Song, Kwan Young;Kim, Hyug Soo;Jung, Myung Hoon;Ahn, Chi Sung;Choi, Sun Wook;Choe, Il Seung;Kang, Dong Soo
Journal of Korean Neurosurgical Society
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v.29
no.8
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pp.1080-1084
/
2000
Spinal neurenteric cyst results from the persistence of an abnormal communication between endodermal and ne-uroectodermal layer. Embryologically, neurenteric cyst is derived from endoderm that is fused with the developing notochord during the third week of gestation. It is a rare malformation that lead to spinal cord compression. The patient is 19-year-old male presented with chest pain, paresthesia and progressive weakness in his low extremities(grade II/II). Preoperative MR imaging revealed intradural extramedullary cyst with intracystic hemorrhage in T1 and T2 level that is ventrally located and compressed the spinal cord. Involved vertebral bodies were scalloped and fused. The cystic tumor were totally removed through costotransversectomy approach. Postoperatively, motor weakness of the low extremities were improved to the level of grade IV/V. And chest pain and paresthesia were gradually disappeared. Postoperative MR imaging showed the decompression of the thoracic spinal cord. Histologic examination revealed a ciliated columnar epithelial neurenteric cyst. The pre- and postoperative clinical, radiological features of a case of upper thoracic neurenteric cyst is described with review of literature.
Objectives: This study examined the natural history of symptomatic patients who did or did not display abnormal results on nerve conduction studies (NCS). Methods: Forty hundred fifty adults were selected among a total of 578 residents who participated in the health examination in a rural Korean district. A symptom questionnaire and NCS were used to diagnose ulnar neuropathy at the elbow (UNE). There were 6.4% of the subjects with UNE, 5.1 % of the subjects showed symptoms without a NCS, and 84.2% of the subjects who were asymptomatic. One year later, 20 symptomatic limbs with an abnormality on the ulnar NCS and 22 symptomatic limbs without any abnormality in the ulnar NCS were enrolled in a follow-up study. The natural history of UNE was evaluated by examining the changes in the clinical and electrodiagnostic examinations. Results: The 1-year follow-up of the enrolled limbs found that for the symptomatic limbs with an abnormality on the NCS, the degree of severe of the clinical grade changed from 20% to 10%. In contrast, for the symptomatic limbs that were without any abnormality in the NCS, the change of the severe degree of the clinical grade was from 0% to 18.2%. Also, for the electrodiagnostic change, only symptomatic limbs without NCS abnormalities showed significant changes in motor latency, amplitude and conduction velocity at the 1-year follow-up. Conclusions: The 1-year follow-up study revealed symptomatic limbs that were without any abnormality on the ulnar NCS were more likely to progress than the symptomatic limbs with an abnormality on the ulnar NCS.
Park, Ho-Young;Lee, Sun-Ho;Park, Se-Jun;Kim, Eun-Sang;Lee, Chong-Suh;Eoh, Whan
Journal of Korean Neurosurgical Society
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v.57
no.1
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pp.42-49
/
2015
Objective : The cervicothoracic junction (CTJ) is a biomechanically and anatomically complex region that has traditionally posed problems for surgical access. In this retrospective study, we describe our clinical experiences of the treatment of metastatic spinal tumors at the CTJ and the results. Methods : From June 2006 to December 2011, 23 patients who underwent surgery for spinal tumors involving the CTJ were enrolled in our study. All of the patients were operated on through the posterior approach, and extent of resection was classified as radical, debulking, and simple neural decompression. Adjuvant radiation therapy (RT) was also considered. Visual analog scale score for pain assessment and Medical Research Council (MRC) grade for motor weakness were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Almost all of the patients were operated using palliative surgical methods (91.3%, 21/23). Ten complications following surgery occurred and revision was performed in four patients. Of the 23 patients of this study, 22 showed significant pain relief according to their visual analogue scale scores. Concerning the aspect of neurological and functional recovery, mean MRC grade and ECOG score was significantly improved after surgery (p<0.05). In terms of survival, radiation therapy had a significant role. Median overall survival was 124 days after surgery, and the adjuvant-RT group (median 214 days) had longer survival times than prior-RT (63 days) group. Conclusion : Although surgical procedure in CTJ may be difficult, we expect good clinical results by adopting a palliative posterior surgical method with appropriate preoperative preparation and postoperative treatment.
