• 한방비만학회지
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• 제2권1호
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• pp.25-36
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• 2002

Objective: The purposes of this study are to know the relations of abdominal obesity and ischemic stroke and to know what index could represent the abdominal obesity appropriately. Methods. We have done case-control study and recruited 97 ischemic stroke patients and 117 controls. Case is matched by control by individual matching. All participants had questionnaire, interview and then were examined waist-hip ratio, waist circumference and body mass index. Results : WC, WHR and Hypertension history had differences in two groups, case and control groups. But BMI and other factors weren't significant. According to Quartile of Waist Circumference, the two groups had the differences in hypertension history, diabetes history, smoking status, WHR, BMI, and weight and in the Quartile of Waist-Hip Ratio Quartile, past history of hypertension and diabetes, WC, BMI and weight had the significances. Sex, Age Adjusted and Multivariate Odds Ratio (95% Confidence Interval) of WC Quartile are 2.083, 1.628, 4.491 and 4.418, 4.964, 12.306, and in WHR, the Ors are 2.252, 5.743, 15.776 and 2.632, 8.918, 23.596. Conclusions: We knew from these results that abdominal obesity is very important risk factor of ischemic stroke and WHR more than WC is a good indicator of abdominal obesity, so we should reduce the WHR to prevent of ischemic stroke.

• 대한한의학회지
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• 제24권3호
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• pp.165-171
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• 2003

Objective : Stroke is the second major cause of death in Korea. It is known that the survival and ultimate outcome in stroke depend on various factors, so it is not easy to predict unexpected death in stroke. This study was performed in order to find predicting factors of unexpected death in stroke. Methods : A retrospective study was accomplished by reviewing 21 medical records of stroke patients who expired in the ward of Kyung Hee Oriental Medical Center from January 1998 to December 2001. Data analyzed Were physical examination, laboratory findings, clinical charts and APACH III scoring system. Results : I. The number of unexpected deaths at the ward of Kyung Hee Oriental Medical Center from January in 1998 to December in 2001 were 21 patients (0.1%). 2. Major risk factors of unexpected death were age (${\geq}60$), high blood pressure on 1st admission day and acute stage (${\leq}30{\;}days$). 3. The most frequent time of unexpected death was from 6 a.m. to noon. 4. Major cause of unexpected death was recurrence of stroke (40%). 5. APACH III scores of 75% of unexpected death patients were over 30 points. 6. Clinical change of symptoms 3 or 4 days before the unexpected death were dyspnea, change of urination and defecation. Conclusion; This mortality study suggests that old age, high blood pressure on 1st admission day, acute stage, and high APACH III score are the major predictors of unexpected death in stroke patients and that intensive medical attention is necessary to reach a better outcome.

• Nutrition Research and Practice
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• 제9권5호
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• pp.503-510
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• 2015

BACKGROUND/OBJECTIVES: Increased serum homocysteine (Hcy) levels have been reported to be related to the occurrence of cardio- and cerebrovascular diseases. High serum Hcy levels are also related to the development of secondary stroke and all-cause mortality. The purpose of this study was to investigate the prevalence of high serum homocysteine level and relating factors, and the change over the 10 month period post-stroke. SUBJECTS/METHODS: Consecutive stroke patients who were admitted to the Asan Medical Center were enrolled. Ten months after the onset of stroke, an interview with a structured questionnaire was performed and blood samples were obtained for the biochemical parameters. Nutritional status was determined using the mini nutritional assessment (MNA) score and dietary nutrient intakes were also obtained using a 24 hour recall method. RESULTS: Out of 203 patients, 84% were malnourished or at risk of malnutrition, and 26% had high homocysteine levels at 10 months post-stroke. Using logistic regression, the factors related with high homocysteine levels at 10 months post-stroke included heavy alcohol consumption (P = 0.020), low MNA scores (P = 0.026), low serum vitamin $B_{12}$ (P = 0.021) and low serum folate levels (P = 0.003). Of the 156 patients who had normal homocysteine levels at admission, 36 patients developed hyperhomocysteinemia 10 months post-stroke, which was related to heavy alcohol consumption (P = 0.013). Persistent hyperhomocysteinemia, observed in 22 patients (11%), was related to male sex (P = 0.031), old age (P = 0.042), low vitamin $B_6$ intake (P = 0.029), and heavy alcohol consumption (P = 0.013). CONCLUSION: Hyperhomocysteinemia is common in post-stroke, and is related to malnutrition, heavy alcohol drinking and low serum level of folate and vitamin $B_{12}$. Strategies to prevent or manage high homocysteine levels should consider these factors.

