• Title/Summary/Keyword: paraplegia

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Percutaneous Pinning in Unstable Two-parts Fracture of Surgical Neck in Humerus (상완골 불안정성 외과적 경부 이분 골절의 경피적 핀 삽입 고정술)

  • Park Jin-Young;Rho Han-Jin;Kim Myung-Ho
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.26-32
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    • 2000
  • Purpose : The aim of this study is the assessment of the clinical outcomes after percutanous pinning of unstable two-parts fracture of surgical neck in humerus. Materials and Methods: This study was based on thirteen cases of non-comminuted unstable surgical neck fracture of humerus among 19 cases, which followed-up more than one year. Follow-up averaged 29 months. We treated with percutaneous pinning techniques and assessed clinical outcomes. Functional evaluation was performed using the standard method of research committee of American Shoulder and Elbow Surgeons(ASES). Results: Last follow-up ROM of shoulder joint were 142 degrees of forward elevation, 57 degrees of external rotation, 72 degrees of external rotation in 90 degrees abduction, and T8 of internal rotation. Pain scale was l(range : 0∼3). ASES scores was 86.2(range : 63.3~98.3). Patient satisfaction based on ASES were excellent in 6 cases, good in 5 cases, fair in 1 case, poor in 1 case. A case of fair result was caused by limitation of motion in shoulder joint and poor case was paraplegia patient after traffic accident. Conclusion : Percutaneous pinning is recommended for non-comminuted unstable fracture of surgical neck in humerus.

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A STATISTICAL STUDY ON THE DENTAL CARIES INCIDENCE IN CEREBRAL PALSY CHILDREN (뇌성마비 아동의 치아우식증에 관한 통계학적 연구)

  • Shin, Young-Soon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.4 no.1
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    • pp.45-52
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    • 1977
  • The purpose of this study was to provide information concerning the dental caries incidence in cerebral palsy children, and to aid improvement of their oral health. The author examined 106 cerebral palsy children and 185 normal children as control group, between 3 and 15 years of age. The obtained results were as follows: 1) In the DMF person rate, DMFT rate and DMFT index, cerebral palsy children (74.68%, 16.24% and 2.76 respectively) showed remarkable increment compare to normal children. (14.28%, 6.95% and 1.20 respectively.) 2) In the df person rate, dft rate and dft index, cerebral palsy children(93.33%, 37.41% and 6.22 respectively) showed remarkable increment compare to normal children. (78.64%, 20.68% and 3.29 respectively.) 3) There showed no significant in sexual differences. 4) In the dental caries incidence of the permanent teeth, athetosis and paraplegia type was found higher than other types. 5) Cerebral palsy children was found higher than normal children in the oral hygiene index. 6) There was found out necessity of the continuous dental enlightenment and treatment through this study.

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Pin and Bone Cement Fixation of Fifth-Sixth Lumbar Vertebral Fracture-Luxation in a Korean Goral (Nemorhaedus caudatus)

  • Choi, Seong-jae;Kim, Jong-taek;Oh, Yeon-su;Kang, Byung-Jae
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.115-118
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    • 2017
  • A Korean goral (immature, female) was presented with paraplegia following motor vehicle trauma. The patient was diagnosed with an L5-6 vertebral fracture-luxation based on digital radiographs. Surgical reduction and stabilization of the fracture-luxation were performed via a dorsal approach to the lumbar spine. It was confirmed in surgery that the patient had L5-7 spinous process fractures, L6 bilateral articular process fractures, and an L5-6 luxation. Free fragments were removed and the luxation was reduced. During reduction, caudodorsal dislocation of the L5 caudal vertebral end plate was discovered and the displaced end plate was removed. The L5-6 vertebral luxation was stabilized using pins and bone cement. However, the presence of an intact spinal cord was not confirmed. Two weeks postoperatively the patient became dyspneic and arrested. A necropsy was performed, which revealed that the surgical stabilization was intact. Pulmonary edema was identified and the immediate cause of death was determined to be systemic inflammatory response syndrome.

Acute disseminated encephalomyelitis caused by Epstein-Barr virus infection in an immunocompetent adult woman

  • Oh, Hyunjoo;Yoo, Jeong Rae;Heo, SangTaek;Oh, Jung-Hwan;Lee, Ho Kyu
    • Journal of Medicine and Life Science
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    • v.16 no.1
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    • pp.17-22
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    • 2019
  • Epstein-Barr virus(EBV) infection is common and usually asymptomatic in young infants and children. However, EBV infections in transplant recipients and other immunosuppressed patients can be fatal. EBV-related neurological complications in immunocompetent adults are extremely rare and self-limited. Acute disseminated encephalomyelitis(ADEM) may also follow EBV infection; ADEM is characterized by abrupt onset and rapid progression. We report an immunocompetent adult patient who developed diffuse meningoencephalitis with ADEM-like features caused by EBV infection. A 35-year-old Vietnamese woman was admitted presenting with urinary retention, altered mental status, and paraplegia. PCR of the patient's cerebrospinal fluid showed positive results for EBV. Brain and spine magnetic resonance imaging showed ADEM-like features. She was treated with acyclovir, steroid, and immunoglobulins. We report the case of an immunocompetent adult Vietnamese woman who presented with rapidly progressive diffuse meningoencephalitis associated with EBV infection and was treated with antivirals, corticosteroids, and immunoglobulins.

