• 한국산학기술학회논문지
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• 제12권1호
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• pp.294-300
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• 2011

본 연구는 연하장애에 대한 병식이 없는 뇌졸중 환자들에서 연하장애의 유무와 양상을 알아보고자 시행되었다. 부산시에 소재하고 있는 P 재활의학병원을 내원한 뇌졸중 환자들 중 설문지 조사를 통하여 병식이 없다고 응답한 11명의 환자(남자 4명, 여자 7명)들을 최종대상으로 선정하였다. 설문지 조사, 비디오 투시 연하 조영 검사(video-fluoroscopic swallowing study, VFSS), 기능적 연하곤란 척도, 신경행동학적 인지상태 검사(neuro- behavioral cognitive status examination, NCSE)를 실시하였다. 결과 분석은 SPSS12.0을 사용하여 기술통계와 피어슨 상관분석을 하였다. 본 연구의 대상 뇌졸중 환자들 중 연하장애에 대한 병식이 없다고 응답한 환자들은 모두 연하장애를 동반하였다. 동반되는 연하장애의 양상으로는 구강기의 문제들과 인두기의 삼킴반사 지연이 있으며 인지적 특성에 있어서는 NCSE 항목 중 구성력, 기억력, 유사성이 다른 항목들보다 더 낮은 것으로 나타났다. 기능적 연하곤란 척도와 NCSE 항목들 간의 상관관계를 살펴본 결과 지남력과 판단력이 삼킴반사 지연과 언어이해가 구강 내 식괴의 잔여정도와 유의한 상관관계가 있었다. 본 연구의 결과에 의하면 연하장애에 대한 병식이 없는 뇌졸중 환자들이 연하장애를 가질확률이 높다. 따라서 연하장애로 인한 합병증을 예방하고 작업치료의 효과를 높이기 위해 뇌졸중 환자들에게 조기에 연하장애 평가가 이루어져야 할 것이다.

• 대한한의학회지
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• 제21권3호
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• pp.129-139
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• 2000

Clinical observation was made on 210 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyungwon University from January to December in 1998. Objective : To evaluate the current status of cerebrovascular disease in Korea, we performed observation on stroke patients. Methods : We performed a retrospective study on 210 cases of stroke who had been admitted to the Dept. of Internal Medicine, College of Oriental Medicine, Kyungwon University from Jan. 1, 1998 to Dec. 31, 1998. Results : The incidence was highest in the patients with the age of above fifty. The frequency of strokes was similar between male and female cases. Ischemic stroke(70.0%) was more common than hemorrhagic stroke(20.5%), with transient ischemic attacks(9.5%) occuring less frequently. Middle cerebra! arterial territory was the most commonly involved site in ischemic strokes. Among intracerebral hemorrhages, putaminal hemorrhages were found in 69.8%, and was followed by IVH(9.3%), IVH with ICH(7.0%), subcortical hemorrhages (4.7%) and pontine hemorrhages(4.7%). The most ordinary preceding disease was hypertension. The next was diabetes mellitus. Most cases were given simultaneous treatment in both western and oriental medical methods. Conclusions : Generally it is thought that CVA occurs frequently in winter. But our observations reveal no such relationship. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. I Patients whose condition of consciousness was bad at the time of admission tended to have a bad prognosis. This study suggests changing trends of stroke in Korea, and that a multicenter prospective study using stroke registry is required for confirmation.

• 한국산학기술학회논문지
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• 제12권12호
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• pp.5731-5740
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• 2011

본 본 연구는 만성 뇌졸중 환자에서 감각기능이 일상생활활동 수행능력에 미치는 영향을 알아봄으로서 추후 감각기능 재활의 기초적 자료를 마련하고자 실시하였다. 연구대상자는 뇌졸중으로 진단 받은 후 6개월이 경과된 환자로 작업치료를 받고 있는 138명이었으며, 우측편마비 환자가 45명(33%), 좌측편마비 환자가 93명(67%) 이었다. 만성뇌졸중 환자들의 감각기능, 운동기능, 인지기능, 일상생활활동 수행능력을 검사하여 수집한 값을 분석하였다. 본 연구 결과 우측편마비 환자에서 환측(우측)의 서화지각과 고유수용성 감각은 개인위생기능과 유의한 상관관계, 좌측편마비 환자군에서는 건측 상지의 기능은 여러 일상생활활동 수행영역과 의미 있는 상관관계, 좌 우측 편마비 환자군 모두에서 건측 상지의 운동 기능과 일상생활활동 수행능력 간에는 유의한 상관관계가 있음을 알 수 있었다.

