• Childhood Kidney Diseases
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• v.15 no.1
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• pp.22-28
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• 2011

Hypertension is one of the most common chronic diseases in childhood and adolescence. Untreated hypertension adversely affects many organs including heart, brain, kidney and peripheral arteries. We reviewed the complication of central nervous system caused by pediatric hypertension. Cerebral blood flows are maintained constantly in response to changes in blood pressure by cerebral autoregulation. Severe hypertension which destructs cerebral autoregulation results in acute hypertensive encephalopathy syndrome, ischemic or hemorrhagic stroke. Chronic pediatric hypertension induces learning disability and cognitive defect which are subclinical symptom prior to brain damage caused by severe hypertension. We should consider the effect of hypertension on pediatric brain because appropriate antihypertensive drugs could prevent these complications.

• Korean Journal of Adult Nursing
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• v.24 no.3
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• pp.305-316
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• 2012

Purpose: The purpose of this study was to test the effectiveness of a cognitive rehabilitation program for the patients having an acute stroke. The variables evaluated were cognitive function, depression and activities of daily living (ADLs). Methods: A non-equivalent control group pretest-posttest design with sixty-two subjects from two separated institutions was the design for the study. Thirty-three patients were assigned to the treatment group and 29 patients comprised the comparison group. The treatment group participated in the nursing intervention for cognitive rehabilitation for a three week period of time. The study was conducted from September 2010 to April 2011. Results: Following the three week intervention, the cognitive function and activities of daily living of the treatment group were significantly improved compared to the comparison group (t=6.33, p<.001; t=4.57, p<.001). Specifically, depression was significantly decreased in the treatment group (t=3.95, p<.001). Conclusion: The cognitive rehabilitation program was effective in increasing the treatment group cognitive function and activities of daily living along with a decrease in depression scores. Therefore, Cognitive Rehabilitation Program could be expected a beneficial nursing intervention in stroke patients.

• The Journal of Korean Physical Therapy
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• v.15 no.4
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• pp.34-45
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• 2003

A 'pusher syndrome' encompassing postural imbalance and hemi-neglect is believed to aggravate the prognosis of stroke patients. The patients with pusher syndrome show a particular posture that pushing away from the unaffected side of the body. The objective of this study was to investigate associated proprioception, associated neuro-psychological symptoms and characteristics of functional outcome with and without pusher syndrome. The subjects of this study were 58 acute stroke patients who been rehabilitated at two university hospitals in Seoul and Buchun. Data were collected using proprioception test and line bisection test. The ability of ADL was assessed by the Modified Barthel Index, transfer by the Functional Independence Measure, and balance by the Modified Motor Assessment Scale. The results were that significant difference was found in the presence of proprioception, in the incidence of hemineglect and anosognosia, and in the score of ADL, transfer and balance between patients with and without pusher syndrome. Patients without pusher syndrome gained more motor score than patients with pusher syndrome. From improvement of view, patients with pusher syndrome gained the lowest score in ability of transfer. The finding suggest that the patients with pusher syndrome is a poorer functional outcome, be related to proprioception, hemineglect and anosognosia.

• Physical Therapy Korea
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• v.17 no.2
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• pp.67-74
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• 2010

The purpose of this study was to examine the acute effects of nerve mobilization, static stretching, and hold-relax on the flexibility of hamstring muscles and their surface electromyographic (EMG) responses to passive stretches in poststroke hemiparesis. This study was a randomized cross-over trial. Fourteen subjects received three treatment sessions in random order with each consisting of ten repetitions. The treatment sessions included nerve mobilization, static stretching, and hold-relax. The treatment sessions were held at least 24 hours apart to minimize any carryover effect. The outcome was measured by the distance between the greater trochanter and lateral malleolus and hamstring EMG activity during passive knee extension stretching. Repeated-measures analysis of variance showed significant changes in hamstring flexibility and EMG activity in main effect of time pre, post and followup (p<.05). However, no significant differences occurred among the three stretching techniques. No technique was consistently found to be superior. The three stretching techniques in this study make it difficult to determine the most effective technique. Therefore, clinicians use nerve mobilization of effective stretching techniques with other stretching techniques.

• The Korean Journal of Health Service Management
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• v.5 no.3
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• pp.53-61
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• 2011

This study was to assess the differences in rehabilitation outcomes between the different facilities in Japan, and to determine if there was any variation in patients' functional recovery at hospital discharge across the different facilities. This study focused on acute patients in the rehabilitation ward using the data of 1,830 patients from 8 hospitals after adjusting for triage at admission obtained from the Rehabilitation Patients Databank in Japan (issued in February, 2011) and compared the therapeutic results of each hospital. We estimate the expected value of levels of activities of daily living(ADL) at discharge for rehabilitation patients using regression analysis and Cluster analysis. There were differences among hospitals in their therapeutic results. The differences in the participation of physicians registered as rehabilitation specialists, amount of exercise, self-exercise without therapist, and exercise in wards, were statistically significant differences between hospitals.

