Biomedical subjects

S Choi-Kwon

Publications and source records attributed to S Choi-Kwon.

14 recordsLinked to original sources

PubMed2005

What stroke patients want to know and what medical professionals think they should know about stroke: Korean perspectives.

BACKGROUND AND PURPOSE: Patients and medical professionals are likely to have different perspectives of stroke, making what patients want to know about stroke different from what medical professionals think they should know. We wished to determine these differences for patients and medical professionals in South Korea, as well as to identify patients' characteristics associated with perceptions of stroke education. METHODS: Fifty consecutive patients with acute stroke admitted to Asan Medical Center, Seoul, Korea, and 88 medical professionals (31 doctors and 57 nurses) working in the Departments of Neurology or Neurosurgery were administered a structured questionnaire regarding various aspects of patient education concerning stroke. RESULTS: The average ranking of total items for stroke education was higher in nurses than in doctors or patients (P < 0.01 for each). Patients gave higher rankings than doctors for 'possibility to cure with drug treatment' (P < 0.01), 'stress management' (P < 0.01), and most items concerning 'general medical knowledge' and 'post-stroke diet management,' whereas doctors gave higher rankings than patients for most items concerning risk factor management and treatment with surgery. Items concerning 'post-stroke diet management' were ranked lower by male patients than females patients (P < 0.005), and were ranked lower by doctors than by patients or nurses (P < 0.001). Younger patients gave higher rankings than older patients for items concerning 'medical knowledge regarding stroke,' 'exercise,' and 'post-stroke sexual activities' (P < 0.001 for each). CONCLUSIONS: Perspectives on stroke education differ among doctors, nurses and patients. They also differ according to the situation of the patient. Education of stroke patients should be based on an understanding of these differences.

Activities of Daily Living↗

PubMed2004

Familiarity with, knowledge of, and attitudes toward epilepsy in residents of Seoul, South Korea.

BACKGROUND AND PURPOSE: The aim of this study was to investigate the perceptions of epilepsy in Seoul, South Korea, a country where social stigma toward epilepsy is still pronounced. METHODS: We randomly selected 1000 persons living in Seoul and performed telephone interviews regarding public awareness, knowledge, and attitudes toward epilepsy. RESULTS: Among 1000 respondents, the 92% who had read or heard about epilepsy became the subjects of the study. Word of mouth was most often referenced as a source of knowledge (78%). Forty-seven percentage believed that epilepsy is inheritable, whereas 5% thought that epilepsy is a mental illness. Marriage of their children to an epileptic person, childbearing by women with epilepsy, and employing a person with epilepsy were opposed by more than 50% of respondents. The reasons for the negative attitudes were that epilepsy was hereditary and untreatable (P < 0.05, respectively). CONCLUSIONS: Our study revealed that there still remains negative attitudes regarding the marriage, childbearing, and employment of persons with epilepsy, which may stem from misconceptions about the cause and treatability of epilepsy, possibly due in part to the influence of herbal medicine, and South Korea's ethnic homogeneity. Public health education either through media or school health education is urgently needed to improve knowledge about, and attitudes toward epilepsy.

Adult↗

PubMed2003

Dietary supplementation of (+)-catechin protects against UVB-induced skin damage by modulating antioxidant enzyme activities.

