• Title/Summary/Keyword: Stroke, Acute

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Guillain-barré Syndrome after Multiple Bee Stings (다발성 벌 자상에 의한 길랑 바레 증후군 1례)

  • Jin, Sang-Chan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.1
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    • pp.57-59
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    • 2018
  • Severe systemic responses including neurologic complications such as myasthenia gravis, myeloradiculopathy, optic neuropathy, parkinsonism, stroke and Guillain-$barr{\acute{e}}$ syndrome can occur after bee stings. This case describes a 78-year-old female who presented with symptoms of acute progressive bilateral symmetrical weakness in both lower legs after multiple bee stings. Nerve conduction study findings were consistent with acute sensorimotor axonal neuropathy and recovered by treatment with intravenous immunoglobulin. This case highlights that bee stings can result in acute onset Guillain-$barr{\acute{e}}$ syndrome, although the pathophysiologies of bee venoms need to be investigated accurately.

Epidemiology and Characteristics of Recurrent Stroke : The Occurrence Type of Restroke is Similar as Previous Stroke

  • Ok, Young-Cheol;Park, Seung-Kyu;Cho, Kyu-Yong;Lim, Jun-Seob;Lee, Rae-Seop
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.224-229
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    • 2007
  • Objective : Despite improvement of therapeutic regimen, incidence of stroke increases and it remains a leading cause of death. Our study aims at offering variable data on recurrent strokes. Methods : There were 59 patients who admitted from Jan. 2002 to Dec. 2004 due to recurrent strokes. A retrospective longitudinal cohort study was done. Results : Four-hundred-seventy five patients, diagnosed with acute stroke, experienced 491 strokes in 3 years, and there were 75 recurrent strokes [15.3%] in 59 patients. These 59 patients were included in the study. First hemorrhagic cases [H] were 19 [32%], and the first infarction cases [I] were 40 [68%]. Subsequent strokes after first stroke were as follows : $H{\to}H$ 14 [23.7%] cases, $H{\to}I$ 5 [8.5%], $I{\to}H$ 8 [13.6%], $I{\to}I$ 32 (54.2%]. A Cox regression analyses showed that the first type of stroke was a significant factor to the second stroke as follows : if one has had a hemorrhagic stroke, the possibility of second hemorrhagic attack ($H{\to}H$ attack) increase 3.2 times than ischemic type and in ischemic stroke [$I{\to}I$ attack] 3.6 times increased incidence of second ischemic attack. Conclusion : The recurrence rate of stroke was 12.4% [59 of 475 patients]. If the first stroke is hemorrhage or infarction, the next stroke would have high potentiality of hemorrhage, or infarction. The possibility of same type in second stroke Increase over 3 times. In $H{\to}H$ group, the time interval between first and second stroke was shorter and the age of onset was earlier than in $I{\to}I$ group. Moreover, the infarction was more frequent than hemorrhage in multiple strokes. There was a correlation in lacunar type infarction between first and second attack.

Effect of Empowerment Program on Rehabilitation Motivation, Depression, Activities of Daily Living Among the Patients with Stroke (임파워먼트 프로그램이 뇌졸중 환자의 재활동기, 우울, 일상생활수행능력에 미치는 효과)

  • Kong, Hee-Kyung;Lee, Hae-Jung
    • Korean Journal of Adult Nursing
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    • v.20 no.3
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    • pp.406-417
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    • 2008
  • Purpose: The purpose of this study was to develop an empowerment program as a nursing intervention for the patients having an acute stroke and to determine the effects of the program on their motivation, depression, and activities of daily living(ADLs). Methods: An non-equivalent control group pretest-posttest design was used in this study. Sixty subjects were recruited from two separated institutions: 31 patients were allocated into experimental group and 29 were into control group. Six week empowerment program was provided to the experimental group. The study was conducted from November 2006 to March 2007. Results: After 6 week empowerment program, rehabilitation motivation was significantly increased in the experimental group in comparison to the control group(t=-2.173, p=.036). There were no significant differences in depression and ADLs between experimental and control groups. Conclusion: The empowerment program effectively increased rehabilitation motivation of patients with stroke, while did not improve the levels of depression and ADLs. Future long-term intervention may benefit the patients more in terms of depression and ADLs when considering the acute stage of the patients in this study.

