• Title/Summary/Keyword: 척수 손상

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소아 배뇨장애와 야뇨증

  • Kim, Seong-Do
    • 학교보건
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    • s.26
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    • pp.21-28
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    • 2006
  • 소아과 영역에서 주로 다루는 소아 배뇨장에는 뇌질환이나 척수손상 등의 신경학적 병변없이 나타나는 배신경인성 배뇨장애로서 주된 증상은 빈뇨, 급박뇨, 요실금, 야뇨등이 있다.

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An Effective Transcranial Electric Motor-Evoked Potentials Method in Spinal Dural Arteriovenous Fistula Ligation Surgery (척수경막동정맥루 결찰술에서의 효과적인 경두개운동유발전위 검사방법)

  • Jang, Min Hwan;Lee, In Seok;Lim, Sung Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.193-198
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    • 2021
  • The purpose of spinal dural arteriovenous fistula (SDAVF) ligation is to prevent neurological injury and the poor blood supply through ligation of arteriovenous fistula. Therefore, intraoperative neurophysiological monitoring (INM) is required via multimodal neurological examination for minimizing the side effects after surgery based on the patient's symptoms. Transcranial electric motor-evoked potentials (TceMEP) help to check the condition of the corticospinal tract. Whenever ligation is performed, TceMEP should be performed every minute to check for abnormalities. However, an examiner's lack of knowledge about the operation procedure and examination and also poor communication between the examiner and surgeon can cause incorrect timing of the stimulation of TceMEP that interferes with the procedure and causes side effects such as paralysis and motor weakness. As a result of this SDAVF ligation survey, it is believed that for proper INM, case reports will be needed along with further research and the examiner will also have to work closely with the surgeon to minimize neurological damage to patients.

손 재활 로봇 연구동향

  • Gu, Gwang-Min;Jang, Pyeong-Hun
    • ICROS
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    • v.16 no.3
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    • pp.16-20
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    • 2010
  • 손 재활 로봇 연구의 목표는 손 기능 장애를 갖는 환자들을 대상으로 치료사를 대신하여 치료는 수행하는 것이다. 일반적으로 손의 운동기능 장애는 골절, 인대 손상 또는 노화에 의한 근력 소실에 의해 발생하거나 뇌졸중이나 파킨슨병, 척수 손상 등에 의한 신경계 문제에 의해 발생할 수 있다.

Effects on Exercise Training in person with Incomplete Hemisection cord injury after Discharge (불완전 척수손상자의 퇴원 후 운동훈련의 효과 사례보고)

  • Park, Mi-Hee
    • Journal of Korean Physical Therapy Science
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    • v.12 no.4
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    • pp.25-31
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    • 2005
  • 이 사례연구는 2002년 10월 15일 칼에 의한 좌상으로 경추 3-4번의 불완전 척수손상을 입은 25세의 남자 환자가 최초 병원에서 2002년 12월 한달 간의 치료를 마친 후, 2003년 1월 3일부터 4월 28일까지 태릉에 위치한 N 재활센터에서 주 5회 2시간의 자세조절 훈련, 심폐지구력 훈련, 웨이트 훈련, 스포츠(축구, 소프트 볼), 여가활동(등산)의 프로그램을 적용하여 척추손상 환자의 사회적응을 돕기위한 재활 프로그램의 다양화를 꾀하기 위한 기초 선행 작업으로 시작되었다. 신체능력을 평가하기 위한 측정도구는 관절가동범위(Range of Motion), 수동근력검사(Muscle Manual Test), 경직(Spasticity), 신체체력(Physical Fitness), 발란스(Balance: one leg stand), 상대적인 등속성 하지근력(Isokinetic Muscle Strength) 그리고 신체조성(Body Composition)로 하였다. 재활기간을 통해 처음 시작 일자에서 45일 간격으로 3차례의 측정을(1월 3일부터 4월 28일까지 실시하였다) 실시하였다. 최초 환자의 상태는 부분적으로 일상생활의 도움을 받아야 하는 상태로 동작을 시작하려 할 때 경직이 발생되어 옷을 입고 벗기, 신발 신고 벗기, 운전, 식사, 보행과 계단보행, 경사보행에서 보조자의 도움이 필요했으며, 작은 물건 잡기와 글씨쓰기, 타이핑 작업은 불가능 한 상태였다. 또한 스포츠 활동과 여가활동 역시 불가능 한 상태였다. 3달 15일간의 기간 동안 환자는 복학을 준비하기 위해 적극적으로 치료에 임했으며, 결과는 다음과 같았다. 신체조성은 재활 훈련을 통해 체중, 체지방율(%), 복부지방율(WHR)의 많은 감소를 가져왔다. 경직을 측정하는 Ashworth Scale은 정상에 가깝게 감소하였다. 관절가동범위는 고관절, 무릎, 발목에서 모두 증가하였다. 수동근력검사(0-9)는 많은 향상을 가져왔다. 신체체력능력 항목에서 근지구력의 윗몸일으키기와 팔굽히기, 악근력, 유연성으로 앉아 체간 숙이기, 민첩성으로 사이드 스텝, 순발력의 서전트는 모두 크게 향상되었다. 환자의 일상능력에서도 옷을 입고 벗기, 신발 신고 벗기, 운전, 식사, 보행과 계단보행, 경사보행에서 보조자의 도움이 필요없었으며, 타이핑 작업은 5손가락을 모두 사용하지는 않았지만, 1분에 80타로 큰 향상을 가져왔다. 또한 축구와 소프트볼, 등산을 달에 1회 정도 실시하여 약간의 도움만으로 가능하게 되었다.

