• Annals of Clinical Neurophysiology
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• 제10권1호
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• pp.43-47
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• 2008

Background: Acute brachial plexitis is an acute idiopathic inflammatory disease affecting brachial plexus, which is characterized by initial severe pain in shoulder followed by profound weakness of affected arm. This is a retrospective study to evaluate the clinical and electrophysiological profile of acute brachial plexitis. Methods: Sixteen patients with acute brachial plexitis were sampled. The electrodiagnostic studies included motor and sensory nerve conduction studies (NCSs) of the median and ulnar, sensory NCSs of medial and lateral antebrachial cutaneous nerves, and needle electromyography (EMG) of selected muscles of upper extremities and cervical paraspinal muscles. The studies were performed on both sides irrespective of the clinical involvement. Results: In most of our patient, upper trunk was predominantly affected (14 patients, 87.50%). Only two patients showed either predominant lower trunk affection or diffuse affection of brachial plexus. All had an acute pain followed by the development of muscle weakness of shoulder girdle after a variable interval ($7{\pm}8.95$ days). Ten patients (62.50%) had severe disability. In NCSs, the most frequent abnormality was abnormal lateral antebrachial cutaneous sensory nerve action potentials (SNAPs). On needle EMG, all the patients showed abnormal EMG findings in affected muscles. Conclusions: In this study, pain was the presenting feature in all patients, and the territory innervated by upper trunk of the brachial plexus was most frequently involved. The most common NCS abnormality was abnormal SNAP in lateral antebrachial cutaneous nerve. Our findings support that the electrodiagnostic test is useful in localizing the trunk involvement in acute brachial plexitis.

• 대한의용생체공학회:의공학회지
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• 제38권4호
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• pp.197-204
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• 2017

The aim of this study was to evaluate driving performance of normal subjects for controlling the steering wheel by using foot operated steering devices in the driving simulator. Many people with complete bilateral loss or loss of use of upper limbs but with normal lower limbs are frequently left without use and/ or control of their hands, arms, or the upper extremities of their bodies. As a result, persons disabled in this manner have problems in operation an automobile because they cannot grasp and manipulate a conventional steering wheel. Therefore, if foot operated steering devices are used for controlling the vehicle on in people with disabilities, the disabled people could improve their community mobility by driving a car safely. Ten normal subjects were involved in this research to evaluate steering performance by using three types of steering devices(conventional steering wheel, pedal type foot steering, circular type foot steering) in driving simulator. STISim Drive 3 program was used for testing the driving performance in two road scenarios: straight road and curved road at low and high speed of vehicle (40 km/h and 80 km/h). This study used two-way ANOVA to compare the influences of two factors(type of foot steering device and road scenario) in the three dependent variables of steering performance(standard deviation of lateral position, the lateral position of vehicle and the number of line crossing). The average values of the three dependent variables(standard deviation of lateral position, lateral position and the number of line crossing) of driving performance were significantly smaller for conventional steering wheel or pedal type foot steering than circular type foot steering.

• The Korean Journal of Pain
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• 제11권1호
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• pp.101-104
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• 1998

Backgrouds: Twent five years have passed since the opening of the first pain clinic in korea, in 1973 at Yonsei University Hospital. The number of pain clinics are gradually increasing in recent times. It is important to plan for future pain clinics with emphasis on improving the quality of pain management. Therefore we reviewed the patients in our hospital to help us in planning for the future of our pain clinic. Methods: We analyzed 2656 patients who had visited our Kim Chan Pain Clinic, accordance to age, sex, disease, and type of treatment block, from July 1996 to August 1997. Results: The prevalent age group was in the fifties, 27.3%, seventy years and older compromised 9.2%. The most common disease were as follows: lower back pain(46.2%); cervical and upper extremities pain(23.1%); trigeminal neuralgia(7.2%); and hyperhydrosis(5.8%) Both nerve blocks and medication were prescribed as treatment. Lumbar epidural block(16.3%) and stellate ganglion block(15.6%) were the most frequent blocks performed among various nerve blocks. Among nerve block under C-arm guidance, lumbar facet joint block(24.4%) and lumbar root block(22.5%) were performed most frequently. Trigeminal nerve block(18.4%), thoracic(17.0%) and lumbar sympathetic ganglion block(11.4%) were next most prevalent blocks performed frequent block. Conclusions: Treatments at our hospital were focused on nerve blocks and medications prescriptions. Nerve blocks are of particular importance in the diagnosis and treatment of chronic pain. However in future, to raise the quality of pain management, we need to fucus on a multidisciplinary/interdisciplinary team approach.

