• Title/Summary/Keyword: treatment rate of hypertension

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Adrenal Vein Sampling in Primary Aldosteronism: A Pictorial Essay for Optimal Left-Side Sampling (일차성고알도스테론혈증에서의 부신정맥채혈술: 최적의 좌측채혈을 위한 임상화보)

  • Gi Joo Kim;Myung Sub Kim;Hyun Pyo Hong;Young Rae Lee;Yeon Gyu Choi
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.386-397
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    • 2023
  • Primary aldosteronism (PA) is a curable cause of hypertension. Recent studies have revealed that the actual prevalence of PA is higher than previously recognized. Adrenal vein sampling (AVS) is an essential diagnostic procedure for revealing the cause of PA and determining the treatment plan. The success of AVS is confirmed by comparing cortisol levels between the samples from each adrenal vein and peripheral vein. The failure rate of the procedure is reported to be high in the right adrenal vein, which is directly connected to the inferior vena cava, while that in the left adrenal vein is relatively low; however, this has rarely been reported. In this review, we introduce and analyze cases of failure in left adrenal vein sampling.

Prevalence of Urinary Incontinence and Other Urologic Symptoms in a Community Residing Elderly People (일개지역 고령자의 요실금의 유병률, 지식 및 배뇨특성)

  • 김증임
    • Journal of Korean Academy of Nursing
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    • v.32 no.1
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    • pp.28-39
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    • 2002
  • The purpose of this study was to measure the prevalence of urinary incontinence (UI), urologic symptoms, chronic health problems they have, and to explore whether the differences in incidence of UI ware by age, sex, voiding pattern, and chronic health problems. Method: 298 subject were selected, age range from 60 to 94 years residing in one city, in republic of Korea. Data was collected presence of UI, urologic symptoms, chronic health problems, knowledge, and the discomfort with incontinent. Collected data was analyzed with frequency, percentage, t-test, and $\chi$2-test. Result: The results of this study are as follows: 1. Mean age was 71.4 years. Prevalent rate of UI was 17.0%, woman showed more than man. 2. UI incidence was significant in age (t=7.84, p=.000), sex ($\chi$2 =9.47, p=.002), and voiding frequency ($\chi$2=18.34, p=.000). Also, UI incidence was significant relationship with chronic health problem of heart disease ($\chi$2 =10.65, p=0.001), hypertension ($\chi$2=4.04, p= 0.046) and respiratory problem ($\chi$2=9.67, p=0.002). 3. The UI was grouped into urgent incontinence (45%), stress incontinence (33%), and combined (22%). UI occurred during the daytime 48% and 17% at night. 4. Only 9.8 % of the UI seek advice and/or treatment for their symptoms, almost 90 % remained untreated due to lack of knowledge or improper information. 5. The discomforts due to their UI was no significant difference in their condition, the urgent use of the rest room, leaking urine, and nocturia. Conclusion: This study suggests that 1 year and 3 year follow-up study is needed to compare health status of UI. Also suggests intervention study for urologic discomfort of incontinent and behavioral education for the elderly are needed.

Literatural observation on the Paralysis agitans (진두마비(震頭痲痺)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Shin, Hyeon-chul;Kim, Jong-dae;Jeong, Ji-cheon
    • The Journal of Dong Guk Oriental Medicine
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    • v.4
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    • pp.81-98
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    • 1995
  • This study is that examine and readjust cause-pathology, symptom, treatment, clinical reports recorded in western medicine, successive literatures of oriental medicine and recent literatures and journals of chinese medicine about Paralysis agitans. The results was followed ; 1. Paralysis agitans is similar with symptoms of Jinjeon, Qi, Gyeong, Gyejong, Lyeon and Pyengo, Tantan, Jungbu of Jungpung. 2. There are Pung, Hwa, Dam, Eo in the causes of disease, Gansinyinheo, Qihyeolyangheo, Jeokyeoldamhwa, Qichehyeoleo, Ganpungnaedong etc in clinical types, to be concerned with liver, kidney, heart and spleen in Jangbu, Gansinyinheo and Qihyeolyangheo are concerned wiyh idopathic paralysis agitans, Jeokyeoldamhwa and Qichehyeoloe successive it, Ganpungnaedongboth idiopathic and successive. 3. Treatments are Jayinjamyang, Pyeonggansikpung, Ikqiyanghyeol, Sikpunghwallak, Seoganhaewool, Hwalhyeoltonglak etc, and prescriptions are Yukmi, Chunmagudeongum, Paljintang, Tonggyuhwalhyeoltang, Hyeolbuchukeotang etc. 4. In caring, it is necessary to live pleasantly, to be temperate sexual intercourse, to control, diet, to do suitable exercises, for example Qigong, Physical exercises, Walking etc. 5. In clinical reports, this disease frequently-occurs more than 60 years, male is more than female, and there are many complications as hypertension and arteriosclerosis etc. The majority of causes are Gansinyinheo, Qichehyeoleo, and the others are Qihyeolyangheo, Damhwa, Ganpungnaedong, Qigiulche, Yeolyoesimsin etc, the majority of care Jabogansin, Yukyinsikpung, Hwalhy-eolhrwaeo, and the others Ikqiyanghyeol, Haldamtonglak, Seoganhaewool. Curing period is generally from 2 to 3 months. In effectiveness rate, successive Qichehyeoleo type is the highest, and idiopathic Qihyeolyangheo type is the lowest. Effectiveness of rigidity is higher than tremor.

