• 제목/요약/키워드: Sequelae

검색결과 552건 처리시간 0.022초

신생아 뇌파의 진단적 유용성에 대한 연구 (Diagnostic Significance of Neonatal Electroencephalography)

  • 김병의;김흥동
    • Clinical and Experimental Pediatrics
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    • 제46권2호
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    • pp.137-142
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    • 2003
  • 목 적 : 신생아기의 뇌파검사가 대뇌질환에 얼마나 예민한 검사인가를 조사하고, 초음파 검사와 비교하여 얼마나 예민하고 특이도가 높은 검사 방법인지를 조사하였다. 그리고 뇌파검사가 신생아의 신경학적 예후를 평가하는데 얼마나 가치가 있는지를 조사하기 위하여 본 연구를 시행하였다. 방 법 : 신경계 질환의 기능평가를 위하여 뇌파검사를 시행한 87명의 신생아를 대상으로 하였으며 출생 후 3일 이내에 뇌파검사를 시행하였다. 출생 후 3일 이내에 시행한 초기 뇌 초음파검사 소견을 7일 이후에 시행한 자기공명영상검사 또는 초음파검사 소견과 비교하였다. 결 과: 뇌파 검사는 신생아의 뇌손상을 진단하는데 초음파 검사보다 높은 감수성과 특이성을 보이는 것으로 나타났다. 신경학적 예후에 대한 뇌파 소견의 감수성은 경증의 장애에 대해서는 91.7%, 중등도 이상의 장애에 대해서는 100.0%로 나타났으나, 초기 초음파 소견은 각각 20.8%, 18.8%로 나타났다. 결 론 : 뇌파검사는 신생아의 뇌손상을 진단하는데 민감한 검사이고, 후기 신경학적 예후를 예측하는데 유용한 검사로 사료된다.

안면신경평가기준에 따른 구안와사(口眼喎斜)의 임상관찰 (The clinical observation on Bell's palsy according to facial nerve grading system)

  • 김종인;서정철;이상훈;최도영;강성길;고형균
    • Journal of Acupuncture Research
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    • 제19권5호
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    • pp.112-123
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    • 2002
  • Background and Objective : The evaluation of facial nerve function is a complex procedure. The House-Brackmann facial nerve grading system(H-B grade)and the Yanagihara grading system(Y-system) have been recommended as universal standards for assessing the degree of facial nerve palsy. The purpose of this study is to compare the effectiveness of Y-system and H-B system and to know the advantages of each system for each stage of incomplete recovery or sequelae of facial paralysis. Materials and Methods : A comparison between H-B grade and Y-system was studied with 137 evaluations of 61 cases of incomplete recovery or sequelae of peripheral facial paralysis. Each case was graded by using H-B system as a gross system and Y-system as a regional system before treatment, after 12 weeks and 6 months Results and Conclusions : The range of score in the Y-system 0-6, 8-16, 14-22, 24-34, 32-38, 38-40 were matched with grade VI, V, IV, III, II and I in the H-B system. The percentage of H-B grade III was the greatest among 137 evaluations and y-system showed the greatest score range. H-B system is easy to use but Y-system is more objective, quantitative and convenient to use in the incomplete recovery or sequelae state.

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술 전 스테로이드 투여가 하악 매복 제 3 대구치 발치 후 예상되는 불편감에 미치는 영향 (THE EFFECT OF PRE-OPERATIVE STEROID INJECTION ON THE RELIEF OF COMPLAINT AFTER THIRD MOLAR SURGERY)

