• Journal of Korean Academy of Nursing Administration
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• v.17 no.1
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• pp.66-73
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• 2011

Purpose: The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER). Method: The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records. Result: Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA ($x^2$=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance. Conclusion: Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.

• The Journal of Internal Korean Medicine
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• v.45 no.3
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• pp.396-414
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• 2024

Objective: This study assessed the effectiveness of Gammaekdaejo-tang for post-stroke depression through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A search was conducted using keywords such as "Post-stroke Depression", "PSD", "Gammaekdaejo", and "Ganmai-dazao" on April 30, 2024. A meta-analysis was conducted according to outcome measurements, such as total effective rate (TER), HDRS (Hamilton Depression Rating Scale), and NIHSS (National Institute of Health Stroke Scale), using the Review Manager website. Results: A total of 10 RCTs was selected. The treatment group ((Gammaekdaejo-tang) or (Gammaekdaejo-tang combined with other ingredients or decoction)+Western medicine) showed significant improvement effects in terms of TER, HDRS, and NIHSS compared to the control group (Western medicine). [TER] RR: 1.19, 95% CI: 1.11 to 1.27, P<0.00001, RR: 1.24, 95% CI: 1.11 to 1.38, P<0.00001; [HDRS] MD: -2.29, 95% CI: -2.58 to -2.00, P<0.00001), MD: -3.28, 95% CI: -4.21 to -2.35, P<0.00001) [NIHSS] MD: -7.70, 95% CI: -8.52 to -6.89, P<0.00001. Conclusion: This study suggests that Gammaekdaejo-tang is effective in treating PSD. However, there are limitations, such as the small number of included studies, inability to clearly determine the effect of Gammaekdaejo-tang, inability to use various evaluation tools, and risk of bias. This research must be supplemented through systematic research design and implementation.

• 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.

• Korean Journal of Health Education and Promotion
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• v.23 no.2
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• pp.109-119
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• 2006

Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

• Journal of Pharmacopuncture
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• v.12 no.4
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• pp.97-110
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• 2009

Objective : The purpose of this study is to determine the effect of Hominis Placenta Pharmacopuncture(HPP) on lower limb spasticity control in stroke patients. Methods : Twenty stroke patients with Leg spasticity were randomly divided into two groups, a Distilled water Pharmacopuncture(group I) and a HPP(group II). The number of Pharmacopuncture was 5 times a week and acupuncture treatment was 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), H-reflex/M-response ratio(H/M ratio), Berg Balance Scale(BBS) and Time Up & Go(TUG) were used for evaluation of spasticity control before experiment, after 1 week, 2 weeks, 3 weeks. Results : Group I showed significant improvement(p$<$.05) in BBS but no significant improvement in MAS, H/M ratio, and TUG. Group II showed significant improvement(p$<$.05) in MAS, BBS, and TUG, but no significant improvement in H/M ratio. The results showed significant difference in TUG, but no significant difference in MAS, H/M ratio and BBS between 2 groups. Conclusion : These results showed that HPP might decrease lower limb spasticity and increase leg motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on lower limb in spasticity by HPP.

• Journal of Korea Multimedia Society
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• v.8 no.4
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• pp.554-568
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• 2005

We suggest the dynamic stroke generation algorithm that provides frame-to-frame coherence in 3D non-photorealistic animations. We use 3D particle system to eliminate the visual popping effect in the animated scene. Since we have located particles on the 3D object's surface, the coherence is maintained when the object or the camera is moving in the scene. Also, this algorithm maintains the coherence when camera is zooming in/out. However, the brush strokes on the surface also zoom in/out. This result(too large or too small brush strokes) can not represent hand-crafted brush strokes. To remove this problem, we suggest stroke generation algorithm that dynamically maintains the number of brush stroke and its size during camera zoom in/out.

• The Journal of the Korea Contents Association
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• v.10 no.5
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• pp.325-332
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• 2010

The purpose of this study was to investigate the relationship between three quantitative measures of the pendulum test for spasticity in strokes: The relaxation index, the number of oscillations, and the duration of oscillations. Twenty-six stroke subjects participated in the study. Correlations among these measures of spasticity used Pearson's correlation coefficient. There was a statistically significant positive correlation between the relaxation index and number of oscillations in strokes (r=.881, p<.01). In addition there was significant positive correlation between the relaxation index and duration of oscillations (r=.896, p<.01), and between the number of oscillations and duration of oscillations (r=.938, p<.01). Thus, it is possible to use the number of oscillations and duration of oscillations as quantitative measures of spasticity, rather than the relaxation index, which is more complicated to obtain. According to the result of this study, the use of the simple and objective measurements of the number of oscillations and the duration of oscillations are required clinically in the quantitative measures of spasticity in the future.

