• Title/Summary/Keyword: Ischemic Stroke

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The Study on the Effect of Oriental Music Therapy in Ischemic Stroke Patients Classified by Sasang Constitutional Medicine (한방음악치료가 사상체질에 따라 분류된 뇌경색환자에 마치는 효과에 관한 연구)

  • Lee, Seung-Hyun;Kim, Deok-Yoon;Koh, Byung-Hee;Lee, Soo-Kyung;Kim, Sang-Bok
    • Journal of Sasang Constitutional Medicine
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    • v.18 no.2
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    • pp.125-132
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    • 2006
  • 1. Objectives The purpose of this study was to examine the regional cerebral blood-flow(r-CBF) difference between OMT(Oriental Music Therapy) group and control group using brain SPECT, to evaluate the effect of OMT in ischemic stroke patients Classified by Sasang Constitutional. 2. Methods We selected 10 ischemic storke patients, classified groups into OMT group or control group. r-CBF of two groups were examined by brain SPECT. in all group we applied SCM(Sasang constitutional medicine)treatment for 4-5 weaks, and additionally in OMT group We applied OMT for 4-5 weaks. after that all the r-CBF of two groups took brain SPECT again. r-CBF difference and change before and after SCM treatment and OMT were quantified and analyzed using SPM. 3. Results r-CBF of OMT groups were increased compared to control groups. 4. Conclusions This study demonstrated that Sasang Constitutional OMT increased regional cerebral blood perfusion to the corresponding brain areas in ischemic stroke patients.

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Clinical Studies on 56 Cases of Having Treated patients suffering from Ischemic Stroke through both Urokinase and Therapeutics of Oriental Medicine (Urokinase와 동의학적요법(東醫學的療法)으로 동시치료(同時治療)한 허혈성뇌졸중환자(虛血性腦卒中患者) 56례(例)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Kim, In-Sup
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.46-91
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    • 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.

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Endovascular Stroke Therapy Focused on Stent Retriever Thrombectomy and Direct Clot Aspiration : Historical Review and Modern Application

  • Kang, Dong-Hun;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.335-347
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    • 2017
  • Intravenous recombinant tissue plasminogen activator had been the only approved treatment for acute ischemic stroke since its approval in 1995. However, the restrictive time window, numerous contraindications, and its low recanalization rate were all limitations of this modality. Under those circumstances, endovascular stroke therapy went through a great evolution during the past two decades of intravenous thrombolysis. The results of the 2013 randomized trials for endovascular stroke therapy were neutral, although they were limited by insufficient imaging screening at enrollment, early-generation devices with less efficacy, and treatment delays. Huge progress was made in 2015, as there were five randomized clinical trials which all demonstrated the safety and efficacy of endovascular stroke treatment. Despite differences in detail patient enrollment criteria, all 5 trials employed key factors for good functional recovery; (1) screening with non-invasive imaging to identify the proximal occlusion and exclude a large infarct core, (2) using highly effective modern thrombectomy devices mainly with stent retriever, and (3) establishment of a fast workflow to achieve effective reperfusion. The results of those trials indicate that modern thrombectomy devices can allow for faster and more effective reperfusion, which can lead to improved clinical outcomes compared to intravenous thrombolysis alone. These advances in mechanical thrombectomy are promising in the global fight against ischemic stroke-related disability and mortality. Two current mainstreams among such mechanical thrombectomy techniques, "stent retriever thrombectomy" and "direct clot aspiration", are the topic of this review. Stent retriever thrombectomy using Solitaire and Trevo retriever will be firstly discussed. And, the commonalities and the differences between two major clot aspiration thrombectomy techniques; a direct aspiration first pass technique (ADAPT) and forced arterial suction thrombectomy (FAST), will be additionally explained. Finally, details regarding the combination of direct clot aspiration and stent retriever thrombectomy, the switching strategy and the Solumbra technique, will be described.

Timely Interventions can Increase Smoking Cessation Rate in Men with Ischemic Stroke

  • Lee, Min Jeong;Park, Eunjeong;Kim, Hyeon Chang;Lee, Hye Sun;Cha, Myoung-Jin;Kim, Young Dae;Heo, Ji Hoe;Nam, Hyo Suk
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.610-617
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    • 2016
  • Purpose: Smoking cessation is strongly recommended for every smoker after ischemic stroke, but many patients fail to quit smoking. An improved smoking cessation rate has been reported with intensive behavioral therapy during hospitalization and supportive contact after discharge. The aim of this study was to demonstrate the usefulness of the timely interventions for smoking cessation in men with acute ischemic stroke. Methods: Patients who participated in the timely interventions strategy (TI group) were compared with those who received conventional counseling (CC group). In the TI group, a certified nurse provided comprehensive education during admission and additional counseling after discharge. Outcome was measured by point smoking success rate and sustained smoking cessation rate for 12 months. Results: Participants, 157 men (86 of the TI group and 71 of the CC group), were enrolled. Mean age was $58.25{\pm}11.23$ years and mean initial National Institutes of Health Stroke Scale score was $4.68{\pm}5.46$. The TI group showed a higher point smoking success rate compared with the CC group (p=.003). Multiple logistic regression analysis showed that the TI group was 2.96-fold (95% CI, 1.43~6.13) more likely to sustain smoking cessation for 12 months than the CC group. Conclusion: Findings indicate that multiple interventions initiated during hospital stay and regular follow-up after discharge are more effective than conventional smoking cessation counseling in men with acute ischemic stroke.

