• Title/Summary/Keyword: stroke

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The Case-Control study on the Risk Factors of Stroke (뇌졸중의 위험요인에 대한 환자-대조군 연구)

  • Baek, In-Kyoung;Kim, Yoon-Sik
    • Journal of Haehwa Medicine
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    • v.22 no.1
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    • pp.201-216
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    • 2013
  • The purpose of this case-control study was to show the relationship between risk factor(Sex, Age, Martial Status, Educational Periods, Family history, Variables of Obesity, Smoking Status, Drinking Status, Past History, Blood Test) and the incidence of stroke. Methods: 788 stroke patients were enrolled as the case group and 450 non-stroke patients as control group from Sep.2006 to Dec.2010. Patients were hospitalized within 30 days after the onset of stroke. Risk factors and warning signs were obtained from personal interview by oriental medicine doctors who used CRF. Results: 1. Age was found to have significant relation with stroke(p<.0001). 2. Martial status(p<.0001, OR=0.44) and educational periods(p<.0001) were both significant risk factor for stroke. 3. As a result of reviewing the influence of family history, it was found to have no significant relation with stroke. Stroke was found to have significant relation with stroke(OR=1.50). 4. Female waist circumference(WC, p<.0001) and female waist-hip circumference ratio(WHR, p<.0001) were risk factors for stroke. On the other hand, male WC and male WHR showed no significant influence on stroke occurrence as an independent risk factor. 5. Both smoking status(p<.0001, current smoker OR=8.95) and drinking status(p<.0001, current drinker OR=2.50, former drinker OR=2.82) were significant risk factors for stroke. 6. As a result of reviewing the influence of past history, transient ischemic attack(p<.0001, OR=8.46), hypertension(p<.0001, OR=4.72), hyperlipidemia(0.0064), diabetes mellitus(p<.0001, OR=3.34), stroke(p<.0001, OR=50.26) were significant risk factors. On the other hand, ischemic heart disease(p=0.2332) was found to have no significant relation with stroke. 7. Increase of WBC, RBC, Platelet, TG, FBS and Cl- level were significant risk factor of stroke, On the other hand, decrease of Hgb, Hct, AST, HDL-chol, LDH, Na+ and K+ level were significant risk factor of stroke. T-chol and ALT level showed no significant influence on stroke occurrence.

Circadian Variation of Acute Stroke;Hospital Based Study

  • 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.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.

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Clinical Analysis of Stroke in Young Adults (청장년층 뇌졸중에 대한 고찰)

  • 정은정;배형섭;문상관;고창남;조기호;김영석;이경섭
    • The Journal of Korean Medicine
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    • v.21 no.1
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    • pp.84-90
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    • 2000
  • Background and Purpose: Stroke in young adults is relatively uncommon. Only 3.7-14.4% of all strokes occur in patients aged 15-45 years. Stroke in young adults has more various and diverse possible causes than stroke in the elderly. We studied to gain further insight into both pathogenic and etiologic determinants in young adults with stroke. Methods : We retrospectively reviewed the medical records of 230 young patients aged 15-45 years who were admitted to the 2nd internal medicine department of Kyung Hee Oriental Medical Center with a diagnosis of stroke between May 1995 and May 1999. We analysed clinical features and diagnostic tests, such as brain imaging, cerebral angiography, echocardiography, 24 hours holter monitoring and other laboratory tests. Results : 1. Of 230 young patients with stroke aged 15-45 years(176 males(76.5%) and 54 females(23.5%)), 140 patients(60.9%) showed ischemic stroke and 90 patients(39.1 %) showed hemorragic stroke. 2. The most prevalent age group was from 40 to 45 years with 142 patients(61.7%) 3. The most frequent site of 140 ischemic stroke was MCA territory in 93 cases(66.4%) and Multiple, VA territory, PCA territory, ACA territory in order of frequency. 4. The most frequent site of 90 hemorrhagic stroke was basal galglia hemorrhage 57 cases(63.3%) and subcortical 13 cases(14.5%), pons, thalmus, subarachnoid, cerebellum in order of frequency. 5. The causes of hemorrhagic stroke were hypertension 49 cases(54.5%), arteriovenous malformation 7 cases(7.8%), ruptured aneurysm 4 cases(4.5%), angioma 3 cases(3.3%). 6. The risk factors of ischemic stroke were smoking, alcohol drinking, hyperlipidemia, hypertension, obesity, heart disease, history of CVA, diabetes mellitus, in order of frequency. 7. The comparison of risk factors between ischemic and hemorrhagic stroke: hypertension was prevalent in hemorrhagic stroke, heart disease and history of CVA were prevalent in ischemic stroke. Conclusions: From the above results, we found that stroke in young adults had various possible causes. Young adults with stroke deserve an extensive but tailored evaluation which include angiography and echocardiography for diagnosis.

