• Title/Summary/Keyword: Traumatic spinal cord injury

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A Case Report of Brown-Sequard Syndrome Caused by Traumatic Cervical Fracture (외상성 경추 골절 후 발생한 Brown-Sequard 증후군 환자 1례)

  • Kim, Sul Gi;Kim, June Hyun;Park, Sueng Hyuk;Choi, Jun Sup;Cho, Nam Geun
    • Journal of Acupuncture Research
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    • v.32 no.1
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    • pp.133-140
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    • 2015
  • Objectives : The purpose of this study is to report a case of Brown-Sequard syndrome caused by traumatic cervical fracture, presenting pain in the right upper extremity and back of the left hand, motor weakness in the right side and diminished pain and temperature in the left side. Methods : A patient received Korean medical treatment(acupuncture, electroacupuncture, herbal medicine, cupping, moxibustion, Silver Spike point electrotherapy(SSP)) and rehabilitation treatment. We evaluated pain with the Numeric Rating Scale(NRS), motor grade with a Medical Research Council(MRC) scale, sensory function and Modified Barthel Index(MBI). Results : After treatment, the patient showed considerable improvement in NRS, motor & sensory function, and MBI. Conclusions : Korean medical and rehabilitation treatments could be effective for Brown-Sequard syndrome patients. More extensive studies should be carried out.

The Effect of Cryotherapy on Spasticity (경직에 대한 한냉치료의 효과)

  • Choi Jin-Ho;Kim Jin-Sang;Kim Han-Soo
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.167-175
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    • 1997
  • The purpose of this study was to determine the efforts of cold applied for reducing spasticity in patients with traumatic brain injury and cerebrovascular accident who did not take neurosurgical treatment and medication except patients with spinal cord injury. The participants consisted of 17 men and 28 female was ramdomly assigned to three groups with each 15. The results were as followings after making on observation about the change of skin temperature and spasticity throughout cryotherapy which was performed with cooling air in Group I (1 min), Group II (5 min) and Group III (10 min). 1. It was found that the Group III, Group II, Group I, in the order named, had the statistically significant reduction of skin temperature, the reduction of spasticity showed statistically significance in Group III, Group II, in order named, but did net show it even though there was a little increase in Group I. 2. The reduction of skin temperature and spasticity did not continue over 24 hours at the same time every day for 5 days. 3. The longer cryotherapy was applied the more skin temperature and spasticity reduced, the more skin temperature was reduced the more spasticity reduced.

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The Effects of Cold Therapy on Patient with Spasticity by Cerebrovascular Accident (한냉치료가 중추신경계 손상환자의 경직에 미치는 영향)

  • Choi Jin-Ho;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.87-95
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    • 1998
  • The purpose of this study was to determine the effects of cold application for reducing spasticity in patients with traumatic brain min injury cerebrovascular accident who did not take neurosurgical treatment and medication except patients with spinal cord injury. The participants consisted of 24 men and 21 female were ramdomly assigned to three groups with each 15. The result were as followings after making an observation about the change of skin temperature and spasticity throughout cryotherapy which was performed with ice stick in Group I (1 min), Group II (5 min) and Group III(10 min). 1. It was found that the Group III, Croup II, Group I, in order named, had the statistically significant reduction of skin temperature, the reduction of spasticity showed statistically significance in Group III, Group II, in order named, but did not show it even though there was a little increase in Group I. 2. The reduction of skin temperature and spasticity did not continue over 24 hours at the same time every day for 5 days. 3. The longer cryotherapy was applied the mere skin temperature and spasticity reduced, the more skin temperature was reduced the more spasticity reduced.

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Diagnosis of Abusive Head Trauma : Neurosurgical Perspective

  • Kwak, Young Ho
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.370-379
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    • 2022
  • Abusive head trauma (AHT) is the most severe form of physical abuse in children. Such injury involves traumatic damage to the head and/or spine of infants and young children. The term AHT was introduced to include a wider range of injury mechanisms, such as intentional direct blow, throw, and even penetrating trauma by perpetuator(s). Currently, it is recommended to replace the former term, shaken baby syndrome, which implicates shaking as the only mechanism, with AHT to include diverse clinical and radiological manifestations. The consequences of AHT cause devastating medical, social and financial burdens on families, communities, and victims. The potential harm of AHT to the developing brain and spinal cord of the victims is tremendous. Many studies have reported that the adverse effects of AHT are various and serious, such as blindness, mental retardation, physical limitation of daily activities and even psychological problems. Therefore, appropriate vigilance for the early recognition and diagnosis of AHT is highly recommended to stop and prevent further injuries. The aim of this review is to summarize the relevant evidence concerning the early recognition and diagnosis of AHT. To recognize this severe type of child abuse early, all health care providers maintain a high index of suspicion and vigilance. Such suspicion can be initiated with careful and thorough history taking and physical examinations. Previously developed clinical prediction rules can be helpful for decision-making regarding starting an investigation when considering meaningful findings. Even the combination of biochemical markers may be useful to predict AHT. For a more confirmative evaluation, neuroradiological imaging is required to find AHT-specific findings. Moreover, timely consultation with ophthalmologists is needed to find a very specific finding, retinal hemorrhage.