A Clinical Study of Korean Medical Treatment and Korean and Western Medical Treatment on Acute Ischemic Stroke Patients

  • Kim, Jong-Deuk;Kwon, Jung-Nam;Kim, Young-Gyun;Lee, Sang-Hee;Kim, Sang-Heon;Son, Yeon-Hui;Kim, Jae-Kyu
    • The Journal of Korean Medicine
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    • v.28 no.4
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    • pp.168-175
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    • 2007
  • Objectives : This is a study of ischemic stroke patients designed for comparing Korean and Western medical treatments and Korean medical treatments alone. Methods : 44 patients were diagnosed by B-MRI scan as having suffered ischemic stroke. They had entered Dong-eui Korean Medicine hospital within seven days of attack, and remained over seven days, all between May 2005 and October 2007. Patients were divided into two groups; a group treated with Korean medical treatments, and another group treated with Korean and Western medical treatments (but in both groups examinations were done and Western medications were given for hypertension, diabetes mellitus and so on) Results : NIHss change one month later was not statistically significant for either groups but the NIHss gap between them was significant. Conclusions : NIHss change one week later was not statistically significant for either group. NIHss change one month later was not statistically significant for either groups but the Korean medical treatment group had a significant NIHss gap more than the Korean and Western medical treatment group.

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Clinical Study of Korean Medical Treatment and Korean-Western Medical Treatment on Acute Ischemic Stroke Patients (급성기 허혈성 뇌중풍 환자의 한방치료와 한양방협진치료의 임상적 고찰)

  • Kim, Jong-Deuk;Kim, Young-Gyun;Kim, Jong-Won;Sa, Eun-Hee;Min, Sung-Soon;Hong, Soo-Hyun;Lee, Sang-Hee;Kim, Jae-Kyu;Kwon, Jung-Nam
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.2
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    • pp.543-547
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    • 2007
  • This is a study of ischemic stroke patients designed for comparison Korean-Western treatments and Korean medical treatments alone. 91 patients were diagnosed by B-MRI scan as having suffered ischemic stroke. They had entered Dong-eui Korean Medicine hospital within seven days of attack, and remained over seven days, all between May 2005 and March 2006. Patients were divided into two groups; a group treated with Korean medical treatments, and other group treated with Korean-Western medical treatments(but examinations were done and medications were given in hypertension, diabetes mellitus and so no) The Korean medical treatment group showed significant changes in NIHss after 1month. The Korean medical treatment group had insignificant improvement that measure for NIHss by treated Korean-Western medical treatment group after 1week. The Korean medical treatment group had significant improvement that measure for NIHss by treated Korean-Western medical treatment group after 1month.

Effect of Bambusae Caulis in Liquamen(Jukryuk) on Ischemic Damage to 4 Vessel Occlusion and Middle Cerebral Artery Occlusion in Mice (죽력(竹瀝)이 흰쥐의 중대뇌동맥(中大腦動脈) 및 전뇌허혈(全腦虛血) 폐쇄 허혈모델에 미치는 영향)

  • Kim, Jae-Hong;Hong, Jin-Woo;Na, Byung-Jo;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Cham-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.629-640
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    • 2008
  • Objective : The purpose of this study was to investigate the neuroprotective effect of Jukryuk on 4-vessel occlusion(4-VO) and middle cerebral artery (MCA) ischemia. Method : After administration of Jukryuk, we compared the Jukryuk-treated group, the control, and the sham groups, in view of several points as follows 1) We evaluated the damage characterized by coagulative cell change of pyramidal neurons and pronounced gliosis in each group 2) We counted the number of normal pyramidal shapes after ischemia in each group 3) Immunohistochemistry (cyclooxygenase-2) 4) In focal ischemic injury model, we measured the volume of ischemic area Results : In this experiment, the effect of Jukryuk was determined to be protecting neuron cell shape, reducing the number of neuron cells damaged by ischemia and the volume of the ischemic area. In immunohistochemistry, Jukryuk reduced cyclooxygenase-2 expression Conclusions : According to this study, Jukryuk can protect neuron cells from injury by cerebrovascular ischemia.

