• Title/Summary/Keyword: effective stroke

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A Case Study of Korean Medicine Treatment in a Patient Complaining of Generalized Dystonia (전신성 근긴장이상을 호소하는 환자에 대한 한의 치료 1례)

  • Kyeong-hwa Lee;Hye-min Heo;Dong-joo Kim;Min-jae Kwak;Ye-chae Hwang;Seung-yeon Cho;Jung-mi Park;Chang-nam Ko;Seong-uk Park
    • The Journal of Internal Korean Medicine
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    • v.45 no.2
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    • pp.208-218
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    • 2024
  • We report a case of generalized dystonia that developed from oromandibular dystonia and improved following Korean medicine treatment. The patient was hospitalized for 18 days and treated with herbal medicine, mainly Hyeongbangsabaek-san and Soyangbowi-tang, acupuncture, electroacupuncture, pharmacopuncture, cupping, and moxibustion. To evaluate the clinical effects of the treatment, we used the Unified Dystonia Rating Scale (UDRS) and Global Dystonia Severity Rating Scale (GDS) and checked dyskinesia occurrence in a diary recorded by the patient's guardian. After 18 days of hospitalization, the UDRS for the trunk, upper extremities, and lower face improved by more than 50%, and the GDS for the whole region, except the larynx and lower face, also improved. In addition, the maximum duration of dystonia decreased from 6 hours to 3 hours, and the pain and numbness associated with dystonia disappeared. This case suggests that Korean medicine treatment is effective in treating generalized dystonia.

Anti-thrombotic effect of artemisinin through regulation of cAMP production and Ca2+ mobilization in U46619-induced human platelets (U46619 유도의 사람 혈소판에서 cAMP 생성 및 Ca2+동원의 조절을 통한 Artemisinin의 항혈전 효과)

  • Chang-Eun Park;Dong-Ha Lee
    • Journal of Applied Biological Chemistry
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    • v.66
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    • pp.402-407
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    • 2023
  • The regulation of platelet aggregation is crucial for maintaining normal hemostasis, but abnormal or excessive platelet aggregation can contribute to cardiovascular disorders such as stroke, atherosclerosis, and thrombosis. Therefore, identifying substances that can control or suppress platelet aggregation is a promising approach for the prevention and treatment of these conditions. Artemisinin, a compound derived from Artemisia or Scopolia plants, has shown potential in various areas such as anticancer and Alzheimer's disease research. However, the specific role and mechanisms by which artemisinin influences platelet activation and thrombus formation are not yet fully understood. This study investigated the effects of artemisinin on platelet activation and thrombus formation. As a result, cAMP production were increased significantly by artemisinin, as well as phosphorylated VASP and IP3R which are substrates to cAMP-dependent kinase by artemisinin in a significant manner. The Ca2+ normally mobilized from the dense tubular system was inhibited due to IP3R phosphorylation from artemisinin, and phosphorylated VASP by artemisinin aided in inhibiting platelet activity via αIIb/β3 platelet membrane inactivation and inhibiting fibrinogen binding. Finally, artemisinin inhibited thrombin-induced thrombus formation. Therefore, we suggest that artemisinin has importance with cardiovascular diseases stemming from the abnormal platelets activation and thrombus formation by acting as an effective prophylactic and therapeutic agent.

Comparison of Intracardiac Echocardiography Versus Transesophageal Echocardiography for Guidance During Transcatheter Aortic Valve Replacement

  • Sang-Hyup Lee;Seunguk Oh;Young-Guk Ko;Yong-Joon Lee;Seung-Jun Lee;Sung-Jin Hong;Chul-Min Ahn;Jung-Sun Kim;Byeong-Keuk Kim;Kyu-Yong Ko;Iksung Cho;Chi Young Shim;Geu-Ru Hong;Donghoon Choi;Myeong-Ki Hong
    • Korean Circulation Journal
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    • v.54 no.2
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    • pp.63-75
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    • 2024
  • Background and Objectives: Evidence regarding the efficacy and safety of intracardiac echocardiography (ICE) for guidance during transcatheter aortic valve replacement (TAVR) is limited. This study aimed to compare the clinical efficacy and safety of ICE versus transesophageal echocardiography (TEE) for guiding TAVR. Methods: This prospective cohort study included patients who underwent TAVR from August 18, 2015, to June 31, 2021. Eligible patients were stratified by echocardiographic modality (ICE or TEE) and anesthesia mode (monitored anesthesia care [MAC] or general anesthesia [GA]). Primary outcome was the 1-year composite of all-cause mortality, rehospitalization for cardiovascular cause, or stroke, according to the Valve Academic Research Consortium-3 (VARC-3) definition. Propensity score matching was performed, and study outcomes were analyzed for the matched cohorts. Results: Of the 359 eligible patients, 120 patients were matched for the ICE-MAC and TEEGA groups, respectively. The incidence of primary outcome was similar between matched groups (18.3% vs. 20.0%; adjusted hazard ratio, 0.94; 95% confidence interval [CI], 0.53-1.68; p=0.843). ICE-MAC and TEE-GA also had similar incidences of moderate-to-severe paravalvular regurgitation (PVR) (4.2% vs. 5.0%; adjusted odds ratio, 0.83; 95% CI, 0.23-2.82; p=0.758), new permanent pacemaker implantation, and VARC-3 types 2-4 bleeding. Conclusions: ICE was comparable to TEE for guidance during TAVR for the composite clinical efficacy outcome, with similar incidences of moderate-to-severe PVR, new permanent pacemaker implantation, and major bleeding. These results suggest that ICE could be a safe and effective alternative echocardiographic modality to TEE for guiding TAVR.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.248-329
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    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Analytical Study on the Jehotang in Literature in Terms of Cooking Science (문헌 속 제호탕의 조리학적 분석 연구)

