• Title/Summary/Keyword: 뇌졸중

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A Study on the Degree of Physical, Psychological and Social Adaptation of CVA Patients (뇌졸중(腦卒中) 환자(患者)의 신체적(身體的).심리적(心理的).사회적(社會的) 적응도(適應度)에 관(關)한 연구(硏究))

  • Hwang Hyun-Sook;Park Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.213-233
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    • 1996
  • This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

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Study on Volume Measurement of Cerebral Infarct using SVD and the Bayesian Algorithm (SVD와 Bayesian 알고리즘을 이용한 뇌경색 부피 측정에 관한 연구)

  • Kim, Do-Hun;Lee, Hyo-Young
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.591-602
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    • 2021
  • Acute ischemic stroke(AIS) should be diagnosed within a few hours of onset of cerebral infarction symptoms using diagnostic radiology. In this study, we evaluated the clinical usefulness of SVD and the Bayesian algorithm to measure the volume of cerebral infarction using computed tomography perfusion(CTP) imaging and magnetic resonance diffusion-weighted imaging(MR DWI). We retrospectively included 50 patients (male : female = 33 : 17) who visited the emergency department with symptoms of AIS from September 2017 to September 2020. The cerebral infarct volume measured by SVD and the Bayesian algorithm was analyzed using the Wilcoxon signed rank test and expressed as a median value and an interquartile range of 25 - 75 %. The core volume measured by SVD and the Bayesian algorithm using was CTP imaging was 18.07 (7.76 - 33.98) cc and 47.3 (23.76 - 79.11) cc, respectively, while the penumbra volume was 140.24 (117.8 - 176.89) cc and 105.05 (72.52 - 141.98) cc, respectively. The mismatch ratio was 7.56 % (4.36 - 15.26 %) and 2.08 % (1.68 - 2.77 %) for SVD and the Bayesian algorithm, respectively, and all the measured values had statistically significant differences (p < 0.05). Spearman's correlation analysis showed that the correlation coefficient of the cerebral infarct volume measured by the Bayesian algorithm using CTP imaging and MR DWI was higher than that of the cerebral infarct volume measured by SVD using CTP imaging and MR DWI (r = 0.915 vs. r = 0.763 ; p < 0.01). Furthermore, the results of the Bland Altman plot analysis demonstrated that the slope of the scatter plot of the cerebral infarct volume measured by the Bayesian algorithm using CTP imaging and MR DWI was more steady than that of the cerebral infarct volume measured by SVD using CTP imaging and MR DWI (y = -0.065 vs. y = -0.749), indicating that the Bayesian algorithm was more reliable than SVD. In conclusion, the Bayesian algorithm is more accurate than SVD in measuring cerebral infarct volume. Therefore, it can be useful in clinical utility.

Relationship between health behaviors and high level of low density lipoprotein-cholesterol applying cardiovascular risk factors among Korean adults: based on the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), 2013 ~ 2015 (성인의 심혈관계 위험인자를 적용한 고저밀도지단백-콜레스테롤혈증과 건강행태의 관련성 연구 : 국민건강영양조사 제6기 (2013 ~ 2015) 자료 이용)

