• Journal of Oral Medicine and Pain
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• 제32권2호
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• pp.187-200
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• 2007

이 연구는 치과임플란트 시술후에 발생할수 있는 감각이상의 평가를 위하여 뉴로미터를 사용하여 정량적으로 측정하여, 임플란트 시술후의 감각신경 평가에 개관적 지침을 마련하고자 하는데 목적이 있다. 2006년 대전 썬 병원 구강내과에 내원한 환자중에 임플란트 술식을 시행한 환자 44명과 대조군 30명을 대상으로 $Neurometer^{(R)}$ CPT/C (Neurotron, Inc., Baltimore, Maryland, U.S.A.)를 이용하여 임플란트 시술전과 시술후 발사시에 2000 Hz, 250 Hz, 5 Hz,주파수로 검사를 시행하였다. 측정 부위는 임플란트 시술부위에 따라 삼차신경의 상악신경 분지와 하악신경 분지에 적용하였다. Neurometer는 세가지의 주파수 (2000 Hz, 250 Hz, 5 Hz)를 적용할 수 있는데, 각 주파수별로 대상자가 감각을 느낄 수 있는 가장 낮은 전류의 세기를 전류인지역치로 기록하였다. 각 신경섬유별 전류인지역치는 $A{\beta}$섬유의 경우 2000 Hz, $A{\delta}$섬유의 경우 250 Hz의 전류자극 하에서 특징적으로 반응하며, C섬유의 경우 5 Hz의 전류자극 하에서 반응한다. 전류인지역치 검사는 삼차신경 영역에 있어서도 말초신경 손상을 평가하기 위하여 검사를 시행할 수 있으며, 말초신경부위에 특징적인 주파수의 전류를 발생시켜 선택적인 신경 섬유를 자극한다. 서로 다른 굵기의 신경 섬유들은 각기 다른 빈도의 전류자극에 선택적으로 반응하는데, 각기 다른 주파수의 전류자극을 적용하며, 각 전류에 선택적으로 반응하는 $A{\beta},\;A{\delta}$, C신경 섬유의 반응 역치를 개별적으로 평가할 수 있다. 전류인지역치를 통한 평가에서는 전류인지 역치의 증감을 측정하여 감각과민이나 감각감퇴등의 감각이상을 진단할 수 있다. 임플란트 시술전후의 전류인지역치를 평가한 본 연구에서는 다음과 같은 결과를 얻었다. 1. 임플란트 시술 전후의 평가에서는 좌우 상하악 각각의 2000 Hz, 250 Hz, 5 Hz에서의 전류인지역치는 전반적으로 수술 후가 증가되었으며, 하악에서는 2000 Hz와 5 Hz에서 수술후에의 전류인지역치가 통계학적으로 유의하게 증가하였다. 2. 전신질환을 가지고있거나 그로 인하여 투약중인 군에서는 임플란트 수술 전후에 유의한 차이가 없었으며, 대조군에 비해서는 좌측 2000 Hz와 5 Hz에서 임플란트 시술군이 전류인지역치가 유의하게 높았다. 3. 대조군과 임플란트 수술군의 수술전의 전류인지역치 측정치의 비교에서는 우측 2000 Hz, 5 Hz에서 임플란트 시술군이 유의하게 높았으며, 대조군과 임플란트 수술후의 전류 인지 역치 평가에서는 2000 Hz에서 유의한 차이를 보였다. 4. 남자가 여자보다는 전류인지역치가 높았으나, 통계학적인 유의성을 보이지는 않았으며, 임플란트 시술군내에서도 남녀차이는 보이지 않았으며, 대조군에서 좌측 2000 Hz에서 유의하게 낮았다. 임플란트 시술 전후의 전류인지 평가에서 남녀성별에 따른 차이는 남자군에서는 통계학적 차이가 없었고, 여자군에서 우측 5 Hz, 좌측 2000 Hz에서 유의하게 높았다. 5. 감각신경이 있다고 호소하는 군과 아닌 군과의 비교에서는 감각이상을 호소하는 군이 전체적으로 전류인지역치가 증가했으나 통계학적인 유의성은 없었다. VAS상에 증가를 보이는 군의 수술전후의 전류인지측정 평가에서는 우측 5 Hz에서 임플란트 시술후 전류인지역치가 유의하게 증가하였으며, VAS 표시가 수술전후에 모두 0 인 경우에 좌측 2000 Hz에서 수술후의 전류인지역치가 유의하게 증가하였다. 이 연구는 뉴로미터를 이용하여 치아 임플란트 시술후에 발생할 수 있는 감각이상을 평가 할수 있는 객관적이고 정량적인 전류인지역치를 제시하고자 하였다.

