• 제목/요약/키워드: Neurologic

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뇌혈관질환을 동반한 진행성 핵상마비 환자의 의식수준저하에 대한 한방복합치료 증례보고 1례 (A Case Report of Complex Korean Medicine Treatments of Decreased Mental Status in a Progressive Supranuclear Palsy Patient with a Cerebrovascular Accident)

  • 강지현;김서현;김준석;장우석
    • 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.

재발된 뇌경색으로 이중항혈소판요법 필수인 환자의 혈뇨에 대한 삼칠근말의 지혈효과 증례보고 1례 (A Case Report of the Hemostatic Effect of Samchilgeun Powder (Panax Motoginseng) on Hematuria in a Patient Requiring Double Antiplatelet Therapy Due to Recurrent Cerebral Infarction)

  • 김서현;강지현;김준석;장우석
    • 대한한방내과학회지
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    • 제43권5호
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    • pp.909-917
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    • 2022
  • Objective: The purpose of this study was to investigate the effect of Samchilgeun powder (panax notoginseng) on the treatment of hematuria in a patient requiring double antiplatelet therapy due to recurrent cerebral infarction. Methods: The patient was treated with Samchilgeun powder (panax notoginseng) combined with Western medicine (an antiplatelet). Urinalysis was performed to observe hematuria and proteinuria levels, and blood tests were used to evaluate anemia levels. Results: After treatment, hematuria levels decreased without exacerbation of anemia and proteinuria and even recurrence of cerebral infarction. Conclusions: This study suggests that Samchilgeun powder (panax notoginseng) can effectively treat patients with hematuria requiring double antiplatelet therapy due to recurrent cerebral infarction, but further studies should be conducted.

뇌졸중 환자 재활 시 간병인 부담에 영향을 미치는 요인 (Factors Influencing Caregiver Burden During Rehabilitation of Stroke Patients)

  • 김유미;백승민;나영일;윤용순
    • 산업융합연구
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    • 제20권11호
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    • pp.27-34
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    • 2022
  • 본 연구에서는 뇌졸중 환자의 어떤 의학적 요인이 간병인 부담에 영향을 미치는지 알아보기 위해 8주간의 치료 전후 환자의 신경학적 상태, 인지, 일상생활수행능력, 보행, 균형 지표와 간병인의 부담감을 측정하여 그 변화를 비교하였습니다. 간병인은 8주간의 재활 치료 기간 동안 경도-중등도의 부담감을 느끼고 있었으며, 환자의 신경학적 상태, 인지 상태가 간병인 부담과 연관이 있었습니다. 전체 환자군 및 아급성기 뇌졸중 환자군의 의학적 지표와 간병인의 부담감을 다중회귀분석 하였을 때, 신경학적 상태와 균형 능력이 보호자 부담감에 영향을 주는 요소로 나타났습니다. 이에 입원한 뇌졸중 환자의 재활 치료 시 간병인 부담 경감을 위해 환자의 균형 능력 향상에 중점을 둘 것을 제안합니다.

귀비온담탕가미방으로 호전된 무통성 갑상선염 중독기 환자 치험 1례 (Case Study of a Patient in a Thyrotoxic Phase of Painless Thyroiditis Treated with Guibiondam-tang-gamibang)

  • 김서현;김채은;김준석;장우석
    • 대한한방내과학회지
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    • 제44권2호
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    • pp.277-284
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    • 2023
  • Objective: This study investigated the effects of Guibiondam-tang-gamibang on patients in the thyrotoxic phase of painless thyroiditis. Methods: A patient in the thyrotoxic phase of painless thyroiditis was treated with Guibiondam-tang-gamibang combined with Western medicine (i.e., beta blockers). The effect of treatment was evaluated according to the pulse rate, NRS, the frequency of subjective symptoms, and sleep time. In addition, the thyroid function was evaluated with TSH, Free T4, and T3 using blood tests. Results: After treatment, the pulse rate decreased, and the NRS and frequency of subjective symptoms disappeared after improvement. Sleep time increased. In the thyroid function test, a significant normalization of each value was observed. Conclusion: This study suggests that Guibiondam-tang-gamibang can be effectively treated in patients with painless thyroiditis in the thyrotoxic phase. However, further studies should be conducted.

중풍 환자의 NIHSS에 따른 중풍 변증 분형 분포의 특성 연구 (A Study on the Relationship between NIHSS and Distribution of Pattern Identification in Stroke Patients)

  • 김미경;양나래;최동준;한창호
    • 대한중풍순환신경학회지
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    • 제10권1호
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    • pp.47-53
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    • 2009
  • Objectives : This study was aim to investigate the relationship between NIHSS and distribution of pattern identification in stroke patients. Methods : 1471 participants from the patients hospitalized for stroke within 4 weeks from April 2007 to August 2009 were included. They were grouped according to the NIHSS score; group 1 for the participants whose NIHSS were less than six, group 2 for seven to fifteen, and group 3 for over than sixteen. And the patients were re-divided into two groups according to their post-onset interval. The difference of distribution of five pattern identification for each group were investigated. And five pattern identification were re-analyzed according to the deficiency-excess pattern identification. K-W test was used for statistical synthesis, and the result was regarded as significant one, if its p-value was below 0.05. Results : Dampness-phelegm pattern was the most frequent out of five patterns in total participants as well as all the subgroups. In group 3 with more serious neurological deficit, larger proportion of patients in early acute stage was diagnosed as excess pattern including Fire-Heat pattern. On the other side the proportion of Deficiency of Qi and Yin was larger in late convalescent stage of group 3 than in other groups. But nothing was statistically significant. Conclusions : Further study including patients with more variant classification with follow-up evaluation is needed to reflect the real characteristics of stroke population.

