• 대한한방내과학회지
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• 제23권1호
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• pp.5-13
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• 2002

Purpose : Studies on stroke were conducted by using the scaling system to estimate, compare severity and to predict prognosis. National Institute of Health Stroke Scale is widely used for this purpose due to its accuracy in predicting clinical symptoms. According to previous studies, neurologic symptoms in acute stage of ischemic stroke did not disappear, and approximately 27% to 43% of them were aggravated, We conducted this study to define clinical aggravation and to improve ischemic stroke in its acute stage by using NIHSS. Methods and Subjects : Due to their acute ischemic stroke, twenty five patients visited Wonkwang Oriental Medicine in Cheonju within forty eight hours from its beginning stage. Two oriental medicine doctors checked NIHSS every six hours during the first ninety six hours and later every twenty four hours for twelve days from the beginning of the disease. Results : The Aggravated group consisted of nineteen out of twenty five cases, which is seventy six % and NIHSS on admissions were $5.88{\pm}0.63$ and it increased linearly over time by the equation of NIHSS on admissions was $8.50{\pm}2.02$ and it decreased linearly over time by the equation of NIHSS=-0.01 one hour+7.91. Conclusion : During the study, we defined the clinical courses of acute ischemic stroke. There have been no reports on this so far. Therefore, we hope that this study will be beneficial to expand the scope of oriental medicine in dealing with aggravating ischemic stroke in the acute stage.

• 대한중풍순환신경학회지
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• 제9권1호
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• pp.1-7
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• 2008

Objectives : We questioned whether the tongue diagnosis is effective for judging seriousness of cerebrovascular accidents. This study is about the relationship between tongue diagnosis and National Institute of Health Stroke Scale(NIHSS) in acute stroke patients. Methods : 738 subjects were recruited from the patients admitted to the department of internal medicine at Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center from April 2007 to August 2008. We looked at the tongue as in three dimensions of tongue color, tongue fur color and tongue body. And, we calculated NIHSS means according to the subtypes of three dimensions. Results : 1. In the Tongue color, from the most commom to least common colors were pale red, red, pale, bluish purple, and ect. The NIHSS mean score of red is significantly higher than pale and pale red. 2. In the Tongue fur color, white fur was the most common, and then yellow fur, etc. There is no significant difference among three subtypes in the NIHSS mean score. 3. In the Tongue body, etc. is the most common, followed by teeth-marked tongue, enlarged tongue, blood patchy tongue, and mirror tongue. The NIHSS mean score of teeth-marked tongue is significantly lower than blood patchy tongue and mirror tongue. Conclusions : The tongue color and the tongue body are useful indexes for judging seriousness of cerebrovascular accidents presented by NIHSS. But in our study, the tongue fur color was not useful. Further study is necessary on the tongue fur.

• 대한한방내과학회지
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• 제30권4호
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• pp.708-718
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• 2009

Objectives : The aim of this study was to assess the relationship between risk factors, warning signs, tongue diagnosis, pulse pattern, pattern identification and National Institute of Health Stroke Scale in acute stroke patients. Methods : We studied patients hospitalized within 4 wks after their ictus who were admitted at the Internal Medical Department at Kyunghee Oriental Medical Center, Kyunghee University East-West Neo Medical Center, Kyungwon University Songpa Oriental Medical Center, Kyungwon University Incheon Oriental Medical Center, Dongguk University Ilsan Oriental Medical Center from April 2007 to August 2009. We analyzed the relationship between risk factors, warning signs, tongue diagnosis, pulse pattern, pattern identification and National Institute of Health Stroke Scale in acute stroke patients. Results : 1506 subjects were included into the final analysis. 1. In the risk factors, the NIHSS mean score of atrial fibrillation was significantly higher than non-atrial fibrillation. 2. In the warning signs, the NIHSS mean scores of weakness, loss of eyesight, dysarthria, and sensory loss were significantly higher than in the non-warning signs. 3. There were no significant differences in lifestyle, tongue fur color, pattern identification between groups. 4. In the tongue color, the NIHSS mean score of red was significantly higher than pale or pale red. 5. There were significant differences statistically between forceful/weak, fine/not fine, slippery/not slippery pulse and NIHSS score. Conclusion : The above results show the relationship between risk factors, warning signs, tongue diagnosis, pulse pattern, pattern identification and National Institute of Health Stroke Scale in acute stroke patients. These results can be utilized in the future as a basis material.