PURPOSE: The aim of this study was to investigate the effects of dietary supplementation with (+)-catechin on cutaneous antioxidant enzymes and the skin damage caused by UVB irradiation. METHODS: BALB/c mice were divided into three groups. Each group was fed a regular diet (RD) or a 2% catechin-supplemented diet for either 2 weeks (2CSD) or 4 weeks (4CSD) ad libitum prior to UVB irradiation. Skin was removed for the antioxidant enzyme assay, hematoxylin and eosin staining, and the TEM analysis before and at various time points after UVB (200 mJ/cm2) irradiation. RESULTS: Before UVB irradiation, the superoxide dismutase (SOD) and catalase (CAT) activities of the 2CSD and the 4CSD groups were found to be lower than those of the RD group, whereas the glutathione peroxidase (GPx) activity of the 4CSD group was higher than those of the RD and the 2CSD groups (P<0.05). The SOD and CAT activities of the RD group decreased after UVB irradiation, while those of the 2CSD and the 4CSD groups increased immediately after irradiation and then decreased (P<0.05). Immediately after UVB irradiation, the GPx activities of the 4CSD and the 2CSD groups increased, but that of the RD group decreased. The GPx activity of all three groups showed a tendency to return to pre-UVB irradiation levels with time. Light microscopic findings of the RD group showed epidermal thinning and apoptotic cells at 24 h after UVB irradiation and mostly necrotic cells at 48 h, whereas only moderate thickening of the epidermis was observed in the 2CSD group at 48 h after irradiation. An electron microscopic examination produced similar findings. At 48 h after irradiation, nearly all epidermal cells seemed to be damaged in the RD group as compared to the 2CSD group. CONCLUSION: These results demonstrate that dietary supplementation with (+)-catechin could protect epidermal cells against UVB-induced damage by modulating antioxidant enzyme activities.

Animals↗

PubMed2003

Factors affecting the quality of life in patients with epilepsy in Seoul, South Korea.

OBJECTIVES: The level of, and factors affecting the quality of life (QOL) in patients with epilepsy may be different in Korea where social prejudice toward them is still pronounced. However, these issues have not yet been addressed properly. METHODS: We consecutively identified 154 epilepsy patients who visited the outpatient clinic at the Seoul National University Hospital. An interview was performed by two research nurses with the use of a standardized questionnaire, which included data pertaining to seizure characteristics, symptoms of depression/anxiety, social support, family life/social life satisfaction, and the activities of daily living (ADLs). The QOL was assessed with the use of QOL in Epilepsy Inventory (QOLIE-31). RESULTS: Factors affecting the QOL were: age (P<0.01), education in years (P<0.01), employment status (P<0.05), employment type (P<0.05), current economic status (P<0.05), seizure frequency (P<0.01), the number of antiepileptic drugs (P<0.01), family life/social life dissatisfaction (P<0.01, respectively), social support (P<0.01), the symptoms of anxiety and depression (P<0.01, respectively) and ADL dysfunction (P<0.01). In multiple regression analysis, the symptom of anxiety was the most important factor in explaining lower QOL in patients with epilepsy, while depression (P<0.01), social life dissatisfaction (P<0.01), ADL dysfunction (P<0.05) and seizure frequency (P<0.05) were also significant factors. CONCLUSION: Psycho-social factors outweighed the physical factors in determining QOL in Korean epilepsy patients. Recognition of these factors will lead health professionals to develop different strategies to improve the QOL of these patients.

Adult↗

PubMed2001

The difference in perceptions of educational need between epilepsy patients and medical personnel.

PURPOSE: This study was undertaken to determine what patients with epilepsy need to know about their condition, and to discern what differences exist between patients' perceptions of this need and the medical profession's perception of what patients should know. METHODS: Seventy-five consecutive patients with epilepsy and 56 medical personnel (residents and nurses) who were working in either Neurology or Neurosurgery Units were studied using a structured questionnaire consisting of 3 subsets with a total of 27 questions. RESULTS: Using a Likert scale, epilepsy patients gave high priority to their need for more information about "how epilepsy is diagnosed," "the structure of the brain" (p < 0.05, p < 0.01, respectively), and "the diet that might prevent the attack" (p < 0.05) than did medical personnel. Our study also revealed that men were more concerned with questions regarding smoking and drinking than were women (p < 0.05, respectively), whereas married patients gave higher scores in the category of employment (p < 0.01) and contraception/pregnancy (p < 0.05) than did unmarried patients. The patients with one or more seizures per month rated higher scores on questions concerning the first aid at the time of attack and dosage of antiepileptic drugs (AEDs; p < 0.05, respectively) than did the patients with fewer than one seizure per month. The patients taking poly-AED treatment gave higher scores on six items related to AED therapy than did those receiving monotherapy. No significant differences were found with regard to the length of time patients had the condition, nor to educational level or current employment status. CONCLUSIONS: An educational program for epilepsy patients should be developed on the basis of understanding that there are differences in perspectives among patients with different sociocultural contexts as well as between patients and medical personnel.

