gathered with treatment withdrawn. Edema was measured with a hand volumeter and a measuring tape. Results : The Moving Cupping had an effect in reducing edema in the hands of the three subjects. Conclusion : The Moving Cupping therapy is a readily available tool that could enhance the treatment of edematous hands of persons with flaccid hemiplegia by offering a contribution to already established treatment protocols. Further research is needed, however, to establish guidelined for use.

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Body Mass Index and Risk of Hemorrhagic Stroke in Korean Adults: Case-control Study (체질량지수와 출혈성 뇌졸중 발생간의 관련성에 대한 환자-대조군연구)

  • Kim, Seon-Ha;Lee, Yong-Seok;Lee, Seung-Mi;Yoon, Byung-Woo;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.313-320
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    • 2007
  • Objectives : To evaluate the association between body mass index (BMI) and hemorrhagic stroke. Methods : A case-control study was conducted on 2,712 persons (904 cases, 904 hospital controls, and 904 community controls) participating in an Acute Brain Bleeding Analysis study from October 2002 to March 2004. Two controls for each case were matched according to age and gender. The information was obtained by trained interviewers using standardized questionnaire. A conditional logistic regression model was used to estimate the association between BMI and the frequency of having a hemorrhagic stroke. Results : Obese men (25.0 $\leq$ BMI < $30.0\;kg/m^2$) had an odds ratios (OR) of 1.39 (95% CI 1.03 to 1.87) a hemorrhagic stroke, compared to men with a normal BMI (18.5 to $24.9\;kg/m^2$). Conversely, women with lower BMI had a higher risk of having hemorrhagic stroke. With respect to subtypes of hemorrahagic stroke, we observed about a three-fold increase in the risk of intracerebral hemorrhage (ICH) in the highly obese group. However, these trends were not significant in patients with subarachnoid hemorrhages. Conclusions : Obesity was identified as one of the risk factors in hemorrhagic stroke, in particular ICH. Conversely, in women, a lean body weight increases the risk of hemorrhagic stroke. Consequently, managing one's weight is essential to reduce the risks of hemorrhagic stroke.