• 대한예방한의학회지
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• 제16권3호
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• pp.15-26
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• 2012

Objective : Only a few studies have investigated the life expectance and health related quality of life (HRQOL) about stroke patients. The purpose of this study is to analyze the life expectancy, preference based quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients. Methods : We used data of 10,533 adults from 4th Korean national health and nutritional examination survey 2009 for evaluating HRQOL of stroke patients. We also analyzed the life expectancy for stroke patients using life table from national public health data. Finally we calculated the QALYs with and without stroke conditions and assumed the difference of QALYs. Results : The mean age of stroke patients was assumed to be 65. Lower income and less educated groups were prone to be exposed to the stroke conditions. Common comorbidities of stroke patients were ischemic heart attack, hypertension, diabetes and hyperlipidemia. The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly at chronic stroke group. Participants with chronic stroke conditions had an almost 6-fold higher risk of impaired health utility(the lowest quartile of EQ-5D utility score) compared with non stroke participants, after adjustment of age, gender, income, education, comorbidity variables. The differences of life expectancy and QALYs between non-stroke and stroke group from the age of 65 till death were assumed to be 0.767 year and 3.103 QALYs. Conclusions : Although the authors analyzed the affecting factors of QOL and assumed the differences of life expectance and QALYs about stroke patients using domestic national data and statistic references, well designed cohort studies should be needed to prove the causal effects of affecting factors and to assume more correct QALY differences.

• 동의생리병리학회지
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• 제21권1호
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• pp.291-297
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• 2007

Although Traditional Korean Medicine had always referred to Mamok(痲木: Paresthesia) as the prodrome of stroke for a long time, yet there were only few research papers on it. Hence, the purpose of this research is to explore the relationship between Mamok(痲木; Paresthesia) as the prodrome and an attack of stroke. Setting 509 Korean impatient women as the subject of research, 264 of the whole are stroke patients and 245 are non-stroke patients. Blood tests, questionnaires, and body measurements (height, weight, waist, hip) are performed to the subjects. Basic population traits, life-style, and past history are included in the contents of questionnaires. whether or not they have experience the numbness, description about the clinical characteristics of the symptom, the body parts which the symptom occurred, the onset of the symptom, and the incidences are examined in the category inquiring the numbness of the hand and foot. After adjusting for age, unilateral numbness was associated with significantly increased risk of stroke. When adjusted for other factors(Half of WHR, History of Hypertension and Diabetes mellitus, Cigarette smoking, Alcohol drinking, Education, Marital status, Regular exercise), the risk of stroke was positively associated with unilateral numbness.(Age Adjusted Odds Ratios=2.282(95%CI=1.107-4.705), Multivariate Odds Ratios=4.105(95% CI=1.233-13.671)) Whereas no significant association was observed in the onset and the incidence of unilateral numbness. This study suggest that preceding Mamok(痲木; paresthesia) before stroke attack is may be common prodrome symptoms of stroke. Prospective cohort study on the association between Mamok(痲木;Paresthesia) as the prodrome and an attack of stroke in Korean population will be necessary.

• 대한한의학회지
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• 제45권1호
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• pp.45-64
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• 2024

Objectives: This study is purposed to investigate the effect and safety of laser therapy for stroke patients by systematic review and meta-analysis of the randomized controlled trials (RCTs). Methods: RCTs on the treatment of laser therapy for stroke patients were selected among the literature published from January 2000 to June 2022 in twelve domestic and foreign databases. The quality of the literature was evaluated using the Cochrane's Risk of Bias tool and RevMan 5.4 was used for the synthesis of results. Results: Total 2,598 patients with stroke were finally selected from 18 RCTs. Meta-analysis showed that laser therapy was effective in significantly improving activities of daily living (MBI), motor function (effective rate), upper motor function (FMA-UE), shoulder pain related factors (CGRP, ET-1, BK). Overall, the risk of bias was uncertain or low in the quality assessment of the literature. Conclusions: Although it is unclear that laser therapy is more effective than sham laser, laser therapy might be more effective in improving symptoms than conventional rehabilitation alone. Furthermore, no serious adverse events were founded in laser therapy studies. However, the quality of the selected literature was generally low. Therefore, further studies with high methodological quality on laser therapy for stroke patients would be required in the future.

