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      • Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

        ( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

      • KCI등재

        한국 민주주의의 이행과 공고화 과정 분석

        김영태(Kim Young-Tae) 동국대학교 사회과학연구원 2006 사회과학연구 Vol.13 No.1

        This paper studies the process of democratic consolidation in Korea since 1987's democratic transition toward civic government and shows the lessons of consolidation for new leap of Korean democracy. The way of democratizing Korean politics is that (l) 'Democratization by agreement between military and democratization influence and (2) economic success was democratization that occur from 'Crisis of success' that bring critical condition of political power of an authority. Roh Tae-Woo government that centralizes power continuously in pro-democracy fight corresponds to transition period by democracy. Kim Young-Sam's civilian government sailing is left perfectly at power center since military party was withdrawn perfectly from centralize power. South Korea has succeeded in democratization transition without cutting or danger of system collapse. It is because it had more profitable condition at democracy consolidation flowing when character of transition period looks back upon historic experience that acted by important variable in unfolding process of hereafter. However, Kim Dae-Jung government as people's government that and Kim Young-Sam government as civilian government speak that failed passing over boundary of negative consolidation and advances active consolidation in Korea's democracy. Korean democracy has achieved some success in procedural and formal side of democratic consolidation since civilian government departure, but democracy is not institutionalized and internalized in virtual side yet. Achieve Korean democracy Consolidation overcoming instability and fluidity of democratization process successfully in circumstance that outside condition of democracy changes rapidly by North Korea nucleus problem, democratic citizen relationship's development and change of politics culture for voluntary politics participation are essential. Citizen relationship and politics culture are expected that is evolved and need considerable time though sweep away remnants with authoritarian culture. Stable society, new democracy welfare society that democracy consolidation is done and institutionalize is achieved, and role division between political society and civic society are achieved properly, and restraint and balance are made together and active interest of people total and continuous effort will have to be redoubled to do it so that democracy consolidation may be deepened still more, and necessity to grope structural innovation plan within synthetic system that is hereafter, country-politics society-civic society will be brought.

      • 太谿穴의 臨床 活用에 대한 文獻考察

        구성태,송문영,강정묵,김용명,박보라,이은석,홍정아,김경식,손인철 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

        Literally, the mean of Tae-gye is highest brook. And on the basis of the acupuncture theory, Tae-gye point is the Soo earth point and source point of the Kidney Channel as well. In addition, Tae-gye point is one of the Yang-Returning Nine points. We were trying to study bibliographically on the Tae-gye point because Tae-gye point can be used very broadly across the symptoms in the theoretical aspect described above. As a results, we found out that according to the classical books of acupuncture, Tae-gye point is entering point of the Meridian Water as a source point and can be used at both Kidney-Sufficient Syndrom and Kidney-Deficient Syndrom. And Tae-gye can be applied to the disease of kidney or bladder that is urogenital symtoms, Also, Tae-gye is an useful option of tooth-ache, asthma, indigestion, constipation, edema etc whose cause is related with decrease of Kidney ki.

      • KCI등재

        Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

        ( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

        Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

      • KCI등재

        맨드라미(Celosia cristata L.) 꽃 메탄올 추출물로부터 용매분획된 분획물의 항산화활성

        김현영(Hyun Young Kim),고지연(Jee Yeon Ko),송석보(Seuk Bo Song),김정인(Jung In Kim),서혜인(Hye In Seo),이재생(Jae Saeng Lee),곽도연(Do Yeon Kwak),정태욱(Tae Wook Jung),김기영(Ki Young Kim),오인석(In Seok Oh),정헌상(Heon Sang Jeong), 한국식품영양과학회 2012 한국식품영양과학회지 Vol.41 No.11