Adult↗

PubMed2000

Poststroke depression and emotional incontinence: correlation with lesion location.

OBJECTIVE: To correlate the location of stroke with poststroke depression (PSD) and emotional incontinence (PSEI). METHODS: The authors prospectively studied 148 patients (94 men and 54 women, mean age 62 years) with single, unilateral stroke (126 infarcts and 22 hemorrhages) at 2 to 4 months poststroke with regard to the presence of PSD (using Diagnostic and Statistical Manual of Mental Disorders IV criteria and Beck Depression Inventory) and PSEI. The lesion location was analyzed by CT or MRI. RESULTS: Twenty-seven patients (18%) had PSD and 50 (34%) had PSEI. The presence of PSD and PSEI was not related to the nature, laterality, or size of the lesion. The frequency of PSEI, but not of PSD, was higher in women than in men and in ischemic rather than hemorrhagic stroke (p < 0. 05). Although both PSD and PSEI were related to motor dysfunction and location (anterior versus posterior cortex) of the lesion, location was a stronger determinant for PSD (p < 0.05). The prevalence of PSD/PSEI in each location was 75%/100% in frontal lobe of anterior cerebral artery territory, 50%/0 in temporal lobe, 30%/40% in frontal-middle cerebral artery territory, 13%/0 in occipital lobe, 19%/45% in lenticulocapsular area, 11%/16% in thalamus, 16%/53% in pontine base, 36%/55% in medulla, and 0/22% in cerebellum. Parietal and dorsal pontine lesions were not associated with PSD or PSEI. PSEI was more closely associated with lenticulocapsular strokes than was PSD (p < 0.01). CONCLUSION: Development of PSD and PSEI is strongly influenced by lesion location, probably associated with the chemical neuroanatomy related to the frontal/temporal lobe-basal ganglia-ventral brainstem circuitry. Although the lesion distribution is similar, PSEI is more closely related to lenticulocapsular strokes than is PSD.

Aged↗

PubMed1999

Risk factors for stroke in different levels of cerebral arterial disease.

BACKGROUND AND PURPOSE: Despite recent studies on risk factors of stroke, it is still unclear whether certain risk factors differently affect different levels of cerebral arteries in stroke patients. We attempted to study risk factors and lifestyle factors in patients with cerebrovascular diseases affecting different levels of the cerebral arteries. METHODS: We studied 343 Korean patients (222 men and 121 women) with acute stroke. Strokes were subdivided into large vessel infarction (LVI, n = 156), small vessel infarction (SVI, n = 105), intracerebral hemorrhage (ICH, n = 82) according to modified TOAST criteria. Patients with cardiogenic embolic infarction, undetermined causes, and miscellaneous causes were excluded. Among the patients with LVI and SVI, 104 and 49 underwent angiographic studies, respectively, who were designated as having definite LVI and definite SVI. Definite LVI was further subdivided into proximal LVI when the internal carotid artery (n = 25), vertebral artery (n = 13) or basilar artery (n = 14) were primarily involved, and distal LVI when the middle cerebral artery (n = 35), anterior cerebral artery (n = 7) or posterior cerebral artery (n = 10) were involved. Using a structured interview, we assessed the risk factors and lifestyles: hypertension, diabetes mellitus (DM), cigarette smoking (CS), alcohol consumption, physical activity and exercise, and the amount of consumption of salt, vegetables, fat, fish and fruits. Serum cholesterol, body mass index and total body fat were also measured. RESULTS: Multivariate analysis showed that in men, DM was a discriminant factor favoring brain infarction (BI) over ICH, definite LVI or ICH and proximal LVI over ICH. Decreased fruit intake differentiated distal LVI from definite SVI, and distal LVI from ICH. In women, DM and abdominal obesity differentiated BI from ICH, while DM favored definite LVI over ICH, proximal LVI over ICH and definite SVI over ICH. Multivariate analysis including sex as a separate variate showed that DM was a factor favoring BI over ICH, definite LVI over ICH, proximal LVI over ICH, distal LVI over ICH and definite SVI over ICH. CS was a factor favoring BI over ICH, while heavy CS was a factor discriminating distal LVI from definite SVI. Male sex was a factor favoring definite LVI over ICH and proximal LVI over ICH. A lesser amount of fruit consumption favored definite SVI over distal LVI. CONCLUSION: Our results demonstrate that DM in all sexes and central obesity in women are factors discriminating BI from ICH. However, these factors as well as others were not found to discriminate the sizes of the vessels involved in the patients with ischemic stroke, except that being male may be a factor favoring proximal large vessel disease over ICH. Genetic factors or other not yet identified risk factors may be responsible for the differences in the subtypes of ischemic stroke among different ethnic populations.

