• Archives of Plastic Surgery
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• v.34 no.4
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• pp.531-534
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• 2007

Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.98-102
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• 2018

Background and Objectives : Detection of vascular abnormalities in vocal cord (VC) leukoplakia is important for the diagnosis of neoplastic change of the mucosa. The aim of this study was to investigate the value of i-scan in the differential diagnosis of VC leukoplakia based on visualization of abnormal vascular features. Material and Methods : Fifty-two patients with leukoplakia were enrolled in the study. Images of their larynx obtained using conventional white light endoscopy and an i-scan-enhanced endoscopy (Pentax DEFINA EPK-3000 Video Processors, with Pentax VNLJ10) were reviewed. The microvascular features of the lesions and vascular changes were analyzed and the results were compared with the histopathologic diagnosis. Results : Among the 52 leukoplakia patients, 7 (13.5%) patients had squamous hyperplasia, 10 (19.3%) mild dysplasia, 2 (3.8%) moderate dysplasia, 14 (26.9%) severe dysplasia, 4 (7.7%) carcinoma in situ, and 15 (28.8%) invasive squamous cell carcinoma on histopathologic examination. Using i-scan-enhanced endoscopy, abnormal vascular change with neoplastic neoangiogenesis was detected in most cases of malignant VC lesion [severe dysplasia : 9/14 (64.3%), carcinoma in situ: 2/4 (50.0%), and invasive squamous cell carcinoma : 11/15 (73.4%)]. Conclusion : i-scan-enhanced endoscopy is a useful optical technique for the diagnosis of VC leukoplakia. Our results suggest that i-scan may be a promising diagnostic tool in the early detection of laryngeal cancer.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.7
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• pp.3109-3116
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• 2011

We studied the effects of vibration stimulation method on upper limbs spasticity in patients with brain lesion. 21 patients with spasticity of the upper limbs selected and divided randomly 3 groups. And then vibratory stimulation was applied to the triceps brachii muscle in group I(n=7), to biceps brachii muscle in group II (n=7), and to both muscles in group III (n=7). Using Neuro-EMG_Micro to investigate the changes in spinal neuronal excitability, F-waves were measured at before and directly after stimulation, and 10 minutes later and 20 minutes later after stimulation especially. MAS(Modified Ashworth Scale) test for muscle tone and MFT(Manual Function Test) for the upper extremity motor function were performed before stimulation and 20 minutes later after stimulation for the purpose of clinical evaluation. In our study, MAS was significant decreased in all groups, F wave and F/M ratio parameters were decreased in all groups and more decreased specially in group III. MFT was increased in group II and III, and more increased specially in group III. Vibration stimulation reduced the neuronal excitability of spinal cord and also muscle tone, and improved the motor function of the upper extremity. These results suggested that vibration stimulation giving to both muscles(triceps and biceps brachii muscle) at the same time was more efficiency in reducing the neuronal excitability of spinal cord and improving the motor function of the upper limbs.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.84-87
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• 1999

The Buford complex is unusual variant of the glenohumeral joint. This complex is distinguished by a cord-like middle glenohumeral ligament that oriented directly form the superior labrum at the base of the biceps tendon and crosses the subscapularis tendon to insert on the humerus. There is no anterior-superior labral tissue present between this attachment and the mid-glenoid notch. This anatomical variation may lead the surgeon to confuse this complex with a sublabral hole, pathologic labral detachment, Bankart lesion or SLAP lesion. We report a case of Buford complex which was found incidentally during the operation of impingement syndrome with stiffness and treated with subacromial decompression only.

• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.176-178
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• 2009

Traumatic brainstem hemorrhage after blunt head injury is an uncommon event. The most frequent site of hemorrhage is the midline rostral brainstem. The prognosis of these patients is poor because of its critical location. We experienced a case of traumatic brainstem hemorrhage. A 41-year-old male was presented with drowsy mentality and right hemiparesis after blunt head injury. Plain skull radiographs and brain computerized tomography scans revealed a depressed skull fracture, epidural hematoma, and hemorrhagic contusion in the right parieto-occipital region. But, these findings did not explain the right hemiparesis. T2-weighted magnetic resonance (MR) image of the cervical spine demonstrated a focal hyperintense lesion in the left pontomedullary junction. Brain diffusion-weighted and FLAIR MR images showed a focal hyperintensity in the ventral pontomedullary lesion and it was more prominent in the left side. His mentality and weakness were progressively improved with conservative treatment. We should keep in mind the possibility of brainstem hemorrhage if supratentorial lesions or spinal cord lesions that caused neurological deficits in the head injured patients are unexplainable.