• PNF and Movement
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• v.7 no.4
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• pp.37-43
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• 2009

Purpose : The purpose of this study was to evaluate the effect of core stability training at deep abdominal muscle for balance control of hemiplegic patient. Method : The subject of this study was a 47-year-old man with right hemiplegia. He was treated five times a week for three weeks with core stability training at deep abdominal muscles. Evaluation tool was used Functional reach test(FRT), timed up and go test(TUG) and one leg standing for stroke patients. Result : The FRT distance increase, TUG time decrease, one leg standing time increase core stability training at deep abdominal muscles for right hemiplegia improved was the ability for maintain balance. Posture and control of trunk stability are changing posture, and so which showed significant improve of total balance control. Conclusion : The result of this study showed that core stability training at deep abdominal muscles is an effective treatment for balance control. Therefore, it could be considered as a treatment method in the rehabilitation of stroke patient with poor postural control and imbalance, although further studies are needed.

• The Journal of the Society of Stroke on Korean Medicine
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• v.9 no.1
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• pp.33-39
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• 2008

Ataxia and vertigo are frequent clinical findings in cerebellar infarction patients. In severe cases, they cannot achieve normal activity in daily life. A 65-year-old man was admitted with ataxia and vertigo diagnosed as acute cerebellar infarction. We prescribed for Chukdam-tang to treat the phlegm disease. After this treatment, ataxia and vertigo improved. We suggest Chukdam-tang is significantly effective on the treatment of cerebellar infarction.

• IMMUNE NETWORK
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• v.21 no.3
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• pp.20.1-20.18
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• 2021

The gut is an important organ with digestive and immune regulatory function which consistently harbors microbiome ecosystem. The gut microbiome cooperates with the host to regulate the development and function of the immune, metabolic, and nervous systems. It can influence disease processes in the gut as well as extra-intestinal organs, including the brain. The gut closely connects with the central nervous system through dynamic bidirectional communication along the gut-brain axis. The connection between gut environment and brain may affect host mood and behaviors. Disruptions in microbial communities have been implicated in several neurological disorders. A link between the gut microbiota and the brain has long been described, but recent studies have started to reveal the underlying mechanism of the impact of the gut microbiota and gut barrier integrity on the brain and behavior. Here, we summarized the gut barrier environment and the 4 main gut-brain axis pathways. We focused on the important function of gut barrier on neurological diseases such as stress responses and ischemic stroke. Finally, we described the impact of representative environmental sensors generated by gut bacteria on acute neurological disease via the gut-brain axis.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.4
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• pp.429-433
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• 2023

84 years old gentle man with past medical history of hypertension and diabetes presented with sudden onset right sided weakness and aphasia for two hours. Initial neurological assessment revealed National Institute of Health Stroke Scale (NIHSS) 17. Computed tomography (CT) scan demonstrated minimal early ischemic changes along left insular cortex with occlusion of left middle cerebral artery (MCA). Based on clinical and imaging findings, decision was made to perform mechanical thrombectomy procedure. Initially, right common femoral artery approach was utilized. However, due to unfavorable type-III bovine arch, left internal carotid artery could not be engaged via this approach. Subsequently, access was switched to right radial artery. Angiogram revealed small caliber radial artery, with larger caliber ulnar artery. Attempt was made to advance the guide catheter through the radial artery, however significant vasospasm was encountered. Subsequently, ulnar artery was accessed and successful thrombolysis in cerebral infarction (TICI) III left MCA reperfusion was achieved with a single pass of mechanical thrombectomy via this approach. Post procedure neurological examination demonstrated significant clinical improvement. Doppler ultrasound 48 hours after the procedure demonstrated patent flow in radial and ulnar arteries with no evidence of dissection.

• Journal of Korean Neurosurgical Society
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• v.57 no.5
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• pp.342-349
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• 2015

Background : Higher reperfusion rates have been established with endovascular treatment for acute ischemic stroke patients. There are limited data on the comparative performance of mechanical thrombectomy devices. This study aimed to analyse the efficacy and safety of the stent retriever device (Solitaire stent) by comparing procedure time, angiographic outcome, complication rate and long term clinical outcome with previous chemical thrombolysis and mechanical thrombectomy using penumbra system. Method : A retrospective single-center analysis was undertaken of all consecutive patients who underwent chemical thrombolysis and mechanical thrombectomy using Penumbra or Solitaire stent retriever from March 2009 to March 2014. Baseline characteristics, rate of successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b-3), symptomatic intracerebral hemorrhage, procedure time, mortality and independent functional outcomes ($mRS{\leq}2$) at 3 month were compared across the three method. Results : Our cohort included 164 patients, mechanical thrombectomy using stent retriever device had a significant impact on recanalization rate and functional independence at 3 months. In unadjusted analysis mechanical thrombectomy using Solitaire stent retriever showed higher recanalization rate than Penumbra system and chemical thrombolysis (75% vs. 64.2% vs. 49.4%, p=0.03) and higher rate of functional independence at 3 month (53.1% vs. 37.7% vs. 35.4%, p=0.213). In view of the interrelationships between all predictors of variables associated with a good clinical outcome, when the chemical thrombolysis was used as a reference, in multiple logistic regression analysis, the use of Solitaire stent retriever showed higher odds of independent functional outcome [odds ratio (OR) 2.62, 95% confidence interval (CI) 0.96-7.17; p=0.061] in comparison with penumbra system (OR 1.57, 95% CI 0.63-3.90; p=0.331). Conclusion : Our initial data suggest that mechanical thrombectomy using stent retriever is superior to the mechanical thrombectomy using penumbra system and conventional chemical thrombolysis in achieving higher rates of reperfusion and better outcomes. Randomized clinical trials are needed to establish the actual benefit to specific patient populations.