• Title/Summary/Keyword: Neurological recovery

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An Analysis of Infection-Related Complications after Epidural Block (경막외 차단술 후 발생한 감염 관련 합병증의 분석)

  • Jo, Dae Hyun;Hong, Ji Hee;Kim, Myuong Hee
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.164-167
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    • 2006
  • Background: There have been an increasing number of reports about infection-related complications after epidural block, and the analysis of these previous reports may offer valuable information for the prevention and treatment of such complications. Methods: We searched for complications about infection that was related to epidural blockade procedures by using the Medline Search program. We analyzed the types of infection-related complications as well as the potential risk factors, the time course from symptom development to treatment, the causative organisms and the treatment outcomes. Results: Seventeen cases were identified. The types of complications were epidural abscess, subdural abscess, spinal arachnoiditis, bacterial meningitis and aseptic meningitis. Five patients received a single block and twelve patients received a continuous block with catheterization. The most common site of epidural catheterization was the lumbar area and eight patients had indwelling catheters for less than fifteen days. Eight patients had a diabetes mellitus as a risk factor and fourteen patients showed less than seven days from the development of symptoms to treatment. Eleven patients received laminectomy and intravenous antibiotics as a treatment and eight patients had full recovery without neurological deficit. Conclusions: Early diagnosis and treatment is essential for the favorable outcome of infection-related complication after epidural block. In addition, absolute sterile technique should always be performed and patient education concerning these potential complications must be accompanied.

Classic Floating Elbow in Adults: A Case Series

  • Cho, Chul-Hyun;Min, Kyung-Keun
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.8-12
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    • 2015
  • Background: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. Methods: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. Results: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. Conclusions: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.

A case of rape poisoning in a Hanwoo (한우 유채중독 증례)

  • Do, Jae-Cheul;Kim, Eun-Young;Kim, In-Kyoung;Cho, Min-Hee;Kim, Joong-Kew;Park, No-Chan
    • Korean Journal of Veterinary Service
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    • v.35 no.1
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    • pp.53-57
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    • 2012
  • This is a case report about rape poisoning in a Hanwoo. Non-protein nitrogen (NPN) compound in rape may cause poisoning in domestic animals. Rape poisoned cattle may show big and rapid breath with opening its mouth, edema and erosion of skin with itching, drooling, dyspnea and indigestion. Besides there can be shown neurological (blindness) and urological (red water) symptoms in some cases. There is no effective therapy for rape poisoning, therefore stopping the rape supplying is basically important. Clinical symptoms and history taking are very important factors in diagnosis of rape poisoning, due to the absence of diagnostic standard of judgment for rape poisoning. A Hanwoo 38 months old cow, in a farm located in Gyeoungbuk province showed typical rape poisoning symptoms such as breath with opening its mouth, drooling, dyspnea and hyperphotosensitivity, and dramatical recovery were occurred after stopping supplying of rape. The cow were diagnosed as the rape poisoning based on observation of clinical symptoms and history taking.

Surgical Management of Acute Cerebellar Infarction

  • Choi, Won-Seok;Chung, Yong-Gu;Kang, Shin-Hyuk;Lee, Hoon-Kap
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.277-280
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    • 2006
  • Objective : The aim of this study is to determine which patients with progressively deteriorating acute cerebellar infarction would benefit from surgical treatment and which surgical procedure would best benefit them. Methods : Seventy six patients were treated at our hospital for cerebellar infarction over the past 3 years. Sixty nine patients received conservative management in the neurological department of our hospital. Among them, 7 patients [5 males and 2 females; average age, 49 yrs] were referred to neurosurgical department because of mental deterioration and underwent emergency surgery. Five patients underwent external ventricular drainage with suboccipital craniectomy and two patients underwent suboccipital craniectomy alone. Results : Of the 7 surgically treated patients, 4 patients experienced good recovery and 2 patients experienced moderate disability [disabled but independent] and 1 patient experienced severe disability [conscious but disabled]. There was no death. Conclusion : In patients conservatively treated for cerebellar infarction and showing mental deterioration and radiologically evident brainstem compression and ventricular enlargement, we strongly recommend suboccipital craniectomy [plus optional external ventricular drainage in case of showing hydrocephalus] as a first treatment option.