Adult↗

PubMed1999

Sensory sequelae of medullary infarction: differences between lateral and medial medullary syndrome.

BACKGROUND AND PURPOSE: A comparison between long-term sensory sequelae of lateral medullary infarction (LMI) and medial medullary infarction (MMI) has never been made. METHODS: We studied 55 patients with medullary infarction (41 with LMI and 14 with MMI) who were followed up for >6 months. We examined and interviewed the patients with the use of a structured format regarding the most important complaints, functional disabilities, and the presence of sensory symptoms. The nature and the intensity of sensory symptoms were assessed with the modified McGill-Melzack Pain Questionnaire and the visual analog scale, respectively. RESULTS: There were 43 men and 12 women, with an average age of 59 years. Mean follow-up period was 21 months. The sensory symptoms were the most important residual sequelae in LMI patients and the second most important in MMI patients. In LMI patients, the severity of residual sensory symptoms was significantly related to the initial severity of objective sensory deficits (P<0.05). Sensory symptoms were most often described by LMI patients as numbness (39%), burning (35%), and cold (22%) in the face, and cold (38%), numbness (29%), and burning (27%) in the body/limbs, whereas they were described as numbness (60%), squeezing (30%) and cold (10%), but never as burning, in their body/limbs by MMI patients. LMI patients significantly (P<0.05) more often cited a cold environment as an aggravating factor for the sensory symptoms than did the MMI patients without spinothalamic sensory impairment. The subjective sensory symptoms were frequently of a delayed onset (up to 6 months) in LMI patients, whereas they usually started immediately after the onset in MMI patients. CONCLUSIONS: Our study shows that sensory symptoms are major sequelae in both LMI and MMI patients. However, the nature, the mode of onset, and aggravating factors are different between the 2 groups, which probably is related to a selective involvement of the spinothalamic tract by the former and the medial lemniscus by the latter. We suggest that the mechanisms for the central poststroke pain or paresthesia may differ according to the site of damages on the sensory tracts (spinothalamic tract versus medial lemniscal tract).

Adult↗

PubMed1998

Nutritional status in acute stroke: undernutrition versus overnutrition in different stroke subtypes.

OBJECTIVES: Nutritional status in the acute stage of stroke has not been properly evaluated in different stroke subtypes. The objective of this study was to investigate the nutritional status of different subtypes of stroke patients. SUBJECTS AND METHODS: We studied 88 female patients with first-ever strokes. Strokes were divided into cerebral infarction (CI, n=67) and intracerebral hemorrhage (ICH, n=21). We measured the nutritional status of the patients in the acute stage of stroke with the use of 8 parameters including 3 biochemical and 5 anthropometric ones. These variables were assessed in stroke patients and 120 age-matched controls, and were compared with each other. RESULTS: In the acute stage of stroke, undernourishment was significantly (P=0.000) more prevalent in the ICH group (62%) than in the CI group (25%) or controls (13%). On the other hand obesity was present in 10%, 24% and 17% in patients with ICH, those with CI, and controls, respectively, which was not significantly different (P=0.461). Only abdominal skinfold thickness was significantly greater in patients with CI than in those with ICH or controls. Conclusions - Our results illustrate that undernourishment is prevalent in acute stroke patients, significantly more so in patients with ICH than in those with CI. Stroke patients, especially those with ICH, should receive special nutritional intervention starting immediately after admission.

