• Title/Summary/Keyword: 부전마비

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Arytenoid Adduction as a Surgical Treatment for Hoarseness with Unilateral Vocal Cord Paralysis (편측성대마비환자에 대한 피열연골내전술)

  • 김광문;김영호;홍원표;최홍식
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.74-74
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    • 1993
  • Unilateral vocal cord paralysis is induced by various causes and its effective treatment has been diversely searched out until now. Currently used treatment modalities are intracordal injection of exogenous materials such as Teflon or Silicone, and thyroplasty and so forth. But, with the above mentioned modalities, it has been not satisfactory to obtain a good postoperative results especially in cases when the glottal incompetence is very severe or the level difference between the vocal cords is large. In such cases, vocal cord adduction can be accomplished by anteromedial traction of the muscular process of paralyzed vocal cord via surgical exposure resulting improvement of voice quality. Recently, authors performed arytenoid adduction in 3 cases of unilateral vocal cord paralysis to obtain a better improvement of voice quality, and experienced satisfiable postoperative results.

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Ventral Fixation of Atlantoaxial Joint under Fluoroscopic Guidance Using Screws in a Chihuahua Dog (환축추 아탈구 견에서 투시기 유도를 통한 복측 나사 고정술)

  • Lee, Jae-Hoon;Yang, Hee-Taek;Yang, Wo-Jong;Chung, Dai-Jung;Kang, Eun-Hee;Eom, Ki-Dong;Choi, Chi-Bong;Chang, Hwa-Seok;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.25 no.2
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    • pp.131-135
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    • 2008
  • A 5-year-old Chihuahua dog was evaluated for a tetraparesis. The dog was presented with a non-ambulatory tetraparesis and neck pain. Radiography demonstrated an atlantoaxial (AA) subluxation and increased distance between the dorsal arch of the C1 and the dorsal spinous process of the C2. The AA joint was fixed with ventral transarticular fixation using two screws under fluoroscopic guidance. Neck brace was applied during 3 weeks post-operation. After 4 weeks, the dog was fully ambulatory with improved neurological function. Postoperative radiographs confirmed reduction of the luxation and no migration of screws. The dog showed complete resolution of clinical signs without signs of recurrence till 4 months after operation. Proper angulations of screws provided under fluoroscopic guidance, enabled adequate stabilization of the AA joints using ventral transarticular screw fixation which improved neurologic outcome of the patient.

Vertebral Osteosarcoma Causing Compression of the Lumbar Spinal Cord in a Dog (개에서 요추부 척수를 압박하는 척추 골육종 발생례)

  • Kang, Byung-Jae;Ryu, Hak-Hyun;Park, Sung-Su;Rahman, Md. Mizanur;Sung, Gyu-Jin;Kim, Yong-Sun;Park, Jun-Won;Kim, Wan-Hee;Yoon, Jung-Hee;Kim, Dae-Yong;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.588-592
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    • 2010
  • A 15-year-old neutered male Yorkshire terrier was presented with a gait disorder of the pelvic limbs. For differential diagnosis of neural disease, magnetic resonance imaging (MRI) and computed tomography (CT) scan were performed. CT showed bone defect in the 4th lumbar vertebra and adjacent soft tissue mass. MRI revealed a mass in left side of the 4th lumbar vertebra. The mass was uniformly enhanced on contrast-enhanced T1-weighted imaging (T1W1). Excision of the mass alleviated back pain. Vertebral osteosarcoma was identified by the histopathological examination. Therefore, CT and MRI were helpful to diagnose vertebral osteosarcoma in the dog and to plan surgical excision of the mass.

Usefulness of the Laryngeal Electromyography in Diagnosis of Vocal Fold Paresis (성대 부전 마비의 진단에서 후두 근전도 검사의 유용성)

  • Kim, Hyun-Ji;Park, Hae-Sang;Kim, Han-Su;Park, Kee-Duk;Chung, Sung-Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.126-132
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    • 2011
  • Background and Objectives : Vocal fold paresis is a clinical condition and considered as a continuum of neurologic dysfunction encompassing partial denervation and variable degrees and patterns of reinnervation. Its incidence, clinical presentation, significance are incompletely understood and still debated. This study describes the clinical, electromyographic findings in patients who presented with complaints of dysphonia and whose laryngoscopic finding revealed vocal fold paresis. Materials and Method : 47 patients (male : 25, female : 22) who referred to Ewha Womans University Medical Center Voice clinic for evaluation of vocal complaints were enrolled in this study. All patients had undergone a through history and physical examination including strobovideoscopic and laryngoscopic examination. Patients with in the history and/or laryngoscopic examination suggestive of vocal fold paresis were evaluated by laryngeal electromyography (LEMG). Results : Of these patients, 23 (48.9%) were found to have evidence of neuropathy on LEMG. There was no significant difference in voice symptoms and laryngoscopic findings between two groups of patients with evidence of neuropathy and who show normal findings on LEMG. Conclusion : LEMG can clinically help to guide the evaluation and management of vocal fold paresis. Due to some limitations of LEMG, laryngoscopic findings and clinical correlations should also be considered when diagnosing the vocal fold paresis.

