Biomedical subjects

P Chou

Publications and source records attributed to P Chou.

At least 91 records · Page 5Linked to original sources

PubMed1996

Factors related to the choice between traditional Chinese medicine and modern Western medicine among patients with two-method treatment.

BACKGROUND: The aim of this paper is to investigate the different factors influencing patients' choice of traditional Chinese medicine or modern western medicine, applying Andersen's health-service utilization model to analyze the basic demographic, enabling and need factors related to the choice of clinics by patients who use two-method treatment (i.e. both Chinese medicine and western medicine). METHODS: Systemic sampling was done and a structured questionnaire survey was carried out among patients from the outpatient departments of 13 teaching hospitals accepting reimbursement by Labor Medical Insurance in Taiwan. RESULTS: The total number of valid respondents was 549. Of them 181 (33%) were visiting western medicine clinics and 368 (67%) visiting Chinese medicine clinics. There were 279 (51%) males and 270 (49%) females, whose age distribution was in the range from 16 to 87 years old, with a mean of 42.7 years. Under univariate analysis, the significant variables (p < 0.05) related to visiting the two types of clinics were: applicability of medical insurance, bed rest from discomfort in recent years, the amount of discomfort from this disease episode, respiratory disease, circulatory disease, endocrine or metabolic disease, and sense organ and skin disorders. By logistic regression analysis, the significant variables (p < 0.05) related to visiting the two types of clinics were religion, bed rest during the past year, discomfort associated with the episode, respiratory disease, and endocrine or metabolic diseases. CONCLUSIONS: Patients with folk-religion beliefs or respiratory diseases favored Chinese medicine; patients with illness requiring bed rest in the past year, who experienced discomfort in this episode, or who suffered from endocrine or metabolic diseases were likely to visit western medicine clinics.

Adolescent↗

PubMed1995

Population-based study of insulin, C-peptide, and blood pressure in Chinese with normal glucose tolerance.

Insulin resistance may play a role in the pathogenesis of essential hypertension. The purpose of the present study was to examine the relations of fasting serum insulin or C-peptide levels with hypertension and blood pressure (BP) in a stable homogeneous southern Chinese population with normal glucose tolerance. This community-based survey of adults aged > or = 30 years in Kin-Chen, Kinmen, was conducted by the Yang-Ming Crusade in 1992 and 1994. Data of fasting serum insulin and C-peptide from a total of 1,447 men and 1,800 women (mean age 46.7 years) were analyzed. Both continuous (by multiple regression) and categorical analyses (by analysis of covariance) were used. Fasting insulin concentrations (as independent variables) were significantly associated with log systolic BP (as outcome variables, coefficient = 0.000081, p = 0.0035) and log diastolic BP (as outcome variables, coefficient = 0.000098, p = 0.0006) after accounting for age, sex, body mass index, and waist-to-hip ratio. Similarly, fasting C-peptide concentrations were significantly associated with log systolic BP (coefficient = 0.023304, p = 0.0001) and log diastolic BP (coefficient = 0.032971, p = 0.0001). In categorical analyses, both fasting insulin and C-peptide concentrations were significantly different (insulin p = 0.01010, and C-peptide p = 0.0004) between hypertensive and normotensive subjects when the similar set of covariates were accounted for. In conclusion, both fasting serum insulin and C-peptide concentrations are significantly associated with BP in this homogeneous Chinese population with normal glucose tolerance.

Adult↗

PubMed1995

Relation between diurnal variation of blood pressure and left ventricular mass in a Chinese population.

