• Title/Summary/Keyword: Spinal Disorder

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Clinical Study on One Patient with Multiple Sclerosis (다발성 경화증 환자 치험 1례)

  • Baek, Dong-Gi;Rhim, Eun-Kyung;Lee, Yun-Jae;Jeong, Hyun-Ae;Cho, Young-Kee;Moon, Mi-Hyun;Lee, Seong-Kyun;Kim, Dong-Woung;Shin, Sun-Ho;Hwang, Sang-Il
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.609-614
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    • 2004
  • 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.

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Chattering Free Sliding Mode Control of Upper-limb Rehabilitation Robot with Handling Subject and Model Uncertainties (환자와 로봇의 모델 불확도를 고려한 상지재활로봇의 채터링 없는 슬라이딩 모드 제어)

  • Khan, Abdul Manan;Yun, Deok-Won;Han, Changsoo
    • Journal of Institute of Control, Robotics and Systems
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    • v.21 no.5
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    • pp.421-426
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    • 2015
  • Need to develop human body's posture supervised robots, gave the push to researchers to think over dexterous design of exoskeleton robots. It requires to develop quantitative techniques to assess human motor function and generate the command to assist in compliance with complex human motion. Upper limb rehabilitation robots, are one of those robots. These robots are used for the rehabilitation of patients having movement disorder due to spinal or brain injuries. One aspect that must be fulfilled by these robots, is to cope with uncertainties due to different patients, without significantly degrading the performance. In this paper, we propose chattering free sliding mode control technique for this purpose. This control technique is not only able to handle matched uncertainties due to different patients but also for unmatched as well. Using this technique, patients feel active assistance as they deviate from the desired trajectory. Proposed methodology is implemented on seven degrees of freedom (DOF) upper limb rehabilitation robot. In this robot, shoulder and elbow joints are powered by electric motors while rest of the joints are kept passive. Due to these active joints, robot is able to move in sagittal plane only while abduction and adduction motion in shoulder joint is kept passive. Exoskeleton performance is evaluated experimentally by a neurologically intact subjects while varying the mass properties. Results show effectiveness of proposed control methodology for the given scenario even having 20 % uncertain parameters in system modeling.

A Case Report of Korean Traditional Medical Therapy about Patient with Guillain-Barre Syndrome (Guillain-Barre Syndrome 환자의 한방 치험 1례)

  • Kim, Jong-Won;Kim, Min-Sang;Oh, Byeong-Yeol;Yu, Byeong-Chan;Jo, Hyun-Kyung;Kim, Yoon-Sik;Seol, In-Chan;Shim, Jae-Chul
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.418-425
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    • 2004
  • The Guillain-Barre Syndrome(GBS), also called acute inflammatory demyelinating polyneuropathy and Landry's ascending paralysis, is an inflammatory disorder of the peripheral nerves - those outside the brain and spinal cord. It is characterized by the rapid onset of weakness and, often, paralysis of the legs, arms, breathing muscles and face. Finally, it leads to respiratory embarrassment and death. There is often a history of antecedent respiratory or gastrointestinal infection. Recently one patient was admitted with GBS. This patient was a 30 year-old man with quadriparesis, both facial palsy, numbness of hands and feet, and gait disturbance. After two weeks of oriental medicine and acupuncture treatment most symptoms improved. Therefore, this application of oriental medicine is reported with a plea for further investigation.

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Dual control of the vestibulosympathetic reflex following hypotension in rats

  • Park, Sang Eon;Jin, Yuan-Zhe;Park, Byung Rim
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.6
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    • pp.675-686
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    • 2017
  • Orthostatic hypotension (OH) is associated with symptoms including headache, dizziness, and syncope. The incidence of OH increases with age. Attenuation of the vestibulosympathetic reflex (VSR) is also associated with an increased incidence of OH. In order to understand the pathophysiology of OH, we investigated the physiological characteristics of the VSR in the disorder. We applied sodium nitroprusside (SNP) to conscious rats with sinoaortic denervation in order to induce hypotension. Expression of pERK in the intermediolateral cell column (IMC) of the T4~7 thoracic spinal regions, blood epinephrine levels, and blood pressure were evaluated following the administration of glutamate and/or SNP. SNP-induced hypotension led to increased pERK expression in the medial vestibular nucleus (MVN), rostral ventrolateral medullary nucleus (RVLM) and the IMC, as well as increased blood epinephrine levels. We co-administered either a glutamate receptor agonist or a glutamate receptor antagonist to the MVN or the RVLM. The administration of the glutamate receptor agonists, AMPA or NMDA, to the MVN or RVLM led to elevated blood pressure, increased pERK expression in the IMC, and increased blood epinephrine levels. Administration of the glutamate receptor antagonists, CNQX or MK801, to the MVN or RVLM attenuated the increased pERK expression and blood epinephrine levels caused by SNP-induced hypotension. These results suggest that two components of the pathway which maintains blood pressure are involved in the VSR induced by SNP. These are the neurogenic control of blood pressure via the RVLM and the humoral control of blood pressure via epinephrine release from the adrenal medulla.

