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Are in-Hospital Delays Important Obstacles in Thrombolytic Therapy Following Acute Ischemic Stroke?
최재철,강사윤,강지훈,고여주,배종면 대한신경과학회 2007 Journal of Clinical Neurology Vol.3 No.2
Background and purpose: The advances in the diagnosis and treatment of acute stroke increase the importance of providing these patients with timely medical attention. This study was designed to assess time delays in neurological evaluation and neuroimaging and to determine whether they are important obstacles to performing thrombolytic therapy. Methods: Data were obtained between May 2004 and September 2006 from 195 consecutive patients who were admitted to Cheju National University Hospital for acute ischemic stroke within 24 hours of the onset of symptoms. We determined the time of the onset of symptoms, arrival time at the emergency department (ED), and times of neurology notification, neurology evaluation, and neuroimaging using interviews and by reviewing the medical record. Results: Short onset-to-door time, performing computed tomography rather than magnetic resonance imaging, presence of aphasia or motor weakness, and severe initial neurological deficit were significantly associated with reduced in-hospital delays. Seventeen (20%) of the 85 patients who arrived within 3 hours of the onset of symptoms received intravenous thrombolysis. Mild neurological deficit, rapidly improving symptoms, and insufficient time to workup were the main causes of the nonreceipt of thrombolytic therapy in these patients. Only one patient did not receive thrombolytic therapy due to delay in neurology consultation. Conclusions: Whilst in-hospital delays were not major obstacles to performing thrombolytic therapy in this study, there is still a high probability of missing patients with mild-to-moderate stroke symptoms. More effective in-hospital organization is required for the prompt evaluation and treatment of patients with acute ischemic stroke.
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이호준(Hojun Lee),박민성(Minsung Park),고여주(Yeoju Go),양영자(Yeong-Ja Yang),배종면(Jong-Myon Bae) 한국역학회 2006 Epidemiology and Health Vol.28 No.2
Objectives: This study was conducted to examine the relationships between muscle mass and hand strength in elderly people. Methods: The study subjects were 659 volunteers aged older than 65 in Jejudo, south Korea. The anthropometric information such as weight, body mass index (BMI) and muscular mass was collected by the body composition analyzer. The hand strength was obtained by the digital grip dynamometer. The fasting blood sugar index called as potential diabetes mellitus (DM) was defined as the condition over 120 ㎎/dL of the blood sugar. The BMI was classified into under 23, 23-25 and over 25 to analyze the relationships of BMI and muscle mass, hand strength. Results: The factors affecting muscle mass were sex (p < 0.001), age (p < 0.001) and BMI (p < 0.001). The factors affecting hand strength were sex (p < 0.001), age (p < 0.001) and BMI (p = 0.003). And there was a weak association between muscle mass and hand strength after controlling with the affected factors (r2=0.15, p<0.001). Conclusions: The hand strength is weekly correlated with the muscle mass. So we recommend to use digital grip dynamometer combining with other measurements for diagnosis the sarcopenia in epidemiologic study.
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