• Korean Journal of Radiology
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• v.23 no.3
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• pp.333-342
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• 2022

Objective: Intracranial atherosclerotic stroke occurs through various mechanisms, mainly by artery-to-artery embolism (AA) or branch occlusive disease (BOD). This study evaluated the spatial relationship between middle cerebral artery (MCA) plaques and perforating arteries among different MCA territory infarction types using vessel wall magnetic resonance imaging (VW-MRI). Materials and Methods: We retrospectively enrolled patients with acute MCA infarction who underwent VW-MRI. Thirty-four patients were divided into three groups according to infarction pattern: 1) BOD, 2) both BOD and AA (BOD-AA), and 3) AA. To determine the factors related to BOD, the BOD and BOD-AA groups were combined into one group (with striatocapsular infarction [BOD+]) and compared with the AA group. To determine the factors related to AA, the BOD-AA and AA groups were combined into another group (with cortical infarction [AA+]) and compared with the BOD group. Plaque morphology and the spatial relationship between the perforating artery orifice and plaque were evaluated both quantitatively and qualitatively. Results: The plaque margin in the BOD+ group was closer to the perforating artery orifice than that in the AA group (p = 0.011), with less enhancing plaque (p = 0.030). In the BOD group, plaques were mainly located on the dorsal (41.2%) and superior (41.2%) sides where the perforating arteries mainly arose. No patient in the AA group had overlapping plaques with perforating arteries at the cross-section where the perforator arose. Perforating arteries associated with culprit plaques were most frequently located in the middle two-thirds of the M1 segment (41.4%). The AA+ group had more stenosis (%) than the BOD group (39.73 ± 24.52 vs. 14.42 ± 20.96; p = 0.003). Conclusion: The spatial relationship between the perforating artery orifice and plaque varied among different types of MCA territory infarctions. In patients with BOD, the plaque margin was closer and blocked the perforating artery orifice, and stenosis degree and enhancement were less than those in patients with AA.

• The Journal of Internal Korean Medicine
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• v.30 no.2
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• pp.438-449
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• 2009

Objectives: Deep vein thrombosis (DVT) is a common complication among stroke patients. The implication of DVT progressing into a fatal pulmonary embolism is one of the main reasons treatment cannot be delayed. However, when there is a contradiction for anticoagulants, such intracranial hemorrhage (ICH), it is difficult to determine the course of treatment. Our team reports a case with both acute DVT and ICH who improved with herbal medicine Hyulbuchuko-tang. Methods : A patient with a variety of thrombosis risk factors (atrial fibrillation, DVT, Cb-inf with intracranial hemorrhage due to thrombolytic complications) showed classic symptoms of DVT (pain, edema, discoloration), disorientation and chest discomfort. The patient was administered Hyulbuchuko-tang three times a day for 24 days without any anticoagulants. Conservative therapy including elastic stocking and leg elevation was co-administered. Laboratory tests and extremity vascular Doppler sonography were carried out 3 times during the treatment period. Results : After our treatment period, both popliteal vein DVT and calf vein DVT were not discovered by sonography, and thrombosis derived factors (eg. D-dimer, fibrinogen) decreased. There was no sign of edema or discoloration after treatment, and the patient no longer complained of leg pain, disorientation or chest discomfort. Conclusion : From these results, we suggest that there is a positive effect of Hyulbuchuko-tang on DVT. Hyulbuchuko-tang should be considered as a treatment option when western medical procedures are unavailable.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.190-194
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• 2015

Blunt cerebrovascular injury is defined as a vertebral or carotid arterial structural wall injury resulting from nonpenetrating trauma. Complete traumatic internal carotid artery occlusion is very rare condition accounting for 0.08~0.4 0f all trauma patients and believed to be associated with the greatest risk of ischemic stroke reported in 50~90% in a few small series. A 55-year-male was admitted with drowsy mentality and severe headache after a fall down accident. Brain computed tomography showed a subdural hematoma at the both frontal area with a fracture of the occipital skull bone. Two days after admission, he suddenly complained with a right side hemiparesis of motor grade 2. Brain magnetic resonance diffusion demonstrated multiple high flow signal changes from the left frontal and parietal lesion. Computed tomographic angiogram (CTA) revealed absence of the left ICA flow. Trans femoral cerebral angiography (TFCA) showed complete occlusion of the left internal carotid artery (ICA) at ophthalmic segment in the left ICA angiogram and flows on the left whole hemispheric lesions through the anterior communicating artery in the right ICA angiogram. We decided to conduct close observations as a treatment for the patient because of acute subdural hematoma and sufficient contralateral cerebral flow by perfusion SPECT scan. Two weeks after the accident, he was treated with heparin anticoagulation within INR 2~4 ranges. He recovered as the motor grade 4 without another neurologic deficit after 3 months.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.2
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• pp.21-29
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• 2019

