• 제목/요약/키워드: nerve paralysis

검색결과 302건 처리시간 0.028초

상완골 근위부 골절에서의 최소 침습적 금속판 술식 (Minimal Invasive Plate Osteosynthesis in Proximal Humerus Fractures)

  • 신상진;도남훈;송미현;손훈상
    • Clinics in Shoulder and Elbow
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    • 제13권2호
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    • pp.202-208
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    • 2010
  • 목적: 상완골 근위부 골절에 대하여 최소 침습적 금속판 술식을 시행하고, 임상 결과를 분석하여 유용성을 알아보고자 하였다. 대상 및 방법: 상완골 근위부 골절에 대하여 최소 침습적 금속판 술식을 시행한 27명을 대상으로 하였다. 골절 분류는 2분 골절 16예, 3분 골절 10예였으며, 4분 골절 1예가 포함되었다. 임상적 평가는 UCLA 점수와 KSS 점수 및 운동 범위 회복 정도와 합병증 발생 여부를 조사하였으며, 방사선학적으로는 골유합 기간과 경간각 회복 정도를 평가하였다. 평균 추시 기간은 19개월이었다. 결과: 최종 추시에서 UCLA 점수는 우수가 15예, 양호가 12예였으며 KSS 점수는 평균 91.4점이었다. 또한 최종 견관절 운동 범위는 전방 거상이 평균 $167.2^{\circ}$로 측정되었다. 모든 환자에서 수술 후 평균 14.1주에 골유합을 얻었으며, 경간각 회복 정도는 우수가 24예였으며 보통이 3예였다. 액와 신경 마비나 심부 감염, 금속판의 충돌 증후군 등의 합병증은 발생하지 않았다. 결론: 상완골 근위부 골절에 대한 최소 침습적 금속판 술식은 충분한 해부학적 지식을 숙지하고 시행하면 주변 연부 조직 박리를 최소화하여 합병증 발생을 감소시키고 조기 관절 운동을 가능하게 하므로 상완골 근위부 골절 치료의 효과적인 수술 방법의 하나로 사료된다.

운동성 조음장애에서 폐쇄자음 발성의 음향학적 특성 (Acoustic Characteristics of Stop Consonant Production in the Motor Speech Disorders)

  • 홍희경;김문준;윤진;박희택;홍기환
    • 대한후두음성언어의학회지
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    • 제23권1호
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    • pp.33-42
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    • 2012
  • Background and Objectives : Dysarthria refers to speech disorder that causes difficulties in speech communication due to paralysis, muscle weakening, and incoordination of speech muscle mechanism caused by damaged central or peripheral nerve system. Pitch, strength and speed are influenced by dysarthria during detonation due to difficulties in muscle control. As evaluation items, alternate motion rate and diadochokinesis have been commonly used, and articulation is also an important evaluation items. The purpose of this study is to find acoustic characteristics on sound production of dysarthria patients. Materials and Methods : Research subjects have been selected as 20 dysarthria patients and 20 subjects for control group, and voice sample was composed of bilabial, alveolar sound, and velar sound in diadochokinetic rate, while consonant articulation test was composed of bilabial plosive, alveolar plosive, velar plosive. Analysis items were composed of 1) speaking rate, energy, articulation time of diadochokinesis, 2) voice onset time (VOT), total duration (TD), vowel duration (VD), hold of plosives. Results and Conclusions : The number of diadochokinetic rate of dysarthria was smaller than control group. Both control group and dysarthria group was highly presented in the order of /t/>/p/>/k/. Minimum energy range per cycle during diadochokinetic rate of dysarthria group was smaller than control group, and presented statistical significance in /p/, /k/, /ptk/. Maximum energy range was larger than control group, and presented statistical significance in /t/, /ptk/. Articulation time, gap, total articulation time during diadochokinetic rate of dysarthria group was longer than control group and presented statistical significance. The articulation time was presented in both control group and dysarthria group in the order of /k/>/t/>/p/, while Gap was presented in the order of /p/>/t/>/k/ for control group and /p/>/k/>/t/ for dysarthria group. VOT, TD, VD regarding plosives of dysarthria group were longer than control group. Hold showed large deviation compared to control group that had appeared due to declined larynx and articulation organ motility.

