• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.1
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• pp.79-85
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• 2009

목적 : 브라운시쿼드는 대부분 척추손상과 수질외 척추 종양에서 주로 나타난다. 드물게 경추 디스크가 브라운시쿼드의 원인이 된다. 경추디스크에 의한 브라운시쿼드 증세의 수술후 물리치료 및 도수치료 결과를 보고하기 위함이다. 방법 : 50세 남자로써 브라운시쿼드 증세로 진단을 받고 수술후 좌측 팔과 다리에 운동신경에 의한 마비증세가 있었으며(팔>다리), 우측으로 감각과 온도감각이 저하된 경우이다(팔>다리). 측정방법은 통증지수(VAS), 근력(Distal PowerTracII$^{TM}$ test), 지구력(Ergometer) 측정과 심리상태(설문)를 치료전과 후를 비교하였다. 물리치료에서는 기능적 전기자극 치료와 도수치료 및 운동치료 방법을 실시하였다. 도수치료는 통증완화와 근력강화를 위한 MET, MFR, Mobilization 등을 실시하였으며, 운동은 슬링시스템 등을 이용한 운동과 견관절의 불안정을 위해 안정화운동을 실시하였다. 결과 : 이 케이스는 수술후 이상 징후가 척수압박으로 인하여 보다 넓게 통증이 나타났으며, 운동 및 감각신경이 둔해지고 온도에 대한 감각이 반대편 결손으로 나타났으며, 좌측 어깨, 팔 견갑부의 근육 마비와 우측의 감각이 떨어진 현상이 나타났다. 물리치료 후 단기목표와 장기목표에 있어서 통증과 운동 및 감각 기능이 회복되어 각각 팔 통증에서는 VAS 8 ${\rightarrow}$ 1, 상지 하지의 운동기능은 Trace ${\rightarrow}$ Good 로 평가 회복되었으며, 근력측정에서 모두 유의한 차이를 보였다. 모든 치료과정 결과에서 심리적 상태의 설문에서도 높은 점수를 얻어 긍정적 신뢰가 높아 진 것으로 나타났다. 검사결과 다리의 근력이 증가는 걷기 운동 및 에르고메터의 지구력 및 균형이 레벨1의 10분 수행능력이 레벨 20에서 30분 수행능력으로 향상되어 일상적인 활동이 가능해졌다. 결론 : 예상하지 못했던 수술 후유증(side effects)에 대한 치료과정이 환자의 심리에 심각한 부정적인 생각이 신체의 기능과 감정의 손상에 영향을 미치기 때문에 체계적이고 장기적인 치료 과정에서 기능적 향상과 더불어 정신적인 심리의 정서 안정이 매우 필요하다고 사료된다.

• Journal of the Korea Convergence Society
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• v.12 no.10
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• pp.305-310
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• 2021

Grisel's syndrome is a non-traumatic subluxation of the atlantoaxial joint with an inflammatory condition in the adjacent soft tissues. Due to the instability of the cervical spine, careful airway management is crucial to prevent potential cervical spinal cord injury following airway manipulation. We successfully secured the patient airway using a supraglottic airway device (I-gel) in a patient who had previously diagnosed with Grisel's syndrome. The operation was successfully completed, and the patient recovered without any neurological complications. I-gel can be a good option for airway management during general anesthesia in a patient diagnosed with Grisel's syndrome.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.2
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• pp.37-54
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• 2022

Objectives This review investigates the effectiveness of electroacupuncture for impairment of motor and sensory functions after spinal cord injury. Methods The databases used for the search were PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), KMBASE, and Oriental Medicine Advanced Searching Integrated System (OASIS). The literature were searched using a total of 9 domestic and foreign databases. Randomized controlled trials (RCTs) using electroacupuncture as an intervention was selected. The selected studies are analyzed the risk of bias through Cochrane risk-of-bias tool, and meta-analysis was perfomed using RevMan version 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Results A total of 14 RCT studies were selected through 9 domestic and foreign databases, and analyzed. As a result of meta-analysis, when electroacupuncture was performed together with rehabilitation treatment or western drug treatment, it was effective in the recovery of motor and sensory functions of spinal cord injury patients. Conclusions This review suggests that electroacupuncture can be applied as an effective treatment for the recovery of motor and sensory functions of spinal cord injuries. However, there are several limitations, including the small number and heterogeneity of the included studies, as well as their poor methodological quality. Therefore, further, higher-quality studies should be required.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.53-65
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• 2001