In western populations, patients with hypertension who have a nocturnal decrease in blood pressure (BP) may have less left ventricular (LV) hypertrophy and cardiovascular morbidity than those without a diurnal variation in BP. To further examine this association between nocturnal BP reduction and LV mass index, we studied 720 normotensives (< 140/90 mm Hg), 380 borderline hypertensives (140 to 159/90 to 94 mm Hg), and 582 hypertensives (> or = 160/95 mm Hg) from Taiwan and Quemoy island by using 24-hour ambulatory BP monitoring and 2-dimensional echocardiography to obtain LV mass index during a community-based cardiovascular survey. After controlling for age, sex, height, weight, daytime BP, and daytime heart rate, the nocturnal reduction of systolic BP was found to associate weakly with LV mass index, for the whole population (partial correlation coefficient = -0.06, p < 0.05), as well as for the patients with hypertension (partial correlation coefficient = -0.09, p < 0.05), but these associations were eliminated when 24-hour BP and heart rate were accounted for. The average and percent nocturnal decrease of systolic BP (mean +/- SD; mm Hg, [%]) of 3.2 +/- 5.9 (2.7 +/- 4.8%); 3.3 +/- 7.3 (2.4 +/- 5.4%); and 4.6 +/- 9.0 (3.0 +/- 6.1%) in normotensives, borderline hypertensives, and hypertensives, respectively, was smaller than that found in previous studies. Hence, in this large Chinese population, a small nocturnal BP drop was found and it was only weakly associated with LV mass index. These results emphasize the general need for ambulatory BP reference values based on internal controls.

Adult↗

PubMed1995

A population-based epidemiological study on cardiovascular risk factors in Kin-Chen, Kinmen.

We conducted a population survey of cardiovascular risk factors in Kin-Chen, Kinmen (Quemoy), an island under military control for 40 years and the focal point of confrontation between mainland China and Taiwan. During the period 1992-1994, all residents > or = 30 years of age in Kin-Chen, the largest township in Kinmen, were invited to participate. The response rate was 60.3% (3826/6346). The prevalence of hypertension (> or = 160/95 mmHg and/or under treatment) was 25.2% in men and 17.6% in women. The rate for smoking was 41.5% in men and 2.9% in women. The prevalence of diabetes was 6.7% in men and 6.4% in women. Mean values for systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were 135.3 mmHg, 85.5 mmHg, 5.3 mmol/l, 1.1 mmol/l, 3.5 mmol/l and 1.4 mmol/l in men; and 128.0 mmHg, 79.5 mmHg, 5.2 mmol/l, 1.0 mmol/l, 3.3 mmol/l and 1.5 mmol/l in women, respectively. The unexpectedly high prevalence of hypertension in Kin-Chen male may reflect the effect of more than 40 years of military control and discipline. The high serum cholesterol level in Kin-Chen relative to mainland China and the low triglyceride level relative to Taiwan and Beijing, suggest further study of the contributions of diet and other psychosocial or environmental factors.

Adult↗

PubMed1995

Alterations of serum lipid levels and their biological relevances during and after pregnancy.

In normal pregnancy, all women displayed a significant elevation of serum triglyceride (TG), total cholesterol (TC), low density cholesterol (LDL-C) and high density cholesterol (HDL-C) during parturition. To study the quantitative changes in serum levels of lipids and their biological relevances during and after pregnancy, blood samples were collected from 62 normally pregnant women throughout gestation and 6 to 12 weeks postpartum. Compared with 184 nonpregnant control subjects, TG, TC, LDL-C and HDL-C were significantly elevated during the second and third trimesters of pregnancy but dropped sharply after pregnancy. To further understand the effect of pregnancy on other metabolic parameters, we compared the relative levels of apolipoproteins such as apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB), lipoprotein (a) (Lp(a)) and blood sugar during and after pregnancy. We found that apoB concentration progressively increased with advancing gestation, while the levels of apoA-I, Lp(a) and blood sugar were independent of gestation process. The physiological significance of hyperlipidemia during pregnancy is also discussed in this study.

Female↗

PubMed1995

MR of leptomeningeal melanosis in children.

PURPOSE: To delineate the magnetic resonance (MR) appearance of leptomeningeal melanosis in children. METHOD: Retrospective review of the medical, surgical, pathologic and MR findings in four children with a confirmed histologic diagnosis of leptomeningeal melanosis. The brain MR was performed with T1- and T2-weighted images in all four children and three had T1-weighted post-gadolinium images. Two of the children also had T1-weighted post gadolinium spine images. RESULTS: The MR brain findings consisted of cortical plaque and nodular hyperintense lesions on the noncontrast T1-weighted images in one child, marked, diffuse leptomeningeal enhancement in two children, and an enlarged, hypointense left temporal lobe with adjacent mild leptomeningeal enhancement in one child. The MR spine findings consisted of diffuse leptomeningeal enhancement in one child and hyperintensity of the cerebrospinal fluid in the other. CONCLUSION: The T1-weighted pre- and post-contrast images were the best to demonstrate the MR findings in leptomeningeal melanosis which consisted of either diffuse or localized enhancement of the leptomeninges; or cortical plaque and nodular hyperintense lesions pre-contrast.

