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The Effect of Physical Therapy after Selective Posterior Rhizotomy patients (선택적 척수후근 절제술 후 물리치료의 효과)

  • Her, Jin-Gang;Park, Sung-Hark
    • Journal of Korean Physical Therapy Science
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    • v.6 no.2
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    • pp.989-995
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    • 1999
  • Musclee spasticity of Cerebral Palsy children brings abnormal posture and becomes delayed for Normal Motor Development. The objective of this study is to discover the effects of physical therapy on subject paitient' s posture and Normal Motor Development after Selective Posterior rhizotomy. The subject patients were 280 children who had physical therapy for about 4 to 6 months after Selective Posterior Rhizotomy. The sum of points both pre and post operation by using Locomotion stage of Vojta and Arens's grading of Gross Motor Function were compared and evaluated. Among total of 280 Cerebral Palsy children who had 4 to 6 months of physical therapy ; total of 206 children(197 by grade 1, 9 by grade 2) has increased out of 218 spasticity type children, and totoal of 42 has increased (by gradel) out of 48 Athetoid type, and total of 8 jas increased (by grade 1) out of 14 Mixed type Physical therapy for Cerebral Palsy children after Selective Posterior Rhizotomy has enhanced Normal Motor Development and their posture. The therapy also has shown the results of shortening the therapy period and better treatment results.

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Extended Epitympanotomy for Facial Nerve Decompression as a Minimally Invasive Approach

  • Chao, Janet Ren;Chang, Jiwon;Lee, Jun Ho
    • Journal of Audiology & Otology
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    • v.23 no.4
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    • pp.204-209
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    • 2019
  • For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

Extended Epitympanotomy for Facial Nerve Decompression as a Minimally Invasive Approach

  • Chao, Janet Ren;Chang, Jiwon;Lee, Jun Ho
    • Korean Journal of Audiology
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    • v.23 no.4
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    • pp.204-209
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    • 2019
  • For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

Policy Measures for Improving Function and Structure of Health Centers (보건소의 기능 및 조직의 재편성 방안)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.159-173
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    • 1994
  • Since the establishment of health centers in the 1960s, the centers have been played an important role in providing basic health care for the people. Although the health centers made a great effect to prevent diseases and promote the health status of the people for the last three decades, the function of health centers should be strengthened to meet the health care need of individual, family and community. Over the last ten years, there have been great changes and developments in health related environments, such as population size and age, rapid urbanization, up-grading of the educational level, increase of income, health care demand for promotive health care measures and practical measures for chronic diseases and also practicing healthy life. According to the great changes in health related environments, the health centers should be reformed. The following policy options are recommended as a summary; First, the function of health centers should be converted from providing basic health services into promotive and preventive health care services, to meet changing needs of people. Second, the health center personnel should be reinforced for their competency to provide a qualitative services to people and also the operation of health center should be reactivated. Third, a close linkage of health centers with the private sector is an essential requirement for the operation of the health care delivery system within a health district in order to improve the health status of people. Fourth, type of manpower mix, scope of organization and health care program should be varied, based on the health care needs of people, geographical characteristics and size of population etc. Fifth, a comprehensive health care delivery system should be developed, for maintaining healthy life style of people and also the health and welfare services should be integrated in order n ensure an effective service.

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A Clinical Analysis of Pediatric Teratoma (소아 기형종의 분포 및 예후)

  • Nam, So-Hyun;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.169-178
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    • 2007
  • Teratomas arising from totipotential primitive germ cell are composed of 2 or 3 germ cell layers. We reviewed the records of 166 children who underwent the operation for teratoma from Jan, 1990 through April, 2007. There were 40 boys and 126 girls (average age $6.93{\pm}5.83$ years). Primary sites were ovary (n = 88), sacrococcygeum (n = 24), testis (n = 16), retroperitoneum (n = 16), mediastinum (n = 8), brain (n = 4), thymus (n = 3) and a single tumor involved the adrenal gland, neck, middle ear, oropharynx, stomach, pelvis, omentum, chest wall and scalp. Teratomas were mature in 141 patients, and immature in 25. Six patients who had ovarian immature teratomas grade 2 or 3 with peritoneal gliomatosis underwent adjuvant chemotherapy. During follow up period, 6 mature teratomas recurred at sacrococcygeal area (n = 1) and contralateral ovary (n = 5). Five patients of them underwent reoperation and diagnosed as a mature teratoma, but one who had underwent a left salpingooophrectomy with right ovary cystectomy at initial operation was observed carefully. Teratomas were dominant in female patients and developed at various organs. Complete excision was needed for good prognosis. In case of immature teratoma, complete excision and appropriate chemotherapy according to grading can contribute to favorable results.

