• International Journal of Advanced Culture Technology
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• 제6권4호
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• pp.124-130
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• 2018

Proper management and prevention of dysphagia are urgently needed in acute care of stroke patients in Korea. However, no highly sensitive and accessible nurse-led screening tools have been validated within the Korean settings. The purpose of this study was to validate a screening tool led by nurses to identify dysphagia and aspiration risks among acute stroke patients. Registered nurses (RNs) screened 131 residents from a university hospital in South Korea using the Korean version of the Standardized Swallowing Assessment (K-SSA). Results were validated against those from the Gugging Swallowing Screen (GUSS). Compared to results from the GUSS, with 9- and 14-point cutoffs, the K-SSA had a sensitivity of 0.80 and specificity of 0.90 [95% CI 0.806, 0.992] for screening dysphagia and 1.00 sensitivity and 0.94 specificity [95% CI 0.862, 1.000] for screening aspiration risks. The K-SSA demonstrated excellent sensitivity and specificity for screening individuals at risk of dysphagia and aspiration when led by RNs for acute stroke patients.

• 한국의료질향상학회지
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• 제27권1호
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• pp.43-50
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• 2021

Purpose: The aim of this study was to determine the effect of side walking on balance confidence, falls efficacy and fall risk in acute stroke patients. Methods: The study included 14 patients with acute stroke who were randomly allocated to a side walking group (Experimental group, N=7) and a forward walking group (Control group, N=7). Both groups performed the exercise 5 times a week for 2 weeks. Outcomes were assessed using Korean-Activities-specific Balance Confidence Scale (K-ABC), Korean-Fall Efficacy Scale (K-FES), Korean-Fullerton Advanced Balance Scale (K-FAB). Results: After 2 weeks of training, both groups showed significantly improved ABC, FES, FAB (p<.05 in both groups). However, the ABC, FES, FAB in the experimental group was significantly better than in the control group (p<.05). Conclusion: These findings indicate that side walking training may be effective at improving balance confidence and decreasing fall down risk in early stroke patients. Therefore, side walking training may be recommended as an intervention in reducing the incidence of falls in acute stroke patient.

• Journal of Korean Neurosurgical Society
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• 제47권4호
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• pp.258-264
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• 2010

Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

• 대한중풍순환신경학회지
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• 제9권1호
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• pp.14-18
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• 2008

Objectives : This study was done to investigate the relationship of differentiation of the patten identification in stroke patients between acute and convalescent stage. Methods : In the time of period Apr. 1st 2007 to Sep. 29th 2008, 903 patients with stroke admitted in the department of Internal Medicine of Kyungwon University Oriental Medical Hospital, Kyunghee University Oriental Medical Hospital, Dongguk University Oriental Medical Hospital were included. Patients were hospitalized within a month after the onset of stroke. Stroke patients were interviewed by doctors who studied standard operation procedures. A questionnaire was completed by a question-and-answer form between patients and doctors after explanation details to patients and the agreement of patients. Results : The frequency of fire-heat patten was the highest in acute stage of stroke and the one of deficiency of Yin group was the highest in convalescent stage of stroke. This result doesn't have statistical significance. (p<0.05) Conclusions : In this study, we found the relationship of differentiation of the patten identification in stroke patients between acute and convalescent stage. Further, we have concluded that this difference should be considered in the management for stroke patients.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.102-109
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• 2018

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.360-368
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• 2009

Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

• 대한물리치료과학회지
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• 제29권3호
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• pp.1-11
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• 2022

Background: The aim of this randomized controlled pilot study was to determine the effect of trunk training in wheelchair on fall efficacy, fall risk and activities of daily living in acute stroke patients. Design: Randomized controlled pilot trial. Methods: The study included 18 patients with acute stroke who were randomly allocated to an experimental group (EG) (n=9) and a control group (CG) (n=9). Patients in the EG group received general rehabilitation therapy combined with trunk training in wheelchair for 20min, whereas CG group received general rehabilitation therapy combined with bicycle training for 20min. Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using Korean-Fall Efficacy Scale (K-FES), Fullerton Advanced Balance Scale (FAB) and Korean-Modified Barthel Index (K-MBI). Results: After 3 weeks of training, both groups showed significantly improved K-FES, FAB and K-MBI (p<.05 in both groups). However, the K-FES, FAB and K-MBI in the experimental group was significantly improving than in the control group (p<.05). Conclusion: These findings indicate that trunk training in wheelchair may be effective at decreasing fall risk and improving activities of daily living in acute stroke patients. Therefore, trunk training in wheelchair may be recommended as an intervention in reducing the incidence of fall risk in acute stroke patient.

• 근관절건강학회지
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• 제20권1호
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• pp.22-30
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• 2013

Purpose: The International Classification of Functioning, Disability and Health (ICF) model was proposed by the World Health Organization for enhancing interdisciplinary communication. The purpose of this study was to examine the functional status of acute stroke patients using ICF core sets-short form. Methods: A set of 15 ICF items on functional status was used by nurses for their daily nursing assessment on functional status in 44 acute stroke patients in a university hospital. Results: The highest level of function was "consciousness", while the lowest was "defecation". Compared with functional status on the first day, consciousness, ingestion, language (mental), and defecation functions were significantly improved on the 14th day. However, there was no significant changes in items on activity and participation or environmental functions. Conclusion: These findings suggest that the function-specific nursing interventions for acute stroke patients need to be developed. Future research needs to test the usefulness of ICF items as an measurement tool.

• 대한임상검사과학회지
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• 제46권4호
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• pp.143-149
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• 2014

Pulse wave velocity (PWV) is used to non-invasively estimate the severity of arteriosclerosis by measuring the patient's arterial stiffness comparing with each normal reference range according to their ages. Increased arterial stiffness is closely related to both atherosclerosis and arteriosclerosis, which have been known for causes of cardiovascular disease and stroke, also negatively affects the prognosis and the re-occurrence in patients with stroke. The study is focused on how brachial-ankle pulse wave velocity (baPWV) is related to cardiovascular disease risk factors in patients with acute stroke. There were 114 subjects, 69 males and 45 females, all in their 60's and had PWV test for acute stroke. The results are as follows: the group with increased arterial stiffness showed significant increase in HbAlc, total cholesterol, RSBP (resting systolic blood pressure), CSBP (central systolic blood pressure) and CDBP (central diastolic blood pressure). Cross tabulation test showed that there was a significant relationship only between the group with increased arterial stiffness and diabetes mellitus (DM). Therefore, it might be useful for preventing re-occurrence and making a favorable prognosis to promptly adjust DM and hypertension-related risk factors in patients with acute stroke.

• 문화기술의 융합
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• 제5권1호
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• pp.417-428
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• 2019

본 연구는 급성 뇌졸중 입원 환자의 연하장애 유병률과 그 관련요인을 탐색하기 위한 서술적 조사연구로, 일상급종합병원에 급성 뇌졸중으로 진단받은 입원 환자 131명(연령 범위 34-92세, 58.0% 남성)을 대상으로 수행되었다. 본 연구의 결과 급성 뇌졸중 입원 환자의 유병률은 24.4%였으며, 대상자의 나이, 뇌졸중 중증도, 구강상태, 일상활동 의존도가 연하장애에 영향을 미치는 것으로 나타났다. 이러한 결과를 기반으로 뇌졸중 발병 직후부터 연하장애 조기 발견을 위한 적극적인 간호사정과 예방적 중재 프로그램 개발과 적용이 필요하다.