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동안신경마비 사시환자 1례 증례보고 (A Clinical Case Report of Oculomotor Nerve Palsy)

  • 엄유식;심성용;남혜정;김경준
    • 한방안이비인후피부과학회지
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    • 제17권3호
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    • pp.126-130
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    • 2004
  • Oculomotor nerve palsy presents itself with sudden onset unilateral ptosis and inability to turn the eye upward, downward, or inward, which causes visual disturbances. Strabismus caused oculomotor nerve palsy refers to muscle imbalance that results in improper alignment of the visual axes of the two eyes It may be divided into paralytic and non paralytic strabismus. paralytic strabismus is primarily a neurologic problem. Characteristic clinical disturbances result from lesions of the third, fourth, and sixth cranial nerves. Lesions of the third nerve result in a paralysis of lateral or outward movement and a crossing of the visual axes. Objective: This study was designed to evaluate the effects of oriental medicine therapy on a peripheral oculomotor nerve palsy. Methods & Result: The clinical data was analyzed on a patient with oculomotor nerve palsy whose main symptoms were right side ptosis and inability to turn the eye inward. The patient was treated by the electroacupucture(4Hz frequency, intensity was adjusted so that localized muscle contractions could be seen). As the result, symptoms are improved remarkably. Conclusion: The patient showed right eye ptosis and unilateral deviation of the right eye ball in neutral position. After acupuncture treatment and electroacupuncture treatment, the ptosis and deviation of the patient's right eye was recovered six weeks after the onset. The study suggests that oriental medicine therapy is significantly effective on the treatment of peripheral oculomotor nerve palsy.

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내엽형 폐격리증 수술 1례 보고 (Intralobar Pulmonary Sequestration A Case Report)

  • 이종수
    • Journal of Chest Surgery
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    • 제18권3호
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    • pp.482-486
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    • 1985
  • Pulmonary sequestration is an uncommon congenital malformation characterized by the presence of non-functioning lung tissues which receives its blood supply from an anomalous systemic artery instead of a pulmonary arterial branch. We present a case of intralobar pulmonary sequestration experienced lately. The patient was 7 years old girl with the complaints of chronic productive cough and right lower chest pain. Serial chest films showed a large cyst with or without a air-fluid level on the right lower lung field. Aortography revealed an aberrant artery originating from thoracic aorta just above the diaphragm and that drained into the right inferior pulmonary vein. During operation, a large abscess cavity measuring 6.5x5x5 cm in dimension at the right lower lobe was noted. And the two aberrant arteries, measuring 3 mm in diameter, arising from thoracic aorta 5 cm above the diaphragm was noted. After division and ligation of the aberrant arteries, right lower lobectomy was performed and the patient`s postoperative course was uneventful.

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연령별 자세변화에 따른 하지체중지지율에 대한 특성 (The Characteristics of Weight Bearing Ratio on Different Position of Ages Group)

  • 권혜정;황성수
    • 대한정형도수물리치료학회지
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    • 제15권1호
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    • pp.9-21
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    • 2009
  • Purpose : To know how much weight bearing on left and right leg on 14 different positions. The second is to know how about different the weight bearing ratio on same positions of ages group. Methods : The third is to know how about changes the weight bearing ration between exercise group and non exercise group. The group of age is divided 20s, 30s, 40s, 50s, over the 60 years. The subjects are 93 males(44), females(49). Results : The ordering of ratio of weight bearing on one side leg is as follows: The position of the highest weight bearing ratio is one leg standing with the other leg on chair(right 0.82, left 0.81) and the position of lowest weight bearing ratio is hooklying with natural leg position(both legs 0.08). There are statistically significant difference between right and left leg of weight bearing ratio on the 6 positions among the 14 positions. As for the ages, there are statistically significant difference on 5 different positions of 20 ages body weight bearing ratio between right and left leg. But as for the 50 ages there are no statistically significant difference on all of 14 positions between right and left leg body weight bearing. As for the exercise group there are statistically significant difference on only one position of one leg standing with the other leg on chair between right and left weight bearing ratio. But as for non exercise group there are statistically significant difference on 4 positions between right and left weight bearing ratio. Conclusion : When the therapist exercise with patient's always considerate of patient's position and weight bearing ratio.

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좌심실 이중유출로를 동반한 교정형 대혈관전위증 -1예보고- (Double-Outlet of Left Ventricle in Corrected Transposition of Great Arteries -One case report-)

  • 권중혁
    • Journal of Chest Surgery
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    • 제12권2호
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    • pp.119-126
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    • 1979
  • This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

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산모에서 요부 경막외 차단후 발생한 편측 호너 증후군과 상지마비 -증례 보고- (Unilateral Horner's Syndrome and Upper Extremity Paralysis following Lumbar Epidural Block in a Obstetric Patient)

  • 장연;조은정;김정태;박수석;이재희
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.285-290
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    • 1997
  • Horner's syndrome is a well-recognized complication of regional analgesia of neck and shoulder region, and not often a complication of lumbar or low thoracic epidural block. Recently we experienced right Horner's syndrome accompanying paralysis of right upper extremity following lumbar epidural block in for an obstetric patient. Epidurography and MRI was performed to clarify the cause of unilateral high epidural block and cervical sympathetic block. Radiologic study demonstrated a loop formation of the epidural catheter and tip of catheter was located in right anterior epidural spaced(L1-2). The initial epidurogram revealed unilateral spreading of dye in the cervical region in right epidural space. A second epidurogram, 10 minutes following, showed dye filling in left epidural space, however spread of dye in left side was limited to lumbar and low thoracic region. We concluded the most probable cause of this unilateral high epidural block was due to misplacement of the catheter into the anterior epidural space.