  • 김성대;김경욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권3호
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    • pp.157-162
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    • 2003
  • Background : The surgical removal of impacted mandibular third molar can result in considerable pain, swelling, and dysfunction that patient are incapable of work for several days. Factors contributing to post operative swelling, trismus and pain are complex. There is no question but that the procedure of surgically removing an impacted mandibular third molar is inherently a traumatic one and that some sequelae related to the inflammation response are expected. Meticulous surgical technique will minimize the sequelae of inflammation but will not prevent them. In an effort to minimize these sequelae the use of steroid was instituted. Patients and Methods : Present study was to investigate the effect of one preoperative steroid injection in the masseter muscle to the patients(male 9, female 11) who needed prophylactic removal of bilateral, symmetrical, impacted wisdom teeth in the mandible on the complaint like swelling, trismus and pain. through Double-Blind test. Results : 1. After 24 hours investigation, preoperative steroid injection had significantly reduced swelling with 39% and trismus with 57.5%. 2. $7^{th}$ post operative day investigation, reduced swelling and trismus had shown, however, not significant. 3. There wasn't major difference from the group who took preve-ntive steroid in the visual analogue scale, the first analgesic intake time and the pain period. 4. There wasn't any adverse reaction of steroid for 20 patient From the above result, If the patients are not contraindication to steroid and pronounced post operative reaction can be expected the use of steroid to the surgical removal of impacted mandibular third molar is recommended.

말초성 안면마비 후유증 환자에서 침 치료와 바깥목동맥으로의 분지 영역에 시행한 고주파 병행 치료의 안면부종 감소 효과: 증례보고 (Effect of Acupuncture and High Frequency Therapy Applied to the Region Branching to the External Carotid Artery on Reduction of Facial Edema in Patients with Sequelae of Peripheral Facial Palsy: A Case Report)

  • 안선주;최성환;강신우;박서현;금동호
    • 한방재활의학과학회지
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    • 제30권4호
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    • pp.233-241
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    • 2020
  • This study was performed to evaluate the effect of high frequency therapy applied to the region branching to the external carotid artery for peripheral facial paralysis sequelae. A patient suffering with facial edema due to facial paralysis sequelae had been treated with acupuncture, high frequency therapy on the branch area to the external carotid artery for 7 weeks. The evaluation of clinical outcome was done by degree of swelling by measuring the distance of the face and skin temperature of face through digital infrared thermographic imaging. After treatment, the patient's degree of swelling and the temperature difference between the affected side and normal side was decreased. In addition, the temperature was changed in the entire facial area as well as the treatment point of high frequency therapy. This result shows that acupuncture combined with high frequency therapy at the region branching to the external carotid artery could be an effective way to improve facial blood flow, although further clinical studies will be needed.

수부의 신경초종: 감별진단과 미세수술의 중요성 (Schwannoma of the Hand: Importance of Differential Diagnosis & Microsurgical Dissection)

  • 탁관철;구현국
    • Archives of Plastic Surgery
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    • 제37권4호
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    • pp.452-456
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    • 2010
  • Purpose: The schwannoma is a benign peripheral nerve tumor arising from the Schwann cell of the nerve sheath. Only 2-8% of schwannomas arise in the hand and wrist. Misdiagnosis is frequent such as ganglion and neurofibroma. This article documents and clarifies the clinical features of schwannomas arising in the hand and wrist, and emphasizes importance of differential diagnosis and meticulous surgical extirpation under magnification. Methods: The author reviewed clinical features of 15 patients with pathologic final diagnosis of schwannoma developed in hand and wrist during the last 12 years from 1998 through 2009. The review included the sex, age of onset, duration, preoperative diagnosis, location, involved nerve, preoperative symptoms and. Postoperative sequelae after surgical extirpation of the lesion with magnification, or without magnification of the surgical fields. Results: The chief complaints were slow growing firm mass in all patients, and followed by pain in 40%, and paresthesia in 40% respectively. The lesions were developed solitarily in 14 patients (93%). The postoperative pathologic diagnosis and preoperative diagnosis were coincided with only in 6 patients (40%). Other preoperative diagnosis were soft tissue tumor in 4 patient (26.6%), and ganglion in 3 patients (20%), and neurofibroma in 2 patients (13%). In all patients who were undergone surgical excision under the fields of magnification, all symptoms were subsided without any sequelae. Meanwhile muscle weakness, paresthesia, hypoesthesia and /or accidental nerve resection developed after surgical excision with naked eye. Conclusion: Schwannoma in hand most commonly appears as a slow growing solitary mass with pain or paresthesia. The chance of preoperative misdiagnosis was 60% in this series. To provide good prognosis and less sequelae, careful and elaborate diagnostic efforts and meticulous surgical excision under the magnification are necessary in management of schwannoma.