        맨드라미꽃의 식품학적 이용가능성을 확인해 보고자 항산화성분 및 항산화활성에 대해 검토하였다. 맨드라미꽃의 항산화성분과 활성은 메탄올 추출물과 순차적 용매분획물에 대해 측정하였으며, 메탄올 추출물과 hexane, chloroform, ethyl acetate, butanol 및 물 분획물의 추출수율은 각각 23.33, 10.27, 20.00, 13.63, 17.55 및 38.54%였다. 맨드라미 꽃 메탄올 추출물의 총 polyphenol, flavonoid 및 tannin 함량은 각각 6.80 ㎎ GAE/g ME, 2.34 ㎎ CE/g ME 및 6.23 ㎎ TAE/g ME였다. 순차적 용매분획물 중 butanol 분획에서 각각 14.92 ㎎ GAE/g SF, 5.44 ㎎ CE/g SF 및 13.38 ㎎ TAE/g SF로 함량이 높았다. 총 proanthocyanidin 함량은 44.72 ㎍ CE/g ME였고 순차적 용매분획물은 각각 42.47, 44.43, 50.03, 49.12 및 41.80 ㎍ CE/g ER로 용매간 유의적인 차이를 보이지 않았다. 맨드라미꽃의 메탄올 추출물의 DPPH 및 ABTS radical 소거활성은 각각 5.24 및 10.70 ㎎ TE/g ME였고 butanol 분획에서 각각 12.53 및 21.09 ㎎ TE/g SF로 활성이 높았다. 메탄올 추출물의 SOD 유사활성은 7.96 unit/mL로 나타났고 hexane, chloroform, ethyl acetate, butanol 및 물 분획물은 각각 4.56, 6.15, 8.07, 12.36 및 5.21 unit/mL로 butanol 분획의 활성이 높았다. 맨드라미꽃 추출물의 항산화성분과 항산화활성 간에 높은 정의 상관관계를 보였고 맨드라미꽃 추출물이 체내 및 식품에서 유익한 도움을 줄 수 있을 것으로 생각된다. The purpose of this study was to evaluate the antioxidant contents and activities of solvent fractions from methanolic extracts of cockscome flowers. The yield of methanolic extracts from cockscome flowers was 23.33%, whereas those of its solvent fractions (hexane, chloroform, ethyl acetate, butanol, and water) were 10.27, 20.00, 13.63, 17.55, and 38.54%, respectively. Total polyphenolic, flavonoid, tannin, and proanthocyanidin contents of methanolic extracts (ME) were 6.80 ㎎ gallic acid equivalent (GAE)/g ME, 2.34 ㎎ catechin equivalent (CE)/g ME, 6.23 ㎎ tannic acid equivalent (TAE)/g ME, and 44.72 ㎍ CE/g ME, respectively. The highest total polyphenolic, flavonoid, and tannin contents of solvent fractions were 14.92 ㎎ GAE/g solvent fraction (SF), 5.44 ㎎ CE/g SF, and 13.38 ㎎ TAE/g SF in the butanol fraction, respectively. The total proanthocyanidin contents were 42.47, 44.43, 50.03, 49.12, and 41.80 ㎍ CE/g SF, respectively. The DPPH and ABTS radical scavenging activities from cockscome flowers were 5.24 and 10.70 ㎎ Trolox equivalent (TE)/g ME, respectively. The highest DPPH and ABTS radical scavenging activities of the solvent fractions were 12.53 and 21.09 ㎎ TE/g SF in the butanol fraction, respectively. SOD-like activities of methanolic extracts from cockscome flowers were 7.96 units/mL, whereas those of its solvent fractions were 4.56, 6.15, 8.07, 12.36, and 5.21 units/mL, respectively. The results of this study show that notable antioxidant activities in cockscome flowers have significant health benefits.

      • KCI등재

        정신분열병에 대한 리스페리돈의 효과 및 안정성

        이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

        연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

      • 당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

        김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

        연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

      • 림프종으로 오인된 위 매독 1 예

        김병규;전태주;박지영;서희영;오태훈;김현정 인제대학교 2011 仁濟醫學 Vol.32 No.-

        Syphilis is a chronic systemic infectious disease caused by Treponema pallidum. Syphilitic involvement of the stomach can occur via the blood flow in the primary or secondary period of syphilis, but its incidence is very rare. Gastric syphilis should be considered in patients at risk of sexually transmitted disease who complains of abdominal pain, nausea and vomiting and in whom unusual endoscopic or radiographic features are found. Because gastric syphilis has no pathognomic clinical findings and it can simulate gastric cancer or lymphoma, it’ s not so easy to diagnose. If diagnosed, however, gastric syphilis can be easily treated with proper antibiotics. We report on a case of gastric syphilis that manifested epigastric pain, anorexia and weight loss. It was initially thought to be lymphoma, but it was correctly diagnosed by serologic testing and progress.

      • KCI등재

        Misorientation Characteristics at the Growth Front of Abnormally-Growing Goss Grains in Fe–3%Si Steel

        TaeYoung Kim,Tae‑Wook Na,Hyung‑Seok Shim,Yong‑Keun Ahn,Yong‑Kwon Jeong,Heung Nam Han,Nong‑Moon Hwang 대한금속·재료학회 2021 METALS AND MATERIALS International Vol.27 No.12

        Penetrating morphologies at the growth front of abnormally-growing Goss grains in Fe–3%Si steel was examined in view ofthe possibility that they are the two-dimensional section of the solid-state wetting (SSW) along the triple junction line. Toobtain the statistically meaningful data, 102 penetrated grain and 204 penetrating abnormally-growing Goss grain morphologieswere examined. The misorientation angles of penetrating and penetrated grains were measured by electron backscattereddiffraction. Among the 102 examined penetrated grain boundaries, none has low misorientation angles less than 15°,whereas 17.2% of the 204 penetrating grain boundaries have low misorientation angles, and 23.5% of them have coincidencesite lattice boundaries. Besides, boundary energies of penetrating Goss grains, which were estimated from misorientationangles of the three grains in the penetrating morphology, satisfied the energetic condition for SSW along the triple junctionline. These results imply that the abnormal grain growth of Goss grains in Fe–3%Si steel occurs by the mechanism of subboundaryenhanced SSW.

      • 18–30세 사이에 발생하는 뇌경색의 특징, 다기관 레지스트리 연구

        장윤경,송태진,김용재,허지회,이경열,김영은,장민욱,조수진,강석윤 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3

        Objectives: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. Methods: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. Results: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). Conclusion: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.

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