• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.186-193
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• 2024

Objective : The treatment paradigm for acute ischemic stroke has undergone several major changes in the past decade, contributing to improved patient prognosis in clinical practice. However, the extent to which these changes have affected patient prognosis in the real-world is yet to be clarified. This study aimed to evaluate the real-world impact of modern reperfusion therapy for acute ischemic stroke using data from the National Health Insurance Service in Korea. Methods : This study included patients aged 18-80 years who were admitted via the emergency room with an I63 code between 2011 and 2020. The rates of intravenous thrombolysis use and endovascular treatment according to the year of admission were investigated. Furthermore, the rates of decompressive craniectomy and 3-month mortality were also analyzed. The 10-year observational period was divided into three periods based on the 2015 guideline change as follows : prior, 2011-2014; transitional, 2015-2016; and modern, 2017-2020. Results : A total of 307117 patients (mean age, 65.7±10.9 years) were included, and most patients were male (59.7%). The rate of endovascular treatment gradually increased during the study period from 0.71% in the prior period to 1.32% in the transitional period and finally to 1.85% in the modern period. Meanwhile, the 3-month mortality rate gradually decreased from 4.78% in the prior period to 4.03% in the transitional period and to 3.71% in the modern period. Conclusion : In Korea, the mortality rate decreased as the rate of modern reperfusion therapy increased in patients with acute ischemic stroke. Overall, technical and scientific advances in reperfusion therapy have improved the outcome of patients with acute ischemic stroke in Korea.

• The Journal of Korean Physical Therapy
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• 제30권4호
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• pp.112-116
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• 2018

Purpose: This study aimed to identify the effects of a task-oriented exercise program on balance in patients with acute stroke. Methods: Twenty participants with hemiparesis resulting from acute stroke volunteered to participate in this study. They were randomly assigned to either the experimental or control group, with 10 patients per group. Both groups underwent a task-oriented exercise program averaging 30 minutes daily for 4 weeks. Balance was assessed before and after the 4-week training period. Before and after the intervention, we conducted a paired t-test to compare the within-group changes and an independent t-test to compare the between-group differences. The statistical significance level was set at p=0.05 for all the variables. Results: Both groups showed significant within-group and between-group changes in balance (p<0.05) after the intervention. Conclusion: This study provides valuable information for future studies in this field. Further research using a larger sample and longer experiment spans can corroborate the results of our study.

• 한국콘텐츠학회논문지
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• 제20권10호
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• pp.385-394
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• 2020

본 연구는 급성기 뇌졸중 환자의 뇌졸중 후 우울 발생 현황을 파악하고 뇌졸중 후 우울에 영향을 미치는 요인을 규명하기 위해 수행되었다. 연구대상자는 2개 지역병원에서 허혈성 뇌졸중으로 입원 치료 후 상태가 안정되어 퇴원 예정인 20대 이상의 성인 104명을 편의추출 하였다. 뇌졸중 후 우울 측정은 뇌졸중 후 우울척도, 사회적지지는 사회적지지 척도, 뇌졸중 심각도는 미국 국립보건원 뇌졸중 척도, 장애정도는 수정 랜킨 척도를 이용하였다. 연구결과 대상자의 뇌졸중 발병 후 입원기간은 평균 5.9±2.1일이었고 79.8%가 7일 이내였다. 뇌졸중 심각도는 평균 2.4±2.5점이었으며 69.2%가 경증 뇌졸중이었고, 장애정도는 평균 1.6±1.1점이었고 46.2%가 발병 전의 모든 업무와 일상활동 실행이 가능했다. 대상자의 32.7%가 경증 이상의 우울상태였으며, 종교가 없고(p<.004), 장애정도가 심하고(p<.031), 뇌졸중 심각도가 높으며(p<.034), 가족지지가 적을수록(p<.009) 뇌졸중 후 우울을 경험할 가능성이 높은 것으로 나타났다. 이러한 결과를 통해 뇌졸중 환자들에게 발병 초기 단계부터 우울이 나타날 수 있음을 알 수 있다. 따라서 뇌졸중 급성기 단계부터 우울에 대한 지속적인 조기 사정과 종교나 가족지지 등을 포함한 급성기 뇌졸중 후 우울 중재에 대한 간호지침 개발이 필요하다.

• 대한한방내과학회지
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• 제27권2호
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• pp.416-428
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• 2006

Objectives : Arterial stiffness and pulse pressure are related to cardiovascular and cerebrovascular survival and longevity. This study is aimed at examining the effects of Chungpyesagan-tang on arterial stiffness and Pulse pressure in acute stroke Patients. Methods: The subject of this study was acute strike Patients within 1 week after ictus, with Cardio-ankle vascular index(CAVI) higher than 9.0. They were divided into two groups: A treatment group (n=44) and a control group(n=46). For two weeks, Chungpyesagan-tang was given to the former, other herbal medicines to the latter. used for stroke patients for the control group for 2 weeks. At the end of first and second week, CAVI, pulse Pressure, National Institute of Health stroke scale(NIHSS), Modified Barthel Index(MBI) were measured. Serum lipid Profile, aspartate transaminase(AST), alanine transaminase(ALT). blood urea nitrogen(BUN), creatinine were also measured at the end of the study. Results : After 2 weeks, CAVI and Pulse Pressure in Chungpyesagan-tane group were significantly tower than those in the control group(P<0.05). NIHSS and MBI were improved in both groups. But there was no significant difference between the treatment group and the control group in terms of the NIHSS and MBI. Conclusions : We suggest Chungpyesagan-tanghas desirable effects on arterial stiffness and Pulse Pressure of acute stroke patients. It can improve morbidity and mortality of patients on the basis of influencing vascular stiffness and increased pulse pressure.