• 대한한방내과학회지
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• 제43권5호
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• pp.881-890
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• 2022

Objectives: This study investigated the effect of complex Korean medicine treatment on decreased mental status in a progressive supranuclear palsy patient with a cerebrovascular accident. Case presentation: The patient was treated with Korean medicine composed of herbal medicine (modified Guibi-tang), acupuncture, moxibustion, and cupping combined with Western medicine (a dopamine precursor and an anticholinergic) and physical therapy. The Glasgow Coma Scale, Mini-Mental State Examination, and Hoehn and Yahr Scale were used to evaluate the effects of the treatments. After treatment, Glasgow Coma Scores increased from 9-10 to 12-13, and Mini-Mental State Examination for dementia screen scores increased from 1 to 2. The Hoehn and Yahr score remained at 5. There were no side effects of the treatment. Conclusion: This study suggests that complex Korean medicine treatments may be effective for the decreased mental status of a progressive supranuclear palsy patient with a cerebrovascular accident, but further studies are needed.

• 대한한의학회지
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• 제18권2호
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• pp.223-244
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• 1997

Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

• 대한한방내과학회지
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• 제25권3호
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• pp.662-668
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• 2004

Cerebrovascular accident(CVA) is a leading cause of death, and severe sequelae, like motor disturbance, mental disorder, dysphagia, recognition disorder, speech disorder(aphasia) often occur. Most of medical cure about CVA sequelae lay emphasis on motor disturbance, so speech disorder(aphasia) has been neglected. But speech disorder therapy is essential for social rehabiltation. Recently, inside and outside South Korea, various clinical approaches and potential medical cures for speech disorder (aphasia) have been researched. In Korean Medicine, papers pertaining to speech disorders have been but a few. In this study two cases of aphasic stroke patients who were treated for speech and language disorders through Korean medical therapy are reported.

• 성인간호학회지
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• 제18권5호
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• pp.760-770
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• 2006

Purpose: This study was aimed at identifying the effect of meridian acupressure on decreasing the severity of constipation in stroke patients admitted to the intensive care unit. Method: The data was collected from June 1 to July 30, 2005 at D Hospital in Busan. They were divided into two group: one experimental group of 18, and the another control group of 17. Meridian acupressure was given to the experimental group and no meridian acupressure was given to the control group. The data was analyzed using the t-test, ${\chi}^2-test$, Fisher exact, and repeated measures ANCOVA. Results: There was a significant improvement in frequency of defecation and severity of constipation in the experimental group compared to the control group. Conclusion: Meridian acupressure can be considered an effective nursing method for the management of constipation among Cerebrovascular Accident patients.

• 음성과학
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• 제8권1호
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• pp.115-122
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• 2001

This paper explored the effectiveness of a hierarchical Treatment of Aphasic Perseveration (TAP) program on an aphasic in two regards: decrease in the frequency of perseveration and improvement in naming ability. The subject was a 54-year-old female with Transcortical Sensory (TCS) aphasia following a left ischemic Cerebrovascular Accident (CVA). It was concluded that the hierarchical TAP program was more effective and efficient in terms of decreasing perseveration and increasing correct naming performance. Within the data of the hierarchical TAP program, however, a substantial decrease in the frequency of occurrence of perseverative behaviors did not necessarily result in proportionate improvement of naming ability. The probable causes and reasons were discussed.

