• 사상체질의학회지
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• 제13권3호
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• pp.23-30
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• 2001

Objective : Stroke is the most frequent cause of death in Korea. Because it remains severe disablities disturbing normal life, it is important to carry out intervention preventing from progression of condition in patients with acute ischemic stroke within therapeutic time window. Thus early western intervention is necessary and beneficial for patients with acute stroke. However its therapeutic efficacy is not known in combination with Sasang Constitutional medical therapy. In this study, we investigated the clinical effect of East(Sasang Constitutional Medicine)-West integrated therapy. Methods : Among 54 patients with acute onset of stroke no later than seven days, 34 patients received East(Sasang Constitutional Medicine)-West integrated therapy and 20 pateints received West medical therapy. We estimated the subjects's status with Sasang Constitutional Symptomatic Scale (SCSS) prior to therapy and at 1 week, 2 weeks, 3 weeks after the starting each therapy. Results : There is no significant difference in SCSS between two group from admission to 1 week. But significant difference was observed after 2 weaks. Conclusion : The results of these investment suggest that East(Sasang Constitutional medicine)-West integrated therapy is more effective in Sasang Constitutional Pathology.

• 대한한의학회지
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• 제28권2호통권70호
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• pp.241-246
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• 2007

Objectives : This study investigated stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in two groups divided by age according to the weakness of shingi (shenqi): younger (40 to 63 years) and older (= 64 years). Methods : 165 male patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from October 2005 to May 2007. Stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in two age groups were examined. Results : Mean ages were $53.01{\pm}6.16$ and $70.95{\pm}6.37$ years for the younger 77 patients and older 88 subjects, respectively. There were no significant differences in stroke type, ischemic stroke subtypes, stroke complications and Sasang constitutions. Current smoking was more frequent in the younger age group (P= 0.005). Conclusion : Age does not seem to influence stroke types, ischemic stroke subtypes, stroke risk factors (except current smoking), stroke complications or Sasang constitutions.

• 한국산학기술학회논문지
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• 제18권5호
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• pp.549-556
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• 2017

본 연구의 목적은 급성기와 직업 사회 복귀전에 있는 뇌졸중 환자의 신경학적 인지기능 및 사회 인지기능의 차이를 비교하고 그 관계를 입증함으로서 급성기 뇌졸중 환자의 인지재활 중재 시 사회 인지 중재의 중요성을 파악하고자 하였다. 2015년 5월에서 2016년 6월까지 서울 소재 재활병원에서 재활치료를 받고 있는 뇌졸중 입원환자 30명과 주간재활센터를 이용하는 환자 30명을 대상으로 LOTCA, 만화 의도추론과제, 사회행동배열과제를 실시하였다. 각 그룹간의 차이를 알아보기 위해 이표본 t 검정을 실시하였다. 각 그룹내에서의 각 변인들간의 상관관계를 알아보기 위해 Pearson's correlations 검정을 실시하였다. 그 결과, 뇌졸중 급성기 뇌졸중 환자군과 지역사회 복귀 전 재활훈련을 받고 있는 만성 뇌졸중 환자군의 신경학적 인지기능과 사회인지 기능 모두에서 통계학적으로 유의한 차이를 나타내었다(p<0.05). 신경학적 인지와 사회인지와의 선형적 관련성을 알아본 결과 급성 뇌졸중군에서는 사고 조직력 항목이 사회행동배열 척도와 상관성을 나타내었다(r=0.539. p<0.05). 만성 뇌졸중군에서는 만화 의도 추론과제는 시지각(r=0.530, p<0.05), 시운동조직화(r=0.655, p<0.05), 사고조작력(r=0.764, p<0.05) 항목과 상관성을 나타내었다. 또한 사회행동배열척도와 시운동조직화(r=0.534, p<0.05). 사고조작력(r=0.650, p<0.05)이 상관성을 나타내었다. 다중회귀 분석 결과, 만화의도 추론과제 결과에서 급성기 뇌졸중 환자의 사회인지기능에 영향을 미치는 신경학적 인지기능은 사고조작력으로 나타났으며(B=0.431), 만성 뇌졸중 환자군의 경우 사고 고작력(B=0.272), 시운동 조직화(B=0.218)로 나타났다. 또한, 사회행동배열과제 결과에서는 급성기 뇌졸중 환자의 경우 사고 조작력(B=0.417)으로 나타났고, 만성 뇌졸중 환자의 경우 사고 조작력(B=0.267), 시운동조직화(B=0.274), 시지각(B=0.151)으로 나타났다. 이번 연구 결과에 의하면, 두 그룹 간 신경학적 인지와 사회인지 수준에 차이를 보였다. 사회인지는 주로 신경학적 인지기능 고차원적 인지 기능인 사고조작력과 높은 관련성이 있고 영향을 받을 것으로 사료된다. 따라서 추후 연구에서는 뇌졸중 환자에게 사회인지기능에 대한 훈련 프로그램을 적용 후 신경학적 인지기능 중 고차원적 인지기능의 변화가 있는지 추정해보는 연구가 필요하겠다.

