• 대한한방내과학회지
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• 제29권4호
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• pp.1011-1024
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• 2008

Objectives : The aim of this study was to assess the distribution of general characteristics and risk factors according to onset time in acute stroke patients. Methods : We studied hospitalized patients within 4 wks after the onset of stroke who were admitted to the Department of Internal Medicine at Kyunghee University Oriental Medical Hospital, Kyunghee University East-West Neo Medical Hospital, Kyungwon University Songpa Oriental Medical Hospital, Kyungwon University Incheon Oriental Medical Hospital, and Dongguk University Ilsan Oriental Medical Hospital from April 2007 to August 2008. The 24-hour day was divided into quartiles (6:00 to 12:00, 12:00 to 18:00, 18:00 to 24:00 and 24:00 to 6:00). We analyzed the general characteristics and risk factors according to onset time in acute stroke patients. Results : 468 subjects were included into the final analysis. 1. The most common time period for ischemic stroke onset was between 6:00 and 12:00. It demonstrated a 50% excess risk between 6:00 and 12:00. 2. On the demographic variables of the patients, the rate of hypertension was significantly higher from 18: 00 to 24: 00 than 24:00 to 6:00. 3. There was no significant difference of stroke type, Sasang constitution, or lifestyle between times. 4. According to the blood test, high density lipoprotein cholesterol was significantly higher at 24:00 to 6:00 and lower at 12:00 to 18:00 than other time-groups. 5. The patients diagnosed with metabolic syndrome were significantly more at 12:00 to 18:00 and fewer at 24:00 to 6:00. 6. Hypertension and coffee drinking showed close relationship with patients whose stroke occurred while awake in multivariate analysis. Conclusions : The above results showed that the overall tendency of acute stage cerebral infarction patients varied according to their onset time. These results can be utilized in the future as a basis material.

• 대한중풍순환신경학회지
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• 제12권1호
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• pp.41-49
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• 2011

Objective : Stroke is the most common disabling neurological disease of adult life. And some part of the clinical symptoms and signs are correlated to the post stroke complication. This study was to analyze the therapeutic effect of the East-West collaborative treatment, especially on the motor power and the clinical symptoms and signs improvement of ischemic stroke patients. Method : For 2 weeks as possible, we observed the patients with acute ischemic stroke receiving East-West collaborative treatment. We assessed the patients using Motricity Index (MI) and the changes of clinical symptoms and signs three times at seven-day intervals. At the end of the study, we compared the results. Result : Motricity Index of patients changed from 71.55 to 76.03 (upper limb) and 73.05 to 79.42 (lower limb), respectively. Some items of clinical symptoms and signs showed the statistically significant result. Especially, the urination and defecation symptoms improved obviously. Conclusion : The East-West collaborative treatment has an effect on motor power and clinical symptoms and signs improvement of acute ischemic stroke patients.

• Journal of Korean Neurosurgical Society
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• 제50권2호
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• pp.89-94
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• 2011

Objective : D-dimer is a breakdown product of fibrin mesh after factor XIII stabilization. Previously, many authors have demonstrated a relationship between D-dimer level and stroke progression or type. This study aimed to investigate the relationship between D-dimer level and stroke volume. Methods : Between January 2008 and December 2009, we analyzed the D-dimer levels of 59 acute ischemic stroke patients in our neurosurgical department both upon admission and after seven days of initial treatment. Each patient's National Institute of Health Stroke Scale score, modified Rankin Scales score, Glasgow outcome score, and infarction volume were also evaluated. Results : Mean D-dimer level at admission was 626.6 ${\mu}g/L$ (range, 77-4,752 ${\mu}g/L$) and the mean level measured after seven days of treatment was 238.3 ${\mu}g/L$ (range, 50-924 ${\mu}g/L$). Mean D-dimer level at admission was 215.3 ${\mu}g/L$ in patients with focal infarctions, 385.7 ${\mu}g/L$ in patients with multiple embolic infarctions, 566.2 ${\mu}g/L$ in those with 1-19 cc infarctions, 668.8 ${\mu}g/L$ in 20-49 cc infarctions, 702.5 ${\mu}g/L$ in 50-199 cc infarctions, and 844.0 ${\mu}g/L$ in >200 cc infarctions (p=0.044). On the 7th day of treatment, the D-dimer levels had fallen to 201.0 ${\mu}g/L$, 293.2 ${\mu}g/L$, 272.0 ${\mu}g/L$, 232.8 ${\mu}g/L$, 336.6 ${\mu}g/L$, and 180.0 ${\mu}g/L$, respectively (p=0.530). Conclusion : Our study shows that D-dimer level has the positive correlation with infarction volume and can be use to predict infarction-volume.