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Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture (외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술)

  • Bae, Jang-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.234-242
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    • 1996
  • Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and hone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient arc remained back pain. According to above results we concluded that anterolateral internal fixation combined with hone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.

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Barrier Techniques for Spinal Cord Protection from Thermal Injury in Polymethylmethacrylate Reconstruction of Vertebral Body : Experimental and Theoretical Analyses (Polymethylmethacrylate를 이용한 척추체 재건술에서 척수의 열 손상을 방지하기 위한 방어벽 기법 : 실험적 및 이론적 분석)

  • Park, Choon Keun;Ji, Chul;Hwang, Jang Hoe;Kwun, Sung Oh;Sung, Jae Hoon;Choi, Seung Jin;Lee, Sang Won;Park, Sung Chan;Cho, Kyeung Suok;Park, Chun Kun;Yuan, Hansen;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.272-277
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    • 2001
  • Objective : Polymethylmethacrylate(PMMA) is often used to reconstruct the spine after total corpectomy, but the exothermic curing of liquid PMMA poses a risk of thermal injury to the spinal cord. The purposes of this study are to analyze the heat blocking effect of pre-polymerized PMMA sheet in the corpectomy model and to establish the minimal thickness of PMMA sheet to protect the spinal cord from the thermal injury during PMMA cementation of vertebral body. Materials & Methods : An experimental fixture was fabricated with dimensions similar to those of a T12 corpectomy defect. Sixty milliliters of liquid PMMA were poured into the fixture, and temperature recordings were obtained at the center of the curing PMMA mass and on the undersurface(representing the spinal cord surface) of a prepolymerized PMMA sheet of variable thickness(group 1 : 0mm, group 2 : 5mm, or group 3 : 8mm). Six replicates were tested for each barrier thickness group. Results : Consistent temperatures($106.8{\pm}3.9^{\circ}C$) at center of the curing PMMA mass in eighteen experiments confirmed the reproducibility of the experimental fixture. Peak temperatures on the spinal cord surface were $47.3^{\circ}C$ in group 2, and $43.3^{\circ}C$ in group 3, compared with $60.0^{\circ}C$ in group 1(p<0.00005). So pre-polymerized PMMA provided statistically significant protection from heat transfer. The difference of peak temperature between theoretical and experimental value was less than 1%, while the predicted time was within 35% of experimental values. The data from the theoretical model indicate that a 10mm barrier of PMMA should protect the spinal cord from temperatures greater than $39^{\circ}C$(the threshold for thermal injury in the spinal cord). Conclusion : These results suggest that pre-polymerized PMMA sheet of 10mm thickness may protect the spinal cord from the thermal injury during PMMA reconstruction of vertebral body.

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The Effects of Treadmill Exercise on Inhibition of Soleus Muscle Atrophy and Improvement Functional Recovery after Spinal Cord Contusion in the Rats (척수타박손상 후 트레드밀운동이 근 위축지연과 기능적 회복에 미치는 효과)

  • Oh, Myung-Jin;Jang, Moon-Nyeo;Seo, Tae-Beom;Kim, Jong-Oh;Byun, Jae-Jong;Yoon, Jin-Hwan;Jeong, Il-Gyu
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1651-1657
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    • 2009
  • Physical activity and exercise can promote sensorimotor recovery from central nerve injury. It has been suggested that the functional recovery promoted by exercise training after spinal cord injury might be associated with insulin-like growth factor-I in the inflicted muscle. To investigate morphological and biochemical change of the soleus muscle after spinal cord injury, all tissues were used for H&E, immunofluorescence staining and Western blot. Also, BBB-test was used to evaluate behavioral improvement after spinal cord contusion. Thirty male Sprague-Dawley rats ($230{\pm}10\;g$; 7week in age) were assigned equally to three different groups; Normal (n=10), SCI (n=10), SCI+TMT (n=10). Every rat in SCI and SCI+TMT groups underwent laminectomy at T9 level and then contusion on the exposed spinal cord site in anesthetized condition. After one week-recovery from contusion, every rat in the SCI+TMT group exercised on a motorized treadmill for 30min/d, 5d/wk for 7wks. TMT followed by injury increased IGF-I induction levels in the soleus muscle and inhibited muscle atrophy. Behavioral scales for 4 and 8 weeks after spinal cord injury were improved in the SCI+TMT group compared to the SCI group. These results suggest that treadmill exercise after spinal cord injury might promote functional recovery along with muscle regrowth through the up-regulation of IGF-1 in muscle tissue.