• Journal of Korean Academy of Fundamentals of Nursing
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• v.22 no.2
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• pp.190-197
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• 2015

Purpose: Recently, the number of post-stroke survivors has increased. The physical deficits following stroke have been well studied, but there is little information on fear of recurrence in stroke patients. Objective: The purpose of this study was to investigate the health risk behaviors, health motivation and sense of control on fear of recurrence after a stroke. Method: Data were collected through a questionnaire that included items on general characteristics. Participants were recruited from the convalescent centers and outpatients clinics. Participants completed the mastery scale, health motivation scale, and a fear of stroke recurrence scale. The data were analyzed using hierarchial multiple regressions analysis with SPSS version 18.0. Results: Levels of fear of recurrence, health motivation and sense of control were moderate with means of 19.76(SD=5.15), 26.85(SD=5.10), and 16.69(SD=4.65), respectively. Health motivation and sense of control contributed to fear of recurrence. The variables explained 30.5% of variance in fear of recurrence. Conclusions: Results indicate that interventions for fear of recurrence management after stroke should take into account health motivation and sense of control.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.73-80
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• 2016

PURPOSE: The purpose of this study was to investigate the quality of life related to fall experiences in chronic stroke patients. METHODS: This cross-sectional study included 117 patients with stroke from 3 hospitals in D metropolitan city. General characteristics, including fall experiences and quality of life, were assessed through a face-to-face interviews conducted in a quiet place using a questionnaire. Measurement of quality of life in stroke patients was conducted using the Korean Stroke Specific Quality of Life Scale (SS-QOL). To identify the SS-QOL items related to fall experiences, the items of the SS-QOL were considered as independent variables, and the variables that were significantly different according to fall experiences were identified using a univariate analysis. A binary logistic regression was then performed using fall experiences as the independent variable. RESULTS: According to the univariate analysis, self help activities, social role, and upper extremity function were significantly lower in the fall group than that in the non-fall group (p<.05). The findings of the binary logistic regression confirmed that social roles and upper extremity function were the SS-QOL items that were related to fall experience in chronic stroke patients. CONCLUSION: These findings suggest that social roles and upper extremity function may be risk factors for fall experience in patients with chronic stroke.

• The Journal of Internal Korean Medicine
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• v.25 no.1
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• pp.132-137
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• 2004

Background : Recent studies have demonstrated relations between inflammation and stroke. The aim of this study was to investigate CRP level in independent risk factors of stroke patients. Method : Thirty-five ischemic stroke patients were included in this study from Febrary to September 2003. Plasma concentration of CRP was measured over 72 hours after stroke. We examined a average CRP level and associations between CRP and other variables. Result : This study didn't show high CRP level in stroke patients comparing with recent reported studies. Associations between CRP level and other variables didn't show any significant change. Conclusion: In this study, CRP level was not associated with acute stroke significantly.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.645-652
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• 2016

Objectives: To compare the effects of Eastern-Western integrative medical care (EWIM) and Western single rehabilitation therapy (WSRT) on the functional recovery of stroke patients.Methods: Seventy-six stroke patients were recruited retrospectively. The participants were divided into two groups: EWIM and WSRT. Data on age, sex, stroke-related risk factors, stroke type, neurological deficits according to the National Institutes of Health Stroke Scale (NIHSS), elapsed time to the initiation of rehabilitation, duration from the onset to follow up, initial functional status, and function after therapy for 3 mon were obtained from a review of the patients’ medical records. Between-group differences in functional outcomes were analyzed before and after treatment using the functional ambulation category (FAC), Fugl-Meyer assessment (FMA), modified Barthel Index-Korean version (K-MBI), and Euro-Quality of Life-5 Dimension (EQ-5D).Results: At 3-mon poststroke, all the functional outcome measures had improved in both groups (P<0.05). However, the improvements were greater in the EWIM group, and the improvement was statistically significant in the K-MBI (P=0.048) and EQ-5D (P=0.042).Conclusions: With respect to activities of daily living and health-related quality of life, EWIM is a more effective stroke therapy than WSRT.

• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.284-293
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• 2007

Objectives : Hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) are the most common risk factors of cerebro-vascular attack(CVA). To prevent CVA, early diagnosis (awareness before CVA) of HTN, DM and HL is essential, and for the effective early diagnosis we need to analyze the data of CVA patients concerned with HTN, DM and HL. In this study, we studied characteristics of patients early diagnosed before CVA. Methods : We analyzed the data of 363 patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Subjects' enrollment was done in the oriental medical hospitals of 3 universities located in the metropolitan region from October 2005 to October 2006. We analyzed all registered data about HTN. DM and HL, for example, how many patients were aware of their HTN, DM or HL before CVA, differences in characteristics of early diagnosed patients, effects of early diagnosis on CAV, etc. Results : Patients aware of their HTN. DM and HL before CVA have more past history and family history about HTN, DM or HL. Early diagnosis rate of HL is lower than HTN and DM, and early diagnosed HL patients were younger and deucated longer than patients who weren't aware of their HL before CVA. These results mean that publicity is the key to promoting early diagnosis rates of HTN, DM and HL. In DM and HL, early diagnosed patients had more SVO type cerebral infarction than patients who weren't aware of risk factors. We can thus see that early diagnosis even affects CVA types. Conclusion : This work helps us to understand the realities and importance of early diagnosis of HTN, DM and HL before CVA. There should be further research, which can contribute to much more improved early diagnosis rates of HTN, DM and HL.