Adolescent↗

PubMed1995

Epidemiology of hypertension in Kin-Hu, Kinmen.

Data on the prevalence and predictors of hypertension in Kinmen, an island very close to southern mainland China but under Republic of China administration, would be very helpful to understand the effect of environmental and psychosocial factors on hypertension in a specific ethnic group. In 1991, Kin-Hu residents > or = 30 years of age, living in the second largest township of Kinmen, were invited to participate in this survey incorporating face-to-face interviews with a structured questionnaire, collection of fasting blood samples and oral glucose tolerance test. The response rate for subjects with complete data was 80.3% (3289 of 4097). The prevalence rates for definite hypertension (> or = 160/95 mm Hg and/or under antihypertensive treatment) were 20.1, 14.0, and 16.9% for men, women, and the total population, respectively. Overall awareness, treatment, and control rates of definite hypertension were 46.9, 25.0, and 4.7%, respectively. According to the final logistic regression model, after controlling for all other covariates, the significant predictors for current-definite hypertension were old age, male sex, nonsmoking, obesity, alcohol intake, high waist-to-hip ratio, high serum triglyceride and high serum uric acid levels. In comparison with Chinese in Taiwan and mainland China, the unexpectedly high prevalence of hypertension and distinct set of its predictors in Kin-Hu form the basis for future study.

Adult↗

PubMed1995

Prevalence and subtypes of dementia in Taiwan: a community survey of 5297 individuals.

OBJECTIVE: To study the prevalence rate of dementia in Taiwan, the relative frequencies of its subtypes, and its associations with age, education, gender, and residence location. PARTICIPANTS: A total of 2753 men and 2544 women from four urban and four rural communities participated. Their age ranged from 41 to 88 years; 28% of them were at least 65 years old. Their education ranged from 0 to 20 years; 27% of them had less than 1 year of formal schooling. DESIGN: Phase I was a screening survey by trained nurses who administered a Chinese version of the Mini-Mental State Examination, the MMSE-T1, to all participants. Phase II involved the assessment for dementia by neurologists on the 1521 individuals who had scored less than 24 on the 30-point MMSE-T1. MAIN RESULTS: Thirty-one cases of dementia were identified by the DSM-III-R criteria, including 18 cases of Alzheimer's disease, 10 cases of vascular dementia, and three cases of other dementias. The prevalence rate in individuals aged 65 and over was 2.0%. Aging and illiteracy were associated with higher rates of dementia; gender and residence location made no difference. CONCLUSIONS: The prevalence rate of dementia was low in this Chinese population. Consistent with common findings from other parts of the world, a high rate of dementia was associated with older age and illiteracy, and Alzheimer's disease was the most frequent cause.

Adult↗

PubMed1995

Different effects of fosinopril and atenolol on wave reflections in hypertensive patients.

We conducted this study to compare the effects of fosinopril versus atenolol on peripheral blood pressure, central arterial wave reflection, and left ventricular mass in a group of patients with essential hypertension. We conducted a double-blind, randomized trial of fosinopril and atenolol in 79 hypertensive patients (52 men, 27 women; mean age, 45.8 +/- 8.5 years; range, 30 to 68 years). Carotid pressure waveforms were recorded noninvasively by applanation tonometry with a Millar micromanometer-tipped probe. The extent of wave reflection was estimated by the augmentation index defined as the ratio of the amplitude of pressure wave above its systolic shoulder to the pulse pressure. The augmentation index, left ventricular mass index by two-dimensional echocardiography, and 24-hour ambulatory blood pressures were determined before and after 8 weeks of daily treatment with fosinopril (10 to 20 mg) or atenolol (50 to 100 mg) with or without diuretics and compared with those values in 79 normotensive control subjects. After 8 weeks of treatment, both drugs lowered 24-hour ambulatory peripheral systolic and diastolic pressures into the normal range to a similar extent (fosinopril, -18/-13 mm Hg; atenolol, -23/-17 mm Hg, both P = NS). On the other hand, whereas the elevated augmentation index in hypertensive patients compared with normotensive subjects (16 +/- 11% versus 10 +/- 8%) was completely normalized by fosinopril (-9.3 +/- 9.8%, P < or = .002), it was lowered by atenolol (-4.8 +/- 8.9%, P < .002) but to a significantly smaller extent (fosinopril versus atenolol effect, P = .04).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population.

