• Title/Summary/Keyword: Left side weakness

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Bilateral Lesions in the Posterior Limb of Internal Capsule Attributed to Combination Therapy of Isoniazid and Rifampin (이소니아지드와 리팜핀 복합 치료에 의하여 발생한 속섬유막뒤다리의 양측성 병변)

  • Park, Min Won;Roh, Jinhong;Im, Seojun;Kim, Min Ok;Kim, Young-Soo;Kang, Jongsoo;Kim, Do-Hyung;Kwon, Oh-Young
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.354-357
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    • 2018
  • Transient isoniazid-induced brain lesions have rarely been reported. The lesions were in the dentate nucleus of cerebellum and thalamus. Meanwhile, the neurotoxicity of rifampin has not been reported evidently. We observed bilateral lesions in the internal capsule in a young woman after taking a combination of isoniazid and rifampin. She transiently suffered numbness in both hands, dysarthria, and left side motor weakness while taking the medication. Isoniazid may induce structural lesions in various brain areas including the internal capsule.

Self-Exercise Oriented Management for Shoulder Pain Patient with Winging Scapular : Case Report (견갑골 익상을 동반한 어깨 통증 환자에 대한 자가 운동 중심의 관리: 사례 보고)

  • Jeon, Jae-guk;Jung, Min-keun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.2
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    • pp.67-75
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    • 2022
  • Background: Scapular winging is a rare disorder that is commonly caused by nerve damage of the dorsal scapular nerve, spinal accessory nerve, or the long thoracic nerve. This affects the scapulohumeral rhythm which may cause abnormal kinetic motion of the shoulder. The purpose of this case report is to describe a self-exercise oriented management incorporating shoulder strengthening to reduce symptoms in a shoulder pain patient with winging scapular. Methods: A 45 year old male patient complained of pain in his both shoulders without any trauma. Shoulders were treated with steroid injections for supraspinatus tendonitis, but although pain improved to some extent, pain and disability continued for 3 months. Both shoulders had pain, decreased active range of motions, muscles weakness, and scapular winging. The patient underwent 9 interventional sessions over 3 months and was managed mainly by self-exercise. The intervention method involved push up plus, sling, muscle strengthening, and stabilization exercises. Loads were increased as symptoms improved. Results: Clinical outcomes were measured at every session. Pain in both shoulders reduced to 0 on a numerical pain rate scale by the 4th session, and the active range of motion was fully recovered. During the 9th session, the strength of the serratus anterior had improved from grade P to G on the right side and grade G to N grade on the left. Conclusion: In this case study, the self-exercise program was effective in reducing pain, increasing active range of motion, and improving muscle strength in subjects with scapular winging.

A Case Report of Tremor Patient Diagnosed as Acute Cerebral Infarction with Dodamhwalhul-tang (도담활혈탕(導痰活血湯)으로 호전된 뇌경색으로 인한 진전 환자 치험 1례)

  • Choi, Koh-Eun;Kim, Hyun-tae;Oh, Jeong-Min;Eom, Tae-Min;Cho, Hyun-Kyoung;Yoo, Ho-Ryong;Kim, Yoon-sik;Seol, In-Chan
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.16 no.1
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    • pp.1-10
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    • 2015
  • ■ Objectives The purpose of this case study is to report that a tremor patient after Acute Cerebral infarction was treated with 'Dodamhwalhul-tang' and then the symptoms were improved. ■ Methods This patient was 81 years old woman whowas diagnosed with acute cerebral infarction. This patient had hypertension and symptoms of tremor on left lower limb, both side weakness, both lower limb numbness, dizziness and low back pain. She was treated with herb medicines, acupuncture, moxibustion during 22 days of hospitalization. Her tremor was evaluated by the tremor frequency and period and other general conditions were measured. ■ Results After taking Dodamhwalhul-tang, symtoms of tremor and patient's general conditions were improved. ■ Conclusion The result shows that Dodamhwalhul-tang is effective for tremor with acute cerebral infarction.

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A Case of Adult Otitis Media with Effusion Accompanied by Atopic Dermatitis (아토피피부염을 동반한 성인 삼출성 중이염 치험례)