  • Cha, Bo-Kyoung
    • Journal of Nutrition and Health
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    • v.51 no.6
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    • pp.556-566
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    • 2018
  • Purpose: This study was designed to determine the relationship between health behaviors and high levels of low-density lipoprotein-cholesterol (LDL-cholesterol) according to cardiovascular risk factors among Korean adults. Methods: This cross-sectional study was based on the sixth Korea national health and nutrition examination survey (KNHANES VI). Participants were 13,841 adults aged 19 years and older. Cardiovascular risk factors were stroke, myocardial infarction or angina, diabetes mellitus, smoking, hypertension, aging, high density lipoprotein-cholesterol (HDL-cholesterol) under 40 mg/dL and HDL-cholesterol over 60 mg/dL. Cardiovascular risk groups were classified as very high risk (stroke, myocardial infarction or angina), high risk (diabetes mellitus), moderate risk (over 2 risk factors), and low risk (below 1 risk factor). The prevalence of high LDL-cholesterol was calculated using the LDL-cholesterol target level according to cardiovascular risk group. Results: The prevalence of high LDL-cholesterol was 25.5% in males and 21.7% in females. Complex sample cross tabulation demonstrated that the high LDL-cholesterol and normal groups differed significantly according to age, education, body mass index, percentage of energy from carbohydrate, fat, saturated fat and n-6 in males and females. These two groups were also significantly different according to smoking in males and the percentage of energy from n-3 in females. Complex sample multiple logistic regression analysis adjusted for multiple confounding factors demonstrated that the probability of high LDL-cholesterol was significantly associated with current smoking (OR: 1.66, 95% CI: 1.40-1.99), obesity (OR: 1.95, 95% CI: 1.64-2.31) in males, and current smoking (OR: 1.73, 95% CI: 1.19-2.52), obesity (OR: 1.63, 95% CI: 1.39-1.90), percentage of energy from n-3 (quartile 1 vs. quartile 2; OR: 0.77, 95% CI: 0.62-0.96; quartile 1 vs. quartile 3; OR: 0.73, 95% CI: 0.56-0.94; quartile 1 vs. quartile 4: OR: 0.67, 95% CI: 0.51-0.87) in females. Conclusion: This study reveals the impact of smoking, obesity, energy percentage of nutrient intake on LDL-cholesterol.

Effectiveness of statin treatment for recurrent stroke according to stroke subtypes (뇌졸중 재발에 대한 스타틴 치료의 뇌졸중 아형에 따른 효과성)

  • Min-Surk Kye;Do Yeon Kim;Dong-Wan Kang;Baik Kyun Kim;Jung Hyun Park;Hyung Seok Guk;Nakhoon Kim;Sang-Won Choi;Dongje Lee;Yoona Ko;Jun Yup Kim;Jihoon Kang;Beom Joon Kim;Moon-Ku Han;Hee-Joon Bae
    • Journal of Medicine and Life Science
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    • v.21 no.2
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    • pp.40-48
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    • 2024
  • Understanding the effectiveness of statin treatment is essential for developing tailored stroke prevention strategies. We aimed to evaluate the efficacy of statin treatment in preventing recurrent stroke among patients with various ischemic stroke subtypes. Using data from the Clinical Research Collaboration for Stroke-Korea-National Institute for Health (CRCS-K-NIH) registry, we included patients with acute ischemic stroke admitted between January 2011 and July 2020. To evaluate the differential effects of statin treatment based on the ischemic stroke subtype, we analyzed patients with large artery atherosclerosis (LAA), cardio-embolism (CE), and small vessel occlusion (SVO). The primary outcomes were recurrent ischemic stroke and recurrent stroke events. The hazard ratio for outcomes between statin users and nonusers was compared using a Cox proportional hazards model adjusted for covariates. A total of 46,630 patients who met the inclusion criteria were analyzed. Statins were prescribed to 92%, 93%, and 78% of patients with LAA, SVO, and CE subtypes, respectively. The hazards of recurrent ischemic stroke and recurrent stroke in statin users were reduced to 0.79 (95% confidence interval [CI], 0.63-0.99) and 0.77 (95% CI, 0.62-0.95) in the LAA subtype and 0.63 (95% CI, 0.52-0.76) and 0.63 (95% CI, 0.53-0.75) in CE subtype compared to nonusers. However, the hazards of these outcomes did not significantly decrease in the SVO subtype. The effectiveness of statin treatment in reducing the risk of recurrent stroke in patients with LAA and CE subtypes has been suggested. Nonetheless, no significant effect was observed in the SVO subtype, suggesting a differential effect of statins on different stroke subtypes.