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갑상선 절제 술 후 기능적 음성장애의 공기역학적 특징과 음성치료 중재 (Aerodynamic Features and Voice Therapy Interventions of Functional Voice Disorder after Thyroidectomy)

  • 이창윤;안수연;장현;정희석;손희영
    • 대한후두음성언어의학회지
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    • 제26권1호
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    • pp.25-33
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    • 2015
  • Background and Objectives:The objective of this study was to investigate the features of post-thyroidectomy subjective voice disorder by Voice Handicap Index (VHI) and Voice Symptom Scale (VOISS) through aerodynamic analysis and to investigate the appropriate voice therapy intervention. Materials and Methods:Twenty post-thyroidectomy patients who had no recurrent laryngeal nerve paralysis through laryngeal stroboscopy were enrolled for this study. Acoustic and aerodynamic evaluations were performed before operation, 2 weeks and 3 months after operation. Subjective voice evaluation was performed by VHI and VOISS. Aerodynamic evaluation was compared and analysed by maximum phonation time(MPT), phonation threshold pressure(PTP), mean air flow rate(MFR), etc. Subjective voice evaluation was surveyed through VHI and VOISS. To evaluate patients' symptoms related to functional voice disorder, scores on physical domain in VHI and VOISS were selected to be compared for each session. Results: The 10 out of 20 participants who complained of voice symptoms had no significant difference with pre-operation in acoustic evaluation, but all showed higher scores on 2 weeks and 3 months after operation compared to pre-operation, in VHI-physical domain and selected questionnaires in VOISS. They reduced MPT and increased PTP value simultaneously. Laryngeal massage and breathing training were simultaneously treated to them, 5 participants resulting in improvement in MPT and PTP compared to pre-treatment. Conclusion:Patients who complained voice change with no organic damage after thyroidectomy were all shown to have reduced MPT and increased PTP in some by aerodynamic evaluations. Reduced MPT may imply some problem in air flow beneath glottis. Increased PTP suggests much more effort in vocalization mechanism than pre-operation. Comparing aerodynamic evaluations in post-thyroidectomy may provide information on behavioral interventions. Additionally, study on laryngeal massage and breathing training simultaneously treated to patients with such voice disorder is needed to be conducted with larger number of participants.

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갑상선암의 임상적 고찰 (A Clinical Analysis of the Thyroid Cancer)

  • 박기민;강형길;김이수;이봉화
    • 대한두경부종양학회지
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    • 제13권2호
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    • pp.213-220
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    • 1997
  • Background: Thyroid cancer is a relatively rare neoplasm and its incidence varies geographically and ethnically around the world. Thyroid cancer is the most common endocrine malignancy, but it has a wide spectrum of biologic behavior, histologic appearance, and management. Purpose: The purpose of the study was to analyse and evaluate all aspects of the clinical consideration in thyroid cancer. Method: Between 1986 and 1995, a retrospective analysis of 77 thyrod cancer patients admitted at the Department of Surgery, Hangang Sacred Heart Hospital, Hallym University was made to assess clinical entities. Result: By the pathological classification, the papillary carcinoma was the most common type(83.1%). Male to female ratio was 1 : 5.4 and most prevalent age group was noted from fourth decade to fifth decade(46.8%). The most common duration of illness between the appearance of the symptoms and the treatment was below 6 months(44.2%), and the most common symptom was the palpable mass at the anterior portion of the neck(96.1%). Most cases of the thyroid cancer were appeared as cold nodule in the $^{99m}$Tc-thyroid scan(95.7%). In the site of tumor location, the right and left lobe was distributed similarly. In the extent of tumor, incidence of intrathyroidal location was 41.6%, and that of the metastasis to the cervical lymph nodes was 44.2% and that of the direct capsular invasion was 27.3%, and incidence of both involved case was 13%. Surgical procedures were total thyroidectomy alone in 27 cases(35.1%) or with modified neck dissection in 6 cases(7.8%), or with radical neck dissection in 2 cases (2.6%), near total thyroidectomy alone in 22 cases(28.6%), ipsilateral lobectomy with isthmectomy alone in 12 cases(15.6%) or with modified neck dissection in 1 case(1.3%), and biopsy only in 7 cases(9.1%). The most common postoperative complications were transient hypoparathyroidism(5.2%) and transient unilateral recurrent laryngeal nerve paralysis(5.2%). Conclusion: The major problem of management of thyroid cancer include a wide spectrum of clinical behaviour of this tumor entity, the lack of reliable prognostic factors and lack of an objective assessment of the various treatment modalities. But because of showing the favorable prognosis for most thyroid cancer, appropriate and aggressive management should be recommended.