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Image-Centric Integrated Data Model of Medical Information by Diseases: Two Case Studies for AMI and Ischemic Stroke

  • Lee, Meeyeon;Park, Ye-Seul;Lee, Jung-Won
    • Journal of Information Processing Systems
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    • v.12 no.4
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    • pp.741-753
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    • 2016
  • In the medical fields, many efforts have been made to develop and improve Hospital Information System (HIS) including Electronic Medical Record (EMR), Order Communication System (OCS), and Picture Archiving and Communication System (PACS). However, materials generated and used in medical fields have various types and forms. The current HISs separately store and manage them by different systems, even though they relate to each other and contain redundant data. These systems are not helpful particularly in emergency where medical experts cannot check all of clinical materials in the golden time. Therefore, in this paper, we propose a process to build an integrated data model for medical information currently stored in various HISs. The proposed data model integrates vast information by focusing on medical images since they are most important materials for the diagnosis and treatment. Moreover, the model is disease-specific to consider that medical information and clinical materials including images are different by diseases. Two case studies show the feasibility and the usefulness of our proposed data model by building models about two diseases, acute myocardial infarction (AMI) and ischemic stroke.

Weight-bearing on Paretic in Patients with Acute Stroke (급성 뇌졸중환자의 마비측 체중지지 임상양상)

  • Seo, Kyung-Chul;Song, Kyo-Hyun;Lee, Jung-Soo;Jang, Dan-Bi
    • Journal of Korean Physical Therapy Science
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    • v.18 no.1
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    • pp.79-84
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    • 2011
  • Background: The purpose of this study was to investigate differences in balancing ability and weight bearing between paretic and non-paretic. Methods: Subjects of the study were consisted of 30 acute hemiplegia patients(paretic 15, non-paretic 15) who were receiving rehabilitation therapy in hospital. Weight shifting was quantitatively evaluated to determine the ability of patients to and during conscious weight shifting on the Gaitview. Independent t-test was utilized to detect the mean difference between the groups. Results: 15 patients with stroke were able to shift more weight onto the paretic leg. And pressure ratio of right hemiplegia was significantly difference on the nonparetic leg, pressure ratio of left hemiplegia was significantly difference onto the paretic leg. Conclusions: Patients with left hemiplegia who was cortical lesions in the right hemisphere were able to shift more body weight onto their paretic leg. These patients should be encouraged to practice shifting their weight towards their non-paretic leg to improve their balance.

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Inadvertent Self-Detachment of Solitaire AB Stent during the Mechanical Thrombectomy for Recanalization of Acute Ischemic Stroke : Lessons Learned from the Removal of Stent via Surgical Embolectomy

  • Kang, Dong-Hun;Park, Jaechan;Hwang, Yang-Ha;Kim, Yong-Sun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.6
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    • pp.360-363
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    • 2013
  • We recently experienced self-detachment of the Solitaire stent during mechanical thrombectomy of acute ischemic stroke. Then, we tried to remove the detached stent and to recanalize the occlusion, but failed with endovascular means. The following diffusion weighted image MRI revealed no significant increase in infarction size, therefore, we performed surgical removal of the stent to rescue the patient and to elucidate the reason why the self-detachment occurred. Based upon the operative findings, the stent grabbed the main thrombi but inadvertently detached at a severely tortuous, acutely angled, and circumferentially calcified segment of the internal carotid artery. Postoperative angiography demonstrated complete recanalization of the internal carotid artery. The patient's neurological deficits gradually improved, and the modified Rankin scale score was 2 at three months after surgery. In the retrospective case review, bone window images of the baseline computed tomography (CT) scan corresponded to the operative findings. According to this finding, we hypothesized that bone window images of a baseline CT scan can play a role in terms of anticipating difficult stent retrieval before the procedure.

Stem cell-derived extracellular vesicle therapy for acute brain insults and neurodegenerative diseases

  • Bang, Oh Young;Kim, Ji-Eun
    • BMB Reports
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    • v.55 no.1
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    • pp.20-29
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    • 2022
  • Stem cell-based therapy is a promising approach for treating a variety of disorders, including acute brain insults and neurodegenerative diseases. Stem cells such as mesenchymal stem cells (MSCs) secrete extracellular vesicles (EVs), circular membrane fragments (30 nm-1 ㎛) that are shed from the cell surface, carrying several therapeutic molecules such as proteins and microRNAs. Because EV-based therapy is superior to cell therapy in terms of scalable production, biodistribution, and safety profiles, it can be used to treat brain diseases as an alternative to stem cell therapy. This review presents evidences evaluating the role of stem cell-derived EVs in stroke, traumatic brain injury, and degenerative brain diseases, such as Alzheimer's disease and Parkinson' disease. In addition, stem cell-derived EVs have better profiles in biocompatibility, immunogenicity, and safety than those of small chemical and macromolecules. The advantages and disadvantages of EVs compared with other strategies are discussed. Even though EVs obtained from native stem cells have potential in the treatment of brain diseases, the successful clinical application is limited by the short half-life, limited targeting, rapid clearance after application, and insufficient payload. We discuss the strategies to enhance the efficacy of EV therapeutics. Finally, EV therapies have yet to be approved by the regulatory authorities. Major issues are discussed together with relevant advances in the clinical application of EV therapeutics.

