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외상성 뇌손상 환자에서 대뇌피질의 재조직화: 사례보고 (Medial Reorganization of Primary Motor Cortex in Patient with Traumatic Brain Injury: a fMRI Case Study)

  • 최진호;권용현
    • The Journal of Korean Physical Therapy
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    • 제17권3호
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    • pp.421-428
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    • 2005
  • The tenn 'Brain plasticity' has been identified that our central nervous system is continuously being adapted and modulated according to environmental needs and demands, and has been used to encompass the multifarious mechanisms related to learning, development, and recovery from damage to the nervous system. The purpose of this study was to demonstrate cortical reorganization in a 26-year-old right-handed hemiparetic patient with traumatic primary motor cortex (M1) injury, using functional MRI (fMRI). The unaffected (left) primary sensori-motor cortex centered on the precentral knob was activated during unaffected (right) hand movements. However, the medial area of the injured M1 was activated during affected (left) hand movements. It seems that the motor function of the affected hand in this patient was reorganized into the medial area of the injured precentral knob. These investigations provide a great useful information and clinical evidences with the specialized clinician in stroke physical therapy about patient's prognosis and therapeutic guidelines.

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Anchitrema sanguineum (Digenea: Anchitrematidae) Accidentally Found during Colonoscopy of a Patient with Chronic Abdominal Pain: A Case Report

  • Kusolsuk, Teera;Paiboon, Nantana;Pubampen, Somchit;Maipanich, Wanna;Dekumyoy, Paron;Waikagul, Jitra
    • Parasites, Hosts and Diseases
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    • 제47권2호
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    • pp.167-170
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    • 2009
  • In November 2007, a 46-year-old male Thai patient presented with chronic abdominal pain for over 3 years. Colonoscopy revealed a small parasite of about $2{\times}1mm$ in size attached to the cecum mucosa. The worm was removed endoscopically, fixed, and stained for morphological observations. The specimen was identified as Anchitrema sanguineum (Digenea: Anchitrematidae), a trematode first reported in a reptile, Chamaeleo vulgaris, from Egypt, and then sporadically found in the intestines of insectivorous bats and other mammals. The patient was treated with praziquantel but no more worms were found in his stool. His symptoms improved slightly but not cured completely. It remains unclear whether the chronic abdominal pain of the patient was caused by this trematode infection. Whatever is the pathogenicity of this trematode, this is the first human case of A. sanguineum infection in the literature.

익상견갑에 대한 전거근 운동: 증례 보고 1. (Serratus anterior muscle exercise for The Winging Scapula: Case Study)

  • 장준혁;구봉오;김선엽
    • 대한정형도수물리치료학회지
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    • 제9권2호
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    • pp.69-77
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    • 2003
  • Objective: The purpose of this study is to describe the effect of the serratus anterior muscle exercise in a patient with winging of the scapular. Background and Purpose: The patient was a 33-year-old man with an 3 years history of the left deltoid region. He had not responded to previous treatments of rest, TENS and medicine. Materials and Methods: After Surgical operation of the shoulder, the patient was treated for 6 months in 144 visits. treatment consisted of push-up with plus in the standing position with his hands against the wall and unique push-up with quadruped position at mat. Also, Sling exercise therapy was utilized to control scapular stabilization and reduce stress on the scapulohumeral joint. Result: Following 104 physical therapy visits, the patient was able to full range of motion of the shoulder without shrug motion. Conclusion and Discussion: Scapular winging and serratus anterior muscle function are important consider in the rehabilitation of the shoulder dysfunction. Therefore, specific exercise program for people with the winging scapular should be considered.

