• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.177-185
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• 2004

This study was designed to analyze the effectiveness of the diagnosis and treatments of hemorrhagic infarction patients in oriental medicine. In this study the clinical symptoms of two hemorrhagic infarction patients improved after diagnosis and treatment of oriental medicine. Though improvement was seen after diagnosis and treatment of both hemorrhagic infarction patients, the early stage of hemorrhagic infarction required western fluid therapy treatments. Study of more cases will be needed in order to varify efficacy for these oriental treatments to be generally applied.

• Health Policy and Management
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• v.21 no.4
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• pp.541-564
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• 2011

This study aimed to investigate health outcome of acute myocardial infarction (AMI) patients such as mortality and length of stay in hospital and to identify factors associated with the health outcome according to the comorbidity index. Nation-wide representative samples of 3,748 adult inpatients aged between 20-85 years with acute myocardial infarction were derived from the Korea National Hospital Discharge Injury Survey, 2005-2008. Comorbidity index was measured using the Charlson Comorbidity Index (CCI). The data were analyzed using t-test, ANOVA, multiple regression, logistic regression analysis in order to investigate the effect of comorbidity on health outcome. According to the study results, the factors associated with length of hospital stay of acute myocardial infarction patients were gender, insurance type, residential area scale, admission route, PCI perform, CABG perform, and CCI. The factors associated with mortality of acute myocardial infarction patients were age, admission route, PCI perform, and CCI. CCI with a higher length of hospital stay and mortality also increased significantly. This study demonstrated comorbidity risk adjustment for health outcome and presented important data for health care policy. In the future study, more detailed and adequate comorbidity measurement tool should be developed, so patients' severity can be adjusted accurately.

• Korean Journal of Health Education and Promotion
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• v.2 no.1
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• pp.63-78
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• 2000

This survey provides, at a participation rate of 70％, 4,790 examinees. The purpose of this study is to study the association of the failed rest after work with 34 diseases including cardiovascular diseases. The index of the failed rest after work was composed of 4 questions about "thinking of work for several hours", "feeling exhausted", feeling unsatisfied or depressed", and "needing to go to bed early for next day′s work". Estimation of correlation among 4 variables, factor analysis, and ANCOVA adjusted for sex, age and job were carried out. A self-rating questionnaire of one′s own disease history and the "London School of Hygiene Cardiovascular Questionnaire" were used in order to discriminate each morbid group from the opposite group. Brief explanations of the result are as follows: 1) Every variable of failed rest after work shows significant difference between the morbid group and the no morbid group for possible infarction; for angina pectoris in the total, and men. 2) Among 4 variables ′exhaustion′ best discriminates the infarction group from the no infarction group, and the angina group from the no angina group. 3) The factor of failed rest after work is a significant factor that distinguishes the infarction group from the no infarction group, and the angina pectoris group from the no angina group. Therefore, stress management through health education and promotion such as behavioral modification can be used to reduce cardiovascular diseases and stress as perceived by an individual.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.1
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• pp.105-112
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• 2012

This study sought a clinical analysis of 43 lacunar infarction patients treated by oriental medical therapies. The patients were divided into two groups (independent living group and dependent living group) according to K-MBI independence level. We had analyzed correlation of many factors like past history, several symptoms of lacunar infarction and ect between independent living group and dependent living group. The male to the female ratio of patients diagnosed lacunar infarction was 1:1.39, female(58.1%) was more dominant than male. The most common age group was 8th decade. The most common past history was Heart disease and without heart disease patients are treated well. Without hemiparesis, cognitive disorder, dysphagia patients are treated well. Patients arrived hopital within 72 hours after onset had treated well In regard to K-MBI of lacunar infarction patients, 65.1% improved and no one got worse. After treatment, 74.4% patients were able to independent living. The correlation between herbal medication and improvement was not founded.

• The Journal of Internal Korean Medicine
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• v.45 no.1
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• pp.75-86
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• 2024

Spinal cord infarction is one of the rare strokes with no clear signs of serious nerve damage or after-effects. This study reports on the effectiveness of a combined treatment of Korean medicine and acupuncture on bilateral paraplegia, dysuria, and constipation in a patient with sudden-onset spinal cord infarction. An 84-year-old male patient was diagnosed with spinal cord infarction in August 2022. After diagnosis by whole spine MRI, he received treatment for two months at another hospital, but the improvement was insignificant. He then received Korean medicine treatment, and during this period, his lower extremity manual muscle test grade improved from 3 to 4 and his modified Rivermead mobility index score increased by 13 points, compared with hospitalization. Dysuria improved with acupuncture, and constipation improved with herbal medicine treatment. A combination of herbal medicine and acupuncture can be used to treat paraplegia, dysuria, and constipation caused by spinal cord infarction.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.896-901
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• 2007

Objectives : This study aimed to evaluate the characteristics of patients with single infarction and multiple infarctions. Method : We studied inpatients who were admitted from 2005/10/1 to 2007/3/30 at the KyungHee University Oriental Medical Center (KOMC) Department of Cardiovascular & Neurology (stroke center). We sorted small vessel occlusion patients and evaluated general characteristics of the patients along with the characteristics of single and multiple infarction patients. Result : We evaluated 262 inpatients, and did not find any significant difference in age, hypertension, diabetes, hyperlipidemia, diet, exercise, homocysteine, or Sasang constitution between single infarction and multiple infarction. However, there were more significant associations with patients' smoking and stress with multiple infarctions than single infarction. Conclusion : From this study we could roughly grasp the characteristics of Small Vessel Occlusion patients and evaluated the characteristics of patients with multiple infarction. However, due to the special circumstance of the KOMC inpatients it is difficult to generalize our results; further multiple center research with a larger study group is needed.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.293-299
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• 2012

