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Single Stage Circumferential Cervical Surgery (Selective Anterior Cervical Corpectomy with Fusion and Laminoplasty) for Multilevel Ossification of the Posterior Longitudinal Ligament with Spinal Cord Ischemia on MRI

  • Son, Seong;Lee, Sang-Gu;Yoo, Chan-Jong;Park, Chan-Woo;Kim, Woo-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.335-341
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    • 2010
  • Objective : Anterior cervical corpectomy with fusion (ACF) or laminoplasty may be associated with substantial number of complications for treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL) with significant cord compression. For more safe decompression and stabilization in multilevel cervical OPLL with prominent cord compression, we propose circumferential cervical surgery (selective ACF and laminoplasty) based on our favorable experience. Methods : Twelve patients with cervical myelopathy underwent circumferential cervical surgery and all patients showed multilevel OPLL with Signal change of the spinal cord on magnetic resonance imaging (MRI). A retrospective review of clinical, radiological. and surgical data was conducted. Results : There were 9 men and 3 women with mean age of 56.7 years and a mean follow up period of 15.6 months. The average corpectomy level was 1.16 and laminoplasty level was 4.58. The average Japanese Orthopedic Association score for recovery was 5.1 points and good clinical results were obtained in 11 patients (92%) (p < 0.05). The average space available for the cord improved from 58.2% to 87.9% and the average Cobb's angle changed from 7.63 to 12.27 at 6 months after operation without failure of fusion (p < 0.05). Average operation time was 8.36 hours, with an estimated blood loss of 760 mL and duration of bed rest of 2.0 days. There were no incidences of significant surgical complications, including wound infection. Conclusion : Although the current study examined a small sample with relatively short-term follow-up periods, our study results demonstrate that circumferential cervical surgery is considered favorable for safety and effectiveness in multilevel OPLL with prominent cord compression.

The clinical observation on Bell's palsy according to facial nerve grading system (안면신경평가기준에 따른 구안와사(口眼喎斜)의 임상관찰)

  • Kim, Jong-in;Seo, Jung-chul;Lee, Sang-hoon;Choi, Do-young;Kang, Sung-keel;Koh, Hyung-kyun
    • Journal of Acupuncture Research
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    • v.19 no.5
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    • pp.112-123
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    • 2002
  • Background and Objective : The evaluation of facial nerve function is a complex procedure. The House-Brackmann facial nerve grading system(H-B grade)and the Yanagihara grading system(Y-system) have been recommended as universal standards for assessing the degree of facial nerve palsy. The purpose of this study is to compare the effectiveness of Y-system and H-B system and to know the advantages of each system for each stage of incomplete recovery or sequelae of facial paralysis. Materials and Methods : A comparison between H-B grade and Y-system was studied with 137 evaluations of 61 cases of incomplete recovery or sequelae of peripheral facial paralysis. Each case was graded by using H-B system as a gross system and Y-system as a regional system before treatment, after 12 weeks and 6 months Results and Conclusions : The range of score in the Y-system 0-6, 8-16, 14-22, 24-34, 32-38, 38-40 were matched with grade VI, V, IV, III, II and I in the H-B system. The percentage of H-B grade III was the greatest among 137 evaluations and y-system showed the greatest score range. H-B system is easy to use but Y-system is more objective, quantitative and convenient to use in the incomplete recovery or sequelae state.

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A Rehabilitation for Ankle Fracture in Korean Medicine: A Report of 4 Cases (발목 골절 수술 후 한방 재활치료 프로토콜 적용의 임상적 효과: 증례 보고)

  • Ha, Won-Bae;Lee, Jong-Ha;Lee, Yoon-Seung;Jo, Dong-Chan;Lee, Jin-Hyun;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.4
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    • pp.171-184
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    • 2017
  • The objective of this study was to propose a rehabilitation protocol for ankle fracture in Korean Medicine and to report its effectiveness. Four patients who had undergone ankle fracture by car accident were treated using the rehabilitation protocol in Korean Medicine. We estimated the outcome evaluating physical examination findings of the ankle joint, numeric rating scale, Olerud-Molander score, and walking state. After the treatment, we observed that ankle movement and muscular strength were improved. Moreover numeric rating scale, Olerud-Molander score, and walking state of patients were improved. A rehabilitation in Korean Medicine can be effectively used for ankle fracture patients. The limitation of this study was the insufficient number of cases. Further studies are needed to design a rehabilitation protocol in Korean Medicine.

