• Journal of Preventive Medicine and Public Health
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• v.29 no.3 s.54
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• pp.639-655
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• 1996

Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of these diseases are mostly alike. But some risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group (RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of monarch, and prothrombin time. The factor whose level was higher in AMI than ill RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAM than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAM and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age, uric acid, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.2
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• pp.85-90
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• 2007

Acute event in cerebrovascular disease is the second most common cause of death in Korea following cancer, and it can also cause serious neurologic deficits. Understanding of perfusion status is important for clinical applications in management of patients with cerebrovascular diseases, and then the attacks of ischemic neurologic symptoms and the risk of acute events can be reduced. Therefore, the normal vascular anatomy of brain, various clinical applications of acetazolamide-enhanced brain perfusion SPECT, including meaning and role of assessment of vascular reserve in carotid stenosis before procedure, in pediatric Moyamoya disease before and after operation, in prediction of development of hyperperfusion syndrome before procedure, and in prediction of vasospasm and of prognosis in subarachnoid hemorrahge were reviewed in this paper.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.51-62
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• 2014

Objectives: The objective of study was to calculate the municipal level environmental burden of disease (EBD) due to heat wave. Methods: The data used were Korea National Health Insurance 2011 claim data and 2011 death registry. Heatwave related diseases included hypertensive heart diseases, ischemic heart diseases, cerebrovascular disease, and heat related illness. According to the method that WHO proposed, the study computed population-attributable fraction with relative risk which come from previous study and proportion of exposure which the study calculated with historical meteorology data. Results: The Average of 251 municipal EBD was 2.11 per thousand persons. The value of years lost due to disability was 11 times higher than that of years of life lost. On average EBD of county and southern geographical areas tended to be higher than those of District or city areas. The relationship between municipal deprivation index (composite deprivation index) and EBD showed the positive association, which means that the worse deprived municipal is, the higher EBD takes. Conclusions: Climate change is getting one of the major risk factors of cardio-cerebrovascular disease, which is the second leading cause of death. The study results suggested the urgent policy planning and reaction of climate change adaptation.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.2
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• pp.91-96
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• 2007

The measurement of pathologically low levels of tissue $pO_2$ is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowaday have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. $^{18}F-MISO$ PET and $^{99}mTc-EC-metronidazole$ SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using $^{123}I-IAZA$ in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.

• Endocrinology and Metabolism
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• v.33 no.4
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• pp.429-434
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• 2018

As diagnostic techniques have advanced, primary aldosteronism (PA) has emerged as the most common cause of secondary hypertension. The excess of aldosterone caused by PA resulted in not only cardiovascular complications, including coronary artery disease, myocardial infarction, arrhythmia, and heart failure, but also cerebrovascular complications, such as stroke and transient ischemic attack. Moreover, PA is associated more closely with these conditions than is essential hypertension. In this review, we present up-to-date findings on the association between PA and cerebrovascular diseases.

• Advances in Traditional Medicine
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• v.6 no.4
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• pp.312-318
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• 2006

The association between apolipoprotein E (apoE) gene polymorphism and ischemic cerebrovascular disease (ICVD) has been controversial. These controversies may be due to inaccurate classification of patients and ethnic differences. The aim of the present study was to assess the relationship between apoE gene polymorphism and the development of ICVD in a population from Korea. We investigated 136 patients with ICVD and 357 controls without ICVD. No differences in the apoE genotypes frequencies ($X^{2}$ = 3.660, df = 5, P = 0.454) and even in the alleles frequencies ($X^{2}$ = 1.946, df = 2, P = 0.378) were observed in the ICVD patients compared with that in controls. The data have been compared with data found in other population groups. However, the risk of ICVD associated with apoE ${\varepsilon}3/{\varepsilon}4$ genotype was increased nearly 3-fold in subjects possessing the history of diabetes mellitus (OR 3.3, 95% CI 1.2-9.4, P = 0.026). We concluded that the apoE polymorphism is not associated with ICVD at least in the Korean population, but the apoE frequencies found in this study differ significantly from those obtained in Japanese.

• Journal of Medicine and Life Science
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• v.16 no.3
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• pp.55-59
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• 2019

Cerebral vessels are functionally and structurally specialized to provide adequate blood flow to brain which shows high metabolic rates. Cerebral hemorrhage or ischemic infarction due to cerebrovascular injury or occlusion can cause the immediate brain damage, and if not treated rapidly, can lead to serious or permanent brain damages, and sometimes life-threatening. Unlike these popular cerebrovascular diseases, there are diseases caused by genetic problems. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is one of them. CADASIL does not show the high incidence, but it is considered to be significantly affected by regional obstructiveness such as islands and therefore, to be an important genetic disease in Jeju. This paper aims to summarize the possibility of animal model research that can provide preclinical data for CADASIL disease research and to evaluate its applicability in future research plans.

• The Journal of Korean Medicine
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• v.21 no.3
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• pp.129-139
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• 2000

Clinical observation was made on 210 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyungwon University from January to December in 1998. Objective : To evaluate the current status of cerebrovascular disease in Korea, we performed observation on stroke patients. Methods : We performed a retrospective study on 210 cases of stroke who had been admitted to the Dept. of Internal Medicine, College of Oriental Medicine, Kyungwon University from Jan. 1, 1998 to Dec. 31, 1998. Results : The incidence was highest in the patients with the age of above fifty. The frequency of strokes was similar between male and female cases. Ischemic stroke(70.0%) was more common than hemorrhagic stroke(20.5%), with transient ischemic attacks(9.5%) occuring less frequently. Middle cerebra! arterial territory was the most commonly involved site in ischemic strokes. Among intracerebral hemorrhages, putaminal hemorrhages were found in 69.8%, and was followed by IVH(9.3%), IVH with ICH(7.0%), subcortical hemorrhages (4.7%) and pontine hemorrhages(4.7%). The most ordinary preceding disease was hypertension. The next was diabetes mellitus. Most cases were given simultaneous treatment in both western and oriental medical methods. Conclusions : Generally it is thought that CVA occurs frequently in winter. But our observations reveal no such relationship. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. I Patients whose condition of consciousness was bad at the time of admission tended to have a bad prognosis. This study suggests changing trends of stroke in Korea, and that a multicenter prospective study using stroke registry is required for confirmation.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.249-259
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• 2011

Objectives: This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults. Methods: Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality. Results: Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans. Conclusions: Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.

• Clinical and Experimental Pediatrics
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• v.55 no.11
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• pp.408-413
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• 2012

Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.