Seroprevalence of Viral Infection in Neurotrauma Patients Who Underwent Emergent Surgical Intervention (응급 수술을 시행한 신경외상 환자들에 있어 전염성 바이러스 감염의 유병율에 대한 분석)

  • Nam, Kyoung Hyup;Choi, Hyuk Jin;Lee, Jae Il;Ko, Jun Kyeung;Han, In Ho;Cho, Won Ho
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.9-14
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    • 2015
  • Purpose: The aim of this study was to estimate the seropositive prevalence of blood-borne infection in neurotrauma patients who underwent emergent surgical intervention, especially patients with hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and human immunodefIciency virus (HIV). Methods: A retrospective review identified 559 patients with traumatic brain injury and spinal trauma who underwent emergent surgery between 2007 and 2014. We reviewed the medical records and extracted data, including age, sex, location of lesion, result of serologic tests, time interval of admission and surgery after presenting to emergency room. Serologic tests for HBV, HCV, syphilis and HIV were performed and analyzed to determine whether the seropositive results were confirmed by the surgeon before surgery. Results: The majority of the patients were male (74.6%), and the mean age was $55.4{\pm}20.2years$. Most patients underwent surgery due to traumatic brain injury (90.0%). Fifty-three patients (10.0%) showed a positive result on at least one serologic test. Seropositive rates according to pathogens were 0.5% for syphilis, 5.2% for HBV and 3.9% for HCV. No positive results were noted on the serologic tests for HIV. HBV in patients with spinal cord injury and age from 40 to 49 years were associated with high serologic positive rate, and that result was statistically significant. However, no statistically significant differences were found in the other variables. Serologic results could not confirmed before surgery in the majority of the cases (62.1%), and 10.4% of these patients showed seropositive results. Conclusion: The results of this study emphasize the importance of taking precautions and conducting rapid serologic testing in preventing the occupational transmission of blood-borne viruses to health-care workers.

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Needs Analysis for Home Rehabilitation Services by Disabled Person in the Rural Areas (농촌 재가 장애인의 가정방문 재활서비스 욕구도 분석)

  • Yi, Chung-Hwi;Lee, Hyun-Ju;Park, Kyoung-Hee;Ahn, Duck-Hyun
    • Physical Therapy Korea
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    • v.9 no.2
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    • pp.61-81
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    • 2002
  • The purposes of this research were to investigate home care rehabilitation services in rural areas and to collect basic data about disabled persons necessary when for carrying out rehabilitation services. Respondents were selected from six of a total of eight townships (Myon) and one town (Eup) in the Wonju city area. Wonju is in Kangwon Province (Do). Of a total of 338 names provided by the Myon offices, 298 persons were located and included registered and non-registered persons. Conditions included stroke, spinal cord injury, and cerebral palsy in addition to disabilities classified as first, second or third degree, in the case of registered cases. Respondent demographic characteristics, medical characteristics, rehabilitation service needs, willingness to receive rehabilitation service and individual opinions regarding rehabilitation services were analysed by frequency and percentage. The results were as follows: 1) Rehabilitation services received by disabled persons living at home in the rural areas surrounding Wonju city were medical rehabilitation (41.7%), diagnosis (36.5%), rehabilitation assistive devices (7.6%), social assistance (7.1%), rehabilitation counseling (3.0%), vocational rehabilitation (1.8%), educational rehabilitation (1.6%) and housekeeping services (0.5%). The majority of rehabilitation services were medical rehabilitation provided at hospitals and oriental medicine hospitals. 2) Sixty point eight percent of respondents expressed their willingness to receive home care rehabilitation services. Needs expressed were highest for medical rehabilitation (27.0%), followed by social assistance (19.4%), medical examination (12.4%), physician-generated diagnosis in the home setting (11.6%), sociopsychological rehabilitation (9.3%), vocational rehabilitation (7.6%), rehabilitation engineering (6.0%), educational rehabilitation (3.3%), and housekeeping services (3.3%). 3) Rehabilitation service needs were analyzed by severity classification: 65.8% of first degree, 62.7% of second degree and 55.6% of third degree disability classification, and 62.7% of non-registered disabled individuals responded that rehabilitation service was necessary. 4) Rehabilitation service needs were also analyzed by diagnosis: 62.6% of stroke, 85.5% of amputation, 60.0% of spinal cord injury and 52.4% of traumatic brain injury respondents answered positively that they were willing to receive rehabilitation service if it were to be provided. Rehabilitation service utilization data of disabled individuals living at home in rural areas were investigated and their rehabilitation needs analyzed. This critical information can be used when community-based rehabilitation programs for disabled persons living at home are planned for provision out of a public health center or when community-based rehabilitation welfare policy is formulated.