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음성장애에 대한 임상적고찰 (Clinical Observation on Voice Disorder)

  • 이종원
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1979년도 제13차 학술대회 연제순서 및 초록
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    • pp.7.2-8
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    • 1979
  • 음성외과는 발성기능를 취급하는 기능외과이기 때문에 수술적응의 결정 수술효과의 판정 수술성적의 비교를 위하여 발성기능의 검사가 필요하다. 청력을 취급하는 수술에서 청력검사가 필요한 것과 같다. 연자는 구유미대학 이비인후과를 방문한 각종후두환자(56례 즉Recurrent laryngeal nerve paralysis, polyp. polipoid vocal cord. sulcus vocalis, Laryngeal cancer, Benign mass, Epitherial hypertrophy. 등에서 발성지적시간, 폐활량/담성지적시간, 평균호기유율 및 후두 Stroboscopy 검사를 시행하여 다음과같은 결과를 얻었다. 1) 성대의 편측성병변은 35례(62.5%)이고 양측성병변은 21례(37.5%)로 편측성병변이 많았다. 2) 성별로는 남성이 39례(69.8%) 여성이 17례(30.2%)로 남성이 많았다. 3) 발성지적시간은 10초이하가 26례(46.4%) 10초이상이 30례(53.6%)이였다. 4) 폐활양/발성지적시간은 300m1/sec이하가 33례(58.9%) 300m1/sec이상이 23례(41.1%)이였다. 5) 평균호기류율은 300m1/sec이하가 37례(66.1%)300ml/sec 이상이 19례(33.9%)이였다. 6) 후두 stroboscopy 검사에서 성대의 대칭성, 규칙성, 진폭, 점막파동 및 성문패쇄에 대해서 관찰하였다. 7) 후두수술전후의 음성검사와 stroboscopy 검사의 비교는 수술후의 성적이 매우 좋다.

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Enterovirus 감염에 의한 자돈의 Polioencephalomyelit: I. 병리조직학적 관찰 (Polioencephalomyelitis in Pigs Experimentally Infected with Porcine Enterovirus Isolated in Korea: I. Histopathological Observations)

  • 신태균;이차수
    • 대한수의학회지
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    • 제25권2호
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    • pp.103-112
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    • 1985
  • 국내에서 분리된 enterovirus의 병원성을 관찰하기 위하여 1~2일령의 자돈 10두와 35일 령의 유돈 6두에 enterovirus 조직배양부유액을 뇌내 또는 근육내 주사한 후 임상 및 병리학적으로 관찰하였던 바 다음과 같은 결과를 얻었다. 임상적으로는 체온의 상승, 보양창랑, 보행실조, 유약성 마비 및 고도의 삭수가 관찰되었다. 병리조직학적으로는 중추신경계 전반에 걸쳐 수막하 세포침윤, 혈관주위 원형세포침윤, 신경세포의 변성, 미만성과 한국성 gliosis, glial nodule의 형성 등이 관찰되었으며 백질부보다 회백질부에서 다소 심한 경향이었고 배측 신경절염이 전 실험예에서 인정되었다. 한편 hog cholera백신과 enterovirus의 공동주사예에서는 중추신경계의 병변이 enterovirus 단독주사예에 비해 급격히 진행되는 경향이었다. 이상의 소견들을 종합해 볼때 국내에서 분리된 enterovirus는 뇌내 또는 근육내에 접종하였을 때 자돈에서 polioencephalomyelitis를 일으킬 수 있는 병원성이 강한 형으로 추측되며 hog cholera백신과 enterovirus를 공동주사한 예에서 병변의 진행이 급격한 점으로 보아 enterovirus의 자연감염에 hog cholera 백신 등의 stress요인이 작용될 것으로 추측된다.