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외상후 스트레스 장애를 가진 만성요통 환자에게 도수치료가 외상후 스트레스와 수면 장애 및 통증에 미치는 영향-사례 연구 (A Case Study of the Effect of the Manual Therapy on Patient with Posttraumatic Stress Disorder, Sleep Disturbance and CLBP)

  • 유성훈;강용주;김태원
    • 대한정형도수물리치료학회지
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    • 제20권1호
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    • pp.47-52
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    • 2014
  • Background: This case study is to describe the manual therapy for the patient with posttraumatic stress (PTSD), sleep disturbance, and pain such as chronic low back pain (CLBP). Methods: The patient who participated in this study was a 60 year-old male PTSD patient with CLBP. His CLBP is not from any genetic or family history but a sequelae of torture that he had gone through about 30 years ago. Prior to the intervention, it was assessed that the PDS-K score was 16, PQSI-K was 12, SLR-90-R was low, VAS score was 10, and KODI socre was 25. The intervention was conducted through manual therapy (myofascial release, muscle energy technique, lumbar stabilization) twice a week for eight weeks in total. Results: After eight week-intervention, the PDS-K, SLR-90-R, VAS, and KODI score were improved whereas PQSI-K was not sufficiently fast improved. Conclusions: The manual therapy is substantially effective in dealing with PTSD and CLBP.

A Case of Asymptomatic, Localized, and Idiopathic Diffuse Alveolar Damage

  • Jeon, Young-Do;Hong, Christian;Joh, Joon-Sung;Jung, Ja-Young;Min, Ji-Won;Park, Seon-Young;Lee, Ga-Ram
    • Tuberculosis and Respiratory Diseases
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    • 제72권4호
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    • pp.386-389
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    • 2012
  • Diffuse alveolar damage (DAD) is a histological change in lung tissue, and is generally caused by an acute lung injury, which is characterized by bilateral and widespread damages. Localized DAD occurs very rarely. The causes for DAD are numerous, but the chief cause is acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia, in cases of idiopathic manifestation. The 82-year-old patient, in this case study, showed a DAD lesion in only 1 lobe. The patient was otherwise healthy, with no previous symptoms of DAD. He was admitted to our medical center owing to localized infiltration, observed on his chest radiograph. Laboratory studies showed no signs of infections. DAD was confirmed by a surgical lung biopsy. The patient received corticosteroid treatment and had gradually improved. We report the case of a patient with localized, idiopathic DAD that cannot be classified as acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia.

심한 치과공포증 환자에서 임플란트 식립을 위한 Propofol과 Remifentanil 진정법 -증례 보고- (Sedation for Implant Surgery using Propofol and Remifentanil in Severe Dental Phobia Patient -A Case Report-)

  • 이정후;서광석;신터전;김현정
    • 대한치과마취과학회지
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    • 제10권2호
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    • pp.209-213
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    • 2010
  • Anxiety and fear is two main factors that keep patients from going to dental clinic. Especially, patients may feel implants operations are more traumatic. Intravenous conscious sedation for dental treatment can make patient comfortable and relaxable. Midazolam is more popular for sedation for dental treatment, but target-controlled infusion (TCI) of propofol and remifentanil is gaining wide popularity. A 54-year-old female patient who had severe dental phobia was referred to our dental hospital. She had past history of 2 times of hyperventilation and syncope during dental treatment. The patient showed a lot of dental anxiety and fear to dental treatments and stress reduction protocol was needed. We administered intravenous conscious sedation using target controlled infusion system with remifentanil and propofol. During sedation, we monitored the status of consciousness with bispectral index and vital signs. Dental treatment could be finished successfully without any problems.

자연성 기흉으로 인한 대량의 혈흉 (Massive hemothorax resulting from spontaneous pneumothorax)

  • 홍지연;김수완
    • Journal of Medicine and Life Science
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    • 제17권1호
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    • pp.16-20
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    • 2020
  • Spontaneous hemopneumothorax is a rare disease, and it can cause life threatening condition. It is characterized by the accumulation of more than 400 mL of blood and air in the pleural cavity without any other apparent causes. A previously healthy 22-year-old female patient presented with acute chest pain and dyspnea. Chest X-ray and computed tomography revealed a massive hemopneumothorax in the left hemithorax. The images showed a completely collapsed left lung with right-sided tracheal deviation, several pleural adhesion bands, and fluid collection with air-fluid level. We emergently performed a closed thoracostomy, and then 560 mL of fresh bloods were initially drained. We considered an emergent video-assisted thoracoscopic surgery for pulmonary wedge resection and bleeding control because of the massive hemothorax. However, the patient's vital signs were stabilized after blood transfusion and supportive cares for re-expansion pulmonary edema. The patient discharged from the hospital on 11th in-hospital day after removal of the chest tube, and there had not been any recurrence of the pneumothorax for 10 months. We suggest that treatment strategy should be decided upon individually based on the patient's condition and clinical course of the disease.

