• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.167-180
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• 1994

In order to inquire the most effective management of increased intracranial pressure(ICP), mannitol, steroid and hyperventilation were used in rabbits after ligation or non-ligation of the carotid artery. Mannitol was more effective than steroid and hyperventilation in the degree of the reduction of ICP. The intracranial pressure was decreased 43~45% for 25~30 minutes after injection of mannitol. Steroid was less effective than mannitol in the degree of the reduction of ICP. But the time of reduction of ICP was longer, that is, the degree of reduction was 24~60 minutes after injection of steroid. Hyperventilation is effective in the initial time only, for 10 minutes after hyperventilation. The degree of ICP reduction was 13.5~16.7% for 10 minutes after hyperventilation. The combined group, that is three kinds of mangenent were used, is the most effective treatment to reduce ICP of ICP. The degree of the reduction of ICP was 42.1~49.3% for 20 minutes, 47.7~52.5% for 30minnutes. There was no significant difference between ligation and non-ligation group.

• The Journal of Korean Medicine
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• v.15 no.2 s.28
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• pp.46-91
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• 1994

l. Backgrounds of Studies Cerebrovascular accident. one of the three major causes of death among audults with cardiopathy and malignancy, has been on the increase in korea while it is on the decrease in European countries and Japan. Types of stroke undergo changes caused by prolongment of life expectancy. and social and economic variety. More patients of ischemic stroke show a tendency to increase now than those of hemorrhagic stroke in the past. Many clinical studies on medical cerebrovascular and oriental stroke of paralysis have been published. but few clinical studies on therapeutics of integrated oriental and western medicine are to be found. So I have made an attempt to study clinical observations and therapeutic responses of ischemic stroke under integrated oriental and western medicine. 2.Methods. Among the patients admitted into the clinic of Joong-Poong, Woo-Suk University Hospital from May 1. 1993 until April 30. 1994 those 56 patients who were diagnosed as ischemic stroke on Computed Tomography(CT) and showed no dubious symptom after examination of coagulation and bleeding time were classified into the following six steps and treated: l)diagnosis 2)emergency treatment 3)basic treatment 4)treatment of risk and provoking factors. and preceeding disease 5)complications and conservative therapy 6)rehabilitation. For a period of basic treatment both herb medication and urokinase therapy were applied at the same time. Intravenous injection has been given at a unit of 300.000 dosage a day as urokinase therapy during basic treatment. If they showed any dubious symptom in glucose tolerance test. fructose 500ml and urokinase 300.000 dosage were mixed and injected. In case of no symptom 5% DW 500ml was mixed with urokinase 300.000 unit. and injected at a speed of 15gtt per minute. 3. Results and Conclusions 1) The level of ambulation has been improved from 42.9% when admitted to 73.2% when discharged in the degree of recovery. The level of severe function disorder has been remarkably decreased from 55.4% when admitted to 19.6% when discharged. 2) The treatment effect on the basis of therapeutic response of clinical and subjective symptom shows as follows: 7.1% Excellent. 35.7% Good. 37.5% Effective. 10.7% Stationary. and 8.9% Aggravated. The total recovery above effective shows 80.3%. Judging from the above results I think it proper to develop the model of better preventing and treating ischemic stroke through effective therapeutic and clinical studies of integrated oriental and western medicine.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.3
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• pp.117-124
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• 2013

Objectives The aims of this study was to observe the effectiveness of East-West Integrative Medicine (EWIM) by analysing between EWIM estimated group and Non-EWIM eastimated group with Brain Rehabilitation Registry. Methods We divided hospitals into two groups, one is EWIM estimated group hospital (Kyeonghee university, Wonkwang university, Dongguk university) and the other is non-EWIM estimated group (Jeonnam university, Gyeongbuk university, Catholic university). Then we analysed the effectiveness of treatments retrospectively using the database of Brain Rehabilitation Registry (http://www.kbrr.or.kr/, version 1.0). Totally 293 patients were included, EWIM estimated group was 175 and non-EWIM estimated group was 118. The main outcome measurements were National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI) and Mini Mental State Examination-Korea (MMSE-K). Results Changes of NIHSS was not significant in both total patient and patient who treated over 3 weeks. MMSE-K showed positively significant difference (p=0.044) in EWIM estimated group patients who treated over 3 weeks. In case of MBI, EWIM estimated group showed more effective result and also statistically significant in both total patients and patients who treated over 3 weeks. Conclusions We patially argued that EWIM estimated group was more effective than non-EWIM estimated group in stroke patients' functional recovery. We suggested base data of EWIM in stroke patiens through this study and this could be applied future researches of developing modified EWIM system.