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Role of Surgery in Squamous Cell Carcinoma (편평 상피 암의 치료에서 수술의 역할)

  • Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Lee, Soo-Yong;Lim, Gyung-Jin;Park, Hyun-Soo;Kim, Chang-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.1
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    • pp.30-36
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    • 1998
  • Squamous cell carcinoma is a neglected disease entity in orthopedic oncology. The purpose of this study was to analyze overall survival and the role of surgery on survival and to evaluate the significance of possible prognostic factors. From Oct, 1986 to Aug, 1996, 57 patients were enlisted and 42 patients ere eligible. Inclusion criteria included more than one year follow-up and no distant metastasis at the first visit. Staging and survival followed AJC classification and Kaplan-Meier plot. Stage II included 17 cases and stage III, 25 cases. Thirty-eight patients underwent operations, chemotherapy, and/or radiotherapy, and the remaining four had operations only. The chemotherapeutic regimen was adriamycin-cisplatin. The average follow-up period was 45 months. The ten-year actuarial survival rate of whole patients was 65.4%. Location of primary lesion, stage, pathologic grading, and intensity of chemotherapy in the same stage showed a significant difference in survival. Nine out of 42 patients had local recurrence. Seven patients had inadequate wide margins and two had intralesional margins. Average period of recurrence from operation was 13(4-35)months. The operation itself had no impact on survival but a surgical margin of no less than 3cm from the lesion was important for local control. Pathological grade and staging were significant variables for long term survival. Acral lesion had a significantly higher chance of regional and distant metastasis but actual survival showed no difference. In stage II, aggressive chemotherapy could delay or reduce the chance of regional or distant metastasis.

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A New Scale(NS) Score System to Predict Outcome of Intracranial Aneurysm Using TCD (TCD를 이용한 두개강내 동맥류의 예후 예측 가능한 New Scale(NS) Score System)

  • Park, Sang Hoon;Park, Chong Oon;Park, Hyeon Seon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.970-975
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    • 2001
  • Objective : By conducing a review of clinical outcomes for patients with aneurysm treated using current microneurosurgical techniques and intensive care unit management, we speculated that grading systems based only on clinical condition or CT finding after admission failed to provide a significant stratification of outcome between individual grades of patients, because these systems did not include the factor for postoperative vasospasm. We hypothesized that postoperative blood flow velocity could have a significant impact on outcome prediction for patients surgically treated for intracranial aneurysms. Methods : We conducted a analysis on patient- and lesion-specific factors that might have been associated with outcome in a series of 55 aneurysm operations performed with measurements of blood-flow velocity with transcranial Doppler ultrasonography(TCD). In the new scale(NS) score system, 1 point is assigned additionally for the case with Hunt and Hess(H-H)/World Federation of Neurological Surgeons(WFNS) Grade IV or V, Fisher Scale(FS) score 3 or 4, aneurysm size greater than 10mm, patient age older than 60 years, blood-flow velocity higher than 120cm/sec, and posterior circulation lesion. By adding the total points, a 6-point scale score(score 0-6) is obtained. Results : Age of patient, size of aneurysm, clinical condition(H-H grade and WFNS), FS score, and blood flow velocity(TCD 1day after operation) were independently and strongly associated with long-term outcome. When NS scores were applied to 55 patients with at least 6 months follow-up, the correlation of individual scores with outcome was strongly validated the retrospective findings. Conclusion : It was speculated that TCD could be used to assess postoperative vasospasm and to monitor noninvasively the patients with aneurysmal SAH. This NS score system is easy to apply, divide patients into groups with different outcome, and is comprehensive, allowing for more accurate prediction of surgical outcome.

