• 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.

• 사상체질의학회지
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• 제13권3호
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• pp.23-30
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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 western intervention is necessary and beneficial for patients with acute stroke. However its therapeutic efficacy is not known in combination with Sasang Constitutional medical therapy. In this study, we investigated the clinical effect of East(Sasang Constitutional Medicine)-West integrated therapy. Methods : Among 54 patients with acute onset of stroke no later than seven days, 34 patients received East(Sasang Constitutional Medicine)-West integrated therapy and 20 pateints received West medical therapy. We estimated the subjects's status with Sasang Constitutional Symptomatic Scale (SCSS) prior to therapy and at 1 week, 2 weeks, 3 weeks after the starting each therapy. Results : There is no significant difference in SCSS between two group from admission to 1 week. But significant difference was observed after 2 weaks. Conclusion : The results of these investment suggest that East(Sasang Constitutional medicine)-West integrated therapy is more effective in Sasang Constitutional Pathology.

• 대한임상검사과학회지
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• 제50권2호
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• pp.126-135
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• 2018

본 연구는 일과성허혈발작 및 급성뇌경색환자에서 양쪽 중 간대뇌동맥의 혈류속도 차이가 예후를 예측할 수 있는 지표가 될 수 있고, 이러한 예후예측력이 뇌졸중 아형 간에 차이가 있는 지를 관찰하는 것이다. 모든 대상자는 일과성허혈발작 및 급성뇌경색환자들이며, 기본적인 평가와 경두개도플러검사(TCD)가 실시되었다. 중간대뇌동맥 비대칭 지수(MCA asymmetry index)는 다음의 공식에 의해 구해졌다; MCA asymmetry index=(|RMCA MFV-LMCA MFV|/mean MCA MFV) ${\times}100$. 뇌경색 분류는 TOAST classification에 따라 진행되었다. 나쁜 예후(poor functional outcome)는 mRS score ${\geq}3$ at 3 months after stroke onset로 정의하였다. 총 988명의 급성뇌경색환자가 분석에 포함되었고, 그 중 157명(15.9%)이 나쁜 예후를 가지고 있었다. 뇌경색 하위유형 및 여러 혼란변수를 보정 후 실시한 다변량분석에서 중간대뇌동맥 비대칭 지수만 유일하게 독립적으로 나쁜 예후와 연관성을 보였다. ROC curve 분석에서 중간대뇌동맥 비대칭 지수를 예측모형에 투입하였을 때 투입 전에 비해 나쁜 예후를 예측하는 능력이 상승하는 것을 관찰하였다(from 88.6% [95% CI, 85.2-91.9] to 89.2% [95% CI, 85.9-92.5]). 급성뇌경색환자에서 중대뇌동맥 비대칭 지수는 나쁜 예후를 독립적으로 예측하였다. 따라서 경두개도플러검사는 급성뇌경색환자에서 나쁜 예후를 예측하는데 유용하게 사용될 수 있을 것이다.

• 대한한의학회지
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• 제28권4호
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• pp.8-12
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• 2007

Objectives : This study aimed to investigate the circadian variation in stroke types, ischemic stroke subtypes, and Sasang constitutions. Methods : 295 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from October 2005 to May 2007. The stroke onset time was subdivided into four groups of 6-hour intervals in a day. Stroke types, ischemic stroke subtypes, and Sasang constitutions in four groups were examined. Results : Most ischemic stroke occurred between 6:01-12:00 hours (30.2%). For ischemic stroke subtypes, the peak period of small-vessel occlusion was between 6:01-12:00 hours (33.2%), large-artery atherosclerosis was most common between 12:01-18:00 hours (39.5%), and cardiac embolism was most frequent between 18:01-24:00 hours (50%). In terms of Sasang constitution, Soyeumin and Taeyeumin were most common between 6:01-12:00 hours (36.4% versus 41.5%, respectively), but the peak time of Soyangin was between 12:01-18:00 hours (35.2%). Conclusion :Most ischemic stroke events occurred in the mid-to-late morning hours in the present study and there was a circadian variation of onset in ischemic stroke subtypes and Sasang constitution.

• Journal of Korean Biological Nursing Science
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• 제4권1호
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• pp.51-69
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• 2002

The purpose of this study was to identify the effect of cerebral ischemia on affected(Lt) and unaffected(Rt) side of soleus, plantaris and gastrocnemius muscle mass and determine the effect of exercise on affected and unaffected side on soleus, plantaris and gastrocnemius muscle mass during acute stage of stroke. Sixteen male Sprague-Dawley rate with 200-270g body weight were randomly divided into three groups: control, stroke, and exercise after stroke(St+Ex) group. The control group received sham operation and the stroke group and St+Ex group received transient right MCA(middle cerebral artery) occlusion operation. The St+Ex groups ran on a treadmill for 20min/day at 10m/min and $10^{\circ}$ grade for 6days. During the experimental period body weight and diet intake was measured every morning. On the 7th day after operation, muscles were dissected from both affected and unaffected side of hindlimb. Cerebral infarction of stroke and St+Ex groups were identified by staining with TCC for 30 minutes. The data were analyzed by Kruskal-Wallis test and Mann-Whitney U test using the SPSSWIN 9.0 program. Significance was accepted at the level of p<0.05. The results were summarized follows : 1) There were no significant difference of the body weight on the first day of experiment among 3 groups. Whereas on the 7th day, the body weight of both stroke group and St+Ex group were significantly smaller than that of control group. Body weight of St+Ex group on the 7th day tended to be larger than that of stroke group. 2) Total diet intake of both stroke group and St+Ex group were also significantly smaller than that of control group. While total amount of diet intake in St+Ex group tended to be larger than that of stroke group. 3) The weight of gastrocnemius muscle of affected side in stroke group significantly decreased compared to that of control group and the weight of soleus and plantaris muscle of affected side in stroke group tended to decrease compared to that of control group. 4) The weight of plantaris muscle of unaffected side in stroke group significantly decreased compared to that of control group and the weight of soleus and gastrocnemius muscle of unaffected side in stroke group tended to decrease compared to those of control group. 5) The weight of gastrocnemius muscle of affected side in stroke group significantly decreased compared to that of unaffected side and there was no significant difference of the weight of soleus and plantaris muscle in stroke group between affected side and unaffected side. 6) The weight of soleus, plantaris and gastrocnemius muscle of both affected side and unaffected side in St+Ex group had a tendency of increase compared to those of stroke group. The relative weight of soleus and gastrocnemius muscle of affected side and soleus muscle of unaffected side in St+Ex group had a tendency to increase compared to those of stroke group. Based on these results, exercise during acute stage of stroke might attenuate muscle atrophy of both affected and unaffected side of hindlimb muscles.