The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) provides ratings of an individual's changes in everyday cognitive functions during the previous 10 years. Original studies conducted in Australia showed that its score was not influenced by the subjects' educational backgrounds and that it performed at least as well as the Mini-Mental State Examination (MMSE) as a screening instrument for dementia. The subjects of the present study were Chinese and included 399 community residents and 61 dementia patients. Their ages ranged from 50 to 92 years; their education levels ranged from 0 to 19 years, and 63% of them had never attended school. We administered the IQCODE to informants and the Cognitive Abilities Screening Instrument (CASI), from which a CASI-estimated score of the MMSE (MMSE-CE) can be obtained, to the subjects. The diagnosis of dementia was made independently by physicians according to the DSM-III-R criteria based on semistructured interview and testing, neurologic examination, and standardized assessments of cerebral vascular disease, Parkinson's disease, and depression. The Chinese IQCODE showed no association with the subjects' education level or gender, low association with their age, and moderately high association with their MMSE-CE score. The area under the receiver operating characteristic curve of the IQCODE was significantly larger than that of the MMSE-CE for the whole group and for the subgroup with 1 to 19 years of education but not for the subgroup with 0 years of education. Nine of the 26 items of the IQCODE could be deleted without appreciable reduction in sensitivity and specificity. The IQCODE (1) can be shortened to 17 items, (2) had good cross-cultural applicability, and (3) was better than the MMSE-CE as a screening tool for dementia in a population with large variation in educational backgrounds.

Age Factors↗

PubMed1995

Short-term and long-term effects of benazepril in mild to moderate hypertensives.

BACKGROUND: Benazepril hydrochloride is a non-sulfhydryl-containing, angiotensin-converting enzyme (ACE) inhibitor. The short-term and long-term antihypertensive effects of benazepril remain to be established in Chinese. METHODS: Hypertensive subjects with diastolic blood pressure 95-110 mmHg, after two week placebo run-in first, entered a four-week double-blind phase with treatment of benazepril 10 mg once daily or captopril 25 mg three times daily, then received one-year open treatment of benazepril 10 mg daily with or without diuretics. Ambulatory blood pressure monitoring was performed at the end of placebo run-in, after four-week double-blind phase, and after one-year open treatment. RESULTS: Of the 75 subjects (41 male, 34 female, mean age 57 +/- 12 years, range 34-88 years) who completed the double-blind phase, 42 subjects finished the one-year extension phase. Reasons for withdrawal from the study included irritable cough (16, 21%), hypotension (1, 1%), and poor compliance (16, 21%). During the short-term double-blind phase, benazepril reduced clinic and mean 24-h ambulatory blood pressure by -21/-10 mmHg and by -17/-10 mmHg respectively, and captopril by -21/-13 mmHg and by -17/-10 mmHg respectively. After one-year open treatment by benazepril for the 42 subjects, the one-year average clinic blood pressure was 134/88 mmHg (155/104 mmHg at entry and 135/93 mmHg at the end of the double-blind phase), and the mean 24-h ambulatory blood pressure was 137/87 mmHg (149/95 mmHg at entry and 132/84 mmHg at the end of the double-blind phase). CONCLUSIONS: The antihypertensive effect of benazepril 10 mg daily with or without diuretics is not significantly different from that of captopril 75 mg daily in the short-term and can reasonably be maintained for one year.

Adult↗

PubMed1994

Associated risk factors of diabetes in Kin-Hu, Kinmen.