A Systematic Review of the Effectiveness of Eastern-Western Integrative Medicine for Musculoskeletal Disorders (근골격계 질환의 한·양방협진치료 효과 연구에 대한 체계적 문헌 고찰)

  • Lee, Seung-Jin;Shin, Byung-Cheul;Song, Geun-Sung;Hwang, Eui-Hyoung;Yun, Young-Ju;Cho, Hyun-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.87-96
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    • 2011
  • Objectives: This study aims to systematically evaluate the effectiveness of Eastern-Western integrative medicine for musculoskeletal disorders compared with Eastern or Western Medicine. Methods: Systematic sea-mes of 9 major Korean databases were conducted for articles published up to July 2011. Searching keyword was "Integrative Medicine". Prospective studies dealt with musculoskeletal disorders by Eastern-Western integrative medicine were included. Quality assessment of included studies was evaluated by Cochrane risk of bias tool. Results: 470 studies in total were seamed, Amalg them 7 studies met our inclusion criteria(3 randomized controlled clinical trials, 2 non-randomized controlled trials and 2 uncontrolled clinical trials). Included studies dealt with lumbar pan(3), shoulder pain(2), pain after traffic injury(1), spinal compression fracture(1). Eastern-Western integrative medicine showed better or equal effect for the treatment of various muscloskeletal disorders compared with Eastern or Western medicine alone. Conclusions: There is very weak evidence for the effectiveness of Eastern-Western integrative medicine for musculoskeletal disorders compared with Eastern or Western medicine alone. Well designed randomized controlled trials with rigorous methodology are needed to evaluate the effectiveness of Eastern-Western integrative medicine objectively in the future.

Study of four weeks repeated-dose toxic test of Sweet Bee Venom in rats Original Articles (Sweet Bee Venom의 rat를 이용한 4주 반복 근육시술 독성시험)

  • Kwon, Hae-Yon;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.14 no.1
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    • pp.5-24
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    • 2011
  • Objective: This study was performed to analyse four weeks repeated -dose toxicity of Sweet Bee Venom (SBV-pure melittin, the major component of honey bee venom) in rats. Methods: All experiments were conducted under the regulations of Good Laboratory Practice (GLP) at Biotoxtech Company, a non-clinical study authorized institution. Male and female rats of 5 weeks old were chosen for the pilot study of four weeks repeated-dose toxicity and was injected at the level of 0.56 mg/kg body weight (eighty times higher than the clinical application dosage as the high dosage), followed by 0.28 and 0.14 mg/kg as midium and low dosage, respectively. Equal amount of normal saline was injected as the control group every day for four weeks. Results: 1. No mortality was witnessed in all of the experiment groups. 2. All experiment groups appealed pain sense in the treating time compared to the control group, and side effects such as hyperemia and movement disorder were observed around the area of injection in all experiment groups, and the higher dosage in treatment, the higher occurrence in side effects. 3. Concerning weight measurement, neither male nor female groups showed significant changes compared to the control group. 4. Concerning to the CBC and biochemistry, all experiment groups didn't show any significant changes compared to the control group. 5. Concerning weight measurement of organs, experiment groups didn't show any significant changes compared to the control group. 6. To verify abnormalities of organs and tissues, those such as cerebellum, cerebrum, liver, lung, kidney, and spinal cords were removed and we conducted histologocal observation with H-E staining. Concerning the histologocal observation of liver tissues, some fatty changes were observed around portal vein in 0.56 mg/kg experiment group. But another organs were not detected in any abnormalities. 7. The proper high dosage of SBV for the thirteen weeks repeated test in rats may be 0.28 mg/kg in one time. Conclusion: Above findings suggest that SBV is relatively safe treatment medium. Further studies on the subject should be conducted to yield more concrete evidences.

Cost-Effectiveness Analysis of Cervical Anterior Fusion and Cervical Artificial Disc Replacement in the Korean Medical System

  • Lee, Hyosang;Kim, Ui Chul;Oh, Jae Keun;Kim, Taehyun;Park, Sohee;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.83-89
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    • 2019
  • Objective : This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease. Methods : We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro $2015^{TM}$ (TreeAge Software, Inc, Williamstown, MA, USA). Results : Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard. Conclusion : Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.

