• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.763-768
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• 2007

Objectives : This study aimed to clarify the difference in blood homocysteine levels of acute cerebral infarction patients categorized by Sasang constitutional medicine. Methods : The subjects were recruited from patients admitted to the Oriental Internal Medical Department at Kyunghee Medical Center between October 2005 and May 2007, who were classified as small vessel occlusion (SVO) patients according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST). The general characteristics along with total homocysteine levels were recorded and analyzed according to Sasang constitutional medicine. Results : A total of 151 patients were included in the trial. The prevalence of constitution was, in order, Soyangin, Taeumin, and Soeumin. No statistical significance was noted for any characteristic except body weight. There was no significant difference in blood homocysteine levels between constitutions. Conclusion : This study investigated the difference in blood homocysteine levels of acute cerebral infarction patients categorized according to Sasang constitutional medicine. Due to many limitations, the correlation between homocysteine levels and Sasang constitution was not clarified. Nevertheless, this study is significant in that it examined the largest study group to date in Oriental Medicine research history on the relation between stroke patients' homocysteine and Sasang constitution, and can be utilized in future as a basic material. Further research on the subject is needed.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.863-871
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• 2007

Objects : To gain better insights of East-west integrated treatment of ischemic stroke. We analyzed 89 patients with severe acute ischemic stroke who were admitted to the East-west integrated intensive care unit. Methods : Subjects enrollment was from the East-west integrated intensive care unit of Kyung Hee Medical Center from March 2006 to February 2007. Patients were admitted within 14 days after the onset of ischemic stroke. We assessed the subjects' general characteristics, risk factors, admitting routes and periods, diagnostic imaging, process of western treatment and Korean traditional treatment, complication and consequence. Results : The proportion of males was 50.6%, of females 49.4%, average age was male 66.0$\pm$10.3 and female 71.1$\pm$10.5. Average length of hospital stays was 19.5 days. Monthly admissions were highest in November and December. The admission route was through emergency room (61.8%) or ward (34.8%). Mean Glasgow coma scale score was 10.0$\pm$2.5, average time from symptom of onset to hospital admission was 2.3$\pm$2.2 days. Dominant ischemic vascular territory was middle cerebral artery (66.3%). Initial western treatment was argatroban (22.5%), urokinase (28.1%), and heparinization (38.2%). Distribution of Sasang constitution of So-yang to Tae-eum to So-eum was equal to 5.4 to 2.9 to 1.5. Major complications were observed in 40 (42.7%) patients. In hospital mortality was 12.4% (11 deaths), all of them caused by aggravation of neurological deficit and only 3 of them with major complications. There appears to be a significant positive relationship between length of hospital stay and occurrence of complications (P<0.05). After discharge from the ICU, 64 (71.9%) patients were improved, 11 (12.4%) patients had expired, and 14 (15.8%) patients were transferred. Conclusions : From this study, we suggest that patients with severe acute ischemic stroke should be treated with East-west integrated therapy for more favorable consequences and decreased mortality.

• Journal of Society of Preventive Korean Medicine
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• v.3 no.1
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• pp.147-155
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• 1999

In order to investigate the effect of circulating blood and extinguishing blood stasis method on acute ischemic stroke treatment, we compared muscle weakness in two groups. Dansamhwanotang was administered to experimental group and the Sopungtang was administered to comparison group. In prospective and consecutive study, 24 patients(male 14, female 10) were admitted to hospital within 6hours(median $4.21{\pm}2.45)$ after stroke attack. All of them were diagnosed computed tomography as acute cerebral infarction. We divided that patients into two groups. The experimental group was 13, took median $4.17{\pm}1.72hrs$ to admission after stroke attack and the comparison group 11, median $4.31{\pm}2.72hrs$ to admission after stroke attack. There was no statistical difference in time consumed from stroke onset to admission(P>0.05). Muscle weakness was measured on admission and 7 days later on AMA(American Medical Association) method. In the experimental group, muscle weakness on admission was $2.23{\pm}0.51$ and $2.79{\pm}0.72$ in upper and lower extremity, respectively. In comparison group, muscle weakness on admission was $2.17{\pm}0.43$ and $2.67{\pm}0.82$ in upper and lower extremity, respectively. There was no difference in muscle weakness(P〈0.05). In 7 days after, muscle weakness was $2.31{\pm}0.35$ in upper extremity and $3.15{\pm}0.12$ in lower extremity in experimental group, and $2.27{\pm}0.74$ in upper extremity and $3.45{\pm}0.48$, lower extremity in comparison group. There was no meaningful improvement statistically in upper extremity(p<0.05) but significant evolution in lower extremity(p<0.05). The muscle weakness comparison between admission time and 7 days later was as follows. Experimental group had improvement at the degree of $0.24{\pm}0.92$, $0.42{\pm}0.82$ in upper and lower extremity, respectively and comparison group, $0.12{\pm}0.82$, $0.27{\pm}0.97$ in same part(p<0.05). So, Dansamhwanotang administered group had more good muscle weakness improvement than Sopungtang administered group(P>0.05). From the above result, I suppose that circulating blood and extinguishing blood stasis method helps recover hemiparesis caused by acute ischemic cerabral disease, in acute stage at least.

