• Journal of Veterinary Clinics
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• v.30 no.4
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• pp.320-323
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• 2013

Spinal cord infarction is becoming recognized as an important cause of acute myelopathy in cats. Although the definitive diagnosis is confirmed through postmortem histopathologic examination, MR imaging features provide valuable informations for the diagnosis of spinal cord infarction. The aim of this report is to describe MR findings of acute spinal cord infarction in two cats and to evaluate usefulness of low field MRI (0.3Tesla) as a potential diagnostic tool of acute spinal cord infarction. A cat (unknown age, neutered male mixed breed cat) was referred one day after the acute onset of non-ambulatory spastic tetraparesis and the other cat (a 9-year-old, neutered female domestic short hair cat) was presented due to the acute onset of non-ambulatory paraparesis and one day later paraplegia. The lesions of the MR images were shown on the spinal cord parenchyma over C2 to C6 in case 1 and L2 to L5 in case 2. The MR images in these two cases were characterized by focal intramedullary lesions, mainly involving grey matter which were hyperintense T2 weighted and FLAIR images and hyperintense on DWI and hypointense on ADC map. The MR findings in both cases were highly suggestive of acute spinal cord infarctions, based upon previous reported small animal cases and human cases. In conclusion, based on MR features, together with the history and clinical examination findings, MRI modality can be used as an antemortem tool for the diagnosis of acute spinal cord infarction in cats.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.73-83
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• 2013

Purpose: The goal of this study is to evaluate the minimum three-year follow-up results of reverse total shoulder arthroplasty (RTSA) for glenohumeral (GH) arthritic and pseudoparalytic patients with severe rotator cuff deficiency. Materials and Methods: We evaluated 13 patients (three males and 10 females) who underwent RTSA from July 2007 to July 2010. The average follow-up duration was 54.2 months (range, 37~74 months). Clinical results were evaluated using the Visual Analog Scale (VAS) for pain, active Range of Motion (ROM): active forward flexion (aFF); active external rotation at the side (aERs); active internal rotation to the back (aIRb), American Shoulder and Elbow Surgeons (ASES) score, Korean Shoulder Score (KSS), and intraoperative and postoperative complications. Results: VAS score improved from 7.5(6~10) points to 1.5(0~4), and ROM of active forward elevation improved from $42.7(10{\sim}100)^{\circ}$ to $129.1(110{\sim}180)^{\circ}$. In addition, ASES score improved from preoperative 32.9 (11.7~46.7) points to 80.2(58.3~95.0) postoperatively, and KSS score improved from 36.8(24~47) points to 78.4 (61~92). Twelve out of 13 cases showed various degrees of scapular notching at the last follow-up. There was one case of intraoperative anterior glenoid fracture and two cases of temporary nerve injury. Revision surgery was performed in two cases for treatment of delayed postoperative deep infection. Conclusion: According to minimum three-year follow-up results, RTSA may be an effective treatment option for glenohumeral (GH) arthritic and pseudoparalytic patients. However, considering the possibility of complications related to delayed deep infection or surgeon's technique, RTSA should be judiciously and carefully indicated by expert surgeons.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.19 no.3
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• pp.185-193
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• 2015

Objectives The purpose of this report is to represent decubitus ulcer(pressure sore) improved by carbon arc and oriental medicine. Methods Patients with decubitus ulcer were treated with carbon arc, acupuncture, herbal medicine and simple dressing. Laser was irradiated at ulcer site once a day for 5 hour, using cored carbon number 3000,3002. Simple dressing with wound cleansing was performed to prevent reinfection. Herbal medicine and acupuncture treatment were applied to improve patients' general condition. Ulcer sizes and aspects were carefully checked by one week. Results Sizes of the decubitus ulcer decreased. Stage of ulcer was improved from stage 3 to stage 2. These results show that carbon arc may play a role in treating the decubitus ulcer with oriental medicine.

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.286-291
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• 2000

Behcet's disease is a systemic disease affecting multiple organs including the central nervous system. Neuro-Behcet's disease was regarded as relatively rare, but thanks to the development of diagnostic tools, more and more cases are being reported. We are reporting a case of neuro-Behcet's disease in which the patient displayed paraparesis, dysarthria and involuntary tremor as neurologic symptoms. The patient's brain MRI showed cerebellar atrophy, and a spinal cord MRI failed to reveal any significant lesions. The patient experienced a couple of fever attacks during hospitalization, which were managed adequately by herbal medicines. Her main neurological symptoms such as paraparesis were, however, grossly unchanged at discharge.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.247-254
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• 1999

Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy, the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death. because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.786-795
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• 2016

Objective: To evaluate the effectiveness of traditional Korean medicine treatment (TKM) on a patient with ACA infarction and hemorrhagic transformation with hemiplegia and urinary disturbance. Methods: A patient diagnosed with left anterior cerebral artery (ACA) infarction and hemorrhagic transformation was treated with electroacupuncture, moxibustion, and herbal medicine. Results: Improvements in the Manual Muscle Test (MMT), modified Barthel Index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), and K-MMSE were observed following the TKM treatment [MMT Gr. (3/0)→Gr. (4+/4+), MBI 20→89, NIHSS 8→2, mRS 5→1, MMSE-K 21→28]. Conclusion: TKM treatment could help improve the symptoms of patients with ACA infarction and hemorrhagic transformation.

• Journal of Korean Physical Therapy Science
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• v.11 no.2
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• pp.46-56
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• 2004

The purpose of this study was to investigate the effect of watsu therapy on muscle tone in adult hemiparesis patient after stroke. The subject was a 66 year old patient with left hemiparesis whose self gait was independent with minimal assist. The subject was ambulatory with some degree of limitation and demonstrated a little tremor and asymmetry in the body. A multiple treatment design(A-B-C-B) for a single-subject research was used for this study. The watsu therapy consisted of basic moves, head cradle, underfar leg, near leg cradle in watsu I (transition flow), for 25 minutes, which lasted 12 sessions for a total 21 sessions. A baseline was conducted for a first time and a general ROM exercise was conducted after the first watsu therapy. Tone assessment scale was tested : 1. posturing at rest 2. response to passive movement 3. associated reaction Comparing to the baseline and general ROM exercise, The results showed that the watsu therapy had some positive effects on improvement of three tests and there was a more positive effects of both response to passive movement and associated reaction.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.621-627
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• 1999

Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1365-1371
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• 2000

Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.395-399
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• 2001

Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate(ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy. The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.