• 제목/요약/키워드: 척추경

검색결과 143건 처리시간 0.023초

연골무형성증(Achondroplasia) 환자에서 술 후 교정시술을 위한 경막외차단 중 발생한 전척추 마취 -증례보고- (Total Spinal Anesthesia following Epidural Block for Correction with IIizarov Apparatus in an Achondroplasia Patient -A case report-)

  • 최원형;이일옥;이미경;김난숙;임상호;공명훈
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.288-291
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    • 2006
  • Epidural analgesia using an epidural catheter is an effective method to relieve the pain during the rehabilitating procedure for postoperative orthopedic patients. Total spinal anesthesia is one of the possible complications of epidural catheterization which can lead to a life-threatening condition. Achondroplasia is the most common form of short-limbed dwarfism resulting from a failure of endochondral bone formation. In patients suffering with short stature syndrome like achondroplasia, the incidence and risk of total spinal anesthesia during epidural anesthesia may increase because of the technical difficulty and structural anomaly of the spine. We report here on a 35-year old female patient with a height of a 115 cm. She was diagnosed as achondroplasia and she had a previous Ilizarov operation; both tibial lengthening and correction of valgus were done. No specific event occurred during epidural catheterization. Immediately after the injection of a test dose via epidural catheter, the patient became hypotensive, drowsy and showed weakness of both her upper and lower extremities. The symptoms were disappeared after 40 minutes. The catheter was removed on the next day. We concluded that the total spinal anesthesia was caused by intrathecal injection of local anesthetics through the epidural catheter, and the anesthesia then migrated into the subarachonoid space.

TiN 및 DLC 코팅된 척추경나사못시스템 수술기구의 기계적 안정성 분석 (Mechanical Stability of TiN and DLC Coated Instrument of Pedicle Screw System)

  • 강관수;정태곤;양재웅;우수헌;박태현;정용훈
    • 한국표면공학회지
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    • 제52권3호
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    • pp.163-170
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    • 2019
  • Durability of instrument is one of the most important factor to ensure accurate treatment and decrease failure for the orthopedic surgical operation. Normally, a set-screw driver tip has been processed with hard coating for their higher durability and wear resistance. And several surface modification methods were obtained such as titanium nitride (TiN) coating, diamond like carbon coating, other nitriding, and etc. In this study, we have surface modified on set-screw driver tip with TiN and DLC, investigated whether the TiN and DLC coatings affect the mechanical properties and durability of the set-screw driver tip in the pedicle screw system. The surface morphologies were observed with scanning-electron microscopy (SEM), and the static/dynamic torsional properties were investigated with universal testing machine based on ASTM F543. Coating thickness of each coatings were commonly around $1^{\circ}C$. Static torsional stiffness, and ultimate torque values for DLC and TiN coated samples were significantly higher than those of non-coated sample by the pared T-test. Surface morphology of after the dynamic torsional test was more clean with less scratch or friction traces from DLC coating than that of TiN coating and non-coated sample.

환축추 회전 아탈구 환자에 대한 도수치료 효과 (Effect of Manual Therapy on a Patient With Atlantoaxial Rotatory Subluxation)

  • 전재국;양성화;신의주
    • 대한정형도수물리치료학회지
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    • 제25권1호
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    • pp.71-76
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    • 2019
  • Background: An 8-year-old girl had severe neck pain and stiffness after trauma. CT scan showed atlantoaxial rotatory subluxation (AARS). She had conservative treatment because she did not have neurological symptoms and spinal basilar artery dysfunction. Conservative therapy was halter traction twice for 4 weeks. However, pain and stiffness persisted. She had been recommended to have surgery from her physician, but she received manual therapy for non-surgical procedures. Methods: The joint mobilization, muscle energy technique, motor control exercise, and deep neck flexor (DNF) endurance exercise were applied as manual therapy and 10 session for 2weeks. Results: Clinical outcomes were measured at initial baseline, after 2 weeks, and after 6weeks. Active range of motion was completely restored after 6weeks and numeric pain rating scale was completely reduced after 2 weeks. The strength of neck flexor muscle recovered to normal after 2 weeks, and the DNF endurance was improved to 25 seconds after 2 weeks and to 42 seconds after 6weeks. Motor control capacity recovered to 30 ㎜Hg after 2 weeks. Conclusions: This case report describes the immediate and short-term clinical outcomes for a patient presenting with symptoms of neck pain following AARS. Clinical rationale and patient preference aided the decision to incorporate manual therapy as a treatment for this patient. Manual therapy has shown a successful recovery in AARS patients, more research is needed to validate the inference of this case report.

