• Journal of Korean Biological Nursing Science
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• 제17권3호
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• pp.277-285
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• 2015

Purpose: This study was to verify the effects of a fluid therapy education program for aged stroke patients for preventing dehydration, pyuria and bacteriuria. Methods: The study employed a non-equivalent control group pretest-posttest design in quasi experimental basis. Subjects were 38 stroke patients (20 in the experimental group and 18 in the control group) older than 65, hospitalized in a senior care center in S city, Korea. Results: The amount of daily average fluid intake, normal ratio of blood urea nitrogen-creatinine ratio, serum $Na^+$ and urine white blood cells were increased significantly in the experimental group. Normal ratio of bacteriuria increased in the experimental group, but not significantly. Conclusion: The education program is considered to be an effective nursing intervention tool for preventing dehydration and urinary tract infections which related to the secondary wellness of aged stroke patients. However, longer term study is necessary for better quality of nursing and developing more specific education programs for aged stroke patients usually hospitalized for a long period of time.

• 대한한의학회지
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• 제21권1호
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• pp.84-90
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• 2000

Background and Purpose: Stroke in young adults is relatively uncommon. Only 3.7-14.4% of all strokes occur in patients aged 15-45 years. Stroke in young adults has more various and diverse possible causes than stroke in the elderly. We studied to gain further insight into both pathogenic and etiologic determinants in young adults with stroke. Methods : We retrospectively reviewed the medical records of 230 young patients aged 15-45 years who were admitted to the 2nd internal medicine department of Kyung Hee Oriental Medical Center with a diagnosis of stroke between May 1995 and May 1999. We analysed clinical features and diagnostic tests, such as brain imaging, cerebral angiography, echocardiography, 24 hours holter monitoring and other laboratory tests. Results : 1. Of 230 young patients with stroke aged 15-45 years(176 males(76.5%) and 54 females(23.5%)), 140 patients(60.9%) showed ischemic stroke and 90 patients(39.1 %) showed hemorragic stroke. 2. The most prevalent age group was from 40 to 45 years with 142 patients(61.7%) 3. The most frequent site of 140 ischemic stroke was MCA territory in 93 cases(66.4%) and Multiple, VA territory, PCA territory, ACA territory in order of frequency. 4. The most frequent site of 90 hemorrhagic stroke was basal galglia hemorrhage 57 cases(63.3%) and subcortical 13 cases(14.5%), pons, thalmus, subarachnoid, cerebellum in order of frequency. 5. The causes of hemorrhagic stroke were hypertension 49 cases(54.5%), arteriovenous malformation 7 cases(7.8%), ruptured aneurysm 4 cases(4.5%), angioma 3 cases(3.3%). 6. The risk factors of ischemic stroke were smoking, alcohol drinking, hyperlipidemia, hypertension, obesity, heart disease, history of CVA, diabetes mellitus, in order of frequency. 7. The comparison of risk factors between ischemic and hemorrhagic stroke: hypertension was prevalent in hemorrhagic stroke, heart disease and history of CVA were prevalent in ischemic stroke. Conclusions: From the above results, we found that stroke in young adults had various possible causes. Young adults with stroke deserve an extensive but tailored evaluation which include angiography and echocardiography for diagnosis.

• 대한한의학회지
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• 제30권2호
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• pp.145-151
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• 2009

Objectives: The purpose of this study was to investigate distribution of pattern identification by age in stroke patients. Methods: From 1 April, 2007 to 29 September, 2008, 903 patients within a month after onset of stroke were included. Stroke patients were interviewed by oriental medicine doctors who used standard operation procedures for this study. A questionnaire was completed by a question-and-answer form between patients and doctors after explanation of details to patients and patients' agreement given. Results: Distributions of pattern identification in stroke patients differed by age groups. Dampness-Phlegm pattern was more common in the younger group aged under 80 years, while Yin-Deficiency pattern was more common in the older group aged over 80 years. Conclusions: In this study, we found a character of distribution of pattern identification by age in stroke patients within one month after stroke onset. We have concluded that these differences should be considered in the management and treatment of stroke patients.

