• Journal of Neurocritical Care
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• v.11 no.2
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• pp.102-109
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• 2018

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

• The Journal of Korean Medicine
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• v.28 no.4
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• pp.1-7
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• 2007

Objectives : This study investigated stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in both sexes. Methods : 307 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from October 2005 to May 2007. Stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in both sexes were examined. Results : Mean age was higher among women than men (64.82${\pm}$10.21 years versus 62.18${\pm}$11.52 years for the 137 female and 170 male patients, respectively, p=0.037). There were no significant differences in stroke type, ischemic stroke subtypes, or stroke risk factors except smoking and Sasang constitutions. Current smoking was more frequent in male patients (p<0.001). Stroke complications, especially urinary tract infection (UTI), were significantly more common in women (p=0.002). Conclusion : Sex does not seem to influence stroke types, ischemic stroke subtypes, or stroke risk factors except current smoking and Sasang constitutions. UTI should be taken into consideration to manage female stroke patients. Smoking cessation is indicated to prevent stroke in men.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.549-556
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• 2017

This study investigated the importance of social cognitive intervention and the cognitive rehabilitation intervention by comparing the difference and examining the relationship between neurological cognitive function and social cognitive function of stroke patients in the acute phase and chronic stroke before returning to the community. LOTCA, cartoon intention inference task, and social behavior sequence task were performed on 30 acute stroke inpatients and 30 chronic stroke patients from May 2015 to June 2016. A two sample t test was conducted to examine the differences between the groups. The Pearson's correlations test was performed to examine the correlation among the variables in each group. As a result, there were statistically significant differences between the neurological cognitive function and social cognitive function of acute stroke patients and chronic stroke patients who were undergoing rehabilitation training before returning to the community (p<0.05). A linear relationship was found between the thinking operation and social behavior sequence task in the acute stroke group (r=0.539, p<0.05). In the chronic stroke group, visual perception (r=0.530, p<0.05), visual motor organization (r=0.655, p<0.05) and thinking operation (r=0.534, p<0.05) were correlated with the cartoon intention inference task. In addition, the social behavior sequence task were correlated with visual organization (r=0.534, p<0.05) and thinking operation (r=0.764, p<0.05). As a result of multiple regression analysis, the neurological cognitive functions influencing the social cognitive function in the cartoon task was found to be the thinking operation (B = 0.431) in acute stroke patients and the thinking operation (B=0.272) and visuomotor organization (B = 0.218) in the case of chronic stroke. In addition, the results of the social behavior sequence task revealed the thinking operation (B=0.417) in the acute stroke patients, and thinking operation (B=0.267), visual motor organization(B=0.274) and visual perception(B=151) in chronic stroke patients to be significant. According to this result, there is a difference in the neurological and social cognitive levels between the two groups. Therefore, the social cognition is strongly related to the high level cognitive function as thinking operation of the neurological cognitive function. Therefore, in further research, it would be necessary to determine if there is a change in higher cognitive function in neurological cognitive function after applying a social cognition intervention program for stroke.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.799-805
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• 2009

Objectives : This study was aimed to assess characteristics in acute stroke patients according to abdominal obesity. Method : 1,506 subjects were included from the patients admitted to the Internal Medical Department at Kyunghee University Oriental Medical Center, Kyunghee University East-West Neo Medical Center, Kyungwon University Songpa Oriental Medical Center, Kyungwon University Incheon Oriental Medical Center, and D ongguk University Ilsan Oriental Medical Center from April 2007 to August 2009. Results : 1. Considering the demographic variables of the patients, the gender, older age, diabetes, hyperlipidemia and multiple infarction were significantly higher in the abdominal obesity group than in the control group. 2. Sasang constitution and oriental medical diagnosis showed significant difference in the abdominal obesity group. By oriental medical diagnosis, the D amp ness-Phlegm group was significantly higher in abdominal obesity group than in the control group. According to this analysis, we observed the general disposition of various characteristic distributions according to abdominal obesity in acute stoke patients These results can be utilized in the future as a basis material.

• The Journal of the Society of Stroke on Korean Medicine
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• v.7 no.1
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• pp.40-45
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• 2006

Objectives : This study was aimed to assess the distribution of Sasang constitution(SC) in acute stroke patients. Methods : We assessed the type of SC of acute stroke patients in the oriental medical hospitals of 3 universities located in metropolitan region from October 2005 to October 2006 by Questionnaire for the Sasang Constitution Clssification II(QSCCII). We investigated general characteristics, stroke type, blood test results, alcohol drinking, smoking and dietary preferences according to SC. Results : 236 subjects were included into the final analysis. 1. This study showed that the proportion of So-yang was highest of all constitutions(45.3%). And the body weight, body mass index, the waist circumference(WC), the hip circumference(HC), and the WC/HC ratio recorded the significantly high result in Tae-eum. 2. In the TOAST classification, SVO was the major type occupying 81.7% in the total subjects. 3. In Tae-eum, total cholesterol, triglyceride and 2 hours postprandial plasma glucose level were the highest and fasting glucose was significantly highest of all constitutions. Conclusion : From this study, we could roughly seize the distribution of Sasang constitution in acute stroke patients. For the further research, it seems to be necessary to construct fundamental databases for stroke by increasing the number of patients and by analyzing delicate characteristics of each constitution type.