• The Journal of the Korea Contents Association
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• v.11 no.3
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• pp.281-292
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• 2011

In this study, for examining an effect of lower limbs' muscle activity on balance capability when applying sprinter pattern among the PNF, the experiment was conducted as followed. Under the object of 24 people diagnosed by hemiplegia, they were divided into control group and experimental group and the experiment was conducted on the experimental group, three times per a week for six weeks. Experimental group received Sprinter pattern of combined PNF upper extremity and lower extremity pattern. For the lower limbs' muscle activity, effective values of Vastus medialis laterails, medial lateral hamstrings, lateral gastrocnemius' action potential were analyzed. The balance ability tests was conducted with FICSIT-4, FSST and MTD-Balance system. For the significance test of control group and experimental group for measuring time by exercise application method, two-way repeated measure ANOVA was conducted and for the significance test among the groups by each measuring time, independent t-test was conducted. Also, for examining the correlation among the measuring item, pearson correlation was used for the analysis. As the result, the application of sprinter pattern increased muscle activity of lower limbs in paretic side and improve static and dynamic balance ability effectively. Therefore, it will be necessary to develop new intervention by combining active application of the therapeutic intervention program for lower limbs' effective muscle mobilizing in paretic side with various exercising patterns.

• The Journal of Korean Medicine
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• v.31 no.5
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• pp.82-89
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• 2010

Objectives: The aim of this study was to determine distribution patterns of TOAST subtypes of ischemic stroke patients admitted to oriental hospitals and to get a better understanding of present conditions in oriental medicine by comparing with the Korea stroke registry (KSR), the largest and representative data. Methods: Clinical data were collected from acute ischemic stoke patients. MRI studies including vascular images were performed in all cases. TOAST criteria were used to determine subtypes of ischemic stroke patients. According to the duration from disease onset to hospital admission time, patients were assigned to 3 groups (Group I0 to 3 d, Group II4 to 7 d, Group III8 to 28 d) and the distribution of TOAST subtypes were compared among these three groups. Results: We collected 514 sets of clinical data from 10 oriental hospitals between May 2007 and September 2009. Small vessel occlusion (SVO) subtype was the most common (57.62%), followed by large artery atherosclerosis (LAA, 29.98%). Compared with TOAST distribution of KSR, the proportion of ischemic stroke patients with SVO subtype was higher than that of KSR. On the other hand the proportion of patients with stroke of undetermined etiology (SUE) was lower. Distributions of SVO, LAA and cardioembolism (CE) in group were I 66.4%, 23.8% and 8.9%, respectively; those in group IIIwere 51.03%, 34.71% and 11.57%, respectively. Conclusions: In oriental hospitals, the proportion of ischemic stroke patients diagnosed as SVO type was higher than that of KSR. At early stage (from onset to 2 d) proportion of SVO was very high, however after 7 days from onset it decreased with concomitant increases in proportions of LAA and CE. These phenomena may be due to the facts that 1) at early stage emergency treatments are limited in oriental hospitals, 2) after early stage many patients prefer oriental treatments, including rehabilitation.

• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.262-274
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• 2007

Objective : It has been reported that two-repeats ($IL1RN^{\ast}2$) of interleukin-1 receptor antagonist (IL-1Ra) gene is associated with ischemic stroke, and that Ala allele of the common Pro12Ala polymorphism in $PPAR-{\gamma}2$ isoform is associated with reduced risk for type 2 DM and its complications. The aim of the present study is to assess the association of IL-1Ra and $PPAR-{\gamma}2$ Pro12Ala polymorphism with the presence of ischemic stroke in the case of diabetic and non-diabetic patients. Methods : Genomic DNA was obtained from 373 healthy subjects, 157 DM subjects without ischemic stroke (known DM duration ${\ge}10$ years) and 302 ischemic stroke patients (including with DM). IL-1Ra polymorphism was analysed by polymerase chain reaction (PCR), and $PPAR-{\gamma}2$ polymorphism by restriction fragment length polymorphism after PCR. Results : $IL1RN^{\ast}1/IL1RN^{\ast}2$ genotype was associated with significantly increased risk for DM (OR=2.86, P = 0.0008) and ischemic stroke (OR=2.74, P = 0.0016). Pro/Ala genotype was associated with the reduced risk for DM (OR=0.53, P = 0.0491) and ischemic stroke (OR=0.38, P = 0.0039). They were also associated with the reduced risk for ischemic stroke in the DM patients compared with DM without ischemic stroke (OR=0.25, P = 0.0321). Conclusions : $IL1RN^{\ast}2$ allele could be an accelerating factor, not a predictive marker for ischemic stroke in type 2 DM. The Pro/Ala genotype of $PPAR-{\gamma}2$ Pro12Ala polymorphism may be associated with reduced risk for ischemic stroke with type 2 DM. Therefore it could be a useful predictive marker for ischemic stroke in Korean type 2 DM.

• The Journal of Internal Korean Medicine
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• v.39 no.5
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• pp.939-948
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• 2018

Objectives: We treated a stroke patient with vancomycin-resistant enterococci (VRE) colonization using Gami-sipjeondaebo-tang. Methods: A patient diagnosed with intracranial hemorrhage with VRE colonization was treated with herbal medicine and acupuncture. We checked general conditions every day and performed stool VRE culture once a week. We evaluated the improvement of symptoms by change in VAS grade, general weakness, and stool VRE culture results. Results: After a treatment of Gami-sipjeondaebo-tang combined with acupuncture therapy, improvement of the general condition was observed. Also, VRE colonization was no longer detected in the stool culture. Conclusions: This case report proved the effect of Korean medicine for a stroke patient with VRE colonization, but further study is needed.