Two Cases of Paralytic Strabismus Treated with Acupuncture and Herbal Medicine (마비성사시의 한방치험 2례)

  • Lee, Seung-eun;Kim, Yoon-bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.16 no.1
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    • pp.168-178
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    • 2003
  • Strabismus refers to a extra-ocular muscle imbalance that results in improper alignment of the visual axes of two eyes. It may be divided into paralytic and non-paralytic strabismus. Paralytic strabismus is primarily a neurological problem: non-paralytic strabismus is more strictly an ophthalmologic problem. This case report focuses on paralytic strabismus resulting from palsies of the third and the sixth cranial nerves, respectively. Oculomotor nerve palsies result in binocular diplopia with characteristic patterns of strabismus. Oculomotor nerve provides motor and parasympathetic innervation to the eyes. Acquired oculomotor nerve palsies are not uncommon. Injury to the third nerve may result in complete or partial dysfunction. Complete third nerve palsy is manifested by ptosis, dilated pupil, an eye that is deviated down and out in primary position, and limited adduction, elevation, and depression. Patients with unilateral sixth nerve palsy complain of binocular, horizontal diplopia esotropia in the primary position due to unopposed action of the medial rectus and limitation of abduction due to weakness of the lateral rectus. Diplopia is worse in the direction of the paretic lateral rectus muscle. Paralytic strabismus are treated, based on the theory of Oriental medicine. with berbal medicines having gun-bi(健脾), bae-to(培土), gue-pung(祛風) effect of acupuncture around the eyes and etc. We describe a 63-year-old woman with complete the 3rd cranial nerve palsy and a 32-year-old woman with the unilateral 6th cranial nerve palsy who treated with acupuncture and herbal medicines and showed complete recovery.

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Pulmonary Function Index Comparisons Depending on Various Postures of Stroke Patients

  • Lee, Kyung-Soo;Lee, Myung-Mo
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.43-51
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    • 2019
  • PURPOSE: To prevent secondary complications from decreased pulmonary functions and promote neurological recovery, identification of respiratory capacity change patterns depending on different postures of stroke patients and investigation of their properties are needed for active rehabilitation. Therefore, this study was conducted to investigate the changes in vital capacity in response to different positions and to implement the results as clinical data. METHODS: A respiratory function test was administered to 52 patients with stroke in the sitting, supine, paretic side lying, and non-paretic side lying positions. Pulmonary function indexes used for comparison were forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), forced expiratory flow 25-75% (FEF 25-75%), and maximum voluntary ventilation (MVV). One-way repeated ANOVA was used for analysis, and post hoc analysis was conducted using least significant difference (LSD). RESULTS: All pulmonary function indexes were measured in the order of sitting, paretic side lying, supine, and non-paretic side lying positions. Excluding the FEF25-75% and MVV of the supine compared with the paretic side lying position, all other pulmonary function indexes differed significantly (p<.05). CONCLUSION: There are differences in pulmonary function indexes depending on different postures of stroke patients, and the study showed that the non-paretic side lying position yielded the greatest effect on lung ventilation mechanisms. Based on these results, appropriate postures need to be considered during physical therapy interventions for stroke patients.

Diplopia developed by cervical traction after cervical spine surgery

  • Kim, Ji-Yoon;Kim, Hyuna;Kang, So Jeong;Kim, Hyunjee;Lee, Young-Seok
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.152-156
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    • 2021
  • Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1-C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient's symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient's fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.

