• The Journal of the Society of Stroke on Korean Medicine
• /
• v.10 no.1
• /
• pp.54-61
• /
• 2009

Arteriosclerosis is a pathologic term that contains hardening of arterial wall, loss of arterial elasticity and stenosis of artery. To diagnose this disease, conventional angiography, MRA, transcranial doppler ultrasonography are commonly used. And it causes various clinical phases by a region of the disease. In oriental medicine, arteriosclerosis is classified into congested fluids(痰飮), blood stasis(瘀血), stagnation of Gi(氣滯) and treated by Herb-Med, acupuncture, cupping, moxibustion, and the like. The purpose of this study was to investigate the effect of oriental medical therapy on cerebral arteriosclerosis. A patient with cerebrovascular disease admitted due to dizziness, mild dysarthria, tinnitus, anxiety disorder and his Brain MRA showed severe arteriosclerosis in right anterior cerebral artery(ACA) and middle cerebral artery(MCA). Every day, we administered to patient Herb Med and Herb pills. Also, acupuncture, moxibustion were done, too. As a result of the treatment, the patient's follow up Brain MRA showed improved state of ACA stenosis.

• The Journal of Korean Medicine
• /
• v.15 no.2 s.28
• /
• pp.46-91
• /
• 1994

l. Backgrounds of Studies Cerebrovascular accident. one of the three major causes of death among audults with cardiopathy and malignancy, has been on the increase in korea while it is on the decrease in European countries and Japan. Types of stroke undergo changes caused by prolongment of life expectancy. and social and economic variety. More patients of ischemic stroke show a tendency to increase now than those of hemorrhagic stroke in the past. Many clinical studies on medical cerebrovascular and oriental stroke of paralysis have been published. but few clinical studies on therapeutics of integrated oriental and western medicine are to be found. So I have made an attempt to study clinical observations and therapeutic responses of ischemic stroke under integrated oriental and western medicine. 2.Methods. Among the patients admitted into the clinic of Joong-Poong, Woo-Suk University Hospital from May 1. 1993 until April 30. 1994 those 56 patients who were diagnosed as ischemic stroke on Computed Tomography(CT) and showed no dubious symptom after examination of coagulation and bleeding time were classified into the following six steps and treated: l)diagnosis 2)emergency treatment 3)basic treatment 4)treatment of risk and provoking factors. and preceeding disease 5)complications and conservative therapy 6)rehabilitation. For a period of basic treatment both herb medication and urokinase therapy were applied at the same time. Intravenous injection has been given at a unit of 300.000 dosage a day as urokinase therapy during basic treatment. If they showed any dubious symptom in glucose tolerance test. fructose 500ml and urokinase 300.000 dosage were mixed and injected. In case of no symptom 5% DW 500ml was mixed with urokinase 300.000 unit. and injected at a speed of 15gtt per minute. 3. Results and Conclusions 1) The level of ambulation has been improved from 42.9% when admitted to 73.2% when discharged in the degree of recovery. The level of severe function disorder has been remarkably decreased from 55.4% when admitted to 19.6% when discharged. 2) The treatment effect on the basis of therapeutic response of clinical and subjective symptom shows as follows: 7.1% Excellent. 35.7% Good. 37.5% Effective. 10.7% Stationary. and 8.9% Aggravated. The total recovery above effective shows 80.3%. Judging from the above results I think it proper to develop the model of better preventing and treating ischemic stroke through effective therapeutic and clinical studies of integrated oriental and western medicine.

• Journal of Chest Surgery
• /
• v.35 no.3
• /
• pp.231-234
• /
• 2002

Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries as well as other collateral arteries. However, moyamoya diseases are recently being reported as a systemic process. We experienced one case of coronary artery occlusive disease affected by moyamoya disease. The patient was a 35-year-old female, experiencing intermittent NYHA class ll dyspnea and exertional chest pain for 6 months and right paresthesia for 1 month before admission. Cerebral artery angiogram showed abnormal cerebrovascular systems and confirmed moyamoya disease with cerebral infarction of the left frontal lobe. In coronary artery angiogram, left coronary artery was not visualized due to total occlusion of the left main ostium and left coronary blood flow was supplied from normal right coronary artery. CABG was performed with OPCAB. Both internal mammary arteries were used for LAD and LCx. Intraoperative coronary artery findings showed intimal hyperplasia and no definite thrombi, and nondiseased coronary arteries were good and patent. We concluded that this patient's coronary artery disease was affected by moyamoya disease, and moyamoya disease should be evaluated in the extracerebral cardiovascular system.

