An, Gyu-Hwan;Sim, Sook-Young;Jwa, Cheol-Su;Kim, Gang-Hyeon;Lee, Jong-Yun;Kang, Jae-Kyu
Journal of Korean Neurosurgical Society
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v.50
no.1
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pp.1-5
/
2011
Objective : There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. Methods : Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. Results : There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. Conclusion : In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.
Objectives: This study aimed to investigate the seasonal variation in stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions. Methods: 226 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from November 2005 to October 2006. The year was subdivided into four parts: spring (March-May); summer (June-August); fall (September-November); and winter (December-February). Stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions in the four groups were examined. Results: Ischemic stroke was most frequent in summer, whereas hemorrhagic stroke was most frequent in winter. There was no significant difference in seasonal variation of stroke. The frequency of ischemic heart disease among stroke risk factors was significantly high in spring (p=0.031). The frequency of hypertension, diabetes mellitus, atrial fibrillation, and hyperlipidemia did not differ among seasons. There was no significant difference in Sasang constitution among seasons. Frequency of small vessel occlusion was highest in summer. Large artery atherosclerosis was frequent in spring and summer,but seasonal variation of ischemic stroke subtypes did not show statistical difference. Conclusion: Acute stroke demonstrates seasonal characteristics according to stroke types, ischemic stroke subtypes, risk factors for stroke, and Sasang constitutions. These results have important clinical implications in stroke prevention.
Chough, Chung-Kee;Cheng, Boyle C.;Welch, William C.;Park, Chun-Kun
Journal of Korean Neurosurgical Society
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v.47
no.2
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pp.134-136
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2010
Bow hunter's stroke is a rare symptomatic vertebrobasilar insufficiency in which vertebral artery (VA) is mechanically occluded during head rotation. Various pathologic conditions have been reported as causes of bow hunter's stroke. However, bow hunter's stroke caused by facet hypertrophy of C1-2 has not been reported. A 71-year-old woman presented with symptoms of vertebrobasilar insufficiency. Spine computed tomography showed massive facet hypertrophy on the left side of C1-2 level. A VA angiogram with her head rotated to the right revealed significant stenosis of left VA. C1-2 posterior fixation and fusion was performed to prevent serious neurologic deficit from vertebrobasilar stroke.
Proceedings of the Korean Environmental Health Society Conference
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2005.12a
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pp.87-94
/
2005
Results from previous studies revealed that metal level in the body is related to certain types of diseases. For example. serum copper level with chronic heart failure, iron and transferrin in the blood serum with acute cerebral vascular diseases, Zn in the CNS, lead with neurotoxicity, hypertension, genetic damage, arsenic with cancer skin lesion, Al with neurobehavioral function (cognitive impairment and memory disorder), and etc. The rate of stroke has increased in recent years and several metals were found to be responsible for causing stroke. This study compared several blood metal concentrations between stroke and non-stroke patients. Patients with stroke (116 samples) and non-stroke (111 samples including lowback pain and others) participated in this study. Total of 227 blood samples were collected and participants completed questionnaires regarding age, gender, occupation, residence, alcohol, smoking, and etc. To be qualified into the stroke group, patients have never experienced stroke previously. Subjects only included ischemic stroke and intracerebral hemorrhage patients diagnosed by brain CT and brain MRI. Patients with high risk of metal exposure such as herbal intake and job related exposure were excluded. 10ml of blood samples were analyzed by ICP-MS method at the Center of Nature and Science at Sangji University. Metal geometric mean (SD) concentrations in blood of study subjects showed higher values, 2.64-36.12%, than WHO reference values in Mn, Ni, Hg, Se, and As. Metal concentration in blood of stroke patients non-adjusted for potential confounders was higher except for Hg and also higher except for Ni in adjusted for potential confounders. Co was significantly higher in stroke patients (p=0.002) than non-stroke patients adjusted for potential confounders. Regression coefficient values of stroke patients was 0.17-8.25 in each metals. Odd ratio of stroke patients had 0.96 (Ni)-2.68 (Co) compared to non-stroke cases. This result means that Co increase of 1 raises the risk ratio of stroke by 2.86 times. Based on the results, metal concentration in blood seems to affect incidence of stroke.
Consumption of vegetables and fruits is associated with a reduced risk of stroke, but it is unclear whether their protective effects are due to antioxidant vitamins or folate and metabolically related B vitamins. The purpose of the study was to test the hypothesis that intake of fruits and vegetables, which are major sources of antioxidant and vitamin B complex vitamins, reduces the risk of stroke. Cases consisted of patients diagnosed with first event of stroke (n = 69). Controls (n = 69) were age-, sex-, and body mass index-matched to cases. Multivariable-adjusted regression analysis showed that subjects who ate four to six servings of vegetable per day had a 32% reduction in the risk of stroke, and those with more than six servings per day had a reduction of 69% after adjusting for age, sex, BMI, and family history of stroke. Intakes of total fat, plant fat, calcium, potassium, vitamin $B_1$, vitamin $B_2$, vitamin $B_6$, niacin, and folate were significantly and negatively associated with the risk of stroke. Although the trend was not significant, stroke risk was reduced in the second quartile (1.21-2.66 servings per week) of fish intake. However, intake of fruits (average daily intake of 1.0 serving) and antioxidant vitamins such as carotene, vitamin C, and vitamin E was not associated with the risk of stroke. In conclusion, our observational study suggests that intake of fat and vegetables, rich sources of vitamin B complex, calcium, and potassium may protect against stroke.
