• 한국산학기술학회논문지
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• 제18권5호
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• pp.549-556
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• 2017

본 연구의 목적은 급성기와 직업 사회 복귀전에 있는 뇌졸중 환자의 신경학적 인지기능 및 사회 인지기능의 차이를 비교하고 그 관계를 입증함으로서 급성기 뇌졸중 환자의 인지재활 중재 시 사회 인지 중재의 중요성을 파악하고자 하였다. 2015년 5월에서 2016년 6월까지 서울 소재 재활병원에서 재활치료를 받고 있는 뇌졸중 입원환자 30명과 주간재활센터를 이용하는 환자 30명을 대상으로 LOTCA, 만화 의도추론과제, 사회행동배열과제를 실시하였다. 각 그룹간의 차이를 알아보기 위해 이표본 t 검정을 실시하였다. 각 그룹내에서의 각 변인들간의 상관관계를 알아보기 위해 Pearson's correlations 검정을 실시하였다. 그 결과, 뇌졸중 급성기 뇌졸중 환자군과 지역사회 복귀 전 재활훈련을 받고 있는 만성 뇌졸중 환자군의 신경학적 인지기능과 사회인지 기능 모두에서 통계학적으로 유의한 차이를 나타내었다(p<0.05). 신경학적 인지와 사회인지와의 선형적 관련성을 알아본 결과 급성 뇌졸중군에서는 사고 조직력 항목이 사회행동배열 척도와 상관성을 나타내었다(r=0.539. p<0.05). 만성 뇌졸중군에서는 만화 의도 추론과제는 시지각(r=0.530, p<0.05), 시운동조직화(r=0.655, p<0.05), 사고조작력(r=0.764, p<0.05) 항목과 상관성을 나타내었다. 또한 사회행동배열척도와 시운동조직화(r=0.534, p<0.05). 사고조작력(r=0.650, p<0.05)이 상관성을 나타내었다. 다중회귀 분석 결과, 만화의도 추론과제 결과에서 급성기 뇌졸중 환자의 사회인지기능에 영향을 미치는 신경학적 인지기능은 사고조작력으로 나타났으며(B=0.431), 만성 뇌졸중 환자군의 경우 사고 고작력(B=0.272), 시운동 조직화(B=0.218)로 나타났다. 또한, 사회행동배열과제 결과에서는 급성기 뇌졸중 환자의 경우 사고 조작력(B=0.417)으로 나타났고, 만성 뇌졸중 환자의 경우 사고 조작력(B=0.267), 시운동조직화(B=0.274), 시지각(B=0.151)으로 나타났다. 이번 연구 결과에 의하면, 두 그룹 간 신경학적 인지와 사회인지 수준에 차이를 보였다. 사회인지는 주로 신경학적 인지기능 고차원적 인지 기능인 사고조작력과 높은 관련성이 있고 영향을 받을 것으로 사료된다. 따라서 추후 연구에서는 뇌졸중 환자에게 사회인지기능에 대한 훈련 프로그램을 적용 후 신경학적 인지기능 중 고차원적 인지기능의 변화가 있는지 추정해보는 연구가 필요하겠다.

• 대한한방내과학회지
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• 제30권4호
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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.

• 대한중풍순환신경학회지
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• 제7권1호
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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.

• 대한중풍순환신경학회지
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• 제10권1호
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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.

• 대한한방내과학회지
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• 제28권4호
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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.

• 대한중풍순환신경학회지
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• 제13권1호
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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.

• 대한한의학회지
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• 제19권2호
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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.

• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.360-368
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• 2009

Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

• 대한한의학회지
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• 제23권4호
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• pp.73-90
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• 2002

Objectives: This study investigated significant factors that influence functional evaluation of stroke so as to be a fundamental data for estimating prognosis of stroke patients. Methods: 204 patients were studied within 7 days of admission, after the diagnosis of stroke through brain CT scan, brain MRI scan and clinical observations. They were hospitalized in the oriental medical hospital of Dongeui University from February to July in 2001. They were examined at the early stage of onset, after 2 weeks, 4 weeks and 6 weeks, and measured for average mark and the degree of improvement by using the Activity Index. Results: Ischemic stroke, past history of stroke, hypertension, diabetes mellitus, risk factor of obesity, non-professional emergency treatment and hospitalizing time after 1 day from onset, high blood pressure, tachycardia pulse and high blood sugar in abnormal vital sign in acute stage, conscious, cognitive or communication disorder, motor aphasia, dysphagia, constipation for more than 3 days, urinary incontinence, visual field defect, insomnia, and chest discomfort in early stage of onset had a negative influence on functional evaluation. Conclusions: Type of stroke, past history, risk factors, emergency treatment and hospitalizing time after onset, abnormal vital sign and intercurrent symptoms in Acute stage were relevant factors in predicting functional evaluation of stroke.

• 대한한의학회지
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• 제16권2호
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• pp.100-114
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• 1995

This bibliographic study was designed to research indications of the Moschus which was representatively used for resuscitation in acute stage of stroke throughout successive books of oriental medicine. Especially, in this study, severe cases with disturbance of consciousness and acute stage of stroke were investigated. The results were summarized as the followings: 1. The Moschus was dried material which secreted from aromatic vescicle of Moschus moschiferus L.. which was pungent in flavor, warm in nature, nontoxic and strongly aromatic. The Moschus removed the obstruction in the channels and used to early stage of stroke. 2. The Moschus was aromatic resuscitatable medicine, which recovered disturbance of consciousness due to stroke. 3. The Moschus had excitatory actions of respirtory center and vascular motor center, heart stimulating action, inhibitatory action of the platelet aggregation and anti thrombin action and recovered cerebral ischemic change. According to these actions, the Moschus could be used cerebral infarction. 4. Prescriptions included the Moschus was used to symptoms of unconsciousness, secretion, stuporous mental state, dysarthria, facial palsy and hemiplegia. That was Angungwoohwangh wan(安宮牛黃丸), Woohwangchungshimwon(牛黃淸心元), Sahyangsohaphangwon(麝香蘇合香元), etc. According to the above mentioned results, the Moschus was aromatic resuscitatable medicine which was used for symptoms of conscius disturbance, convulsion, sudden fainting etc., promoted cerebral blood flow and had good effect on acute stage of stroke and severe cases with conscious disturbance. Therefore, it is considered that the Moschus must be studied for effect of cerebral infarction and hemorrhage in clinic with animal's and pharmacological experimental results.