Purpose : To improve the local control of patients with nasopharyngeal cancer, we have implemented 3-D conformal radiotherapy and forward intensity modulated radiation therapy (IMRT) to used of compensating filters. Three dimension conformal radiotherapy with intensity modulation is a new modality for cancer treatments. We designed 3-D treatment planning with 3-D RTP (radiation treatment planning system) and evaluation dose distribution with tumor control probability (TCP) and normal tissue complication probability (NTCP). Material and Methods : We have developed a treatment plan consisting four intensity modulated photon fields that are delivered through the compensating tilters and block transmission for critical organs. We get a full size CT imaging including head and neck as 3 mm slices, and delineating PTV (planning target volume) and surrounding critical organs, and reconstructed 3D imaging on the computer windows. In the planning stage, the planner specifies the number of beams and their directions including non-coplanar, and the prescribed doses for the target volume and the permissible dose of normal organs and the overlap regions. We designed compensating filter according to tissue deficit and PTV volume shape also dose weighting for each field to obtain adequate dose distribution, and shielding blocks weighting for transmission. Therapeutic gains were evaluated by numerical equation of tumor control probability and normal tissue complication probability. The TCP and NTCP by DVH (dose volume histogram) were compared with the 3-D conformal radiotherapy and forward intensity modulated conformal radiotherapy by compensator and blocks weighting. Optimization for the weight distribution was peformed iteration with initial guess weight or the even weight distribution. The TCP and NTCP by DVH were compared with the 3-D conformal radiotherapy and intensitiy modulated conformal radiotherapy by compensator and blocks weighting. Results : Using a four field IMRT plan, we have customized dose distribution to conform and deliver sufficient dose to the PTV. In addition, in the overlap regions between the PTV and the normal organs (spinal cord, salivary grand, pituitary, optic nerves), the dose is kept within the tolerance of the respective organs. We evaluated to obtain sufficient TCP value and acceptable NTCP using compensating filters. Quality assurance checks show acceptable agreement between the planned and the implemented MLC(multi-leaf collimator). Conclusion : IMRT provides a powerful and efficient solution for complex planning problems where the surrounding normal tissues place severe constraints on the prescription dose. The intensity modulated fields can be efficaciously and accurately delivered using compensating filters.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.6 no.1
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• pp.1-15
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• 2008

This study was designed to investigate the effect of treadmill exercise of low-intensity and high-intensity on the functional recovery and histological change in spinal cord injury rats. Sprague-Dawley rats were experimented(n=15) for this research. Spinal cord injury was induced by the NYU drop impacter device after laminectomy. After operation, rats were test at modified Tarlov scale at 3 days, and divided into the control group(n=5), experimental group I(n=5, low-intensity treadmill) and experimental group II(n=5, high-intensity treadmill). The rats were disciplined from 7 day through 21 day. Functional recovery was evaluated by the BBB scales and the Grid Walk test for the progressive locomotor recovery at 3, 7, 14, 21 days. Histopathological studies for the muscle in order to observation the change of damage and size of the organized surface which is visible visually it executed hematoxylin & eosin stain. According to the result of 4 weeks of treadmill exercise, group II showed improvement than group I of motor behavior after spinal cord injury.

