• Title/Summary/Keyword: STROKE

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Pathway of stroke patients seeking medical care (뇌졸중 환자의 의료이용 경로에 관한 연구)

  • Byun Young-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.149-163
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    • 2000
  • The purposes of this study were to investigate the pathway which stroke patients take in seeking medical care and to identify factors which influence that pathway. This study was conducted by a survey. The subjects were 130 adults, who were diagnosed with a stroke between January and April of 2000. Data was collected by means of a interview, questionnaires, and an Activity Index. The result of this study are summarized as follows: 1. The mean age of subject was 61.58 years. Forty-nine percent were men and fifty percent were women. The majority of the subjects were married. For educational level, thirty-three percent finished elementary school, and twenty-three percent, high school. Most of the subjects reported 'middle' economic status. Ninety-two percent lived with their spouse and children. The diagnosis for seventy-two percent was ischemic stroke and for twenty-two percent, hemorrhagic stroke. 2 The most frequent early sign of stroke was hemiplegia(43.3%), loss of consciousness (36.7%), dysarthria(33.3%). The type of hospital first used was a herb hospital(40.8%), or a western hospital(59.2%). The factors in their choice were ; distance from the hospital to the place that the stroke occurred(47.5%), desire for a herb hospital(15.8%), and an invitation(12.9%). The ischemic stroke patients preferred herb hospitals, but hemorrhagic stroke patients preferred a western hospitals. 3. The pattern of stroke patients seeking medical care was that forty-three percent of stroke patients pass through step 1, forty-six percent, through step 2, and 8.5% through step 3. The more steps, the higher the use of herb hospitals. 4. The factors influencing the pathway of stroke patients seeking medical care were diagnosis, and level of consciousness. Ischemic stroke patients used herb hospitals, more frequently hemorrhagic stroke patients, who used western hospitals. The alert patient preferred a herb hospital, but stupor patients preferred a western hospital. 5. The Activity Index was not related to the pathway which stroke patients used in seeking medical care.

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The Analysis of Relation between Cigarette Smoking and Stroke; case-control study (흡연과 중풍발생의 상관관계에 관한 환자-대조군 연구)

  • 양대진;배종면;이경섭;조기호;김영석;배형섭
    • The Journal of Korean Medicine
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    • v.22 no.4
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    • pp.69-78
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    • 2001
  • Objectives : It is known that cigarette smoking is associated with increased risk of both thrombotic and hemorrhagic stroke. However, in Korea, especially in the academic world of Korean Medicine, there is a lack of study about the relation between cigarette smoking and stroke. We carried out a case-control study to clarify the relation between cigarette smoking and stroke. Method : We interviewed 441 stroke patients (236 men, 205 women) as a case group and 432 non-stroke patients (208 men, 224 women) as a control group. We investigated the smoking pattern of all patients and stroke-subtype of the case group. Smoking pattern is classed into two (Class I), four (Class II) and five groups (Class III). Class I consists of current non-smokers and current smokers. Class II consists of non-smokers, former smokers, current light smokers and current heavy smokers. Class III consists of never smoked, secondhand smokers, former smokers, Current light smokers and current heavy smokers. Stroke-subtype consists of cerebral infarction and cerebral hemorrhage. Results : The percentage of current smokers of case group is higher significantly than that of control group. The number of cigarettes smoked per day is associated positively with the risk of stroke. According to our study, generally cigarette smoking is related with ischemic stroke. The percentage of secondhand smokers of the case group is lower than that of the control group. According to our study, characteristically secondhand smoking is associated with hemorrhagic stroke. Conclusions : From the above results we found that cigarette smoking is an important risk factor of stroke - especially cerebral infarction - and the number of cigarettes smoked per day is associated positively with the risk of stroke. Characteristically according to our study, secondhand smoking is associated with hemorrhagic stroke. Overall we conclude that cigarette smoking may be an important preventable factor for stroke.