• The Journal of Internal Korean Medicine
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• v.28 no.3
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• pp.492-501
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• 2007

Objectives : This study was executed in order to evaluate the effects of electroacupuncture on upper-extremity spasticity control in stroke patients. Methods : Eighteen patients with stroke were enrolled and classified into two groups, the study and control group. The control group did not receive any oriental medical treatment. In the study group, the electroacupuncture points were applied to Kokt'aek (PC3) and $Ch'{\u{o}}ch'{\u{o}}n$ (PC2), Naegwan (PC6) and $Ch'{\u{o}}kt'aek$(LU5) of the affected limb. H-reflexl M-response ratio (HIM ratio), modified Ashworth scale (MAS) and Fugl-Meyer motor function assessment (FMA) were used for evaluation of spasticity control before electroacupuncture, within two hours after electroacupuncture, and at two weeks. Results : In MAS, the study group declined more than the control group. but there was no statisticallysignificant consideration. In H/M ratio. the study group was more efficient than the control group. and spasticity decreased successively during the series in the study group. In FMA, motor function in the study group improved more than in the control group and motor function in the study group increased successively during the series. Conclusions : These results showed that electro acupuncture was a useful method to decrease upper-extremity spasticity in patients with stroke. Further studies are needed to explore more cases and the long-lasting carryover effects on upper-extremity spasticity in electroacupuncture.

• The Journal of Internal Korean Medicine
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• v.28 no.3
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• pp.421-433
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• 2007

Objectives : This study was performed to evaluate the relationships among blood-stasis. cardio-ankle vascular index(CAVI) and cardiovascular risk. Methods : We obtained general characteristics. blood-stasis score and CAVI from 150 stroke patients. Blood-stasis score was evaluated by blood-stasis criteria. Cardiovascular risk (the following. Stuart's risk score) was evaluated by Stuart's risk scoring scale. We divided subjects into a blood-stasis group and a non blood-stasis group by blood-stasis scores. high CAVI and normal CAVI groupsby CAVI. We compared the general characteristics. CAVI (excluded from comparison between high CAVI group and normal CAVI group), Stuart's risk score and blood-stasis score (excluded from comparison between blood-stasis group and non blood-stasis group) between each pair of groups. Pearson correlation analysis was applied to examine the relationship between blood stasis score and CAVI, blood stasis score and Stuart's risk score. CAVI and Stuart's risk score. Results : The blood-stasis group had significantly higher CAVI and Stuart's risk scores than the non blood stasis group. The high CAVI group had significantly higher blood-stasis score and Stuart's risk score than the normalCAVI group. In correlation analysis. there were significant positive relationship between blood stasis score and Stuart's risk score, CAVI and Stuart's risk score. and blood stasis score and CAVI. Conclusions : This study suggeststhat there is a significant relationship among blood stasis,CAVI and cardiovascular risk.

• Journal of Korean Physical Therapy Science
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• v.19 no.4
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• pp.47-52
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• 2012

Purpose : The purpose of the study was to examine if a respiratory muscle strengthening training in patients with stroke can improve their pulmonary function. Methods : Volunteers were included for the study if a patient diagnosed stroke more than 6 months and had 24 points or higher in MMSE-K scores. Twenty-eight subjects participated in this study and were randomly divided into two groups; a breathing exercise group(n=14) and a control group(n=14). The intervention for all subjects was conducted for 20minutes, three times a week for 4 weeks. Subjects for the breathing exercise group had the respiratory muscle strengthening training using spiro-tigers, where-as subjects in the control group got their usual treatment ie a postural training. The six-minute walking test(6MWT) and the pulmonary function tests(FVC, $FEV_1$, $FEV_1$/FVC, VC, Vt, IRV and ERV) were employed to assess treatment effects at baseline and after their intervention. Results : Twenty-four subjects finished their 4-week treatment programs. The general characteristics between groups were found to be similar (p>0.05). The pulmonary function between groups were also observed no difference across groups at the baseline measurement (p>0.05). In the post treatment group comparison, subjects in the breathing exercise group showed an increase in lung function with VC ($2.73{\pm}0.80{\ell}$) and Vt ($0.87{\pm}0.38{\ell}$) than those in the control group ($1.91{\pm}0.80{\ell}$ and $0.48{\pm}0.22{\ell}$ respectively) (p<0.05). However, there was no difference found in 6MWT, FVC, $FEV_1$, $FEV_1$/FVC, IRV, and ERV across groups (p>0.05). Conclusion : A significant increase in VC and Vt was found in subjects with stroke, who had four-week training on respiratory muscle strengthening. However, respiratory muscle strengthening showed no effect on walking speed and FVC, $FEV_1$, $FEV_1$/FVC, IRV, and ERV in patients with stroke.