• Title/Summary/Keyword: acute stroke

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The Comparison on the General Characteristics of Acute Stroke Patients between Excess Syndrome and Deficiency Syndrome (급성기 뇌중풍 환자의 실증(實證) 및 허증(虛證)군 특성비교연구)

  • Leem, Jung-Tae;Kim, Mi-Young;Choi, Won-Woo;Min, In-Kyu;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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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.

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A Clinical Study on the Patients Admitted at the Acute Stage of Stroke (급성기 뇌졸중 환자에 대한 임상적 고찰)

  • Jang, In-Soo;Yu, Kyung-Suk;Lee, Jin-Goo;Yun, Hee-Sik;Lee, Young-Goo;Kang, Hyon-Chel;Son, Dong-Hyug
    • The Journal of Internal Korean Medicine
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    • v.21 no.2
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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.

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Adaptation of the Evidence Based Nursing Practice Guideline (근거중심 급성 뇌졸중 간호 가이드라인 수용개작)

  • Kim, Ji Hyun;Song, So Lee;Kim, Mi Kyung;Cho, Myoung Sook
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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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.

Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study

  • Ko, Keun Hyuk;Kang, Ji-Hoon;Kang, Sa-Yoon;Lee, Jung Seok;Song, Sook-Keun;Oh, Jung-Hwan;Kim, Joong-Goo;Han, Eun Young;Lee, Ho Kyu;Choi, Jay Chol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.102-109
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    • 2018
  • Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

Sex Differences in Acute Stroke Patients;Clinical Features, Stroke Subtypes, and Sasang Constitutions

  • Yun, Sang-Pil;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.28 no.4
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    • pp.1-7
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    • 2007
  • Objectives : This study investigated stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in both sexes. Methods : 307 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from October 2005 to May 2007. Stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in both sexes were examined. Results : Mean age was higher among women than men (64.82${\pm}$10.21 years versus 62.18${\pm}$11.52 years for the 137 female and 170 male patients, respectively, p=0.037). There were no significant differences in stroke type, ischemic stroke subtypes, or stroke risk factors except smoking and Sasang constitutions. Current smoking was more frequent in male patients (p<0.001). Stroke complications, especially urinary tract infection (UTI), were significantly more common in women (p=0.002). Conclusion : Sex does not seem to influence stroke types, ischemic stroke subtypes, or stroke risk factors except current smoking and Sasang constitutions. UTI should be taken into consideration to manage female stroke patients. Smoking cessation is indicated to prevent stroke in men.

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Relations of neurological and social cognitions in patients with acute phase and chronic phase before returning to the community (급성기와 지역사회 복귀 전 만성 뇌졸중 환자의 신경학적 인지기능과 사회인지 기능의 관계)

  • Park, Myoung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.549-556
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    • 2017
  • This study investigated the importance of social cognitive intervention and the cognitive rehabilitation intervention by comparing the difference and examining the relationship between neurological cognitive function and social cognitive function of stroke patients in the acute phase and chronic stroke before returning to the community. LOTCA, cartoon intention inference task, and social behavior sequence task were performed on 30 acute stroke inpatients and 30 chronic stroke patients from May 2015 to June 2016. A two sample t test was conducted to examine the differences between the groups. The Pearson's correlations test was performed to examine the correlation among the variables in each group. As a result, there were statistically significant differences between the neurological cognitive function and social cognitive function of acute stroke patients and chronic stroke patients who were undergoing rehabilitation training before returning to the community (p<0.05). A linear relationship was found between the thinking operation and social behavior sequence task in the acute stroke group (r=0.539, p<0.05). In the chronic stroke group, visual perception (r=0.530, p<0.05), visual motor organization (r=0.655, p<0.05) and thinking operation (r=0.534, p<0.05) were correlated with the cartoon intention inference task. In addition, the social behavior sequence task were correlated with visual organization (r=0.534, p<0.05) and thinking operation (r=0.764, p<0.05). As a result of multiple regression analysis, the neurological cognitive functions influencing the social cognitive function in the cartoon task was found to be the thinking operation (B = 0.431) in acute stroke patients and the thinking operation (B=0.272) and visuomotor organization (B = 0.218) in the case of chronic stroke. In addition, the results of the social behavior sequence task revealed the thinking operation (B=0.417) in the acute stroke patients, and thinking operation (B=0.267), visual motor organization(B=0.274) and visual perception(B=151) in chronic stroke patients to be significant. According to this result, there is a difference in the neurological and social cognitive levels between the two groups. Therefore, the social cognition is strongly related to the high level cognitive function as thinking operation of the neurological cognitive function. Therefore, in further research, it would be necessary to determine if there is a change in higher cognitive function in neurological cognitive function after applying a social cognition intervention program for stroke.

