• Title/Summary/Keyword: Cord sign

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Brachial plexus impingement secondary to implantable cardioverter defibrillator: A case report

  • Jumper, Natalie;Radotra, Ishan;Witt, Paulina;Campbell, Niall G;Mishra, Anuj
    • Archives of Plastic Surgery
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    • v.46 no.6
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    • pp.594-598
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    • 2019
  • Overall complication rates of 9.1% have been reported following implantable cardioverter defibrillator (ICD) placement. Brachial plexus injury is infrequently reported in the literature. We describe a 26-year-old female experiencing left arm nerve pain, a positive Tinel's sign, numbness in the median nerve distribution of the hand and biceps muscle weakness following revision ICD via subclavian vein approach. Nerve conduction studies identified severe partial left brachial plexopathy, which remained incompletely resolved with conservative management. Surgical exploration revealed lateral cord impingement by the ICD generator and a loop of the ICD lead, along with fibrosis, necessitating surgical neurolysis and ICD generator repositioning. As increasing numbers of patients undergo cardiac device implantation, it is incumbent on practitioners to be aware of potential increases in the prevalence of this complication.

The Effect of Acrylamide on the Ultrastructures of Nervous System of the Mouse (생쥐 신경계의 미세구조에 미치는 Acrylamide의 영향)

  • 김동수;하재청
    • The Korean Journal of Zoology
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    • v.33 no.4
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    • pp.454-460
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    • 1990
  • The effed of acrylamide on the nervous system has heen morphologically studied using light and electron microscopes. The light micrographs on central and pedpheral nervous tissues of mouse treated with acrylamide monomer showed total vacuolation of spinal cord, cell degradation containing neuron and neuroglia, and distal nerve fiber degeneration. The electron micrographs showed ultrastrudural changes. Abnormal mitochondria in neuron, splitting of myelin sheath in lumbar ventral root nerve, partial disintergration of myelin sheath and axoplasmic degeneration in sciatic nerve, and overafl polyneuropathies in nervous system were observed. These results suggest that acrylarnide intoxicated mouse shows distal behavioral neuropathy as an earlist clinical sign, but the initial effect of acrylamide on the nervous system seems to appear at nearly the same time in both central and peripheral nervous systems.

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Effect of Bosentan, $ET_{A+B}$ antagonist, on EAE-induced lewis rat.

  • Park, Young shim;Bong su Kang;In hoi Huh
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.192-192
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    • 1996
  • Endothelin has $ET_{A}$ type and $ET_{B}$ type receptors, and it has been thought that ET-1 proves vasoconstriction effect via $ET_{A}$ receptor and vasodilation via $ET_{B}$ receptor. Recently, it has been reported that $ET_{B}$ receptor is also related to the vaso-constriction. Bosentan is a $ET_{A+B}$ receptor antagonist, and proves it's effect on trauma and ischemia. We already announced that the level of Endothelin-1 increase in the brain and spinal cord of EAE-induced lewis rat and showed the origin of ET-1 is activated macrophages. Intracisternal injection of Bosentan, $ET_{A+B}$ receptor antagonist, (300nmol/body) was done for observing the role of endothelin-1 on the pathogenesis of EAE. Bosentan ameliorated the severity of clinical score of EAE and decreased the histologically observed inflammatory region. The blocking effect on the progression of EAE model suggests that Bosentan is a physiological antagonist in terms of development of the sign of multiple sclerosis.

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A Study for the Development of Standardized Management Manuel in Sanhujoriwon - Centered on the Management of Women & Newborn - (산후조리원의 표준화 관리 지침을 위한 연구 - 산모와 신생아 관리현황을 중심으로 -)

  • Jung, Eun-Sil;Yoo, Eun-Kwang
    • Women's Health Nursing
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    • v.8 no.2
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    • pp.301-313
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    • 2002
  • The purpose of this study was to develop the frame for standardized manual for Sanhujoriwon by finding out the status of the management of women & newborn in Sanhujoriwon, like postpartum care center. The subjects were 95 staffs of 22 Sanhujoriwon agreed on oral consent, in Seoul and Bundang, Korea. Data were collected from Sep. 15 to Oct. 24, 2001. The instrument used for this study was a structured questionnaire consisted of 16 items of general characteristics & educational characteristics about postpartum care, 31 items of degree of management of women's postpartum care (Cronbach's $\alpha$.93 ), 24 items of degree of management of newborn's care(Cronbach's $\alpha$.94 ), 10 items of methods of management of women's postpartum care, 8 items of methods management of newborn's care. The data were analyzed by the SPSS/PC+ program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows ; 1. The mean of the degree of management for postpartum women was 4.1. The mean score for the degree of management of general postpartum care for women was 4.00 & traditional postpartum care(Sanhujori) was 4.20. The degree of management of traditional postpartum care was higher than general postpartum care for women. 2. The degree of management for newborn : The mean score for the degree of management of newborn was 4.37. 3.There was a strong positive correlation between general postpartum care and traditional postpartum care($r=.744^{**}$), and postpartum mother care and newborn care($r=.798^{**}$). 4.The basic frame for the management of the women and newborn in Sanhujoriwon. 1) For women: Integrated postpartal care Physical management : Vital sign & BP check, contraction of uterus, form and amount of lochia, management of personal hygiene, management of breast & breast-feeding, management of postpartum exercise, prevention of infection, symptom & sign of high risk and prevention & management of high risk condition; Emotional-psychological management: assessment and management of mother-baby attachment, emotional state; Educational management : education of vaccination schedule, urinary incontinence, rearing infant, breast-feeding ; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. 2) For newborn Physical management : check of vital sign, management of umbilical cord, jaundice, prevention of infection, management of diaper rash; Emotional-psychological management : assessment of sleep, crying, activity, response of mother-baby attachment; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. In conclusion Sanhujoriwon must be health care center for the postpartum women and newborn. Therefore, the establishment of various laws and regulations in such a way to meet the realistic needs of Sanhujoriwon as a health care center for women and infants future health should be done. The standardized management manual based on the results is absolutely required above all.