Effect of Direction to be Used for the Timed Up and Go Test on Walking Time in Stroke Patients (일어서서 걷기 검사 시 회전 방향이 뇌졸중 환자의 보행 시간에 미치는 영향)

  • Lee, Geon;Cho, Cheol-hoon;Lim, Kyung-jin;Lee, Joo-hyun;Yoon, Gyu-ri;Woo, Young-keun
    • Physical Therapy Korea
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    • v.23 no.2
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    • pp.11-19
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    • 2016
  • Background: In the stroke patients with the characteristics of hemiplegic gait, turning direction of the affected and unaffected side influences turning time. Therefore, it is important to investigate the walking response to turning directions in stroke patients. Objects: This study aimed to measure the walking time while turning direction in hemiplegic patients depending on balance ability measured by Berg Balance Scale. Methods: A group of forty-five subjects with stroke (Berg Balance Scale score${\geq}46$ were twenty-eight, Berg Balance Scale score${\leq}45$ were seventeen) were enrolled in this study. Subjects were asked to perform the Timed Up and Go test. Testing indications included two directions for turning in each subject. These indications were for turning toward the affected and unaffected side in stroke patients. The duration of total analysis duration, sit to stand phase, stand to sit phase, mid-turning phase, and end turning phase were recorded. The obtained data were analyzed by using paired t-test and Wilcoxon signed rank test in the group that are below and above 45 points of Berg Balance Scale score. The significance level was set at ${\alpha}=.05$. Results: There were significant increase time in the analysis duration and end turning phase duration while subjects were turned the unaffected side in stroke patients that presented a Berg Balance Scale score${\leq}45$ (p<.05). However, the comparison between the affected side and the unaffected side in the stroke patients with Berg Balance Scale score${\geq}46$, revealed no significant differences of the measured parameters. Conclusion: This finding should be suggested in the specific definition of turning direction for evaluation with Timed Up and Go test in the Berg Balance Scale score${\leq}45$, and other intervention for hemiplegic patients need to be suggested the direction of turning during walking training program.

Acetycholinesterase Inhibiting Effect and Free Radical Scavenging Effect of Soybean(Glycine max) and Yak-Kong(Rhynchosia nolubilis) (대두와 약콩의 Acetylcholinesterase 활성 억제효과와 항산화 효과)

  • 강순아;한진아
    • Journal of the East Asian Society of Dietary Life
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    • v.14 no.1
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    • pp.64-69
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    • 2004
  • The deficiency of the neurotransmitter acetylcholine(ACh) is responsible for the initiation of Alzheimer's disease. In addition, there is a simple evidence that oxidative stress significantly increases in persons with Parkinson's disease compared to age-matched healthy persons. Therefore, the objective of the study was to investigate the neurodegeneration inhibitory effect of soybean(Glycine Max) and Yak-Kong(Rhynchosia Nolubilis) by measuring the degree of inhibiting Acetylcholinesterase (AChE) catabolizing the ACh and the free radical scavenger effect in vitro. AChE was measured by the minor modified Ellman assay. Free radical scavenging activity was measured using l-diphenyl-2-picrylhydrazyl (DPPH). First, the MeOH extracts of Soybean and Yak-Kong showed the AChE inhibiting activity of 62.0$\pm$2.43% and 65.0$\pm$3.29% at the 5 mg/$m\ell$ concentration. The 50% inhibitory concentration ($IC_{50}$/) of AChE was 1.96 and 1.31 mg/$m\ell$ in the MeOH extracts of soybean and Yak-Kong. Second, the MeOH extracts of soybean and Yak-Kong showed the free radical scavenger activity of 23.1$\pm$4.26% and 80.7$\pm$4.61% at the 5 mg/$m\ell$. IC50 of free radical scavenger activity in Soybean and Yak-Kong was 13.00 and 1.41 mg/$m\ell$ in MeOH extracts and was 5.95 and 2.74 mg/$m\ell$ in hot-water extracts, respectively. In this study, the extracts of Soybean and Yak-Kong showed powerful effects in the AChE inhibition and free radical scavenging. The extracts of Soybean and Yak-Kong were expected to prevent the many neurodegenerative diseases.

