• 제목/요약/키워드: autonomic dysfunction

검색결과 84건 처리시간 0.023초

척수 손상 환자에 관한 실태 조사 (A Study of the Evaluation of the Spinal Cord Injuries)

  • 김명훈
    • 대한물리치료과학회지
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    • 제3권2호
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    • pp.1011-1019
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    • 1996
  • The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

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화병 환자의 심학변이도 특성에 대한 임상적 연구 (Clinical Study for Characteristics of Heart Rate Variability in Hwabyung Patients)

  • 배은주;김동현;유경환;박성욱;윤성우;고창남
    • 대한한방내과학회지
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    • 제26권4호
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    • pp.844-852
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    • 2005
  • Objectives : Through spectral analysis of heart rate variability(HRV) to study autonomic nervous system dysfunction of Hwabyung, culture related disease in Korea. Methods : HRV of 18 patients diagnosed as Hwabyung was measured against 13 healthy controls. HRV was measured by SA-2000p(Mediocre, Korea) for five minutes after 5 minutes resting. Results : 1. In time domain analysis, mean pulse rate(PRT) of in Hwabyung group was significantly higher than healthy controls. Standard deviation of all normal P-P intervals(SDNN), the square root of the mean of the sum of the squares of differences between adjacent normal P-P intervals(RMS-SD) in Hwabyung group was lower than healthy controls, but not significant. 2. As for frequency domain analysis, In TP(logarithmic total power), In VLF(logarithmic very low frequency), and In LF(logarithmic low frequency )in Hwabyung group was significantly lower than healthy controls. Ln HF(logarithmic high frequency), LF/HF ratio in Hwabyung group was also lower but not significant. Conclusions : This study suggests tile activity and imbalance of cardiac autonomous nervous system in Hwabyung patient is significantly lower than healthy individuals.

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항정신병약물악성증후군에 동반한 횡문근융해증으로 인한 급성 신부전 1례 (A Case of Acute Renal Failure due to Rhabdomyolysis Associated with Neuroleptic Malignant Syndrome)

  • 박규희;정성관;임형은;유기환;홍영숙;이주원
    • Childhood Kidney Diseases
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    • 제13권2호
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    • pp.267-270
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    • 2009
  • 항정신병약물악성증후군은 항정신병약물의 사용과 관련하여 드물게 발생하는 부작용으로 생명을 위협하는 질환으로 의식변화, 고열증, 근육강직의 특징적 증상을 보인다. 항정신병약물악성증후군 환자에서 고열증과 근육강직으로 인하여 횡문근융해증이 발생하여 합병증으로 급성 신부전이 생기는 경우가 드물게 발생하며 심한 경우 투석 등의 치료가 필요하며 생명에 위협이 되므로 빠른 진단과 치료가 요구된다. 저자들은 소아에서 보고되지 않던 항정신병약물악성증후군에 동반하여 횡문근융해증을 보인 급성 신부전의 예를 경험하였기에 보고하는 바이다.

11세 남아에서 발생된 치사성 긴장증 1례 (A CASE OF LETHAL CATATONIA IN A 11-YEAR-OLD BOY)

  • 조인희;홍성도;정유숙
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제10권1호
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    • pp.121-133
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    • 1999
  • 치사성 긴장증은 긴장증의 한 유형이지만 극단적인 임상양상과 높은 치사율로 인하여 따로 분류하여서 하나의 증상군으로 취급되고 있다. 최근 정신 약물학의 발전과 질병 초기에 적절하고 집중적인 치료를 시행함으로써 전세계적으로 치사성 긴장증의 발생율이 현저하게 감소되었다. 본 저자들은 급성으로 발생된 고열, 자율신경계 이상, 다양한 긴장성 증상 및 긴장성 흥분과 혼미상태를 보였던 11세 남아에서의 치사성 긴장증 1례에 대한 매우 드문 경험을 소개하였다. 특히, 본 증례는 전형적인 경과에 비하여 경한 초기증상을 보인 치사성 긴장증에서 초기에 집중적인 대증요법과 정신약물 투여, 전기충격요법의 병행이 성공적인 치료 효과를 거둘 수 있음을 보여준 사례라 할 수 있다.

