• 제목/요약/키워드: Pain of Lower Extremities

검색결과 179건 처리시간 0.03초

Primary Intramedullary Spinal Sarcoma : A Case Report and Review of the Current Literatures

  • Kim, Su-Hyeong;Bak, Koang-Hum;Kim, Dong-Won;Kang, Tae-Hoon
    • Journal of Korean Neurosurgical Society
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    • 제48권5호
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    • pp.448-451
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    • 2010
  • Primary central nervous system (CNS) sarcomas are exceedingly rare, and, to the best of our knowledge, there has not yet been a report of intramedullary sarcoma. Here, we report a primary intradural intramedullary sarcoma of the spinal cord in a four-year-old boy who presented with low back pain and a radiculopathy involving both lower extremities. The tumor showed significant enhancement on magnetic resonance (MR) images due to its extreme vascularity. Gross total tumor removal was performed with microelectrical pulse recording, and the patient also received adjuvant radiotherapy and chemotherapy. After the operation, the patient's sensory deficits were improved. Because CNS dissemination is common, entire neuraxis evaluation is essential, although there was no evidence of dissemination in this case. The prognosis of primary CNS sarcoma is poor due to infiltrative nature and early CNS dissemination is common, and the treatment of choice is radical surgical resection. Adjuvant therapy is also beneficial with radiotherapy and chemotherapy.

궤양성 대장염에 동반된 간정맥 혈전증 1예 (A Case of Hepatic Vein Thrombosis Associated with Ulcerative Colitis)

  • 김준성;김경모
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제12권2호
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    • pp.235-239
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    • 2009
  • 저자들은 궤양성 대장염으로 진단되어 치료 중이던 15세 소아에서 발생한 간정맥 혈전증(Budd-Chiari 증후군) 1예를 경험하였기에 문헌고찰과 함께 보고한다. 간정맥 혈전증은 소아 궤양성 대장염의 매우 드문 혈관계 합병증으로 이환율과 사망률의 주요한 원인이 될 수 있으므로 진단과 치료에 보다 세심한 주의가 필요하다.

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인공 슬관절 전치환술 후 발생한 May-Thurner 증후군 (May-Thurner Syndrome after Total Knee Arthroplasty)

  • 심창헌;박진우;왕립
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.277-281
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    • 2021
  • 장골정맥 눌림 증후군으로 알려져 있는 May-Thurner 증후군은 May와 Thurner에 의해 1957년 처음으로 기술되었다. 좌측 하지에서 침습적인 처치 없이 심부 정맥 혈전증의 증상이 나타날 때 May-Thurner 증후군을 의심할 수 있다. 저자들은 우측 인공 슬관절 전치환술 후 좌측 하지의 급작스러운 통증, 부종 및 피부색 변화를 보여 컴퓨터 단층촬영 정맥 조영술 시행 후 May-Thurner 증후군을 진단 받은 중년 여성 환자의 흥미로운 증례를 경험하였다. 본 증례를 통해서 우측 인공 슬관절 전치환술 후 간과할 수 있는 좌측 하지 May-Thurner 증후군을 조기에 진단하여 합병증을 예방하는 데 임상적 의의가 있다고 본다. 이에 문헌 고찰과 함께 증례를 보고하고자 한다.

Effect of High-frequency Diathermy on Hamstring Tightness

  • Kim, Ye Jin;Park, Joo-Hee;Kim, Ji-hyun;Moon, Gyeong Ah;Jeon, Hye-Seon
    • 한국전문물리치료학회지
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    • 제28권1호
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    • pp.65-71
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    • 2021
  • Background: The hamstring is a muscle that crosses two joints, that is the hip and knee, and its flexibility is an important indicator of physical health in its role in many activities of daily living such as sitting, walking, and running. Limited range of motion (ROM) due to hamstring tightness is strongly related to back pain and malfunction of the hip joint. High-frequency diathermy (HFD) therapy is known to be effective in relaxing the muscle and increasing ROM. Objects: To investigate the effects of HFD on active knee extension ROM and hamstring tone and stiffness in participants with hamstring tightness. Methods: Twenty-four participants with hamstring tightness were recruited, and the operational definition of hamstring tightness in this study was active knee extension ROM of below 160° at 90° hip flexion in the supine position. HFD was applied to the hamstring for 15 minutes using the WINBACK device. All participants were examined before and after the intervention, and the results were analyzed using a paired t-test. The outcome measures included knee extension ROM, the viscoelastic property of the hamstring, and peak torque for passive knee extension. Results: The active knee extension ROM significantly increased from 138.8° ± 9.9° (mean ± standard deviation) to 143.9° ± 10.4° after the intervention (p < 0.05), while viscoelastic property of the hamstring significantly decreased (p < 0.05). Also, the peak torque for knee extension significantly decreased (p < 0.05). Conclusion: Application of HFD for 15 minutes to tight hamstrings immediately improves the active ROM and reduces the tone, stiffness, and elasticity of the muscle. However, further experiments are required to examine the long-term effects of HFD on hamstring tightness including pain reduction, postural improvement around the pelvis and lower extremities, and enhanced functional movement.

