• The Journal of Internal Korean Medicine
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• v.31 no.2
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• pp.308-313
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• 2010

Objectives : The weekly variation of ischemic stroke incidence according to the age and sex. Methods : 977 consecutively admitted patients (521 males and 456 females) in a single stroke center from 2006 to 2008. All cases were confirmed with standardized criteria. We used the independent t-test and $x^2$ test in statistical methods. Results : The results demonstrated significant weekly variations of ischemic stroke incidence showing higher incidence on Saturday, Monday and Tuesday and lower incidence on the other days. Difference of ischemic stroke incidence was also shown between transit days, which included the transit days from the weekend to the week and vice versa, and non-transit days. Those aged older than 60 years and females showed more significant differences of weekly variation on transit days than on non-transit days. Conclusions : Ischemic stroke incidence has significant weekly variation, and transit days have higher incidence than non-transit days. Further study is required to identify the general weekly variation by multi-center trial.

• The Journal of Korean Medicine
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• v.27 no.1 s.65
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• pp.118-129
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• 2006

Objectives : A human being is classified into 4 constitutions(Taeyangin, Soyangin, Taeumin, and Souemin) and each constitution has the different incidence, treatment and prevention of disease in Sasang Constutional Medicine[SCM], The purpose of this study is to find relative risk(RR)s of each risk factors including Sasang Constitution[SC] for incidence of ischemic stroke. Methods : In 344-case patients with ischemic stroke and 1446 healthy control subjects without ischemic stroke, we evaluated sex, age. height, weight, BMI, ECG abnormality, hypertension, diabetes mellitus, blood lipid level and SC. These data were statistically analysed to investigate the relations between risk factors and the incidence of ischemic stroke by chi-square test. And then significant factors were analysed to get each adjusted odds ratio[OR] by binary logistic regression analysis. Results : ECG abnormality, hypertension, diabetes mellitus, HDL(high density lipoprotein) cholesterol, and SC were significantly related to the incidence of ischemic stroke, while age, sex and BMI were adjusted in a binary logistic regression analysis. Especially in SC, the incidence of ischemic stoke in Tae-eumin and Soyangin were higher than that in Soeumin (Tae-eumin OR=11.68[95% CI: 6.26-21.80], Soyangin OR=4.64[95% CI: 2.66-8.10]). Conclusions : These results suggested that SC may be one of important risk factors for ischemic stroke and it should be a useful data for prediction of incidence of ischemic stroke.

• Biomedical Science Letters
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• v.24 no.4
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• pp.405-410
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• 2018

Stroke is a leading cause of death in the Korean population and remains a major health burden worldwide. The two main pathologic types of stroke are ischemic stroke and intracranial hemorrhage (ICH), but comparisons of risk factors for these have been limited. We under took a nationwide population-based study to analyze the relationship between these risk factor sand ischemic stroke and ICH. From January 2003 to December 2013, a total of 37,561 patients with newly diagnosed ischemic stroke or ICH were identified using the National Health Insurance Service data base as the study population. Multivariable logistic regression analysis was used to determine the association between baseline risk factors and presentation with ICH versus ischemic stroke. The incidence of ischemic stroke showed an increasing rend every year, while there was no significant change in the incidence of ICH. Of the several risk factors associated with stroke, old age (OR 2.35, 95% CI 2.12~2.49, P < 0.001) was more closely associated with ischemic stroke than ICH, whereas renal disease (OR 0.74, 95% CI 0.55~0.99, P = 0.04) and carotid disease (OR 0.25, 95% CI 0.17~0.35, P < 0.001) were more strongly associated with ICH. In addition, diabetes mellitus, dyslipidemia, hypertension, ischemic heart disease and male sex was associated with an increased risk of ischemic stroke. Old age was more strongly associated with ischemic stroke than ICH, while carotid stenosis and renal impairment were more closely associated with ICH risk. Classic risk factors for stroke have considerably different associations with the two main pathologic types of stroke.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.437-448
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• 2018

Objective: Acute ischemic stroke (AIS) requires time-dependent reperfusion therapy, and early recognition of AIS is important to patient outcomes. This study was conducted to identify the clinical features and risk factors of AIS patients that are missed during the early stages of diagnosis. Methods: We retrospectively reviewed AIS patients admitted to a hospital through the emergency department. AIS patients were defined as ischemic stroke patients who visited the emergency department within 6 hours of symptom onset. Patients were classified into two groups: an activation group (A group), in which patients were identified as AIS and the stroke team was activated, and a non-activation group (NA group), for whom the stroke team was not activated. Results: The stroke team was activated for 213 of a total of 262 AIS patients (81.3%), while it was not activated for the remaining 49 (18.7%). The NA group was found to be younger, have lower initial National Institutes of Health Stroke Scale scores, lower incidence of previous hypertension, and a greater incidence of cerebellum and cardio-embolic infarcts than the A group. The chief complaints in the A group were traditional stroke symptoms, side weakness (61.0%), and speech disturbance (17.8%), whereas the NA group had non-traditional symptoms, dizziness (32.7%), and decreased levels of consciousness (22.4%). Independent factors associated with missed stroke team activation were nystagmus, nausea/vomiting, dizziness, gait disturbance, and general weakness. Conclusion: A high index of AIS suspicion is required to identify such patients with these findings. Education on focused neurological examinations and the development of clinical decision tools that could differentiate non-stroke and stroke are needed.

