• Journal of Korean Neurosurgical Society
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• 제63권4호
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• pp.463-469
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• 2020

Objective : This study aimed to investigate the changes and significance of microRNA155 levels in serum of patients with cerebral small vessel disease (CSVD). Methods : Thirty patients with CSVD who met the inclusion criteria were selected and divided into eight patients with lacunar infarction (LI) group and 22 patients with multiple lacunar infarction (MLI) combined with white matter lesions (WML) group according to the results of head magnetic resonance imaging (MRI). Thirty samples from healthy volunteers without abnormalities after head MRI examination were selected as the control group. The levels of serum microRNA155 in each group were determined by real-time polymerase chain reaction, and the correlation between microRNA155 in the serum of patients with CSVD and the increase of imaging lesions was analyzed by Spearman correlation analysis. Results : Compared with the control group, the serum microRNA155 level in the LI group, MLI combined with WML group increased, the difference was statistically significant (p<0.05); serum microRNA155 level was positively correlated with the increase of imaging lesions (p<0.05). Conclusion : The change of serum microRNA155 level in patients with CSVD may be one of its self-protection mechanisms, and the intensity of this self-protection mechanism is positively correlated with the number of CSVD lesions.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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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.

• 대한중풍순환신경학회지
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• 제6권1호
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• pp.33-43
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• 2005

Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 169 patients who were admitted to Dept. of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2003 to Dec. 31, 2003. Results : Ischemic stroke(include TIA, 85.2%) was more common than hemorrhagic stroke(14.8%). The incidence in male was 46.7%, in female was 53.3% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in MCA territory and lacunar-inf., hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus. The rate of recurrence was 30.18%. Cerebral infarction and cerebral hemorrhage was much occurred in acting. The most patients visited the hospital after 5 days. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly urinary tract infection. Physical treatment from onset, in cerebral infarction was 9.14 days and in cerebral hemorrhage was 18.33 days. Conclusions : Our study on CVA patients was similar to previous studies from 1994 to 2002. In most cases, western and oriental treatment and medicine were given synthetically.

• 대한중풍순환신경학회지
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• 제7권1호
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• pp.23-33
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• 2006

Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 102 patients who were admitted to Department of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2004 to Dec. 31, 2004. Results : Ischemic stroke(include TIA, 82.4%) was more common than hemorrhagic stroke(17.6%). The incidence in male was 41.2%, in female was 17.6% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in lacunar-infarction and hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus and CVA. The rate of recurrence was 27.45%. Cerebral infarction and cerebral hemorrhage was much occurred after rising. The most patients visited the hospital within 24 Hours. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly mental disorder. Conclusion : Our study on CVA patients was similar to previous studies from 1994 to 2003. In most cases, western and oriental treatment and medicine were given synthetically.

• 대한한방내과학회지
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• 제25권2호
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• pp.335-343
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• 2004

The two case reports here presented are based on an inpatient with lateral medullary infarction, known as Wallenberg's syndrome with chief complains of central dizziness and cerebellar ataxia, and an inpatient with infarctions of cerebellar, pontine, and lacunar thalamic region. QSCCII was performed while the patient was hospitalized and, by consultation with the Dept. of Sasang Constitutional Medicine, the patient was diagnosed with Taeumin. Thus, an oriental medical therapy of Cheongsimyeonjatang, acupuncture, and moxibustion was carried out. As a result the degree of dizziness decreased noticeably while other symptoms improved as well. Before leaving the hospital, the degree of cerebellar ataxia also improved and the patient was able to go on foot by himself. In conclusion, significant improvements were observed in cerebellar and a pontine infarction patients who suffered central dizziness and cerebellar ataxia through Sasang medical therapy.

• Annals of Clinical Neurophysiology
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• 제20권2호
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• pp.79-84
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• 2018

Background: Pulsatility of cerebral arteries and aortic stiffness have been associated with white matter hyperintensities (WMH). We explored which is better correlated with the severity of WMH in a population with acute lacunar infarct. Methods: We included patients with acute small subcortical infarcts who underwent transcranial Doppler (TCD) and brachial ankle pulse wave velocity (baPWV). Exclusion criteria were any stenosis or occlusion on major cerebral arteries on magnetic resonance angiography; poor temporal insonation windows; ankle brachial index < 0.9; and atrial fibrillation. We assessed the performance of the pulsatility index of bilateral middle cerebral arteries (PI-MCA) and baPWV for predicting moderate-to-severe WMH, defined as an Age Related White Matter Changes score > 5, and then sought to find independent predictors using binary logistic regression analysis. Results: Eighty-three patients (56 males, mean age $61.5{\pm}11.4$) participated in the study. Uni-variate analysis showed old age and high PI-MCA were significantly correlated with moderate-to-severe WMH. However, baPWV was not associated with the severity of WMH. Multivariate analysis revealed old age (odds ratio per 1-year increase, 1.068; p = 0.044) and upper tertile of PI-MCA (odds ratio, 5.138; p = 0.049) were independently associated with moderate-to-severe WMH. Receiver-operating characteristics showed PI-MCA differentiated those with and without moderate-to-severe WMH with an area under the curve of 0.719. Conclusions: PI-MCA derived from TCD was better correlated with the severity of WMH than baPWV in a population with lacunar infarction. Pulsatility of cerebral arteries may better predict cerebral small vessel disease than the aortic stiffness index.