• 사상체질의학회지
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• 제7권2호
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• pp.59-88
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• 1995

Three groups have participated in this study. 1) The first group consists of 57 patients were who had been treated in the Oriental Medical Hospital at Kyung Hee Medical Center. 2) The second group consists of 37 outpatients who had been treated in the Oriental Medical Hospital at Kyung Hee Medical Center. 3) The third group consists of 76 students of the Oriental Medical School at Kyung Hee University. The following conclusions were made in comparison with EAV measurement values, SaSang Constitution Classfication and CVA. 1. The following conclusions were made in comparison with EAV measurement values and Type(SaSang Constitution Classfication). 1) The analsis of the Correlation in Normal group with EAV measurement values and Type(SaSang Constitution Classfication). 2) The analysis of the correlation in patient group with EAV measurement values showed significant differences in Right meridians(Nerval degeneration vessel, Circulation, Allergy) and in Left meridian(Liver). 3) The analysis of the correlation in Total(Normal+patient)group with EAV measurement values showed significant differences in Right meridians(Large intestine, Nerval degeneration vessel, Circulation, Allergy, Pancreas) and in Left meridians(Lymph vessel, Nerval degeneration vessel, Spleen, liver). 4) The above results showed common-significant differences in Right Allery meridian and in Left Liver meridian. 2. The analysis of the correlation in EAV measurement values and Group (Cerebrovascular accident) showed significant differences in Right meridians(Lymph vessel, Lung, Nerval degeneration vessel, Allergy, Paren & Epith. degeneration vessel, Triple warmer, Heart, Pancreas, Stomach, Fibroid degeneration vessel, Skin, Fatty degeneration vessel, Heart, Stomach, Fibroid degeneration vessel, Skin, Fatty degeneration vessel, Bile duct, Kidney). 3. The analysis of the correlation in EAV measurement values and Para(GROUPS according to PARALYSIS)showed significant differences in Left Stomatch meridian. The analysis of the correlation in EAV measurement values and Para(GROUPS according to PARALYSIS) about the differance of right measurement values and left measurement values showed significant differences in Nerval degeneration vessel, Stomatch, Gall bladder & Bile duct, Kidney and Urinary Bladder meridians. 4. The analysis of the correlation in EAV measurement values and Compl(GROUPS according to COMPLICATION with CVA)showed significant differences in Right meridians(Lymph vessel, Articular degeneration vessel, Fatty degeneration vessel) and in Left meridians(Lung, Stomatch, Fatty degeneration vessel). 5. The analysis of the correlation in Type and MORPHOROGICAL DIAGRAMING (HTOUPS according to MORPHOROGY) showed significant differences in Cranium region, Chest region, Stomatch region and Umbilicum region. 6. The analysis of the correlation in BAZ measurement values and Group(Cerebral Vascular Attack)showed significant differences, the analysis on the correlation of BAZ measurement values and Type(SaSang Constitution Classfication) didn't show any significant differences. 7. In comparison with Actual measurement vales and Voll's measurement values, BAZ measurement values agree with Voll's measurement values but CMP measurement values lower than the Voll's measurement values. Later We have to research further about classifications of race, age, sex etc. The EAV measurement values have Group(Cerebrovascular accident) more correlative than Type(SaSang Constitution Classfication). The EAV may well be that it will be used as an accessory method in SaSang Constitution Classfication and as a diagnostic method in medicine too.

• 대한한의학회지
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• 제24권1호
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• pp.181-189
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• 2003

Background : Patient, family, society and country are badly damaged by stroke (CVA : cerebrovascular accident). To reduce sequelae and return rapidly to society, treatment in the acute stage is very important. In many studies on purgation therapy (下法) used in acute stages of stroke, the changes of blood pressure, pulse and so on before and after purgation therapy were reported. However, the changes in the human body according to the day elapsed after defecation were not reported, so study was needed to confirm such changes. Methods : Seventy-six patients were studied. We observed forty-three patients at acute stroke and thirty-three patients at convalescent stroke. To confirm the importance of regular defecation in stroke patients, we analyzed blood pressure according to the day elapsed after defecation. Results : The following result were obtained. 1. In stroke group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute stroke group. 2. Especially in stroke and acute stroke groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. 3. In the infarction group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute infarction group. 4. Especially, in the infarction and acute infarction groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. Conclusion : In stroke patients, regular defecation is important, so we think that purgation therapy (下法) is needed in stroke patients over the third day elapsed after defecation. We think that the bowel movement control in acute stroke patients is more important than in convalescent stroke patients.