• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.5
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• pp.1075-1078
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• 2002

Objective: The management for the stroke should ,given as soon as possible to be effect. But Patients with stroke symptoms commonly delay many hours before seeking medical attention. We evaluated the factors which are related to the time of hospital arrival after acute stroke. Method: Data were obtained from 317 patients admitted to our hospital within 72 hours of stroke onset. We assessed demographic variables, stoke subtype. referral routes. history of previous stroke, level of consciousness, distance from the place where stroke occurred to hospital, and the time interval between onset of stroke and arrival at the hospital. Results: Mean patient age was 65.99±9.57 years. The mean time interval between onset of stroke and hospital arrival was 17.26±18.69 hours and 128 (40.38%) patients arrived within 6 hours. The patients whoes stoke subtype was infarction, who arrived our hospital by way of other hospital, who had no suffered from previous stroke and who showed no impairement of consciousness was arrived at the hospital late(p<0.05). Conclusion: The majority of patients arrive at the hospital after prolonged delays for multiple reasons, and patients with milder symptoms, for whom treatment might be more effective, were less likely to arrive in time for therapy. Our study suggest that effective education about stroke to the patients and public would be highly necessary.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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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.

• Herbal Formula Science
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• v.20 no.1
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• pp.133-147
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• 2012

Objectives : This study was intended to understand characteristics of symptoms, oriental medicine prescription and laboratory test results according to elapsed time of stroke. Methods : Through the medical records of 205 stroke inpatients in the oriental medical hospital in the year 2010, we investigated manifested symptoms, administered oriental medicine prescription and clinical pathological examination results. Collected items were classified to depend on stroke types, cerebral infarction and hemorrhage. We analyzed association between manifested symptoms, the oriental medicine prescription, and laboratory test results of stroke patients and elapsed time. Chi-square tests were performed to determine the significance level of association. Results : All symptoms, prescriptions and laboratory test results in cerebral infarction patients were associated with elapsed time. Especially, symptoms, prescriptions and pathological examination results showed very high statistical significance with elapsed time (a symptom; chi-square(df)=164.3(22), p<0.001, prescription; chi-square(df)=93.5(22), p<0.001, and pathological examination results; chi-square(df)=164.3(22), p<0.0004). But in the case of cerebral hemorrhage, there was not statistical significance. Conclusions : The elapsed time of stroke may be an essential requisite in catching symptoms and prescribing for stroke patients in oriental medical treatment.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.751-757
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• 2007

Objectives : The aim of this study was to provide basic background information on stroke by evaluating various etiological factors on the basis that the onset time of cerebral infarction varies according to its cause. Methods : We studied hospitalized patients within 4 weeks after their ictus who were admitted at Kyunghee OMC, Kyungwon OMC, or Donguk Ilsan OMC from [month] $1^{st}$, 2005 to June $30^{th}$, 2007. We compared the general characteristics of acute stroke patients according to onset time. Results : Regardless of the onset time, the distribution of cerebral infarction patterns showed high SVO. The onset time did not show significant difference for average age, height, weight, BMI, waist measurement, hip measurement, or waist/hip ratio between onset during sleep and awakening. Patients whose stroke occurred while awake were more likely to have a past history of HTN, DM, ischemic heart disease, or atrial fibrillation but did not show significant difference according to their onset time. Conclusions : The above results show that the overall tendency of acute stage cerebral infarction patients varies according to their onset time. This study was carried out on the basis of previous findings that cerebral infarctions that occurred during sleep were more likely to have been caused by cerebral thrombosis, and strokes that occurred while awake were more likely to have been caused by cerebral embolism. However, there were no statistically relevant results, so a larger study group is needed to research the tendency of stroke patients.

• Journal of Korean Biological Nursing Science
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• v.11 no.1
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• pp.23-31
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• 2009

Purpose: The purpose of the present study was to investigate the prevalence and related factors of sleep-wake disturbance (SWD) in Korean post-stroke patients. This study was the first to address post-stroke SWD in Korea using a structured questionnaire. Method: We investigated the prevalence of SWD and related factors including lesion location, stroke severity, presence of depression and fatigue. We assessed sleep-wake pattern including quality of sleep, sleep latency, wake episodes, wake time after sleep onset, daytime sleep episode and sleep time at daytime. Ninety stroke patients admitted to a university affiliated hospital in Seoul between the period September 2008 and January 2009 were included in the study. Result: Thirty five patients (38.9%) complained insomnia and 32 (35.6%) complained excessive daytime sleepiness (EDS). Quality of sleep (p=.000), sleep latency (p=.000) and total sleep time (p=.001) were significantly poorer in 16 patients with both insomnia and EDS than in the others. The related factors to insomnia were level of education (p=.030), depression (p=.007) and fatigue (p=.034), though related factors to EDS were stroke onset time (p=.049), stroke severity (p=.005), motor dysfunction (p=.035), dysphasia (p=.018), fatigue (p=.001) and lesion location (p=.019). Conclusion: Sleep-wake disturbance is a common problem in Korean stroke patients. Strategies to improve quality of sleep are urgently needed in the post-stroke patients.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.86-92
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• 2018