보존적 한방치료를 시행한 척추 수술 실패 증후군 환자 증례보고 : 출산 후 악화를 포함한 장기 경과 관찰 (A Case Report of Lumbar Spine Failed Back Surgery Syndrome (FBSS) Patient Treated with Korean Medicine: Long-Term Progress Including Postpartum Aggravation)

  • 노지애;이지원;변다영;홍정수;김동진
    • 대한한방내과학회지
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    • 제40권1호
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    • pp.126-135
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    • 2019
  • Background: Because of fear of reoperation and low efficiency, some patients with failed back surgery syndrome (FBSS) opt for Korean medicine treatment. Gold standard treatment is not present for FBSS, therefore both surgical and non-surgical treatment are possible. Studies of Korean conservative medicine for FBSS had a short duration of treatment and mainly pre- and post-treatment comparisons. And case of female patients who have worsened after childbirth is rare. The purpose of this study was to report long-term follow-up and rare cases of FBSS. Case summary: A 33-year-old female patient diagnosed with lumbar disc herniation complained with low back pain and radicular pain in the left leg after surgery in 2011. Acupuncture and decoction (Cheongpa-jeon, GCSB-5) were administered to her twice a day for about 6 years and 6 months. The patient's complaints improved with each hospitalization, and Magnetic Resonance Imaging (MRI) showed a slight decrease in the size of the recurrent disc (L4/5) and a newly developed disc (L5/S1) that had deteriorated after delivery. Conclusion: Korean medicine could be used to manage the pain of lumbar spine FBSS patients for 6-7 years and to alleviate lumbago after delivery.

척추 신경섬유종 진단을 받은 요통 환자에 대한 복합적 한방처치 및 영상학적 경과 관찰 증례 보고 1례 (A Patient with a Diagnosis of Spinal Neurofibroma and Complaining of Lower Back Pain: A Case Report, Including Two Follow-ups after Discharge)

  • 문희영;류광현;주아라;최요섭;추원정;박지원;김두리;전용현
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.938-947
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    • 2019
  • Objective: This study was performed to report the changes in symptoms and radiological consequences of a patient diagnosed with spinal neurofibroma and complaining of lower back pain. Methods: The patient was diagnosed with a spinal neurofibroma after MRI examination and was treated with traditional Korean medicine, including traditional Korean medication and acupuncture. We measured the change in symptom severity using a numerical rating scale (NRS) and the Oswestry Disability Index (ODI). We also used the EQ-5D (EuroQoL-5D) scale to assess the patient's quality of life. In addition, we examined the change in the size of the cyst by MRI twice after discharge: at about 3 months after discharge and at about 8 months after discharge. Results: After about 6 weeks of treatment, most pathological symptoms had decreased. The patient showed a decline in NRS and ODI scores and showed an increase in quality of life. The two MRI examinations after the discharge revealed a decrease in the size of the cyst. Conclusions: Traditional Korean medicine can be a solution for patients with spinal neurofibroma causing neurological pain.

산지습지의 친환경복원이 저서성 대형무척추동물 분포에 미치는 영향 (Effect of eco-friendly restoration on the community characteristics of benthic macroinvertebrates in forested bog)

  • 정유경;이헌호;강원석;박기형;권세명
    • 한국환경복원기술학회지
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    • 제24권3호
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    • pp.33-47
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    • 2021
  • This study was conducted to investigate the influence of eco-friendly restoration in forested bog on the structure of benthic macroinvertebrate community. The benthic macroinvertebrates collected from the surveyed sites were composed of 1,071 individuals, 60 species, 40 families, 13 orders, 6 classes and 5 phyla. At the control and Site 3(small dam), the number of species and individuals were larger than that of other sites, and EPT group ratio was same as well. Considered by index, the dominance index (DI) was found the highest at the biotope area. The diversity index (H') and richness index (RI) were the highest at the control and Site 3. In addition, the ecological score of benthic macroinvertebrate (ESB) showed the highest at site 3, while the lowest at biotope area. The stability and recovery of benthic macrointebrates showed different according to restoration types at forested bog. After restoration project, the benthic macroinvertebrates were observed to get recovery at Site 3, and to have the highest communities stability at control and Site 3. At biotope areas (Site 4, Site 5 and Site 6) communities stability were the lowest, but showed different community stability values according to the presence of water. It is confirmed that the eco-friendly restoration projects indeed provided the better environment for the inhabitation of benthic macroinvertebrate community. The change of community index depending on the restoration projects suggests that the eco-friendly restoration can provide a more suitable environment for benthic macroinvertebrate ecosystem that prefers the stream environment.