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Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation (중풍환자에 대한 일차 한의임상진료 가이드라인)

  • Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.347-366
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    • 2012
  • The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

Recent Epidemiological Trends of Stroke

  • Park, Hyun-Seok;Kang, Myong-Jin;Huh, Jae-Taeck
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.16-20
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    • 2008
  • Objective : Rapid increase in aged population and westernization of lifestyle have modified epidemiological status of stroke. The purpose of this study is to analyze changing trends of stroke epidemiology in South Korea. Methods : We reviewed retrospectively medical records of 1,124 cases diagnosed as stroke among 54,534 patients who visited the Emergency Medical Center at our hospital from January 1994 to December 1996 (Group A). Also, we evaluated 1,705 cases diagnosed as stroke among 55,381 patients who visited to the same hospital from January 2003 to December 2005 (Group B). The variable features of stroke, such as age, sex, seasonal variation and distribution of stroke subtypes were studied by comparing group A with B. Results : In group A, hemorrhagic stroke (67.9%) was more prevalent than ischemic stroke (32.1%). However, group B showed that the ratio of hemorrhagic stroke (40.3%) to ischemic stroke (59.6%) has been reversed. The highest incidence of stroke was noted in their sixties and seventies of age in group B, which was older than that of group A. In group A, male ischemic stroke (IS) patients outnumbered female patients (1.26:1). Moreover, this gender disproportion became higher in group B (1.53:1). In group A, the number of male intracerebral hermorrhage (ICH) patients were similar to that of female patients (0.97:1). However, male ICH patients outnumbered female patients in group B (1.23:1). As for subarachnoid hemorrhage (SAH), female patients outnumbered male patients more than two-fold in both groups. Both groups showed that the occurrence of ischemic stroke was highest in summer, but that of hemorrhagic stroke was the highest in winter. Conclusion : This study showed the changing trends of stroke in its distribution of subtypes. Multicenter prospective study using stroke registry would be required for the determination of national epidemiologic trends.

StrokeMed: an integrated literature database for stroke and the differentiation of stroke syndrome

  • Kim, Young-Uk;Kim, Jin-Ho;Park, Young-Kyu;Kim, Young-Joo
    • Interdisciplinary Bio Central
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    • v.2 no.2
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    • pp.2.1-2.4
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    • 2010
  • Complex diseases, such as stroke and cancer, have two or more genetic influences and are affected by environmental factors, which complicate them. Due to the complex characteristics of these diseases, we must search and study comprehensive literature-based article resources. Some disease-related literature databases have been developed through specialized journal issues or major websites. Most of them, however, are scattered throughout a website, and users encounter difficulties in finding accurate and comprehensive information easily and quickly. We developed StrokeMed, an integrated literature database for stroke and the differentiation of stroke syndrome. The system allows users to explore PubMed search results, categorized by MeSH (Medical Subject Headings), and the differentiation of stroke syndrome in Oriental medicine. StrokeMed collects data from important sites, such as PubMed, Scirus, and Scopus, automatically to maintain higher-quality and updated content. Currently, the system indexes more than 20,000 PubMed abstracts that are related to stroke, stroke etiology, and Oriental medicine. The system provides valuable literature information to the scientific and medical fields in stroke.

