• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.437-448
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• 2018

Objective: Acute ischemic stroke (AIS) requires time-dependent reperfusion therapy, and early recognition of AIS is important to patient outcomes. This study was conducted to identify the clinical features and risk factors of AIS patients that are missed during the early stages of diagnosis. Methods: We retrospectively reviewed AIS patients admitted to a hospital through the emergency department. AIS patients were defined as ischemic stroke patients who visited the emergency department within 6 hours of symptom onset. Patients were classified into two groups: an activation group (A group), in which patients were identified as AIS and the stroke team was activated, and a non-activation group (NA group), for whom the stroke team was not activated. Results: The stroke team was activated for 213 of a total of 262 AIS patients (81.3%), while it was not activated for the remaining 49 (18.7%). The NA group was found to be younger, have lower initial National Institutes of Health Stroke Scale scores, lower incidence of previous hypertension, and a greater incidence of cerebellum and cardio-embolic infarcts than the A group. The chief complaints in the A group were traditional stroke symptoms, side weakness (61.0%), and speech disturbance (17.8%), whereas the NA group had non-traditional symptoms, dizziness (32.7%), and decreased levels of consciousness (22.4%). Independent factors associated with missed stroke team activation were nystagmus, nausea/vomiting, dizziness, gait disturbance, and general weakness. Conclusion: A high index of AIS suspicion is required to identify such patients with these findings. Education on focused neurological examinations and the development of clinical decision tools that could differentiate non-stroke and stroke are needed.

• Physical Therapy Korea
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• v.18 no.2
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• pp.52-59
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• 2011

The purpose of this study was to examine the relationship of the Stroke Rehabilitation Assessment of Movement (STREAM), the Berg Balance Scale (BBS), and the Modified Barthel Index (MBI) in the acute stroke care setting. Twenty patients with their first stroke were evaluated using STREAM, BBS, and MBI initially and at 4 weeks. The data was analyzed using the independent t-test, paired t-test, and the Pearson product moment correlation analysis. The scores on the STREAM were strongly associated with the scores on both the BBS and MBI (with Pearson correlation coefficients ranging from .88 to .95), and there was significant improvement between the initial scores and those obtained four weeks later for STREAM, BBS, and MBI (p=.001, p=.001, p<.001). The results suggest that STREAM may be able to reflect functional recovery and to assess voluntary movement in patients who have suffered an acute stroke.

• Journal of Korean Critical Care Nursing
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• v.2 no.1
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• pp.26-35
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• 2009

Purpose: This paper reviews current diagnostic evaluation, treatment, nursing considerations, and the nurse practitioner’s (NP) role in acute ischemic stroke care. Methods: National guidelines and extensive literature on acute stroke care were reviewed and a relevant clinical case was introduced. Results: Computerized tomography (CT) of the head without contrast is the initial brain imaging procedure for patients with an acute stroke. Magnetic resonance imaging (MRI) can be an alternative test. Restoration of cerebral perfusion to the affected area is a key therapeutic strategy for ischemic stroke. A number of treatment strategies such as thrombolysis, anticoagulation, antiplatelet, and surgical treatment can be selected to improve blood flow to the ischemic region. The NP on the stroke team is involved with immediate stroke management including neurological assessment, ensuring adequate oxygenation, blood pressure management, activity, and diet. Discharge planning with the patient, family teaching and coordination of follow up care should also be implemented early in the hospitalization. Conclusion: The nurse practitioner is one of the cardinal members on the stroke team, and must be updated with current treatment and management guidelines.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.2
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• pp.137-151
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• 2003

The purpose of this study was to develop a multidisciplinary team approach program for stroke survivors, and to identify its effects on their rehabilitation. The team was composed of 7 members: a rehabilitation nurse, a physician, a physical therapist, an occupational therapist, a therapeutic recreational therapist, a nutritionist, and a researcher. A quasi-experimental study was performed with 36 subjects: 18 in the experimental group and 18 in the control group, using a noneqivalent control group pretest-posttest design. The experimental group participated 4 times in rehabilitation programsfocused on information and emotional support provided by the rehabilation team-and received telephone counseling from the researcher. The control group did not receive any treatment. The selection criteria for the subjects in this study were: (a) patients who were diagnosed as having had an ischemic stroke within the last year, (b) patients free of any communication disorder, (c) and those having a primary caregiver who could assist in filling out the form assessing the level of ADL. The data were collected from patients who had been discharged from a tertiary hospital, between October 1st, 1999 and September 30th, 2000. The data were analysed by $X^2$ test, Fisher's exact test, ANCOVA, Wilcoxon's rank sum test, and Wilcoxon's signed rank test using an SAS program. The results were as follows: 1. In terms of physical variables (blood pressure, grasp power, and ADL) 1) There was a significant difference in blood pressure between the two groups (systolic pressure P= .012, diastolic pressure P= .050). 2) There was also a significant difference in grasp power between the two groups (affected side : P= .012, unaffected side : P= .010). 3) There was no significant change in the level of ADL between the two groups. 2. In terms of psychosocial variables (depression, self-efficacy, self-esteem, and social activities) 1) There were no significant differences between the two groups. However, all four psychosocial variables showed a tendency to improve in the experimental group, while only two variables (depression and self-efficacy) showed a simalar tendency in the control group. 2) The level of social activities in the control group decreased significantly after a month (P= .050). 3. The level of life satisfaction improved in both groups, but no significant difference was found. Stroke has high recurrence rate and requires considerable follow-up care. The program used in this study was developed and designed for stimulting the rehabilitation process of stroke survivors. Through the program period of one month (meetings were held weekly), a positive effect was detected in physical variables, although the psychosocial variables did not improve significantly. In retrospect, a one month period may not be an adequate length of time to improve the psychosocial variables, as the stroke survivors were complicated cases, and most of them were elderly. Further research is therefore recommended by increasing the length of program, so that its effect can be more noticeable.

