AIMS: The purpose of this study was to explore the differences of general characteristics and nutritional factors such as anthropometry and dietary intake between alcohol-related cirrhosis and virus-related liver cirrhosis and to assess the nutritional status of both of these groups. METHODS: In this study, the nutritional status of 67 patients with liver cirrhosis (25 with alcohol-related and 42 with virus-related) was evaluated by using clinical assessment, anthropometric measurements, dietary intakes, and biochemical indices. RESULTS: Although anthropometric measurements were not significantly different between alcoholic cirrhosis and viral cirrhosis, anthropometry of patients with viral cirrhosis had a higher tendency than that of alcoholic cirrhotic patients. Alcohol intake factors such as amount, duration, and frequency in alcoholic cirrhotic patients were higher than those in patients with viral cirrhosis. Energy excluding alcohol and vitamin C were significantly different between patients with alcoholic and viral cirrhosis. All subjects had lower intake of energy excluding alcohol, protein, vitamin A, thiamin, riboflavin, niacin, calcium, and iron as than recommended by the Recommended Dietary Allowances (RDA) for Koreans. Of special note was the fact that the intakes of energy excluding alcohol, vitamin A, riboflavin, and calcium were less than 75% of RDA for Koreans. Although the glucose and triglyceride levels were significantly different between alcoholic and viral cirrhotic patients, there were within normal range in both groups. There was an interaction effect in triceps skinfold thickness of the subjects according to both etiology and severity of liver disease. CONCLUSION: These data suggests that nutritional disorders are common in patients with both alcohol-and virus-related cirrhosis. It is necessary to educate patients with cirrhosis about the importance of a balanced dietary intake as well as its pattern, and quality of diet.
Alcoholics ; Anthropometry ; Ascorbic Acid ; Calcium ; Child ; Diet ; Fibrosis ; Glucose ; Humans ; Iron ; Liver Cirrhosis* ; Liver Cirrhosis, Alcoholic ; Liver Diseases ; Liver* ; Niacin ; Nutrition Disorders ; Nutritional Status* ; Recommended Dietary Allowances ; Reference Values ; Riboflavin ; Skinfold Thickness ; Triglycerides ; Vitamin A

No abstract available.
Infarction* ; Paralysis*

BACKGROUND AND PURPOSE: Interarm differences in the systolic and diastolic blood pressures (IASBD and IADBD, respectively) are found in various populations, including stroke patients, but their significance for stroke outcomes has rarely been reported. We aimed to determine the associations of IASBD and IADBD with early neurological deterioration (END), functional outcome, and mortality. METHODS: This study included 1,008 consecutive noncardioembolic cerebral infarction patients who were admitted within 24 hours of onset and had automatic measurements of blood pressures in the bilateral arms. END was assessed within 72 hours of stroke onset according to predefined criteria. A poor functional outcome was defined as a score on the modified Rankin Scale ≥3 at 3 months after the index stroke. All-cause mortality was also investigated during a median follow-up of 24 months. The absolute difference of blood pressure measurements in both arms were used to define IASBD and IADBD. RESULTS: END occurred in 15.3% (155/1,008) of the patients. A multivariate analysis including sex, age, and variables for which the p value was < 0.1 in a univariate analysis revealed that IASBD ≥10 mm Hg was significantly associated with END [odds ratio (OR)=1.75, 95% CI=1.02–3.01]. IADBD ≥10 mm Hg was also related to END (OR=3.11, 95% CI=1.61–5.99). Moreover, having both IASBD ≥10 mm Hg and IADBD ≥10 mm Hg was related to a poor functional outcome (OR=2.67, 95% CI=1.36–5.35) and mortality (hazard ratio=7.67, 95% CI=3.76–12.83) even after adjusting for END. CONCLUSIONS: This study suggests that an interarm blood pressure difference of ≥10 mm Hg could be a useful indicator for the risks of END, poor functional outcome, and mortality.
Ankle Brachial Index ; Arm ; Blood Pressure* ; Cerebral Infarction ; Follow-Up Studies ; Humans ; Mortality* ; Multivariate Analysis ; Stroke*

