• The Journal of the Korea Contents Association
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• v.12 no.8
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• pp.264-273
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• 2012

The purpose of this study was to determine the test-retest reliability and the concurrent validity between tinetti mobility test (TMT), berg balance scale (BBS) and space balance 3D which is one of the computerized measurement and visual feedback balance assessment system in subacute stroke patients. Twenty three ambulatory acute stroke subjects were measured the TMT, BBS and space balance 3D. The test-retest reliability(intra-class correlation coefficient: ICC) indicated that the static and dynamic balance in space balance 3D considered moderate reliability and TMT, BBS were good reliability. In case of concurrent validity, there were moderate validity (p<.01) between static balance test with space balance 3D and each TMT, BBS. But there were only poor validity (p<.05) between center to forward-left, center to backward-left phase in dynamic balance test with space balance 3D and each TMT, BBS. These findings suggest that in subacute stroke patients the test-retest reliability and concurrent validity using the space balance 3D and TMT were valuable in balance test but there was limitation to evaluate dynamic balance test.

• Journal of the Institute of Electronics and Information Engineers
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• v.53 no.12
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• pp.180-190
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• 2016

This prospective pilot clinical trial mainly focuses on developing dual chamber-based assistive cups which are suitable for stroke patients who have struggled with using there affected arms. It is unable to provide motor and sensory enhancement during drinking activities and to examine the feasibility of the devices for acute phase, even for chronic stroke survivors. The stroke patients(n=16; male=8, female=8), in this trial, were provided informed consent to the investigation. All the individuals participated in 1 weeks of training for using cups, randomized over dedicated dual chamber based assistive cups(DC) or placebo-cups(PC) training. All the participants were assessed within 1 week before and after the intervention period. 3-dimensional motion analysis, sEMG(surface electromyography) and 3-dimensional trunk movement were assessed. The result presents DC data group compared with PC showed, they needed lesser ROM(range of motion) at the phase of drinking in shoulder movements and lesser muscle activities on upper trapezius, deltoid middle fiber and triceps brachii muscles, lesser tilting movement on front and back side in drinking phase, the differences were statistically significant(p<.05). Dual chamber-based assistive cup could be one of efficient way to complete ADLs(activities of daily living), especially drinking tasks, and these evidence data may contribute to determine certain rehabilitation policies related to assistive devise usage.

• Journal of Preventive Medicine and Public Health
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• v.56 no.3
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• pp.248-254
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• 2023

Objectives: Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care. Methods: Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients' characteristics over time, and significant changes in the rates were identified by joinpoint regression. Results: The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic. Conclusions: The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.

• The Journal of Korean Physical Therapy
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• v.11 no.2
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• pp.111-114
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• 1999

Some hemiplegic patients show a particular posture that pushing away from the nonaffected side of the body. A few study has been conducted of any aspect of this syndrome. But despite the lack of a scientific basis, this term is widely used in the physical therapy of hemiplegic patients. The purposes of this study was to investigate whether pusher syndrome has an adverse impact on functional outcome. Included were all acute stroke patients admitted in a months period a hospital in Seoul. The presence of pusher syndrome was assessed by a Bobath trained physical therapist. The ability of transfer was assessed by the Functional Independence Measure(FIM), Activities of daily living by the Modified Barthel Index(MBI), and standing balance by Bohannon's Standing Balance Scale(BSBS) on admission, weekly during the hospital stay, and at discharge. Pusher syndrome was found in $52.4\%$ of the left side and $50.0\%$ of the right aide hemiplegic patients. Significant differences were found in the score of transfer, ADL and standing balance between patients with and without pusher syndrome.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.5
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• pp.883-891
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• 2010

The purpose of this study was to investigate the relation between each pattern identification such as Dampness-Phlegm, Fire-Heat, Deficiency of Qi, Deficiency of Yin and Blood Stagnation and blood lipid level in acute stroke patients. This study was done over patients hospitalized in 13 Oriental Medical Hospitals in the period of November 2006 to Jun 2009. Patients had been interviewed by residents and medical specialists who studied standard operation procedures in Fundamental Study for Syndrome of Oriental Medicine for Stroke. Study subjects consisted of group A that was distributed to specified pattern identification by medical specialist and discriminating program, group B that was distributed to specified pattern identification by medical specialist or discriminating program, and the control group that wasn't distributed to specified pattern identification by medical specialist and discriminating program. For the purpose of obtaining suitable result, we analyzed blood lipid level of each group by univariate analysis. In this study, there was not statistically significant relation between most of each pattern identification and blood lipid level except relation between Fire-Heat pattern group B and decreasing HDL cholesterol. Based on these results, it is suggested that Dampness-Phlegm would not be the independent predictors of hyperlipidemia unlike other studies that were presented in. More prospective studies between Fire-Heat and decreasing HDL cholesterol are to be done with more clinical data.

• Korean Journal of Radiology
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• v.23 no.8
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• pp.811-820
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• 2022

Objective: To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. Materials and Methods: Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. Results: Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825-0.910) in the training cohort and 0.890 (0.844-0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. Conclusion: The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.

