• The Journal of Korean Medicine
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• v.29 no.1
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• pp.146-155
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• 2008

Objectives : This study was to assess the effectiveness of oriental medical therapy (OM) on acute Bell's palsy, comparing its outcome with that of oriental-western medical therapy (OWM). Methods : Subjects were enrolled atKyung Hee Medical Center from March 2007 to December 2007. We prescribed Igigeopung-san and acupuncture therapy to both the OM and OWM groups, and prednisolone only to the OWM group. Effectiveness was assessed by the House-Brackmann facial nerve grading system (HBGS) and Yanagihara's unweighted grading system (YUGS) every week. Results : There were 31 patients in the OM group and 34 in the OWM group. About grading system scores and weekly score gaps, no significant differences were revealed between the two groups, but statistical significant difference was detected at recovery time. After 2 weeks of treatment, the OM group's HBGS score showed significant difference from baseline score, but the OWM group showed it after 1 week. After 3 weeks of medication, pain was reduced in 22% of OM group patients, but 50% in the OWM group (p=0.028). We made the same comparison study for patients treated within 4 days from onset, but there was no significant difference between the two groups. 3 cases of adverse effect of hyperglycemia were found in the OWM group, which could be due to hyperglycemic side-effect of prednisolone. Conclusion : This work could help us to understand the effectiveness of OM compared to OWM on acute Bell's palsy.

• The Journal of the Society of Stroke on Korean Medicine
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• v.9 no.1
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• pp.19-24
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• 2008

Objectives : This study was conducted as part of the national project to standardize stroke diagnosis in Korean medicine. In this study, we assessed what categories of stroke diagnosis these three most common risk factors of cerebro-vascular attack(CVA), hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) fall into. Also we looked into stroke subtypes and its diagnosis in Korean medicine. Methods : 806 patients with acute stroke from 5 universities(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) across the country were involved from April, 2007 til August, 2008. We had data of 482 patients to be analyzed and diagnosed by a Korean medicine training doctor and a professor. Results : All three major stroke risk factors were diagnosed as being dampness-phlegm pattern, but no significant difference was observed except in hyperlipidemia patients. Stroke subtypes such as hemorrhage and infarction showed no significant difference in this study. Conclusions : This study provides evidence that hyperlipidemia can be diagnosed as dampness-phlegm by Korean medicine. Further studies with various subtypes of stroke patients are required to prove solid evidence with other stroke risk factors.

• Journal of Preventive Medicine and Public Health
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• v.40 no.2
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• pp.130-136
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• 2007

Objectives : Recent educational efforts have concentrated on patient's early hospital arrival after symptom onset. The purpose of this study was to evaluate the time interval between symptom onset and hospital arrival and to investigate its relation with clinical outcomes for patients with acute ischemic stroke. Methods : A prospective registry of patients with signs or symptoms of acute ischemic stroke, admitted to the OO Medical Center through emergency room, was established from September 2003 to December 2004. The interval between symptom onset and hospital arrival was recorded for each eligible patient and analyzed together with clinical characteristics, medication type, severity of neurologic deficits, and functional outcomes. Results : Based on the data of 256 patients, the median interval between symptom onset and hospital arrival was 13 hours, and 22% of patients were admitted to the hospital within 3 hours after symptom onset. Patients of not-mild initial severity and functional status showed significant differences between arrival hours of 0-3 and later than 3 in terms of their functional outcomes on discharge. Logistic regression models also showed that arrival within 3 hours was a significant factor influencing functional outcome (OR=5.6; 95% CI=2.1, 15.0), in addition to patient's initial severity, old age, cardioembolism subtype, and referral to another hospital. Conclusions : The time interval between symptom onset and hospital arrival significantly influenced treatment outcome for patients with acute ischemic stroke, even after controlling for other significant clinical characteristics. The findings provided initiatives for early hospital arrival of patients and improvement of emergency medical system.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.2
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• pp.154-162
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• 2003

Purpose: The purpose of this study was to investigate factors which can delay hospital arrival for patients with acute stroke. Method: The participants for this study were 102 patients who were admitted to the Department of Neurology in a hospital in Chungnam province. Data were collected from Oct, 2002 to June, 2003. The data were analyzed with frequencies, percentages, and $x^2$ test using the SPSS PC program. Result: The results of this study were as follows: 1. Only 33.8 % of participants arrived at the hospital within 3 hours. 2. Educational level, economic status, people living in same residence, and place of residence were factors which significantly affected prehospital delay time. Also there were significant differences in prehospital delay time according to family history of stroke, day of the week when symptoms began, perception of seriousness of symptoms, type of hospital first used, and transportation. Conclusion: Therefore, to reduce prehospital delay time, educational programs which focus on the above factors need to be developed. Also, a public campaign for utilizing emergency service to reduce transportation time for acute stroke patients need to be facilitated.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.73-86
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• 2021

