Objective : We examined patients admitted to Dong Eui University Oriental Medical Hospital from 1st January to 31st December in 2000. We studied 110 cases of patients who were diagnosed as Brain stem(pons, mid brain, medullar) infarction with brain CT, MRI scan, MR Angiography. Methods : We analyzed patients into sex, age, onset time, invasion lesion, past and family history, risk factor, abnormal vital sign for early 2 weeks, prodromal symptoms, symptoms at entry, progress and incidental symptoms at acute stage, complications, the state of condition at discharge, demonstrations, herb medications, western and oriental medical cooperation and admission period. Results : Our study was similar to existing studies in the distribution of sex, age, past and family history and risk factors. But there was some differences in the prodromal symptoms, symptoms at entry progress and incidental symptoms at acute stage, and the state of condition at discharge. Conclusions : Our study shows the brain stem infarction patients differed from other cerebrovascular accident patients in the symptoms. We hoped that our study would be further studied in western and oriental medicine.
Background : Patient, family, society and country are badly damaged by stroke (CVA : cerebrovascular accident). To reduce sequelae and return rapidly to society, treatment in the acute stage is very important. In many studies on purgation therapy (下法) used in acute stages of stroke, the changes of blood pressure, pulse and so on before and after purgation therapy were reported. However, the changes in the human body according to the day elapsed after defecation were not reported, so study was needed to confirm such changes. Methods : Seventy-six patients were studied. We observed forty-three patients at acute stroke and thirty-three patients at convalescent stroke. To confirm the importance of regular defecation in stroke patients, we analyzed blood pressure according to the day elapsed after defecation. Results : The following result were obtained. 1. In stroke group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute stroke group. 2. Especially in stroke and acute stroke groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. 3. In the infarction group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute infarction group. 4. Especially, in the infarction and acute infarction groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. Conclusion : In stroke patients, regular defecation is important, so we think that purgation therapy (下法) is needed in stroke patients over the third day elapsed after defecation. We think that the bowel movement control in acute stroke patients is more important than in convalescent stroke patients.
This study was undertaken to obtain information about selected characteristics and the degree of physical disability of patients with a diagnosis of cerebrovascular accident upon their discharge from a general hospital. It was hoped that this information would contribute to the assessment of their needs for follow-up nursing care. Nurse's and Physician's Progress Notes of all stroke patients discharged from five general hospitals in Seoul from January to December 1975 were analysed using a prepared check list. Patients with other complicating diagnosis such as diabetes, tuberculosis or heart disease were excluded from the sample. According to six factors used to grade the total sample of 334 stroke victims degree of physical ability at discharge, 144 (43%) of the Survivors had good functional ability, 72 (22%) fair, 62 (18%) poor, and 57(17%) very Poor. Certain clinical diagnosis correlated with the degree of physical ability. Intra cranial Hemorrhage and Subarachnoid Hemorrhage tended to be related to poor and very poor outcome categories. There was no significant correlation between nae and ability outcome, women had revealed a significantly positive correlation with poor and very poor ability outcomes. The hospitalization period was less than three days for 37.5% of the total group, and more than one month for 4.7%. Those patients with less than three days hospitalization accounted for the highest relationship with poor and very poor ability outcomes. Of the total groups 175(50.99%), were discharged with a diagnosis of condition improved (though not necessarily with good physical ability). The results suggest serious need for comprehensive follow- up nursing care for stroke survivors discharged a from general hospitals in Seoul.
Purpose: This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. Methods: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. Results: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(${\chi}^2=18.629$, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. Conclusion: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.
Purpose: Agent Orange (AO) is a herbicide and defoliant used by the United States and its military allies during the Vietnam War. Pneumonia is a common cause of death among Vietnam veterans in our hospital. There have been no previous studies researching any association between AO exposure and the prognosis for pneumonia. The primary objective of this study was to investigate associations between AO exposure and 30-day mortality due to pneumonia. The secondary objective was to examine the clinical factors associated with therapeutic outcomes in veterans with pneumonia, and to assess the prevalence of combined diseases in AO-exposed veterans. Methods: This study retrospectively included veteran patients diagnosed with pneumonia in the emergency department and hospitalized between February 2014 and March 2018. The enrolled patients were grouped according to their defoliant exposure history, and the clinical information of defoliant-exposed and non-defoliant-exposed groups were compared. Patients were divided according to 30-day mortality, and significant factors influencing mortality were evaluated by using univariate analysis and multivariate analysis. The final multivariate model revealed the effect of AO exposure on therapeutic outcomes of pneumonia. Results: A total of 1006 patients were analyzed. Of these, 276 patients had a history of AO exposure, whereas 730 patients had not been exposed. Factors positively associated with 30-day mortality were malignancy, respiratory rate, blood urea nitrogen, and albumin which was negatively associated with mortality. Conclusion: Exposure to defoliant is not associated with 30-day mortality in patients with pneumonia. However, veterans with defoliant exposure are associated with a high prevalence of diabetes mellitus, hypertension, cerebrovascular accident, malignancy, and chronic kidney disease.