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Hepatic compartment syndrome, a rare complication after any liver insult or liver transplantation: Three case reports and literature review

  • Alexandra Nassar;Theo Braquet;Beatrice Aussilhou;Maxime Ronot;Emmanuel Weiss;Federica Dondero;Mickael Lesurtel;Safi Dokmak
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.3
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    • pp.283-290
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    • 2024
  • Hepatic compartment syndrome (HCS) is a rare but life-threatening entity that consists of a decreased portal flow due to intraparenchymal hypertension secondary to subcapsular liver hematoma. Lethal liver failure can be observed. We report three cases, and review the literature. A 54-year-old male was admitted for extensive hepatic subcapsular hematoma after blunt abdominal trauma. Initially, he underwent embolization of the hepatic artery's right branch, after which he presented clinical deterioration, major cytolysis (310 times the upper limit of normal [ULN]), and liver failure with a prothrombin time (PT) at 31.0%. A 56-year-old male underwent liver transplantation for acute alcoholic hepatitis. On postoperative day 2, he presented a hemorrhagic shock associated with deterioration of liver function (cytolysis 21 ULN, PT 39.0%) due to extensive hepatic subcapsular hematoma. A 59-year-old male presented a hepatic subcapsular hematoma five days after a cholecystectomy, revealed by abdominal pain with liver dysfunction (cytolysis 10 ULN, PT 63.0%). All patients ultimately underwent urgent surgery for liver capsule excision, hematoma evacuation, and liver packing, if needed. The international literature was screened for this entity. These three patients' outcomes were favorable, and all were alive at postoperative day 90. The literature review found 15 reported cases. HCS can occur after any direct or indirect liver trauma. Surgical decompression is the main treatment, and there is probably no place for arterial embolization, which may increase the risk of liver necrosis. A 13.3% mortality rate is reported. HCS is a rare complication of subcapsular liver hematoma that compresses the liver parenchyma, and leads to liver failure. Urgent surgical decompression is needed.

The Effect of Barbiturate Coma Therapy for the Patients with Severe Intracranial Hypertension : A 10-Year Experience

  • Kim, Young-Il;Park, Seung-Won;Nam, Taek-Kyun;Park, Yong-Sook;Min, Byung-Kook;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.141-145
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    • 2008
  • Objective : Barbiturate coma therapy (BCT) has been known to be an useful method to control increased intracranial pressure (IICP) refractory to medical and surgical treatments. We have used BCT for patients with severe IICP during the past 10 years, and analyzed our results with review of literatures. Methods : We analyzed 92 semicomatose or comatose patients with Glasgow coma scale (GCS) of 7 or less with severe IICP due to cerebral edema secondary to parenchymal damages irrespective of their causes. Forty patients who had received BCT with ICP monitoring from January 1997 to December 2006 were included in BCT group, and fifty-two patients who had been managed without BCT from January 1991 to December 1995 were divided into control group. We compared outcomes with Glasgow outcome scale (GOS) and survival rate between the two groups. Results : Good outcome (GOS=4 and 5) rates at 3-month after insult were 27.5% and 5.8% in BCT and control group, respectively (p<0.01). One-year survival rates were 35.9% and 12.5% in BCT and control group, respectively (p<0.01). In BCT group, the mean age of good outcome patients ($37.1{\pm}14.9$) was significantly lower than that of poor outcome patients ($48.1{\pm}13.5$) (p<0.05). Conclusion : With our 10-year experience, we suggest that BCT is an effective treatment method for severe IICP patients for better survival and GOS, especially for younger patients.

