• 제목/요약/키워드: Progressive Intervention

검색결과 90건 처리시간 0.025초

Surgical Management and Outcome of Tethered Cord Syndrome in School-Aged Children, Adolescents, and Young Adults

  • Kang, Joon-Ki;Yoon, Kang-Jun;Ha, Sang-Su;Lee, II-Woo;Jeun, Sin-Soo;Kang, Seok-Gu
    • Journal of Korean Neurosurgical Society
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    • 제46권5호
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    • pp.468-471
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    • 2009
  • Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

기능적 과제훈련이 낙상경험노인의 일상생활수행능력에 미치는 영향: 단일대상연구 (The Effects of Functional Task Training on Activities of Daily Living in the Fall Experienced Elderly)

  • 우지희;박혜연;김종배
    • 재활치료과학
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    • 제5권1호
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    • pp.43-54
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    • 2016
  • 목적 : 본 연구는 낙상 후 회복에 대한 개입으로 기능적 과제훈련이 포함된 작업치료적 중재가 낙상경험노인의 일상 생활수행능력에 어떠한 영향을 미쳤는지 알아보고자 한다. 연구방법 : 본 연구는 지역사회에 거주하는 낙상경험노인 1명을 대상으로 하였으며, 반전설계에 동시 중재 교차설계를 더한 것이다. 총 실험회기는 18회로 기초선 A와 A'는 주 3회 2주간 걸쳐 6회, 중재과정 B는 2가지 중재가 동일한 날 점진적 저항근력운동의 낙상중재프로그램 1회, 점진적 저항근력운동에 기능적 과제훈련이 더해진 낙상중재 프로그램 1회가 오전, 오후 교대로 적용하여 주 3회씩 4주간 총 12회 진행하였다. 기초선 6회기, 중재 매 회기 마다 버그균형척도(Berg-Balance Scale), 과제수정척도(Task Modification Scale), 한국어판 낙상 효능감(Korean versioin Fall Efficiency Scale)을 측정하였고 실험 전, 후에 대상자의 일상생활수행능력을 비교하기 위해 캐나다 작업수행평가(Canadian Occupational Performance Measurement)와 가정 내 일상생활활동평가(Assessment of Home-Based Activities)로 측정하였다. 결과 : 중재 전, 후에 일상생활수행능력은 수행도보다 만족도에서 향상되었고, 가정 내 일상생활활동의 독립성과 안전성 영역에서 점수가 더 향상됨을 보였다. 점진적 저항근력운동만 중재했을 때보다 점진적 저항근력운동에 기능적 과제훈련이 더해진 중재 후 낙상효능감과, 버그균형점수에서 통계적으로 더 큰 변화를 보였다. 결론 : 본 연구는 낙상을 경험한 노인을 대상으로 한 작업치료 중재의 근거를 제시하는데 의의가 있다.

Effect of lower extremity resistance exercise on gait performance in a patient with systemic lupus erythematosus with cerebral infarction and lower extremity vasculitis: a case study

  • Oh, Yongseop;Woo, Youngkeun
    • Physical Therapy Rehabilitation Science
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    • 제5권2호
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    • pp.106-112
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    • 2016
  • Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.

담도폐쇄증 환아의 치과치료 : 증례보고 (DENTAL MANAGEMENT OF THE PATIENT WITH BILIARY ATRESIA : A CASE REPORT)

  • 백병주;양연미;이승익;김재곤
    • 대한소아치과학회지
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    • 제27권1호
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    • pp.70-76
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    • 2000
  • Intra- & extra-hepatic duct system의 경화를 야기하는 Biliary atresia는 출생시 1 : 10,000의 발생빈도를 보이며, 5년 이하의 생존율을 나타내는 예후가 좋지 않은 질환이다. 담도폐쇄증의 원인은 아직 명확하지 않으나, 유전적인 요소나 발육성 원인으로 믿고 있다. 임상적 특징으로 두드러진 황달, 간비증대, 가려움증, 지방변, 황색종, 성장지연, 문맥압항진증, 출혈, 골연하증, 복수 그리고 호흡기계 감염 등을 나타낸다. 구강내 소견으로 녹색을 띄는 변색치아, 유치의 확장된 치수강과 치근관, 치아맹출지연, 법랑질 형성부전, 그리고 심한 치아 우식 등이다. 담도폐쇄증은 조기진단과 수술에 의해 사망률이 감소되고, 성장과 발달이 정상으로 돌아오며 생존율도 향상되었으나 여전히 그 원인과 치료에 대한 연구가 계속되어야 할 것이다. 이에 저자는 전북대학교 치과병원에 내원한 2명의 담도폐쇄증환아에 대해 임상, 방사선학적 특징 및 적합한 처치에 대하여 보고하고자 한다.