  • Song, Ji-Hoon;Yu, Pei-Yen;Kim, Jong-Han;Jung, Min-Yeong;Choi, Jung-Hwa;Park, Soo-Yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.2
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    • pp.95-104
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    • 2022
  • Objectives : This study is to report a case of otitis media with effusion accompanied by atopic dermatitis improved by Korean medicine monotherapy. Methods : A 31-year-old woman patient visited our clinic for aural fullness, hearing loss, and tinnitus of the left ear on August 14th, 2021. She also had abdominal pain, diarrhea, and general weakness because of side effects of antibiotics. Besides, she had nasal congestion, rhinorrhea, and dry skin. Through otoscopy, her tympanum was fully filled with yellow effusion. She only took Korean medicine therapy including acupuncture and herbal medicine weekly. The treatment continued for about 4 months(total 14 visits) until December 4th, 2021. Otoscopy, numerical rating scale(NRS), scoring atopic dermatitis(SCORAD) index were used to assess the symptoms. Results : On August 30, 2021, her intestinal symptoms improved. The left tympanum was recovered to normal condition as the treatment continued. The effusion disappeared on October 16th, 2021. On November 6th, 2021, peritympanic blood congestion also almost alleviated. Subjective symptoms including aural fullness, hearing loss, and tinnitus disappeared on October 16, 2021. Nasal symptoms and dry skin also improved. The SCORAD index dropped from 15 to 4. Conclusions : These results suggests that otitis media with effusion can be sufficiently managed by Korean medicine therapy. Further, active application of Korean medicine therapy to common otolaryngological diseases is necessary.

A STUDY ON THE SAFETY ANALYSIS OF ROCK FILL DAM (2) (필댐의 안정성 해석 연구 (II))

  • HoWoongShon;DaeKeunLee
    • Journal of the Korean Geophysical Society
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    • v.6 no.3
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    • pp.189-207
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    • 2003
  • The purpose of this paper is to analyze the behavior and to study the safety evaluation of the Unmun Dam located in Cheongdo-Gun of GyeongBuk Province, Korea. For this purpose, soil analyses including boring data, geophysical surveys and monitoring the buried geotechnical gauges, such as pore-pressure gauge, earth-pressure gauge, displacement gauge, multi-layer settlement gauge, leakage flow-meter, were conducted. In addition to these data, numerical analyses of behavior of dam were performed to predict and to compare the data which were obtained from the above methods. Since many defects, such as gravel and weathered rock blocks in the dam core, and lots of amounts of leakage, by boring analyses were found, reinforcement by compaction grouting system (CGS) has been conducted in some range of dam. Some geotechnical gauge data were also used to confirm the effects of reinforcement. Analyses of monitoring the data of geotechnical gauges buried in the dam, such as pore-pressure gauge, earth-pressure gauge, displacement gauge, multi-layer settlement gauge, and leakage flow-meter shows the load transfer of dam and the possibility of hydraulic fracturing. As a conclusion, some problems in the dam found. Especially, the dam near spillway shows the high possibility of leakage. It should be pointed out that only the left side of he dam has not a leakage problem. As a whole, the dam has problems of weakness, because of unsatisfactory construction. It is strongly recommended that highly intensive monitoring is required.

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Surgical Outcomes of Schwannoma Occurred at the Brachial Plexus (상완 신경총에 발생한 신경초종의 수술적 치료 결과)

  • Lee, Hyuk-Jin;Lee, Young-Ho;Gong, Hyun-Sik;Rhee, Seung-Hwan;Lee, Joon-Oh;Roh, Young-Hak;Kim, Kang-Wook;Baek, Goo-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.19 no.1
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    • pp.1-6
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    • 2010
  • Schwannoma of the brachial plexus region is very rare. There has not been general agreement in terms of surgical outcome from limited number of studies. We analyzed surgical outcomes from 11 cases of schwannomas which occurred in the brachial plexus. From February 2000 to August 2009, 11 patients with schwannomas of the brachial plexus region were surgically treated by a single surgeon. We retrospectively reviewed the medical records and MRI of our cases, and evaluated the neurologic deficit and the recurrence of tumors after surgery. All the cases were proven histologically as schwannomas. The mean age of the patients was 52.6(36~67) years old, 4 of them were male and 7 were female. The tumor was located in the left side in 9 patients, and right in 2. The mean postoperative follow-up was 24.7(6~78) months. Initial presentation was usually painless, palpable mass. The mass was located in various level of the brachial plexus such as root, trunk, cord, or terminal branch level. The size of mass was from $1.5{\times}1.5{\times}0.5$ cm to $11.0{\times}10.0{\times}6.0$ cm. Eight of 11 patients showed no neurologic deficit. Three patients showed postoperative neurologic deficit; two of them had transient sensory deficit, and one of them had weakness of flexor pollicis longus and 2nd flexor digitorum profundus. There were no recurrences. The schwannoma of the brachial plexus region should be considered as a curable lesion with an acceptable surgical risk of injury to neurovascular structures. With precise surgical techniques, these tumors can be removed to improve patient's symptoms with minimal morbidity.