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신음허(腎陰虛)로 변증(辨證)된 중풍환자(中風患者)와 신음허(腎陰虛)로 변증(辨證)되지 않은 중풍환자(中風患者)의 당뇨(糖尿)에 대한 육미지황탕(六味地黄湯)의 치험례(治驗例) (Case Report of Yukmijihwang-tang(Liuweidihuang-fang) on Diabetes Mellitus in Stroke Patients Diagnosed as Kidney-Yin Deficiency or Non Kidney-Yin Deficiency Syndrome)

  • 정우상;문상관;조기호;김영석
    • 대한중풍순환신경학회지
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    • 제11권1호
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    • pp.82-88
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    • 2010
  • Because syndrome-differentiation is one of the major characteristics in oriental medicine, there would be a possibility that the same herbal medicine show different effects on the same disease, if syndrome differentiation is ignored. In this report, we observed different response of Yukmijihwang-tang in diabetic stroke patients according to their syndrome differentiation. One case diagnosed as 'Kidney-yin deficiency syndrome' showed remarkable improvement on diabetes mellitus, whereas the serum glucose levels of the other 4 cases diagnosed as 'non Kidney-yin deficiency syndrome' were lowered little. These results are in accordance with the oriental medical theory that Yukmijihwang-tang can treat 'Kidney-yin deficiency syndrome'. Therefore, we suggest that subsequent clinical trials on oriental medicine would have to include the concept of differentiation of syndromes in order to take out the merit of oriental medicine.

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합곡-곡지 전침치료가 정상인의 뇌혈류에 미치는 영향 - Brain SPECT와 SPM을 이용하여 - (Effect of LI4-LI11 Electro-acupuncture on Regional Cerebral Blood Flow in Healthy Human - Evaluated by $^{99m}Tc-ECD$ Brain SPECT -)

  • 류종만;김영석;박성욱;정우상;고창남;조기호;배형섭;김덕윤;문상관
    • 대한한의학회지
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    • 제27권2호
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    • pp.36-43
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    • 2006
  • Objectives : Acupuncture has been widely applied to rehabilitation after stroke by Oriental medical doctors in Korea. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. In addition, a correlation between activation of specific areas of brain cortices and corresponding acupuncture stimulation at the therapeutic points had been well illustrated. rill now, however, there were few studies which evaluated a correlation between activation of specific areas of brain and frequently-used acupuncture therapy for stroke, such as LI4-LI11 electro-acupuncture (EA) for paresis after stroke. This study was undertaken to evaluate the effect of LI4-LI11 EA on regional cerebral blood flow (rCBF) in normal volunteers using Single Photon Emission Computed Tomography (SPECT). Methods : In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (8 males, 2 females, mean age $25.6{\pm}2.3$years; age range from 24 to 31 years). 7 days after the resting examination, 15 minutes of electro-acupuncture were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by Statistical parametric mapping with a threshold of p=0.001, uncorrected (extent threshold: k=100 voxels). Results : EA applied at right LI4-LI11 increased rCBF in right frontopolar area (Brodmann area 10) and left middle frontal area (Brodmann area 46). Interestingly, all the areas showing increased rCBF corresponded to the territories of both anterior cerebral arteries. However, LI4-11 EA decreased rCBF in the left occipital lobe (peristriate area, Brodmann area 19). Conclusions : The results demonstrated a correlation between LI4-11 EA and rCBF increase in the frontal lobes. It is also suggested that there may be a correlation between LI meridian and the territory of the anterior cerebral arterties.

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두개강내 혈관 협착에 대한 경두개도플러와 자기공명 혈관조영술의 일치도 평가 (The Diagnostic Accordance between Transcranial Doppler and MR Angiography in the Intracranial Artery Stenosis)