• 사상체질의학회지
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• 제15권2호
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• pp.94-100
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• 2003

The purpose of this study is to give an account of the effects of the Korean herbal medicine therapy which is based on the Sasang constitutional medicine for the patient who has suffered from scale of both foot caused by chronic psoriasis. The subject is a 81-year old man who has the symptoms caused by lacunar infarction, which are both leg weakness, gait disturbance, dizziness, dysarthria, frequency voiding, and scale of both foot caused by chronic psoriasis. We have diagnosed him as Shaoyangin(少陽人), and have prescribed Yukmi jiwhangtang(六味地黃湯). The consequence is the accompanied scale of both foot, both leg weakness, gait disturbance, dizziness, frequency voiding and general condition has improved.

• 지역사회간호학회지
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• 제10권1호
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• 대한중풍순환신경학회지
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• 제14권1호
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• pp.115-121
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• 2013

2013년 2월 19일부터 2013년 3월 16일까지 대전대학교 둔산한방병원에서 입원치료를 받은 시상통증증후군 환자 1례를 태음인(太陰人) 간조열증(肝燥熱證)으로 인한 중풍(中風)으로 판단하고 열다한소탕(熱多寒少湯) 가감방(加減方)을 투여하고 침구(鍼灸)치료, 부항요법(附缸療法), 물리치료, 재활 및 운동치료 등을 병행하면서 환자의 시상통증증후군 증상을 면밀히 관찰한 결과 유의한 효과를 얻었는바 이에 보고하는 바이나 향후 더 많은 증례를 통한 지속적인 연구가 필요할 것으로 사료된다.

• Investigative Magnetic Resonance Imaging
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• 제7권2호
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• pp.124-131
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• 2003

목적 : 뇌종양 환자에서 감각운동과 언어 자극을 통해 기능적 자기공명영상(fMRI)을 시행하여 fMRI에서 감각운동 그리고 언어중추와 병변과의 해부학적인 관계를 관찰하여 수술 계획수립에 도움을 줄 수 있는지 알아보고자 하였다. 대상 및 방법 : 뇌종양이 감각운동중추 혹은 언어중추 부위에 발생한 오른손잡이 환자 12명을 대상으로 하였다. 12명의 환자 중 11명에서 감각운동중추의 활성화 여부를 관찰하였고 이 중 6명은 언어중추의 활성화를 함께 관찰하였으며, 1명은 언어중추의 활성화 여부만을 관찰하였다. fMRI를 얻기 위해서 1.57 MR Scanner를 사용하여 EPI-BOLD 기법으로 영상을 얻어, SPM99 분석 프로그램과 자체제작 프로그램을 이용하였다. 분석은 감각운동, 그리고 언어 자극이 대뇌중추를 활성화시킬 수 있는지 관찰하였고, 감각운동중추 및 언어중추와 병변과의 위치 관계를 확인하여 수술 계획수립에 도움을 줄 수 있는지 알아보았다. 또한 환자의 신경학적 기능평가를 수술전후 시행하여 변화여부를 알아보았다. 결과 : 뇌종양환자 12명 모두에서 활성화 영상을 얻을 수 있었고, 대뇌활성화 영역과 병변의 해부학적인 관계를 파악할 수 있었다. 감각운동중추의 활성화영상을 성공하였을 11명 중 9명에서 수술전후 신경학적 수기운동검사에서 등급의 변화를 보이지 않았으며, 1명은 수술 후 오히려 등급이 높아져 운동기능의 회복이 있었고, 1명은 수술 후 한 등급 낮아지는 운동기능의 저하를 보였다. 언어중추의 활성화영상을 성공적으로 얻을 수 있었던 7예에서 수술 후 언어기능의 저하를 보인 경우는 없었다. 결론 : fMRI는 감각운동중추나 언어중추 부위에 발생한 뇌종양을 가진 환자에서 수술을 위한 최적의 접근 경로를 결정하는데 많은 도움을 줄 수 있으리라 생각된다.