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Multidetector CT Findings of Solid Organ Injury Based on 2018 Updated American Association for the Surgery of Trauma Organ Injury Scaling System (2018 개정 미국외상수술협회 복부고형장기 손상척도에 따른 다중검출 CT 소견)

  • Hyo Hyeon Yu;Yoo Dong Won;Su Lim Lee;Young Mi Ku;Sun Wha Song
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1348-1363
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    • 2020
  • The newly revised 2018 Organ Injury Scale (OIS) has a similar format to the previous American Association for Surgery and Trauma (AAST) Emergency General Surgery Grading System, dividing the criteria for grading solid organ damage into three groups; imaging, operation, and pathology. The most significant alteration in the OIS system 2018 revision is the incorporation of multidetector CT (MDCT) findings of vascular injury including pseudoaneurysm and arteriovenous fistula. Similar to the previous OIS, the highest of the three criteria is assigned the final grade. In addition, if multiple grade I or II injuries are present, one grade is advanced for multiple injuries up to grade III. This pictorial essay demonstrates the MDCT findings of solid organ injury grades based on the 2018 OIS system.

Risk identification, assessment and monitoring design of high cutting loess slope in heavy haul railway

  • Zhang, Qian;Gao, Yang;Zhang, Hai-xia;Xu, Fei;Li, Feng
    • Structural Monitoring and Maintenance
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    • v.5 no.1
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    • pp.67-78
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    • 2018
  • The stability of cutting slope influences the safety of railway operation, and how to identify the stability of the slope quickly and determine the rational monitoring plan is a pressing problem at present. In this study, the attribute recognition model of risk assessment for high cutting slope stability in the heavy haul railway is established based on attribute mathematics theory, followed by the consequent monitoring scheme design. Firstly, based on comprehensive analysis on the risk factors of heavy haul railway loess slope, collapsibility, tectonic feature, slope shape, rainfall, vegetation conditions, train speed are selected as the indexes of the risk assessment, and the grading criteria of each index is established. Meanwhile, the weights of the assessment indexes are determined by AHP judgment matrix. Secondly, The attribute measurement functions are given to compute attribute measurement of single index and synthetic attribute, and the attribute recognition model was used to assess the risk of a typical heavy haul railway loess slope, Finally, according to the risk assessment results, the monitoring content and method of this loess slope were determined to avoid geological disasters and ensure the security of the railway infrastructure. This attribute identification- risk assessment- monitoring design mode could provide an effective way for the risk assessment and control of heavy haul railway in the loess plateau.

Bankart Suture Repair for Anterior Instability of the Shoulder- Results of Arthroscopic versus Open Repair - (견관절 전방 재발성 탈구의 치료-관절경 및 관혈적 Bankart병변 수복술의 비교 -)

  • Choi, Chang-Hyuk;Kwun, Koing-Woo;Kim, Shin-Kun;Lee, Sang-Wook;Shin, Dong-Kyu;Kim, Kyung-Min
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.47-54
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    • 2002
  • Purpose : We evaluated clinical result of arthroscopic and open Bankart repair in anterior shoulder instability to identify factors iuluencing operative result and prognosis. Materials & Methods . We reviewed 24 patients of anterior shoulder instability treated with arthroscopic Bankart repair in 16 cases and open Bankart repair in 8 cases. Average age was 26 years old and involved in dominant arm in 15 cases. Patients were suffered instability for 3.1 years before operation and mean follow-up was 2 year 9 months ( 1 you 9 months -4year 10 months). Results : Post operative pain was subsided in 2 weeks in arthroscopic surgery and 3 weeks in open surgery. The final range of motion after arthroscopic repair were flekion in 168" , external rotation in 54" , and internal rotation in 79, and after open repair 168" ,49" , and 78 respectively. In arthroscopic surgery,2 cases (13%) were redislocated, and 4 cases(25%) showed mild instability. In open case,1 case (11%) showed mild instability. According to function- al result by Rowe grading scale, satisfactory results were 12case (76%) in arthroscopic repair and 7 cases (88%) in open cases. Conclusions Both arthroscopic or open Bankart could get good results in the treatment of anterior instability of shoulder. In arthroscopic repair, perioperative morbidity was lower than open repair, but it needs careful rehabilitation program to prevent redislocation and to return to sports activity.