• The Journal of Internal Korean Medicine
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• v.34 no.4
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• pp.428-437
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• 2013

Objectives : The aim of this study was to examine if there is a significant correlation between the changes of Fire- and Heat- related symptoms and motor function recovery in acute cerebral infarction patients. Methods : We studied inpatients within a month after the onset of cerebral infarction who were admitted at Kyunghee University Medical Center from May 2011 to January 2013. We executed correlation analysis between Fire-heat pattern score and motricity index score at visit 1 and visit 2, and checked if there was a significant correlation between the changes of Fire-heat pattern score and changes of motricity index score. Also, we compared the changes of both scores in patients taking Fire-heat and non Fire-heat pattern prescriptions. Results : There was a significant correlation between the Fire-heat pattern score and Motricity index score at visit 1 and visit 2, and changes of Fire-heat pattern score showed significant correlation with changes of motricity index score. Patients taking Fire-heat pattern prescriptions showed significant change in Fire-heat pattern score after herb-medication treatment while patients taking non-Fire-heat prescriptions showed insignificant change in Fire-heat pattern score. Conclusions : This study provides evidence that taking a Fire-heat pattern prescription could be considered as a first line herb-medication treatment in acute cerebral infarction patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.6
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• pp.929-933
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• 2012

This study was done to examine the prognosis according to onset and duration of treatment in acute ischemic cerebral infarction patients. We analysed NIHSS(National Institutes of Health Stroke Scale) score of acute ischemic cerebral infarction patients who visited department of Internal Korean Medicine, one medical center in Busan from January to December 2009. We divided patients into two groups by the initial time of treatment. Group A is admitted within 7 days, Group B is admitted from 7 to 14 days. We used NIHSS for functional recovery after 3 weeks later from admission day, and analyzed prognostic factor by analysis of covariance. All patients showed statistically significant improvement after 1week, 2weeks, 3weeks from admission, and between 1st week and 2nd week. However, there was no significant difference between 2nd week and 3rd week. NIHSS recovery score after 3weeks were analysed according to the timing of treatment. There was a statistically significant difference between two groups. The percentage of aggravated patients showed no statistically significant difference between the two groups. This study suggests that earlier admission care has an effect on functional recovery of patients with acute ischemic cerebral infarction. Further research on the large scale and long-term follow up is required.

• The Journal of Internal Korean Medicine
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• v.36 no.2
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• pp.93-104
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• 2015

Objectives: This study examined the correlation between the Scandinavian Stroke Scale (SSS) and the Motricity Index (MI) in acute cerebral infarction patients. Methods: We studied 75 inpatients within a month after the onset of cerebral infarction; patients were recruited from July 2012 to November 2013. We analyzed the correlation between changes in SSS and MI by pattern identification. Results: A significant moderate positive linear correlation was noted between SSS and MI in the total patient cohort and in a Fire-heat group, Dampness-phlegm group, Qi deficiency group, and Deficiency syndrome group. A significant strong positive linear correlation existed between SSS and MI in the Excess syndrome group. The Yin deficiency group showed a weak positive linear correlation, but it was not statistically significant. Conclusions: This study provides evidence that the correlation between SSS and MI in acute cerebral infarction patients could differ depending on pattern identification.

• 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.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.3
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• pp.573-581
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• 2011

This study was done to examine the risk factors between controls group and acute brain infarction patients group, and to compare high risk group with low risk group through NIHSS(National Institutes of Health stroke scale). We compared the risk factors between acute brain infarction patients group(N=180) and controls group(N=93). And according to risk factors, we analyzed 1st NIHss, after 3 weeks improved extent within acute brain infarction patients group. The results were as follows. 1. Among the risk factors, HTN, DM, the blood levels of HCY were significantly higher and the blood levels of HDL-C was significantly lower in patients group than controls group. 2. In scale analysis according to risk factors, 1st NIHss were significantly higher in Hypo-HDL-cholesterolemia, Obesity, High-Homocysteine, HTN, DM, previous CVA history group than low risk group within acute brain infarction patients group. 3. In after 3 weeks improved extent analysis according to risk factors, improved extent were lower in Hyperlipidemia, HTN, DM, previous cardiac history, older age group than low risk group within acute brain infarction patients group. The above results suggest that significant risk factors of acute brain infarction, and shows the High risk group that had risk factor of brain infarction recognized from the former research tends to have higher 1st NIHss. Also the High risk group tends to have lower improved extent, but the results are not statistically significant. Furthur research on subject is needed.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.296-312
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• 1998

BACKGROUND The purpose of this study was to find out predictors influencing on the clinical course of stroke during the first 4 weeks after the onset through statistical research, especially whether the blood glucose level after stroke and the stroke with Diabetes Mellitus correlate with functional impairments and neurological outcome or not. METHOD During 7 months period(from 1-1-1997 to 7-31-1997), 32 selected patients prognosed as acute cerebral thrombosis were studied by using Modified Barthel Index, PULSES profile in an attempt to correlate Diabetes Mellitus and hyperglycemia(more than $120mg/d{\ell}$, $150mg/d{\ell}$) with functional impairment and neurological outcome and to evaluate the influence of sex, the side of hemiparesis and age at admission, 1 week and 4 weeks after admision(admitted within 2 days after the onset). RESULT 1. The sex, side of hemiparesis and age had no significant effect upon functional impairment during first 4 weeks after the onset, but recurrent-stroke resulted in significantly higher degree of functional impairment than first-stroke during first 4 weeks after the onset. 2. The patients with Diabetes Mellitusin in acute cerebral thrombosis resulted in significantly higher degree of functional impairment than the patients without Diabetes Mellitus in acute cerebral thrombosis during first 4 weeks after the onset. 3. The patients with hyperglycemia in acute cerebral thrombosis resulted in significantly more severe neurological outcome than the patients without hyperglycemia in acute cerebral thrombosis within 2 days after the onset. CONCLUSION The study suggested that recurrent-stroke and Diabetes Mellitus were the poorer prognosis factors of functional impairment in acute cerebral thrombosis patients during first 4 weeks after the onset. and the poorer prognosis factor of neurological outcome in acute cerebral thrombosis patients was hyperglycemia within 2 days after the onset.

• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.33-42
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• 2012

Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.