• The Journal of the Institute of Internet, Broadcasting and Communication
• /
• v.20 no.1
• /
• pp.141-148
• /
• 2020

Unilateral neglect is associated with stroke, a neurological disorder caused by cerebrovascular injury, and is a symptom of not recognizing or responding to the opposite stimulus of the cerebral hemisphere, mainly in the right cerebral hemisphere injury. In this paper, we implemented contents using Virtual Reality based on 10 items and contents of Korean Catherine Bergego Scale(K-CBS), which is used as a behavioral evaluation scale for unilateral neglect. Implemented contents can evaluate body disregard, motility disregard, visual and spatial disregard, auditory attention, etc., which are symptoms of unilateral neglected patients, and can confirmed progression of disease quantitatively by measuring time and rotation angle of head during visual recognition. This method is expected to be useful for rehabilitation training using convenient unilateral neglect diagnosis and its applied contents.

• Korean Journal of Adult Nursing
• /
• v.14 no.1
• /
• pp.15-25
• /
• 2002

Purpose: This study was performed to identify the prevalence and type of urinary incontinence (UI) after a stroke, to find the differences in urinary symptoms according to continence or incontinence, and to find the degree of impact of UI on daily life. Method: For data collection, we had a structured interview with a questionnaire. The subjects were 239 post stroke patients. Results: Among the subjects(mean age: $65{\pm}10$), 66.1 percent had an infarction, and 25.5 percent had a hemorrhage. And 26.4 percent of subjects were within 2 weeks and 28.9 percent from 1 year to 5 years since their episodes of a stroke. Forty five point six percent of subjects had various types of UI: urge 25.7 percent, stress 14.7 percent, functional 20.2 percent, and mixed 39.4 percent. There were significant differences in frequency, nocturia, decreased stream, and incomplete emptying between the incontinent and continent groups. Subjects reported UI influenced various aspect of daily life, 54.1 percent as cause of distress, 53.2 percent on overall quality of life, and 40.4 percent on sleep. The Mixed UI, including urge UI, had higher impact on daily life than others. Conclusion: There was a high prevalence of UI, mixed, urge, and functional type as most prevalent, and it had a strong impact on daily life of post stroke patients.

• The Journal of Internal Korean Medicine
• /
• v.21 no.3
• /
• pp.369-376
• /
• 2000

Purpose : Cerebrovascular disease is the most frequent cause of death in Korea and it remains severe disabilities disturbing normal life, According to the previous studies, mortality of the stroke in the first one week is up to the 20% and 95% of stroke patients in the acute stage are accompanied by more than one complications. These complications affect not only the acute stage mortality but also the late stage rehabilitations. In Korea the oriental medicine is preformed in the treatment of stroke. Therefore it is important to recognize thoroughly the complications in the acute stage of stroke and to prevent them. But studies about complications of acute stage stroke is rarely presented in the fields of oriental medicine. So this study is prepared for investigating the characteristics and frequency of complications in the acute stage of stroke. And we are to assess the importance of theses acute complications by systemic reviewing the previous studies. Methods : Fifty one patients are included who had been admitted to ICU(intensive care unit) of Chenju Hospital of Wonkwang Oriental Medicine. Twenty nine patients are diagnosed as ischemic stroke and twenty one patients are diagnosed hemorrhagic stroke. Medical and neurological complications were investigated retrospectively based on medical notes excluding primary symptoms of stroke Le. motor weakness, sensory disturbance and speech disorder. And risk factors of stroke such as D.M. or hypertension are excluded. Results : Medical complications are more frequent than neurological ones. Most frequent medical complication is dysuria(61%) and constipation(45%), fever(30%) and aspiration pneumonia(22%) are followed in order of frequency. In Neurological complication dysphagia(56%), the exacerbation of infarction due to increased intracranial pressure(24%), irritability or insomnia(21%) is most frequently complicated in order of frequency. Conclusions : These complications are mostly caused by bed rest state in acute stage stroke. It is supposed that more aggressive management can prevent theses ones. And it is possible to improve the medical and neurological conditions by sticking theses study results.