Orthodontic treatment of a transposed maxillary canine and first premolar in a young patient with Class III malocclusion

  • Gracco, Antonio;Siviero, Laura;Perri, Alessandro;Favero, Lorenzo;Stellini, Edoardo
    • 대한치과교정학회지
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    • 제45권6호
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    • pp.322-332
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    • 2015
  • A 12-year-old girl was referred to our clinic for evaluation of an unaesthetic dental appearance. All permanent teeth were erupted, while the deciduous maxillary right canine was retained. Cone-beam computed tomography revealed a complete transposition of the maxillary left canine and first premolar involving both the crowns and the roots. Initial cephalometric analysis showed a skeletal Class III pattern, with a slight maxillary retrusion and a compensated proclination of the upper incisors. The patient's teeth were considered to be in the correct position; therefore, we decided to attempt treatment by correcting the transposition and using only orthodontic compensation of the skeletal Class III malocclusion. After 25 months of active orthodontic treatment, the patient had a Class I molar and canine relationship on both sides, with ideal overbite and overjet values. Her profile was improved, her lips were competent, and cephalometric evaluation showed acceptable maxillary and mandibular incisor inclinations. The final panoramic radiograph showed that good root parallelism was achieved. Two-year follow-up intraoral photography showed stable results.

Late Occurrence of Cervicothoracic Ossification of Posterior Longitudinal Ligaments in a Surgically Treated Thoracic OPLL Patient

  • Hyun, Seung-Jae;Kim, Jong-Soo;Hong, Seung-Chyul
    • Journal of Korean Neurosurgical Society
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    • 제47권1호
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    • pp.55-57
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    • 2010
  • Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine is rare, even in the Far East. A 45-year-old female presented with a 4month history of progressive motor weakness in the lower extremities, numbness below the midthoracic area, and spastic gait disturbance. Neuroradiological examinations revealed massive OPLLs at the T4-T6 levels with severe anterior compression of the spinal cord. Anterior decompressive corpectomies with bone grafts were performed from T4 to T6 using a trans-thoracic approach. After surgery, the patient made an uneventful recovery. However, eleven years after surgery, the patient developed recurrent lower extremity weakness and spastic gait disturbance. De novo OPLLs at the C6-T2 levels were responsible for the severe spinal cord compression on this occasion. After second surgery, paralysis in both legs was resolved. We present a rare case of late cervicothoracic OPLL in a patient surgically treated for thoracic OPLL.

산후(産後) 우울증(憂鬱症)을 자하거(紫河車) 약침(藥鍼)을 활용하여 치료(治療)한 1례(例) (A case report of the postpartum depression with Hominis Placenta Herbal acupuncture therapy)

  • 이철웅;김진우;조진형;이순이
    • 대한한방부인과학회지
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    • 제19권2호
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    • pp.282-294
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    • 2006
  • Purpose : The purpose of this study is to report the effect of oriental treatments to postpartum depression Methods : We treated the patient who had postpartum depression and visited Joong-hwa oriental hospital. The patient in this case, 36-years-old female, was admitted for 15days(161th/May/2005-30th/May/2005) due to postpartum depression which was measured by EPDS(Edinburgh Postnatal Depression Scale) and BDI(Beck's depression Inventory). The symptoms of patient are insomnia, anxiety, palpitation, chest discomfort and depression. This patient was treated with Hominis Placenta Herbal acupuncture at CV4(Kwanwon, Guanyuan), CV6(Kihae, Qihai), B23(Shinsu, shenshu), GVl5(Amun, Yamen), herb medication, acupuncture, auricular acupuncture, moxa treatment, and so forth. Results : As a result, symptoms are remarkably alleviated. Conclusions : Hominis Placenta Herbal acupuncture is expected to have an effect on postpartum depression. After this, further approach and study on postpartum depression might be needed.

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