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A Study on the Activities of Daily Living and Life Quality of Stroke Patients after the Client-centered Occupational Therapy Intervention According to the Periods of its Outbreak (발병기간에 따른 뇌졸중 환자의 클라이언트 중심 작업치료 중재가 일상생활활동과 삶의 질에 미치는 효과)

  • Jang, Chel;Song, Minok;Sa, Gongsang;Byeon, Seungbae
    • Journal of The Korean Society of Integrative Medicine
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    • v.3 no.2
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    • pp.79-87
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    • 2015
  • Purpose: This study was conducted to provide occupational performance evaluated by stroke patients themselves as an intervention according to the periods of its outbreak and examine the effects of it on their activities of daily living and life quality by using the Canadian Occupational Performance Measure (COPM). Method: The subjects of this research were divided into nine persons for the experimental group receiving the client-centered occupational therapy intervention and another nine for the control group getting the conventional occupational therapy intervention. And the intervention was performed for 30 minutes, three times a week, for total eight weeks. The level of activities of daily living was evaluated by the Functional Independence Measure (FIM), and life quality was tested by using SS-QOL. Results: First, about the difference of change in the FIM points of the two groups, there was statistically significant difference in Mauchly's sphericity verification (p<.05). Second, about the difference of change in the SS-QOL points of the two groups, there was statistically significant difference in Mauchly's sphericity verification (p<.05). Third, regarding the coefficient of difference in the change of FIM and SS-QOL points according to the two groups, there existed statistically significant correlation in all the evaluations of before, in the middle of, and after the FIM points and also before, in the middle of, and after the SS-QOL points (p<.05). Conclusion: With the findings of this research, we can see that the client-centered occupational therapy training group shows more improved activities of daily living and life quality than the conventional occupational therapy training group. Therefore, it is expected that the client-centered occupational therapy training will be applied usefully to clinical situations as an intervention to improve stroke patients' activities of daily living as well as life quality.

Effect of exercise during acute stage of stroke on affected and unaffected hindlimb muscle mass of cerebral ischemic rat (뇌졸증 후 급성기 운동이 뇌허혈 유발쥐의 뒷다리근 질량에 미치는 영향)

  • Im, Ji-Hye;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.4 no.1
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    • pp.51-69
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    • 2002
  • The purpose of this study was to identify the effect of cerebral ischemia on affected(Lt) and unaffected(Rt) side of soleus, plantaris and gastrocnemius muscle mass and determine the effect of exercise on affected and unaffected side on soleus, plantaris and gastrocnemius muscle mass during acute stage of stroke. Sixteen male Sprague-Dawley rate with 200-270g body weight were randomly divided into three groups: control, stroke, and exercise after stroke(St+Ex) group. The control group received sham operation and the stroke group and St+Ex group received transient right MCA(middle cerebral artery) occlusion operation. The St+Ex groups ran on a treadmill for 20min/day at 10m/min and $10^{\circ}$ grade for 6days. During the experimental period body weight and diet intake was measured every morning. On the 7th day after operation, muscles were dissected from both affected and unaffected side of hindlimb. Cerebral infarction of stroke and St+Ex groups were identified by staining with TCC for 30 minutes. The data were analyzed by Kruskal-Wallis test and Mann-Whitney U test using the SPSSWIN 9.0 program. Significance was accepted at the level of p<0.05. The results were summarized follows : 1) There were no significant difference of the body weight on the first day of experiment among 3 groups. Whereas on the 7th day, the body weight of both stroke group and St+Ex group were significantly smaller than that of control group. Body weight of St+Ex group on the 7th day tended to be larger than that of stroke group. 2) Total diet intake of both stroke group and St+Ex group were also significantly smaller than that of control group. While total amount of diet intake in St+Ex group tended to be larger than that of stroke group. 3) The weight of gastrocnemius muscle of affected side in stroke group significantly decreased compared to that of control group and the weight of soleus and plantaris muscle of affected side in stroke group tended to decrease compared to that of control group. 4) The weight of plantaris muscle of unaffected side in stroke group significantly decreased compared to that of control group and the weight of soleus and gastrocnemius muscle of unaffected side in stroke group tended to decrease compared to those of control group. 5) The weight of gastrocnemius muscle of affected side in stroke group significantly decreased compared to that of unaffected side and there was no significant difference of the weight of soleus and plantaris muscle in stroke group between affected side and unaffected side. 6) The weight of soleus, plantaris and gastrocnemius muscle of both affected side and unaffected side in St+Ex group had a tendency of increase compared to those of stroke group. The relative weight of soleus and gastrocnemius muscle of affected side and soleus muscle of unaffected side in St+Ex group had a tendency to increase compared to those of stroke group. Based on these results, exercise during acute stage of stroke might attenuate muscle atrophy of both affected and unaffected side of hindlimb muscles.