Objective : This study evaluated the effect of Moving Cupping therapy for the edematous hands of the three person with flaccid hemiplegia. Method : The subjects were from 1 month to 4 month post-cerebrovascular accident with flaccid hemiplegia. Each subjects routine therapy program was maintained throughout Single subject ABA withdrawal design. During the first week, baseline data were gathered, during the second week the intervention was provided(20 minutes of Moving Cupping therapy), during third week data were gathered with treatment withdrawn. Edema was measured with a hand volumeter and a measuring tape. Results : The Moving Cupping had an effect in reducing edema in the hands of the three subjects. Conclusion : The Moving Cupping therapy is a readily available tool that could enhance the treatment of edematous hands of persons with flaccid hemiplegia by offering a contribution to already established treatment protocols. Further research is needed, however, to establish guidelined for use.
In order to study the effects of Gagamyounjo-Tang(加減潤燥湯) on the experimentally hypercoagulable state and hyperlipidemia in rats, we have made the hypercoagulable state in rats by injection of Bothrops jararaca venom (0.1ml/200g : Control group), and have administered solid extract of Gagamyounjo-Tang(加減潤燥湯)(132mg/200g : Sample group). After 1 hour we measured the platelet count, fibrinogen level, APTT, FDP and D-dimer. And we have made the hyperlipidemia in rats by injection of Triton WR-1339 for 3 days(30mg/200g/day : Control group), and have administered solid extract of Gagamyounjo-Tang(加減潤燥湯)(132mg/200g : Sample group), then we measured the total cholesterol, triglyceride, phoshpolipid and HDL-cholesterol levels. The results are summarized as follows : 1. In the hypercoagulable state, Sample group significantly decreased in platelet count compared with Control group(p<0.01), and significantly prolonged in APTT compared with Control group(p<0.05). 2. In the hyperlipidemia, Sample group significantly decreased in the total cholesterol, triglyceride and phoshpolipid compared with Control group(p<0.01), and significantly increased in HDL-cholesterol level compared with Control group(p<0.01). According to the above experimental results, Gagamyounjo-Tang(加減潤燥湯)is assumed to have curative effects against the hypercoagulable state in rats induced by Bothrops jararaca venom and the hyperlipidemia in rats induced by Triton WR-1339. And we can suppose that Gagamyounjo-Tang(加減潤燥湯) has a curative effect against the cerebrovascular accident caused by blood stasis.
Purpose : This study is to determine effects of cane-shape which influenced on the change of muscle activation, gait component in hemiplegic patients caused by cerebrovascular accident. Methods : Twenty one stroke patients using T-shape cane(TCG) and twenty one stroke patients using I-shape cane(ICG) participated in this study. Surface electromyography(SEMG) of erector spinae, transvers abdominis, tibialis anterior, soleus of both side were measured during walking without cane and walking with cane. Results : The activation of tibialis anterior was significantly increased in affected side of ICG. The activation of tibialis anterior was significantly decreased in affected side of TCG. The activation of soleus was significantly increased in affected side of ICG. The activation of soleus was significantly decreased in affected side of TCG. The activation of erector spinae was significantly increased in nonaffected side of ICG and TCG. The activation of transvers abdominis was significantly increased in nonaffected side of ICG and TCG. Conclusion : From the finding of this study, it was suggested that I-shape cane increase weight bearing of affected side in hemiplegic patient. Therefore, I-shape cane can be applied to improve gait asymmetry of hemiplegic patients.
Acupuncture and herbal medicine have been used to prevent and treat the cerebrovascular accident, such as a stroke, and many studies of acupuncture and moxibustion concerning to the stroke have been undertaken in the human and various animals. However, it was not published the protective effect of the electroacupuncture (EA) of Huan-do (GB30) on the transient forebrain ischemia injury. The neuroprotective effects of EA (2 ms, 10 Hz, and 1 - 2 mA) of GB30 on the transient forebrain ischemia injury was investigated by western blot of nNOS and hematoxylin and eosin stain in Sprague-Dawley rats. The transient forebrain ischemia injury resulted in increased expression of nNOS in the brain for 6 hrs after ischemia, and EA decreased significantly expression of nNOS protein in brain increased by transient forebrain ischemia injury. The survived neuronal cell stained with hematoxylin and eosin (H&E) decreased in the hippocampus by the 7 days after ischemia comparing with the normal. Comparing with the normal, the survived neurons seriously decreased cell in the hippocampus after the injury. However, the proportion of survived neurons was increased in EA treatment. These results suggest that EA of GB30 have neuroprotective effects on transient forebrain ischemia injury.
The clinical validity of a korean EEG and EP mapping system(Neuronics) was evaluated with schizophrenic patients(n=20), normal controls(n=19), and 10 patients with central nervous system disease(8 patients with cerebrovascular accident, 1 patient with brain mass, and 1 patient with periodic paralysis). In the normal control group, the pattern of resting computerized EEG with eyes closed showed normal parieto-occipital dominance of alpha wave. Compared with normal controls, schizophrenic patients had more delta activity in the frontal region, and less alpha activity especially in the parieto-occipital region. In most cases patients with cortical organic lesions(n=5) revealed increased delta and theta activity and decreased alpha activity on the lesion areas. These findings were compatible with their MRI and clinical findings. However in the cases of subcortical lesions(n=5) EEG showed various findings which suggest diverse influences of subcortical abnormalities on cortical activities. The P300 of schizophrenic group was smaller and more delayed than those of normal controls. These results are generally compatible with the previous studies using other EEG and EP mapping systems consequenty and suggest that the this EEG and EP mapping system(Neuronics) has clinical validity.
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