• The Korean Journal of Pain
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• 제31권3호
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• pp.183-190
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• 2018

Background: Vitamin B12 deficiency has been associated with peripheral neuropathy, loss of sensation in the peripheral nerves, and weakness in the lower extremities. Methylcobalamin is the most effective analogue of vitamin B12 used to treat or prevent the complications associated with vitamin B12 deficiency. The current study aimed to compare the serum cobalamin levels after administration of two different regimes of methylcobalamin in peripheral neuropathy patients. Methods: The present study was a prospective, randomized, comparative study. The study consisted of two parallel groups, group A (methylcobalamin $500{\mu}g$ injection intramuscularly three times a week) and group B (methylcobalamin $1500{\mu}g$ injection intramuscularly once a week). A control group of healthy volunteers was also included. Results: A total of 24 patients (12 in each group) were included in the study. Five healthy volunteers were also included as a control in each group. At the end of treatment, serum cobalamin levels were significantly (P = 0.028) higher in group A ($1892.08{\pm}234.50$) as compared with group B ($1438.5{\pm}460.32$). The serum cobalamin levels in Group A healthy volunteers were also two times higher than that of group B (P = 0.056). Both the LANSS scale and DN4 questionnaire reported similar results at end of treatment. Conclusions: The $500{\mu}g$ methylcobalamin thrice weekly regime is more effective in increasing the serum cobalamin levels as compared to the $1500{\mu}g$ methylcobalamin once weekly regime.

• 한국콘텐츠학회논문지
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• 제9권1호
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• pp.323-330
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• 2009

무릎의 신전이 방해되는 이유는 여러 가지가 있다. 하지만 우리가 특별히 구조적인 기형을 환자에게서 찾아내지 못하는 한 넙다리근육 강화나 신전을 위한 하지 폄근육군 완화운동 방법을 알려주는 것 이외에 별달리 해줄 수 있는 것이 없다. 이 연구에서 저자는 Sacro-Occipital Technique을 활용한 무릎 움직임 방해 완화에 대하여 새로운 사례연구를 하였다. 이 연구에서는 무릎을 완전히 펴고 서지 못하는 14세의 여학생에게 7회의 S.O.T categoryⅠ. 방법이 적용되었으며 이로서 별다른 방해 없이 무릎을 펴고 설수 있게 되었다. 대체적으로 무릎을 곧바로 펴지 못하는 많은 경우 근육 연조직 마사지 등을 뒤넙다리근에 적용하여 완화 시켜 보기도 한다. 그러나 만약 이러한 방법들이 잘 듣지 않는다면 S.O.T categoryⅠ. 방법을 고려하여 보는 것도 도움이 될 수 있을 것으로 사료된다.

• The Korean Journal of Pain
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• 제30권1호
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• pp.44-50
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• 2017

Background: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods: This retrospective cohort was carried out in the neurosurgery departments of hospitals in KahramanmaraŞ city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. Results: The average age was $38.4{\pm}8.0$ and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. $Las{\grave{e}}gue$ tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was $13.6{\pm}5.4$ months (range: 5-22). Conclusions: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

• 대한물리치료과학회지
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• 제9권3호
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• pp.97-106
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• 2002

Purpose. This study was tried to compare the effect of the change in postural deviation caused by the pain side Subjects and Methods. Inpatients and outpatients (n=71) were selected from I hospital who have a musculoskeletal low back pain and shoulder pain without any history of the central nervous system (CNS) lesions, orthopaedic problems of the both lower extremities, or the vestibular and the visual default. For the control group, normal and healthy subjects (n=30) were selected without any history of weight bearing disorders. the weight bearing was rated by the computerized force plate. Results. 1) Postural deviation was not significant difference between patients and control group(p<0.01). But postural deviation in patients was more pronounced than control group. 2) There was significant difference of postural deviation between in patients according to the pain side(p<0.01). When the pain side was on the left side, postural deviation tended to the right. When the pain side was on the right side and vertebral body, postural deviation tended to the left. 3) There was no significant difference of postural deviation between regional pain in shoulder and regional pain in low back(p<0.01). Discussions and Conclusion. As a result, the pain, for sure, affected the good posture and its keeping process directly or/and indirectly. Therefore, as the postural deviation increases, the additional energy consumption increased by the works of the muscles to keep the good posture. Preponderated postural deviation, furthermore, could load too much to the musculoskeletal system, leading to increase the pain. The postural deviation, a result of the pain, can cause a secondary deformity of the distal area as a compensatory reaction, and this compensation actually become a cause of the musculoskeletal symptom back in a cycle. Therefore, the appropriate treatment of the musculoskeletal problem and the education of the posture correction should be given to decrease the pain, preventing the secondary deformities, and increasing muscle energy efficiency of the posture remaining muscles.