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Paradoxical Exacerbation of Symptoms with Obstruction of the Venous Outflow after Gamma Knife Radiosurgery for Treatment of a Dural Arteriovenous Fistula of the Cavernous Sinus

  • Ko, Jun Kyeung;Cho, Won Ho;Lee, Tae Hong;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • 제57권2호
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    • pp.127-130
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    • 2015
  • A 59-year-old female presented with progressive right proptosis, chemosis and ocular pain. An imaging work-up including conventional catheter angiography showed a right-sided dural arteriovenous fistula of the cavernous sinus, which drained into the right superior petrosal sinus, right superior ophthalmic vein, and right inferior ophthalmic vein, and cortical venous reflux was seen via the right petrosal vein in the right posterior fossa. After failure of transvenous embolization, the patient underwent Gamma Knife radiosurgery (GKRS). At one month after GKRS, she developed increasing ocular pain and occipital headache. Repeat angiography showed partial obliteration of the fistula and loss of drainage via the superior and inferior ophthalmic veins with severe congestion, resulting in slow flow around the right cerebellar hemisphere. Prompt transarterial embolization relieved the patient's ocular symptoms and headache. We report on a case of paradoxical exacerbation of symptoms resulting from obstruction of the venous outflow after GKRS for treatment of a dural arteriovenous fistula of the cavernous sinus.

편측 요부 교감신경절 차단에 의해 발생한 성기능 -증례 보고- (A Case of Erection Failure due to Unilateral Lumbar Sympathetic Block)

  • 신동엽;문순홍;홍기혁
    • The Korean Journal of Pain
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    • 제6권2호
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    • pp.258-260
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    • 1993
  • We experienced a rare case of erection failure which developed after unilateral lumbar sympathetic block. A 43 year old male patient suffering from reflex sympathetic dystrophy, which had developed after multiple communitted fracture of the right ankle, underwent right lumbar sympathetic block with 99.9% alcohol. The effectiveness of the lumbar sympathetic block was evaluated by monitoring the clinical symptoms, signs and temperature changes by digital infrared thermographic imaging. Postoperatively, the temperature of the affected side limb rose about $2^{\circ}C$, but the patient's conditions gradually returned to normal. Ten days after the operation the patient complainted of difficulty in achieving an erection. The patient was examined by a urologst without much results. The patient gradually recovered his ability to achieve an erection approximately 5 weeks after the lumbar sympathetic block.

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폐 내엽형 격절부:1례 보고 (Intralobar Puhnonary Sequestration - Report of one case -)

  • 김승규
    • Journal of Chest Surgery
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    • 제25권5호
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    • pp.541-543
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    • 1992
  • We experienced a case of intralobar pulmonary sequestration preoperatively confirmed. The 10 years old male patient was admitted beacuse of recurrent episode of coughing and production of purulent sputum. the chest X-ray showed a dense mass containing a large cyst with air-fiuid level in right lower lung field. An aortogram was performed and revealed that the sequestrated portion of the RLL was supplied by an aberrant large artery arising directly from the lower thoracic aorta. After division and ligation of the aberrant artery in pulmonary ligament, the right lower lobectomy was performed and the patient`s postoperative course was uneventful.

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Cervical Spinal Epidural Hematoma Following Cervical Posterior Laminoforaminotomy

  • Choi, Jeong Hoon;Kim, Jin-Sung;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • 제53권2호
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    • pp.125-128
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    • 2013
  • A 65-year-old man who had lateral cervical disc herniation underwent cervical posterior laminoforaminotomy at C5-6 and C6-7 level right side. During the operation, there was no serious surgical bleeding event. After operation, he complained persistent right shoulder pain and neck pain. Repeated magnetic resonance image (MRI) showed diffuse cervical epidural hematoma (EDH) extending from C5 to T1 level right side and spinal cord compression at C5-6-7 level. He underwent exploration. There was active bleeding at muscular layer. Muscular active bleeding was controlled and intramuscular hematoma was removed. The patient's symptom was reduced after second operation. Symptomatic postoperative spinal EDH requiring reoperation is rare. Meticulous bleeding control is important before wound closure. In addition, if patient presents persistent or aggravated pain after operation, rapid evaluation using MRI and second look operation is needed as soon as possible.

Sperm retrieval by conventional testicular sperm extraction for assisted reproduction in patients with Zinner syndrome

  • Cito, Gianmartin;Gemma, Luca;Giachini, Claudia;Micelli, Elisabetta;Cocci, Andrea;Fucci, Rossella;Picone, Rita;Sforza, Simone;Nesi, Gabriella;Santi, Raffaella;Minervini, Andrea;Masieri, Lorenzo;Carini, Marco;Coccia, Maria Elisabetta;Natali, Alessandro
    • Clinical and Experimental Reproductive Medicine
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    • 제48권1호
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    • pp.85-90
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    • 2021
  • We present data from three Caucasian men with Zinner syndrome who attended our center for the treatment of primary couple's infertility. Each patient was scheduled for conventional testicular sperm extraction (cTESE) and cryopreservation. Sperm analysis confirmed absolute azoospermia. Patient 1 had right and left testis volumes of 24 mL and 23 mL, respectively; left seminal vesicle (SV) agenesis, severe right SV hypotrophy with right renal agenesis. Follicle-stimulating hormone (FSH) was 3.2 IU/L. Patient 2 exhibited right and left testis volumes of 18 mL and 16 mL, respectively; a left SV cyst of 32 × 28 mm, ipsilateral kidney absence, and right SV agenesis. FSH was 2.8 IU/L. Patient 3 showed a testicular volume of 10 mL bilaterally, a 65 × 46 mm left SV cyst, right SV enlargement, and left kidney agenesis. FSH was 32.0 IU/L. Sperm retrieval was successful in all patients. Nevertheless, cTESE should be performed on the day of oocyte retrieval.