• 보건의료산업학회지
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• 제12권2호
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• pp.125-134
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• 2018

Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

• 한국의료질향상학회지
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• 제15권2호
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• pp.73-81
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• 2009

문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로 활용하고 있지만 아직 간호현장에서는 보편적으로 사용하지 않고 있다. 이에 뇌졸중 환자 간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중 환자 간호의 질을 보다 향상시키기 위하여 본 활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를 향상시키기 위한 프로그램을 개발 적용한다. 둘째, 간호사가 급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중 악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬 수 있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과 치료를 위한 의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실. 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 "NIHSS 간호사 교육 프로그램"을 마련하였다. 둘째, NIHSS 측정을 통한 뇌졸중 악화 예측율 향상을 위하여 "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"을 개발하고 추적 관찰하였다. 개선효과: NIHSS 측정 신뢰도는 질 향상 활동 전 89%에서 92%로 향상되었다. 그리고 간호사의 뇌졸중 악화 양성 예측율은 58.7%에서 87.1%로 향상되었다(참고 : 간호사의 뇌졸중 악화 음성 예측율 100% 유지). 즉 "NIHSS 간호사 교육 프로그램 활용", "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"의 적용으로 뇌졸중의 조기 발견 및 치료가 가능하였고, 향후 환자 예후에 긍정적인 영향을 줄 수 있을 것이라 기대된다.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.1-5
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• 2011

Objective : There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. Methods : Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. Results : There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. Conclusion : In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.

• 대한한방내과학회지
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• 제28권4호
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• pp.727-732
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• 2007

Objectives : This study investigated using National Institutes of Health Strokes Scale in acute and subacute stroke patients and evaluated relativity of pulse pattern to NIHSS. Methods : 104 acute and subacute stroke patients were selected from 4 oriental medical hospitals from April 2007 to May 2007. The patients were admitted to hospital within 1 month after stroke. Pulse feeling diagnosis was done by oriental medical doctor and classified into 7 subtypes. Results : There were significant results statistically between slow/rapid pulse and NIHSS score in the male group; in the female group, there were no significant results statistically but the results showed that slow pulse has lower NIHSS score than rapid pulse. Patients with surging pulse had lower NIHSS score than the other patients. Another pulse pattern had no relativity to NIHSS score.

• 대한한방내과학회지
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• 제22권3호
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• pp.393-396
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• 2001

Objectives: We were to assess the effectiveness of combined therapy of Oriental Medicine and Western Medicine on acute stroke. Methods: We selected acute middle cerebral artery territory infarction subjects, within 3 days after stroke onset, who had never have any type of stroke history before. The subjects, admitted to department of Oriental Medicine, received combination therapy of western medical treatment including thrombolytic, anticoagulant, or antiplatelet agents and oriental medical treatment including acupuncture and herbs medication. The other subjects, admitted to department of Neurology, received only modern western medical treatment. The National Institute of Health Stroke Scale (NIHSS) was checked at admission, 1 week and 2 weeks later to assess neurologic improvement. The Modified Barthel Index (MBI) was checked 1 week and 2 weeks after admission to motor function recovery. Results: Comparing the NIHSS between baseline and 1 week later, the combination therapy group showed more improvement than the single-treated with anticoagulants group. However, there was no significant difference between the two groups, comparing 1 week and 2 weeks later with the NIHSS and the MBI. Conclusions: Combination therapy have more beneficial effect on acute stage of stroke.

• 대한중풍순환신경학회지
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• 제10권1호
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• pp.47-53
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• 2009

Objectives : This study was aim to investigate the relationship between NIHSS and distribution of pattern identification in stroke patients. Methods : 1471 participants from the patients hospitalized for stroke within 4 weeks from April 2007 to August 2009 were included. They were grouped according to the NIHSS score; group 1 for the participants whose NIHSS were less than six, group 2 for seven to fifteen, and group 3 for over than sixteen. And the patients were re-divided into two groups according to their post-onset interval. The difference of distribution of five pattern identification for each group were investigated. And five pattern identification were re-analyzed according to the deficiency-excess pattern identification. K-W test was used for statistical synthesis, and the result was regarded as significant one, if its p-value was below 0.05. Results : Dampness-phelegm pattern was the most frequent out of five patterns in total participants as well as all the subgroups. In group 3 with more serious neurological deficit, larger proportion of patients in early acute stage was diagnosed as excess pattern including Fire-Heat pattern. On the other side the proportion of Deficiency of Qi and Yin was larger in late convalescent stage of group 3 than in other groups. But nothing was statistically significant. Conclusions : Further study including patients with more variant classification with follow-up evaluation is needed to reflect the real characteristics of stroke population.

• 대한한의학회지
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• 제28권4호
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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.