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전단벽 구조물의 모멘트 저항능력에 관한 비탄성 해석모델개발 (Development of Analytical Model to Predict the Inelastic Moment Capacity of Reinforced Concrete and Masonry Shear Wall)

  • 홍원기;이호범;변근주
    • 콘크리트학회지
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    • 제5권4호
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    • pp.123-134
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    • 1993
  • 큰 수평하중을 견딜 수 구조물의 해석 및 설계는 구조물의 거동에 대한 완전한 이해에 바탕을 두는 설계기법의 측면에서 이루어져야 한다. 본 연구는 일반적인 구조물, 특히 콘크리트 전단벽 구조물의 설계와 해석에 적용될 수 있으며, 실험에 의해 그 정도가 확인되는 수치적 해석 모형을 개발하는데 있다. 즉 설계방법을 이해하고 개선하므로써 구조물의 안전성을 보장해 줄 수 있는 해석모형을 제시하는 것이 본연구의 기본 목적이다. 이상적으로 이러한 안전성을 모형내에 확보하기 위해서 구조물의 연성거동을 확인할 수 있도록 하였으며 면내하중을 받는 전단벽에 대해 다수의 실험을 통해, 개발된 해석모형의 정확도를 입증하였다. 최종적으로 실험검증을 통한 해석모형을 콘크리트조적도 전단벽의 거동을 잘 예측하였으며, 또한 실무에 관련된 설계화 해석에 응용될 수 있도록 시도되어 그 설계예와 함께 수치적 해석모형의 실용성을 보였다.

DITI 진단을 통한 Bell`s palsy의 임상적 고찰 (The Clinical Observation of Digital Infrared Thermographic Imaging on Bell`s palsy)

  • 박경화;김종한;황충연
    • 한방안이비인후피부과학회지
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    • 제11권1호
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    • pp.23-39
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    • 1998
  • The clinical data and thermographic imaging were analyzed on the 100 cases of Bell's palsy who were treated in the Kwang-Ju Oriental Medical Hospita! of Wonkwang University from February to October 1997. All the cases were taken Digital Infrared Thermograph Imaging(DITI) before treatment and 30 cases of them were taken follow up imaging again after recovery. And the following results were obtained. 1. Of 100 cases, under teenager occupied $1\%,\;teenager\;8\%,\;2nd\;decade\;14\%,\;3rd\;decade\;11\%,\;4th\;decade\;16\%,\;5th\;decade\;26\%,\;6th\;decade\;16\%,\;7th\;decade\;7\%\;and\;over\;80\;occupied\;1\%$. 2. Male occupied $48\%$ and female occupied $52\%$. 3. $42\%\;of\;male\;and\;23\%$ of female had the affected side at left side. And right facial nerve palsy occured at $29\%\;of\;male\;and\;29\%$ of female. 4. The most common cause of Bell's palsy was cold wind $18\%$, and the next were excessive labor $15\%,\;stress\;12\%,drinking\;2\%\;and\;cold\;food\;1\%$. 5. Thermal pattern were present as hyperthermal pattern in $44\%$ and hypothermal pattern in $22\%$. 6. The DITI showed hyperthermal pattern as close as to the onset day and changes to hypothermal pattern as times passed. 7. The DITI pattern and post-auricular pain, the most common prodomal syndrome, showed no significant relationship. 8. The relationship between the grade of paralysis and thermal patttern of DITI showed no significance. 9. Mean temperature of loci in affected side indicrtted $30.27^{\circ}C\;at\;Yang\;baek,\;30.02^{\circ}C\;at\;Taeyang,\;29.25^{\circ}C\;at\;Geoyo,\;29.62^{\circ}C\;at\;Jichang,\;29.78^{\circ}C\;at\;Hakwan,\;29.61^{\circ}C\;at\;Hyupgeo,\;and\;30.59^{\circ}C$at Yeopoong. 10. Mean temperature of loci in unaffected side showed $30.16^{\circ}C\;at\;Yang\;baek,\;30.02^{\circ}C\;at\;Taeyang,\;29.61^{\circ}C\;at\;Geoyo,\;29.68^{\circ}C\;at\;Jichang,\;29.70^{\circ}C\;at\;Hakwan,\;29.57^{\circ}C\;at\;Hyupgeo,\;and\;29.89^{\circ}C$at Yeopoong. 11. Of 30 cases who were taken follow up imaging again after recovery, the relationship between delta T at loci and symptoms showed no significance. It should be needed further investigation in order to apply them for clinical evaluation.