A Study on the Change in Inflammatory Activity of Macrophages and T Cells Using Pulsed Magnetic Field (펄스자기장(PMF)을 이용한 대식세포와 T 세포의 염증활성도 변화추이에 대한 연구)

  • Sojin Kim ;Hyunsook Lee
    • Journal of Biomedical Engineering Research
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    • v.44 no.5
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    • pp.324-328
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    • 2023
  • Excessive inflammation in the body causes immune cells to release cytokines that damage normal tissues and cells, leading to rheumatoid arthritis and sepsis. Pulsed magnetic field(PMF) stimulation has many applications in the treatment of neurological, muscular disorders and pain. Therefore, in this study, we aim to investigate the effect of PMF stimulation on the regulation of excessive inflammation in the overall immune system. Macrophages, a primary immune cell, and T cells, a secondary immune cell, were co-cultured in the insert wells under the same conditions, and then inflammation was artificially induced. The changes in inflammatory activity following PMF stimulation were measured by pH and IL-6 concentration. After inflammation induction, both cells became more acidic and increased IL-6 expression, but after PMF stimulation, we observed improved acidification of macrophages and T cells and decreased IL-6 expression. Our results showed that infected macrophages activated T cells and that the recovery of excessive inflammatory response regulation after PMF stimulation proceeded more rapidly in macrophages. Therefore, this study suggests that PMF has a positive anti-inflammatory effect on the overall immune system and thus has the potential to be used as a non-invasive therapy for the treatment of chronic inflammatory diseases.

The Communication Repair Strategy Characteristics According to Communication Breakdown of Elderly Man With Alzheimer's Dementia (알츠하이머 치매 노인의 의사소통 단절에 따른 의사소통 회복전략 특성)

  • Kim, Sun-Young;Park, Hee-June
    • Therapeutic Science for Rehabilitation
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    • v.8 no.4
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    • pp.53-63
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    • 2019
  • Objective : Many communication recovery strategies should be used when communication breakdowns occur for successful communication, however, communication problems increase due to inadequate use of such strategies in older people with dementia. The purpose of this study was to investigate the difference of recovery strategy between dementia and the elderly in conversational discourse. Method : The subjects were eight of Alzheimer's dementia and 10 general elderly. Conversation discourse tasks were conducted face-to-face with the subjects. Communication breakdown and communication recovery strategies were analyzed based on 200 utterances collected in the conversation discourse. Result : First, the AD group had more communication breakdown than the control group, but the recovery rate did not differ between the groups. Second, in the AD group, the nonspecific recovery strategy and the clarification demand strategy were used as the expression strategy. The recovery rate after using expressive strategy was more than 90% in explanation strategy, combined strategy, nonspecific repair strategy, and repetition confirmation strategy. The response strategy used a lot of paraphrase strategy and combined strategies, and the recovery rate after using the response strategy was 100% for the simplification strategy, repeat strategy and gesture strategy. Conclusion : The AD group showed more breakdown of research subjects and breakdown of researchers than control group, and it showed ability to use various expression strategy and response strategy though there was difference in repair rate between communication repair strategy. AD group used nonspecific repair strategy in expression strategy the most and paraphrase strategy in response strategy the most. This shows different characteristic from ordinary elderly people. Therefore, it is necessary to utilize this repair strategy for rehabilitation of AD elderly.

The Effect of Complex Exercise Program of Diabetic Rats with Ischemic Brain Injury Model (허혈성 뇌손상 모델 당뇨쥐의 복합운동프로그램의 효과)

  • Kim, Dong-Hyun;Bang, Hyun-Soo
    • The Journal of Korean society of community based occupational therapy
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    • v.6 no.1
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    • pp.41-48
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    • 2016
  • Objective : We tried to know the improvement and neurological effect of diabetes when the complex exercise training was applied on diabetes that delayed the recovery of the ischemic brain injury. Methods : We performed this study in a animal lab which located in Gyengsangbukdo. We used 10 diabetes rats with ischemic brain injury, which is induced by STZ. We applied the complex exercise training on the rats for 4 weeks. We executed the maze test to confirm the recovery of the brain function and checked the blood sugar to know the improvement. Results : As a result of applying the complex exercise on diabetes rats with ischemic brain injury, there was a significant reduce of error and escape time in 3 weeks and 1 weeks, respectively. There was no difference of the blood sugar in control but there was a significant improvement in experiment group after applying the exercise training in 4 weeks. Conclusion : The senile disease like stroke and diabetes was increased currently. It is important for rehabilitation to improve the quality of life during the remainder of their life. In the study, we've known the improvement of diabetes and the recovery of the brain function when the complex exercise training was applied the rats with both diabetes and the ischemic brain injury.