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The Antiallodynic Effects of Intrathecal Zaprinast in Rats with Chronic Constriction Injury of the Sciatic Nerve (좌골신경 만성협착손상 흰쥐에서 척수강 내로 투여된 Zaprinast의 항이질통 효과)

  • Lee, Jae Do;Jun, In Gu;Choi, Yun Sik;Im, So Hyun;Park, Jong Yeon
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.16-20
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    • 2009
  • Background: Zaprinast is an inhibitor of phosphodiesterase 5, 6 and 9. Phosphodiesterase inhibitors could produce anti-nociceptive effects by promoting the accumulation of cGMP. We hypothesized that intrathecal zaprinast could attenuate the allodynia induced by chronic constriction injury of the sciatic nerve in rat. Methods: Sprague-Dawley rats were prepared with four loose ligations of the left sciatic nerve just proximal to the trifurcation into the sural, peroneal and tibial nerve branches. Tactile allodynia was measured by applying von Frey filaments to the lesioned hindpaw. The thresholds for the withdrawal responses were assessed. Zaprinast ($3-100{\mu}g$) was administered intrathecally by the direct lumbar puncture method to obtain the dose-response curve and the 50% effective dose ($ED_{50}$). Measurements were taken before and 15, 30, 45, 60, 90, 120, and 180 min after the intrathecal doses of zaprinast. The side effects were also observed. Results: Intrathecal zaprinast resulted in a dose-dependent antiallodynic effect. The maximal effects occurred within 15-30 min and then they gradually decreased down to the baseline level over time in all the groups. There was a dose dependent increase in the magnitude and duration of the effect. The $ED_{50}$ value was $17.4{\mu}g$ (95% confidence intervals; $14.7-20.5{\mu}g$). No severe motor weakness or sedation was observed in any of the rats. Conclusions: Intrathecally administered zaprinast produced a dose-dependent antiallodynic effect in the chronic constriction injury neuropathic pain model. These findings suggest that spinal phosphodiesterase 5, 6 and 9 may play an important role in the modulation of neuropathic pain.

Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

Treatment of Skin Diseases in Hyungsang Medicine (피부병의 형상의학적 치료)

  • Suk Min He;Hwang Won Duek;Jung Haeng Gyu;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.3
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    • pp.646-669
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    • 2004
  • By treating skin diseases with Hyungsang medicine and reviewing the clinical cases of them through classifying skin diseases into general care and into Hyungsang medical care, the writer came to the conclusion as followings. The skin is a house of Kyungnak, and it' s a place which Ki comes in and out, which human body controls conditions of his physiological function and which doctors can make a diagnosis from seeing it. The skin is subject to lung and large intestine in the point of organ, but in the point of movement, to spleen and stomach. Skin diseases come from unbalance of Ki and Hyul, mostly from fever in blood and also from Dam, Wind, Dampness and Dryness because of including fire. Generally skin diseases are treated according to classifying into distinctive symptoms, region, cause or time being occurred, and concomitant symptoms. After being divided into man and woman, age and youth, fatness and leanness, Jung Ki Shin Hyul type, visceral figures, Yukkyung shapes on Hyungsang medicine method, the remedy of skin diseases which is combined common meditation with Hyungsang medical method is efficacious. In distinguishing into man and woman, age and youth, man gets sick mainly by drinking liquor and exhausting Jung, woman is taken ill generally by indigestion and Damwha, especially by drinking liquor. Young child gets ill mostly from inherent weakness, but in many cases he is occurred by disturbed digestion, so he must be taken care of ingesting food. The aged becomes ill from weakening, so he must be treated according to reasons of diseases. To fatness and leanness, skin diseases are showed symptoms by weakened Yang, insufficient Yin or excess fever on the theory of upper and lower parts, by unbalance of Ki and Hyul on the theory of left and right, by Dryness and Dampness on the theory of front and rear and by insufficiency of vitality and combined fever on the theory of inside and outside. Therefore doctors must cure the symptoms according to the theory of upper and lower, left and right, front and rear and inside and outside. In type of Jung Ki Shin Hyul, the balances between Jung-Hyul and Shin-Ki are important points. Concretely Jung type comes to easily shortage of Jung or gathering abnormally Dampness and Dam, Ki type is easy to make a mass with Ki or to be deficient of Ki, Shin type comes to press seven emotions togather or to be insufficient of Yin and fever inside, and Hyul type is inclined to be deficient of Hyul and to become feverish or to be deficient of Ki. Therefore on the ground of the above reasons skin diseases come into existence. Inclusively in Jung-Hyul type , Ki must be moved on the base of full Jung-Hyul, so Wukmijiwhangtang or Samultang is prescribed basically. In Shin-Ki type , Jung-Hyul is saved on the base of moving Ki, so Hyangsosan or Yijintang is the proper prescription. Considering the visceral figures, doctors judge for diagnosis and remedy by putting together the elements, that is, great and small sizes of a set of features (eye, ear, mouth, nose), color and temper. The yukkyung types are classified according to many or few of Ki-Hyul, and then skin diseases appear by being inclined toward one side between Ki and hyul, or among the six atmospheric elements(wind, cold, heat, dampness, dryness, and fire). Especially because Yangmyung type is full of much Ki and Hyul, and also has much fever in stomach, he gets skin symptoms frequently. So his prescription is based on taking off fever in stomach, and also he must be careful about regimen certainly.