Alagille 증후군 환아의 임상 양상과 장기 예후에 대한 연구 (Clinical manifestation and outcome of alagille syndrome in Korea: a study of 30 patients)

  • 신지연;김유정;서정기
    • Clinical and Experimental Pediatrics
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    • 제49권10호
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    • pp.1067-1072
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    • 2006
  • 목 적 : Alagille 증후군에 대하여 국내 증례 보고가 된 바 있으나 국내 Alagille 증후군 환자의 임상 양상에 대한 종합적인 분석은 없는 실정이다. 이에 국내 Alagille 증후군 환자의 임상양상과 장기 예후, 예후에 미치는 요인에 대해 알아보고자 한다. 방 법 : 1984년 7월부터 2006년 5월까지 서울대학교병원 소아과를 방문하여 Alagille 증후군으로 진단받은 30명의 환자를 대상으로, 만성 쓸개즙정체, 심혈관계 질환, 척추 이상, 눈의 이상, 특징적 얼굴형, 검사 결과, 예후를 기록지를 통하여 후향적으로 검토하였다. 결 과 : 만성 쓸개즙정체를 보인 환자가 100%, 심혈관계 이상이 있는 환자가 84.4%, 골격계 이상이 있는 경우가 30.0%, 안구의 이상이 있는 경우가 43.3%, 특징적 얼굴형을 보이는 경우가 100%였다. 30례의 환자 가운데 17례는 2세 경에 만성 쓸개즙정체가 호전되었고, 13례는 2세 이후에도 만성 쓸개즙정체가 지속되었다. 2세 경에도 만성 쓸개즙정체가 지속되는 환자는 합병증의 빈도가 유의하게 높았다(P=0.001). 30례의 환자 가운데 Alagille 증후군으로 인한 사망이 6례였고 이중 5례가 간질환의 합병증으로 사망하였다. 결 론 : Alagille 증후군 환자에서 간질환의 합병증이 사망의 중요한 원인이 되므로 이에 대한 주의 깊은 추적 관찰이 필요하며, 2세경에도 만성 쓸개즙정체가 호전되지 않는 경우 간이식을 요하거나 사망하는 빈도가 높으므로, 2세경에도 만성 쓸개즙정체가 지속되면 간이식을 고려해야 할 것이다.

관절경적 전방 견봉 성형술을 이용한 만성 견관절 충돌 증후군의 치료 (Arthroscopic Anterior Acromioplasty for the Treatment of Chronic Impingement Syndrome of the Shoulder)

  • 박태수;김재영
    • 대한관절경학회지
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    • 제4권1호
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    • pp.49-53
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    • 2000
  • 목적 :. 만성 견관절 충돌증후군에 대한 수술적 치료로서 사용한 관절경적 전방 견봉 성형술의 치료 결과를 분석하고 임상적 효용성을 평가하고자 하였다. 대상 및 방법 : 1995년 7월부터 1997년 12월까지 만성 견관절 충돌증후군 환자 중 6개월 이상 보존적 치료에도 불구하고 증상이 호전되지 않아 관절경을 이용하여 전방 견봉 성형술을 시행한 26명의 환자, 27례의 견관절들을 대상으로 하였다. 심한 퇴행성 관절염 회전근 개 전층 파열 및 견관절 비출구 충돌증후군 (nonoutlet impingement) 등은 모두 연구 대상에서 제외하였다. 평균 추시 기간은 2년 3개월(범위, 1년 7개월-3년 11개월)이었다. 임상적인 결과 판정은 UCLA 견관절 평가지수를 이용하였다. 결과 : 27례 중 23례$(85.2\%)$에서 매우 우수 또는 우수한 결과를 보였으며, 4례$(14.8\%)$에서 양호의 결과를 나타내었다. 환자의 만족도는 27례 중 26례$(96.3\%)$에서 주관적인 만족을 나타내었고, 1례 $(3.7\%)$에서 불만족을 나타내었으며 이 경우 Parkinson 증후군과 경추 후종인대 골화증 및 제 5-6번 경추의 척추 협착증이 동반된 환자였다. 결론 : 관절경적 전방 견봉 성형술은 특히 술전 동통의 정도가 술후 현저히 개선되는 등 증상 완화에 우수한 결과를 예상할 수 있는 만성 견관절 충돌증후군의 효율적 치료법이지만, 견관절 및 그 주위의 병변이나 전신 질환 등이 동반될 경우 치료 결과에 영향을 미칠 수 있다.