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Cerebrolysin Attenuates Astrocyte Activation Following Repetitive Mild Traumatic Brain Injury: Implications for Chronic Traumatic Encephalopathy (만성외상성뇌병증과 관련된 반복적 경도 외상성뇌손상(rmTBI)모델에서 cerebrolysin의 별아교 세포활성 억제효과)

  • Kang, Hyun Bae;Kim, GiHun;Kim, HyunJoong;Han, Sa Rang;Chae, Dong Jin;Song, Hee-Jung;Kim, Dong Woon
    • Journal of Life Science
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    • v.23 no.9
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    • pp.1096-1103
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    • 2013
  • Chronic traumatic encephalopathy (CTE), which is common in athletes, is a progressive neurodegenerative disease and a long-term consequence of repetitive closed head injuries. CTE is regarded as a chronic brain syndrome due to the effects of repetitive traumatic brain injury (TBI). Because neurotrophic factors are neuroprotective in models of brain and spinal cord injuries, we examined the effects of cerebrolysin, a mixture of various neurotrophic factors, on brain pathology in a mouse model of repetitive mild TBI (rmTBI), which is a good model of CTE. Five groups were created and treated as follows: groups 1 and 2: rmTBI for 4 weeks following cerebrolysin injection for 4 weeks; groups 3 and 4: rmTBI for 8 weeks with or without cerebrolysin injection for 4 weeks; group 5: control. We found that p-tau expression was increased in the pyramidal layer of the cortex and hippocampus, particularly the CA3 region, but not in the CA1 region and the dentate gyrus (DG). Intra-tail vein administration of cerebrolysin ($10{\mu}l$ of 1 mg/ml) after/during rmTBI treatment reduced p-tau expression in both the cortex and hippocampus. Histological analysis revealed mild astrocyte activation (increased expression of glial fibrillary acidic protein (GFAP)) but not microglia activation (ionized calcium binding adaptor molecule 1 (iba-1) expression) and peripheral macrophage infiltration (CD45). Additionally, administration of cerebrolysin after rmTBI resulted in reduced astrocyte activation. These observations in rmTBI demonstrated that cerebrolysin treatment reduces phosphorylation of tau and astrocyte activation, attenuates brain pathology, and mitigates function deficits in TBI. Taken together, our observations suggest that cerebrolysin has potential therapeutic value in CTE.

Aortoplasty with Using Gore-Tex Conduit in Dissecting Aneurysms of Descending Thoracic Aorta - Two Cases Report - (GoreTex$^{\circledR}$ 인조혈관을 이용한 해리성 하행 흉부대동맥류 성형술 - 수술치험 2례 -)

  • 정진용
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.816-822
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    • 1989
  • Aneurysms of the descending thoracic aorta can be caused by various etiologies. So, its abrupt rupture leads life-threatening state, it must be operated as soon as possible. Surgical treatment of the descending thoracic aortic aneurysm requires temporary cross-clamping of major artery. The obligatory occlusion of the descending thoracic aorta during management causes proximal arterial hypertension and distal arterial hypotension. The former may leads to left ventricular failure, or cerebrovascular accident, whereas the latter may leads to spinal cord ischemia or renal injury. Some have recommended insertion of temporary shunt around the occluded descending aorta to prevent above problems. Still others would favor expeditious operation employing simple aortic occlusion during the repair of the descending aorta. Recently we had experienced two cases of dissecting aneurysms of descending thoracic aorta which performed aortoplasty with Gore-Tex conduit under simple aortic occlusion. The one was 34-year-old female patient with traumatic dissecting aortic aneurysm [5 em X 5 cm] on the descending thoracic aorta distal to the origin of the left subclavian artery and the other was 58-year-old female patient with atherosclerotic dissecting descending thoracic aortic aneurysm [6 cmX7 cm] and diffuse abdominal aortic aneurysms [3X5 cm]. Both patients performed standard left posterolateral thoracotomy. After the aneurysmal sac was mobilized, occluding vascular clamps were placed on the transverse aorta proximal to the origin of the left subclavian artery, and on the distal descending aorta without adjuvant bypass procedures for 31 and 32 minutes, respectively, and the aneurysmal sac was repaired with 18 mm ringed Gore-Tex conduit graft. Both patients postoperative courses were uneventful.

