Multiple Sclerosis(MS) is an acquired, demyelinating disease of the central nervous system. Clinically, it is characterized by episodes of focal disorder of the optic nerves, spinal cord, and brain, which remit to varying extent and recur over a period of many years. The average age at diagnosis is 30, typically starting between the ages of 15 and 50. Women are affected at least twice as often as men. It is more common in persons of northern European heritage and those living furthest from the equator. The diagnosis of MS is based on a history of multiple attacks of neurologic lesions over time that affect different parts of the central nervous system. A case of MS was confronted. The patient was treated with Cheongsimyonjaum-gami(淸心蓮字飮加味), YangMyung channel(陽明) and had significant improvement was seen.
Purpose: The neural injuries by the sprain around the ankle joint may contribute the chronic pain. Authors analyzed the incidence and the contributing factor of the neural injuries in ankle sprain. Materials and Methods: 52 patients (54 cases) were involved in this retrospective study. Patient with diabetes or spinal disease were excluded. Plain radiograph and MR image were evaluated. Treatments were consisted of cast immobilization for 4 weeks with weight bearing ambulation following bracing for 8 weeks. Neurologic evaluation were performed at 3 months, 6 months, 12 months post-injury period and each neural injury were confirmed by electromyography or lidocaine block test. Results: The average age was 39 years old and 34 cases were male and 20 cases were female. Rupture of the anterior talofibular ligament was observed in 48 cases, distal anterior tibiofibular ligament in 37 cases, calcaneofibular ligament in 6 cases. One cases revealed no injury of the ligament. Neural injuries around ankle was observed in 13 cases ; superficial peroneal nerve in 9 cases, sural nerve in 5 cases, saphanous nerve in 1 case. Neural injury was not influenced by the degree of ligament injuries but by the incidence numbers of ankle sprain. All cases were treated conservatively and symptom was subsided in all but 2 cases. Conclusion : Although the incidence is relatively low, the neural injuries in ankle sprain may occur in the recurrent ankle sprain and conservative treatment for neural injuries is satisfactory.
Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted. However, the FET technique is associated with a non-negligible incidence of spinal cord injury, due to the extensive coverage of the descending aorta with the excessive sacrifice of intercostal arteries. The indications for the FET technique include chronic thoracic aortic dissection, acute or chronic type B dissection when endovascular treatment is contraindicated, chronic aneurysm of the thoracic aorta, and chronic aneurysm of the distal arch. The F ET technique is also indicated in acute type A aortic dissection, especially when the tear is localized in the aortic arch; in cases of distal malperfusion; and in young patients. In light of the great interest in the FET technique, the Vascular Domain of the European Association for cardio-thoracic Surgery published a position paper reporting the current knowledge and the state of the art of the FET technique. Herein, we describe the surgical techniques involved in the FET technique and we report our experience with the F ET technique for the treatment of complex aortic disease of the thoracic aorta.
The ultimate goal of radiotherapy is to result in complete local control of tumor while sparing the surrounding normal tissues as much as possible. Since the development of CT in 1970s, patient's anatomical normal tissues and the site and extent of infiltration of tumor were identified almost accurately. In addition, the isodose distribution of delivered radiation to target tumor was shown in each cross-section. In the treatment planning of head and neck cancers, CT-reconstruction provided almost 3-dimensinonal inter-relationship between tumor and normal tissues. The utilization of imaging system of the CT scanner made it possible to illustrate in superposition the patient structure image, the radiation beams, and the isodose distributions. Thus it was possible to deliver radiation enough to control the local disease, and to avoid unnecessary administration of radiation to normal tissue such as spinal cord. CT-reconstructed image in axial, sagittal, and coronal planes suggested 3-dimensional radiotherapy treatment planning be possible and practical instead of conventional 2-dimensional planning at coronal plane.