• Korea Journal of Hospital Management
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• v.15 no.2
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• pp.15-26
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• 2010

Stroke is a high-risk disease. The future of the medical environment is that the proportion of elderly population is increasing, the average life expectancy is being increased, while the fatal rate of stroke will be low. These situation will due to the financial burden on medical insurance. The most important factor that affects on the medical costs of stroke patients is the length of stay. In this study the mean length of hospital for stroke stay was 21.81days(37.97days for intracerebral hemorrhage, 18.89 days for cerebral infarction). The payment per case of stroke was 6.86 million won(12.6 million won for intracerebral hemorrhage, 5.72 million won for cerebral infarction). The payment per case of intracerebral hemorrhage was 2.2 times more than that of cerebral infarction. The payment in the day of hospitalization was the highest and until the second day medical costs was high. After the third day medical costs tended to decline, after that seemed to show an almost constant level. The length of hospital stay was found to be the most important determinant of inpatient charges for stroke. Accordingly rational management of the length of stay will be beneficial to health care consumers, providers, states.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.850-862
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• 2007

Background : Cerebrovascular disease is a major cause of death and disability in adults. Silent cerebral infarction (SCI) portends more severe cerebral infarction or may lead to insidious progressive brain damage resulting in vascular dementia. Known cardiovascular risk factors, such as arterial hypertension, diabetes mellitus, smoking, hyperlipidemia and ischemic heart disease may increase the risk of SCI. This study was designed to evaluate the risk factors of SCI in an apparently normal adult population. Methods : We divided 340 neurologically normal adults (mean age=59.90$\pm$8.30, men:women = 146:194) who underwent brain computed tomography (CT) or magnetic resonance imaging (MRI) at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital in two groups, Silent inf. and Controls,and analyzed risk factors of SCI by interview, physical examination and blood test. Risk factors of SCI were assessed by interview, physical examination and blood test. We performed Pearson's chi-square test and two-sample t-test for univariate analysis and multiple logistic regressions for multivariate analysis to evaluate risk factors of SCI. Results : Old age, diabetes mellitus, and high lactate dehydrogenase (LDH) levels were associated with SCI on univariate analysis. Diabetes mellitus was demonstrated to be an independent risk factor for SCI on multivariate analysis. Conclusions : Advanced age, diabetes mellitus, and LDH levels are associated with SCI.

• 재활복지
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• v.21 no.2
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• pp.247-259
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• 2017

We investigated the improvement of cognitive functions, activity of daily living (ADL), and quality of life (QoL) after hemorrhagic stroke and identified associated factors. For this research, twenty-five patients with a hemorrhagic stroke were enrolled. We measured cognitive function, activity of daily living (ADL), and quality of life (QoL) from 7 days to 12 months after onset of stroke. Then we analyzed the correlation between cognitive function and other risk factors. According to results, cognitive functions improved during 12 months with statistically significant differences. Other functions were similar to cognitive functions. Improvement of cognitive functions were correlated with age, the type of hemorrhagic stroke and Glasgow coma scale at 7 days after stroke. Overall, cognitive function in patients with hemorrhagic stroke recovered from acute to 12 months after onset of stroke. And, improvement of cognitive function at this phase were associated with age, the type of hemorrhagic stroke and GCS score at 7 days. These results would provide us an information to plan cognitive rehabilitation in patients with hemorrhagic stroke.

• Journal of Gastric Cancer
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• v.10 no.3
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• pp.118-125
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• 2010

Purpose: Operative morbidity and mortality from gastric cancer have decreased in recent years, but many studies have demonstrated that its prevalence is still high. Therefore, we investigated the risk factors for morbidity and mortality considering the type of complication in patients with gastric cancer. Materials and Methods: A total of 259 gastrectomies between 2004 and 2008 were retrospectively reviewed. Results: Overall morbidity and mortality rates were 26.6% and 1.9%, respectively. A major risk factor for morbidity was combined resection (especially more than two organs) (P=0.005). The risk factors for major complications in which a re-operation or intervention were required were type of gastrectomy, upper location of lesion, combined resection, and respiratory comorbidity (P=0.042, P=0.002, P=0.031). Mortality was associated with preexisting neurologic disease such as cerebral stroke (P=0.016). In the analysis of differen complication's risk factors, a wound complication was not associated with any risk factor, but combined resection was associated with bleeding (P=0.007). Combined resection was an independent risk factor for a major complication, surgical complication, and anastomotic leakage (P=0.01, P=0.003, P=0.011, respectively). Palliative resection was an independent risk factor for major complications and a previous surgery for malignant disease was significantly related to anastomosis site leakage (P=0.033, P=0.007, respectively). Conclusions: The risk factors for gastrectomy complications of gastric cancer were combined resection, palliative resection, and a previous surgery for a malignant disease. To decrease post-gastrectomy complications, we should make an effort to minimize the range of combined resection, if a palliative gastrectomy is needed for advanced gastric cancer.

• Dementia and Neurocognitive Disorders
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• v.17 no.3
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• pp.73-82
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• 2018

Cerebral microbleeds (CMBs) are increasingly recognized neuroimaging findings, occurring with cerebrovascular disease, dementia, and aging. CMBs are associated with subsequent hemorrhagic and ischemic stroke, and also with an increased risk of cognitive deterioration and dementia. They occur in the setting of impaired small vessel integrity due to hypertension or cerebral amyloid angiopathy. This review summarizes the concepts, cause or risk factors, histopathological mechanisms, and clinical consequences of CMBs.