• The Journal of Internal Korean Medicine
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• v.22 no.2
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• pp.263-269
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• 2001

Monoplegia is the paralysis of either the upper or lower limb. Monoplegia is commonly caused by an injury to the cerebral cortex; it is rarely caused by an injury to the internal capsule, brain stem, or spinal cord. Most cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. According to motor homunculus, lower limb monoplegia occurs from limited damage to the most upper part of the primary motor area(Brodmann's area 4, located in precentral gyrus). Clinically, lower limb monoplegia due to brain cortical infarction is commonly misunderstood as monoplegia due to spinal injury because the lesion is situated at the most upper part of precentral gyrus. We had many difficulties in finding lesion on brain CT, but we diagnosed two patients correctly by using an MRI, who have lower limb monoplegia due to brain cortical infarction oriental treatment.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.302-308
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• 2005

This study was performed to examine the absolute skin temperature and temperature difference $({\Delta}T)$ between the left and the right, the upper and the lower parts on the back of dog and to investigate the clinical usefulness of infrared thermography as diagnostic or prognostic aid on experimental spinal cord compression by using Digital Infrared Imaging System. In normal dogs, symmetrical and contouring patterns were observed in thermogram. The skin temperature difference was not significant between the left and the right, the upper and the lower parts on the back. In spinal cord compressed dog, there was symmetrical temperature reduction pattern around lesion. Patterns of ${\Delta}T$ between thoracic and lumbar portions were remarkable and showed the tendency to return to normal after 4 weeks of operation. It is considered that infrared thermography is a useful diagnostic and prognostic aid for spinal cord injury in dogs.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.95-102
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• 1986

Among the skeletal tuberculosis, tuberculous spondylitis is high incidence and curable disease, if early diagnosis and treatment are possible. We reviewed clinical manifestations and radiologic analysis of 30 cases tuberculous spondylitis from May 1983 to Sept. 1986, at Yeungnam medical center, Yeungnam University. The results were follows : 1. The frequent involve sites were thoracolumbar vertebra. 2. The continuous lesion is 86.7% of the all cases. 3. The most common type was intervertebral type, and lytic and sclerotic lesion were same incidence. 4. Paravertebral abscess, kyphosis and disc space narrowing were demonstrated more than 80.0% of the cases. 5. Computed tomography was more accurate diagnostic method rather than conventional plain study to evaluation of extent of lesion, involvement of spinal canal and cord, and size and location of paravertebral abscess. And CT guided abscess drainage procedure was helpful to diagnosis and treatment. 6. Ultrasonography was helpful to differential diagnosis between paravertebral abscess and other solid mass, and useful to follow up study of paravertebral abscess after treatment.

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.467-469
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• 2017

Signalment: A 7-month-old, female domestic shorthaired cat was presented for acute pelvic limb paraparesis. Results: There was no abnormality on survey radiographs and blood analysis, however neurological examination revealed proprioception positioning and hopping was absent in the pelvic limbs. Also, anal tone and perineal sensation were reduced. Magnetic resonance (MR) imaging showed nucleus pulposus dehydration and disc protrusion at T12-T13. Ill-defined diffuse lesion was found at T10-L2 level and it showed isointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. This lesion was considered as edematous lesion secondary to disc protrusion. The presumptive diagnosis was focal spinal cord edema associated with intervertebral disc protrusion. A traumatic aetiology was suspected. The cat was treated corticosteroids and analgesic and clinical sign improved following 9 days of treatment. Clinical relevance : Intervertebral disc protrusion is rare disease in a cat. However, it could be considered as a cause of paraparesis in cats.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.565-569
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• 2000

Background; Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. Material and Method; From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. Result; There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. Conclusion; Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.