• Korean Circulation Journal
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• v.54 no.7
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• pp.409-421
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• 2024

Background and Objectives: The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical practice following the development of a multidisciplinary team, based on our 7 years of experience. Methods: Multidisciplinary team was established in 2015 offering both balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) with technical upgrades by internal and external expertise. For operable cases, PEA was recommended as the primary treatment modality, followed by pulmonary angiography and right heart catheterization after 6 months to evaluate treatment effect and identify patients requiring further BPA. For patients with inoperable anatomy or high surgical risk, BPA was recommended as the initial treatment modality. Patient data and clinical outcomes were closely monitored. Results: The number of CTEPH treatments rapidly increased and postoperative survival improved after team development. Before the team, 38 patients were treated by PEA for 18 years; however, 125 patients were treated by PEA or BPA after the team for 7 years. The number of PEA performed was 64 and that of BPA 342 sessions. World Health Organization functional class I or II was achieved in 93% of patients. The patients treated with PEA was younger, male dominant, higher pulmonary artery pressure, and smaller cardiac index, than BPA-only patients. In-hospital death after PEA was only 1 case and none after BPA. Conclusions: The balanced development of BPA and PEA through a multidisciplinary team approach proved synergistic in increasing the number of actively treated CTEPH patients and improving clinical outcomes.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.772-779
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• 2009

Object : In the present study, we investigated the obesity and blood parameters between Qi-deficiency and Fire/Heat pattern identification/syndrome differentiation (PI/SD) in acute stroke patients. Materials and Methods : A total of 391 stroke patients within 7 days after onset were consecutively recruited from 12 hospitals across South Korea from Nov. 1st, 2006 to Jun. 31st, 2009. They were diagnosed as Fire/Heat or Qi-deficiency among five PI/SD subtypes by two independent stroke experts. We investigated the differences of obesity and blood characteristics between Fire/Heat and Qi-deficiency by statistical analyses. Results : In male subjects, obesity was significantly associated with Fire/Heat PI/SD. The averaged mean BMI ($24.13kg/m^2$) and waist circumference(89.34cm) of the Fire/Heat group were higher than those of the Qi-deficiency group ($22.60kg/m^2$ and 83.43 cm, respectively). The number of obese patients was larger in the Fire/Heat group than in the Qi-deficiency group (p = 0.001). Hyperlipidemia was also related with Fire/Heat. However, obesity was not associated with PI/SD in female subjects where the number of hyperlipidemic patients was higher in the Qi-deficiency group. Among blood parameters, the levels of triglycerides and fasting blood sugar were higher in the Fire/Heat group compared with the Qi-deficiency group in male subjects. However, total cholesterol of the Qi-deficiency group was higher than in the Fire/Heat group among female subjects. Conclusion : This study shows that obesity and hyperlipidemia are significantly difference between Qi-deficiency and Fire/Heat. We suggests that PI/SD may be associated with clinical characteristics and large population study between PI/SD and clinical characteristics including blood parameters are needed.

• Journal of dental hygiene science
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• v.18 no.2
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• pp.105-112
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• 2018

The purpose of this study was to focus on the number of brushing strokes among the performance factors and identify if the 10 times stroke of the rolling method is rational. Moreover, we evaluated the changes in oral health knowledge, perception, and behavior after our rolling method instruction. The 10-stroke method of toothbrushing has been regarded as an effective method of removal of dental plaque, although there is little evidence to support this claim. We allocated 40 healthy subjects to two intervention groups. During five visits, we measured a score for dental plaque removal and instructed the subjects on a toothbrushing technique with 5 or 10 strokes per section. At the initial and final visits, subjects completed a questionnaire on one designed specifically for this study about oral health knowledge, perceptions, and behaviors. Repeated measures analysis of variance was used to compare the dental plaque removal score between the groups, and the changes in scores within each group over time. We also compared changes in mean scores in oral health knowledge, perceptions and behaviors before and after toothbrushing instruction. We found that the score for dental plaque removal increased with each additional toothbrushing instruction in both groups (p<0.001). However, we found no differences in the dental plaque removal scores between the 5-stroke and 10-stroke groups (p=0.399). The levels of oral health knowledge, perceptions and behaviors increased after the toothbrushing instructions in both groups. Our findings suggest that there is no advantage in emphasizing the 10-stroke method of toothbrushing in an oral health education program.