Splenic artery steal syndrome after liver transplantation - prophylaxis or treatment?: A case report and literature review

  • Sofia Usai;Marco Colasanti;Roberto Luca Meniconi;Stefano Ferretti;Nicola Guglielmo;Germano Mariano;Giammauro Berardi;Matteo Cinquepalmi;Marco Angrisani;Giuseppe Maria Ettorre
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.386-394
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    • 2022
  • Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

Effects of Uwhangchungsim-won(Niuhuangqingxin-yuan) on Systemic Blood Pressure, Pulse Rate, Cerebral Blood Flow, and Cerebrovascular Reactivity in Humans (우황청심원(牛黃淸心元)이 정상인의 혈압(血壓), 맥박수(脈搏數), 뇌혈류(腦血流) 및 뇌혈관반응도(腦血管反應度)에 미치는 영향(影響))

  • Yun, Sang-Pil;Lee, Sang-Ho;Kim, Eun-Ju;Na, Byong-Jo;Jung, Dong-Won;Shin, Won-Jun;Moon, Sang-Kwan;Bae, Hyung-Sup;Kim, Lee-Dong
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.440-450
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    • 2004
  • Objectives: Uwhangchungsim-won(UC) has been used in the treatment of a wide variety of conditions including stroke, hypertension, arterosclerosis, autonomic imbalance, and mental instability, in Korean traditional hospitals. The aim of this study was to evaluate the effect of DC on cerebral hemodynamics and to determine the appropriate dosage. Methods: We studied changes in hyperventilation-induced cerebrovascular reactivity and mean blood flow velocity of the middle cerebral arteries(MCAs) were studied by means of transcranial Doppler ultrasound. Changes in mean blood pressure, pulse rate and expiratory CO2(PECO2) were observed using Cardiocap TM/5. Six healthy young volunteers who were administrated with full doses of DC for group A, and half doses for group B. Six other healthy subjects comprised the control group. The evaluation was performed during basal condition, and repeated at 20, 40, 60, 120, and 180 minutes after administration. Results: Increases of cerebrovascular reactivity and mean blood flow velocity in the middle cerebral artery in group A were significantly different compared with group B and the control group (p<0.1). Mean blood pressure, pulse rate and expiratory CO2 did not change during the observation and were not different among these three groups. We observed that in cerebrovascular reactivity induced hyperventilation, group A was most effective at 40 minutes after administration, and its effectiveness lasted for 120 minutes. Conclusions: This study provides evidence for UC, in full doses, as an agent for dilation of the cerebral arteriols to increase hyperventilation-induced cerebrovascular reactivity as a consequence of faster recovery of blood flow velocity.

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The effects of Aroma foot reflexology and foot reflexology on blood pressure, pulse rate and blood lipid level of elderly essential hypertensive patients in a rural area (아로마발반사요법과 발반사요법이 농촌의 본태성고혈압 노인환자의 혈압, 맥박, 혈중지질농도에 미치는 효과)

  • Lee, Hyeon-Soon;Kim, Dong-Oak
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.9
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    • pp.4053-4064
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    • 2012
  • The purpose of this study was to examine the effects of aroma foot reflexology and foot reflexology on blood pressure, pulse rate and blood lipid level of elderly essential hypertensive patients in a rural area. The research method was a non-equivalent control group pretest-posttest quasi-experimental design and the participants were consisted of 71 elderly patients with essential hypertension who were being registered at C health Clinic(G gun, Chungnam province). Here, we compared experimental group I(aroma foot reflexology) 24 persons, experimental group II(foot reflexology) 27 persons and control group(conventional treatment) 20 persons to measure the effect. The data were analyzed with SPSS/WIN 12.0. The systolic blood pressure(p<.05), the diastolic blood pressure(p<.05), and the pulse rates(p<.01) of experimental group I and II after intervening respectively with aroma foot reflexology, and foot reflexology for 6 weeks were significantly decreased than the control group, but the blood lipid level was no significant difference among 3 groups(p>.05). In conclusion, both of aroma foot reflexology and foot reflexology had positive effects to decrease the blood pressure and pulse rates of the elderly essential hypertensive patients in a rural area and would be utilized as a nursing intervention for them.

The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases (죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상)

  • Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.619-625
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    • 2006
  • Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.