Background: A delay of transfer for patients with acute stroke needing emergent revascularization is a huge hurdle for efficacy of revascularization. The objective of this study was to investigate changes of transportation time calculated by image to door (ITD) time (from checking brain images at first contact hospital to arriving at our emergency center) before and after 2015. Methods: This study was performed in a retrospective manner from 2013 into 2017. Acute ischemic stroke (AIS) patients having intravenous thrombolysis and/or mechanical thrombectomy during the observation period were enrolled. Among them, those who had revascularization under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm were selected. Results: During the observation period, 225 patients were treated under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm. Twenty-three were excluded due the lack of detailed data. Among 202 patients, 73 and 129 were treated under Drip-and-Ship and Ship-and-Drip paradigms, respectively. In 2013, 35 patients from 18 hospitals (median distance, 25 km) were transferred to our regional stroke center and their median ITD time was 116 minutes. It was gradually decreased after 2015. In 2017, ITD time was significantly (P<0.01) shortened to 85 minutes without significant changes in transfer distance. The median onset to puncture time was also significantly (P=0.03) decreased from 365 minutes in 2013 to 270 minutes in 2017. Conclusion: Our results implicate that many hospitals in our stroke region might have recognized the importance of rapid transportation for AIS after 2015.

• The Journal of Internal Korean Medicine
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• v.21 no.1
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• pp.135-145
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• 2000

Objective : This study has been made to analysis of clinical type of vertigo prodromic Cerebral Vascular Disease in stroke patients who admitted to sangji oriental hospital department of circulatoty internal medicine in the period from July. 1999 to October 1999. Methods : A Questionaire was done after explanationin details to patients and agreement of patients. The inquire was done as follows. Sex and age, risk factor of stroke, type of stroke, existence of vertigo last three years before stroke attack, the beginning age of vertigo and period of prevalence, frequency, continuance time of vertigo, predilection season and time, factor of causing vertigo, accompanying symptoms of vertigo, severity of vertigo. Result and Conclusion : The existence of Rotation sense(Rotation group and non-Rotation group) and the type of Stroke is no difference significantly but the Rotation vertigo group and non-Rotation vertigo group is difference significantly in distribution. The sixties in age of vertigo attack, previous vertigo before 3 year Stroke attack, irregular in predilection season of vertigo, have a high frequency significantly in distribution and previous period of vertigo has no significantly difference in distribution. One or two per a month in frequency of vertigo, below 5 minute in continuance time of vertigo, irregular in predilection time of vertigo, stand up and sit down in causing vertigo position have a high frequency significantly in distribution.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.5-8
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• 2002

Stroke is a leading cause of death in most developed countries and some developing countries including South Korea. It is well known that stroke has is related in some way with several sleep disorders. At first, the onset time of stroke varies according to circadian rhythm. Early morning is the most prevalent time and late evening the least. The changes of blood pressure, catecholamine level, plasminogen activity and aggregation of platelet during sleep have been suggested as possible mechanisms. Sleep apnea (SA), a representative disorder in the field of sleep medicine, is found in more than 70% of acute stroke patients compared to 2-5% of the general population. Various sleep related breathing disorders occur after stroke and snoring is a distinct risk factor for stroke. So the relationship between stroke and SA is obvious, but the cause and effect are still not clearly known. Also, stroke may cause many sleep related problems such as insomnia, hypersomnia, parasomnia and changes in sleep architecture. Patients, family members and even medical personnel often ignore stroke-related sleep problems, being concerned only about the stroke itself. The clinical impacts of sleep problems in stroke patients may be significant not only in terms of quality of life but also as a risk factor or prognostic factor for stroke. More attention should be paid to the sleep problems of stroke patients.

• Physical Therapy Rehabilitation Science
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• v.5 no.3
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• pp.143-148
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• 2016

Objective: This study aimed to quantify one of the useful upper extremity movements to evaluate motor control abilities between the groups of people with mild and moderate arm impairments performing a door handling task. Design: Cross-sectional study. Methods: Twenty-one healthy participants and twenty-one persons with chronic stroke (9 mild stroke and 12 moderate stroke) were recruited for this study. Stroke participants were divided into 2 groups based on Fugle-Meyer Assessment scores of 58-65 (mild arm) and 38-57 (moderate arm). All they performed door handling task including the pronation and supination phases 3 times. We measured some movement factors which were reaction time, movement time, hand of peak velocity, hand of movement units to perform door handling task using the three-dimensional motion analysis. Results: The majority of kinematic variables showed significant differences among study groups (p<0.05). The reaction time, total and phase of movement time, hand of peak velocity, the number of movement units discriminated between healthy participants and persons with moderate upper limb stroke (p<0.05). In addition, reaction time, total and phase of movement time, the number of movement units discriminated between those with moderate and mild upper limbs of stroke patients (p<0.05). Conclusions: Three-dimensional kinematic motion analysis in this study was a useful tool for assessing the upper extremity function in different subgroups of people with stroke during the door handling task. These kinematic variables may help clinicians understand the arm movements in door handling task and consist of discriminative therapeutic interventions for stroke patients on upper extremity rehabilitation.

• Korean Journal of Adult Nursing
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• v.19 no.2
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• pp.167-177
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• 2007

Purpose: This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. Methods: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. Results: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(${\chi}^2=18.629$, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. Conclusion: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.