• Journal of Chest Surgery
• /
• v.36 no.10
• /
• pp.772-775
• /
• 2003

Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries, but the etiology remains unclear. Angiographic characteristics include bilateral stenosis or occlusion of the terminal portions of the intracranial internal carotid arteries and bilateral development of fine collateral vessels at the base of the brain known as ‘Moyamoya vessels’. Cardiac surgery using cardiopulmonary bypass due to coronary artery disease and others among patients with moyamoya disease is very rare, and cardiac surgery for such patients has a potential risk of intraoperative and perioperative brain ischemia. We successfully treated a patient who underwent artrial septal defect closure and coronary artery bypass graft using the cardiopulmonary bypass, so we report this case with a brief literature review.

• The Journal of Internal Korean Medicine
• /
• v.32 no.1
• /
• pp.144-151
• /
• 2011

Objectives : To report the cases of forgotten needles found in the patients' bodies since Dong-guk University Ilsan Hospital opened, and arouse considerable attention to prevent recurrence. Methods : Oriental medical doctors in the hospital has applied acupuncture on patients' bodies in case of need, and the other staffs removed the needles after treatment. Results : All the patients in the cases had cerebrovascular disease with paralysis, aphasia, cognitive disorder and disturbance of consciousness as well as dysphagia requiring gastrotomy tube and dysfunction of respiration requiring tracheal cannula. The pathways the acupuncture needles were passing through are presumed to be transtracheal via the hole of tracheal cannula in two cases, and transgastrointestinal via mouth or the opening of gastrotomy tube. The needle was excreted with stool without any harm to the patient in the latter case, while the impact of the needles on the respiratory system or thorax of the patients in the former two cases is ambiguous. The hospital has taken some measures to prevent recurrence. Conclusions : There are not a few at high-risk of occurrence of forgotten needles that might induce medical problems among patients in oriental medical clinics or hospitals. Authors expect this report arouses all the people involved in the whole procedure of acupuncture treatment, including oriental medical doctors, nurses, nurse-assistants and caregivers considerable attentions to the possible occurrence and risk of forgotten needles.

• Korean Journal of Clinical Pharmacy
• /
• v.27 no.4
• /
• pp.276-283
• /
• 2017

Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

• Journal of Korean Neurosurgical Society
• /
• v.46 no.6
• /
• pp.558-563
• /
• 2009

Objective : Moyamoya disease (MMD) is an uncommon cerebrovascular disorder, characterized by progressive occlusion at the terminal portion of the internal carotid artery. Incidence of the disease is high in East Asia and familial MMD accounts for about 15% of the disease. Although the pathogenesis is unknown, association of HLA class I or II alleles with MMD has been reported with conflicting results. We investigated whether there is a difference in HLA class II association between familial and non-familial forms of the disease. Methods : A total of 70 Korean children with MMD, including 16 familial cases (10 probands), and 207 healthy controls were studied. Among familial cases, only 10 probands were used for the HLA frequency analysis. High resolution HLA-DRB1 and DQB1 genotyping was performed using polymerase chain reaction (PCR)-sequence specific oligonucleotide hybridization and PCR-single strand conformation polymorphism methods. Results : The phenotype frequencies of HLA-DRB1*1302 (70.0%) and DQB1*0609 (40.0%) were significantly increased in familial MMD compared to both controls [vs. 15.5%, corrected p ($p_c$) = 0.008, odds ratio (OR) = 12.76; vs. 4.3%, $p_c\;=\;0.02$, OR = 14.67] and non-familial MMD patients (vs. 14.8%, $p_c\;=\;0.02$, OR = 13.42; vs. 1.9%, $p_c\;=\;0.02$, OR = 35.33). The frequencies of DRB1 and DQB1 alleles in non-familial MMD patients were not significantly different from those in controls. Conclusion : Our findings suggest that the genetic polymorphism of HLA class II genes or other closely linked disease relevant gene(s) could be a genetic predisposing factor for familial MMD.