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The Effects of Eucommiae Cortex Pharmacopuncture Injected at Sinsu($BL_{23}$) on Neuropathic Pain in Rats (신유(腎兪)($BL_{23}$) 두중약침(杜仲藥鍼)이 흰쥐의 신경병리성 동통모델에 미치는 영향)

  • Lee, Dong Geun;Lee, Ook Jae;Lee, Ju Hee;Lee, Sang Hyun;Lee, Jung Hun;Shin, Jeong Cheol;Kim, Jae Hong
    • Journal of Acupuncture Research
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    • v.30 no.4
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    • pp.69-78
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    • 2013
  • Objectives : The purpose of this study is to examine whether Eucommiae Cortex pharmacopuncture may affect to the neuropathic pain in a rat model. Methods : To produce the model of neuropathic pain, under isoflurane 2.5 % anesthesia, underwent tight ligation by 6.0 silk thread and transection of the tibial and sural nerves, leaving the common peroneal nerve intact. After neuropathic surgery, the author examined if the exhibited the behavioral sign of allodynia. The allodynia was assessed by stimulating the plantar with Dynamic Plantar Aesthesiometer. Three days after the neuropathic surgery, Eucommiae Cortex pharmacopuncture was injected at Sinsu($BL_{23}$) once every week for 6 weeks. After that, the author examined the withdrawal response of neuropathic rats' leg by Dynamic Plantar Aesthesiometer. And also the author examined Bax, Bcl-2, Bax/Bcl-2 ratio in the spinal cord of neuropathic rats and the change of WBC, RBC, HGB, HCT count in the blood of neuropathic rats. Results : 1. The Eucommiae Cortex pharmacopuncture decreased the withdrawal response of mechanical allodynia that assessed with Dynamic Plantar Aesthesiometer in EC2-$BL_{23}$ group as compared with control group. 2. The Eucommiae Cortex pharmacopuncture decreased Bax/Bcl-2 ratio in EC1-$BL_{23}$, EC2-$BL_{23}$ group. But The Eucommiae Cortex pharmacopuncture injected at Sinsu($BL_{23}$) didn't change Bax, Bcl-2 expression level in the all group. 3. The Eucommiae Cortex pharmacopuncture decreased WBC count in EC1-$BL_{23}$, EC2-$BL_{23}$ group. Conclusions : We have noticed that Eucommiae Cortex pharmacopuncture decreased mechanical allodynia in the model of neuropathic pain compared with the control group. Bax/Bcl-2 ratio in spinal cord of that group was also decreased compared with the control group. This study can be used as a basic resource on a study and a treatment of neuropathic pain.

Microcystic Adnexal Carcinoma of the Lower lip: A Case Report (하구순부에 발생한 미세낭포성 피부부속기 암의 치험례)

  • Lee, Chae Su;Rah, Dong Kyun;Kim, Sang Kyum;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.329-332
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    • 2008
  • Purpose: Microcystic adnexal carcinoma is a rare malignant appendage tumor, first described by Goldstein et al in 1982. Here, we present our experience in treatment of a case on the lower lip. Methods: A 52-year-old female with an asymptomatic nodule on the chin, previously misdiagnosed as trichoadenoma by needle aspiration biopsy, was treated by wide excision combined with multiple circumferential frozen biopsies. Results: Pathological examination revealed typical features of microcystic adnexal carcinoma, such as basaloid and squamous cells forming nests and cord-like patterns, horn cysts, and minimal cytologic atypia. The patient has been followed up for 6 months. No sign of recurrence is noted to date. Conclusion: Differentiation from other benign adnexal neoplasms is important for its appropriate treatment. Differentiation can be difficult histologically because it is difficult to acquire an adequate biopsy due to its invasiveness, and clinically due to its asymptomatic and slow growing features. Complete excision is the key treatment, but it may not always be the best solution considering the huge defect that may result and the low incidence of metastasis & deaths owing to the tumor. We add this case to the approximately 300 cases reported worldwide with a review of literature.