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Systematic Review of Driving Rehabilitation for Improving On-Road Driving (도로 주행 능력을 향상시키기 위한 운전재활의 체계적 고찰)

  • Park, Jin-Hyuck;Heo, Seo-Yoon;Seo, Jun;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.5 no.2
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    • pp.35-47
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    • 2016
  • Objective: The aim of this study was to identify the driving rehabilitation for on-road driving through a systematic review. Methods: We systematically examined papers published in journals from December 2014 to January 2015, using CINAH, Embase, Pubmed, PsycINFO, and The Cochrane Library. Eventually, 15 studies were included in the analyses. Results: The evidence of 15 studies was from levels I, III, and V. The subjects included in the analyses were patients with stroke(40.0%), older driver(20.0%), traumatic brain injury(20.0%), acquired brain injury(13.3%) and spinal cord injury(6.7%). The intervention types were driving simulator training(53.3%), cognitive skills training(26.6%), off-road educational training(6.7%), adaptation of assistive device(6.7%), and behind-the-wheel training(6.7%). The effects of driving rehabilitation were different depending on the types of intervention. However, driving simulator training showed significant improvement of on-road assessments in all studies included this study. Conclusions: Driving rehabilitation for on-road driving has been used in various types. Specially, the effect of the driving simulator training has been proved by many studies. Future studies are to be required with client from a range of diagnostic groups to establish evidence-based interventions and determine their effectiveness in improving on-road driving.

Necessity and Features of Adequate Service for Home Visiting Physical Therapy - by Physical Therapist - (가정방문 물리치료의 필요성 및 적절한 서비스의 특성 - 물리치료사를 대상으로 -)

  • Han, Dong-Uck;Kim, Young-Gun
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.787-798
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    • 2001
  • This study was performed to investigate the necessity and the features of adequate services of home visiting physical therapy for chronic ill patients. The study subjects were physical therapist visited in Taejon for Korea Physical Therapy Association Seminar on March 19, 2000. Authors developed questionnaire and distributed it to each physical therapist attended at the Seminar. The number of distributed questionnaire was 1,500, and 487 questionnaire were collected and 388 questionnaire analysed finally. 1. The rate of necessity for home visiting physical therapy by kinds of disease was 70.6% in cerebral palsy, 84.3% in spinal cord injury, 89.7% in cerebral vascular accident and traumatic brain injury, 20.1 % in other diseases. 2. The rate of necessity of education for home visiting physical therapy was 94.5% of men, 97.3% of women. 54.4% of answerer replied that the best education method was that developed clinical program. 3. In the general features of adequate service for home visiting physical therapy, 70.9% of men and 69.1 % of women want special isolated physical therapy center, 61.8% of men and 63.7% of women want distance of 15minutes-29minutes by car. 59.4% of men and 47.5% of women want 3 times per week in frequency(P<0.05), 70.9% of men and 61.0% of women want 30-60minutes in treatment duration. and 47.2% of men and 51.6% of women want to teach only evaluation and treatment method. 4. In the payment of adequate service for home visiting physical therapy, 47.9% of men and 49.3% of women want insurance with private charge (P<0.05), 58.8% of men and 55.2% of women want insurance direct charge and traffic fee and visiting fee for the private charge. 37.0% of men wants 4,000won-4,900won and 32.7% of women wants 2,000won-2,900won for the traffic fee. 43.0% of men wants 5,000won-9,900won and 48.0% of women wants 5,000won-5,900won for the visiting fee. 5. In the qualifications for home visiting physical therapy, 44.8% of men wants to have license and learn home treatment method but 47.1% of women wants to have license and career and learn home treatment method(P<0.05). In the career, 38.8% of men wants above 5 years, 39.5% of women wants above 3 years(P<0.01). 63.0% of men and 66.4% of women answered with unconcern but 18.8% of men wants physical therapist worked in general hospital and 20.6% of women wants in welfare center(P<0.01). 92.7% of men and 92.4% of women answered no interested in physical therapist's gender. The most preferential age of home visiting physical therapist was also no interested in physical therapist's age.

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