일산화탄소 중독에 의한 Delayed Neuropsychiatric Sequalae 환자 치험 1례 (A Case Report of Delayed Neuropsychiatric Sequelae in a Patient Due to Carbon Monoxide Intoxication)

  • 배영롱;최유진;정누리;고흥;김기태;신선미
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.957-966
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    • 2019
  • Carbon monoxide intoxication leads to hypoxia, which eventually leads to tissue ischemia. Delayed neuropsychiatric syndrome (DNS) can be a consequence and appears in the form of cognitive impairment and movement disorders after a lucid interval. A 58-year-old Korean male was admitted to our hospital with delayed neuropsychiatric sequelae (DNS) after an 11-day lucid interval following recovery from acute carbon monoxide intoxication. We treated him with herbal medication, acupuncture, electroacupuncture, and moxibustion. The effects were assessed by the activity index and Mini Mental State Examination-Korea (MMSE-K) scores, and by changes in gait disturbance. In this case, the clinical symptoms, including gait disturbance, and the activity index and MMSE-K scores, improved after traditional Korean treatment. The findings of this case report suggest that traditional Korean medicine treatment can be effective for treatment of symptoms of delayed neuropsychiatric sequelae due to CO intoxication.

제초제 음독 후 발생한 신경학적 후유증으로 사지마비, 인지저하를 호소한 환자의 한의치료 증례보고 1례 (A Case Report on Korean Medical Treatment for a Patient with Quadriplegia and Impaired Cognition as Neurological Sequelae after Ingestion of Herbicides)

  • 심상송;안재윤;진효원;윤종민;문병순
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.904-915
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    • 2021
  • This study is a case report of Korean medicine treatment for a patient with quadriplegia and impaired cognition as neurological sequelae after ingestion of herbicides. A 59-year-old man with toxic encephalopathy and hypoxic encephalopathy after the ingestion of herbicides was treated with acupuncture, Hyulbuchuko-tang mixed with Ondam-tang-gami (血府逐瘀湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), and Modified Barthel Index (MBI). After three months of treatment, clinical symptoms improved. The motor function improved (MMT on both sides, Gr. 3+F/4G→Gr. 4-G~4G/4+G), cognition improved (K-MMSE, 13→21), and ADL (Activities of Daily Living) scores also improved (FIM 41→74; MBI 20→63). Korean medical treatment could effectively treat neurological sequelae after ingestion of herbicides in this case.

급성 일산화탄소 중독 환자들에서 흡연과 지연성 신경정신과학적 후유증 발생의 상관관계 (Association between Smoking and Delayed Neuropsychological Sequelae in Acute Carbon Monoxide Poisoning)

  • 김학면;최성우;나상운;최효정;임훈;김기운;한상수;이영환
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.102-107
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    • 2018
  • Purpose: This study examined the association between smoking and delayed neuropsychological sequelae (DNS) in acute carbon monoxide (CO) poisoning. Methods: Patients admitted to the medical center emergency department from March 2016 to March 2017 because of CO poisoning were examined retrospectively. The patients were divided into two groups: DNS and Non-DNS group. Multiple factors were analyzed to explain DNS, which was assessed by motor disturbances, cognitive impairment, dysphagia, Parkinson-like syndromes, epilepsy, and emotional lability in CO poisoning. Results: A total of 120 patients were included. The factors related to DNS were smoking (pack-years) (p=0.002) and initial carbon monoxide-hemoglobin level (p=0.015). On the other hand, after multivariate logistic regression analysis, smoking (Odds ratio 1.07; 95% CI, 1.02-1.13; p=0.004) was the only factor associated with DNS. Conclusion: Smoking is a very reliable factor for predicting the occurrence of DNS. A history of smoking in patients who suffer from CO intoxication is important. If a patient smokes, treatment should be started actively and as soon as possible.

