• 제목/요약/키워드: Two-stroke

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Endovascular Stroke Therapy Focused on Stent Retriever Thrombectomy and Direct Clot Aspiration : Historical Review and Modern Application

  • Kang, Dong-Hun;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • 제60권3호
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    • pp.335-347
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    • 2017
  • Intravenous recombinant tissue plasminogen activator had been the only approved treatment for acute ischemic stroke since its approval in 1995. However, the restrictive time window, numerous contraindications, and its low recanalization rate were all limitations of this modality. Under those circumstances, endovascular stroke therapy went through a great evolution during the past two decades of intravenous thrombolysis. The results of the 2013 randomized trials for endovascular stroke therapy were neutral, although they were limited by insufficient imaging screening at enrollment, early-generation devices with less efficacy, and treatment delays. Huge progress was made in 2015, as there were five randomized clinical trials which all demonstrated the safety and efficacy of endovascular stroke treatment. Despite differences in detail patient enrollment criteria, all 5 trials employed key factors for good functional recovery; (1) screening with non-invasive imaging to identify the proximal occlusion and exclude a large infarct core, (2) using highly effective modern thrombectomy devices mainly with stent retriever, and (3) establishment of a fast workflow to achieve effective reperfusion. The results of those trials indicate that modern thrombectomy devices can allow for faster and more effective reperfusion, which can lead to improved clinical outcomes compared to intravenous thrombolysis alone. These advances in mechanical thrombectomy are promising in the global fight against ischemic stroke-related disability and mortality. Two current mainstreams among such mechanical thrombectomy techniques, "stent retriever thrombectomy" and "direct clot aspiration", are the topic of this review. Stent retriever thrombectomy using Solitaire and Trevo retriever will be firstly discussed. And, the commonalities and the differences between two major clot aspiration thrombectomy techniques; a direct aspiration first pass technique (ADAPT) and forced arterial suction thrombectomy (FAST), will be additionally explained. Finally, details regarding the combination of direct clot aspiration and stent retriever thrombectomy, the switching strategy and the Solumbra technique, will be described.

장염을 동반한 뇌졸중환자의 시령탕을 이용한 호전 2례 (Effects of Shirhyung-Tang in Two Stroke Patients with Pseudomembranous Colitis)

  • 노기환;정기현;조기호;김영석
    • 대한한의학회지
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    • 제22권3호
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    • pp.179-188
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    • 2001
  • Diarrhea is the frequent passage of loose, watery stool (frequency: ${\geq}4/day$, weight: ${\geq}250g/day$) Most antibiotics can cause inflammatory change of the colon or Pseudomembranous colitis (PMC). Typical presentations of PMC are watery diarrhea, abdominal pain, fever, leukocytosis ($12,000~20,000/\textrm{mm}^3$), hypoalbuminemia, hypovolemia and recent or concurrent use of antibiotics. Diagnostic methods of PMC are stool assay, sigmoid scopy, abdominal CT, abdominal US, etc. The age-related susceptibility noted with PMC is impressive but unexplained. Two stroke patients had diarrhea, abdominal pain, fever hypoalbuminemia and a history of recent or concurrent use of antibiotics. By use of Shirhyung- Tang, we could improve clinical symptoms (diarrhea, abdominal pain, fever hypoalbuminemia, etc.) and so report clinical course of two stroke patients with antibiotics-associated PMC.

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연소실 압력을 이용한 2행정 엔진의 소기효율 측정연구 (A Study on the Evaluation of Scavenging Efficiency in Two- Stroke Engines by Analysis of the In-Cylinder Pressure Data)

  • 김영민
    • 한국자동차공학회논문집
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    • 제7권8호
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    • pp.66-75
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    • 1999
  • In two-stroke engines, methods of evaluating scavenging effciency have been studied in parallel with trials for improvement of scavenging process. But simulating methods have a wide difference with difference with scavenging process in real engines and methods of evaluating scavening efficiency in real engines are very difficult and very expensive. This study shows that there is a possbility of evaluating scavenging efficiency in real engines very easily by analysis of in-cylinder pressure data. And as a characteristics two-stroke engines, the poly tropic indices in the process of compression are varies with degreeof scavenging and good representatives of scavenging efficiency.