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A Clinical Study of Non-Accidental Intracranial Hemorrhage in Children (소아에서 사고에 의하지 않은 두개내 출혈의 임상적 고찰)

  • Huh, Kwon Hoe;Song, Keum Ho;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1067-1072
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    • 2003
  • Purpose : Non-accidental intracranial hemorrhage in children is not low in incidence and results in high mortality and serious sequelae. So, the authors have researched the distribution of sex and age, causes, symptoms and signs, hemorrhagic types, mortality rate and sequelae of the patients hospitalized with non-accidental intracranial hemorrhage at Hallym University Sacred Heart Hospital. Methods : The medical records of twenty patients, aged 15 or younger, and excluding neonatal patients, were analyzed retrospectively. The patients in this study were admitted with non-accidental intracranial hemorrhage from January 1999 to June 2002. Results : Of the twenty cases, the ratio of male to female was 1 : 0.8. The patients aged one or less and between 11 and 15 were discovered to be the most frequent cases. Shaken baby syndrome and arteriovenous malformation were found to be the most frequent causes. Seizure was most frequently found to be a symptom and a sign. Hemorrhagic type was classified into subdural hemorrhage eight, intracerebral hemorrhage five. There were three mortal cases. Twelve surviving patients, excluding five not-followed ones, were reclassified into six cases of complete recovery and six of sequalae. Conclusion : Non-accidental intracranial hemorrhage in children is not low in incidence, with a high mortality rate and a high incidence of serious sequelae after survival. Consequently, early diagnosis and appropriate treatment are required. In addition, appropriate rehabilitation after treatment is needed because the high survival rate due to advanced medical treatment results in an increasing number of neurologic sequelae.

A Clinical Study about Gait Disturbance of Patient who Diagnosed Spinal Cord Concussion after Traffic Accident (교통사고 후 척수진탕으로 인한 양하지 부전마비 환자 1례에 대한 증례보고)

  • Choi, Yi Jeong;Lee, Bong Hyo;Lee, Yun Kyu;Kim, Jae Su;Lee, Hyun Jong;Jung, Tae Young;Lim, Sung Chul
    • Journal of Acupuncture Research
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    • v.30 no.2
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    • pp.81-90
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    • 2013
  • Objectives : The purpose on this study is to report clinical effects of oriental medicine for gait disturbance after traffic accident. Methods : The patient was treated using electro-acupuncture, 8 constitution acupuncture, herbal medicine, moxibustion and physical treatment. The effects for gait disturbance have measured with modified barthel index(MBI) and that for lower back pain have measured with visual analog scale(VAS). Results : 1. The Modified barthel index gradually increased according to treatment time. 2. The VAS of low back pain decreased to less than half. Conclusion : Oriental medical treatment showed positive effect on gait disturbance after traffic accident.

A Case of Erythropoietic Protoporphyria with Severe Liver Dysfunction and Neurological Symptoms (신경 및 위장관 증세를 동반한 Erythropoietic Protoporphyria 환아 1예)

  • Kim, Bo Hyun;Park, Young Nyun;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.263-268
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    • 2005
  • Erythropoietic protoporphyria is a genetic disorder due to a deficiency of ferrochelatase resulting in excessive accumulation and excretion of protoporphyrin. The predominant clinical feature is photosensitivity. Severe hepatic failure occurs in a small percentage of patients, and neurological symptoms are very rare. We report a case of erythropoietic protoporphyria associated with severe hepatic dysfunction and neurological symptoms. A 9-year-old girl presented with severe abdominal pain, nausea, weakness and pain of extremities, and urinary retention. Ultrasonogram and abdominal CT scanning revealed a diffuse infiltrated and enlarged liver. Liver biopsy showed deposition of dense dark brown pigment within the bile, hepatocytes and Kupffer cells. Plus, dense dark brown deposits gave a red birefringent under polarize light. Porphyrin studies demonstrated markedly elevated serum free erythrocyte protoporphyrin. This girl was diagnosed as erythropoietic protoporphyria with severe liver dysfunction and neurological symptoms.