• 대한간호학회지
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• 제26권1호
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• pp.138-147
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• 1996

Although sensory deficits caused by stroke have been occasionally reported, dysfunctions of discriminative sensation have seldom been studied in patients with strokes. With the use of specifically designed methods, discriminative sensations including texture discrimination and position sense were tested in 67 patients with acute unilateral stroke. Thirty-two age and sex-matched healthy subjects were used as controls. Impaired discriminative sensation was common in patients with unilateral stroke (detected in 57 out of the 67 patients) regardless of the lesion location except for patients with lateral medullary stroke. Proprioceptive discriminative sensation remained intact in all except for three out of 25 patients who were initially diagnosed as having pure motor stroke on the bases of conventional sensory tests. However, tactile discriminative sensation remained intact in only 17 out of 25 patients. Discriminative sensory disturbances are common in patients with unilateral stroke even in those with intact sensory function on routine examination. The subtle disturbances of this sensation may explain, at least in part, the clumsiness of the patients that is not readily explained by conventional neurological tests.

• 기본간호학회지
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• 제19권1호
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• pp.87-97
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• 2012

Purpose: This study was done to evaluate nursing guidelines for patients with acute stroke, developed by adapting the guidelines of Registered Nurses Association of Ontario, Canada to clinical settings on a large scale and evaluating the effectiveness as a research study. Method: The general characteristics of the 319 patients and the effectiveness of guideline application were evaluated in terms of structure, process, and outcome using questionnaires on the guidelines application with reference to the medical records of patients with acute stroke hospitalized on a ward of the stroke center of S General Hospital in Seoul. Results: Structures as a guidance system for assessment were consistent with the recommendations. With respect to the process of the guidelines, for items on nursing assessment, improved performance was found to be statistically significant. For outcomes of the guidelines, complications occurred in 8 patients (5.3%) prior to application of the guidelines and 11 patients (6.5%) after application of the guidelines, but this result was not statistically significant (p=.841). Conclusion: The results of the study indicate that for the effectiveness of the guidelines, accessibility to the guidelines and effectiveness of quality improvement need to be evaluated, in addition to complications of a stroke.

• 대한한의학회지
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• 제23권4호
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• pp.9-14
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• 2002

To assess the clinical efficacy of Chungpyesagan-tang on acute stroke, we prescribed this medicine to 88 acute stroke patients without thrombolytic treatment. The rate of progressive stroke type was 2.3%, remarkably lower than in previous reports. 1.1 % felt an itching sensation, and 17.0% complaxined of loose stool and diarrhea. Chungpyesagan-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale (NIHSS), and increased Modified Barthel Index (MBI). Thus, we could suggest that this medicine has a desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, ALT had anupward tendency and increased over normal value in 16 cases (18.2%). However, the mean serum level 2 weeks later was within the normal value and the other hepatic enzymes did not increase.

• International Journal of Arrhythmia
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• 제17권1호
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• pp.41-45
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• 2016

Atrial fibrillation (AF) can occur in acute coronary syndrome (ACS), which is a serious medical condition and may require the use of antiplatelet agents in addition to anticoagulants for stroke prevention. Recently, novel or non-vitamin K antagonist oral anticoagulants (NOACs) have been increasingly used for stroke prevention in patients with AF instead of traditional OACs. The duration of treatment or treatment with a stepwise approach (e.g. triple, double, or monotherapy) is determined depending on the clinical setting and the balance between the risks of ischemic stroke and bleeding. However, some concerns and controversies in the use of NOACs in patients with AF and ACS need to be addressed. Here, the current management for NOAC therapy in patients with ACS and AF will be reviewed based on recently published guidelines.

• 대한중풍순환신경학회지
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• 제7권1호
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• pp.40-45
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• 2006

Objectives : This study was aimed to assess the distribution of Sasang constitution(SC) in acute stroke patients. Methods : We assessed the type of SC of acute stroke patients in the oriental medical hospitals of 3 universities located in metropolitan region from October 2005 to October 2006 by Questionnaire for the Sasang Constitution Clssification II(QSCCII). We investigated general characteristics, stroke type, blood test results, alcohol drinking, smoking and dietary preferences according to SC. Results : 236 subjects were included into the final analysis. 1. This study showed that the proportion of So-yang was highest of all constitutions(45.3%). And the body weight, body mass index, the waist circumference(WC), the hip circumference(HC), and the WC/HC ratio recorded the significantly high result in Tae-eum. 2. In the TOAST classification, SVO was the major type occupying 81.7% in the total subjects. 3. In Tae-eum, total cholesterol, triglyceride and 2 hours postprandial plasma glucose level were the highest and fasting glucose was significantly highest of all constitutions. Conclusion : From this study, we could roughly seize the distribution of Sasang constitution in acute stroke patients. For the further research, it seems to be necessary to construct fundamental databases for stroke by increasing the number of patients and by analyzing delicate characteristics of each constitution type.

• 대한중풍순환신경학회지
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• 제13권1호
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• pp.33-42
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• 2012

Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.

• Annals of Clinical Neurophysiology
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• 제7권2호
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• pp.75-79
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• 2005

Vestibular evoked myogenic potentials (VEMP) have been known to useful in documenting abnormality in patients with various vestibular disorders but the studies of VEMP in stroke patients are rare. We recorded VEMP in 17 consecutive patients with acute ischemic stroke in the brainstem lesions. All patients underwent magnetic resonance imaging and we compare VEMP results with the lesion documented by brain imaging. VEMP were defined to be abnormal when they were very asymmetrical (one is 2 times of more as large as the other), or absent in one side. VEMP abnormalities were found in 71%(12/17) of acute infarction patients with brainstem lesions. Most abnormalities found in the ipsilateral side of the lesion(9/12) but abnormalities in contralateral side of lesion were found in 25%(3/12) of patients.VEMP would be considered a useful complementary neurophysiological tool for the evaluation of brainstem dysfunction in acute stroke patients.