• Korean Journal of Radiology
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• v.22 no.9
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• pp.1547-1554
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• 2021

Objective: We aimed to investigate whether repeated intravascular administration of iodinated contrast media (ICM) or gadolinium-based contrast agents (GBCAs) within a short interval was associated with an increased risk of post-contrast acute kidney injury (PC-AKI). Materials and Methods: This retrospective study included 300 patients (mean age ± standard deviation, 68.5 ± 8.1 years; 131 male and 169 female) who had undergone at least one ICM-enhanced perfusion brain CT scan, had their baseline and follow-up serum creatinine levels available, and had not undergone additional contrast-enhanced examinations 72 hours before and after a time window of interest were included. The study population was divided into three groups: single-dose group and groups of patients who had received multiple contrast administrations in the time window of interest with the minimum contrast repeat interval either within 4 hours (0-4-hour group) or between 4 to 48 hours (4-48-hour group). Multivariable logistic regression analysis was conducted to evaluate the association between AKI and repeated ICM administrations. A similar supplementary analysis was performed including both ICM and GBCA. Results: When ICM was only considered ignoring GBCA, among 300 patients, 207 patients received a single dose of ICM, 58 had repeated doses within 4 hours (0-4-hour group), and 35 patients had repeated doses between 4 to 48 hours (4-48-hour group). Most patients (> 95%) had a baseline estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m². AKI occurred in 7.2%, 13.8%, and 8.6% of patients in the single-dose, 0-4-hour, and 4-48-hour groups, respectively. In the 0-4-hour and 4-48-hour groups, additional exposure to ICM was not associated with AKI after adjusting for comorbidities and nephrotoxic drugs (all p values > 0.05). Conclusion: Repeated intravascular administrations of ICM within a short interval did not increase the risk of AKI in our study patients suspected of acute stroke with a baseline eGFR of ≥ 30 mL/min/1.73 m².

• Journal of Korean Academy of Nursing
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• v.31 no.3
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• pp.432-442
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• 2001

Purpose: The purpose of this study was to investigate the effects of biofeedback exercise training on muscle activity and activities of daily livings (ADL) in hemiplegic patients. An experimental group consisting of 17 people, was given biofeedback exercise training for 30- 60 minutes per week for 5 weeks, while a control group consisting of 18 people, was given normal exercise with quasi-experimental design. Result: The results of the study show that biofeedback exercise is effective for improving muscle activity in hemiplegic patients, especially in the hemiplegic limbs. However, this study found no significant differences in ADL and IADL between the experimental and the control groups. It implies that ADL and IADL may not be improved for a short period of time, such as 5 weeks, for people with more than five years of hemiplegia. The study suggests that the effect of biofeedback exercise on ADL and IADL should be determined in hemiplegic patients in acute stage.

• The Journal of Internal Korean Medicine
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• v.32 no.2
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• pp.232-242
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• 2011

Objectives : The purpose of this study was to develop the Korean standard pattern identifications for stroke-III (KSPIS-III). KSPIS-III includes 4 major pattern identifications (PIs) and clinical indicators for each. Methods : To extract the indicators for 4 major PIs, we analyzed 1548 clinical data from 15 traditional Korean medicine hospitals. Patients got acute stroke within 30 days from onset. Two physicians independently checked 65 indicators and performed pattern diagnosis. If the PI were diagnosed the same, PI would be confirmed. First we built an assumption model that set up the relationship among pattern identifications. Second, we extracted the indicators for fire-heat pattern and qi deficiency pattern by comparison between excessive and deficiency group, heat and non-heat group. By comparing yin deficiency pattern and 3 other patterns respectively, we extracted the indicators for yin deficiency pattern. Dampness-phlegm pattern indicators were extracted by the same method. Results : After cross tabulation with 65 indicators on the basis of our assumption model, we finally extracted 19 indicators for fire-heat pattern, 11 for qi deficiency pattern, 7 for yin deficiency pattern, and 7 for dampness-phlegm pattern. Conclusions : KSPIS-III was more improved than KSPIS-II because it was based on more clinical data. Further study to establish the PI diagnostic model would be required for practical use in the clinical field.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.224-235
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• 2022

Objective : Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, neurointerventionists have been increasingly concerned regarding the prevention of infection and time delay in performing emergency thrombectomy procedures in patients with acute stroke. This study aimed to analyze the effects of changes in mechanical thrombectomy protocol before and after the COVID-19 pandemic on procedure time and patient outcomes and to identify factors that significantly impact procedure time. Methods : The last-normal-to-door, first-abnormal-to-door, door-to-imaging, door-to-puncture, and puncture-to-recanalization times of 88 patients (45 treated with conventional pre-COVID-19 protocol and 43 with COVID-19 protection protocol) were retrospectively analyzed. The recanalization time, success rate of mechanical thrombectomy, and modified Rankin score of patients at discharge were assessed. A multivariate analysis was conducted to identify variables that significantly influenced the time delay in the door-to-puncture time and total procedure time. Results : The door-to-imaging time significantly increased under the COVID-19 protection protocol (p=0.0257) compared to that with the conventional pre-COVID-19 protocol. This increase was even more pronounced in patients who were suspected to be COVID-19-positive than in those who were negative. The door-to-puncture time showed no statistical difference between the conventional and COVID-19 protocol groups (p=0.5042). However, in the multivariate analysis, the last-normal-to-door time and door-to-imaging time were shown to affect the door-to-puncture time (p=0.0068 and 0.0097). The total procedure time was affected by the occlusion site, last-normal-to-door time, door-to-imaging time, and type of anesthesia (p=0.0001, 0.0231, 0.0103, and 0.0207, respectively). Conclusion : The COVID-19 protection protocol significantly impacted the door-to-imaging time. Shortening the door-to-imaging time and performing the procedure under local anesthesia, if possible, may be required to reduce the door-to-puncture and door-to-recanalization times. The effect of various aspects of the protection protocol on emergency thrombectomy should be further studied.