소아에서 출혈성 수포를 동반한 $Henoch-Sch{\"{o}}nlein$ 자반병 1례 (A Case of $Henoch-Sch{\"{o}}nlein$ Purpura with Hemorrhagic Bullae in a Child)

  • 오연미;정미림;최혜정;차희정;정진영
    • Childhood Kidney Diseases
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    • 제10권1호
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    • pp.40-44
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    • 2006
  • [ $Henoch-Sch{\"{o}}nlein$ ] 자반증은 소혈관의 혈관염으로 오는 전신적 혈관 장애로 자반, 위장 증세, 관절 증세, 신 증세를 주 증세로 하는 질환이다. HSP의 흔한 피부증상은 주로 궁둥이와 하지의 자반 증상이며 성인에서는 출혈성 수포를 동반하는 경우가 흔하나 소아에서는 드문 것으로 알려져 있다. 저자들은 관절통과 복통을 호소하는 환아에서 출혈성 수포가 동반되어 있어 피부조직 검사를 하였고 진피의 leukocytoclastic vasculitis와 면역 형광법상 소혈관의 IgA와 fibrinogen의 침착을 관찰하였다. HSP로 진단하여 스테로이드 치료를 하였고 수일 내로 관절통과 복통이 호전되어 문헌고찰과 함께 보고하는 바이다.

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신경근 압박을 동반한 요추부 척수 경막외 동정맥루의 혈관 내 치료: 증례 보고 (Endovascular Treatment of a Lumbar Spinal Epidural Arteriovenous Fistula with Radiculopathy: A Case Report)

  • 황현;신재호;홍재택;인연권
    • 대한영상의학회지
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    • 제82권6호
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    • pp.1628-1633
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    • 2021
  • 척수 경막외 동정맥루는 매우 드문 질환으로 진단과 치료가 어렵다. 무증상 환자도 있으나 동정맥단락으로 척수주위정맥으로 역류되고 늘어난 정맥이 인접한 신경근을 압박하면서 증상이 생길 수 있다. 본 증례는 31세 남자 환자로 2년 동안 지속되는 요통, 방사성 허벅지통증, 하지 감각변화로 내원하였다. 컴퓨터단층촬영, 자가공명장치 및 척수혈관조영술에서 요추의 경막외 공간에서 동정맥단락에 의해 늘어난 정맥이 신경근을 압박하고 있는 척수 경막외 동정맥루로 진단하였다. 코일색전술을 시행하여 동정맥단락을 차단하였고 수일 내에 신경근 압박증상이 호전되었다. 이번 증례에서는 척수 경막외 동정맥루에서 외과적 수술의 대안으로 코일 색전술이 효과적인 치료가 될 수 있다는 것을 보여주었다.

퇴행성 관절질환을 앓고 있는 노인환자를 위한 한방과 양방을 적용한 통합의료 서비스의 효과 (Effect of an Integral Care System: a Combination of Oriental and Western Care for Older Adults with Degenerative Arthritis)

  • 이지아;지은선
    • 대한간호학회지
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    • 제41권1호
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    • pp.18-25
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    • 2011
  • Purpose: This study was done to examine the effect of an integrated care service which included a combination of oriental and western care on health outcomes in elderly patients with degenerative arthritis. Methods: A prospective comparative design was used. Data were collected from May 1, 2008 to June 30, 2009 from 85 elderly patients with degenerative arthritis in the lower extremities who were followed in a hospital out-patient department for 8 weeks. The integrated care service group (n=36) received a combination of physical therapy, acupuncture, western medicines or herbal medicines, and the western care group (n=49) received physical therapy or western medicines. Functional independence, walking speed, rotation balance, pain intensity, service satisfaction and total medical costs for the two groups were compared at 8 weeks. Results: Functional independence (t=2.14, p=.036) and walking speed (t=2.51, p=.014) improved significantly in the integrated care group while pain intensity improved significantly in the western care group (t=3.35, p=.002). The integrated care group reported higher scores for service satisfaction (t=2.09, p=.041) and higher medical costs than the western care group (t=2.15, p=.035). Conclusion: The results suggest that integrated care services are effective modalities to improve mobility and quality of life for elders with degenerative arthritis.