Purpose: Repeated transcranial direct current stimulation (tDCS) is expected to have the potential to improve cognitive function in patients with mild cognitive impairment (MCI). We aimed to evaluate the efficacy and safety of at-home tDCS for elderly patients with MCI. Materials and Methods: Patients aged 60–80 years, who maintained normal daily living but reported objective memory impairments, were enrolled. Active or sham stimulations were applied to the dorsal frontal cortex (left: anode; right: cathode) at home for 2 weeks. Changes in cognitive function were assessed using visual recognition tasks and the Mini-Mental State Exam (MMSE), and safety and efficacy were assessed using self-reports and a remote monitoring application. Results: Of the 19 participants enrolled, 12 participants were included in the efficacy analysis. Response times and MMSE scores significantly improved after active stimulation compared to the sham stimulation; however, there were no significant differences in the proportion of correct responses. The mean compliance of the efficacy group was 97.5%±4.1%. Three participants experienced burns, but no permanent sequelae remained. Conclusion This preliminary result suggests that home-based tDCS may be a promising treatment option for MCI patients; however, it requires more attention and technological development to address safety concerns.

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.
Carotid Artery, Internal, Dissection ; Cerebral Infarction ; Demography ; Humans ; Male ; National Institutes of Health (U.S.) ; Prognosis ; Prospective Studies ; Stroke* ; United Nations ; Vertebral Artery Dissection

BACKGROUND AND PURPOSE: Low-density lipoprotein (LDL) particle size is considered to be one of the more important cardiovascular risk factors, and small LDL particles are known to have atherogenic potential. The aim of this study was to determine whether LDL particle size is associated with stroke severity and functional outcome in patients with atherothrombotic stroke. METHODS: Between January 2009 and May 2011, 248 patients with first-episode cerebral infarction who were admitted to our hospital within 7 days after symptom onset were prospectively enrolled. LDL particle size was measured using the nondenaturing polyacrylamide gradient gel electrophoresis assay. Stroke severity was assessed by applying the National Institutes of Health Stroke Scale (NIHSS) at admission. Functional outcome was investigated at 3 months after the index stroke using the modified Rankin Scale (mRS), and poor functional outcome was defined as an mRS score of > or =3. RESULTS: The LDL particle size in the 248 patients was 25.9+/-0.9 nm (mean+/-SD). LDL particle size was inversely correlated with the degree of cerebral artery stenosis (p=0.010). Multinomial multivariate logistic analysis revealed that after adjustment for age, sex, and variables with p<0.1 in univariate analysis, LDL particle size was independently and inversely associated with stroke severity (NIHSS score > or =5; reference, NIHSS score 0-2; odds ratio=0.38, p=0.028) and poor functional outcome (odds ratio=0.44, p=0.038). CONCLUSIONS: The results of this study demonstrate that small LDL particles are independently correlated with stroke outcomes. LDL particle size is thus a potential biomarker for the prognosis of atherothrombotic stroke.
Atherosclerosis ; Cerebral Arteries ; Cerebral Infarction ; Constriction, Pathologic ; Electrophoresis ; Humans ; Lipoproteins ; National Institutes of Health (U.S.) ; Particle Size* ; Prognosis ; Prospective Studies ; Risk Factors ; Stroke*

No abstract available.
Churg-Strauss Syndrome* ; Humans ; Infarction*

PURPOSE: This study was conducted to evaluate the association between intakes of potassium, magnesium, and calcium and diet quality in ischemic stroke patients. METHODS: This study analyzed data from 285 subjects recruited from February 2011 to August 2014 in Seoul, Korea. Nutrition intakes were obtained from a semi-quantitative food frequency questionnaire composed of 111 food items. The subjects were divided into 4 groups by quartiles according to intakes of potassium, magnesium, and calcium. Index of Nutritional Quality (INQ), Mean Adequacy Ratio (MAR), and DQI-International (DQI-I) were analyzed for assessment of diet quality. RESULTS: We found a positive association of intakes of these three minerals with MAR and DQI-I after adjustment for age, sex, education level, smoking, atrial fibrillation, and total energy intake. However, total moderation of DQI-I score in the Q4 group was significantly lower than that of the Q1 group. The age, sex, education level, and smoking, atrial fibrillation, and total energy intake-adjusted odds ratios of extensive cerebral atherosclerosis were inversely associated with intake of magnesium (Ptrend = 0.0204). However, this association did not exist with intakes of potassium and calcium. CONCLUSION: Potassium, magnesium, and calcium rich and high quality diet could be associated with decreased risk of ischemic stroke, in part, via effect on extensive cerebral atherosclerosis.
Atrial Fibrillation ; Calcium ; Diet* ; Education ; Energy Intake ; Humans ; Intracranial Arteriosclerosis* ; Korea ; Magnesium* ; Minerals* ; Nutritive Value ; Odds Ratio ; Potassium ; Surveys and Questionnaires ; Seoul ; Smoke ; Smoking ; Stroke*