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Zoster Paresis Misconceived as a Radiculopathy due to Herniated Intervertebral Disc (추간판 탈출증에 의한 신경근병증으로 오인된 대상포진성 부전마비)

  • Kim, Hyun Jee;Yeo, Jin Seok;Jeon, Young Hun;Choi, Jy Young;Ha, Mi Jin;Hong, Jung Gil
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.181-185
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    • 2009
  • Herpes zoster is a viral disease of the posterior root ganglion and sensory nerve fiber, which presents clinically with vesicular eruption of the skin, radicular pain and sensory changes in the distribution of the affected ganglion. However, involvement of the motor neurons can be seen as well. If classic cutaneous lesions are present, herpes zoster-related motor paresis is easily diagnosed. Otherwise, the diagnosis may be more difficult and suspicious, especially if weakness occurs as a symptom before cutaneous lesions appear, or abnormal findings on the MRI are consistent with the signs. There have been few reports of sciatica with motor loss preceding skin lesions. Here, we report a patient with herpes zoster-related motor paresis preceding skin lesions. In the preliminary diagnosis, the herpes zoster-related motor paresis was confused for some structural disorder.

Differential Diagnostic Characteristics of Movement Disorders in Children With Lesch-Nyhan Syndrome (LNS): A Case Report (Lesch-Nyhan 증후군 아동의 운동장애에 대한 감별진단 특성)

  • You, Sung H.;Bunker, Linda K.
    • Physical Therapy Korea
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    • v.9 no.4
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    • pp.13-35
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    • 2002
  • Lesch-Nyhan 증후근(LNS)은 hypoxanthine guanine phosphoribosyle transferase(HGPRT) 효소를 암호화 하는 X 염색체가 불완전해서 일어나는 유전적인 추제외로계(또는 기저핵)의 드문 병변이다. 출생시 LNS 유아는 정상적인 운동발달이 관찰되어진다. LNS에게서 현저하게 진단적인 특징으로 보여지는 운동심리적 행동인 self-mutilating 행위는 4살 이후에나 나타난다. LNS 아이들은 오히려 초기에 Rett's 증후근, 뇌성마비, 자폐, 다운증후근과 유사한 운동행위를 보인다. 그래서 LNS 아이들은 앞에 기술한 신경학적 장애로 오진을 받을 수가 있다. 오진으로 인해 초기에 적절한 치료를 받지 못한다면 LNS는 결과적으로 합병증(신장부전)과 self-mutilating 행위로 인하여 치명적일 수가 있다. 그러므로, 이 연구의 목적은 LNS 평가 동안 더 나은 진단을 하도록 하기 위하여 LNS와 관련된 기능부전에 대한 지식을 임상가들에게 제공하고자 함이었다. 연구 대상자는 10살인 2명의 쌍둥이 남아이었으며 실험은 뻗기 과제 수행(reaching task)시 움직임 특성을 보기 위하여 운동형상학적과 비디오 분석을 사용하였다. 기술통계로 분석 결과 움직임 시간과 단위가 증가됨을 보였고 사지의 분절적 움직임이 협응되지 않음을 보였다. ballistic과 jerky 움직임 양상은 dysmetric과 비긴장성 운동 행위에서 우세하였다. LNS은 추체로계 운동 장애 (과근긴장도나 저긴장도) 와 추체외로계의 운동 장애(dystonia와 choreoathetosis)의 혼합된 형태를 보였다. 결론으로 이 연구는 운동발달 장애를 가진 아이들을 치료하고자 할 때 임상가들한테 LNS 아이들의 움직임 장애의 다른 진단적 특징을 알아야 한다는 것을 제시하고자 한다.

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Abnormal Eye Movements in Patients with Dementia (치매 환자에서 나타나는 비정상적인 안구운동)

  • Kim, Hyun;Lee, Kang-Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.73-80
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    • 2007
  • Anumber of prior studies have reported eye movement dysfunction in patients with dementia. The eye movement test which is non-invasive can evaluate the local brain function quantitatively. Therefore, it can be a useful method for characterizing regional brain abnormalities of patients with dementia. The aim of this paper is to review the literatures on eye movement abnormalities in dementia patients. Saccade system dysfunctions in Alzheimer disease include increased latency, reduced accuracy, and increased antisaccade error rates. Patients with frontotemporal dementia showed impaired reflexive saccade inhibition and increased latency and errors of antisaccade task. And delayed initiation of voluntary saccades, slow saccades, and increased errors and latency on antisaccade task were found in Huntington's disease. Patients with Parkinson’s disease dementia and dementia with Lewy bodies have characteristics of impaired in both reflexive saccade execution and complex saccade performance. However, there were few reports of abnormal eye movements in Creutzfeldt-Jakob disease; they could be found at the later stages after symptoms of dementia came to be evident, and secondary to cerebellar and vestibular involvement. Slowing of saccades and hypometric saccades might precede the supranuclear limitation of vertical gaze in PSP. Dysfunction of voluntary eyelid movements was a characteristic finding of PSP as well. In conclusion, patients with dementia can show various abnormal eye movements and they are related with cortial and subcortical brain dysfunctions. The research on localization of brain relevant to each symptom can promise more clinical implications of eye movement of dementia.

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