Background: The purpose of this study is to investigate the effect of the combined exercise program on the static balance ability of the lumbar instability of adults. Methods: The experimental group was divided into two groups and randomly. The experimental group 1 (Exp 1) applied the combined exercise program for the lumbar stabilization exercise and strengthening exercises and the experimental group 2 (Exp 2) applied the combined exercises program for the lumbar stabilization exercises and active stretching exercises. Each experiment group performed exercise program for 4 weeks, 3 times a week, 30 minutes a day. Static balance ability was measured using GOOD BALANCE system. Results: As the comparing results of static balance ability, normal standing eye open was Ant-Post and Med-Lat showed significant differences in Exp 1 (p<.05). One leg left eye open was velocity moment showed significant differences in Exp 1 (p<.05). and one leg right eye open was Med-Lat showed significant differences in Exp 1 (p<.05). Conclusion: These results show that thoracic self mobilization is immediate effective on balance and gait ability. Thus, thoracic self mobilization will help recovery of balance and gait ability in acute stroke patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.6
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• pp.1291-1296
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• 2002

Blood circulation of brain is divided into two major categories; anterior one from carotid artery and posterior one from vertebrobasilar artery. In stroke patients, it is important to diagnose which is involved, because there is many difference in the aspects of clinical menifestations and prognosis, especially in the acute stage. In some cases of vertebrobasilar infarction, such as Wallenberg's syndrome, charicteristic cranial nerve signs, eye movement disorders and cerebellar signs are appeared. And in Dejerine's syndrome, only pure motor or sensory defecits can be appeared without any brainstem signs. So It shoud be differenciated by Brain MRI from those of the cerebral hemisphere lesions. And in the cases that nausea, vomitting and dysphagia are the first menifestations, it is frequently misdiagnosed as internal medical disease, causing appropriate treatment delayed. In this case report, we are to describe the clinical menifestations and progresses of two cases of brainstem infarctions, review previously published case reports about them and compare them to our cases. The first is Dejerine's syndrome i.e. medial medullary infarction, the second is Wallenberg's syndrome i.e. lateral medullary infarction. Simultaneously we are to investigate the oriental medical approach in the bran stem infarctions.

• Journal of the Korea Convergence Society
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• v.6 no.5
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• pp.287-294
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• 2015

The purpose of this study, was Let's examine the exposure dose at the time of cerebral blood flow CT scan of acute ischemic stroke patients. In particular, long-term high doses of radiation sensitive organs and we Measured using phantom and a glass dosimeter. Apply the existing protocol suggested by the manufacturer (fixed time delay technique) and the proposed new convergence protocol (bolus tracking technique), reporting to measure the dose, dose reduction was to prepare the way. Results up to 39.8% as compared to the existing protocols in a new suggested convergence protocol, a minimum of 5.8% was long-term dose is reduced. Test dose of $CDTI_{vol}$ and DLP values decreased 25%, respectively, were measured at less than recommended dose. Try checking the protocol set out in the existing based on the analysis result of the above, by applying the proposed new convergence protocol by reducing the dose would have to contribute to improved public health. It is believed to be research continues to find the optimum protocol in the other tests.