Purpose : This study aimed to investigate the effects of oropharyngeal sensory stimulation using low-temperature capsaicin on dysphagia, dietary level, aspiration pneumonia, and nutritional status in acute stroke patients with dysphagia admitted to a stroke intensive care unit. Methods : This study used a randomized controlled trial design and 43 participants were randomly assigned to the experimental group (n=21) or control group (n=22). An oropharyngeal sensory stimulation intervention program was constructed based on previous studies. The intervention was provided before meals twice a day for seven days and started with the first meal after hospitalization. In the control group, a solution was made using only bottled water without adding capsaicin solution, and the intervention was provided at the same time, method, and number of times as the experimental group. Results : As a result of the study, dysphagia and dietary level improved in the experimental group that received oropharyngeal sensory stimulation using capsaicin. There were no effects on the nutritional status or aspiration pneumonia. Conclusion : This study provides basic data for the development of an intervention program for patients with dysphagia by presenting a theoretical basis that oropharyngeal sensory stimulation intervention using capsaicin improves dysphagia and dietary levels.

• The Korean Journal of Health Service Management
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• v.12 no.2
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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.

• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.43-51
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• 2012

Object : The purpose of this study was to evaluate the relationship between pattern identification (PI) and stroke risk factors, such as hypertension, diabetes mellitus, dyslipidemia, stroke history, obesity, abdominal obesity and metabolic syndrome. Methods : 46 patients with acute ischemic stroke were recruited from May 2012 to November, 2012. We analyzed the data of 32 patients, and pattern identification was identified by resident and specialist of Korean medicine. We analized patient's PI and risk factor by Fisher's exact test. Results : We found that Dampness-phlegm group was more related with patient's metabolic syndrome than non Dampness-Phlegm group. And Yin deficiency group had less relationship with patient's metabolic syndrome, obesity, abdominal obesity and dyslipidemia than non Yin deficiency group. Conclusions : According to the analysis, these results provide evidence for relationship between the Dampness-phlegm group, Yin deficiency and metabolic syndrome.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.3
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• pp.573-581
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• 2011

This study was done to examine the risk factors between controls group and acute brain infarction patients group, and to compare high risk group with low risk group through NIHSS(National Institutes of Health stroke scale). We compared the risk factors between acute brain infarction patients group(N=180) and controls group(N=93). And according to risk factors, we analyzed 1st NIHss, after 3 weeks improved extent within acute brain infarction patients group. The results were as follows. 1. Among the risk factors, HTN, DM, the blood levels of HCY were significantly higher and the blood levels of HDL-C was significantly lower in patients group than controls group. 2. In scale analysis according to risk factors, 1st NIHss were significantly higher in Hypo-HDL-cholesterolemia, Obesity, High-Homocysteine, HTN, DM, previous CVA history group than low risk group within acute brain infarction patients group. 3. In after 3 weeks improved extent analysis according to risk factors, improved extent were lower in Hyperlipidemia, HTN, DM, previous cardiac history, older age group than low risk group within acute brain infarction patients group. The above results suggest that significant risk factors of acute brain infarction, and shows the High risk group that had risk factor of brain infarction recognized from the former research tends to have higher 1st NIHss. Also the High risk group tends to have lower improved extent, but the results are not statistically significant. Furthur research on subject is needed.

• The Journal of Internal Korean Medicine
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• v.34 no.4
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• pp.428-437
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• 2013

Objectives : The aim of this study was to examine if there is a significant correlation between the changes of Fire- and Heat- related symptoms and motor function recovery in acute cerebral infarction patients. Methods : We studied inpatients within a month after the onset of cerebral infarction who were admitted at Kyunghee University Medical Center from May 2011 to January 2013. We executed correlation analysis between Fire-heat pattern score and motricity index score at visit 1 and visit 2, and checked if there was a significant correlation between the changes of Fire-heat pattern score and changes of motricity index score. Also, we compared the changes of both scores in patients taking Fire-heat and non Fire-heat pattern prescriptions. Results : There was a significant correlation between the Fire-heat pattern score and Motricity index score at visit 1 and visit 2, and changes of Fire-heat pattern score showed significant correlation with changes of motricity index score. Patients taking Fire-heat pattern prescriptions showed significant change in Fire-heat pattern score after herb-medication treatment while patients taking non-Fire-heat prescriptions showed insignificant change in Fire-heat pattern score. Conclusions : This study provides evidence that taking a Fire-heat pattern prescription could be considered as a first line herb-medication treatment in acute cerebral infarction patients.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.102-108
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• 2018

Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation. Design: Retrospective study. Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cut-off values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups. Results: The optimal MCID cut-off point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively. Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.