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뇌졸중 환자의 보행과 균형에 대한 트레드밀과 에르고미터 자전거 훈련의 효과 (The Comparison of Effect of Treadmill and Ergometer Training on Gait and Balance in Stroke)

  • 김창숙;배성수
    • 대한물리의학회지
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    • 제5권3호
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    • pp.435-443
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    • 2010
  • Purpose : The goal of this study was to identify the effects of treadmill walking training (TW) and ergometer bicycle training (EB) on gait and balance in stroke patients. Methods : The subjects consisted of 42 stroke patients. They were randomly divided to two groups: TW(n=20) and EB(n=22). Each group trained along with the conventional physical therapy, three times a week for six weeks. The ability of gait was assessed by the 10m walk test and Timed Up and Go test(TUG). The ability of balance was assessed by Berg Balance Scale(BBS) and Balance Performance Monitor(BPM). Results : There was no significant difference between the 10m walking test and TUG groups, but there was a statistical difference between before and after the training for all groups. The result of BBS that assessed balance showed a significant reduction between before and after the training for all groups, but there was no difference between the two groups. While the two groups showed no difference in the BPM assessment, only the EB showed a significant improvement of before and after the training in each group. Conclusion : The outcomes suggest that stroke patients can improve their gait and balance performance through the TW and EB trainings. Although dynamic mean balance showed significance from EB, no significant difference was found between two groups. Even though it cannot be determined through this study which training group is more effective among the above mentioned two, it could be suggested that each training is effective to gait ability and the ability of balance of stroke patients.

체감각 자극치료가 뇌졸중 환자의 감각, 상지 기능 및 자아존중감의 변화에 미치는 영향 (Effects of Somatosensory Stimulation Therapy on Upper Limb Sensory and Function and Self-Esteem of Stroke Patients)

  • 이지웅;최원호
    • 대한통합의학회지
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    • 제8권1호
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    • pp.87-99
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    • 2020
  • Purpose : This study aims to investigate the effect of somatosensory stimulation on the upper limb sensory and function and self-esteem of stroke patients. Methods : This study period was march 4 to april 4 (5 weeks). The subject were 20 stroke patients with somatosensory impairment in B hospital, seongnam, gyeonggi province. They were devided into two group-experimental and control-with 10 members each. The members of the experimental group underwent somatosensory stimulation, whereas the members of the control group underwent an occupation-based intervention for 5 weeks. Thirty-minute therapy was provided 3 times per week for 5 weeks. Before and after the intervention, both groups were evaluated via light touch, static two-point discrimination, stereognosis, Fugl-Meyer assessment (FMA), and self-esteem scale Results : In this study, light touch was not significant in both groups. Static two-point discrimination was significant among the experimental group member's index fingers. Among the control group members, it was significant in the ring finger. The comparison between the two groups was significant in the index finger. The stereognosis results were significant in the experimental group but not in the control group. The comparison between the groups after the intervention was not significant. FMA was significant in the shoulder/ elbow/ forearm (SEF), hand and coordination among the experimental group. Among the control group, it was significant in the SEF and hand. The comparison between the groups was significant in the SEF, hand and coordination. The self-esteem scale results were significant among both groups, and the comparison between the group's score was likewise significant. Conclusion : In conclusion, somatosensory stimulation therapy increases the static two-point discrimination, stereognosis, upper extremity function, and self-esteem of patients with stroke. Therefore, while somatosensory stimulation therapy is not the best therapy, it is one of the best occupational therapies for stroke patients.

뇌졸중 환자의 촉각 및 위치 식별감각 이상에 관한 연구 (Tactile and Proprioceptive Discriminative Sensory Dysfunction After Unilateral Stroke)

  • 최스미
    • 대한간호학회지
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    • 제26권1호
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    • pp.138-147
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    • 1996
  • Although sensory deficits caused by stroke have been occasionally reported, dysfunctions of discriminative sensation have seldom been studied in patients with strokes. With the use of specifically designed methods, discriminative sensations including texture discrimination and position sense were tested in 67 patients with acute unilateral stroke. Thirty-two age and sex-matched healthy subjects were used as controls. Impaired discriminative sensation was common in patients with unilateral stroke (detected in 57 out of the 67 patients) regardless of the lesion location except for patients with lateral medullary stroke. Proprioceptive discriminative sensation remained intact in all except for three out of 25 patients who were initially diagnosed as having pure motor stroke on the bases of conventional sensory tests. However, tactile discriminative sensation remained intact in only 17 out of 25 patients. Discriminative sensory disturbances are common in patients with unilateral stroke even in those with intact sensory function on routine examination. The subtle disturbances of this sensation may explain, at least in part, the clumsiness of the patients that is not readily explained by conventional neurological tests.

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중풍환자의 흉중번열증(胸中煩熱症)에 대한 양격산화탕(凉膈散火湯)투여 2례(例) (Two Cases of Chest Fever with Dysphoria in Stroke Patients Treated with Yangkyuksanhoa-tang)

  • 김은주;정기현;김영석;배형섭;이경섭;김정열
    • 대한한방내과학회지
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    • 제23권2호
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    • pp.292-297
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    • 2002
  • Fire is known as one of the most common causes of stroke. Chest fever with dysphoria caused by heat in the stomach is one of the fire symptoms, meaning feeling oppressed in the chest. We observed two stroke patients who had chest fever with dysphoria. These patients' clinical symptoms were headache, thirst, heat in the upper part of the body and constipation. They were diagnosed as Chest fever with dysphoria. It is assumed that Exuberance of Yang causes heat. We treated them with Yangkyuksanhoa-tang(凉膈散火湯) based on Dong Ui Su Se Bo Won for about 2 weeks. During this period, we observed that their symptoms of heat in the upper part of the body and constipation had been improved. We suggest that Yangkyuksanhoa-tang makes the balance between water and fire, and improves chest fever with dysphoria of stroke patients.

