• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.220-230
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• 1991

Internuclear ophthalmoplegia is a conjugated gaze disorder characterized by impaired adduction on the side of a lesion involving the medial longitudinal fasciculus with dissociated nystagmus of the other abducting eye. Six patients with INO(who had clinical cerebrovascular diseases) underwent MR imaging and the results were as follows : 1. The MLF lesions were identified by MR imaging in 5 cases 2. The ratio of unilateral INO to bilateral INO was 5:1 3. The nature of lesions was infarction in 4 cases and hemorrhage in 1 case 4. The sites of MLF lesion were in the midbrain in 4 cases and in the pons in 1 case 5. All 5 cases of INO identified by MR imaging had other lesion sites in addition to MLF lesion.

• 대한장애인치과학회지
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• 제11권2호
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• pp.62-66
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• 2015

Temporomandibular joint dislocation causes considerable pain, discomfort, and swelling. The anatomic construction of the articular fossa and the eminentia articularis may predispose to dislocation, and weakness of the connective tissue forming the capsule is believed to be a predisposing factor. The capsule may be stretched and, more rarely, torn. Dislocation may be unilateral or bilateral and may occur spontaneously after stretching of the mouth to its extreme open position, such as during a yawn or during a routine dental operation. Manual reduction with the patient under muscle-relaxing condition or anesthesia is recommended method. After the reduction of an acute dislocation, immobilization of the jaw is recommended to allow the stretched and sometimes torn capsule to heal, thus preventing recurrence. A Barton's bandage may be applied for 2 to 3 weeks to prevent the patient from opening the jaw too wide. But, it results in recurrent dislocation in the neurologically disabled patient, because of loose intermaxillary fixation. This is a case report about management of recurrent temporomandibular joint dislocation by multiple loop wirings and intermaxillary elastics in cerebrovascular accident patient.

• 한국융합학회논문지
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• 제3권4호
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• pp.23-28
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• 2012

이 연구는 1990년대부터 국내외 전반에 걸쳐 진행된 다양한 규모와 기관에서 진행된 급성 뇌졸중 환자의 연구를 바탕으로 뇌졸중 환자의 예후 관련 접근에 대해 올바른 발전 방향을 모색하고자 한다. 이를 위하여 국내외 문헌 검토는 BNBI PubMed, KMBase, RISS, KoreaMed를 이용하였다. 검색된 논문을 대상으로 발생빈도, 병원 전 뇌졸중 환자의 평가 및 응급처치, 병원 내 전문치료로 구분하여 분석하였다. 뇌졸중 평가의 중요한 척도로 사용되고 있는 신시내티 뇌졸중 척도와 로스앤젤레스 뇌졸중 척도를 이용한 평가가 중요하며, 이를 바탕으로 전문적인 응급처치가 시행되어야 한다.

• 기본간호학회지
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• 제14권1호
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• pp.53-61
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• 2007

Purpose: The purpose of this study was to investigate the effects of an information protocol for anxiety and nursing satisfaction of family caregivers. The caregivers were caring for a family member who had a CVA (cerebrovascular accident) and who had been admitted to the ICU (intensive care unit). Method: The research design was a non-equivalent control group non-synchronized design. Data were collected from April 1 to October 31, 2005 at D hospital in Busan City The participants were 40 family caregivers of patients with a CVA admitted to the ICU. Caregivers in the experimental group participated in the information protocol for 30 min. Both groups were pre-tested before the intervention for two variables, anxiety and nursing needs. The post-test of both groups included anxiety and nursing satisfaction. The instruments used in this study were the Spielberger's state anxiety inventory (1976) and the nursing satisfaction scale developed by Molter (1979). Results: Anxiety scores were significantly lower and nursing satisfaction scores were significantly higher for caregivers in the experimental group compared to those in the control group. Conclusion: The information protocol was effective in reducing anxiety and increasing the level of nursing satisfaction of family caregivers caring for an ICU patients with a CVA.

• 대한예방한의학회지
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• 제15권3호
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• pp.67-81
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• 2011

Background : Complementary and alternative medicine has bee used to cardiovascular diseases. In recent years, many hospitals have tried to integrate complementary and alternative medicine(CAM) with conventional medical approaches for patients with chronic diseases. Recently, the prevalence of the use of traditional Korean medicine(TKM) among patients with chronic diseases, expecially, hemiplegia patients after cerebrovascular accident is increasing in Korea. To date, however, there were only few studies addressing the patients' attitudes, and utilization of TKM, compared to the well-documented escalating use of TKM among consumers in Korea. Objectives : The objective of this study was to analyze the prevalence of TKM use among hemiplegia patients after cerebrovascular accident and to determine what factors affect to use CAM among the patients. The study also aims to provide information on TKM and assist therapy selection among various CAM therapies for hemiplegia patients after cerebrovascular accident within health care system in which both practitioners of TKM and practitioners of modern Western medicine coexisted. Methods : The design of the study was descriptive cross-sectional, and data were collected using a 32-items questionnaire. The subjects were one hundred fifty nine patients with chronic diseases who visited or admitted to health care facilities in a hospital in Seoul Metropolitan city, Korea. Data were analyzed using 'SPSS Statistics 18.0 Network Version(on release 18.0.1 of PASW Statistics)' program. Various statistical methods were used to obtain a profile for participants and the therapies most frequently used by hemiplegia patients of TKM. Logistic regression analysis was employed in order to determine the predicting variables of TKM use. Results : The prevalence of the use of TKM was 51.6%. The most common TKM therapies used by the patients included acupuncture(93.2%), herbal medicine(64.8%), and cupping(37.5%). Results of logistic regression analysis revealed that the variables significantly related with TKM use were gender, marital status, job, No. of visiting health care facilities/week. Conclusions : This study shows that the use of TKM among the hemiplegia patients is relatively high in Korea, this topic should be taken into account in the development of a holistic approach for patients with chronic diseases and an efficient chronic disease management system in Korea.