• 대한한방내과학회지
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• 제28권2호
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• pp.250-261
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• 2007

Objectives : The purpose of this study was to evaluate the blood flow using doppler ultrasound of the MCA, ACA, PCA, BA, ICA in the patients with risk factor for stroke. Methods : 110 patients with risk factor for stroke were selected who had hypertension, diabetes mellitus, hyperlipidemia, or heart disease, as well as 89 healthy adults who did not have any symptoms of those diseases. To evaluate the blood flow, the Vs and Vm of the MCA, ACA, PCA, BA, and ICA in the two groups were measured. Result : In normal healthy adults, subjects showed a decrease in the Vs and Vm: with advancing in age, there was a significant difference in the Vs of MCA, PCA, BA, and ICA. There was a significant difference in the Vm of MCA, PCA, BA, and ICA. In normal healthy adults, females showed high velocities in all examined vessels. There was a significant difference in the Vs of BA. There was a significant difference in the Vm of BA, and ICA. There was a decrease in the Vs, and Vm of all examined vessels of patients with risk factors for stroke in comparison with normal healthy adults. There was no significant difference in the Vs. There was a significant difference in the Vm of MCA, ACA, and PCA. Results were the same between patients aged under 50 and total patients in the Vs and Vm of examined vessels. There were differences between patients aged over 50 and total patients in the Vs of MCA, PCA, BA and for patients aged over 50; patients with risk factor for stroke who had hypertension, diabetes mellitus, hyperlipidemia, or heat disease has higher Vs than healthy adults. Conclusions : There was a significant difference in the blood flow velocity between patients with risk factors for stroke and healthy adults. However, this result was different from results of comparison of TCD findings between patients and healthy individuals by age. Therefore, more detailed studies about aged patients are needed.

• Journal of Korean Neurosurgical Society
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• 제43권1호
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• pp.16-20
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• 2008

Objective : Rapid increase in aged population and westernization of lifestyle have modified epidemiological status of stroke. The purpose of this study is to analyze changing trends of stroke epidemiology in South Korea. Methods : We reviewed retrospectively medical records of 1,124 cases diagnosed as stroke among 54,534 patients who visited the Emergency Medical Center at our hospital from January 1994 to December 1996 (Group A). Also, we evaluated 1,705 cases diagnosed as stroke among 55,381 patients who visited to the same hospital from January 2003 to December 2005 (Group B). The variable features of stroke, such as age, sex, seasonal variation and distribution of stroke subtypes were studied by comparing group A with B. Results : In group A, hemorrhagic stroke (67.9%) was more prevalent than ischemic stroke (32.1%). However, group B showed that the ratio of hemorrhagic stroke (40.3%) to ischemic stroke (59.6%) has been reversed. The highest incidence of stroke was noted in their sixties and seventies of age in group B, which was older than that of group A. In group A, male ischemic stroke (IS) patients outnumbered female patients (1.26:1). Moreover, this gender disproportion became higher in group B (1.53:1). In group A, the number of male intracerebral hermorrhage (ICH) patients were similar to that of female patients (0.97:1). However, male ICH patients outnumbered female patients in group B (1.23:1). As for subarachnoid hemorrhage (SAH), female patients outnumbered male patients more than two-fold in both groups. Both groups showed that the occurrence of ischemic stroke was highest in summer, but that of hemorrhagic stroke was the highest in winter. Conclusion : This study showed the changing trends of stroke in its distribution of subtypes. Multicenter prospective study using stroke registry would be required for the determination of national epidemiologic trends.

• 대한간호학회지
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• 제36권5호
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• pp.792-802
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• 2006

Purpose: The purpose of this study was to understand the adjustment process of middle-aged people in Korea with hemiplegia after a stroke. Method: For this study, the grounded theory method was utilized. Results: After constant comparative analysis, the core category emerged as 'rebuilding the body which was ruined'. In addition, the causal conditions were 'restriction of physical function', and 'loss of roles'. The adjustment process consisted of the 'facing reality phase', 'overcoming depression phase', 'overcoming physical limits phase' and 'reestablishing roles phase' The main strategies in the facing reality phase were 'holding on to a glimmer of hope', 'getting away from the harsh reality' and 'facing up to the reality'. The main strategies in the overcoming depression phase were 'soothing oneself', 'Self-introspection' and 'restoring self-esteem'. In addition, the main strategies in the self-initiative overcoming physical limits phase was 'discovering personal strategies and striving to recover'. The main strategies in the reestablishing roles phase were 'reestablishing a parents' role', 'reestablishing a spouse's role' and 'reestablishing social roles'. Conclusion: In conclusion, even though many middle aged stroke patients remained in the depression phase, most of them who overcame depression strived to conquer physical limits on their own initiative.