• 한국응급구조학회지
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• 제24권2호
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• pp.27-38
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• 2020

Purpose: Stroke is a time-sensitive disease that could have reduced complications and mortality with timely diagnosis and treatment. This study aimed to analyze the causes of delay in detecting the clinical signs and symptoms of stroke. Methods: This retrospective observational study analyzed the emergency medical services reports of suspected stroke patients with positive predictive values on the Cincinnati Prehospital Stroke Scale. The study was conducted in Daejeon, Republic of Korea from January 1, 2016 through December 31, 2017. Results: Prolonged prehospital time was associated with high blood pressure, history of cerebrovascular disease, and incidences during daily activities, and sleep. High blood pressure and complications from a previous stroke strongly associated with the prolonged stroke-detection phase (p<.05). Total prehospital time was shortened when patients had evident stroke symptoms, such as decreased level of consciousness, dysarthria, and hemiplegia (p<.05). There was no significant difference in gender or age as a factor that delayed the total prehospital time of the suspected stroke patients. Conclusion: Many patients did not recognize the early clinical symptoms and signs of a stroke. Furthermore, risk factors, such as high blood pressure and history of stroke, prolonged the total prehospital time. Therefore, we need targeted interventions that educate about warning symptoms of stroke, along with emphasis on the importance of emergency calls to substantially reduce the prehospital delays.

• Investigative Magnetic Resonance Imaging
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• 제22권3호
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• pp.168-171
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• 2018

Cannabis or marijuana is the most commonly used recreational drug after alcohol in the world, and usage is generally recognized as having few serious adverse effects. However, usage is restricted in South Korea. The report of ischemic stroke associated with cannabis is rare in literature. We present a case of a 47-year-old female patient with no underlying disease presenting with acute ischemic stroke after smoking cannabis in South Korea. The result for synthetic cannabinoid metabolites (delta-9 tetrahydrocannabinol) screening was positive. Absence of other vascular risk factors and drug screening results suggest a causal role of cannabis in this ischemic stroke case. The patient eventually progressed to brain death. The underlying mechanism, clinical manifestation, and imaging findings of cannabis-related stroke will be reviewed.

• Journal of Biomedical and Translational Research
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• 제19권4호
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• pp.110-115
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• 2018

Transient ischemic attack (TIA) indicates high risk for major stroke and is considered a medical emergency. Diffusion-weighted imaging (DWI) enables detection of acute ischemic lesions. The clinical significance of DWI positive lesions in TIA is obscure and its prevalence, clinical features are not established. Therefore, we performed a clinical, etiological and prognostic analysis through a cross-sectional analysis of 235 TIA patients, grouped according to presence of DWI lesion. Clinical features, underlying risk factors for stroke, outcome and rate of recurrence were analyzed. 3 months follow-up of modified Rankin Scales (mRS) were done with telephone survey. DWI positive lesions were present in 14.0% of patients. Etiological factors significantly associated with DWI lesions in TIA patients were male sex (p = 0.038), stroke history (p = 0.012) and atrial fibrillation (p < 0.001). Presence of at least one medium or high risk of cardioembolism from TOAST classification were not associated with lesions when excluding association to atrial fibrillation (p = 0.108). Clinical features showed no significant difference. Whether the patients had lesion-positive DWI was not related to an increase in mRS score during the hospital stay or at the 3-month follow-up after discharge. Future studies should include multi-center samples with large numbers, considering each unique medical environment. Routine acquisition of follow-up DWI for proper evaluation of the tissue-based definition of TIA should also be considered.

• 대한간호학회지
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• 제40권3호
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• pp.359-366
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• 2010

Purpose: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. Methods: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. Results: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. Conclusion: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.