Physical activity is a primary cancer control strategy that has received little attention to date. However, an Increasing number of epidemiological studies have proposed that physical exercise may be beneficial by enhancing anticancer immune system responses. We investigated the effects of acute exercise on changes in nitric oxide (NO) production and inducible nitric oxide synthase (iNOS) expression. The amounts of NO generated by abdominal macrophages in mice were measured after exercise. Thirty-two mice, which were challenged with thioglycollate broth to activate peritoneal macrophages, were randomly assigned to control, exercise and recovery groups. The mice exercised on a motor-driven treadmill for 3 consecutive days, either moderately (18m/min, 30 min/day, 5% grade) or severely (18-35m/min, 60 min/day, 5% grade). The mice were killed immediately after exercise or after 6 hrs of recovery. Nitric oxide was quantified by the Griess assay. The exercised mice showed higher levels of NO generation than those of the control mice, but the intensity of exercise had no significant effect on NO generation. Mice allowed six hours of recovery after exercise showed higher levels of NO generation than that of animals sacrificed immediately after exercise, but there were no significant differences in NO generation with variations in the intensity of exercise. Increased levels of iNOS were found in the exercised groups, and this was greatest in the groups allowed six hours of recovery compared to those groups sacrificed immediately after exercise. The results of this study suggest that acute exercise may enhance an immune response by inducing macrophage-derived NO generation; these results support the epidemiological findings which support the benefits of exercise in the prevention and control of cancer. Further study is needed to determine the physiological significance of these findings, which could be applied to the use of therapeutic exercises to assist in the prevention and control of cancer.
The Journal of Korea Assosiation for Disability and Oral Health
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v.7
no.1
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pp.15-20
/
2011
A person with neurological disorder is defined as a person with limitation of ambulation or basic life activity due to the cerebral palsy or traumatic brain damage, stroke. Recently, the DMFT of the children with neurological disorders is similar or lower than the DMFT of the children with no disability. But, this article is about the severe-early childhood caries in children with grade 1 neurological disorder. It is supposed that the primary motor impairment and secondary physical weakness, frequent hospitalization, sugar- rich food and drugs, lack of oral care, delayed dental visit made high caries susceptibility. In case of treatment of the children with severe neurological disorders, dentists should make a thorough caries preventive plan based on individualized caries risk assessment. Also parents and medical doctors should recognize the importance of oral care and do the early dental visit and home care.
The purpose of this study were carpal tunnel syndrome in stroke patients according to the degree of spasticity in the median nerve cross-sectional area, nerve conduction velocity, and to evaluate differences in upper extremity function. The subjects of this study was in adult patients with stroke 42 patients from 21 patients CTS group and 21 patients Non-CTS group were selected. Measurement of median nerve-cross sectional area, nerve conduction velocity, GST, FMAS, CTS-FSS was measured. The study results were each group between the unaffected side and the affected side CTS and Non-CTS group in each grade between groups unaffected side(p<.001), and affected side(p<.001) median nerve-cross sectional area, median motor and sensory nerve onset latency, there was a statistically significant difference. CTS and Non-CTS group between groups in each grade GST(p<.05), FMAS(p<.05), CTS-FSS(p<.001), there was a statistically significant difference. In this study, the carpal tunnel pathokinesiology ever presented by the contents of upper extremity functional training in stroke patients is one of the information that you need to consider when presented.