A Convergence Study on the Effects of Core Nursing Skills Improvement Program on Nursing Skills Competence in Nursing Students (핵심간호술 강화프로그램이 간호학생의 간호술 수행능력에 미치는 효과에 관한 융합연구)

  • Ha, Young-ok;An, Ji-Yoen
    • Journal of the Korea Convergence Society
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    • v.8 no.5
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    • pp.223-231
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    • 2017
  • This convergence study was done to identify the effectiveness of core nursing skills improvement program on nursing skills competence in nursing students. The design of research was one group pretest-posttest and the participants were 158 nursing students. The core nursing skills improvement program was composed of 7 fundamental nursing skills(vital sign, intramuscular injection, oral medication, subcutaneous injection, enema, oxygen therapy and nelaton). The data were collected using self-report questionnaires from January 19 to 23, 2015 and analyzed using paired t-test. The mean score of nursing skills competence in posttest was significantly higher than those in pretest (t=-4.71 ~ -8.00, p<.001). The score for self-confidence(t=-11.61, p<.001) and that for problem solving skills(t=-2.04, p=.043) increased significantly after core nursing skills improvement program. The results indicate that core nursing skills improvement program was effective in improving nursing skills competence.

An Verification of the Effect of Structured Cognitive Behavioral Intervention Program for Elementary School Students with High Risk Behavior (고위험 문제행동을 보이는 초등학생을 위한 구조화된 인지행동 중재 프로그램의 효과 검증)

  • Lee, A-Reum;Song, Won-Young
    • Journal of the Korea Convergence Society
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    • v.9 no.1
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    • pp.241-251
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    • 2018
  • The study is a preliminary study of the effectiveness of the structured cognitive behavioral arbitration program targeting elementary school students who perform high risk problems based on schools for convergence with local communities. The program is designed to be practiced by semi-trained professionals. To screen high-risk students, total 102 students were tested K-CBCL and those who scored over 60T on problem behavior syndrome scale were recruited. 32 students were selected and devided into intervention group and control group. Intervention group was received 90-minutes-sessions per week, for nine weeks. The program was done by graduate students and undergraduate students majoring counseling and supervised by school psychologist. The internalization group showed significantly lower score in Internalization, anxiety/depression, and externalization group showed externalization, aggressive behavior. but mixed group didn't showed significantly lower score. Implications of the results, limitations and suggestions for future study were mentioned.

The Use of Hook Plate on the Management of Unstable Neer II Lateral End Fracture of The Clavicle (불안정한 Neer II형 원위쇄골 골절의 치료에서 Hook 금속판의 이용)

  • Ko, Sang-Hun;Cho, Sung-Do;Park, Moon-Soo;Ryu, SuGoo
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.131-137
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    • 2003
  • Purpose: Unstable Neer type II lateral end fracture of clavicle may be required operation. The purpose of this study is the effectiveness of the use of Hook plate in the management of unstable Neer type II fractures. We preliminary reported the results of Unstable Neer type II lateral end fracture of clavicle using by Hook plate. Material and Methods: From May 1998 to May 2002, we operated 6 cases unstable Neer type II lateral end fracture of clavicle with Hook plate by one surgeon. We checked radiologic evaluation and disappearance of pain per 1 week, and evaluated improvement of range of motion per 2 week. And we followed up at each interval 3 months,6 months, 12 months and after that per 6months interval, at that each time we checked stress radiogram of shoulder and functional evaluation. The shoulder function was evaluated using Modified Shoulder Rating Scale (MSRC) for Distal Clavicle Fracture and UCLA score. Average follow up was on 37.2 (12∼57) months. Results: All 6 patients were regained satisfactory function. Average MSRC for distal clavicle fracture was 17.3 (15∼20) and average UCLA score was 33.2 (31∼35) at last follow up. Conclusion: There are many advantage of the use of Hook plate on management of unstable Neer II distal clavicle fracture in spite of several disadvantage. There have not yet been reported in our country. So we obtained good to excellent clinical result in surgical treatment of 6 cases on type II displaced lateral end fracture of the clavicle. But we think that more cases will be review and longer follow up will be needed in the future.

Effects of Remote Ischemic Conditioning Methods on Ischemia-Reperfusion Injury in Muscle Flaps: An Experimental Study in Rats

  • Keskin, Durdane;Unlu, Ramazan Erkin;Orhan, Erkan;Erkilinc, Gamze;Bogdaycioglu, Nihal;Yilmaz, Fatma Meric
    • Archives of Plastic Surgery
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    • v.44 no.5
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    • pp.384-389
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    • 2017
  • Background The aim of this study was to investigate the effects of remote ischemic conditioning on ischemia-reperfusion injury in rat muscle flaps histopathologically and biochemically. Methods Thirty albino rats were divided into 5 groups. No procedure was performed in the rats in group 1, and only blood samples were taken. A gracilis muscle flap was elevated in all the other groups. Microclamps were applied to the vascular pedicle for 4 hours in order to achieve tissue ischemia. In group 2, no additional procedure was performed. In groups 3, 4, and 5, the right hind limb was used and 3 cycles of ischemia-reperfusion for 5 minutes each (total, 30 minutes) was applied with a latex tourniquet (remote ischemic conditioning). In group 3, this procedure was performed before flap elevation (remote ischemic preconditoning). In group 4, the procedure was performed 4 hours after flap ischemia (remote ischemic postconditioning). In group 5, the procedure was performed after the flap was elevated, during the muscle flap ischemia episode (remote ischemic perconditioning). Results The histopathological damage score in all remote conditioning ischemia groups was lower than in the ischemic-reperfusion group. The lowest histopathological damage score was observed in group 5 (remote ischemic perconditioning). Conclusions The nitric oxide levels were higher in the blood samples obtained from the remote ischemic perconditioning group. This study showed the effectiveness of remote ischemic conditioning procedures and compared their usefulness for preventing ischemiareperfusion injury in muscle flaps.