A New Classification for Cervical Ossification of the Posterior Longitudinal Ligament Based on the Coexistence of Segmental Disc Degeneration

  • Lee, Jun Ki;Ham, Chang Hwa;Kwon, Woo-Keun;Moon, Hong Joo;Kim, Joo Han;Park, Youn-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.1
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    • pp.69-77
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    • 2021
  • Objective : Classification systems for cervical ossification of the posterior longitudinal ligament (OPLL) have traditionally focused on the morphological characteristics of ossification. Although the classification describes many clinical features associated with the shape of the ossification, including the concept of spondylosis seems necessary because of the similarity in age distribution. Methods : Patients diagnosed with OPLL who presented with increase signal intensity (ISI) on magnetic resonance imaging were surgically treated in our department. The patients were divided into two groups (pure versus degenerative) according to the presence of disc degeneration. Results : Of 141 patients enrolled in this study, more than half (61%) were classified into the degenerative group. The pure group showed a profound male predominance, early presentation of myelopathy, and a different predilection for ISI compared to the degenerative group. The mean canal compromise ratio (CC) of the ISI was 47% in the degenerative group versus 61% in the pure group (p<0.0000). On the contrary, the global and segment motions were significantly larger in the degenerative group (p<0.0000 and p=0.003, respectively). The canal diameters and global angles did not differ between groups. Conclusion : Classifying cervical OPLL based on the presence of combined disc degeneration is beneficial for understanding the disorder's behavior. CC appears to be the main factor in the development of myelopathy in the pure group, whereas additional dynamic factors appear to affect its development in the degenerative group.

Self-Exercise Oriented Management for Shoulder Pain Patient with Winging Scapular : Case Report (견갑골 익상을 동반한 어깨 통증 환자에 대한 자가 운동 중심의 관리: 사례 보고)

  • Jeon, Jae-guk;Jung, Min-keun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.2
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    • pp.67-75
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    • 2022
  • Background: Scapular winging is a rare disorder that is commonly caused by nerve damage of the dorsal scapular nerve, spinal accessory nerve, or the long thoracic nerve. This affects the scapulohumeral rhythm which may cause abnormal kinetic motion of the shoulder. The purpose of this case report is to describe a self-exercise oriented management incorporating shoulder strengthening to reduce symptoms in a shoulder pain patient with winging scapular. Methods: A 45 year old male patient complained of pain in his both shoulders without any trauma. Shoulders were treated with steroid injections for supraspinatus tendonitis, but although pain improved to some extent, pain and disability continued for 3 months. Both shoulders had pain, decreased active range of motions, muscles weakness, and scapular winging. The patient underwent 9 interventional sessions over 3 months and was managed mainly by self-exercise. The intervention method involved push up plus, sling, muscle strengthening, and stabilization exercises. Loads were increased as symptoms improved. Results: Clinical outcomes were measured at every session. Pain in both shoulders reduced to 0 on a numerical pain rate scale by the 4th session, and the active range of motion was fully recovered. During the 9th session, the strength of the serratus anterior had improved from grade P to G on the right side and grade G to N grade on the left. Conclusion: In this case study, the self-exercise program was effective in reducing pain, increasing active range of motion, and improving muscle strength in subjects with scapular winging.

General Radiography Examination Statistical analysis of Patients in Geriatric hospitals (노인요양병원 내원환자의 일반촬영 통계분석)

  • Kim, Kyuhyung;Lee, Junhang;Kim, Youngwan
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.71-79
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    • 2013
  • The purpose of this study is to establish the basic data for the management of the elderly patients aged more than 60 suffering from musculoskeletal disorders in geriatric hospitals. From January, 1 2012 to December 31, 2012, 2,500 patients who were taken the x-ray inspection and were analyzed x-ray order 5,042 cases above spines, upper lower extremities and joints. The elderly age was divided into 3 groups according to Brody elderly statistics. The majority of elderly patients who visited the hospital are exposed to spinal disorders and joint diseases. Shoulder, knee, L-spine examination cases had accounted for more than half the number of total. By age group, the number of the first quarter was most dominant commonly. Second and third quarter was maintaining slightly decrease. The fourth quarter had reduced compared to the first quarter. If the visiting purposes and the disease causes analysis and preventive measures are taken in a study, it is expected to utilize as basic data to make a plan of the education for preventing diseases and elderly behavior planning for geriatric hospitals and to redistribute health care resources of the rural areas efficiently.