This is a community-based survey carried out by the Yang-Ming Crusade to investigate potential risk factors of non-insulin-dependent diabetes in Kin-Hu, Kinmen. A total of 3236 people completed both questionnaire and venipuncture (1536 men and 1700 women). Sex, age, education level, family history, obesity, hypertension, triglyceride, cholesterol levels and usage of diuretics were found significantly correlated with diabetes in univariate analyses. The stepwise logistic regression was used in multivariate analysis. Important correlates were age (OR = 1.03; 95% CI, 1.02-1.05), body mass index (OR = 1.96; 95% CI, 1.31-2.94), waist/hip ratio (OR = 2.08; 95% CI, 1.38-3.13), triglyceride (OR = 1.47; 95% CI, 1.19-1.81), cholesterol (OR = 1.47; 95% CI, 1.23-1.77), HDL-cholesterol (OR = 0.50; 95% CI, 0.25-0.99) and previous hypertension (OR = 1.66; 95% CI, 1.05-2.61). In addition to body mass index, waist/hip ratio was an independent risk factor. Besides the risk factor of total cholesterol, HDL-cholesterol was an independent protective factor. Previous history of hypertension was a stronger predictor on diabetes than current hypertension.

Age Factors↗

PubMed1994

Intraspinal Wilms' tumor metastases.

BACKGROUND: Intraspinal Wilms' tumor metastasis is rare, and is associated with a high mortality rate. METHODS: The authors reviewed the clinical course of two patients with Wilms' tumor in whom extradural metastasis developed. In addition, a review of the literature and of patients entered in the National Wilms' Tumor Studies was performed to determine the clinical presentation, treatment, and outcome of other patients with Wilms' tumor with intraspinal metastases. RESULTS: Both of the patients initially had abdominal pain without neurologic deficits. Despite therapy, paraplegia secondary to cord compression from recurrent epidural metastases developed in one patient, although a third remission has been achieved with further chemotherapy. the second patient remains in disease-free remission 25+ months after surgical resection of the extradural spinal tumor, adjuvant chemotherapy and radiation therapy, and autologous bone marrow transplantation. Review of the literature and of the patients entered in the National Wilms' Tumor Studies revealed an additional 27 patients with Wilms' tumor with this pattern of metastasis. Only four were disease-free at the time of this report. CONCLUSIONS: The authors' experience stresses the importance of early recognition and treatment of this complication of Wilms' tumor and demonstrates that intensive multimodality therapy can result in long-term disease-free remission.

Child↗

PubMed1994

Performance on a dementia screening test in relation to demographic variables. Study of 5297 community residents in Taiwan.

OBJECTIVE: To examine the relation between performance on a dementia screening test and the demographic variables of age, education, gender, and urban vs rural residency. DESIGN: Community survey with cluster sampling. SETTING: One urban and one rural community from each of four geographic regions in Taiwan, Republic of China. PARTICIPANTS: A total of 5265 nondemented individuals approximately equally divided between men and women and between urban and rural residency with a range in age from 41 to 88 years and in education from 0 to 20 years. MAIN OUTCOME MEASURE: Score on a Chinese adaptation of the Mini-Mental State Examination. RESULTS: Lower test scores were associated with older age and less education. The decrease in score with age was faster among participants who had never attended school. Better performance by men and by urban residents was found only among participants with fewer than 6 years of schooling. In this group, the magnitudes of sex and residency differences were comparable among those subjects aged 41 to 64 years and those aged 65 to 88 years. Women who had never worked outside of the home performed poorer than those who had worked outside of the home. CONCLUSIONS: The influence of educational background on test performance is most evident in individuals with less education. Commonly used dementia screening tests may be unfair to poorly educated individuals, especially women and rural residents. Efforts should be made to develop ecologically relevant cognitive tests for the intended study populations. To help distinguish test bias from different rates of cognitive decline, the study populations should include individuals in predementia age ranges.

Adult↗

PubMed1994

Long-term outcome in children with opsoclonus-myoclonus and ataxia and coincident neuroblastoma.

We reviewed the neurologic and developmental courses in 10 children with opsoclonus-myoclonus ("dancing eyes syndrome") and neuroblastoma. All patients are alive without evidence of neoplastic disease after 8+ to 111+ months of follow-up. All had localized disease and 50% had extraabdominal tumors. Neuroblastomas of nine children had favorable Shimada histologic characteristics, and all tumors had single copies of the N-myc oncogene. After neuroblastoma resection, all patients had persistent opsoclonus-myoclonus or ataxia that responded to therapy with adrenocorticotropic hormone. Nine children had relapses of neurologic symptoms. Three years after resection, six of seven patients with sufficient follow-up were free of symptoms and had discontinued therapy. However, nine children had chronic neurologic deficits, including cognitive and motor delays, language deficits, and behavioral abnormalities. All six patients in educational programs required special assistance. Five children required physical, occupational, or speech therapy. Long-term developmental and cognitive problems should be anticipated in patients with neuroblastoma who have opsoclonus-myoclonus or ataxia or both, and early intervention should be instituted to try to minimize these deficits.