• Physical Therapy Korea
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• v.13 no.2
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• pp.1-8
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• 2006

The main purposes of this study were to find the correlation between walking ability assessment tools using the Modified Barthel Index (MBI), Functional Independence Measure (FIM), Spinal Cord Injury Measurement II (SCIM II), Walking Index for Spinal Cord Injury (WISCI), walking velocity, and walking endurance. The study population consisted of 56 patients with spinal cord injury referred to the department of Rehabilitative Medicine in the National Rehabilitation Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed by MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance. The data were analyzed using Pearson correlation analysis and X2. There was significant correlation between the MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance (p<.01). In particular, WISCI has a significant correlation with SCIM II(p<.001). Therefore the WISCI scale is an appropriate assessment tool to predict the gait ability of patients with spinal cord injury. Further study about MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance is needed using a longitudinal study design.

• Journal of Pharmacopuncture
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• v.13 no.1
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• pp.129-144
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• 2010

Objective : Traumatic lumbar burst fracture causes significant spinal cord injury. This report is intended to estimate the efficacy using oriental treatment on a patient with lumbar burst fracture and spinal cord injury. Methods : From 21th December, 2009 to 5th February, 2010, 1 female inpatient diagnosed with lumbar burst fracture and spinal cord injury was treated with general oriental medicine therapy : mae-sun therapy ; acupuncture ; moxibustion ; pharmacopuncture ; physical therapy and herbal medication. TUG, SCIMII and VAS were used for evaluation of gait disturbance and pain in both feet. Measurement of self voiding amount and remaining amount through CIC was used for evaluation of neurogenic vesical dysfunction. Results : The patient showed a certain degree of improvement in gait disturbance, pain in both feet and neurogenic vesical dysfunction through above evaluation methods. Conclusion : Oriental treatments such as mae-sun therapy, acupuncture and moxibustion therapy, pharmacopuncture therapy and herbal medication can be effective for spinal cord injury due to traumatic lumbar burst fracture.

• Journal of the Korean Society for Precision Engineering
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• v.21 no.8
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• pp.171-179
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• 2004

The purpose of this study is to generate cycling motion for FES (functional electrical stimulation) using knee muscles only. We investigated the possibility by simulation. The musculoskeletal model used in this simulation was simplified as 5-rigid links and 2 muscles (knee extensor and flexor). For the improvement of the present feedforward control in FES, we included feedback path in the control system. The control system was developed based on the biological neuronal system and was represented by three sub-systems. The first is a higher neuronal system that generates the motion command for each joint. The second is the lower neuronal system that divides the motion command to each muscle. And the third is a sensory feedback system corresponding to the somatic sensory system. Control system parameters were adjusted by a genetic algorithm (GA) based on the natural selection theory. GA searched the better parameters in terms of the cost function where the energy consumption, muscle force smoothness, and the cycling speed of each parameter set (individual) are evaluated. As a result, cycling was implemented using knee muscles only. The proposed control system based on the nervous system model worked well even with disturbances.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.878-881
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• 2007

Pneumocephalus after thoracoscopic excision of a mediastinal mass is a very rare complication. It presumably occurs due to dural injury near the spinal root and development of a subsequent subarachnoid-pleural fistula. A 60-year-old woman complained of nausea and headache after thoracoscopic excision of a posterior mediastinal mass. She was diagnosed with pneumocephalus by brain CT and recovered with supportive management.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.105-110
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• 2000

Central neuropathic pain may occur in 10~20% of the patients after spinal cord injury. The central pain syndrome include spontaneous continuing and intermittent pain as well as evoked pain. The pain is evoked by non-noxious stimulation of the region (allodynia) and repeated stimulation (wind-up phenomenon). Four patients were referred suffering from severe pain, allodynia and hyperaesthesia after spinal cord injury. They had received conventional treatment with non-steroidal anti-inflammatory drugs, steroid, anticonvulsant, antidepressant and rehabilitation which failed to provide pain relief. We administered combination of low doses of morphine and ketamine (10 mg) through the epidural catheter with other conventional therapy. Satisfactory pain relief was achieved in each patient. The reduction of pain was not associated with severe side effects. The most bothersome side effect of ketamine was dizziness in one patient, only caused by bolus injection (ketamine 10 mg with normal saline 10 ml). This suggests synergy from this combination that provides an alternative treatment for central pain.