The present experiment was designed to examine the effects of Jeongjihwan on carecholamines, serotonin, amino acids, lipid peroxide, free radical scavenging activity, malondialdehyde and superoxide dismutase activity in senile brain. It was performed by administering Jeongjihwan extracts of a variety of concentration to senile rats to experimentally determine effects of Jeongjihwan on biochemical changes in senile brain and examine protective effects against neurotoxin. To examine survival rate, the rat's spinal cord sensory ganglion cell pretreated in Jeongjihwan extracts was cultured in oxygen free radical. The results were summarized as follows: 1. Jeongjihwan significantly increased noradrenaline in the hippocampus and hypothalamus of the brain tissue of senile rats, and even though Jeongjihwan increased noradrenaline also in other brain tissue, there was no significance. 2. Jeongjihwan had no effects on dopamine changes in all brain tissue of senile rats. 3. Jeongjihwan significantly increased serotonin, but decreased in other brain tissue. 4. Jeongjihwan increased amino acid in the brain tissue of senile rats. 5. Jeongjihwan significantly decreased lipid peroxide and free radical in the brain tissue of senile rats. 6. Jeongjihwan significantly increased survival rate of nerve cell exposed to oxygen free radical. According to the above results, Jeongjihwan is assumed to improve brain function by reacting on biochemical changes of the senile brain and carries effects of protecting against neurocytotoxicity, and that Jeongjihwan can be used to treat regressive brain disease carrying symptoms of psychoactive disorders.
Magnetic Resonance Imaging (MRI) scanner is the device to draw an image of conditions and the spread of various tissue in the body. It is used by making the patient into rounded superconductor and using high frequency which cause resonances. It uses superconduction magnet and high frequency that is non-ionizing radiation so can acquire biochemical, physical, and functional information of tissue. It is also very useful because it can scan tomography from many different angles to diagnose disease of a nervous system, the heart, and a skeletal structure. It also has advantages of that there is no risk of radiation exposure and the ability of observation on organizations such as brains, livers and the spinal cord of people. Since these features, the rate of use has been increased accordingly more considerations of the security are required when it plans. The weight of devices and the cover problem of the strong magnetic field which is occurred by magnetic resonance at the time of diagnosis can cause very important structure problems and architectural condition. That also the recent tendency which needs stronger equipment means that planning of the MRI unit should generally aim at purposing of the proximity for the device maintenance and up-grade and of further expansion. However there are not enough studies and data on the magnet resonance imaging in domestic hospitals. According to these reasons, this study has an object of indicating basic data on MRI unit plan standard and alternative proposals.
Back pain has plagued humans for many thousands of years. The treatment of back pain is divided into operative treatment and conservative treatment. It is reported that cure rate of conservative treatment is 80~90 percent. Generally, the treatment of oriental medicine is mostly conservative treatment. But, surgery should not be used as a last resort in treatment; it is just one of many treatment options for various spinal conditions. In some instance, it can be to preferred choice; in other situations, alternative therapies may be superior. Selections of the operation in HIVD 1. Acute disc herniations with a protracted significant component af back pain. 2. Chronic disc degeneration with significant back pain and degeneration limited to one or two disc levels. 3. Sugical instability created during decompression. 4. The presence of neural arch defects coincident with disc disease. 5. Symptamatic and radiographically demonstrable segmental instability. Selections of the operation in stenosis 1. If it does not slowly progress in physical therapy and other nonoperative measures, many of these patients may ultimately need surgical decompression. 2. Absolute stenosis in an impression of CT, MRI.(under 10mm) 3. In patients with established symptoms of .neurogenic claudication. 4. In patients with bad influence of neurogenic derangement.(strength, sensory) Selections of the operation in spondylolisthesis 1. Persistence or recurrence of major symptoms for at least one year despite activity modification and physical therapy. 2. Tight hamstrings, persistently abnormal gait, or postural deformities unrelieved by physical therapy. 3. Sciatic scoliosis. 4. Progressive neurologic deficit. 5. Progressive slipping beyond 25 or 50 percent, even when asymptomatic. 6. A high slip angle (40 to 50 degrees) in a growing child, since it is likely to be associated with further progression and deformity. 7. Psychologic problems attributed to shortness of trunk, abnormal gait, and postural deformities characteristic of more severe slips.