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Protective Effects of Traditional Korean Medicine Preparations, Herbs, and Active Compounds on the Blood-brain Barrier in Ischemic Stroke Models (허혈성 뇌졸중 모델에서 혈액-뇌 장벽에 보호효과를 나타내는 한약처방, 한약재 및 활성화합물)

  • Shin, Su Bin;Jang, Seok Ju;Lee, Na Gyeong;Choi, Byung Tae;Shin, Hwa Kyoung
    • Journal of Life Science
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    • v.32 no.7
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    • pp.550-566
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    • 2022
  • Stroke is among the leading causes of death and long-term physical and cognitive disabilities worldwide, affecting an estimated 15 million people annually. The pathophysiological process of stroke is complicated by multiple and coordinated events. The breakdown of the blood-brain barrier (BBB) in people with stroke can significantly contribute to the development of ischemic brain injury. Therefore, BBB disruption is recognized as a hallmark of stroke; thus, it is important to develop novel therapeutic strategies that can protect against BBB dysfunction in ischemic stroke. Traditional medicines are composed of natural products, which represent a promising source of new ingredients for the development of conventional medicines. Indeed, several studies have shown the effectiveness of Korean medicine on stroke, highlighting the value of Korean medicinal treatment for ischemic stroke. This review summarizes the current information and underlying mechanisms regarding the ameliorating effects of the formula, decoction, herbs, and active components of traditional Korean medicine on cerebral ischemia-induced BBB disruption. These traditional medicines were shown to have protective effects on the BBB in many cellular and animal ischemia models of stroke, and experiments in various animal species, such as mice and rats. In addition, they showed brain-protective effects by protecting the BBB through the regulation of tight junction proteins and matrix metalloproteinase-9, reducing edema, neuroinflammation, and neuronal cell death. We hope that this review will help promote further investigation into the neuroprotective effects of traditional Korean medicines and stimulate the performance of clinical trials on Korean herbal medicine-derived drugs in patients with stroke.

The Study about Characteristics Affecting Functional Recovery of Stroke Patients Treated in an Oriental Medical Center (한방병원에 입원한 뇌경색 환자의 기능회복과 관련된 특성에 대한 연구)

  • Kim, Young-Jee;Kim, Mi-Young;Lee, Seung-Yeop;Choi, Won-Woo;Park, Joo-Young;Kwon, Seung-Won;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Park, Sung-Wook;Park, Jung-Mi;Ko, Chang-Nam;Bae, Hyung-Sup;Na, Byong-Jo
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.719-731
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    • 2009
  • Objectives : Stroke is the most common disabling neurological disease of adult life. The treatment and rehabilitation of stroke patients is an important and challenging area in the field of medicine. In Korea, a lot of stroke patients are treated using oriental medicine and there have been reports on their functional recovery. The aim of this study was to prove the therapeutic effect of oriental medicine on ischemic stroke. We also tried to identify characteristics of patients whose functional recovery was prominent and studied whether or not the use of fluids, anticoagulants, antiplatelets and neuroprotective agents increased the functional recovery of patients. Methods : We studied 794 patients within 2 weeks after first attack of ischemic stroke who were admitted to Kyung-Hee Oriental Medical Center from 1999 to 2000. Their maximum admission period was 60 days. Results : Motor power grade, NIHSS and MBI scores of patients improved during hospitalization significantly. Factors affecting functional recovery were admission period, motor power grade, NIHSS and MBI at admission. Age, waist-hip ratio and HDL cholesterol also affected functional recovery of patients. Whether or not fluids, anticoagulants, antiplatelets and neuroprotective agents were administered had nothing to do with functional recovery. Conclusion : Oriental medicine is effective for treatment and rehabilitation of ischemic stroke patients. When we manage stroke, we have to consider some important factors.

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The Effect of Modified Boyanghwano-tang on the Brain Infarction Through the Anti-apoptosis of Neuronal Cells in Ischemic Rats (가미보양환오탕이 뇌허혈모델에서 신경세포보호를 통해 뇌경색억제에 미치는 효과)

  • Han, Chang-Ho;Park, Yong-Ki
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.29-38
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    • 2010
  • Objectives : The purpose of the study is to determine the neuroprotective effect of modified Boyanghwano-tang(mBHT), a traditional Korean medicine, on the transient focal cerebral ischemia in rats. Methods : Focal ischemia and reperfusion were induced by middle cerebral artery occlusion(MCAO) for 90 min, followed by 144 h reperfusion in rats. mBHT(200mg/kg body weight, p.o.) was administrated in rats once a day during reperfusion. At the end of treatment, brain infarction was measured by TTC staining, and histological change was observed by H&E staining. The expressions of Bax, Bcl-2 and cytochrome c in ischemic brains were determined by immunofluorescent analysis. Results : mBHT significantly reduced the cerebral infarct volumes of the MCAO rats. mBHT also attenuated the neuronal cell death and the expressions of pro-apoptotic molecules, bax and cytochrome c in ischemic brains. Further, mBHT significantly increased the survival time of ischemeic rats and the expression of anti-apoptotic molecule, Bcl-2 in ischemic brains. Conclusions : Our results suggest that mBHT is neuroprotective and may prove to be useful adjunct in the treatment of ischemic stroke.