• Journal of the Society of Naval Architects of Korea
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• v.60 no.2
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• pp.95-109
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• 2023

In the 4th industrial revolution, changes in the technological paradigm have had a direct impact on the maintenance system of ships. The 2-stroke low speed engine system integrates with the core equipment required for propulsive power. The Condition Based Management (CBM) is defined as a technology that predictive maintenance methods in existing calender-based or running time based maintenance systems by monitoring the condition of machinery and diagnosis/prognosis failures. In this study, we have established a framework for CBM technology development on our own, and are engaged in engineering-based failure analysis, data development and management, data feature analysis and pre-processing, and verified the reliability of failure mode DB using LSTM algorithms. We developed various simulated failure mode scenarios for 2-stroke low speed engine and researched to produce data on onshore basis test_beds. The analysis and pre-processing of normal and abnormal status data acquired through failure mode simulation experiment used various Exploratory Data Analysis (EDA) techniques to feature extract not only data on the performance and efficiency of 2-stroke low speed engine but also key feature data using multivariate statistical analysis. In addition, by developing an LSTM classification algorithm, we tried to verify the reliability of various failure mode data with time-series characteristics.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.27-38
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• 2020

Purpose: Stroke is a time-sensitive disease that could have reduced complications and mortality with timely diagnosis and treatment. This study aimed to analyze the causes of delay in detecting the clinical signs and symptoms of stroke. Methods: This retrospective observational study analyzed the emergency medical services reports of suspected stroke patients with positive predictive values on the Cincinnati Prehospital Stroke Scale. The study was conducted in Daejeon, Republic of Korea from January 1, 2016 through December 31, 2017. Results: Prolonged prehospital time was associated with high blood pressure, history of cerebrovascular disease, and incidences during daily activities, and sleep. High blood pressure and complications from a previous stroke strongly associated with the prolonged stroke-detection phase (p<.05). Total prehospital time was shortened when patients had evident stroke symptoms, such as decreased level of consciousness, dysarthria, and hemiplegia (p<.05). There was no significant difference in gender or age as a factor that delayed the total prehospital time of the suspected stroke patients. Conclusion: Many patients did not recognize the early clinical symptoms and signs of a stroke. Furthermore, risk factors, such as high blood pressure and history of stroke, prolonged the total prehospital time. Therefore, we need targeted interventions that educate about warning symptoms of stroke, along with emphasis on the importance of emergency calls to substantially reduce the prehospital delays.

• Physical Therapy Korea
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• v.17 no.3
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• pp.11-19
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• 2010

The purpose of the study was to determine the effects of balance training with 'TETRAX' system, a balance training and assessment tool, on balance and mobility in acute hemiplegic patients. Nineteen matched subjects were assigned randomly into either an experimental group or a control group. An experimental group with 10 subjects received balance training with 'TETRAX' exercise program and conventional physical therapy interventions 5 times per week during 4 weeks. A control group with 9 subjects received conventional physical therapy interventions 5 times per week during 4 weeks. Outcome measures were taken before and after 4 weeks of interventions using the Stroke Rehabilitation Assessment of Movement (STREAM), the Berg Balance Scale (BBS), gait speed, and the fall down index. Results indicated that both exercise groups improved significantly in STREAM, BBS, and gait speed (p<.05). The experimental group had a little improvement than the control group. Both exercise groups did not show statistical significance in fall down index (p<.05). Following 4 weeks of intervention, except gait speed there was no statistically significant difference between two groups. However, these findings suggest that conventional physical therapy interventions with visual feedback training could be effective on improving balance and mobility than conventional physical therapy alone in acute hemiplegic patients.

• The Journal of Internal Korean Medicine
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• v.33 no.4
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• pp.347-366
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• 2012

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

• Journal of the Korean Society of Propulsion Engineers
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• v.24 no.6
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• pp.28-44
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• 2020

In this paper, the scavenging process of various transfer ports was evaluated to improve the performance of a small two-stroke engine for unmanned aerial vehicles. Three-dimensional computational fluid dynamics simulations were performed to four transfer ports for the evaluation, and a three-phase scavenging model was developed and applied to the simulation results for the quantitative comparison of scavenging performance. the short-circuit of fresh charge was restrained and an in-cylinder turbulent kinetic energy was enhanced by changing the transfer port. Also, a difference in the scavenging for each port were confirmed by applying the three-phase model to the simulation results.

• International Journal of Advanced Culture Technology
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• v.7 no.4
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• pp.1-13
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• 2019

Purpose: Rehabilitation nursing requires an interdisciplinary comprehensive team approach that allows for enough time to promote patients' functional recovery. We identified the effects of a nurse-led rehabilitation intervention program on subacute stroke patients' activities of daily living, anger, and muscle strength, as well as their chief caregivers' satisfaction. Methods: Intervention group participants (n = 20) completed a rehabilitation intervention program, which integrated physical activities with psychological and social approaches. Results: The program did not significantly improve patients' activities of daily living or anger management; however, it significantly affected both anger-in (t = 3.384, p = .002) and anger-out (t = 2.167, p = .037) attitudes. Caregivers' satisfaction among the intervention group (t = 6.935, p < .001) decreased more significantly than that of the comparison group (t = 0.224, p = .825). Conclusion: Rehabilitation intervention program should enlist nurses' participation and promote a team-based approach during the rehabilitation program. Further, patients and their caregivers should be encouraged to express their emotions during counseling.