Lee Jeong-A;Lee Jae-Hyuk;Yim Seung-Man;Park Sang-Dong
Journal of Oriental Neuropsychiatry
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v.11
no.2
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pp.149-154
/
2000
Objectives:This study was to investigate the post-stroke depression morbidity and to evaluate the post-stroke depression in relation to activities of daily living by using BDI(Beck's Depression Inventory)and MBI(Modified Barthel Index) in 45 patients with stroke. Methods:The subjects of this study were 45 stroke patients who were admittied to the Dong-Seo oriental hospital.The post-stroke depression was determined by using the BDI and the evaluation of activities daily living was measured by using the MBICollected data analysis were completed by using correlation analysis.Results:1. The post-stroke depression morbidity was 30%.2. The post-stroke depression have no significant correlation with activities of daily living skills.Conclusions:This study shows that the post-stroke depression have no significant correlation with impairment in activities of daily living.Advanced studies are required to investigate other factors that influence post-stroke depression and post-stroke depression follow-up studies.
Purpose: The purpose of this study was to determine the effect of a 2-week somatosensory stimulation program on cognitive function and ADL of patients with brain damage. Methods: The sample consisted of two groups of patients with stroke: 10 patients with a mean age of 59.0 years who were treated with somatosensory stimulation, and 9 patients with a mean age of 51.78 years, who were not treated with somatosensory intervention. A nonequivalent control group non-synchronized design was used to assess the functional recovery after stroke. Instruments used in this study were MMSE-K for cognitive function and FIM for ADL. Results: The hypothesis 1 that "Patients with stroke who were treated with the somatosensory stimulation program will show higher MMSE-K score than that of the non-treatment group" was supported(Z = -2.390, p = .017). The hypothesis 2 that "Patients with stroke who were treated with the somatosensory stimulation program will show higher FIM score than that of the non-treatment group", however, was partially supported(social cognition: Z = -2.204, p = .045). Conclusion: Somatosensory stimulation was effective to patients with stroke in improving their cognitive function. These findings suggest that somatosensory input can be adopted to nursing intervention for functional recovery after stroke.
This study was done to analyze the trends of research on stroke in Korea, to suggest future direction, for research on stroke. This article reviewed 75 nursing research papers on stroke done since 1990 to 2000 by examining them according to the period of publication or presentation, research design, type of subjects, measurement variables, the intervention outcome of experimental research, and theme of qualitative research. The research were as follows : 1. 26 of 75 studies were composed of master thesis and dissertation of graduate school. There were 53 nonexperimental research, 15 experimental research, and 7 qualitative studies design. 2. Stroke patients subject' Characteristic were 44 and Family and Spouses of caregiver support were 28 of total studies. 3. Most measurement instruments used for research were translated and redesigned it into Korean that developed by foreigners, and development measurement instruments used Kang's ADL. 4. Family support and Social support was shown the frequently among correlational research. 5. Methodological research were development of an evaluation tool for the quality of nursing care in stroke patients, caregiver support of development of nursing intervention list, and Home care Nursing Intervention protocol, and development of client selection criteria based on the needs of services to be offered. 6. The experimental research of intervention were mostly education nursing intervention, rehabilitation program on functional recovery, support nursing intervention, and applying a home care protocol on the nursing care intervention. 7. Theme of qualitative research were family experience, home care in family experience, soobal experience, illness experience, hope of Stroke patients and so on. Phenomenologic methodology and Granded Theory was designed of Qualitative research. On the basis of the above finding the following recommendations are made: 1. It's necessary to develop a reliable and variable measurement tool for stroke patients and family care of stroke patients. 2. It's necessary to study the comparison of Nursing Studies of stroke research abroad, the replication to establish the effect of nursing intervention stroke patients and family care of stroke patients.
Purpose: We analyzed the incidence of falls and the related factors, circumstances, and consequences associated with falls in stroke patients. Methods: We recruited 127 stroke patients and used a self-reported questionnaire to measure fall prevalence rates and the related factors, circumstances, and consequences of falls. The chi-square test was used to establish associations between related factors. Results: The prevalence of falls in stroke patients was 69.3%, and was associated with gender and time since the stroke. Falls occurred 2-5 times (55.4%) poststroke and most subjects first fall in the 2$\sim$6 month (46.5%) after the stroke. Most (55%) falls occurred at the hospital. Walking was the most frequent circumstance for falls (38.5%). Most (54.4%) falls led to consequences such as fractures, ligament strains, bruises, or abrasions. Conclusion: Fall-prevention strategies decrease the number of falls and the severity of fall-related injuries. These data support the concept of preventive strategies for falls in stroke patients who are at risk.
Physical therapists use assumptions about motor control in every aspect of their work in treating stroke patients. An understanding of the recovery process after stroke, some neural mechanism of recovery and therapeutic model is critical factor for physical therapist to evaluate and obtain a higher final stage of recovery. The purpose of this article was to review the recovery process after stroke, some neural mechanism of recovery, the role of rehabilitation in the process of recovery, therapeutic model and its limitation. This article will help understanding of recovery process. evaluation, and treatment of the stroke patients. Each therapeutic method consists of a different set of assumptions and they are not completely independent of one another. Therefore specializing in any techniques of physical therapy will not be enough to treat stroke, so we are in need of integrated approach and objective measurement instrument to adequately evaluate and treat stroke patients.
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