  • Ji, Myoung-Soon;Kim, Jong-Goon
    • Journal of the East Asian Society of Dietary Life
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    • v.18 no.4
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    • pp.446-454
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    • 2008
  • The traditional Korean drink "Jehotang", which is one of the most commonly prescribed drugs for treatment of the heat stroke accompanied by high fever, severe sweat and thirst, it is effective far quenching thirst strengthening the stomach, stopping diarrhea and regulating intestinal function. It is also known to play a role in activating the growth of useful microbes in the intestine and in multiplying intestinal immune cells. Thus, this study investigated all aspects of the drink in an effort to develop a new functional beverage. In the course of this study, the analytical research into the literature concerning Jehotang an error in the secrets of preparing the drink. The Japanese apricot, which was given the botanical name, "Prunusmume", should only be used with the flesh (scientifically referred to as "Fructusmume"), which is fumigated with straw fire before drying. and the seed should be thrown away. The honey should only be used after it is heated with a gentle fire, before removing the white foam that farms on its surface to make the "Yeonmil". Two kinds of cooking processes were found in the ancient literature. One procedure boiling down the powered Fructus mume mixed with the Yeonmil, while the other procedure involved preparing the Fructus mume's water by adding water to it and blending the water with the Yeonmil and the rest of the raw ingredient before boiling them down. The current procedure, in which the cooking is done in a double boiler, has been widely adopted to its simplicity. The finished Jehotang is put in porcelain, kept at room temperature, and consumed after mixing with cold water.

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Outcomes of the Modified Maze Procedure for Chronic Atrial Fibrillation Combined with Rheumatic Mitral Valve Disease (류마티스성 승모판막질환과 동반된 만성 심방세동 치료에 대한 변형 Maze 술식의 결과)

  • Baek Man-Jong;Kim Jae-Hyun;Seo Hong-Joo;Lee Chang-Ha;Oh Sam-Se;Na Chan-Young
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.681-691
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    • 2006
  • Background: The aim of this study was to investigate the mid-term outcomes of our modifications to the maze procedure using cryoablation for treating atrial fibrillation associated with rheumatic mitral valve disease. Material and Method: Between March 2000 and February 2004, 177 consecutive patients underwent the modified maze procedure with the use of cryoablation concomitant with mitral valve surgery for atrial fibrillation associated with rheumatic mitral valve disease, and were divided into three groups: (1) modified Cox-maze III (CM group, n=88): (2) modified Kosakai-maze (KM group, n=63): and (3) left atrial maze procedure (LA group, n=26). The postoperative and follow-up results were analyzed and compared between the groups. Result: There were three hospital deaths (1.7%) and no significant differences in the incidence of postoperative complications between the three groups. The operative time, such as the cardiopulmonary bypass and aortic crossclamp time, were significantly longer in the CM group than in the KM and LA groups, respectively (p<0.0001). The mean follow-up was $22.4{\pm}15.1$ months ($1\sim52.6$ months) for all patients. One late death developed in the CM group (0.0%). At last follow-up, 139 patients exhibited sinus rhythm (79.9%), which was also regained in 67 patients (77.9%) in the CM group, 50 (80.7%) in the KM group and 22 (84.6%) in the LA group (p=0.743). The actuarial freedom from stroke at 4 years was $84.5{\pm}9.4%$ in the CM group, $95.0{\pm}4.9%$ in the KM group, and $92.9{\pm}6.9%$ in the LA group (p=0.916). Conclusion: The modified maze procedure using cryoablation is safe and effective in treating chronic atrial fibrillation associated with rheumatic mitral valve disease.