The Study on the investigation of oriental medical theraphy(oriental medical theraphy by symptoms and signs and Sasang constitutional medicine)and the each effect of oriental medicine, occidental medicine and both joint control (뇌졸중(腦卒中)에 대(大)한 한방치료법(韓方治療法) 연구(硏究)(증치의학(證治醫學)과 사상의학(四象醫學)) 및 한방(韓方), 양방(洋方), 양(洋)·한방(韓方) 협진치료(協診治療) 효과(效果)에 관(關)한 연구(硏究))

  • Kim, Jong-won;Kim, Young-kyun;Kim, Beob-young;Lee, In-seon;Lee, In-seon;Jang, Kyung-jeon;Gwon, Jeong-Nam;Lee, Won-oe;Song, Chang-won;Park, Dong-il
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.2
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    • pp.351-429
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    • 1998
  • The Purpose of Study 1. Inspection of clinical application on TCD to CVA 2. Objective Comparement and analysis about treatment effect of Western-Medicine, Korean Medicine, Cooperative consultation of Korean and Western medicice for CVA The Subject of Study We intended for the eighty six patient of CVA who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. I to 1998. 7. 31 1. View of CT, MRI : the patient of Cb infarction 2. Attack Time : The patient who coming hospital falling ill within the early one week The method of study 1. Treat four group of Korean medicine, Constitution medicine, Western medicine, cooperative consultation of Korean medicine and Western medicine. 2. Application of TCD Check the result for three times, immediatly after the attack, two months later, four months later 3. Comparative analysis of each treatment effect by clinical symptoms and pathologic examination 4. The Judgement of the patient The Result From 8/1/1997 to 7/31/1998, We have the following result by clinical analysis intended for CVA 86 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. 1 to 1998. 7. 31 in 1. Analysis according to Age The first stage of thirties, forties, seventies is heavier than forties, fifties in improvement and Index of improvement of symptom 2. Analysis according to sex We have no special relation in an average of symptom and improvement, Index improvement 3. Analysis according to Family History We have the better result in first stage and improvement, index improvement when no family history. 4. Analysis according to Past History We have no special relation in past history like hypertension, DM, heart problem 5. Analysis devided two group, above group and under group on the basis of the average in first stage of all patient. We have the better result when the first stage is light, that the first score of barthel index and CNS is high. 6. Analysis of the effect of treatment about Korean medical treatment, Western medical treatment, cooperative treatment. In this study, the highest group of rate of treatment at four contrast groups (Korean medicine, Constitution medicine, Western medicine, cooperative treatment according to dyagnosis and range of treatment was the patient group of doing dyagnosis and method of treatment based on constitution medicine theory. This is that of doing demostation, A-Tx, po-herb-medication according to dyagnosis and treat method of constitution of Lee Je-ma In case of left, the case of dyagnosis any disease according to doctor view but, normal in TCDwas 22-beginning of attack, 20- two weeks later, 11 case-four weeks later in case of right, 15-beginning of attack, 12-two weeks later, 9 case four weeks later. So left vessel compares to right vessel is more interference, in fact more than a 1/2 of the patients of MCA disease can't do dyagnosis. In rate of imparement, the state of pacient improved but there isn't the improved case of result in TCD. 7. In TCD dyagnosis, between the case of inconsus the doctor view specially MCA in brain blood vessel is in large numbers and in total 86's patient, impossible case of dyagnosis according to interferiance of temporal is 21 case. 7. Result study about application of Kreaan medical treatment 1) The impossible patient of observation MCA blood vescular for interference temporal bone happened in large numbers. 2) There is the case having difference result to CT,MRI, MRA result. 3) Because individual difference is large, excluding to ananalogy of symptom. This is normal numerical value that has possibility of being checked as abnormal numerical value 4) there are a lot of cases that the speed of normal part is as similarly measured as that of abnormal part. It means that we cannot judge the disease by this measure 5) It is rare that this measure represent degree of improvement in patient's condition of disease. When we observe patient's condition become better, but we have no case that the result of TCD test better. 6) The result could be appear differently by the technique of the tester or by the experience of the tester 7) In the TCD test, abnormal symptoms is checked at 0 week, but at 2th week, normal symptoms is checked, again at 4th week abnormal is checked. According to the above result, CVA diagnosis is difficult only with TCD, as it appear in diagnosis error check which is suggested in the problem connected to project, for the aged persons who have the worst hardening of part of the cranium (1998. 5. 26 77 of 83 patients is 50s) there is a lot of cases that the measurement is impossible by TCD and the correction of measurement numerical value is decreased, as the age of cerebral infarction is high, TCD is inappropriate to diagnosis equipment through this study.

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