BACKGROUND AND PURPOSE: Alterations in blood fatty acid (FA) composition are associated with cardiovascular diseases. We investigated whether plasma FA composition was related to stroke severity and functional outcome in acute ischemic stroke patients. METHODS: We prospectively enrolled 156 patients with first-episode cerebral infarction, within 7 days of symptom onset. The proportion of FAs was analyzed using gas chromatography, and the summation of the omega-3 polyunsaturated fatty acids (omega3-PUFA), 18:3 omega3 alpha-linolenic acid, 20:3 omega3 eicosatrienoic acid, 20:5 omega3 eicosapentaenoic acid (EPA), and 22:6 omega3 docosahexaenoic acid (DHA) was reported as Sigmaomega3-PUFAs. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) score on admission. Poor functional outcome was defined by modified Rankin scale (mRS) > or =3 at three months after the index stroke. RESULTS: Lower proportions of EPA (beta=-0.751), DHA (beta=-0.610), and Sigmaomega3-PUFAs (beta=-0.462) were independently associated with higher NIHSS score, after adjusting for stroke subtype, hemoglobin, high density lipoprotein, high sensitivity C-reactive protein, fasting glucose, 16:0 palmitic acid, and Sigmasaturated fatty acids. Moreover, a lower proportion of DHA (odds ratio [OR]: 0.20, 95% confidence interval [CI]: 0.04-0.88), and Sigmaomega3-PUFAs (OR: 0.22, 95% CI: 0.05-0.84) showed an independent relationship with poor functional outcome after adjusting for age, sex, smoking status, NIHSS score, stroke subtype, and 16:0 palmitic acid. CONCLUSIONS: Our results demonstrate that omega3-PUFAs correlated with stroke severity on admission and functional outcomes at 3 months. omega3-PUFAs are potential blood biomarkers for prognosis of acute non-cardiogenic ischemic stroke patients.
alpha-Linolenic Acid ; Biomarkers ; C-Reactive Protein ; Cardiovascular Diseases ; Cerebral Infarction ; Chromatography, Gas ; Eicosapentaenoic Acid ; Fasting ; Fatty Acids* ; Fatty Acids, Unsaturated ; Glucose ; Humans ; Lipoproteins ; National Institutes of Health (U.S.) ; Palmitic Acid ; Plasma* ; Prognosis ; Prospective Studies ; Smoke ; Smoking ; Stroke*

BACKGROUND AND PURPOSE: Elevated postprandial blood glucose is a critical risk factor for stroke. The dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of the postprandial blood glucose response to estimate the overall glycemic effect of diets. We hypothesized that high dietary GL, GI, or total carbohydrate intake is associated with a poor functional outcome in patients with acute ischemic stroke. METHODS: We prospectively included 263 first-ever ischemic stroke patients who completed a semiquantitative food-frequency questionnaire. The dietary GL, GI, and total carbohydrate intake were investigated by examining the average frequency of intake during the previous year based on reference amounts for various food items. Poor functional outcome was defined as a score on the modified Rankin Scale (mRS) of ≥3 at 3 months after stroke. RESULTS: The patients were aged 65.4±11.7 years (mean±standard deviation), and 58.2% of them were male. A multivariate analysis adjusted for age, sex, marital status, prestroke mRS score, diabetes mellitus, hyperlipidemia, body mass index, triglycerides, low-density lipoprotein, hemoglobin A1c, stroke classification, and National Institutes of Health Stroke Scale score, early neurological deterioration, and high-grade white-matter hyperintensities revealed that the dietary GL and total carbohydrate intake were associated with a poor functional outcome, with odds ratios for the top quartile relative to the bottom quartile of 28.93 (95% confidence interval=2.82–296.04) and 36.84 (95% confidence interval=2.99–453.42), respectively (p for trend=0.002 and 0.002, respectively). In contrast, high dietary GI was not associated with a poor functional outcome (p for trend=0.481). CONCLUSIONS: Increased dietary GL and carbohydrate intake were associated with a poor short-term functional outcome after an acute ischemic stroke.
Blood Glucose ; Body Mass Index ; Cerebral Infarction* ; Classification ; Diabetes Mellitus ; Diet ; Glycemic Index ; Glycemic Load* ; Humans ; Hyperlipidemias ; Lipoproteins ; Male ; Marital Status ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Odds Ratio ; Prospective Studies ; Risk Factors ; Stroke ; Triglycerides