• Korean Journal of Radiology
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• 제21권1호
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• pp.101-107
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• 2020

Objective: Avoiding a catastrophic outcome may be a more realistic goal than achieving functional independence in the treatment of acute stroke in octogenarians. This study aimed to investigate predictors of catastrophic outcome in elderly patients after an endovascular thrombectomy with an acute anterior circulation large vessel occlusion (LVO). Materials and Methods: Data from 82 patients aged ≥ 80 years, who were treated with thrombectomy for acute anterior circulation LVO, were analyzed. The association between clinical/imaging variables and catastrophic outcomes was assessed. A catastrophic outcome was defined as a modified Rankin Scale score of 4-6 at 90 days. Results: Successful reperfusion was achieved in 61 patients (74.4%), while 47 patients (57.3%) had a catastrophic outcome. The 90-day mortality rate of the treated patients was 15.9% (13/82). The catastrophic outcome group had a significantly lower baseline diffusion-weighted imaging-Alberta stroke program early CT score (DWI-ASPECTS) (7 vs. 8, p = 0.014) and a longer procedure time (42 minutes vs. 29 minutes, p = 0.031) compared to the non-catastrophic outcome group. Successful reperfusion was significantly less frequent in the catastrophic outcome group (63.8% vs. 88.6%, p = 0.011) compared to the non-catastrophic outcome group. In a binary logistic regression analysis, DWI-ASPECTS (odds ratio [OR], 0.709; 95% confidence interval [CI], 0.524-0.960; p = 0.026) and successful reperfusion (OR, 0.242; 95% CI, 0.071-0.822; p = 0.023) were independent predictors of a catastrophic outcome. Conclusion: Baseline infarct size and reperfusion status were independently associated with a catastrophic outcome after endovascular thrombectomy in elderly patients aged ≥ 80 years with acute anterior circulation LVO.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.58-66
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• 2017

본 연구는 중년기 뇌졸중 환자의 우울과 재활동기의 관계에서 극복력의 매개효과를 규명하기 위한 서술적 상관관계 조사연구이다. 연구대상자는 대학병원에서 뇌졸중으로 진단받고 S시에 소재한 3개의 병원과 U시에 소재한 4개의 병원에서 입원하여 재활치료중인 40세 이상 64세까지의 중년기 환자 185명이었다. 자료 수집은 2016년 12월 1일부터 12월 30일까지 구조화된 설문지를 이용한 자가 보고식으로 이루어졌다. 자료 분석은 SPSS/WIN 22.0 통계 프로그램을 이용하여 t-test와 ANOVA, Pearson's correlation coefficient, 인과적 단계방식이 활용 되었다. 매개효과의 통계적 유의성 검정을 위해 PROCESS가 활용되고 Bootstrapping 방식을 이용하였다. 연구결과는 대상자들의 평균 연령은 56.26이었고, 남성이 70.3%이었으며 우울 수준은 평균 21.21점, 극복력은 평균 25.52점, 재활동기의 평균은 47.44점이었다. 우울은 극복력 및 재활 동기와 부적인 관련성을 가졌다. 이에 반해서, 극복력과 재활 동기는 정적인 관련성을 가졌다. 즉 우울과 재활동기의 관계에서 극복력이 완전 매개효과로 보이는 것으로 나타난다. 그러므로 뇌졸중 환자에게 재활동기를 향상시키기 위하여 극복력 증진 프로그램을 개발하여 활용하도록 하는 것이 중요할 것이다.

• 고령자･치매작업치료학회지
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• 제12권2호
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• pp.37-46
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• 2018

목적 본 연구에서는 체계적 고찰을 통해서 뇌졸중 환자의 운전재활에 대한 연구동향을 알아보고, 향후 연구 방향을 제시하는 것이다. 연구방법 본 연구는 2008년부터 2017년까지 동안 선정된 총 6편을 대상으로 하였다. 분석기준은 질적수준, 발간학술지, 평가도구, 키워드 등으로 구분하였다. 연구결과 뇌졸중환자 운전재활에 대한 논문은 연구수준은 IV단계 및 V단계가 각 33.32%로 가장 많았고, 2014년에 가장 많은 연구가 발행되었다. 연구의 키워드는 운전과 뇌졸중에 관련된 단어가 각 33.32%로 가장 많았다. 결론 본 연구를 통해서 뇌졸중 환자의 운전재활에 대한 고찰을 수행하였다. 결과를 바탕으로 향후 운전 재활을 위한 다양한 프로그램의 효과에 대한 연구가 지속적으로 필요할 것으로 생각한다.

• 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.