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Hyperlipidemia as a predictor of physical functioning for stroke

  • Sim, Jae-hong;Hwang, Sujin;Song, Chiang-soon
    • Physical Therapy Rehabilitation Science
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    • 제7권2호
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    • pp.88-93
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    • 2018
  • Objective: Elevated cholesterol levels contribute to changes of the arterial endothelial permeability. Hyperlipidemia promotes atherosclerosis and is associated with an increased risk of stroke incidence. The purpose of this study was to investigate the effects of having a history of hyperlipidemia prior to a stroke incidence on postural balance, anticipatory dynamic postural control, gait endurance and gait performance in individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: Fifty-two adults who were diagnosed with stroke 6 months ago or more were enrolled in this study. They were divided into two different groups according to hyperlipidemia history before stroke. All participants were assessed with the Activities-specific into Balance Confidence (ABC) scale, Berg Balance scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go test (TUG), and the 6-minute walk test (6MWT). An independent t-test was used to analyze the difference between the hyperlipidemia group and non-hyperlipidemia group. Results: After analysis, the BBS, TUG, and 6MWT scores were significantly different between the hyperlipidemia and non-hyperlipidemia group, but not the ABC and DGI scores. Conclusions: The results of this study show that having a history of hyperlipidemia before stroke affects static and dynamic postural balance performance, anticipatory dynamic postural balance, and gait endurance in individuals with chronic hemiparetic stroke. Based on the results of this study, we also suggest treatment for hyperlipidemia should be implemented throughout the therapeutic interventions, such as pharmacological or exercise programs, in order to restore the physical function of stroke survivors.

Effects of Interferential Current Treatment on Pain, Functional Ability, and Health-Related Quality of Life in Chronic Stroke Patients with Lumbago; A Randomized Controlled Study

  • Jung, Kyoung-Sim;In, Tae-Sung
    • 대한물리의학회지
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    • 제15권1호
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    • pp.25-32
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    • 2020
  • PURPOSE: This study examined the efficacy of an interferential current (IFC) treatment on the improvement of pain, disability, and quality of life in stroke patients with lumbago. METHODS: A double-blind, randomized clinical trial was conducted on 40 stroke patients with lumbago. The patients were allocated randomly into two groups: the IFC treatment group (n= 20) and the placebo treatment group (n= 20). The IFC group received 30 minutes of IFC treatment on the lumbar region, while the placebo group received IFC treatment but without real electrical stimulation. The intervention was administered five days a week for four weeks. The primary outcomes of pain intensity were measured using a visual analogue scale. The secondary measurements included the Barthel Index, Oswestry Disability Index (ODI), and health-related quality of life (HRQoL). RESULTS: The measurements were conducted before and after the two-week intervention period. Compared to the placebo treatment group, the IFC treatment group showed significantly greater improvement in the pain intensity (p<.05), ODI (p<.05), and SF-36 (p<.05) at the end of the intervention. No significant differences in the Barthel Index were found between the two groups. CONCLUSION: These findings show that an IFC treatment can improve pain, functional ability, and quality of life, highlighting the benefits of somatosensory stimulation from IFC in stroke patients with lumbago.

날개짓에 의한 공중정지비행의 이차원 메카니즘 (Two-Dimensional Mechanism of Hovering Flight by Flapping Wings)

  • 김도균;최해천
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2003년도 추계학술대회
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    • pp.759-764
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    • 2003
  • Numerical simulations are conducted to investigate the mechanism of hovering flight by single flapping wing, and to examine the effect of the phase difference between the fore- and hindwings in hovering flight by two flapping wings. The numerical method used is based on an immersed boundary method in Cartesian coordinates. The Reynolds number considered is Re=150 based on the maximum translational velocity and chord length of the wing. For single flapping wing, the stroke plane angles are $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, $75^{\circ}$ and $90^{\circ}$ and the downstroke angles of attack are varied for each stroke angle. Results show that for each stroke plane angle, there is an optimal angle of attack to maximize the vertical force. Below the stroke angle of $60^{\circ}$, wake capturing reduces the negative vertical force during the upstroke. For two flapping wings, The phase lags of the hindwing are $0^{\circ}$, $90^{\circ}$, $180^{\circ}$ and $270^{\circ}$. The amplitudes of the stroke are 2.5 and 4.0 times the chord length at each phase lag. The results show that maximum vertical force is generated when the phase lag is zero, and the amplitude of the vertical force is minimum at the phase lag of $180^{\circ}$.

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