  • 문상관;정우상;박성욱;박정미;고창남;조기호;배형섭;김영석;조성일
    • 대한중풍순환신경학회지
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    • 제7권1호
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    • pp.11-16
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    • 2006
  • Objectives : Transcranial Doppler (TCD) has been reported to be established as useful in detecting spasm after subarachnoid hemorrhage and to be probably useful in diagnosing stenosis or occlusion in intracranial arteries. In the detection of intracranial stenosis using TCD there have been reported some kinds of diagnostic criteria. This study was aimed to evaluate the accordance between TCD and magnetic resonance angiography (MRA) in detection of intracranial stenosis and to find out more accurate criteria for intracranial stenosis using TCD. Methods : Seventy-six stroke patients were evaluated by TCD and MRA. TCD criteria for middle cerebral artery (MCA) stenosis were used by 3 methods; ≥ 80cm/sec of mean velocity(Vm), ≥ 140 cm/sec of systolic velocity(Vs), and both. For stenosis of vertebral(VA) and basilar arteries(BA), the TCD criteria followed by 2 methods; ≥ 70 cm/sec of Vm and ≥ 100 cm/sec of Vs. The stenosis of intracranial artery in MRA followed by the interpretation of specialist in the department of radiology. The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and kappa agreement were calculated in each criteria of TCD compared with the result of MRA. Results : The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and kappa agreement using ≥ 80cm/sec of Vm for MCA stenosis were 55.6%, 81%, 34.5%, 91.0%, 77.1%, and 0.293, respectively. Using 140 cm/sec of Vs, those were 44.4%, 92.0%, 50.5%, 90.2%, 84.7%, 0.380, and using both criteria those were 44.4%, 95.0%, 61.5%, 90.5%, 87.3%, 0.445, respectively. Those using ≥ 70 cm/sec of Vm for VA and BA stenosis were 71.4%, 93.7%, 26.3%, 99.0%, 93.0%, 0.186 and using ≥ 100 cm/sec of Vs those were 71.4%, 97.3%, 45.5%, 99.1%, 96.5%, 0.539, respectively. Conclusion : These results suggested that for the diagnosis of MCA stenosis using TCD we should use the criteria of both ≥ 80cm/sec of Vm and 140 cm/sec of Vs, and for the VA and BA stenosis we adapt the criteria of ≥ 70 cm/sec of Vm.

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급성기 뇌경색 환자에서 화열 관련 증상과 증후의 변화에 관한 연구 (The Study about the Changes of the Fire and Heat Related Symptoms and Signs On the Acute Cerebral Infarction Patients.)

  • 곽승혁;박수경;우수경;이은찬;박주영;정우상;문상관;조기호;조승연;박성욱;고창남
    • 대한중풍순환신경학회지
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    • 제12권1호
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    • pp.24-31
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    • 2011
  • Objective : Fire and heat related symptoms and signs are considered common in acute stage of diseases. The purpose of this study is to evaluate the occurrences and changes of fire and heat related symptoms and signs in acute cerebral infarction patients. Method & subjects : 40 acute cerebral infarction patients hospitalized in Oriental medicine hospital, Kyung-Hee University, who had examined and diagnosed 2 or 3 times based on oriental medical diagnosis were selected. We chose 23 as fire and heat related symptoms and signs from 94 diagnostic articles, and we added all those scores together of each patient. We analysed the scores of fire and heat related symptoms and signs as the time passed, and depending on oriental medical diagnosis. Result : In acute cerebral infarction patients of this study, 4 of fire and heat related symptoms and signs were took 1st, 2nd, 4th and 8th places in most changeable 10 articles of total 94 articles. The mean score of fire and heat related symptoms and signs of all patients were decreased significantly over the 3 times of measurements. The 8 patients diagnosed as fire and heat diagnosis at visit1 were samely diagnosed as fire and heat diagnosis at visit2, and at visit3 5 patients of them except for 3 patients excluded between visit2 and visit3, were still diagnosed as fire and heat diagnosis. At all of 3 measuring times, the scores of fire and heat related symptoms and signs of fire and heat diagnosis group were higher than non-fire and heat diagnosis group. Conclusion : This study indicated that fire and heat related symptoms and signs were very changeable phenomenon in acute cerebral infarction patients. And they decreased as time goes on.

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Braden scale을 이용한 신경외과 중환자의 욕창 위험 요인 사정과 욕창 발생과의 관계 (The Relationship of Risk Assessment Using Braden Scale and Development of Pressure Sore in Neurologic Intensive Care Unit)

  • 이종경
    • 성인간호학회지
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    • 제15권2호
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    • pp.267-277
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    • 2003
  • Purpose: The purpose of this study was to evaluate the applicability of braden scale to assess pressure ulcer risk patients and to identify additional risk factors of pressure sores in an neurologic intensive care unit. Method: The subjects of this study were 66 patients in neurologic intensive care units. Data was prospectively collected from Sep. to Dec., 2002. Data were analyzed by mean, percentage, t-test, chi-square, discriminant analysis using Spss pc+. Result: The results of this study were as follows: 1) There was a significant difference between scoring of braden scale and pressure ulcer development. The subscales that predicted pressure ulcer development using braden scale only were sensory perception, moisture, mobility, friction & shear. By using these subscales, sensitivity was 86.7%, and specificity was 61.1%, and total hit ratio was 72.7%. 2) Additional pressure ulcer risk factors which showed significance for discriminating two group were protein, albumin, gender, level of consciousness, pattern of bowel elimination. By using the combination of these additional risk factors in addition to the braden scale, total hit ratio increased to 84.8%. Conclusion: This data suggest that albumin, protein, gender, level of consciousness, pattern of bowel elimination in addition to the braden scale should be included in the pressure sore assessment tool.

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