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급성 치성상악동염으로 인한 안구후농양: 증례보고 (Retrobulbulbar Abscess Due to Acute Odontogenic Sinusitis: a Case Report)

  • 조현주;정용선;채병무;정태영;박상준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권6호
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    • pp.563-566
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    • 2010
  • Retrobulbar abscess is a rare, but severe complication of paranasal sinusitis. The clinical presentations are eyelid swelling, erythema, proptosis, conjunctival chemosis, restricted ocular movement, and decreased visual acuity. Diagnostic methods available for evaluating retrobulbar abscess include sinus X-ray, ultrasonography, computed tomography (CT), and bacterial culture. For the treatment of retrobulbar abscess, immediate surgical drainage and systemic antibiotic therapy are needed. Proper diagnosis and treatments are necessary for preventing visual loss, cavernous sinus thrombosis, subdural abscess, and other lifethreatening complications. A patient, a 30-year-old man, was admitted to our hospital because of progressive eyelid swelling, erythema, ptosis and decreased visual acuity on the right eye after endodontic treatment. The sinusitis occurred secondary to the infection from an upper molar tooth. The spread of the infection led to the orbit via ethmoidal sinus and posterior orbital wall. Immediate surgical intervention was performed and systemic antibiotics was administrated. The symptoms and signs are improved after treatments, so we present our case with a brief review of the literature.

유도 선수에서 발생한 수지 근위 지관절의 재발성 전방 회전 탈구 - 1례 보고 - (Recurrent Volar Rotatory Dislocation of the Proximal Interphalangeal Joint of the Finger in Judo Player - A Case Report -)

  • 황정철;정덕환;한정수
    • 대한정형외과스포츠의학회지
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    • 제8권1호
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    • pp.51-55
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    • 2009
  • 수지 근위 지관절의 전방 회전 탈구는 매우 드물게 발생한다. 저자들은 여자 유도 선수에서 발생한 수지 근위 지관절의 전방회전 탈구를 경험하였기에 이를 문헌고찰과 함께 보고하고자 한다. 24세 여자 유도 선수로 총 4번의 근위 지관절 전방 탈구가 발생하였다. 수술 시 회전 손상으로 파열된 척측 측부 인대와 파열 없이 늘어져 있는 중앙 건을 확인할 수 있었다. 수술적 치료로 파열된 척측 측부 인대 봉합술과 중앙 건과 측부대 사이를 봉합하여 근위 지관절의 배측부를 강화 시켜주었다. 술 후 운동시에 탈구는 다시 발생하지 않았다. 수지 근위 지관절의 전방 회전 탈구는 매우 드문 손상이지만 다른 탈구처럼 조기 진단과 치료, 그리고 단계적인 재활이 무엇보다 중요하겠다.

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스위스볼을 이용한 코어 저항 운동이 농업 여성노인의 근감소증 지표에 미치는 영향 (Effect of core exercise with swiss ball on sarcopenia index in agriculture older women)

  • 박우영
    • 한국응용과학기술학회지
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    • 제36권4호
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    • pp.1349-1357
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    • 2019
  • 이 연구의 목적은 코어 저항 운동이 농업 여성노인들의 근감소증 지표에 미치는 영향을 보고자 하였다. 이 연구에 참여한 피검자는 65세 이상의 천안시 거주 농업 여성노인 15명과 통제군 여성 15명으로 하였다. 코어 운동군은 주 2회 60분간 코어 강화 운동을 실시하였고, 종속변인인 근감소증 지표로는 악력, 의자 앉았다 일어서기, 근육의 면적과 단기운동수행력으로 4m 보행, 2.44m 걷기 및 400m 걷기를 실시하였다. 코어 저항 운동 결과 의자 앉았다 일어서기의 유의한 개선을 보였으나 근단면적에서는 집단 간에 유의한 차이를 보였다. 또한 단기운동수행 능력 중 4m 보행속도에서 유의한 상호 작용과 2.44m 왕복걷기와 400m 걷기에서는 유의한 개선을 보이는 것으로 나타났다. 이상과 같이 코어 저항 운동은 근육의 활성화로 인해 하체근육 및 단기 운동수행능력을 개선을 가져오는 것으로 판명되었다.