Acute Disease↗

PubMed1998

Type A behavior and stroke: high tenseness dimension may be a risk factor for cerebral infarction.

Although type A behavior (TAB) has been shown to be related to coronary heart disease, the relationship between TAB and stroke was rarely investigated. We studied TAB in stroke patients with the use of the questionnaire developed by Eysenck and Fulker that has 4 subdimensions: Tenseness, Ambition, Activity, and Unrepressed. The questionnaire was administered to 224 patients with acute stroke and 100 controls. The patients were further classified as having cerebral infarction (large vessel infarction and small vessel infarction), and intracerebral hemorrhage. We found that, among the 4 subdimensions, only the Tenseness score was significantly higher in patients with cerebral infarction but not in those with intracerebral hemorrhage compared to the controls. On subgroup analysis, Tenseness score was higher in patients with large vessel infarction but not in those with small vessel infarction than in those with intracerebral hemorrhage or controls. The association of high Tenseness score with cerebral infarction (and large vessel infarction) remained significant after multiple logistic analysis adjusting various risk factors such as hypertension, diabetes mellitus, cigarette smoking and habitual alcohol drinking. Our data suggest that a high Tenseness dimension of TAB may be an independent risk factor for ischemic stroke, probably associated with atherogenesis.

Cerebral Infarction↗

PubMed1996

Discriminative sensory dysfunction after unilateral stroke.

BACKGROUND AND PURPOSE: Although sensory deficits caused by stroke have been reported occasionally, dysfunction of discriminative sensation has seldom been studied in patients with unilateral stroke. The frequency and modality of bilaterally impaired discriminative sensation also remain to be clarified. METHODS: With the use of specifically designed methods, we tested discriminative sensations including texture discrimination, two-point discrimination, stereognosis, point localization, and position sense in 67 patients with acute unilateral stroke. The locations of the lesions were identified with the use of CT and/or MRI. Thirty-two age- and sex-matched healthy subjects were used as a control. RESULTS: Impaired discriminative sensation was common in patients with unilateral stroke (detected in 57 of the 67 patients) regardless of lesion location except for patients with lateral medullary infarction. Discriminative sensation remained intact in only 3 of 25 patients who were initially diagnosed as having pure motor stroke on the basis of conventional sensory tests. Point localization and stereognosis were bilaterally impaired in 17 of 39 patients and 7 of 38 patients, respectively, regardless of the laterality of the lesion. Dysfunction of other sensory modalities was observed exclusively on the side contralateral to the lesion. CONCLUSIONS: Discriminative sensory disturbances, which often occur bilaterally in some modalities, are common in patients with unilateral stroke even in those with intact sensory function on routine examination. The subtle disturbances of this sensation may explain, at least in part, the clumsiness of the patients that is not readily explained by conventional neurological tests.

Adult↗

PubMed1991

Basic fibroblast growth factor regulates the ability of astrocytes to support hypothalamic neuronal survival in vitro.