Acute Intervertebral Disc Protrusion in a Korean Domestic Shorthaired Cat: Clinical and MRI Findings

  • Lee, Narae;Lee, Young-jae;Song, Jin-young;An, Dae-gi;Kang, Byeung-taek;Chang, Jin-hwa;Chang, Dong-woo
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.467-469
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    • 2017
  • Signalment: A 7-month-old, female domestic shorthaired cat was presented for acute pelvic limb paraparesis. Results: There was no abnormality on survey radiographs and blood analysis, however neurological examination revealed proprioception positioning and hopping was absent in the pelvic limbs. Also, anal tone and perineal sensation were reduced. Magnetic resonance (MR) imaging showed nucleus pulposus dehydration and disc protrusion at T12-T13. Ill-defined diffuse lesion was found at T10-L2 level and it showed isointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. This lesion was considered as edematous lesion secondary to disc protrusion. The presumptive diagnosis was focal spinal cord edema associated with intervertebral disc protrusion. A traumatic aetiology was suspected. The cat was treated corticosteroids and analgesic and clinical sign improved following 9 days of treatment. Clinical relevance : Intervertebral disc protrusion is rare disease in a cat. However, it could be considered as a cause of paraparesis in cats.

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

Diagnostic Methods of Traumatic Tracheobronchial Injury (외상성 기관-기관지 손상의 진단 방법)

  • Son, Shin-Ah;Cho, Suk-Ki;Do, Young-Woo;Lee, Hong-Kyu;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.675-680
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    • 2010
  • Background: The aim of this study was to identify the distinguishing clinicoradiologic findings of traumatic tracheobronchial injury. Material and Method: Between January 2003 and December 2009, six patients who underwent surgical repair for traumatic tracheobronchial injury due to blunt trauma were included in this study. We evaluated the mechanism of the injury, the coexisting injuries, the time until the making diagnosis and treatment, the diagnostic methods, the anatomic location of the injury and the surgical outcomes. Result: The mechanisms of injury were traffic accident and crushing forces. The frequent symptoms were subcutaneous emphysema, dyspnea and pain, and the common radiologic findings were pneumothorax, mediastinal emphysema, rib fracture and lung contusion. Only 2 patients were diagnosed by chest CT and the others were not diagnosed preoperatively. The location of injury was the trachea in 2 patients and the bronchial tree in 4 patients. There was no postoperative mortality or anastomotic leak; however, vocal cord palsy occurred in one patient. The most distinguishing sign was persistent lung collapse even though the chest tube was connected with negative pressure. Conclusion: Although it was not easy to diagnose traumatic tracheobronchial injury without a clinical suspicion, the distinguishing clinical symptoms and CT findings could help to make an early diagnosis without performing bronchoscopy.

Epidermoid Tumor of Posterior Fossa : Analysis of 10 Cases (후두개와 유표피낭종 : 10례 분석)

  • Lim, Hyo Joo;Ahn, Jae Sung;Kwon, Yang;Lee, Jung Kyo;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.744-747
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    • 2000
  • Objectives : The purpose of this study was to evaluate the clinical features of the epidermoid tumor of posterior fossa and to assess the surgical outcome. Methods : We reviewed the clinicoradiological records of 10 epidermoid tumor of posterior fossa, treated surgically at our hospital between 1991 and 1996. Results : The mean age of onset was 36 years old and mean duration of symptom was 5.2 years. Six were men and four were women. The location of tumors were cerebellopontine angle(CPA) 5 cases, cerebellum(Cbll)& 4th ventricle 3 cases, foramen magnum 1 case, and pineal region extended to Cbll and 4th ventricle 1 case. Common clinical features were trigeminal neuralgia in 3 cases, cerebellar signs 2 case, headache 2 cases, hemifacial spasm with deafness 1 case, cbll signs and multiple cranial nerve dysfunctions 1 case. One CPA epidermoid had no clinical symptom and sign associated with the tumor. The surgical approaches were suboccipital approach in 9 cases and one transcallosal approach to the tumor of pineal region. The extent of surgical removal was gross total resection in 5 cases and near total or subtotal resection in 5. Two patients with CPA tumor were complicated with facial paresis. One patient with tumor located in cerebellum extended into cisterna magna had postoperative vocal cord paresis. All complicated cases had severe adhesion of tumor capsule with brainstem or cranial nerve. The mean duration of follow up was 26 months. The overall outcome was improvement of symptoms and signs in 6 cases and stationary 4 cases. During follow up, imaging study was done in 7 patients and none of them had finding of tumor recurrence. Conclusion : We conclude that recurrence of tumor is rare in both total and subtotal resected cases, but long-term follow-up is required. Aggressive removal of tumor capsule that adhesed to brianstem or cranial nerve is avoided for preventing severe postoperative complication.

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