• The Journal of Korean Physical Therapy
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• 제25권4호
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• pp.224-231
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• 2013

Purpose: The purpose of this case study was to investigate three poor fibrinolytic responders with chronic ischemic stroke to acute exercise intensity and time. Methods: Three ischemic stroke patients (male) from the stroke center located at Busan metropolitan area in Republic of Korea volunteered at this study. They performed two single session exercises that were a VO2peak test and a single bout treadmill walking (70-75%HRpeak, 30 min, 50min). Fasting blood samples for determination of tissue Plasminogen Activator (tPA) and Plasminogen Activator Inhibitor-1 (PAI-1) were obtained before, immediately after, 30min after acute exercise. SPSS 12.0 was used for analyzing of data and computing mean and standard deviation, and change rate was conducted between times. Results: In fibrinolytic activity according to the intensity and time of acute exercise, tPA change increased steadily during the recovery stage after the VO2peak in the cases, but PAI-1 activity showed different patterns among the cases. In a single bout treadmill walking (70-75%HRpeak, 30 min, 50min), tPA change increased between 30min and 50min. Conclusion: In conclusion, these results suggest that the exercise prescription for poor fibrinolytic responder with three male chronic ischemic stroke patients without motor disability recommend at 70-75%HRpeak, over 30min.

• 대한한방내과학회지
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• 제28권1호
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• pp.34-46
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• 2007

Objectives: This study was to assess characteristics in acute stroke patients according to Sasangconstitution (SC). Methods : We assessed the type of SC of acute stroke patients in $2^{nd}$ Department of Internal Medicine at KyungHee University Oriental Hospital from October 2005 to September 2006. Each subject's SC type was confirmed when the result of QSCC II+ was in accordance with the opinion of the Sasangconstitutional medicine specialist. We investigated general characteristics, stroke type, blood test results, alcohol drinking, smoking and dietary preferences according to SC. Results: 108 subjects were included in the final analysis. This study showed that out of the total patients, the proportion of So-yang to Tae-eum to So-eum was equal to 5.5 to 3.5 to 1. Especially, men were higher proportion So-yang while women recorded a more significant ratio of Tae-eum. Also, the BMI, waist circumference, hip circumference, and WC/HC ratio recorded significantly high results. The result indicated that even though the Tae-eum let on the highest numerical value in the aspect of their past history and the final diagnosis, no significant difference was revealed according to SC. The ratio of cerebral infarction to cerebral hemorrhage was 9 to 1. SVO, LAA, SUE are the 3 types of cerebral infarction classified by TOAST; SVO ranked the highest while SUE ranked the lowest in all constitutions. The blood test result displayed that averages of both TL and the T-chol were the highest in Tae-eum while that of hematocrit in So-yangand that of HDL-chol in So-eum. However, there was no significant difference. There were no significant differences classified by gender or by SC in the aspect of the alcohol drinking and smoking history. The majority of So-yang and Tae-eum demonstrated a preference for meat while So-eum and So-yang displayed high preferences for sea food. Conclusions : With respect to these results. we could observe the general disposition of various characteristic distributions according to SC of acute stroke patients. For further research in this field. it seems necessary to construct fundamental databases for the prevention and treatment of stroke by increasing the number of patients observed and by analyzing delicate characteristics of each constitution type.

• 대한한방내과학회지
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• 제29권1호
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• pp.149-159
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• 2008

Background and Purpose : This study was to assess characteristics in acute stroke patients according to obesity and abdominal obesity. Methods : From1 Oct. 2005 to 31 Jul. 2007, 629 patients with a stroke were included. Patients were hospitalized within 30 days after the onset of stroke at Kyungwon University Incheon Oriental Hospital, DongGuk University International Hospital and Department of Cardiovascular and Neurologic Disease (Stroke Center), or Kyung Hee University Oriental Hospital. We investigated general characteristics preferences according to general obesity and abdominal obesity. Results : 629 acute stroke patients were included in the final analysis. Male, young age, hypertension, heart disease in the family history, hypertension in the past history, care of invalids or grandchildren and Taeumin in the Sasang constitution were higher among obese patients. Male, transient ischemic attack in the past history, smoker and Soyangin in the Sasangconstitution were higher among patients with abdominal obesity. The incidence of abdominal obesity corresponded to lower education level. Conclusions : In our study, we observed the general disposition of various characteristic distributions according to obesity and abdominal obesity in acute stroke patients.

• 대한중풍순환신경학회지
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• 제11권1호
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• pp.1-8
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• 2010

Objectives : We designed this study to investigate difference of heart rate variability(HRV) according to sex, age, acute or chronic phase, category of stroke, national institute of health stroke scale(NIHSS), lesion of stroke. Methods : 64 subjects were recruited from the patients admitted to the department of oriental medicine at East-West Neo Medical Center, Kyung Hee University from 1 September 2009 to 31 August 2010. We compared heart rate(HR), standard deviation of all normal P-P intervals(SDNN), low frequency(LF), high frequency(HF), LF/HF ratio. Results and Conclusions : 1. LF/HF ratio is significantly different between over-70 and below-70 of age. 2. SDNN is significantly different between acute and chronic stroke patients. 3. In sex, category of stroke, national institute of health stroke scale(NIHSS), lesion of stroke, there are no significantly different among the any values of heart rate variability(HRV).