• 대한한의학회지
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• 제31권5호
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• pp.136-145
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• 2010

Objectives: Electroacupuncture according to Voll (EAV) has been used to quantify the skin's electrical resistance and conductance over acupuncture points that, based on traditional Chinese medicine, represent the state of health or disease of the organ or tissue. However, it doesn't have enough objective data yet, so the purpose of this study was to aid in the use of EAV in analysis of cerebrovascular disease risk factors. Methods: This study researched the clinical statistics of 216 cases: cerebrovascular attack (CVA) group 43, control group 173. We measured control meridian points (CMP) on hands and feet and the cardio ankle vascular index (CAVI) which represents atherosclerosis severity, and sex, age, hypertension, diabetes, dyslipidemia, and obesity. The data were then analyzed by t-test, chi-square test and logistic regression. Results: Between the CVA and control groups, there were not statistically significant differences in CMP. However, logistic regression analysis of the presence of CVA, mean of CMP heart and lung, sex, age, DBP (diastolic blood pressure), and HDL (high density lipoprotein) cholesterol showed that the risk of CVA was 1.1 times increased with CMP heart (p=0.002), in men was 4.12 times higher than in women (p=0.001), 1.09 times higher with age (p=0.000), 1.04 times higher with DBP (p=0.045), while was lower by 0.924 times with CMP lung (p=0.005) and 0.957 times with HDL cholesterol (p=0.006). Conclusion: Although there were not clear evidence or mechanisms about EAV, this study showed that if we study EAV further, we may be able to apply EAV as an objective instrument of oriental medicine in cerebrovascular disease.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.76-82
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• 2000

Objectives : We attempted to assess He accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. Methods : A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met ore of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. Results : The accuracy rate of the ICMIC was 83.0% (425 cases) Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. Conclusion : The accuracy rate of the ICMIC was 83.0%.

• 가정간호학회지
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• 제7권1호
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• pp.26-38
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• 2000

The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

• 재활간호학회지
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• 제3권2호
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• pp.141-153
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• 2000

The several Chinese herbs such as Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, So-Hap-Hyang-Won and O-Yak-Soon-Ki-San were extracted with water and then lyophilized. For identification of the effect of extracted herbs, they were medicated to 103 patients of cerebrovascular accident for 4 week. They were hospitalized in D-Oriental Medical Hospital from April to August in 1999. The herbs were extracted with water and lyophilized and then, used as samples. The medical history of each patient was detected and analyzed from their medical records. The results were as follows; 1) Each sample (Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, and O-Yak-Soon-Ki-San) was statistically significant differences of systolic blood pressure(t=4.22, P=0.0004; t=3.44, P=0.0028; t=2.11, P=0.0463; t=3.23, P=0.0052). The statistically significant difference of diastolic blood pressure showed by medicated with Soon-Ki-Hwal-Hyal-Tang, Seong-Hyang-Jeong-Ki-San, and O-Yak-Soon-ki-San (t=2.13, P=0.0459; t=2.68, P=0.0136; t=3.12, P=0.0066). 2) The statistically significant difference of the arm/leg-ROM showed by medicated with Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O Tang, So-Hap-Hyang-Won(t=4.74/4.95, P=0.0002/0.0001; t=2.25/2.44, P=0.0368/0.0248; t=5.85/6.76, P=0.0001/0.0001). 3) In the verbal disorder, Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang had statistically significant differences(t=4.50, P=0.0002; t=3.32, P=0.0036). 4) In the conscious disorder, Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, and So-Hap-Hyang-Won had statistically significant differences(t=6.32, P =0.0001; t=8.32, P=0.0001; t=3.74, P=0.0012; t=5.14, P=0.0001). 5) Bovine aortic endothelial cell (BAEC) were cultured in DMEM treating 0.01mg/ml, and 0.1mg/ml of each lyophilized samples for 24 hours. In BAECs were treated by 5 kinds of samples, the effect of So-Hyap-Hyang-Won induced syncytium of adjacent endothelial cells. It may induce the recovering of the damaged blood vessels in cerebrovascular accidental patient by angiogensis of endothelial cells. Therefore, it suggests that the medication of So-Hap-Hyang-Won will help to nursing care for cerebrovascular accidental patients.

• 대한한의학회지
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• 제30권1호
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• pp.95-108
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• 2009

Objectives: Uwhangchungsim-won (DC) has been used in various medical fields such as stroke, hypertension, atherosclerosis, autonomic imbalance and mental instability, etc. The aim of this study was to evaluate the effect of UC on cerebral hemodynamics and estimate the appropriate dose of UC. Methods: We studied changes of hyperventilation-induced cerebrovascular reactivity and mean blood flow velocity of middle cerebral arteries (MCA) using transcranial Doppler. We observed the changes of mean blood pressure, pulse rate and expiratory CO2 using S/5 Compact Anesthesia Monitor from 10 healthy young volunteers who were administered UC twice a day in the 1 st section and then once a day in the 2nd section. Results: Mean blood pressure tended to decrease at 1 hour and pulse rate tended to decrease at 2 hours after second administration. After 2 hours, mean blood pressure rose to state before administration, but pulse rate maintained from 2 hours to 4 hours. The changes were not statistically significant. Cerebral blood flow velocity in middle cerebral artery was not statistically significant after second administration. Cerebrovascular reactivity increased from 2 hours to 4 hours after second administration. Conclusions: This study provides that administration of UC twice a day is more effective on hyperventilation-induced cerebrovascular reactivity than administration of UC once a day.