The putative neurotrophic effects of basic fibroblast growth factor (bFGF) were tested on embryonic hypothalamic neurons in dissociated cell culture. Basic FGF dramatically increased the survival of embryonic hypothalamic astrocytes plated on a poly-L-lysine (PLL) substrate. Basic FGF treatment also increased the number of hypothalamic neurons surviving in vitro; however, no neurotrophic effects were observed when astrocyte proliferation was prevented by using serum-free N2 medium or by using the mitotic inhibitor cytosine arabinoside. In contrast to effects when PLL was used as a substrate, bFGF reduced the survival of hypothalamic neurons plated on a confluent, contact-inhibited monolayer of astrocytes. This effect appears to be due to the direct actions of bFGF on astrocytes: treatment of confluent astrocytes with 5 ng/ml bFGF caused the protoplasmic astrocytes to develop a fibrillar morphology and reduced the ability of the astrocyte monolayer to promote neuronal survival after a further 24 hr in bFGF-free medium. It is concluded that in addition to its mitogenic effects, bFGF acts as a differentiation factor for protoplasmic astrocytes in vitro, and these morphological and functional changes may reflect the process of normal astrocytic development and response to brain injury in vivo.

Analysis of Variance↗

PubMed1991

Splanchnic osmosensation and vasopressin: mechanisms and neural pathways.

Hypertonic (2 ml, 598 mosmol/kgH2O) solutions were infused over 4 min via a stomach tube in 12 groups (n = 5-10) of conscious rats with indwelling arterial catheters. Mean changes over 4-21 min of plasma arginine vasopressin (AVP) were 6.1 +/- 0.9 for NaCl (P less than 0.01), 9.3 +/- 3.0 for LiCl (P less than 0.01), 4.5 +/- 1.3 for sodium isethionate (P less than 0.01), 2.8 +/- 0.9 for sucrose (P less than 0.025), 3.9 +/- 2.8 for mannitol (P less than 0.01), and -0.1 +/- 0.1 (SE) pg/ml for urea. The AVP responses to NaCl and sucrose were proportional to the rate of gastrointestinal absorption of radiolabeled NaCl and sucrose, respectively. The AVP response to 598 mosmol/kgH2O NaCl was attenuated by 60.6% (P less than 0.001) in rats with lesion of the side branches of the major splanchnic nerves innervating the mesentery of the upper small intestine and the portal vein area, by 34-37% (P less than 0.05) in rats with right or left splanchnic nerve lesions, and was not affected by subdiaphragmatic vagotomy. Changes in systemic plasma osmolality were small and could not explain the AVP responses. Thus splanchnic receptors are osmosensitive, are situated in the mesentery of the upper small intestine and possibly the portal vein area, and project to the spinal cord via the right and left major splanchnic nerves.

Animals↗

PubMed1990

Splanchnic control of vasopressin secretion in conscious rats.

Saline solutions (NaCl, 2 ml, pH 7.4, 10-598 mosmol/kgH2O) were infused over 4 min in conscious rats, via tail artery catheter or intragastric tube. Intragastric infusions of hyper- and hypotonic solutions caused, within 14.4 +/- 2.2 min, a maximal increase and decrease, respectively, of plasma vasopressin (AVP) relative to time controls (r = 0.97; P less than 0.00001) without affecting systemic plasma osmolality (r = -0.09; P less than 0.92). Mean changes of plasma AVP between 11 and 21 min were also correlated with the osmolality of gastric infusion (r = 0.72; P less than 0.000001), whereas systemic osmolality was unchanged (r = 0.14; P less than 0.42). Systemic infusions caused within 9.0 +/- 2.0 min a maximal change in both plasma AVP (r = 0.82; P less than 0.00001) and systemic osmolality (r = 0.97; P less than 0.00001). However, mean changes of plasma AVP between 11 and 21 min weakly correlated with the osmolality of systemic infusions (r = 0.27; P less than 0.20), although correlations between mean changes of systemic osmolality and the osmolality of systemic infusions were significant (r = 0.72; P less than 0.00001). Lack of correlations with mean arterial pressure and heart rate suggest that hemodynamic changes did not mediate the AVP responses. Pretreatment with atropine methyl bromate (2 mg/kg) abolished the AVP response to gastric but not systemic infusions of hypertonic saline. These results indicate that a splanchnic cholinergic receptor mechanism modulates AVP secretion during a moderate gastric intake of salt or water.

Animals↗