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A study about the Life Expectancy, Quality of Life and QALYs of Stroke patients (뇌졸중 환자의 기대여명과 삶의 질, QALY에 대한 연구)

  • Kim, Nam-Kwen;Lee, Dong-Hyo;Jo, Ga-Won;Seo, Eun-Sung
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.3
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    • pp.15-26
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    • 2012
  • Objective : Only a few studies have investigated the life expectance and health related quality of life (HRQOL) about stroke patients. The purpose of this study is to analyze the life expectancy, preference based quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients. Methods : We used data of 10,533 adults from 4th Korean national health and nutritional examination survey 2009 for evaluating HRQOL of stroke patients. We also analyzed the life expectancy for stroke patients using life table from national public health data. Finally we calculated the QALYs with and without stroke conditions and assumed the difference of QALYs. Results : The mean age of stroke patients was assumed to be 65. Lower income and less educated groups were prone to be exposed to the stroke conditions. Common comorbidities of stroke patients were ischemic heart attack, hypertension, diabetes and hyperlipidemia. The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly at chronic stroke group. Participants with chronic stroke conditions had an almost 6-fold higher risk of impaired health utility(the lowest quartile of EQ-5D utility score) compared with non stroke participants, after adjustment of age, gender, income, education, comorbidity variables. The differences of life expectancy and QALYs between non-stroke and stroke group from the age of 65 till death were assumed to be 0.767 year and 3.103 QALYs. Conclusions : Although the authors analyzed the affecting factors of QOL and assumed the differences of life expectance and QALYs about stroke patients using domestic national data and statistic references, well designed cohort studies should be needed to prove the causal effects of affecting factors and to assume more correct QALY differences.

The Comparison of Risk Factors for Ischemic Stroke or Intracranial Hemorrhage in Korean Stroke Patients: A Nationwide Population-based Study

  • Choi, Sun-Young;Kim, Ji-In;Hwang, Shin-Woo
    • 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.

Clinical Study of Dysphagia in Stroke Patients (1) (Preliminary paper) (뇌졸중환자의 연하장애에 관한 임상적 연구 (1))

  • Ko, Seong-Gyu
    • The Journal of Internal Korean Medicine
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    • v.18 no.1
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    • pp.62-68
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    • 1997
  • Dysphagia generally has a good prognosis after stroke involving cerebral hemisphere or braibstem, but it could have serious consquence with dehydration leading to haemoconcentration, renal failure and aspiration leading to pneumonia. This preliminary report was written for main report. The main report will be written to give an objective guide post of management and treatment in stroke patient with dysphagia. The objective guide posts were follows as, 1. Close examination for relationship between dysphagia in stroke patients and other neurological deficits 2. Influence on the prognosis of dysphagia in stroke patients by the grade of dysphagia at admission time. 3. The realtionship between the site and size of brain damage and the grade and prognosis of dysphagia 4. The frequency and prognosis of dysphagia in stroke patients according to sex and age. 5. The rate and speed of recovery with dysphagia after stroke. 6. Frequency and process of complications, aspiration pneumonia, weight loss, sore, in stroke patient group with dysphagia.

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A Meta-Analysis of Utility Weights for Stroke (뇌졸중의 효용가중치에 대한 메타분석)

  • Heo, Ji-Haeng;Chung, Kyu-Hyuk;Lee, Eui-Kyung
    • YAKHAK HOEJI
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    • v.53 no.5
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    • pp.265-273
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    • 2009
  • The aims of this study are to conduct meta-analysis for obtaining pooled estimates of the utility weight for stroke and to explore the study design characteristics that determine the utility weight for stroke. Medline (Pubmed), CEA Registry (Tufts Medical Center), and KERIS (Korea Education & Research Information Service) were searched to find out the literature that reported quality of life with stroke. Patient characteristics, utility weights and standard errors were extracted and stratified by severity, study method, respondent and country. All estimates were measured on a 0 to 1 scale with 0 representing the death and 1 representing the perfect health. The pooled estimates of the utility weight were 0.627 for total stroke, 0.756 for mild stroke, 0.631 for moderate stroke, and 0.389 for severe stroke (p=0.0001). Non-patients showed significantly lower utility weights than patients for severe (p=0.0122) stroke.

The Clinical Efficacy of Yangkyuksanwha-tang on Acute Stroke (급성기 중풍 환자에 대한 양격산화탕의 임상적 효능)

  • 최동준;류순현;정우상;문상관;조기호;김영석;배형섭
    • The Journal of Korean Medicine
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    • v.25 no.1
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    • pp.111-116
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    • 2004
  • Objective : To assess the clinical efficacy of Yangkyuksanwha-tang on acute stroke Methods : We prescribed Yangkyuksanwha-tang to 83 acute stroke patients without thrombolytic treatment. Results : The rate of progressive stroke type was 1.2%, it was remarkably lower than previous reports. 3.6% felt an itching sensation, 3.6% complained headache, dizziness and powerless, 2.4% complained indigestion and diarrhea, 1.2% appeared hematuria and G-I bleeding. Yangkyuksanwha-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale(NIHSS), and increased Modified Barthel Index(MBI). So we could suggest that this medicine have desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, all results were within the normal value, which showed no hepatic or renal toxicity. Conclusion : We could suggest that Yangkyuksanwha-tang is a useful medicine which has clinical efficacy for acute stroke, but further investigation for an administration of more than 2 weeks is necessary.