Study on Characteristics of Abdominal Obesity among Acute Stroke Patients (뇌졸중 환자의 복부비만에 따른 제특성 연구)

  • Choi, Won-Woo;Kim, Mi-Young;Park, Su-Kyung;Leem, Jung-Tae;Park, Sung-Wook;Jung, Woo-Sang;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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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.

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Cross-sectional study on the distribution of Sasang constitution in acute stroke patients (급성기 뇌경색 환자의 사상체질별 분포에 관한 단면적 연구)

  • Sun, Jong-joo;Jung, Jae-han;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Ko, Seong-gyu;Chen, Chan-yong;Han, Chang-ho
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.7 no.1
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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.

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Predictors of Catastrophic Outcome after Endovascular Thrombectomy in Elderly Patients with Acute Anterior Circulation Stroke

  • Younsu Ahn;Seul Kee Kim;Byung Hyun Baek;Yun Young Lee;Hyo-jae Lee;Woong Yoon
    • Korean Journal of Radiology
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    • v.21 no.1
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    • pp.101-107
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    • 2020
  • Objective: Avoiding a catastrophic outcome may be a more realistic goal than achieving functional independence in the treatment of acute stroke in octogenarians. This study aimed to investigate predictors of catastrophic outcome in elderly patients after an endovascular thrombectomy with an acute anterior circulation large vessel occlusion (LVO). Materials and Methods: Data from 82 patients aged ≥ 80 years, who were treated with thrombectomy for acute anterior circulation LVO, were analyzed. The association between clinical/imaging variables and catastrophic outcomes was assessed. A catastrophic outcome was defined as a modified Rankin Scale score of 4-6 at 90 days. Results: Successful reperfusion was achieved in 61 patients (74.4%), while 47 patients (57.3%) had a catastrophic outcome. The 90-day mortality rate of the treated patients was 15.9% (13/82). The catastrophic outcome group had a significantly lower baseline diffusion-weighted imaging-Alberta stroke program early CT score (DWI-ASPECTS) (7 vs. 8, p = 0.014) and a longer procedure time (42 minutes vs. 29 minutes, p = 0.031) compared to the non-catastrophic outcome group. Successful reperfusion was significantly less frequent in the catastrophic outcome group (63.8% vs. 88.6%, p = 0.011) compared to the non-catastrophic outcome group. In a binary logistic regression analysis, DWI-ASPECTS (odds ratio [OR], 0.709; 95% confidence interval [CI], 0.524-0.960; p = 0.026) and successful reperfusion (OR, 0.242; 95% CI, 0.071-0.822; p = 0.023) were independent predictors of a catastrophic outcome. Conclusion: Baseline infarct size and reperfusion status were independently associated with a catastrophic outcome after endovascular thrombectomy in elderly patients aged ≥ 80 years with acute anterior circulation LVO.

A Comparison on the General Characteristics of Acute Stroke Patients between Fire-Heat and Deficiency of Yin (화열과 음허로 진단된 급성기 뇌질환 환자의 특성 비교 연구)

  • Kim, Hye-mi;Gwak, Ja-young;Cho, Seung-yeon;Shin, Ae-sook;Lee, In-whan;Kim, Na-hee;Na, Byung-Jo;Park, Seong-Uk;Jung, Woo-sang;Mun, Sang-gwan;Park, Jung-mi;Ko, Chang-nam;Cho, Ki-ho;Kim, Young-suk;Bae, Hyung-sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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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.

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