Timely Interventions can Increase Smoking Cessation Rate in Men with Ischemic Stroke

  • Lee, Min Jeong;Park, Eunjeong;Kim, Hyeon Chang;Lee, Hye Sun;Cha, Myoung-Jin;Kim, Young Dae;Heo, Ji Hoe;Nam, Hyo Suk
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.610-617
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    • 2016
  • Purpose: Smoking cessation is strongly recommended for every smoker after ischemic stroke, but many patients fail to quit smoking. An improved smoking cessation rate has been reported with intensive behavioral therapy during hospitalization and supportive contact after discharge. The aim of this study was to demonstrate the usefulness of the timely interventions for smoking cessation in men with acute ischemic stroke. Methods: Patients who participated in the timely interventions strategy (TI group) were compared with those who received conventional counseling (CC group). In the TI group, a certified nurse provided comprehensive education during admission and additional counseling after discharge. Outcome was measured by point smoking success rate and sustained smoking cessation rate for 12 months. Results: Participants, 157 men (86 of the TI group and 71 of the CC group), were enrolled. Mean age was $58.25{\pm}11.23$ years and mean initial National Institutes of Health Stroke Scale score was $4.68{\pm}5.46$. The TI group showed a higher point smoking success rate compared with the CC group (p=.003). Multiple logistic regression analysis showed that the TI group was 2.96-fold (95% CI, 1.43~6.13) more likely to sustain smoking cessation for 12 months than the CC group. Conclusion: Findings indicate that multiple interventions initiated during hospital stay and regular follow-up after discharge are more effective than conventional smoking cessation counseling in men with acute ischemic stroke.

Role of Balloon Guide Catheter in Modern Endovascular Thrombectomy

  • Chueh, Ju-Yu;Kang, Dong-Hun;Kim, Byung Moon;Gounis, Matthew J.
    • Journal of Korean Neurosurgical Society
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    • v.63 no.1
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    • pp.14-25
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    • 2020
  • Proximal flow control achieved with a balloon guide catheter (BGC) during endovascular treatment of acute ischemic stroke is reviewed in this article. In clinical practice, BGCs offer a multi-faceted approach for clot retrieval by creating proximal flow arrest, reducing embolic burden, and shortening procedure time. Evaluation of frontline thrombectomy procedures with BGCs revealed advantages of combined use over the conventional guide catheter (CGC), notably in the significant reduction of distal emboli to both the affected and previously unaffected territories. Recently, new measures of early and complete reperfusion at first thrombectomy pass have been identified as independent predictors of improved outcomes, which were consistently demonstrated with use of BGC as a safe and effective option to minimize number of passes during intervention. Prior randomized controlled trials reported the positive correlation between BGC-treated patients and a lower risk of mortality as well as shortened procedure time. While BGC use is more common in stent retriever-mediated mechanical thrombectomy, preliminary data has shown the potential benefit of device application during contact aspiration thrombectomy to achieve successful recanalization. However, the question of which major endovascular strategy reigns superior as a frontline remains to be answered. Along with clinical case assessments, BGC performance during in-vitro simulation was analyzed to further understand mechanisms for optimization of thrombectomy technique.

Effects of swallowing training of high viscosity bolus on swallow function based on videofluoroscopic swallowing examination in stroke patients with dysphagia (비디오 투시조영 검사를 통한 높은 점도의 음식 삼킴 훈련이 삼킴 장애가 있는 뇌졸중 환자의 삼킴 기능에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Hee-Jin;Seo, Jin-Young;Hong, Deok-Gi
    • The Journal of the Korea institute of electronic communication sciences
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    • v.11 no.9
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    • pp.909-916
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    • 2016
  • The purpose of this study is to investigate the effect of swallowing training of high viscosity bolus for swallow function of stroke patients with dysphagia. This study subjects, acute stroke 18 patients, which were recruited to receive treatment in inpatient at general hospital, located in Kyunggido. Subjects were randomly allocated in experimental group and control group. Experimental group performed swallowing training of high viscosity bolus, while control group conducted Traditional dysphagia therapy. Both groups received treatment 30 minutes a day five times a week for four weeks. The assessment was conducted FDS(: Functional Dysphagia Scale), PAS(: Penetration Aspiration Scale), ASHA NOMS(: American Speech-language-hearing Association National Outcomes Measurements System Swallowing Scale) to compare swallow function for both group. Both groups showed significant improvements after intervention in all measures(p<.05). Change score between the two groups showed a significant improvement on experimental group than control group in FDS(p<.05). Swallowing training of high viscosity bolus could have a positive impact on swallow function for acute stroke patients with dysphagia.