• 대한한방내과학회지
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• 제42권5호
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• pp.1035-1044
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• 2021

Objective: This study investigated two cases of Korean medical treatment for visual field impairment after stroke: Case 1, a 56-year-old male with a posterior cerebral artery infarction and right homonymous hemianopsia, and Case 2, a 46-year-old male with an intracerebral hemorrhage in the left parietal lobe and right homonymous hemianopsia. Methods: Case 1 was treated with acupuncture, electroacupuncture, and herbal medicine (Mangeum-tang) for two months, and Case 2 was treated with acupuncture, electroacupuncture, and herbal medicine (Oryeong-san) for 40 days. Results: Following treatment, for Case 1, the Humphrey visual field test showed improvement. The visual field indexes (VFIs) for the left and right eyes improved from 44% to 55% and 49% to 64% respectively, and the mean deviations (MDs) for the left and right eyes improved from -21.11 dB to -19.91 dB and -17.45 dB to -13.89 dB, respectively. The mean visual sensitivities (MVSs) of the left and right eyes also improved from 8.67 dB to 11.33 dB and 1.67 dB to 9.67 dB, respectively, with no side effects. For Case 2, the VFI for the left eye improved from 36% to 64% and that for the right eye remained unchanged. The MDs for the left and right eyes also improved from -22.02 dB to -14.47dB and -22.11 dB to -21.34 dB, respectively, with no side effects. Conclusions: This study suggests that Korean medical treatment may improve visual impairment after stroke, but further research is needed.

• 대한한방내과학회지
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• 제41권6호
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• pp.1191-1199
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• 2020

We studied the effect of Korean medicine treatment on the clearance of vancomycin-resistant enterococcus (VRE) colonization and on improvement in symptoms in a stroke patient. The patient was continuously followed up with stool VRE cultures while being treated with herbal medicine, Chunglijagam-tang, acupuncture, and oxygen therapy. We also checked the coccygeal pressure sore condition and the oxygen levels during therapy. No VRE colonization was found after treatment and the oxygen levels and pressure sores had improved. This study proved that Korean medicine treatment could be effective for the clearance of VRE colonization and improvement of symptoms.

• 대한통합의학회지
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• 제9권3호
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• pp.87-97
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• 2021

Purpose : The purpose of this meta-analysis was to evaluate the effects of transcranial direct current stimulation on the lower extremity function of stroke patients. Methods : Domestic data were gathered from studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function of stroke patients. A total of 592 studies published between 2012 and 2020 were identified, with 7 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, and outcome (PICO) data. The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. Cochrane risk of bias (ROB) was used to evaluate the quality of 3 randomized control trials. The quality of 4 non-randomized control trials was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publishing bias. Results : The following factors had a large total effect size (Hedges's g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges's g=2.38, 95 %CI=1.08~3.68), balance (Hedges's g4=2.41, 95 %CI=1.33~3.60), walking ability (Hedges's g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges's g=2.45, 95 % CI: 0.85~4.05). Egger's regression test showed that the publishing bias had statistically significant differences but 'trim-and-fill' test showed that there was still statistical difference. Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on the lower extremity in terms of muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality of studies and high heterogeneity factors, the results of our study should be interpreted cautiously.

• 대한물리의학회지
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• 제17권4호
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• pp.103-111
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• 2022

PURPOSE: This study was performed to investigate the effects of the whole-body vibration exercise combined with ankle joint mobilization on the gait and balancing ability in patients with hemiplegic stroke. METHODS: A total of 19 patients at a rehabilitation hospital who had suffered a hemiplegic stroke were randomly assigned to the experimental group (whole-body vibration exercise combined with ankle joint mobilization, n=10) or control group (whole-body vibration exercise, n=9). All participants underwent 30 min of comprehensive rehabilitation therapy (5 × /week for 6 weeks). Additionally, the experimental group performed the whole body vibration exercise and ankle joint mobilization (15 minutes each, 30 minutes total, 3 × / week for 6 weeks). In the control group, only the whole- body vibration exercise was performed in the same manner and not the ankle joint mobilization. The gait and balancing abilities were measured before and after the 6-week training. RESULTS: Significant improvements were observed in the 10-m walk test, timed up-and-go (TUG) test, center of pressure (COP) path length, and COP path velocity in the experimental group (p < .05). The experimental group showed a larger decrease in the COP path length and velocity than the control group (COP path length, -10.27 mm vs. -3.67 mm, p < .05; COP path velocity, -.33 cm/sec vs. -.13 cm/sec, p < .05, respectively). CONCLUSION: The whole-body vibration exercise combined with ankle joint mobilization could be effective in improving the gait and balancing ability of stroke patients and could also be more effective for improving the static balance ability than the general whole-body vibration exercise alone.