Abdominal Neoplasms↗

PubMed1994

Assessing cognitive abilities and dementia in a predominantly illiterate population of older individuals in Kinmen.

A community survey of dementia was conducted on a Chinese islet. A total of 221 men and 234 women in the age range of 50-92 were assessed. The Cognitive Abilities Screening Instrument (CASI), a 100-point cognitive test designed for cross-cultural studies and adapted in Chinese for individuals with little or no formal education, was administered twice by trained field workers with a retest interval of 3 to 4 weeks. In addition, all participants were assessed by physicians who did not know the CASI scores. The physicians' assessment included a complete neurological examination, plus semi-structured tests and interviews covering cognitive abilities, daily activities, depression, cerebrovascular disease, and Parkinson's disease. Dementia was diagnosed by consensus among the physicians according to the DSM-III-R criteria. Among the 455 participants, 16 cases of dementia were identified, including 13 with probable Alzheimer's disease and 1 each with vascular dementia, Parkinson's disease, and alcoholism. The rates of dementia were 0, 3.9 and 11.5% for the age groups of 50-69, 70-79 and 80-92; and 4.4, 2.0 and 0% for the education groups of 0-1, 2-6 and 7-15 years of schooling. No sex difference was found after controlling for education. The Chinese version of the CASI had an intraclass retest reliability of 0.90. Using a cut-off score of < or = 50 for dementia, the sensitivity was 0.88 and the specificity was 0.94. The preliminary study suggests that the CASI can be used in Chinese populations with generally low education levels and that Alzheimer's disease was the most common type of dementia in this population.

Aged↗

PubMed1994

Maternal role in type 2 diabetes mellitus: indirect evidence for a mitochondrial inheritance.

BACKGROUND: The role of mitochondrial inheritance in type 2 diabetes mellitus has received much attention recently. In this study, three existing datasets in Taiwan are analysed to examine this theory. METHODS: Two of the datasets were community surveys and one a hospital case series. Subjects who had information regarding their paternal or maternal diabetic status were selected for the present study. In the first dataset, 745 subjects had information about paternal diabetic status and 765 had information about maternal diabetic status. In the second dataset, 255 and 267 subjects had the paternal and maternal information, respectively. In the third, a total of 3625 subjects had information about both their paternal and maternal diabetic status. Diabetic status of the study subjects was determined by fasting plasma glucose levels and/or oral glucose tolerance test; their parental diabetic status was collected by interview. RESULTS: The three datasets consistently demonstrated a significantly elevated odds ratio (OR) for reporting maternal diabetes (OR = 2.64, 95% confidence interval: 1.12-5.71) in diabetic patients as compared to non-diabetic subjects. The reporting of paternal diabetes, however, was not significantly different between diabetics and non-diabetics. In addition, the OR for reporting paternal diabetes were not significantly different between groups of different age-at-onset. With respect to maternal history, the OR increased significantly when age-at-onset was younger (test-for-trend P < 0.001). CONCLUSIONS: Our findings support mitochondrial inheritance of type 2 diabetes mellitus in the human population. The age-modifying effect was also in accordance with the mitochondrial oxidative phosphorylation paradigm for degenerative diseases.

Adult↗

PubMed1994

Further analysis of a pilot study for planning an extensive clinical trial in traditional medicine--with an example of acupuncture treatment for stroke.

Statistical methods for evaluating the effects of treatments and prognostic factors in clinical trials are discussed. Exploratory data analysis, nonparametric methods, regression modeling, and regression diagnostics of influential cases are applied to the analysis of a pilot 'randomized' controlled trial on the treatment of acute stroke with acupuncture. The utility of this analysis for modifying patient eligibility criteria, determining required sample size and utilizing stratified randomization in a future extensive stroke trial is discussed.

Acupuncture Therapy↗