• Korean Journal of Radiology
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• v.21 no.1
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• pp.101-107
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• 2020

Objective: Avoiding a catastrophic outcome may be a more realistic goal than achieving functional independence in the treatment of acute stroke in octogenarians. This study aimed to investigate predictors of catastrophic outcome in elderly patients after an endovascular thrombectomy with an acute anterior circulation large vessel occlusion (LVO). Materials and Methods: Data from 82 patients aged ≥ 80 years, who were treated with thrombectomy for acute anterior circulation LVO, were analyzed. The association between clinical/imaging variables and catastrophic outcomes was assessed. A catastrophic outcome was defined as a modified Rankin Scale score of 4-6 at 90 days. Results: Successful reperfusion was achieved in 61 patients (74.4%), while 47 patients (57.3%) had a catastrophic outcome. The 90-day mortality rate of the treated patients was 15.9% (13/82). The catastrophic outcome group had a significantly lower baseline diffusion-weighted imaging-Alberta stroke program early CT score (DWI-ASPECTS) (7 vs. 8, p = 0.014) and a longer procedure time (42 minutes vs. 29 minutes, p = 0.031) compared to the non-catastrophic outcome group. Successful reperfusion was significantly less frequent in the catastrophic outcome group (63.8% vs. 88.6%, p = 0.011) compared to the non-catastrophic outcome group. In a binary logistic regression analysis, DWI-ASPECTS (odds ratio [OR], 0.709; 95% confidence interval [CI], 0.524-0.960; p = 0.026) and successful reperfusion (OR, 0.242; 95% CI, 0.071-0.822; p = 0.023) were independent predictors of a catastrophic outcome. Conclusion: Baseline infarct size and reperfusion status were independently associated with a catastrophic outcome after endovascular thrombectomy in elderly patients aged ≥ 80 years with acute anterior circulation LVO.

• The Journal of the Society of Stroke on Korean Medicine
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• v.10 no.1
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• pp.33-39
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• 2009

Objects : This study propose to compare on general characteristics of acute stroke patients between Fire-Heat group and Deficiency of Yin group. Method : We recruited acute stroke patient within 4 weeks after stroke admitted to Department of Internal Medicine of Kyunghee University Oriental Medicial Center, Dongguk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Centar and Kyungwon University Incheon Oriental Medical Center from April 2007 to August 2009. We investigate age, sex, type of stroke, past history, general characteristics, smoking, drinking alcohol, marriage sasang constitution, etc. Result : It was significant different in sex, smoking, dringking alcohol and marriage between Fire-Heat group and Deficiency Yin group. We need more cases for another result that could associate with diagnosis of stroke. Conclusion : We found that Fire heat group was more associated with lifestyle than deficiency yin group. Further study will be needed to analysis for the diagnosis and the treatments of stroke.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.763-768
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• 2007

Objectives : This study aimed to clarify the difference in blood homocysteine levels of acute cerebral infarction patients categorized by Sasang constitutional medicine. Methods : The subjects were recruited from patients admitted to the Oriental Internal Medical Department at Kyunghee Medical Center between October 2005 and May 2007, who were classified as small vessel occlusion (SVO) patients according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST). The general characteristics along with total homocysteine levels were recorded and analyzed according to Sasang constitutional medicine. Results : A total of 151 patients were included in the trial. The prevalence of constitution was, in order, Soyangin, Taeumin, and Soeumin. No statistical significance was noted for any characteristic except body weight. There was no significant difference in blood homocysteine levels between constitutions. Conclusion : This study investigated the difference in blood homocysteine levels of acute cerebral infarction patients categorized according to Sasang constitutional medicine. Due to many limitations, the correlation between homocysteine levels and Sasang constitution was not clarified. Nevertheless, this study is significant in that it examined the largest study group to date in Oriental Medicine research history on the relation between stroke patients' homocysteine and Sasang constitution, and can be utilized in future as a basic material. Further research on the subject is needed.

• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.33-42
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• 2012

Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.296-312
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• 1998

BACKGROUND The purpose of this study was to find out predictors influencing on the clinical course of stroke during the first 4 weeks after the onset through statistical research, especially whether the blood glucose level after stroke and the stroke with Diabetes Mellitus correlate with functional impairments and neurological outcome or not. METHOD During 7 months period(from 1-1-1997 to 7-31-1997), 32 selected patients prognosed as acute cerebral thrombosis were studied by using Modified Barthel Index, PULSES profile in an attempt to correlate Diabetes Mellitus and hyperglycemia(more than $120mg/d{\ell}$, $150mg/d{\ell}$) with functional impairment and neurological outcome and to evaluate the influence of sex, the side of hemiparesis and age at admission, 1 week and 4 weeks after admision(admitted within 2 days after the onset). RESULT 1. The sex, side of hemiparesis and age had no significant effect upon functional impairment during first 4 weeks after the onset, but recurrent-stroke resulted in significantly higher degree of functional impairment than first-stroke during first 4 weeks after the onset. 2. The patients with Diabetes Mellitusin in acute cerebral thrombosis resulted in significantly higher degree of functional impairment than the patients without Diabetes Mellitus in acute cerebral thrombosis during first 4 weeks after the onset. 3. The patients with hyperglycemia in acute cerebral thrombosis resulted in significantly more severe neurological outcome than the patients without hyperglycemia in acute cerebral thrombosis within 2 days after the onset. CONCLUSION The study suggested that recurrent-stroke and Diabetes Mellitus were the poorer prognosis factors of functional impairment in acute cerebral thrombosis patients during first 4 weeks after the onset. and the poorer prognosis factor of neurological outcome in acute cerebral thrombosis patients was hyperglycemia within 2 days after the onset.