• 대한중풍순환신경학회지
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• 제19권1호
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• pp.21-30
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• 2018

■ Objectives This case study is to report the two cases of Gami-Guibitang on cognitive impairment after stroke with improved recall memory. ■ Methods We used Korean medicine treatments including Gami-guibitang, acupuncture and moxibustion to treat patients who had cognitive impairment after stroke for at least two months. We observed the changes of symptoms by measuring Korean version of Mini-mental status examination (MMSE-K), Clinical Dementia Rating (CDR) and Global Detration Scale (GDS). ■ Results After treatment, the patient's symptoms were improved including MMSE-K, CDR and GDS. Improvement appeared to be prominent in recall memory. The general condition were also improved after treatment. ■ Conclusion This clinical case study suggests that Korean medicine including Gami-guibitang could be used to treat patients who had cognitive impairment after stroke especially suffering from degraded recall memory.

• 대한중풍순환신경학회지
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• 제14권1호
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• pp.71-79
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• 2013

■ Objectives The goal of this pilot study is to observe the change of stroke gait by auditory cue training. ■ Methods An intracranial hemorrhage patient was trained for 4 weeks. For the 1^st consecutive 6days(the 1^st week), the patient was trained to walk with auditory cue, what was called auditory cue gait training condition. For the 2^nd consecutive 6days(the 2^nd week), the patient was trained to walk naturally without auditory cue, what was called free gait training condition. For the 3^rd consecutive 6days(the 3^rd week), the patient was trained to walk under auditory cue gait training condition. For the 4^th consecutive 6days(the 4^th week), the patient was trained to walk under free gait training condition. We analyzed the gait using a treadmill gait analysis system 3 hours after the 6^th gait training. ■ Results Auditory cue gait training showed effects on gait parameters, which were increasing walking velocity, step length, stride length, decreasing cadence, step time and stride time. ■ Conclusion Auditory cue gait training improved gait parameters of a stroke patient.

• 동의신경정신과학회지
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• 제35권2호
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• pp.163-175
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• 2024

Objectives: To investigate the relationship between rehabilitation treatment, mental state and resilience of stroke patients undergoing rehabilitation by examining the correlation between The Core Seven Emotions Inventory-Short Form (CSEI-s) and the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC). Methods: All 104 participants (44 diagnosed with stroke who were receiving rehabilitation and 60 without stroke or psychiatric history) completed the CSEI-s, K-CD-RISC, and Questionnaire for stroke symptoms. All data were analyzed using by Statistical Package for the Social Sciences (SPSS) ver. 27.0. Descriptive statistics, chi-square test, t-test, Mann-Whitney U test, Kruskal-Wallis H test, and Pearson correlation coefficient were used for data analysis. Results: As a result of the CSEI-s, compared to the control group, the stroke group showed significantly lower Joy (喜) scores and significantly higher scores for Depression (憂) and Sorrow (悲). With a morbidity period of 12 months or less, the Thought (思) score was significantly higher. The Fear (恐) score was significantly higher when the rehabilitation was initiation more than 4~8 weeks after than that when the treatment was started immediately. Meanwhile, the K-CD-RISC score was significantly higher when rehabilitation was started immediately. In the stroke group, the K-CD-RISC score was positively correlated with Joy (喜) but negatively correlated with Depression (憂) and Fear (恐). In the control group, K-CD-RSIC showed a positive correlation with Joy (喜) but negative correlations with Depression (憂), Sorrow (悲), and Fear (恐). Conclusions: In addition to early rehabilitation treatment, mental approach through Korean medicine psychotherapy is crucial for enhancing the resilience of stroke patients.