Objectives: This is a case report regarding the effect of Korean traditional medicine on vision disorder and quadriplegia in a patient with neuromyelitis optica. Methods: We treated a patient who was diagnosed with neuromyelitis optica with Korean traditional medicine, including acupuncture, moxibustion, and herbal medicine (Gigugyanghyeol-tang gamibang) for 106 days. We evaluated the patient with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), Modified Barthel Index (MBI), Modified Ashworth Scale (MAS) Grade, and Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient's symptoms were improved. The ISNCSCI scores increased from 42 to 66 in motor score, from 152 to 196 in sensory score, and from A to D in the ASIA impairment scale; the MBI score increased from 9 to 33, while the score of the MAS Grade decreased from I+ to I, and the NRS-11 scores of vision disorder, spasticity, and tingling decreased from 10 to 7, 3, and 2-3, respectively. Conclusions: Korean traditional medicine may be effective for treatment of vision disorder and quadriplegia in patients with neuromyelitis optica.
The incidence of brachial plexus injury is increasing because of the development of motor vehicle but the the results of treatment was reported poor due to its complex anatomical structure and changes of function and sensory during the recovery after trauma. But the results of treatment has been improved by the recently introduced high sensitive diagnostic method that can evaluate accurately the site and extent of the injury and treatment method. Restoration of the elbow flexion is the most important goal of treatment after brachial plexus injury and nerve graft, neurotization and muscle transfer were used for methods of treatment. From December 1992 to May 1994, the author performed 6 cases of latissimus dorsi transfer at the same side for the improvement of elbow flexion in the patients of brachial plexus injury. There were 5 cases of male, one case of female and average age was 22 years old. The causes of injury were traffic accident in 3 cases, gun shot injury, falldown and birth injury in each one case and in all cases, the type of injury were upper arm type. The average follow up period were 1 year 5 months ranging from 12 months to 4 years 5 months. In all cases, active elbow flexion was impossible before operation and average muscle power was grade I. We analysed the active range of motion, muscle power and the functional results. At the last follow up, range of active elbow flexion was average $124^{\circ}$ and flexion contracture was average 11 degrees and the average of muscle power was grade IV. In the functional analysis, there were two cases of excellent, three cases of good and 1 case of fair. There was no complications including wound infection, vascular compromise and donor site problem. The results of latissimus dorsi transfer for improvement elbow flexion in the patients of brachial plexus injury is one of the useful mettled for the restoration of elbow flexion.
Objective: The decision to adopt a conservative or surgical modality for a relatively small volume of spontaneous intracerebral hemorrhage (SICH) is difficult and often controversial, especially when consciousness is tolerable. The authors examined the results of stereotactic-guided evacuation of SICH for relatively small volumes with respect to functional outcome. Methods: This prospective study was performed on 387 patients with SICH who underwent stereotactic-guided evacuation (n = 204, group A) or conservative treatment (n = 183, group B) during the past 8 years. The primary end-point was recovery of functional status, which was estimated using the Modified Barthel Index (MBI) and the modified Rankin Scale (mRS). Results: All patients had a Glasgow coma scale (GCS) score of $\geq$ 13 and unilateral hemiparesis of less than motor power grade 3. Group demographic characteristics and initial neurological statuses were similar. In all cases, the volume of SICH involved was < 30 cm$^3$ and location was limited to basal ganglia and thalamus. At 6-month follow-ups, MBI was 90.9 in group A and 62.4 in group B (p < 005), and MRS was 1.2 in group A and 3.0 in group B (p < 0.05). Better motor function and stereotactic-guided evacuation had a significant effect on a functional recovery in regression analyses. Conclusion: Even in patients with a small volume of SICH, stereotactic-guided evacuation improved functional recovery in activities in daily life than conservative treatment did.
Kim, Keum-Soon;Kim, Bog-Ja;Kim, Kyung-Hee;Choe, Myoung-Ae;Yi, Myung-Sun;Hah, Yang-Sook;Chung, Sun-Ju;Kwon, So-Hi
Journal of Korean Academy of Nursing
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v.37
no.2
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pp.242-248
/
2007
Purpose. Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. Methods. A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology out-patient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. Results. The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion (47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). Conclusion. Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.
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