• 한국산학기술학회논문지
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• 제18권5호
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• pp.355-365
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• 2017

본 연구의 목적은 급성기 뇌졸중 환자를 대상으로 수공예 작업치료 프로그램 활동을 시행하였을 때 인지기능과 손 기능에 미치는 효과를 알아보고, 추후 급성기 뇌졸중 환자의 중재방법에 대한 유용한 자료를 제공하는 것이다. 본 연구의 진행은 서울 경기도에 위치한 A종합병원, B재활병원에 입원 중인 뇌졸중 환자 30명을 대상으로 2016년 3월부터 2016년 11월까지 두 그룹을 무작위 할당한 후 실험군에는 수공예 프로그램 활동을 4주 동안 주 2회, 30분간 적용하고 그룹 간 비교를 실시하였다. 치료 전 후에 뇌졸중 환자의 인지기능과 손 기능을 평가하기 위해서 사용한 평가도구는 Box & Block Test, Jebsen-Taylor Hand Function Test, Neurobehavioral Cognitive Status Examination(NCSE), Trail-Making Test이다. 결론적으로 중재 전 후 비교에서 수공예 프로그램 활동군의 손 기능 평가가 유의하게 향상되었고(p<.05), 인지기능도 유의하게 향상되었다(p<.05). 본 연구의 결과를 통해서 수공예 프로그램 활동이 급성기 뇌졸중 환자의 인지기능과 손 기능 향상에 더 효과적임을 파악한 점에서 연구의 의의를 지니며, 향후 급성기 뇌졸중 환자의 작업치료 중재 프로그램의 개발 및 적용 시 기초자료로 의미있게 활용될 수 있을 것이다.

• 대한방사선기술학회지:방사선기술과학
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• 제39권4호
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• pp.543-547
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• 2016

급성 뇌졸중(acute stroke)의 경우 빠른 처치가 이루어지지 않으면 뇌손상으로 인해 평생 장애를 가지고 살아가야 하는 질환이다. 따라서 뇌졸중 환자가 발생할 경우에는 신속한 진단과 치료가 이루어져야 하므로 장시간의 검사를 해야 하는 MRI 보다는 빠른 검사와 3D 구현이 가능한 뇌 관류전산화단층촬영(Brain Perfusion CT)이 널리 활용되고 있다. 그러나 환자에게 많은 방사선 피폭이 이루어질 수 있기 때문에 저선량(low dose) 기법을 사용하여 영상을 획득하게 된다. 이로 인해 촬영된 영상의 질 저하가 유발되며, 특히 가우시안노이즈의 영향을 크게 받아 정확한 혈관 영상의 확인을 저해한다. 본 연구에서는 관류전산화단층촬영을 통해 얻어진 동적 CT 데이터에 시공간 분석 기법을 적용하여 진단 영상의 질을 향상시키고자 한다. 특히, 가우시안노이즈를 제거하기 위해서 선형 특징 축출 방법 중 하나인 주성분 분석 기법을 적용하여 분석하였으며, 그 결과 시공간 특징에 따른 각각의 관류 영상 성분을 축출한 경우 뇌-혈관 영상뿐만 아니라 뇌-실질 영상의 질이 향상됨을 가시적으로 확인할 수 있었다. 새롭게 시도된 시공간 기반 영상기법이 향후 급성 뇌졸중 진단뿐만 아니라 다양한 시계열 정보가 포함된 뇌질환 진단 영상분석에 활용된다면, 임상 진단의 질 향상에 도움이 될 것이라 기대한다.

• 대한한의학회지
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• 제30권2호
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• pp.56-62
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• 2009

Objectives: We tried to clarify the relationship between lifestyle and plasma homocysteine concentration. We analyzed the data of patients with acute ischemic stroke from the Hanbang stroke registry supported by the Ministry of Science and Technology of Korea. Methods: 458 subjects were recruited from the patients admitted to the Internal Medical Department of Kyunghee University oriental medical center, Dongguk University Ilsan oriental medical center, Kyungwon University Songpa oriental medical center and Kyungwon University Incheon oriental medical center from April 2007 to August 2008. We divided the subjects into four groups by quartiles of plasma homocysteine concentrations and compared the first and last quartile groups. Results: 1. In univariate analysis, the high homocysteine concentration group showed higher rate of older age, male gender, smoking, drinking and lower values in vitamin B12, folic acid, creatinine than the control group with statistical significance. 2. In multivariate analysis, older age, male gender smoking and folic acid showed a close relationship with statistical significance (each OR=3.620, OR=4.218, OR=3.558, OR=0.789). Conclusions: According to the analysis, the relationship between high homocysteine concentration and smoking in patients with acute ischemic stroke were clarified. We hope to standardize and establish criteria on homocysteine in Korea by large epidemiological survey. These study results could be utilized in the future as a basis material.