• 대한유전성대사질환학회지
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• 제24권1호
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• pp.1-9
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• 2024

MELAS 증후군은 다양한 임상 증상을 나타내는 복잡하고 다면적인 미토콘드리아 질환으로, 반복적인 뇌졸중 유사 에피소드, 발작, 당뇨병, 심근병증 등을 포함한다. 이러한 증상들은 뇌, 심장, 근육과 같은 대사적으로 활발한 조직에 미토콘드리아 기능 장애가 미치는 심각한 영향을 반영한다. 현재의 치료는 이러한 증상을 완화하고 미토콘드리아 기능을 개선하는 데 중점을 두고 있으며, 증상 치료, 고용량 비타민 요법 및 고용량 타우린 보충과 같은 혁신적인 접근 방식을 포함한다. 유전자 치료 및 미토콘드리아 표적 약물 분야의 새로운 치료법은 근본적인 유전자 돌연변이를 해결하고 미토콘드리아 건강을 향상시킬 수 있는 유망한 새로운 길을 제공한다. MELAS에 대한 이해가 계속 깊어짐에 따라, 유전자 검사 및 치료적 개입의 발전은 환자의 결과를 크게 개선할 가능성을 갖고 있다. MELAS 치료의 미래는 낙관적이며, 진행 중인 연구는 더 효과적이고 표적화된 치료법을 위한 길을 열어 이 질환의 부담을 줄이고 영향을 받는 개인들의 삶의 질을 향상시키는 것을 목표로 하고 있다.

• 대한통합의학회지
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• 제12권3호
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• pp.189-199
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• 2024

Purpose : This study aimed to investigate the test-retest reliability, minimal detectable change (MDC), and the effect of turning direction on the time and number of steps taken during the 180 ° turn test in subacute stroke patients. Additionally, it examined the concurrent validity of the 180 ° turn test. Methods : The study included 28 subacute stroke patients. The test-retest reliability of the 180 ° turn test according to the direction of rotation (paretic and non-paretic sides) by comparing the consistency between the initial assessment and a reassessment conducted 7 days later. Concurrent validity was examined by assessing the correlation of the 180 ° turn test with the Fugl-Meyer assessment of lower extremity (FMA-L/E), Berg balance scale (BBS), 10-meter walk test (10 mWT), and timed up and go test (TUG). Results : The ICC for the time taken to turn 180 ° to the affected and unaffected sides were 0.971 and 0.918, respectively, indicating excellent reliability. The ICC for the number of steps were 0.944 and 0.932, respectively. The MDC for the time taken were 0.33 seconds (affected side) and 0.67 seconds (unaffected side). The MDC for the number of steps were 0.49 (affected side) and 0.63 (unaffected side). The paired t-test showed the limited community ambulator group took significantly longer to turn to the unaffected side (p<.048). Significant correlations were found between the 180 ° turn test and FMA-L/E (r= -0.395 to -0.416), BBS (r= -0.622 to -0.684), 10 mWT (r= 0.720 to 0.730), and TUG (r= 0.684 to 0.790) (p<.05 to .01). Conclusion : The 180 ° turn test demonstrated excellent test-retest reliability and high validity when correlated with other functional measures in subacute stroke patients. MDC values indicated high reliability. Faster walking speeds (≥0.95 m/s) were unaffected by turning direction, while slower speeds (<0.58 m/s) showed significant effects. The 180 ° turn test is a simple, sensitive, and reliable tool for evaluating turning ability in subacute stroke patients.