Objective : To evaluate the surgical efficacy of and factors associated with decompressive craniectomy in patients with an internal carotid artery (ICA) territory infarction. Methods : Seventeen patients (8 men and 9 women, average age 61.53 years, range 53-77 years) were treated by decompressive craniectomy for an ICA territory infarction at our institute. We retrospectively reviewed medical records, radiological findings, and National Institutes of Health Stroke Scale (NIHSS) at presentation and before surgery. Clinical outcomes were assessed using the Glasgow Outcome Scale (GOS). Results : Of the 17 patients, 15 (88.24%) achieved a poor outcome (Group A, GOS 1-3) and 2 (11.76%) a good outcome (Group B, GOS 4-5). The mortality rate at one month after surgery was 52.9%. Average preoperative NIHSS was $27.6{\pm}10.88%$ in group A and $10{\pm}4.24%$ in group B. Mean cerebral infarction fraction at the septum pellucidum level before surgery in group A and B were 33.67% and 23.72%, respectively. Mean preoperative NIHSS (p=0.019) and cerebral infarction fraction at the septum pellucidum level (p=0.017) were found to be significantly associated with a better outcome. However, no preexisting prognostic factor was found to be of statistical significance. Conclusion : The rate of mortality after ICA territory infarction treatment is relatively high, despite positive evidence for surgical decompression, and most survivors experience severe disabilities. Our findings caution that careful consideration of prognostic factors is required when considering surgical treatment.

• Health Policy and Management
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• v.30 no.3
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• pp.386-398
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• 2020

Background: We determined the differences in awareness of myocardial infarction and stroke according to the presence or absence of diabetes mellitus in the community. Methods: The 2018 Community Health Survey identified 20,812 people with diabetes mellitus aged 40-79 years. Using 1:1 matching by propensity score, 20,812 people without diabetes mellitus but with similar sociodemographic characteristics were selected as a comparison. Outcome variables were awareness of early symptoms of myocardial infarction and stroke and awareness of coping strategies in case of occurrence. Results: There was no significant difference between nondiabetic and diabetic people in terms of recognizing all early symptoms of myocardial infarction (nondiabetic, 42.7%; diabetic, 43.0%; p=0.43) and stroke (nondiabetic, 49.4%; diabetic, 49.4%; p=0.91). In addition, no significant difference was found between nondiabetic and diabetic people in the proportion of knowing correct emergency response to myocardial infarction (nondiabetic, 84.6%; diabetic, 84.4%; p=0.56) and stroke (nondiabetic, 81.3%; diabetic, 81.4%; p=0.77). Conclusion: Since people with diabetes are at greater risk of cardiovascular disease than the general public, it is important to lower the risk of disability and death by improving their awareness of early symptoms and correct emergency response to myocardial infarction and stroke.

• Journal of Korean Neurosurgical Society
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• v.49 no.2
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• pp.92-96
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• 2011

Objective : We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction. Methods : Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients. Results : The mean age of the patients was $70{\pm}13.4$ years and the mean survival was $41.7{\pm}2.8$ months. The mean survival of the poor functional outcome group ($mRS{\geq}4$) was $33.9{\pm}3.3$ months, whereas that of the good functional outcome group ($mRS{\leq}3$) was $58.6{\pm}2.6$ months (p value=0.000). The mean survival of the older patients (270 years) was $29.7{\pm}3.4$ months, whereas that of the younger patients (<70 years) was much better as $58.9{\pm}3.2$ months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study. Conclusion : Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.

• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.157-167
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• 1998

Background and Purpose : Cerebrovascular reactivity(CVR) can be estimated by measuring the change of cerebral blood flow that occurs during vasostimulation. To estimate the cerebrovascular reactivity, we investigated the change of flow velocity of the middle cerebral artery(MCA) during hyperventilation and hypoventilation with the transcranial doppler. So we studied whether the CVR measured by this method could show a significant difference between the normal and the cerebral infarction subjects and whether the CVR may decrease with age in normal subjects. Methods : Using transcranial doppler, we measured the mean velocity(Vm), the pulsatility index(P.I.) at the resting state, the end of breath-holding and the end of hyperventilation in 36 normal and 10 cerebral infarction subjects, so we calculated the percentile change of mean velocity(%${\Delta}$Vm) and P.I.(%${\Delta}$P.I.) after the vasostimulation. We estimated the change of Vm, P.I., %${\Delta}$Vm and %${\Delta}$P.I. by the age group and compared those parameters between the age-matched normal control and cerebral infarction subjects. Results : The Vm in MCA significantly decreased with age(p<0.05), but there was no significant difference in Vm and P.I. between normal and cerebral infarction subjects. The %${\Delta}$Vm and %${\Delta}$P.I. in response to hyperventilation significantly decreased with age in MCA and there was significant difference in $%{\Delta}Vm$ of MCA after breath-holding between the normal and cerebral infarction subjects. Conclusion : The breath-holding and hyperventilation tests could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied in the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.