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Recent clinical study of stroke patients (뇌졸중 환자의 최근 임상적 고찰)

  • Kim, Chan-Kyu;Oh, Myung-Hwa
    • Journal of Korean Physical Therapy Science
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    • v.9 no.1
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    • pp.177-182
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    • 2002
  • The purpose of this study is to present the tendency of stroke data on patients with stroke admitted to the hospital and to investigate the risk factors of stroke. We reviewed of 104 patients with stroke admitted to the hospital of from July 2001 to August 2001. The highest incidence of the stroke was noted in the group of 60 years of age with the rate of male(63.5%) to female(36.5%). The occurrence rate of ischemic stroke(51.9%) was higher than that of hemorrhagic stroke(48.1%). Middle cerebral arterial territory was the most commonly involved site cerebral arterial causes. The possible contributing factors of stroke were hypertension(52%), cigarette smoking(36.5%) and diabetes mellitus(18.3%). cardiac patients(16.3%). The seasonal preference was winter and autumn followed by summer and spring.

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BL-ALGEBRAS DEFINED BY AN OPERATOR

  • Oner, Tahsin;Katican, Tugce;Saeid, Arsham Borumand
    • Honam Mathematical Journal
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    • v.44 no.2
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    • pp.165-178
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    • 2022
  • In this paper, Sheffer stroke BL-algebra and its properties are investigated. It is shown that a Cartesian product of two Sheffer stroke BL-algebras is a Sheffer stroke BL-algebra. After describing a filter of Sheffer stroke BL-algebra, a congruence relation on a Sheffer stroke BL-algebra is defined via its filter, and quotient of a Sheffer stroke BL-algebra is constructed via a congruence relation. Also, it is defined a homomorphism between Sheffer stroke BL-algebras and is presented its properties. Thus, it is stated that the class of Sheffer stroke BL-algebras forms a variety.

AN EXPLORATORY STUDY COMPARING BLOOD METAL CONCENTRATIONS BETWEEN STROKE AND NON-STROKE PATIENTS IN KOREANS

  • Lee, Sun-Dong;Ko, Seong-Gyu;Kim, Rok-Ho;Hu, Howard;Amarasiriwardena, Chitra J.;Park, Hae-Mo
    • Proceedings of the Korean Environmental Health Society Conference
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    • 2005.12a
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    • pp.87-94
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    • 2005
  • Results from previous studies revealed that metal level in the body is related to certain types of diseases. For example. serum copper level with chronic heart failure, iron and transferrin in the blood serum with acute cerebral vascular diseases, Zn in the CNS, lead with neurotoxicity, hypertension, genetic damage, arsenic with cancer skin lesion, Al with neurobehavioral function (cognitive impairment and memory disorder), and etc. The rate of stroke has increased in recent years and several metals were found to be responsible for causing stroke. This study compared several blood metal concentrations between stroke and non-stroke patients. Patients with stroke (116 samples) and non-stroke (111 samples including lowback pain and others) participated in this study. Total of 227 blood samples were collected and participants completed questionnaires regarding age, gender, occupation, residence, alcohol, smoking, and etc. To be qualified into the stroke group, patients have never experienced stroke previously. Subjects only included ischemic stroke and intracerebral hemorrhage patients diagnosed by brain CT and brain MRI. Patients with high risk of metal exposure such as herbal intake and job related exposure were excluded. 10ml of blood samples were analyzed by ICP-MS method at the Center of Nature and Science at Sangji University. Metal geometric mean (SD) concentrations in blood of study subjects showed higher values, 2.64-36.12%, than WHO reference values in Mn, Ni, Hg, Se, and As. Metal concentration in blood of stroke patients non-adjusted for potential confounders was higher except for Hg and also higher except for Ni in adjusted for potential confounders. Co was significantly higher in stroke patients (p=0.002) than non-stroke patients adjusted for potential confounders. Regression coefficient values of stroke patients was 0.17-8.25 in each metals. Odd ratio of stroke patients had 0.96 (Ni)-2.68 (Co) compared to non-stroke cases. This result means that Co increase of 1 raises the risk ratio of stroke by 2.86 times. Based on the results, metal concentration in blood seems to affect incidence of stroke.

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