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자기공명촬영으로 확인된 횡단성 척수염 29례에 대한 후향적 분석 (A Retrospective Analysis of MRI-verified 29 Cases of Transverse Myelitis)

  • 김영래;송준혁;박향권;김성학
    • Journal of Korean Neurosurgical Society
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    • 제29권12호
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    • pp.1642-1649
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    • 2000
  • Objectives : Transverse myelitis(TM) is characterized by bilateral motor, sensory, and autonomic dysfunction of the spinal cord in the absence of pre-existing neurologic disease. It is an uncommon but not rare condition. But it remains as poorly understood syndrome not only etiologically but also in terms of its clinical behavior. Neurosurgically, It is often quite difficult to distinguish from other surgical intramedullary lesions. We present our clinical experiences of TM in order to assess its clinical behavior and to define the radiological characteristics that can distinguish TM from other intramedullary lesions. Methods : From June 1991 to May 1997, twenty-nine patients with transverse myelitis were admitted to our department. All cases revealed acute or subacute syndrome of non-compressive myelopathy and intramedullary lesions in the MRI. We analyze the radiological data and medical records retrospectively. Results : Patients ranged in age from 16 to 66 years, with 22 males and 7 females. Mean follow-up period was 53 months. For the offending levels, cervical was 5, thoracic 21, and lumbar 3 in number. The patients who presented the return of symptoms after a diminution or abatement of initial symptoms were 7(24%). In the MRI, TM showed typical characteristics of high signal intensity lesions in the center of spinal cord in T2 weighted images and low- to iso-signal intensity in T1 weighted images. A focal nodular enhancement pattern was observed in 58.6%(17/29) of the patients. MR follow-up studies were done in the 21 patients and radiological improvement were verified. Biopsies were done in 3 patients. Normal to good outcome was achieved in 62% of the patients. Conclusion : Transverse myelitis has characteristic radiological findings that can be distinguished from other intramedullary lesions. In our series, it is associated with significant recurrence rates thus, should not be considered a selflimiting disease with good prognosis.

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12주 규칙적인 유산소 운동이 제 2형 당뇨환자의 ST 분절과 QTc 연장에 미치는 영향 (Effects of 12 Week Regular Aerobic Exercise on ST-segment and QTc Interval in Type 2 Diabetes Mellitus Patients)

  • 김영일;백일영;진화은;서아람;곽이섭;우진희
    • 생명과학회지
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    • 제19권1호
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    • pp.81-86
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    • 2009
  • 12주 유산소 트레이닝 결과, 제 2형 당뇨 대상자의 신체적 특성 및 심혈관계 기능은 향상되었고, 심근허혈을 판단하는 ST-level과 ST-slope가 트레이닝 후 감소함을 나타냈다. 또한, 당뇨에서 자주 나타나는 대표적인 자율신경계 이상 마커인 QTc interval을 감소시켰다. 따라서, 12주 유산소 트레이닝은 심혈관계 기능과 당뇨로 인한 심장허혈, 자율신경계 기능을 증진시킨 것으로 나타냈다.

Review on Diagnostic Criteria of Neurasthenia : Suggesting Pathway of Culture-bound dieases

  • Lee, Myeong Hun;Kim, Yunna;Cho, Seung-Hun
    • 대한약침학회지
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    • 제20권4호
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    • pp.230-234
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    • 2017
  • Objective: Neurasthenia is a disease which consists of increased fatigue or bodily weakness and exhaustion plus pantalgia, dizziness, headache and other symtoms relevant to autonomic nerve dysfunction. There are plenty of studies investigating the history of diagnostic criteria of neurasthenia, which is influenced by diverse cultural(or social) environment. The obejective of this study is to provide review of the previous studys on the changes of neurasthenia diagnoses in the context of local area to find meanings of these transition and improve health care for psychiatric patient. Methods: Literature review was conducted on studies demonstrating diagnostic criteria of neurasthenia with cultural(or social) environment. We investigated the literature reviews or observative studies which described alteration of diagnostic criteria of neurasthenia and assessed its significance. After selecting eligible studies, the authors read the articles and summarized the meaningful contents those were significant in clinical practice. Results: Transformation of Chinese Classification of Mental Disorder(CCMD) integrated with internationally utilized DSM-IV or ICD-10 is controversial about its significance in that it had limited effect on public health care due to the variables of sociocultural context, but primarily differentiated neurasthenia from other disorders. The latter one can be the directing point of the diagnostic criteria of other culture-bound diseases, which is the traits of not outstanding mood(or affect) than other neurotic disorders. Conclusion: As diagnostic criteria of neurasthenia varies, the significance of this variation is controversial, but could be the paragon of other culture-bound diseases.

다발성 대칭성 지방종증: 한국인에서의 특징 및 치료 (Multiple Symmetric Lipomatosis: Characteristics and Treatment in Korean Patients)