Traditional Korean Medicine Treatment of a Traumatic Brain Injury Patient with Aggressive Behavior (외상성 뇌손상 환자의 공격성에 대한 치료 1례)

  • Park, Hye-lim;Hong, Min-na;Cho, Jae-hyun;Bae, Go-eun;Choi, Jin-yong;Hong, Jin-woo;Park, Seong-ha;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.831-838
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    • 2016
  • Objective: To describe the effectiveness of traditional Korean medicine (TKM) on a patient showing aggressive behavior after a traumatic brain injury. Methods: We used complex TKM treatments. The acupoints used were as follows: Soyangin Taegeuk acupuncture (HT3, KI3, and SP3) and acupoints frequently used in hemiparesis (GV20, GV24, ST4, LI11, LI4, ST36, GB34, SP9, and LR3). Moxibustion was also applied to GV20, and herbal medicine (Samulanshin-tang-gami, 四物安神湯 加味方) was administered. The efficacy was evaluated at baseline, week 8, and week 16 using the Modified Overt Aggression Scale (MOAS). Results: After 8 weeks, the total MOAS score was decreased from 13 to 5, and this score was maintained until week 16. The average sleep time was increased and waking up during the night was decreased. Conclusions: We suggest that TKM could be effective for reducing aggressive behavior and alleviating sleep disturbances. Further studies are needed.

The Effects of the Robot Based Instruction on Improving Immersion Learning (로봇활용수업이 학생의 학습몰입 향상에 미치는 효과)

  • Kim, Kyung-Hyun
    • The Journal of Korean Association of Computer Education
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    • v.14 no.2
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    • pp.1-12
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    • 2011
  • This paper is to explore the effects of Robot Based Instruction(RBI) on improving immersion learning. According to our research, we found out that there is significant improvement in learning immersion and there's 9 sub-factors score after RBI was applied. Also from the result that there is no significant difference between male and female students in learning immersion score, we can found that RBI can improve the learning immersion of students regardless of the learner's sex. The result of verification on the learning immersion is difference by subjects showed that there is significant improvement only in korean, science, art subject among 7 subjects. The above-mentioned results are based on as follows two reasons. First, RBI is efficient to improve students' internal motivation and ownership about tasks, and that is related to environment of learning and instruction focused on authentic task and practice. Second, educational advantages of robot media was reflected appropriately in RBI, also appropriate instructional environment for RBI was supported.

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Effects of Smoking Cessation Program for Male University Students: Perceived Nicotine Dependency and Self-efficacy (남자 대학생을 위한 금연프로그램의 효과 - 니코틴 의존도와 자기효능감을 중심으로 -)

  • Chaung, Seung-Kyo;Kim, Chun-Gill
    • Korean Journal of Adult Nursing
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    • v.17 no.2
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    • pp.219-229
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    • 2005
  • Purpose: The purpose of this study was to evaluate the effectiveness of 8 weeks smoking cessation program(SCP) developed by researchers. Method: One group pretest-posttest design was used in this study. The subjects were 88 male university students who consented to participate in the 8 weeks SCP. The SCP in this study consisted of a stop-smoking class, e-mail, SMS(short message service), cellular phone, internet cafe, displayed panel, and patch or acupuncture for quitting smoking. Korean version of questionnaire for nicotine dependency by Ahn et al.(2002), the smoking self-efficacy scale translated by Choi(1999) and subjects' opinion about the SCP were measured. The data were analyzed by using frequency, Chi-Square test, paired t-test and repeated measures ANOVA with SPSS WIN 10.1 Program. Results: 1) The rate of quitting smoking was 31.8% after 8 weeks SCP. 2) There was no significant decrease in the nicotine dependency score among smoking subjects after SCP. 3) There was a significant increase in self-efficacy after SCP. The mean score of self -efficacy in the quitting smoking group increased significantly, but did not significantly change in the smoking group. 4) The stop-smoking class was the most helpful among contents of the SCP. Contents of the SCP except for internet cafe were useful for quitting smoking in this study. Conclusion: The above results indicated that the 8 weeks SCP would be a helpful intervention to quit smoking for male university students.

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