Treatment of Ramsay Hunt Syndrome Using Korean Medicine including Sinbaro3 Pharmacopuncture: A Case Report

  • Shin, Won Bin;Park, Ji Won;Choi, Hyo Jung;Namgoong, Jin;Kim, Sang Gyun;Min, Baek Ki
    • Journal of Acupuncture Research
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    • v.36 no.3
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    • pp.161-165
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    • 2019
  • This study was conducted to investigate whether treatment with Korean medicine might help to improve symptoms of patients diagnosed with Ramsay Hunt Syndrome. A patient diagnosed with Ramsay Hunt Syndrome was hospitalized for 15 days from October 4, 2018 to October 18, 2018 and treated using Korean medicine (Sinbaro3 pharmacopuncture, acupuncture, electroacupuncture, and herbal medicine). Therapeutic effects were evaluated using the Numerical Rating Scale (NRS), House-Brackmann grade, Yanagihara's score survey, and Digital Infrared Thermographic Imaging (DITI). After treatment, the Numerical Rating Scale score (6 at admission down to 2 points at discharge), House-Brackmann grade (Grade V down to Grade II), Yanagihara's score (6.0 up to 22.0), and Digital Infrared Thermographic Imaging showed improvement from admission to discharge. Treatment with traditional Korean medicine, may help improve symptoms of Ramsay Hunt Syndrome such as facial nerve paralysis, neuralgia after paraplegia, hearing difficulties, and dizziness.

Mid-Term Results of Thoracic Endovascular Aortic Repair for Complicated Acute Type B Aortic Dissection at a Single Center

  • Hong, Young Kwang;Chang, Won Ho;Goo, Dong Erk;Oh, Hong Chul;Park, Young Woo
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.172-178
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    • 2021
  • Background: Complicated acute type B aortic dissection is a life-threatening condition with high morbidity and mortality. The aim of this study was to report a single-center experience with endovascular stent-graft repair of acute type B dissection of the thoracic aorta and to evaluate the mid-term outcomes. Methods: We reviewed 18 patients treated for complicated acute type B aortic dissection by thoracic endovascular aortic repair (TEVAR) from September 2011 to July 2017. The indications for surgery included rupture, impending rupture, limb ischemia, visceral malperfusion, and paraplegia. The median follow-up was 34.50 months (range, 12-80 months). Results: The median interval from aortic dissection to TEVAR was 5.50 days (range, 0-32 days). There was no in-hospital mortality. All cases of malperfusion improved except for 1 patient. The morbidities included endoleak in 2 patients (11.1%), stroke in 3 patients (16.7%), pneumonia in 2 patients (11.1%), transient ischemia of the left arm in 1 patient (5.6%), and temporary visceral ischemia in 1 patient (5.6%). Postoperative computed tomography angiography at 1 year showed complete thrombosis of the false lumen in 15 patients (83.3%). Conclusion: TEVAR of complicated type B aortic dissection with a stent-graft was effective, with a low morbidity and mortality rate.

Pediatric tetrasomy 18p presenting as a spastic cerebral palsy: A case report

  • Lim, Ikhyun;Park, Sang Hee;Suh, Mi Ri;Kwak, Hyunseok;Park, Wookyung;Shim, Sung Han;Kim, MinYoung
    • Journal of Genetic Medicine
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    • v.18 no.2
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    • pp.105-109
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    • 2021
  • Tetrasomy 18p is a genetic syndrome caused by an isochromosome consisting of two copies of the short arm of chromosome 18. Clinically, pediatric cases of tetrasomy 18p manifest with global developmental delay, similar to most cases of chromosomal abnormality. In addition, it causes various symptoms including abnormal muscle tone. We report a case of an infant with global developmental delay and remarkable spasticity, the typical phenotype of bilateral spastic cerebral palsy. However, she had a subtle anomaly in her face, and brain magnetic resonance imaging (MRI) findings were inconsistent with her strong upper motor neuron signs. Upon genetic testing, she was determined to have an 18p isochromosome, confirming de novo non-mosaic tetrasomy 18p. Cerebral palsy is a neurological disorder that includes developmental delay caused by a non-progressive lesion in the developing brain. During diagnostic workup in patients with cerebral palsy, genetic testing should be considered when there are minor physical anomalies or equivocal MRI findings.