• Journal of Acupuncture Research
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• 제20권5호
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• pp.244-251
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• 2003

Objective: The main symptoms of the Wallenberg's syndrome are ataxia of gait, clumsiness of ipsilateral limbs, nausea and vomiting, vertigo, visual disturbance such as difficulty in focusing blurred vision diplopia, numbness, dysphagia, hoarseness, hiccup, nystagmus, Homer's syndrome. The purpose of this paper is to report the patient with the Wallenberg's syndrome who was improved by oriental medical treatment. Methods: In terms of exuberance of Yang(vital function) of the liver and stagnation of the liver Ki(energy), we let the patient take Chunghunhwadam-Tang, Hwangryeonhaedok-Tang and Dangkwihwalhyeol-Tang, at the same time, treated with acupuncture, Sa-Am and Dong-Si acupuncture therapy twice a day. Results: We could know that symptoms of the Wallenberg's Syndrome were improved after observing left sensory paralysis was almost recovered, hiccup was completely healed and vertigo was reduced to 1/10. Conclusions: We confirmed that oriental drugs and acupuncture by differentiation of syndromes make the patient with the Wallenberg's Syndrome reduce and improve symptoms he has.

• Parasites, Hosts and Diseases
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• 제51권6호
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• pp.739-742
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• 2013

A 52-year-old woman presented with lower back pain, progressive symmetrical paraparesis with sensory impairment, and sphincter disturbance. Magnetic resonance imaging (MRI) of the whole spine revealed multiple intradural extramedullary serpiginous-mass lesions in the subarachnoid space continuously from the prepontine to the anterior part of the medulla oblongata levels, C7, T2-T8, and T12 vertebral levels distally until the end of the theca sac and filling-in the right S1 neural foramen. Sparganosis was diagnosed by demonstration of the sparganum in histopathological sections of surgically resected tissues and also by the presence of serum IgG antibodies by ELISA. DNA was extracted from unstained tissue sections, and a partial fragment of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified using a primer set specific for Spirometra spp. cox1. After sequencing of the PCR-amplicon and alignment of the nucleotide sequence data, the causative agent was identified as the larva of Spirometra erinaceieuropaei.

• 대한한방내과학회지
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• 제25권1호
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• pp.119-125
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• 2004

Hemiplegic migraine is a typical symptom of general migraine. With this disorder, patients at any age can have a series of unilateral paralysis that would outlast a normal headache. It can be classified into three types, such as familiar hemiplegic migraine, sporadic hemiplegic migraine and unclassifiable hemiplegic migraine. Although it is known that normal hemiplegic migraine is associated with the gene on chromosome 19, the accurate cause and effective therapeutics have not been demonstrated yet. When a patient, subjected to this study complained unilateral hemiparesis and sensory disturbance with severe migraine and dysarthria, we thought that the direct cause of this symptoms was the stress. Therefore, we approached this disorder by focusing on the psychological aspect and finally gained a good result with Chilbok-yeum which releases the psychological irritation, so we report it for the better treatment.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.648-651
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• 2006

Purpose: Tarsal tunnel syndrome is characterized by pain and paresthesia of the entire posterior tibial nerve and its branches of the lower extremity. The cause of the tarsal tunnel syndrome is usually unknown but, rare case of space occupying benign tumors such as a ganglion may be one of the causes. We report our experiences of surgical treatment of the tarsal tunnel syndrome caused by ganglion we have encountered recently. Methods: A 54-year-old male patient presented with paresthesia, burning pain, positive Tinnel's sign without preceeding trauma, infection or any other causes of event. With surgical intervention, we completely removed the space occupying ganglion and with performed surgical release of the posterior tibial nerve and its branches. Results: At a 14-month follow up examination, the symptoms of paresthesia, burning pain, sensory disturbance was much improved compared to the preoperative conditions. Takakura's rating scale was elevated from 4(Poor) to 8(Good). Conclusion: We report our surgical experience of a rare case of tarsal tunnel syndrome caused by a ganglion, with a review of literature.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1377-1382
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• 2000

Ossification of ligamentum flavum(OLF) is a type of ectopic bone formation developed within the spinal ligament. Thoracic myelopathy is common symptom of OLF but radiculopathy is uncommon. We present 3 operated cases of OLF. Two showed myelopathy and one radiculomyelopathy. Main symptoms were motor weakness, sensory disturbance, incoordination of both legs, and back pain. One patient complained of left girdle pain in T4 dermatome. Deep tendon reflex(DTR) was increased in all cases. The diagnosis was made from myelogram, CT and MRI. Sufficient posterior decompressive laminectomy and medial facetectomy were performed. Postoperative diagnosis was comfirmed by histopathological examination. One patient could return to work 3 months after operation and two patients showed satisfactory improvement 2-3 months after operation. Early diagnosis and appropriate surgical treatment were prerequisite of good outcome.