• Journal of Korean Society of Rural Planning
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• v.28 no.2
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• pp.33-40
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• 2022

The purpose of this study is to review the effect of previous research data with virtual reality-based Physical Activity Therapy Programs(PATPs) in adult on the physical fitness factors. Research articles were retrieved from 2008 to 2021 with the Research Information Sharing Service(RISS) and Pubmed database. The main search terms were 'care', 'therapy', 'healing', 'exercise' or 'physical activity', and 'virtual reality'. The criteria for selecting articles of this study were the originality, duplication, Randomized controlled trial(RCT) experiment and subject. Finally, 18 papers were selected among 318 articles, which were excluded if any of the criteria was not satisfied. Most of papers(15) were conducted in the last 5 years, because of the high interest due to the development of virtual reality implementation technology and COVID-19 pandemic. The participants were mainly patients(8), and the types of diseases were stroke(2). The physical fitness factors were mostly balance ability(7), muscle strength(7), and range of motion(6). All the physical fitness factors were significantly improved after PATPs. However, 11 studies were conducted for less than 4 weeks, including 6 studies were performed a bout of acute exercise. Also, 14 studies did not clearly present the intensity of PATPs. In addition, there were 9 studies, that simply applied games without specialized programs. In conclusion, it seems that virtual reality-based PATPs have a positive effect on physical fitness factors. However, VR-based PATPs should be specialized and developed in order to verify their effectiveness for the further research.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.823-829
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• 2023

Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment. Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (Boyanghwanoh-tang-gagam) three times a day. Jowiseunggi-tang extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient's clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency . Results: The patient's MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication. Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1281-1286
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• 2021

Brainstem infarction due to vertebrobasilar insufficiency is a rare initial presentation of systemic lupus erythematosus (SLE) patients and small-vessel dissection as the direct cause of infarction has not been reported. We report the case of a 20-year-old female with acute infarction on the right side of the pons due to a small artery (pontine perforator) dissection, identified on digital subtraction angiography and high-resolution vessel wall MRI (vwMRI). She was diagnosed with SLE based on the presence of neurologic disorders and relevant laboratory findings. The pontine perforator-dissecting aneurysm had occluded and the right distal vertebral artery had resolved on subsequent vwMRI. She had a modified Rankin Scale (mRS) score of 1 at discharge with mild symptom improvement, and exhibited no further aggravation of symptoms at 3 or 12 months, maintaining an mRS score of 1.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.782-798
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• 1996

This study was a survey done for the purpose of constructing a nursing theory according to Korean culture and to identify the traditional Korean view of humans and the expectations of the sick role, and to confirm changes from the traditional view of humans and expectations of the sick role according to general characteristics of the population. The subjects were all adults over 18 years old. 517 who lived in six large cities and 191 who lived in five rural communities. Data collection was done from November 19th, 1994 to January 19th, 1995 using a tool to measure the traditional view of humans and expectations of the sick role which was developed by the investigator through a literature review. Collected data were analyzed using frequency, percent, Cronbach alpha, 1-test, F-test and Scheffe post hoc contrasts, with the SAS program. The results of this study are summerized as follows : 1. The Traditional view of human score for all subject was 49.92, which shows that Korean traditional view of human is moderate. High scored items were "human need to live by making harmony with nature, not by overcoming the nature" (3.44), "Filial duty to parents and elders is important" (3.31), "Think of family more than a individual" (2.96). 2. The differences in the traditional view of humans between residential districts showed that the residents of Chungbuk(56.00), Kyungbuk(55.26), Chonbuk(51.32), Taegu(50.59) had a more traditional view of humans than those in Pusan(45.42) and Seoul (47.27). 3. The differences in the traditional view of humans according to general characteristics showed that rural community residents, males, older people, people with lower levels of education, married and house-resident groups had a significantly higher traditional view of humans than urban residents, females, younger people, people with a higher levels of education, single and apartment-resident groups. There were differences according to religion and job. Buddhism had a higher traditional view of humans than those of atheism, Christianity and Catholicism and physical workers, a significantly highers score, than technicians and professional workers. 4. Daily expected task performance during illnesses was lowest for patients with stroke (2.16) and psychosis(2.40), in which case almost no daily general tasks were expected, followed by arthritis 4.06, peptic ulcer 4.79, headache 4.99 and cough 5.58. The amount of expected role exemption during illnesses was also highest for stroke(2.25), followed by psychosis(2.08), arthritis(1.64), peptic ulcer(1.29), headache(1.16) and cough(1.09). The amount of daily task performance in the acute stage(3.05) was significantly lower than that of convalescent stage(4.95). 5. Total expectation of role exemption according to general characteristics showed that there was no significant differences in urban /rural community, marriage, level of education and religion. By sex, women showed higher expectation of role exemption during illnesses than men. By age, the 31-40 year old group showed lower expectation of role exemption than the 41-50 year old group or over the 61 year old group.or over the 61 year old group.