Treatment of Spinal Infection Following Bilateral Total Knee Replacement Postoperative Infection (척추감염을 동반한 양측 슬관절 전치환술 후 감염의 치료)

  • Shim, Bum-Jin;Sohn, Oog-Jin;Cho, Chang-Woo
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.92-96
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    • 2017
  • Postoperative infection from total knee arthroplasty (TKA) is an issue drawing great attention, which can manifest as a local or general infection. Its development into sepsis has also occasionally been reported. Such sepsis is a critical complication that can spread to various parts of the body, which can ultimately lead to mortality. However, the cases where infection has spread to the spine do not have clear clinical signs, making diagnosis difficult. These cases are not found in the literature. Therefore, this is a case study on both postoperative infection from TKA that has developed into sepsis and spread to the spine.

A Study on the Paraplegia Men′s Ready-made Pants Pattern and Grading Method (하반신마비 남성의 기성복 바지원형 및 그레이딩 연구)

  • Kim, Kyung-Im;Lee, Jeon-Ran
    • Journal of the Korean Society of Clothing and Textiles
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    • v.27 no.12
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    • pp.1441-1452
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    • 2003
  • 오늘날 지체장애인의 수는 후천적 원인으로 인하여 점점 증가하는 추세에 있다. 이에 본 연구는 훨체어를 사용하는 하반신마비자 중 성인남성을 중심으로 인체계측을 통해 적합성이 높은 바지를 개발하는데 목적이 있다. 연구 결과는 다음과 같다. 1. 인체계측 결과 하반신마비자들은 정상인과 비교했을 때 허리둘레 및 배둘레에서 유의한 차이를 보여 새로운 치수체계가 필요로 함을 알 수 있었다 또 자세 변화에 따른 둘레항목의 치수 변화와 피부 신축율에 의해 허리선의 변화가 고려되어 평상시의 휠체어에 앉은 자세에서 계측한 항목으로 원형이 설계되어야 할 필요가 있다고 분석되었다. 2. 연구원형은 기성복화 하기 위한 방법으로 먼저 기준치수(98-102)를 선정하고, 원형 각 부위는 절대치로 수치화 시켜서 제시하였다. 뒤밑위길이선은 허리선에서 8cm 늘이고 앞밑위길이선은 허리선에서 6cm 줄여 앉은 자세에서 편안함을 확보할 수 있도록 하였다. 기준치수의 경우 바지길이 107cm, 밑위길이 26cm, 밑위선 28cm, 엉덩이둘레선은 밑위선 위로 8.5cm, 바지부리는 10.5cm이고 외관과 기능성 평가 결과 대부분의 항목에서 우수한 평가를 받았다. 3. 계측 대상자 계측치를 근거로 치수의 출현율을 고려하여 연구 치수체계를 기본 신체부위인 앉은 허리둘레와 앉은 엉덩이둘레의 순으로 적용하여 총 7개의 치수로 설정하였다. 기준치수(98-102)의 연구원형을 마스터 패턴으로 하고 구체적인 원형 부위별 절대치로써 치수 차를 검토하여 연구 그레이딩 룰을 설계하였으며 기준치수 보다 작은 사이즈 88-93과 큰 사이즈 108-111의 적합성을 검증하였다.

Unsuspected Plasticity of Single Neurons after Connection of the Corticospinal Tract with Peripheral Nerves in Spinal Cord Lesions

  • Brunelli, Giorgio;Wild, Klaus von
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.1-4
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    • 2009
  • Objective: To report an unsuspected adaptive plasticity of single upper motor neurons and of primary motor cortex found after microsurgical connection of the spinal cord with peripheral nerve via grafts in paraplegics and focussed discussion of the reviewed literature. Methods: The research aimed at making paraplegics walk again, after 20 years of experimental surgery in animals. Amongst other things, animal experiments demonstrated the alteration of the motor endplates receptors from cholinergic to glutamatergic induced by connection with upper motor neurons. The same paradigm was successfully performed in paraplegic humans. The nerve grafts were put into the ventral-lateral spinal tract randomly, with out possibility of choosing the axons coming from different areas of the motor cortex. Results: The patient became able to selectively activate the re-innervated muscles she wanted without concurrent activities of other muscles connected with the same cortical areas. Conclusion: Authors believe that unlike in nerve or tendon transfers, where the whole cortical area corresponding to the transfer changes its function a phenomenon that we call "brain plasticity by areas". in our paradigm due to the direct connection of upper motor neurons with different peripheral nerves and muscles via nerve grafts motor learning occurs based on adaptive neuronal plasticity so that simultaneous contractions of other muscles are prevented. We propose to call it adaptive functional "plasticity by single neurons". We speculate that this phenomenon is due to the simultaneous activation of neurons spread in different cortical areas for a given specific movement, whilst the other neurons of the same areas connected with peripheral nerves of different muscles are not activated at the same time. Why different neurons of the same area fire at different times according to different voluntary demands remains to be discovered. We are committed to solve this enigma hereafter.