• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.806-812
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• 2009

Objective : The aim of this study was to provide basic background information on stroke by evaluation various etiological factors on the basis that the Tongue fur color of acute stroke patients. Method : We studied patients hospitalized within 4 weeks after their ictus who were admitted at Kyunghee University Oriental Medical Center, Dongguk University Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center, and Kyungwon University Incheon Oriental Medical Center from April 2008 to August 2009. We compared the general characteristics of acute stroke patients according to tongue fur color. Result : Tongue fur color showed significant difference for past history of hypertension, hyperlipidemia, stroke, HDL-chol, BUN, Hg, and pulse pattern. Conclusion : The above results show that the overall tendency of acute stage cerebral infarction patients varies according to their tongue fur color. Further studies will be needed to better understand the difference between yellow fur group and white fur among acute stroke patients.

• The Journal of Korean Medicine
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• v.22 no.4
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• pp.158-163
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• 2001

Clinical symptoms of acute stroke include loss of consciousness, aphasia, dysphagia, hemiplegia, without urination or defecation, headache, dizziness, chest discomfort, etc. As methods of oriental medical treatment at acute stroke state, acupuncture, fumigating, emetic, sternutatory therapy etc. were known. We treated a 69-year-old female patient who was unconscious after acute stroke with acupuncture and herbal medicine. Also, we chose Croton seed (Crotonis Fructus) Tansy (Artemisiae Argi Folium)-hwan for treatment and fumed it on the patient's nose once a day. After 7 days of treatment with fumigating therapy, we observed improvement in consciousness on the Glasgow coma scale, and other symptoms (aphasia, dysphagia, hemiplegia, without urination or defecation)

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.633-638
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• 2001

Objective : Stroke is the most frequent cause of death in Korea. Because it remains severe disablities disturbing normal life, it is important to carry out intervention preventing from progression of condition in patients with acute ischemic stroke within therapeutic time window. Thus early thrombolysis is beneficial for patients with acute ischemic stroke. However its therapeutic efficacy is not known in combination with oriental medical therapy. In this study, we investigated the safety and the clinical effect of continous intravenous urokinase therapy and oriental medical therapy. Methods : Twenty eight patients with acute onset of ischemic stroke no later than three days received continous infusion of urokinase and oriental medical therapy. We estimated the subjects's neurological deficit and functional status with National institute of Neurologic Disorders and Stroke Scale(NIHSS) and Europian Stroke Scale (ESS) prior to therapy, on day 3, 7, 14 after the starting urokinase therapy and on day at discharge. Results: After day 7, the scores of NIHSS and ESS were improved significantly. There are no differences in therapeutic effects of the interval between onset of stroke and initiation of therapy. Complication were noted in four(14%) patients, but these are not fatal complication and make no neurological deficiency. Conclusion : The results of these investment suggest that continuous intravenous urokinase with oriental medical therapy could be a safe and effective intervention to prevent from progression in acute ischemic stroke. But this findings should be confirmed in multicenter double blind controlled trial.

• Korea Journal of Hospital Management
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• v.27 no.1
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• pp.20-30
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• 2022

Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke. Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data. Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful. Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

• The Journal of Korean Medicine
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• v.23 no.4
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• pp.9-14
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• 2002

To assess the clinical efficacy of Chungpyesagan-tang on acute stroke, we prescribed this medicine to 88 acute stroke patients without thrombolytic treatment. The rate of progressive stroke type was 2.3%, remarkably lower than in previous reports. 1.1 % felt an itching sensation, and 17.0% complaxined of loose stool and diarrhea. Chungpyesagan-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale (NIHSS), and increased Modified Barthel Index (MBI). Thus, we could suggest that this medicine has a desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, ALT had anupward tendency and increased over normal value in 16 cases (18.2%). However, the mean serum level 2 weeks later was within the normal value and the other hepatic enzymes did not increase.

• Journal of Korean Physical Therapy Science
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• v.28 no.2
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• pp.1-9
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• 2021

Background: The requirements for postural and motor control in backward walking training (BWT) may improve balance and walking speed in patients with acute stroke. The aim of this study was to analyze the effect of BWT on balance, balance confidence, and fall efficacy in this population. Design: Randomized controlled pilot trial. Methods: This study included 14 subjects with acute stroke (onset of illness less than one month). They were randomly allocated to a BWT (n=7) or forward walking training (n=7) group and observed five times in a week for a period of two weeks. Measurements were taken before and after the experiment using the Berg balance scale (BBS), Activities-specific balance confidence scale (ABC), and Fall efficacy scale (FES). Results: The BBS, ABC and FES scores obtained in both groups after the experiment were significantly higher than those before the experiment (p<0.05). In addition, the BBS, ABC, and FES scores in the experimental group were significantly higher than those in the control group (p<0.05). Conclusion: These findings indicate that BWT improved balance and balance confidence and decreased the risks of fall in patients with acute stroke. Further study is needed to better understand the effects of backward walking in acute stroke patients.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.3
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• pp.297-305
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• 2023

Objective: The term "weekend effect" refers to an increase in the mortality rate for hospitalizations occurring on weekends versus weekdays. In this study, we investigated whether such an effect exists in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (currently the standard treatment for this condition) at a single center in Japan. Methods: We surveyed 151 patients who underwent mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (75 and 76 patients were treated during daytime and nighttime, respectively) from January 2019 to June 2021. The items evaluated in this analysis were the rate of modified Rankin Scale ≤2 or prestroke scale, mortality, and procedural treatment time. Results: The rates of modified Rankin Scale ≤2 or prestroke scale and mortality at 90 days after treatment did not differ significantly between daytime and nighttime (41.3% vs. 29.0%, p=0.11; 14.7% vs. 11.8%, p=0.61, respectively). The door-to-groin time tended to be shorter during daytime versus nighttime (57 [IQR: 42.5-70] min vs. 70 [IQR: 55-82]) min, p=0.0507). Conclusions: This study did not reveal differences in treatment outcome between daytime and nighttime in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion. Therefore, the "weekend effect" was not observed in our institution.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.27-37
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• 2002

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of 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.

• Investigative Magnetic Resonance Imaging
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• v.25 no.2
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• pp.81-92
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• 2021

The role of neuroimaging in patients with acute ischemic stroke has been gradually increasing. The ultimate goal of stroke imaging is to make a streamlined imaging workflow for safe and efficient treatment based on optimized patient selection. In the era of multimodal comprehensive imaging in strokes, imaging based on computed tomography (CT) has been preferred for use in acute ischemic stroke, because, despite the unique strengths of magnetic resonance imaging (MRI), MRI has a longer scan duration than does CT-based imaging. However, recent improvements, such as multicoil technology and novel MRI acceleration techniques, including parallel imaging, simultaneous multi-section imaging, and compressed sensing, highlight the potential of comprehensive MR-based imaging for strokes. In this review, we discuss the role of stroke imaging in acute ischemic stroke management, as well as the strengths and limitations of MR-based imaging. Given these concepts, we review the current MR acceleration techniques that could be applied to stroke imaging and provide an overview of the previous research on each essential sequence: diffusion-weighted imaging, gradient-echo, fluid-attenuated inversion recovery, contrast-enhanced MR angiography, and MR perfusion imaging.