• 한국임상수의학회지
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• 제24권1호
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• pp.73-75
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• 2007

Heat stroke can lead multi-organ damage with hemorrhage and necrosis in the lungs, heart, liver, kidneys, brain and Ut. Heat stroke occurs when the elevation of core body temperatures induce a failure of thermoregulatory mechanism. A four-year-old male African Lion(Panthera leo) showed clinical signs such as panting, tachycardia, hyperthermia, unconsciousness and mydriasis under He hish humidity and hot weather. Clinical treatment and pouring cool water was unsuccessful. Grossly, congestion of lungs and pleura was observed. Yellowish discoloration was observed in the renal cortex. Microscopically, the coagulative necrosis in kidney and congestion of lungs and spleen were observed. In our knowledge, this case was closely associated with acute heat stroke.

• 대한한방내과학회지
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• 제33권4호
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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.

• Annals of Clinical Neurophysiology
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• 제14권2호
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• pp.64-71
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• 2012

Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

• 대한한방내과학회지
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• 제25권1호
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• pp.132-137
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• 2004

Background : Recent studies have demonstrated relations between inflammation and stroke. The aim of this study was to investigate CRP level in independent risk factors of stroke patients. Method : Thirty-five ischemic stroke patients were included in this study from Febrary to September 2003. Plasma concentration of CRP was measured over 72 hours after stroke. We examined a average CRP level and associations between CRP and other variables. Result : This study didn't show high CRP level in stroke patients comparing with recent reported studies. Associations between CRP level and other variables didn't show any significant change. Conclusion: In this study, CRP level was not associated with acute stroke significantly.

• 한국전문물리치료학회지
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• 제18권2호
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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.

• 대한한의학회지
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• 제24권4호
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• pp.1-5
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• 2003

Leptin has a close correlation with obesity, which is known to be a major factor for stroke. This study was performed to determine whether serum leptin level would be an independent risk factor for stroke and whether it would change significantly early after stroke. Subjects were selected from those within I month after onset and non-stroke referents at Kyung Hee Oriental Medical Center in Seoul, Korea. We compared leptin and the other characteristics between stroke subjects and referents. Body mass index, hypertension history, presence of drinking and smoking, waist/hip ratio, total cholesterol and triglyceride were recorded. To assess odds ratio of leptin for stroke, we used logistic regression analysis. Leptin was rechecked 2 weeks later and compared with the former value in acute stroke subjects. In this study, serum leptin did not differ significantly between stroke subjects and referents, and its odds ratio was not significant in male (OR=0.52, 95％ Cl; 0.13-2.08) and female (OR=1.57, 95％ Cl; 0.53-4.67). In acute stroke subjects, leptin did not change significantly 2 weeks later. Hypertension had a significant odds ratio in male (OR=3.39, 95％ Cl; 1.02-11.24) and female (OR=12.37, 95％ Cl; 3.67-41.65). High waist/hip ratio was only in female (OR=6.70, 95％ Cl; 1.73-26.02). In conclusion, leptin was not an independent risk factor for stroke and its serum level did not change significantly early after stroke. Hypertension and waist/hip ratio had significant relative risks.

• 대한한의학회지
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• 제28권1호통권69호
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• pp.35-41
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• 2007

Objectives : To gain better insights on the characteristics of stroke patients admitted to oriental medical hospitals, we analyzed the data of 363 consecutive patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Methods : Subjects' enrollment was in the oriental medical hospitals of 3 universities located in the metropolitan region from October 2005 to October 2006. We assessed the subjects' general characteristics, risk factors, and etiology of stroke. Each patient's TOAST classification type was confirmed by two independent specialists. Those were small vessel occlusion (SVO), large artery atherosclerosis (LAA), cardioembolism (CE), stroke with other determined etiology (SOE), and stroke with undetermined etiology (SUE).Results 'The distribution of the subjects' general characteristics and risk factors for stroke were similar with result storm previous reports. However, in the TOAST classification, SVO was the major type occupying 78.5% in the total subjects, which is the highest share compared with other research with similar methods. These results imply that patients with more severe symptoms rarely visit oriental medical hospitals. Conclusion : Assuming that this research will continue adding patient's data continuously, this work will help us to understand the features of stroke patients at oriental medical hospitals, and contribute to expansion of the Korean Hanbang Stroke Data Bank.

• Journal of Chest Surgery
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• 제49권5호
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• pp.392-396
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• 2016

We report a case of aortic dissection masquerading as acute ischemic stroke followed by intravenous thrombolysis. A 59-year-old man presented with dizziness. After examination, the patient had a seizure with bilateral Babinski signs. Soon after identifying multiple acute infarctions in both hemispheres on diffusion-weighted brain magnetic resonance (MR) imaging, tissue plasminogen activator (t-PA) was administered. Both common carotid arteries were invisible on MR angiography, and subsequent chest computed tomography revealed an aortic dissection. The emergency operation was delayed for 13 hours due to t-PA administration. The patient died of massive bleeding.

• 대한중풍순환신경학회지
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• 제12권1호
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• pp.24-31
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• 2011

Objective : Fire and heat related symptoms and signs are considered common in acute stage of diseases. The purpose of this study is to evaluate the occurrences and changes of fire and heat related symptoms and signs in acute cerebral infarction patients. Method & subjects : 40 acute cerebral infarction patients hospitalized in Oriental medicine hospital, Kyung-Hee University, who had examined and diagnosed 2 or 3 times based on oriental medical diagnosis were selected. We chose 23 as fire and heat related symptoms and signs from 94 diagnostic articles, and we added all those scores together of each patient. We analysed the scores of fire and heat related symptoms and signs as the time passed, and depending on oriental medical diagnosis. Result : In acute cerebral infarction patients of this study, 4 of fire and heat related symptoms and signs were took 1st, 2nd, 4th and 8th places in most changeable 10 articles of total 94 articles. The mean score of fire and heat related symptoms and signs of all patients were decreased significantly over the 3 times of measurements. The 8 patients diagnosed as fire and heat diagnosis at visit1 were samely diagnosed as fire and heat diagnosis at visit2, and at visit3 5 patients of them except for 3 patients excluded between visit2 and visit3, were still diagnosed as fire and heat diagnosis. At all of 3 measuring times, the scores of fire and heat related symptoms and signs of fire and heat diagnosis group were higher than non-fire and heat diagnosis group. Conclusion : This study indicated that fire and heat related symptoms and signs were very changeable phenomenon in acute cerebral infarction patients. And they decreased as time goes on.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.57-66
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• 2019

Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group ($n_1=7$) and conventional postural vertical training (CPVT) group ($n_2=7$). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.