Dimethylnitrosamine-Induced Reduction in the Level of Poly-ADP-Ribosylation of Histone Proteins of Blood Lymphocytes - a Sensitive and Reliable Biomarker for Early Detection of Cancer

  • Kma, Lakhan;Sharan, Rajeshwar Nath
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6429-6436
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    • 2014
  • Poly-ADP-ribosylation (PAR) is a post-translational modification of mainly chromosomal proteins. It is known to be strongly involved in several molecular events, including nucleosome-remodelling and carcinogenesis. In this investigation, it was attempted to evaluate PAR level as a reliable biomarker for early detection of cancer in blood lymphocyte histones. PAR of isolated histone proteins was monitored in normal and dimethylnitrosamine (DMN)-exposed mice tissues using a novel ELISA-based immuno-probe assay developed in our laboratory. An inverse relationship was found between the level of PAR and period of DMN exposure in various histone proteins of blood lymphocytes and spleen cells. With the increase in the DMN exposure period, there was reduction in the PAR level of individual histones in both cases. It was also observed that the decrease in the level of PAR of histones resulted in progressive relaxation of genomic DNA, perhaps triggering activation of genes that are involved in initiation of transformation. The observed effect of carcinogen on the PAR of blood lymphocyte histones provided us with a handy tool for monitoring biochemical or physiological status of individuals exposed to carcinogens without obtaining biopsies of cancerous tissues, which involves several medical and ethical issues. Obtaining blood from any patient and separating blood lymphocytes are routine medical practices involving virtually no medical intervention, post-procedure medical care or trauma to a patient. Moreover, the immuno-probe assay is very simple, sensitive, reliable and cost-effective. Therefore, combined with the ease of preparation of blood lymphocytes and the simplicity of the technique, immuno-probe assay of PAR has the potential to be applied for mass screening of cancer. It appears to be a promising step in the ultimate goal of making cancer detection simple, sensitive and reliable in the near future.

Change in Adiponectin and Oxidative Stress after Modifiable Lifestyle Interventions in Breast Cancer Cases

  • Karimi, Niloofar;Roshan, Valiollah Dabidi
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2845-2850
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    • 2013
  • Background: Breast cancer is one of the most frequent diseases in women today. Little information exists on modifiable lifestyle factors including effects of ginger supplements (as an anti-oxidant and anti-inflammatory herbal) and water-based exercise on biomarkers related to oxidative stress such as malondialdehyde (MDA), nitric oxide (NO) and glutathione peroxidase (GPx) and adiponectin in obese women with breast cancer. The aim of this study was to determine the single and concomitant effect of 6-wks water-based exercise and oral ginger supplement on the aforesaid markers in obese women with breast cancer. Materials and Methods: Forty women diagnosed with breast cancer ($48{\pm}5.4$ years, $76{\pm}9$ kg, fat mass $41.8{\pm}4%$), volunteered to participate in the study. Subjects were randomly assigned into four groups; placebo, water-based exercise, ginger supplement and water-based exercise+ginger supplement groups. Subjects in the ginger supplement group and the water-based exercise+ginger supplement group orally received 4 capsules (each capsule contained 750 mg), 7 days a week for 6 weeks. The water-based exercise program featured progressive increase in intensity and time, ranging from 50% to 75% of heart rate reserve, in a pool with 15 meters width, 4 times a week for 6 weeks. Fasting blood samples were collected at pre-test and post-test time points. Results: The ginger supplementation and or the water-base exercise resulted in an increase of adiponectin, NO and GPx and reduction MDA, as compared to pre-test values. However, the combined intervention (water-base exercise and ginger supplement) group showed significantly a far better effect on the biomarkers related to oxidative stress and adiponectin levels, as compared to the waterbase exercise or ginger supplement alone groups and the age-matched placebo group. Conclusions: Our results revealed that water-base exercise is a non-drug therapeutic strategy to reduce systemic stress in obese women suffering from breast cancer. Further, ginger supplementation alone or in combination with training, also play an important role in the pathogenesis of oxidative stress in obese women diagnosed with breast cancer.

괴사성 근막염 환자의 원인 균주에 따른 경과 비교 (Analysis of Necrotizing Fasciitis Patient by Causative Pathogens)

  • 박선형;노복균;김의식;황재하;김광석;이삼용
    • Archives of Plastic Surgery
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    • 제34권3호
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    • pp.319-324
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    • 2007
  • Purpose: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. Methods: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis. Results: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit. Conclusion: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.