• 대한핵의학회지
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• 제32권6호
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• pp.490-496
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• 1998

목적: 본 연구의 목적은 MELAS 증후군과 미토콘드리아 근육병의 뇌 SPECT 소견을 알아보고 SPECT 소견과 자기공명영상 소견을 비교 분석하여 MELAS증후군의 특징적인 영상 소견을 찾아보고자 하였고 MELAS 증후군에 있어서 뇌 SPECT의 역할을 평가해 보고자 하였다. 대상 및 방법: 뇌졸중 유사 증상이나 경련 또는 발달 지연을 주소로 하였고, 혈청 또는 뇌척수액의 lactic acid치가 상승되어 있는 1세에서 25세의 5명의 환자를 대상으로 하였고 남녀비는 4:1이었다. 모든 환자에서 Tc-99m ECD를 이용한 뇌혈류 단일광전자방출 전산화 단층촬영술(SPECT)와 자기공명영상을 시행하여 영상 소견을 분석하였다. 결과: 자기공명영상에서는 주로 두정엽(4/5)과 후두엽(4/5), 그리고 기저핵(1/5)에 백질과 회백질에 증가된 T2 신호강도를 나타내었는데, 특정한 혈관 영역에는 부합하지 않는 병변의 분포양상을 보였다. SPECT상에서는 자기공명영상에서 이상소견을 보인 모든 부위에서 관류 저하를 보였으며 추가적으로 두정엽(1예), 측두엽(1예), 전두엽(1예), 기저핵(1예)와 시상(2예)에서도 감소된 Tc-99m ECD의 섭취를 나타내어서, 자기공명영상과 SPECT에서 이상 소견을 보인 수를 비교하면 자기공명영상에서 나타난 해부학적인 이상소견보다 SPECT에서 보인 관류 저하가 더 광범위하였다. 결론: MELAS 증후군의 SPECT에서는 특정한 혈관 영역에는 부합하지 않는 두정엽과 후두엽, 기저핵, 시상, 측두엽등의 관류저하를 보여 주었는데, 본 연구의 여러 제한점으로 인하여 MELAS 증후군에서만 나타나는 특징적인 소견이라고 할 수는 없었다. 자기공명영상에서 상응하는 이상 소견이 없이 SPECT에서만 관류 저하를 보이는 경우의 중요성은 좀 더 많은 수의환자를 대상으로 한 연구를 통해 평가되어져야 할 것으로 생각한다. 나타내었다.속도를 향상시킬 수 있었다. 정상인의 뇌영상에 대해 위치 정합을 실시한 결과 평균 거리 오차는 2mm 이하였다. 가중정규화 방법을 사용하였을 때 합성된 영상의 정성적인 식별 명확도가 향상하였다. 결론: 견실한 PET 영상 경계점 추출과 거리지도를 이용한 계산 속도의 향상을 통해 뇌 PET과 MR 영상 합성기법의 성능을 개선할 수 있었으며 이를 이용하며 개발한 영상정합 프로그램은 임상 환경에서 유용하게 사용될 수 있을 것이다.은 환자군을 대상으로 한 추가 연구가 필요한 것으로 판단된다.07% ID/g 이하로 매우 낮았다. 결론: 이실험에서 표지한 Re-188 황 교질은 표지효율과 안정성이 높고 임상적으로 방사선 활액막 절제술 등에 사용할 수 있을 것으로 생각한다.}I$] 또는 [$^{131}I$]OMIMT는 종양의 아미노산 대사 영상제제로 이용될 수 있으며 앞으로 이에 대한 임상연구가 필요할 것으로 생각되었다.>$R_A,\;R_v$의 결과간에 좋은 상관관계를 가졌다. 따라서 이러한 약역학 컴퓨터시뮬레이션이 SPECT 영상을 이용한 도파민 운반체 또는 수용체 정량분석을 최적화하는데 매우 유용할 것으로 생각된다.TEX>-CIT SPECT는 파킨슨병의 조기진단 및 진행 추적에 임상적으로 유용할 것으로 판단된다., SCC 4예, AC 1예)였으며, 11예 중 9예(81.8%)에서 방사선학적 검사결과와 Tc-99m MIBI섭취율의 변화가 일치하였다. 결론적으로, Tc-99m MIBI SPECT는 폐암병소의 국소화 및 방사선치료 효과의 판정에 어느정도 유용하리라 사료되었다.냈고 4명에서는 low CBD obstruction을 나타내었으며 후에 CBD stone, CBD carcinoma, gall bladder Ca.의 porta hepatis 전이 및 clonorchis worms의 cluster에