• Physical Therapy Rehabilitation Science
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• 제4권2호
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• pp.61-65
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• 2015

Objective: The aim of this study was to objectively evaluate sensory disturbance in cervical spondylosis using grip force and investigate the relationship between the grip force and upper extremity function. Design: Cross-sectional study. Methods: Eleven cervical spondylosis patients with paresthesia conducted grip and lift tasks using a precision grip with the tips of the thumb and index finger on either side. The sum of the grip force used during the first four seconds was calculated and defined as the total grip force. The cutaneous pressure threshold of the fingers, the pinch power, the grip power and three subtests of the Simple Test for Evaluating Hand Function (STEF) were also assessed. Correlations between the total grip force and cutaneous pressure threshold, pinch power, grip power, and STEF subtest times were evaluated. Results: We found that the total grip force correlated with the cutaneous pressure threshold (p<0.05). Moreover, the total grip force of the dominant thumb correlated with the results of the three STEF subtests (p<0.05). There were no significant correlations between the total grip force and pinch/grip powers. Conclusions: We found that the total grip force correlated with cutaneous pressure threshold and upper extremity function. The results suggest that the total grip force could serve as an objective index for evaluating paresthesia in cervical spondylosis patients, and that the impaired ability of the upper extremity function is related to grip force coordination.

• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.380-384
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• 2009

급성 횡단성 척수염은 갑자기 발생하는 하지의 진행성 쇠약과 감각 장애가 특징이며, 대부분의 환자가 선행하는 바이러스 감염 증상의 병력을 가진다. 원인이 되는 선행 바이러스는 Epstein-Barr 바이러스, 헤르페스, 인플루엔자, 풍진, 볼거리, 수두 바이러스 등이 있다. 대개 발병 1주 내에 회복을 보이기 시작하지만 수 주 또는 수 개월 동안 지속되는 경우도 있으며, 방광 기능 장애와 하지 쇠약감 등의 후유증이 남을 수 있는 소아에서 비교적 발병이 드문 질환이다. 저자들은 수두를 앓고 난 뒤 전신 마비를 주소로 내원하여 척수 자기공명영상에서 횡단성 척수염을 진단받고, 치료 후 경미한 방광 기능 장애만 남고 거의 완전한 회복을 보인 1예를 경험하였기에 보고하는 바이다.

• 한국한의학연구원논문집
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• 제2권1호
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• pp.40-70
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• 1996

In the literatual study on the cerebral vascular dementia, the results were as follows : 1. Cerebral vascular dementia is so called apoplectic dementia, because it almost occurs after apoplexy, the attack rate has gradually increased by increase of life, so it exert a harmful influence to geriatric diseases. 2. The etiological factors are summarized on deficiency in the heart, kidney, liver(心, 腎, 肝虛), pathogenic wind(豊) pathogenic fire(火) phlegm(痰) and stagnated blood(瘀血) in the oriental medicine, and multiple cerebral infarction, cerebral anemia, decrease of cerebral vascular flow are etiological factors in the occidental medicine. 3. The region of infarction and attack of cerebral vascular dementia have a close connection, and generally the cerebral vascular dementia easily occur in injury of white matter of brain. 4. Symptoms of cerebral vascular dementia are dysphasia, walking disorder, hemiplegia, sensory paralysis, disturbance of memory, judgement, calculation, emotion incontinence, speech impediment, silence or talkative, lower thinking ability and depersonalization, and symptoms are aggravated by stage. 5. Therapeutic herb medicines are Palpungsan(八風散), Baepungsan(排風散), Jinsaanshinhwan(辰砂安神丸), Sabacksan(四白散), Kanghwalyupungsan(姜活愈風散), Woohwangchungshimhwan(牛黃淸心丸), and they are used to dispelling pathogenic wind(祛風), soothe the nerves(安神), dispel pathogenic heat from lung, nourish the blood(淸肺養血).

• Journal of Korean Neurosurgical Society
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• 제64권2호
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• pp.238-246
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• 2021

Objective : To retrospectively analyze the clinical characteristics and surgical experience of 10 adults with spinal extradural meningeal cysts (SEMCs) in the thoracolumbar spine which may further provide evidence for surgical decision-making. Methods : Ten adults with SEMCs in the thoracolumbar spine were surgically treated and enrolled in this study. Clinical manifestations, imaging data, intraoperative findings and postoperative outcome were recorded. Results : Clinical manifestations of SEMCs included motor and sensory dysfunction of the lower limbs and urination and defecation disturbance. The cysts presented as intraspinal occupying lesions dorsal to the spine, ranging from the T8 to L3 level. Defects of eight cases were found on preoperative magnetic resonance imaging (MRI). Selective hemilaminectomy or laminectomy were used to reveal the defect within the cyst, which was further sutured with microscopic technique. The final outcome was excellent or good in seven cases and fair in three cases. No recurrence was observed during follow-up. Conclusion : SEMCs are rare intraspinal cystic lesions. Radiography and MRI are clinically practical methods to assess defects within SEMCs. Selective hemilaminectomy or laminectomy may reduce surgical trauma. Detection and microscopic suturing of the defects are the key steps to adequately decompress the nervous tissue and prevent postoperative recurrence.