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방사성(放射性) 스트론듐의 체내오염(體內汚染)에 대한 응급처치제(應急處置劑)의 효과(效果) (Effect of First-Aid Drugs on Internal Contamination of Radiostrontium)

  • 정인용;김태환;진수일
    • Journal of Radiation Protection and Research
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    • 제14권1호
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    • pp.16-23
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    • 1989
  • 방사성 물질 체내 오염에 대한 진단에 필요한 기초 자료를 얻기 위하여 $^{85}SrCl_2\;1{\mu}Ci$를 NIH(GP) 마우스의 복강내 투여로 체내 오염시키고, $CaNa_3DTPA$ 8.4 mg, sodium alginate 5 mg 및 saline 5 ml등을 병행 투여로 응급 처치한 후 경과 시간에 따라 도살 부검하여 중요 장기 및 배설물의 방사능을 측정하였다. 그 결과 방사성 스트론튬에 대한 단기간의 유효 반감기는 33 시간으로 나타났으며 각 처치제의 배설효과는 $CaNa_3DTPA$가 4.7배, sodium alginate가 1.7배, 그리고 saline이 2.4배 이었다. 스트론튬 단독 투여군의 체내 축적은 척추(脊椎), 대퇴골(大腿骨), 흉골(胸骨), 간장(肝臟)의 순이었으며, 배설 경로는 요(尿) 35.4%, 변(便) 64.4% 및 기타 0.2%이었고, $CaNa_3DTPA$ 및 saline 투여군은 주로 뇨, 그리고 sodium alginate 투여군은 변(便)을 통하여 배설하였다. 이로부터 방사성 스트론튬 체내 오염에 대한 응급 처치는 $CaNa_3DTPA$, sodium alginate 및 saline등을 병행 투여함으로써 방사선 피폭을 경감시킬 것으로 사료 되었다.

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친환경농업 시범마을에 대한 환경영양평가 (Environmental Impact Assessment for Demonstration Villages of Sustainable Agriculture)

  • 이남종;고병구;노기안;한민수;김민경;곽한강;박문희
    • 한국환경농학회지
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    • 제22권4호
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    • pp.246-250
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    • 2003
  • 1999년부터 2001년까지 3년간 친환경농업 시범마을에 적용되고 있는 INM (Integrated Nutrient Management) and IPM (Integrated Pest Management) 실천에 따른 추진효과를 분석하기 위하여 시범마을로 지정된 옥천과 양평지역의 농가 포장에서 시비량, 양분유실 및 생태계 변화 등을 조사 분석하였다. 3요소 시비량은 토양검정시비로 인하여 농가관행시비와 비교하여 $28.6{\sim}39.4%$ 절감할 수 있었으며, 쌀 수량도 시비량이 비교적 적은 토양검정 시비구에서 $3{\sim}10%$ 증수하였다. 영농기간동안 토양 침투수중 $NO_3-N$ 농도는 농가관행 시비구 2.9 mg/L에 비하여 토양검정 시비구는 1.5 mg/L로 감소하였으며, 시범마을 논으로 유입되는 관개수의 COD, $NH_4-N$, $NO_3-N$ 농도는 각각 15.0, 0.67, 1.39 mg/L, 시범마을 논에서 배출된 용수는 각각 12.4, 0.29, 2.42 mg/L로 감소되는 경향이었다. 처리별 수서곤충, 환형동물, 패류 및 감각류 등의 개체수는 농가관행구 100에 대하여 토양검정 시비구 295, 토양검정과 개량제 혼용구 276, 무비구 90으로 토양검정 시비구에서 많았으며 수서 무척추 동물은 관행농업을 수행하고 있는 지역을 100으로 볼 때 친환경농업마을은 242와 443으로 INM과 IPM을 실천하는 시범마을에서 생물종이 다양하고 그 개체수가 많은 것으로 나타났다. 친환경농업 시범마을 조성 후 작물 추천시비량 준수와 적기 예찰을 통하여 필요이상 사용되는 비료와 농약을 절감하여 생태계의 개선과 토양이 건전화된 것으로 평가되었다.