성인형 모공성 홍색 비강진에 대한 한방치료 증례 보고 1례 (A Case Report of Korean Medicine Treatment for Adult-type Pityriasis Rubra Pilars)

  • 전상우;강세영
    • 대한한방내과학회지
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    • 제41권5호
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    • pp.787-799
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    • 2020
  • Objectives: Pityriasis rubra pilaris (PRP) is a rare papulosquamous disorder with unknown etiology. Studies on adults have not been conducted yet in Korean medicine. We report the progress of Korean medicine treatment for adult-type pityriasis rubra pilaris. Methods: A 62-year-old female patient was diagnosed with PRP in June 2019. After the diagnosis of PRP, retinoid treatment was continued for about 6 months, and then the drug was switched to an oral immunosuppressant. However, the patient's symptoms did not improve, but instead worsened. The patient was treated with Mihudeungsikjang-tang and acupuncture therapy. We evaluated her treatment progress based on the Dermatology Life Quality Index (DLQI), a visual analogue scale (VAS), and the changes in the patient's subjective symptoms. Results: After Korean medicine treatment, the DLQI and VAS scores improved from 18 points to 16 points and from 6 points to 4 points, respectively. The whole-body itching and scaling were reduced by 30% compared to pretreatment. The itching and pain in the neck, which had been severely symptomatic, decreased by 50%. The pain and dysesthesia in the upper and lower extremities disappeared, but the erythema still remained. Conclusions: Conventional treatments for PRP have limitations due to adverse effects and difficulty in treating refractory forms. Korean medicine treatment is worth considering as it can complement the limitations of conventional treatments, although more studies will be needed.

요추부 척추관 협착증과 동반된 경막내 신경초종: 증례 보고 (Intradural Schwannoma Associated with Lumbar Spinal Stenosis: A Cese Report)

  • 소재완;김태헌;권세원
    • 대한골관절종양학회지
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    • 제17권2호
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    • pp.106-110
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    • 2011
  • 요추부 척추관 협착증과 경막내 종양이 동반되어 있는 환자에서, 척추관 협착증에 대한 수술적 치료만 시행하였다가 수술 후 증상이 잔존할 수 있다. 본 증례는 척추 신경이 척추관 협착증으로 인한 외적인 압박과 함께, 종양의 공간 점유로 경막내 압박을 동반하였던 경우로, 신경 감압술과 경막내 종양의 제거를 동시에 시행하여 성공적으로 치료되었기에 문헌 고찰과 함께 보고하는 바이다. 71세 여자환자가 하부 요통 및 양측 하지로의 방사통을 주소로 내원하였다. 자기 공명 영상에서 제 4-5 요추부는 척추관 협착증 소견과 함께 제 5 요추-제 1 천추부에 경도의 척추 전방 전위증 소견이 관찰되었고, 제 4 요추체 부위에서 타원형의 경막내 공간의 대부분을 점유하는 종괴가 관찰되었다. 후방 도달법으로 감압술 및 유합술을 시행한 다음, 정중 경막 절개술을 통해 종괴를 제거하였다. 조직 검사상 신경초종으로 진단되었고, 수술 후 증상은 현저히 호전되었다.

금궤요약(金匱要略).복만한산숙식병맥증병치제십(腹滿寒疝宿食病服證幷治第十)에 대(對)한 연구(硏究) (A Study ‘On the Morbid Pulse of Abdominal Fullness, Cold Mounting, and Abiding Food' in the Chapter 10 of Synopsis of Golden Chamber)

  • 서대선;안준모;조경종;정헌영
    • 대한한의학원전학회지
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    • 제19권2호통권33호
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    • pp.138-162
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    • 2006
  • 'On the Morbid Pulse of Abdominal Fullness, Cold Mounting, and Abiding Food' in the Chapter 10 of Synopsis of Golden Chamber that enunciates Abdominal Fullness, Cold Mounting, and Abiding Food is related to the stomach and intestines respectively, and is similar to the region and symptom of disease in the light of both abdominal fullness and symptoms of pain. This chapter was united into one because the formula mentioned in this chapter can be applied to three disease patterns. Abdominal fullness shows the symptoms of distention and unease, but judging from the text as well as a specific formula and symptoms, it follows pain. Accordingly Abdominal fullness dealt with in this chapter is the first consideration and it is a kind of a disease pattern attendant on abdominal pain. Cold Mounting does not mean mounting gi disease but means the abdominal pain. The cause of cold mounting is mainly due to insufficiency of yang gi and oversufficiency of cold evil. And the main symptoms of cold mounting follow the severe pain around the naval and sweating, cold of the extremities, pulse deep and tight. Abiding food is of the same meaning such as damage of food today. Abiding food is now referred to as damage of food. Principles which have set forth in this chapter are put to use of the method of ejection in case that abiding food places in the upper part, precipitation in the lower part. The symptoms of abiding food show that the pulse is slight and slippery and the wrist pulse is both superficial and large and rough in applying the pressure, and the cubit pulse is also slight and superficial as well, and that have diarrhea and have little appetite.

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