• 대한물리치료과학회지
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• 제15권2호
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• pp.1-13
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• 2008

Background: This study had been carried out with 18 ischemic stroke patients as its object for about eight months from October, 2006 to May, 2007 in order to observe the recovery of motor function and the change of important blood factors according to the different quantitative exercises. Methods: Subjects were assigned randomly either experimental group (n＝19) or the control group (n＝19), when the study began the halfway on this study dropout 20 patients, and final subjects remained experimental group's 9 patients and control group's 9 patients. Both groups received thermotherapy and functional electrical stimulation (FES), also taken different quantitative exercise therapy (experimental group 180 minutes, control group 80 minutes). Subjects were assessed for upper and lower extremities motor function Fugl－Meyer Scale; FMS), blood test (white blood count; WBC, low density lipoprotein －cholesterol; LDL-C, high density lipoprotein-cholesterol; HDL-C, Troponin) during pretest, after 2 months, after 3 months. Results: The results of this study were as follows; 1. FMS has no statistically significant difference with intergroup(p>.05). But there was a statistically significant difference with each groups (p<.05). 2. WBC has no statistically significant difference with intergroup (p>.05). But there was a statistically significant difference in control group (p<.05), without experimental group (p>.05). 3. LDL-C has no statistically significant difference with intergroup (p>.05). But there was a statistically significant difference in control group (p<.05), without experimental group (p>.05). 4. HDL-C has no statistically significant difference with intergroup (p<.05). But there was a statistically significant difference with each groups (p>.05). 5. Troponin Ⅰ has no statistically significant difference with intergroup (p>.05). Also there was no statistically significant difference with each groups (p>.05). Conclusion: These findings suggest that different quantitative exercises has no effect on FMS, LDL-C, HDL-C, WBC, Troponin Ⅰ with ischemic stroke patients. But the treatment period that there's less correlation between the recovery of motor function and the different quantitative exercise, also less correlation between the change of important blood factors and the different quantitative exercises with ischemic stroke patients.

• Clinical and Experimental Pediatrics
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• 제45권2호
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• pp.256-260
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• 2002

골수괴사는 골수를 침범하는 매우 드문 조직 소견으로 저자들은 급성 혼합형 백혈병 환아가 요통, 발열을 주소로 방문하여 세번째 재발하였을 때 골수 천자 도말 검사에서 골수괴사가 동반되고 혈청 LDH와 ferritin이 증가되었으며 자기공명영상에서 골수괴사의 특징적인 소견을 보인 1례를 경험하였기에 보고하는 바이다.

• Investigative Magnetic Resonance Imaging
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• 제19권3호
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• pp.186-190
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• 2015

Acute disseminated encephalomyelitis (ADEM) is a demyelinating and inflammatory condition of the central nervous system, occurring predominantly in white matter. ADEM involving the rhombencephalon without affecting the white matter is very rare. Here, we present an unusual case of ADEM involving only the rhombencephalon in a 4-year-old Asian girl. The patient complained of pain in the right lower extremities, general weakness, ataxia, and dysarthria. The initial brain CT showed subtle ill-defined low-density lesions in the pons and medulla. On brain MRI, T2 high signal intensity (T2-HSI) lesions with mild swelling were present in the pons, both middle cerebellar peduncles, and the anterior medulla. The initial diagnosis was viral encephalitis involving the rhombencephalon. Curiously, a cerebrospinal fluid (CSF) study revealed no cellularity, and negative viral marker findings. Three weeks later, follow up brain MRI showed that the extent of the T2-HSI lesions in the brain stem had decreased. After reinvestigation, it was found that she had a prior history of upper respiratory infection. In this case, we report the very rare case of a patient showing isolated involvement of the rhombencephalon in ADEM, mimicking viral rhombencephalitis on CT and MR imaging. ADEM can involve unusual sites such as the rhombencephalon in isolation, without involvement of the white matter or deep gray matter and, therefore, should be considered even when it appears in unusual anatomical areas. Thorough history taking is important for making a correct diagnosis.