일산화탄소중독에서 지연신경정신장애의 장기적인 예후 (Long-term outcome of delayed neuropsychiatric sequelae after carbon monoxide poisoning)

  • 유주영;김갑득;고찬영
    • 대한응급의학회지
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    • 제29권5호
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    • pp.519-528
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    • 2018
  • Objective: Delayed neuropsychiatric sequelae (DNS) following carbon monoxide (CO) poisoning, which may result from a demyelinating leukoencephalopathy, is a disease with a poor prognosis. This study examined the factors affecting the long-term prognosis of DNS and the efficacy of hyperbaric oxygen therapy (HBOT) in patients with DNS. Methods: This retrospective study included 84 patients with DNS following CO poisoning from January 2013 to June 2016. HBOT was given to 24 patients. The patients were divided into an improvement group and non-improvement group based on their clinical condition on a telephone interview at intervals between 3 months and 3 years after the onset of DNS. The improvement group was defined as having Cerebral Performance Category (CPC) scores in their daily life that improve to 1 or 2 grade. Results: Of the 594 patients, DNS were found in 18.2%, and 70.2% (59 of 84) of the patients with DNS improved. The prognostic factors for the improvement of DNS were an age of 45 years or less (odds ratio [OR], 12.068; 95% confidence interval [CI], 2.393-60.858; P<0.005), CPC score of 1 or 2 group at the time of DNS onset (OR, 12.361; 95% CI, 3.161-48.330; P<0.005), and a lucid interval longer than 20 days (OR, 5.164; 95% CI, 1.393-19.141; P<0.01). HBOT was not associated with the improvement of DNS in CO poisoning (OR, 0.467; 95% CI, 0.172-1.269; P>0.1). Conclusion: Patients aged less than 45 years, low grade CPC score of 1 and 2, and lucid interval longer than 20 days are more likely to have a good prognosis. On the other hand, HBOT failed to produce a benefit for DNS patients.

뇌졸중 증상별 경혈 활용에 대한 주제범위 문헌고찰: 전침을 중심으로 (A Scoping Review of Acupuncture Points for Post-Stroke Sequelae: Focusing on the Electroacupuncture)

  • 이화연;김송이;최수현;송호섭
    • Korean Journal of Acupuncture
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    • 제38권4호
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    • pp.197-208
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    • 2021
  • Objectives : The aim of this study was to conduct a scoping review focusing on acupuncture points information applied in experimental studies using electroacupuncture for stroke. Methods : First, we set the research question of this study to identify which acupuncture points were studied for various symptoms of post-stroke sequelae in clinical and animal experiments. For this purpose, among the records searched through EMBASE, experimental studies including acupuncture points used in electroacupuncture treatment for stroke were selected as inclusion criteria for this study. The acupoints information used in each experiment was extracted from the included studies according to the type of study design and symptoms of stroke sequelae, and quantitative analysis was performed. Results : A total of 973 studies using acupuncture treatment, of which 429 papers including electroacupuncture were analyzed. Most of the animal experiments were conducted on general conditions instead of specific symptoms of stroke, and in clinical studies, electroacupuncture studies were conducted on symptoms such as hemiplegia and spasticity, cognitive and mental problems, dysphagia, shoulder problems, and depression that occur after stroke. Acupuncture points such as GV20, ST36, LI11, and LI4 were mainly used regardless of stroke symptoms. Except for these acupuncture points, GV26, GV14, GV16, and GV24 were frequently used in animal experiments, and TE5, LI15, LI10, and LR3 were widely used in clinical studies. Conclusions : Although this study extracted and analyzed only the frequent acupuncture points in the electroacupuncture study for stroke. However, in the future, it is necessary to be able to secure the evidence for acupuncture treatment elements through comparative studies between different acupuncture points or other elements constituting electroacupuncture.