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Carotid Artery Intima-Media Thickness Measured by Iterated Layer-cluster Discrimination (순차적 층위군집(層位群集)판별에 의한 경동맥 내중막 두께 측정)

  • Hwang Jae-Ho;Kim Wuon-Shik
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.43 no.5 s.311
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    • pp.89-100
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    • 2006
  • The carotid intima-media thickness (IMT) is very important, because the severity of it is an independent predictor of transient cerebral ischemia, stroke, and coronary events such as myocardial infarction. The conventional image processing to measure the IMT has not been satisfactory, because the methods have relied on the manual section drawing and a regional segmentation by differential estimation. We propose a new image processing technology effective to extract features from the carotid artery image whose pixels have the directional vector properties with composed color distribution. The technique we presented here is not by differential variation but by verification of the layer properties of carotid artery image. Iterated vertical and horizontal analysis and segmentation of the IMT image show the vector characteristics. This new technique makes it possible to cluster the layers statistically, and to classify mathematical correlation between regions and resulting in correct measurements of thickness and its variation. The advantages and effectiveness of this approach are applicable to region process and character extraction of such a vector image.

Recent Epidemiologic Trends on Stroke Patients Admitted to Department of Acupuncture & Moxibustion, Oriental Medical Hospital, Kyung Hee University (침구과에 입원한 뇌졸중 환자의 최근 역학적 동향)

  • Hong, Jang-mu;Kang, Mi-kyeong;Kim, Jong-deog;Yin, Chang-sik;Kang, Jung-won;Park, Sang-min;Seo, Byung-kwan;Chung, In-tae;Koh, Hyung-kyun
    • Journal of Acupuncture Research
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    • v.21 no.4
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    • pp.19-29
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    • 2004
  • Objective : The purpose of this study is to present the epidemiological data on patients with a stroke admitted to Department of Acupuncture & Moxibustion, Oriental Medical Hospital Kyung Hee University and to investigate the difference between preceding diseases of stroke. Methods : We reviewed medical records of 700 patients with a stroke admitted to Department of Acupuncture & Moxibustion, Oriental Medical Hospital, Kyung Hee University. Results: The incidence of cerebral infarction was 6.7 times that of cerebral hemorrhage. The incidence in males was 1.28 times of that in females. The incidence of stroke increased with aging and more cerebral hemorrhage occured in lower age group than cerebral infarction. There was higher morbidity in October, during the changing of the seasons, than any other months. Hypertension was the most common preceding disease followed by diabetis mellitus, heart disease, hyperlipidemia, and according to Odds's ratio for Male/Female, the probability of having preceding diseases was higher in females than males. In cerebral infarction, MCA territory was the most frequent lesion sites. Of the cerebral hemorrhage, basal ganglia (60%) was the most commonly involved site which was followed by thalamus(33.3%), cortex (3.3%) and subcortex (2.2%). The most common symptom accompanied by stroke was motor dysfunction which was followed by verbal disturbance, urination disorder and dysphagia. Conclusion : This study showed the trends of stroke in Oriental medical center. We expects that Multicenter cooperative and prospective study including Oriental Medicine will be inspired by this study for establishing more accurate chacteristics of stroke in Korea in the future.

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