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타액선 종양의 임상적 고찰 (A Clinical Study on Salivary Gland Tumors)

  • 장경훈;장유철;정환우;양훈식;김훈;김춘길
    • 대한기관식도과학회지
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    • 제3권2호
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    • pp.277-286
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    • 1997
  • 저자들은 1988년부터 1996년까지 중앙대학교 부속병원에서 수술적으로 치료한 47례의 타액선 종양환자를 대상으로 다음과 같은 결론을 얻었다. 1) 호발연령은 50대에서 가장 높았으며 악성종양의 경우 양성종양보다 호발연령이 높았다. 2) 여자에서 남자보다 호발하며 그 비율은 1.5;1 이었다. 3) 발생부위는 이하선이 가장 많아 48.9% 였으며, 악하선, 소타액선의 순이었으며 소타액선 종양은 구개에서 가장 많이 발생하였다. 4) 악성의 빈도는 소타액선에서 발생한 경우가 가장 높았으며, 악하선, 이하선 순이었다. 5) 가장 많은 증상은 무통성의 종물이었다. 6) 세침흡인 세포검사의 진단적 정밀도는 88.9% 였다. 7) 가장 흔한 타액선종양은 혼합종으로 전체의 57.4 %였다. 8) 악성종양 중 경부임파절 전이율은 22.2%였다. 9) 수술적 치료후 합병증의 발생률은 19.1% 였으며 일시적 안면신경마비가 가장 많았다.

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Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Primary Hyperparathyroidism: A Prospective Study

  • Hui-hui Chai;Yu Zhao;Zeng Zeng;Rui-zhong Ye;Qiao-hong Hu;Hong-feng He;Jung Hwan Baek;Cheng-zhong Peng
    • Korean Journal of Radiology
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    • 제23권5호
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    • pp.555-565
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    • 2022
  • Objective: To assess the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with primary hyperparathyroidism (PHPT). Materials and Methods: This prospective study enrolled 39 participants (14 male, 25 female; mean age, 59.5 ± 15.3 [range, 18-87] years) between September 1, 2018, and January 31, 2021. All participants had parathyroid lesions causing PHPT, proven biochemically and through imaging. The imaging features of the PHPT nodules, including the shape, margin, size, composition, and location, were evaluated before treatment. Serum intact parathyroid hormone, calcium, and phosphorus levels; parathyroid nodule volume; and PHPT-related symptoms were recorded before and after treatment. We calculated the technical success, biochemical cure, and clinical cure rates for these patients. Complications were evaluated during and after the ablation. Results: Complete ablation was achieved in 38 of the 39 nodules in the 39 enrolled participants. All the patients were treated in one session. The technical success rate was 97.4% (38/39). The mean follow-up duration was 13.2 ± 4.6 (range, 6.0-24.9) months. At 6 and 12 months post-RFA, the biochemical cure rates were 82.1% (32/39) and 84.4% (27/32), respectively, and the clinical cure rates were 100% (39/39) and 96.9% (31/32), respectively. Only 2.6% (1/39) of the patients had recurrent PHPT. At 1, 3, 6, and 12 months after technically successful RFA, 44.7% (17/38), 34.3% (12/35), 15.8% (6/38), and 12.5% (4/32) of participants, respectively, had elevated eucalcemic parathyroid hormone levels. Recurrent laryngeal nerve paralysis occurred in 5.1% (2/39) of the patients, who recovered spontaneously within 1-3 months. Conclusion: US-guided RFA was effective and safe for PHPT patients. RFA may be an alternative treatment tool for patients who cannot tolerate or refuse to undergo surgery.