  • 전영우;노태석;김용욱;권지은;탁관철;유원민
    • Archives of Plastic Surgery
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    • 제34권4호
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    • pp.478-484
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    • 2007
  • Purpose: Multiple symmetric lipomatosis (MSL) is a relatively rare disorder characterized by presence of multiple, symmetric, nonencapsulated fat masses in face, neck, shoulder and other areas. There has been only a few cases reported in Korea. The main purpose of this research is to examine the Korean patients to see what kinds of special characteristics occurred due to this disease and to decide the proper treatment.Methods: A total of 16 patients were evaluated retrospectively. 5 patients were treated at our hospital. The other patients were reviewed from literature. We analyzed the biological characters of patients, location of fat deposit, morphologic characters of patients, clinical evidence of neuropathy, associated metabolic disorders and treatment modality.Results: All cases were male patient. The mean age of onset was 47.43 years. All patients were moderate to heavy alcoholics. The most common location of fat deposition was posterior neck and abdomen. In neurologic exam of 9 patients, 5 patients showed muscle weakness, tremor, pain and autonomic nerve dysfunction. In metabolic studies of 9 patients, total cholesterol values were higher in 1 patient. A glucose tolerance test was abnormal in 1 patient. In treatment modality, 14 patients were treated with surgical resection, 1 patient was treated with liposuction and surgical excision, 1 patient was treated only with liposuction. Conclusion: To treat MSL patients successfully, we should concentrate not only on the removal of the fatty tissue but also on neurologic abnormities, metabolic disorders and associated diseases.

Usefulness of infrared thermography in diagnosing and evaluating severity of carpal tunnel syndrome

  • Yang, Jiwon;Lee, Yeong-Bae;Sung, Young-Hee;Shin, Dong-Jin;Kim, Yong-Jin;Park, Hyeon-Mi
    • Annals of Clinical Neurophysiology
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    • 제23권2호
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    • pp.99-107
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    • 2021
  • Background: Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function. Methods: This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS. Results: No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS. Conclusions: IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.

Rett 증후군 환자에서의 자율신경 활성도 및 심박수 변이도 측정 (Heart Rate Variability and Autonomic Activity in Patients Affected with Rett Syndrome)

  • 최덕영;장진하;정희정
    • Clinical and Experimental Pediatrics
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    • 제46권10호
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    • pp.996-1002
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    • 2003
  • 목 적 : Rett 증후군 환자에서는 일반인에서 보다 돌연사의 확률이 높은 것으로 알려져 있으며, 그 원인으로 자율신경계 기능 부전에 의한 치명적인 부정맥 같은 심장의 전기 생리적 불안정성이 가장 의심되고 있다. 본 연구는 Rett 증후군 환자에서 심박수 변이도와 교정 QT 간격을 측정하여 실제로 자율신경 활성도에 문제가 있는지의 여부를 확인하기 위하여 실시하였다. 방 법 : 분자유전학적 염색체검사나 임상적 진단기준에 의하여 진단된 Rett 증후군 환자 12례를 대상군으로, 나이가 비슷한 정상아 30례를 대조군으로 하여 이들에서의 자율신경 활성도인 심박수 변이도와 교정 QT 간격을 측정하여 비교하였다. 심박수 변이도는 24시간 보행 심전도를 기록한 후 디지털화 된 심전도를 자동적으로 분석하여 power spectrum을 만들고 그 중 주파수영역(고주파 성분, 저주파 성분, 극소저주파 성분, LF/HF 비율)과 시간 영역(평균 RR 간격, SDNN, rMSSD, pNN50), 교정 QT 간격을 측정하여 비교하였다. 비교는 세 그룹으로 나누어서 전체 Rett 증후군과 정상 대조군 사이, 전형적인 Rett 증후군과 정상 대조군 사이, 비전형적 Rett 증후군과 정상 대조군 사이에서 실시하였다. 결 과 : 1) Rett 증후군 환자에서는 대조군에서 보다 시간영역의 rMSSD이 통계적으로 의미있게 낮았고(P<0.005), LF/HF 비율이 의미있게 높았으며(P<0.005), 교정 QT 간격도 의미있게 연장되어(P<0.005) 있었다. 2) 전형적인 Rett 증후군 환자에서도 대조군에서 보다 rMSSD이 통계적으로 의미있게 낮았고(P<0.005), LF/HF 비율도 의미있게 높았으며(P<0.05), 교정 QT 간격도 의미있게 연장되어 있었다(P<0.001). 3) 비전형적 Rett 증후군에서도 마찬가지로 rMSSD이 통계적으로 의미있게 낮았고(P<0.05), LF/HF 비율도 의미있게 높았으며(P<0.001), 교정 QT간격도 의미있게 연장되어 있었다(P<0.05). 4) 이상의 결과에서 Rett 증후군에서는 전형적인 환자나 비전형적인 환자 모두 미주신경긴장의 변화와 호흡에 의해 민감한 영향을 받는 rMSSD의 저하가 있었고, 교감-부교감신경 균형성을 나타내는 LF/HF 비율의 증가가 있었으며, 자율신경계에 영향을 받는 교정 QT 간격이 연장되었던 것으로 보아, 교감-부교감신경의 균형성에 이상이 있는 것으로 사료된다. 결 론 : Rett 증후군 환자에서 자율신경 활성도의 지표인 심박수 변이도의 의미있는 저하와 교정 QT 간격의 의미있는 연장이 나타나는 것으로 미루어 보아, 이 질환에서 자주 동반되는 돌연사가 일어나는 원인 중의 하나로 이러한 교감-부교감신경의 불균형을 의심할 수 있겠다.