• Journal of Korean Neurosurgical Society
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• v.41 no.4
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• pp.224-229
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• 2007

Objective : Despite improvement of therapeutic regimen, incidence of stroke increases and it remains a leading cause of death. Our study aims at offering variable data on recurrent strokes. Methods : There were 59 patients who admitted from Jan. 2002 to Dec. 2004 due to recurrent strokes. A retrospective longitudinal cohort study was done. Results : Four-hundred-seventy five patients, diagnosed with acute stroke, experienced 491 strokes in 3 years, and there were 75 recurrent strokes [15.3%] in 59 patients. These 59 patients were included in the study. First hemorrhagic cases [H] were 19 [32%], and the first infarction cases [I] were 40 [68%]. Subsequent strokes after first stroke were as follows : $H{\to}H$ 14 [23.7%] cases, $H{\to}I$ 5 [8.5%], $I{\to}H$ 8 [13.6%], $I{\to}I$ 32 (54.2%]. A Cox regression analyses showed that the first type of stroke was a significant factor to the second stroke as follows : if one has had a hemorrhagic stroke, the possibility of second hemorrhagic attack ($H{\to}H$ attack) increase 3.2 times than ischemic type and in ischemic stroke [$I{\to}I$ attack] 3.6 times increased incidence of second ischemic attack. Conclusion : The recurrence rate of stroke was 12.4% [59 of 475 patients]. If the first stroke is hemorrhage or infarction, the next stroke would have high potentiality of hemorrhage, or infarction. The possibility of same type in second stroke Increase over 3 times. In $H{\to}H$ group, the time interval between first and second stroke was shorter and the age of onset was earlier than in $I{\to}I$ group. Moreover, the infarction was more frequent than hemorrhage in multiple strokes. There was a correlation in lacunar type infarction between first and second attack.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.5
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• pp.1167-1171
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• 2009

Ischemic stroke has been the leading cause deaths and the critical disability. In addition, the clinical problem of ischemic stroke have the poor prognosis and high mortality rate. The study aim was to identify the incidence variation of ischemic stroke by days of the week and its relationship with residences in males. We analyzed 607 males patients with ischemic stroke diagnosed by magnetic resonance image or computerized tomography. They were admitted to the oriental hospital of Kyunghee, Daejeon, Wonkwang university. We analyzed the onset of ischemic stroke using a ${\chi}2$ test. The results showed significant weekly variation of ischemic stroke onset and the differences of weekly variation according to residences. A deeper knowlegde of the underlying weekly variation could be provide more effective insights for preventive approach.

• Journal of Neurocritical Care
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• v.11 no.2
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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.

• Toxicological Research
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• v.29 no.3
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• pp.157-164
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• 2013

Although stroke is one of the leading causes of death and disability worldwide, preventive or therapeutic options are still limited. Therefore, a better understanding of the pathophysiological characteristics of this life-threatening disease is urgently needed. The incidence and prevalence of ischemic stroke are increased by exposure to certain types of xenobiotics, including heavy metals, suggesting the possible toxicological contribution of these compounds to the onset or aggravation of stroke. Among the potential targets, we have focused on alterations to cerebral endothelial cells (CECs), which play important roles in maintaining the functional integrity of brain tissue.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.423-431
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• 1993

To eveluate the risk factors which are related to recurrence of ischemic stroke, we selected subjects who were admitted to YNUH due to recurrent stroke and compared their risk factors with non-recurred group who suffered from single ischemic stroke. In the subjects, 55 of them are men and 22 were women and in the non-recurred groups, 84 of them were men and 40 were women, Subject's age ranged from 29 to 85 years(Mean 62, 5years), and non-recurred group's age ranged from 27 to 90 years(Mean 60, 7years), Peak incidence of ischemic stroke is in the 7th decade in both groups. Age and sex are not, statistically significant for recurrence of ischemic stroke. The patient's history of diabetes mellitus, myocardial infarction, atrial fibrillation, transient attack and type or site of ischemic stroke had no significant effect statistically on the recurrent ischemic stroke. However, when the patient had previous history of hypertension or systolic blood pressure more than 160mmHg and diastolic more than 95mmHg, there was substantial difference(P<0.05) between the two group in the recurrence of ischemic stroke. According to the above results, hypertension is most likely significant risk factor of the recurrence of ischemic stroke within 2years after initial one. Therefore, adequate treatment of the hypertension is important for the prevention of ischemic stroke. Further study is required for searching other risk factors.

• Journal of Korean Neurosurgical Society
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• v.43 no.1
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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.