Journal of Korean Academy of Fundamentals of Nursing
/
v.6
no.1
/
pp.64-77
/
1999
This study was conducted to investigate the use of medical equipment in patients receiving home care service. The subjects of this study were 88 patients cared by seven home care nursed who were registered in the Seoul Nurses Association. Data was collected from Aug. 1, 1998 to Dec. 30, 1998. The findings are as follows. 1. The sample was found to be 55.7% female : 51.7% over 65 years old. 75% with neurologic disease including CVA, brain tumor, ICH, Parkinsonism & Spinal stenosis and 78.4% living in Seoul. The Clinical experience of the home care nurses was greater than five years. 2. Medical equipment which the patients possessed were foley catheters(61.4%), L-tubes(59.1%) and tracheostomy tubes(51.1%). 3. Technical difficulties in use of medical equipment were related to home care ventilators(60.0%), L-tubes(3.8%) and tracheostomy tubes(2.2%). 4. Most of the medical equipment were obtained from the hospital where they had been admitted previously or from medical equipment companies. 5. Complications from the use of this equipment were infection through invasive techniques including wound drainage tubes(50%), and IV injections(22.2%), The complications were resolved through referral to the doctor of the hospital where they were previously admitted or through community health centers. 6. Most of the equipment was disposable, and equipment was disinfected by using various methods including boiling and soaking in antiseptic solutions. These findings suggest that consistant policy on the management of medical equipment is necessary for the safety of home care patients.
Objective : Following central nervous system(CNS) injury, inhibitory influences at the site of axonal damage occur. Glial cells become reactive and form a glial scar, gliosis. Also myelin debris such as MAG inhibits axonal regeneration. Astrocyte-rich gliosis relates with up-regulation of GFAP and CD81, and eventually becomes physical and mechanical barrier to axonal regeneration. MAG is one of several endogenous axon regeneration inhibitors that limit recovery from CNS injury and disease. It was reported that molecules that block such inhibitors enhanced axon regeneration and functional recovery. Recently it was reported that treatment with anti-CD81 antibodies enhanced functional recovery in the rat with spinal cord injury. So in this current study, the author investigated the effect of the water extract of Uncariae Ramulus et Uncus on the regulation of CD81, GFAP and MAG that increase when gliosis occurs. Methods : MTT assay was performed to examine cell viability, and cell-based ELISA, western blot and PCR were used to detect the expression of CD81, GFAP and MAG. Then also immunohistochemistry was performed to confirm in vivo. Results : Water extract of Uncariae Ramulus et Uncus showed relatively high cell viability at the concentration of 0.05%, 0.1% and 0.5%. The expression of CD81, GFAP and MAG in astrocytes was decreased after the administration of Uncariae Ramulus et Uncus water extract. These results was confirmed in the brain sections following cortical stab injury by immunohistochemistry. Conclusion : The authors observed that Uncariae Ramulus et Uncus significantly down-regulates the expression of CD81, GFAP and MAG. These results suggest that Uncariae Ramulus et Uncus can be a candidate to regenerate CNS injury.
Seo, Eun Ji;Choi, Ahnryul;Oh, Seung Eel;Park, Hyun Joon;Lee, Dong Jun;Mun, Joung H.
Journal of Biosystems Engineering
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v.38
no.1
/
pp.64-71
/
2013
Purpose: The purpose of this study was to select standing posture parameters that have a significant difference according to the severity of spinal deformity, and to develop a novel Cobb angle prediction model for adolescent girls with idiopathic scoliosis. Methods: Five normal adolescents girls with no history of musculoskeletal disorders, 13 mild scoliosis patients (Cobb angle: $10^{\circ}-25^{\circ}$), and 14 severe scoliosis patients (Cobb angle: $25^{\circ}-50^{\circ}$) participated in this study. Six infrared cameras (VICON) were used to acquire data and 35 standing parameters of scoliosis patients were extracted from previous studies. Using the ANOVA and post-hoc test, parameters that had significant differences were extracted. In addition, these standing posture parameters were utilized to develop a Cobb-angle prediction model through multiple regression analysis. Results: Twenty two of the parameters showed differences between at least two of the three groups and these parameters were used to develop the multi-linear regression model. This model showed a good agreement ($R^2$ = 0.92) between the predicted and the measured Cobb angle. Also, a blind study was performed using 5 random datasets that had not been used in the model and the errors were approximately $3.2{\pm}1.8$. Conclusions: In this study, we demonstrated the possibility of clinically predicting the Cobb angle using a non-invasive technique. Also, monitoring changes in patients with a progressive disease, such as scoliosis, will make possible to have determine the appropriate treatment and rehabilitation strategies without the need for radiation exposure.
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