• 대한중풍순환신경학회지
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• 제11권1호
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• pp.70-75
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• 2010

Objective : This study is aimed to investigate the present status in acute stroke patients in Koran medicine hospital. Method : We used the Korean medicine stroke database. We collected data from 4 Korean medicine hospital from Feb. 2010 to Aug. 2010. We surveyed past history, motive, diseases, diagnostic machines, the day from onset to admission in acute stroke patients. Results : 1. In Korean medicine hospital, it has been grown up the portion of cerebral infarction and age. 2. In Korean medicine hospital, the patients within 1 day from onset to admission were 63case(34.60%) 3. In Korean medicine hospital, the diagnotic machine has been well used, but MRA utilzation was low. 4. Acute stroke patients were not well known the risk factor, and the patients cerebral infarction didn't know that they had hyperlipidemia. Conclusions : In this study, we know the present status in acute stroke patients. It seems necessary to investigate more further study.

• Journal of Yeungnam Medical Science
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• 제20권1호
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• pp.1-12
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• 2003

Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.86-92
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• 2018

Background: A delay of transfer for patients with acute stroke needing emergent revascularization is a huge hurdle for efficacy of revascularization. The objective of this study was to investigate changes of transportation time calculated by image to door (ITD) time (from checking brain images at first contact hospital to arriving at our emergency center) before and after 2015. Methods: This study was performed in a retrospective manner from 2013 into 2017. Acute ischemic stroke (AIS) patients having intravenous thrombolysis and/or mechanical thrombectomy during the observation period were enrolled. Among them, those who had revascularization under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm were selected. Results: During the observation period, 225 patients were treated under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm. Twenty-three were excluded due the lack of detailed data. Among 202 patients, 73 and 129 were treated under Drip-and-Ship and Ship-and-Drip paradigms, respectively. In 2013, 35 patients from 18 hospitals (median distance, 25 km) were transferred to our regional stroke center and their median ITD time was 116 minutes. It was gradually decreased after 2015. In 2017, ITD time was significantly (P<0.01) shortened to 85 minutes without significant changes in transfer distance. The median onset to puncture time was also significantly (P=0.03) decreased from 365 minutes in 2013 to 270 minutes in 2017. Conclusion: Our results implicate that many hospitals in our stroke region might have recognized the importance of rapid transportation for AIS after 2015.

• 대한한방내과학회지
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• 제29권4호
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• pp.979-987
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• 2008

Objectives : This study aimed to evaluate the characteristics of acute stroke patients between excess syndrome and deficiency syndrome groups. Method : We recruited stroke patients from the patients admitted to the Department of Internal Medicine of Kyunghee University Oriental Medical Center, Dongguk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center and Kyungwon University Incheon Oriental Medical Center from April 2007 to August 2008. We diagnosed acute stroke patients as either excess syndrome or deficiency syndrome and analyzed their characteristics for type of stroke, blood test result. Sasang constitution and lifestyle. Result : We found height, weight, BMI, W/H ratio, hypertension, diabetes, migraine, silent infarction, TG, total lipid, HDL-chol, RBC, Hb, hematocrit, alcohol, smoking and Sasang constitution (Tae-eum, So-yang) were more associated with the excess syndrome group. And we found sea food and Sasang constitution(So-eum) was more associated with the deficiency syndrome group. Conclusion : According to the analysis, we found that the excess syndrome group had more risk factors than the deficiency syndrome group. These results could be utilized in the future as a basis material for Oriental medicine therapy. Further studies will be needed to better understand the differences between excess syndrome and deficiency syndrome groups among acute stroke patients.

• 대한한방내과학회지
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• 제21권2호
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• pp.203-212
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• 2000

Objective : We studied only patients at the acute stage but existing studies on stroke didn't almost classify the stage. We examined 243 patients admitted to the Woo Suk university oriental medical hospital from January 1998 to December 1999 for 2 years. Methods : We analyzed patients into sex, Sasang constitution, the incidence and lesion according to the stroke types, post and family history, onset time, period to admission and physical treatment from onset, and symptom, blood pressure, cholesterol level and herb medicine at entry. Results : Our study was similar to existing studies in the distribution of sex, age and the lesion of stroke, post and family history, and symptoms at entry. But it differed in the constitution, incidence of cerebral infarction and intracranial hemorrhage, attack time, period to admission and physical treatment from onset day, and the symptoms, blood pressure, cholesterol level and herb medication. In comparison between infarction and hemorrhage patients, there was some difference in the distribution of onset time, but wasn't in the cholesterol level. Conclusions : Our study on the acute stage of stroke was similar to existing studies in the general characteristics. But it showed some differences in the herb medicine at entry. In particular, there were much differences in the blood pressure at entry and the incidence of infarction and hemorrhage. We hoped that stroke patients would be synthetically studied in western and oriental medicine.

• 임상간호연구
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• 제17권2호
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• pp.176-191
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• 2011

Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.