Comparative Study of Risk Factors for Ischemic Stroke in Koreans : Multi-center Study (한국인의 허혈성 뇌졸중의 위험요인에 대한 비교고찰 - 다기관 연구)

  • Kim, Hye-Mi;Lee, In-Whan;Shin, Ae-Sook;Kim, Na-Hee;Shim, So-Ra;Kim, Min-Kyung;Na, Byung-Jo;Cho, Seung-Yeon;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.870-879
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    • 2010
  • Objective : This study is about stroke risk factors which may differ between countries. Methods : We recruited 1725 ischemic stroke patients from multiple-centers. We analyzed stroke risk factors: hypertension, diabetes mellitus, dyslipidemia, depression, cardiac source, smoking, waist-to hip ratio, alcohol intake, physical activity, and psychosocial stress. We then compared risk factor results from other countries (the INTERSTROKE study) with this study. Results : 10 risk factors are related to stroke incidence. They were somewhat different between this study and the INTERSTROKE study. Conclusions : Hypertension is the most important risk factor of stroke, and other 9 risk factors also should be managed to prevent stroke incidence. Frequency of risk factors were different from the INTERSTROKE study. I think it could be partly due to differences of ethnicity and age. More studies are needed to describe characteristics of risk factors of Koreans.

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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The Relationship between Stroke Risk Factors, Stroke Subtypes and Diagnostic Pattern in Korean Medicine of Acute Stroke - Multi Center Trials (급성기 중풍 환자들의 위험요인 및 중풍유형과 변증분형의 관련성 연구)

  • Shin, Ae-Sook;Lee, In-Whan;Gwak, Ja-Young;Cho, Seung-Yeon;Park, Seong-Uk;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.9 no.1
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    • pp.19-24
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    • 2008
  • Objectives : This study was conducted as part of the national project to standardize stroke diagnosis in Korean medicine. In this study, we assessed what categories of stroke diagnosis these three most common risk factors of cerebro-vascular attack(CVA), hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) fall into. Also we looked into stroke subtypes and its diagnosis in Korean medicine. Methods : 806 patients with acute stroke from 5 universities(Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center) across the country were involved from April, 2007 til August, 2008. We had data of 482 patients to be analyzed and diagnosed by a Korean medicine training doctor and a professor. Results : All three major stroke risk factors were diagnosed as being dampness-phlegm pattern, but no significant difference was observed except in hyperlipidemia patients. Stroke subtypes such as hemorrhage and infarction showed no significant difference in this study. Conclusions : This study provides evidence that hyperlipidemia can be diagnosed as dampness-phlegm by Korean medicine. Further studies with various subtypes of stroke patients are required to prove solid evidence with other stroke risk factors.

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The Effect of Recovery of disability on Post-stroke Depression (뇌졸중 환자의 장애 회복이 뇌졸중 후 우울증에 미치는 영향)

  • Ha, Mi-Sook;Park, Min-Chull;Goo, Bong-Oh
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.4
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    • pp.623-632
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    • 2010
  • Purpose : The purpose of this study was to identify the effect of recovery of disability on post-stroke depression in stroke patients. Methods : Fifty patients with stroke were participated in this study. The stroke impact scale(SIS) was used to assess the recovery of disability according to stroke and short form of geriatric depression scale(SGDS) was used to assess the poststroke depression(PSD). Results : The suspicious for depression were exhibited in 38%(n=19) and patients with depression were 58% (n=26) of 50 patients with stroke. In correlation between recovery of disability and depression, emotion and recovery of stroke negatively correlated with depression(p<.05). Conclusion : These results demonstrates that patients with stroke need to manage and treat emotion for the prevention and management of PSD.