• Title/Summary/Keyword: Leg weakness

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Review on the Jaeumkangwha-tang in Hyungsang Medicine (자음항화탕의 형상의학적 고찰)

  • Jung Heung Shik;Kang Kyung Hwa;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.4
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    • pp.982-989
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    • 2004
  • The following is the conclusion drawn from a review on the clinical cases cured by Jaeumkangwha-tang in perspective of Hyungsang medicine. Jaeumkangwha-tang originated from the modified Jibaiksamul-tang in 'Manbyunghuichun(萬病回春)' and applied to the diseases induced by flaming fire due to deficiency of Yin. In 'Donguibogam', there are two kinds of Jaeumkangwha-tang. One in the chapter of kidney is mainly prescribed to replenish the Jung of kidney and applicable to the cases with configuration and symptom of kidney along with fire. The other one in the chapter of fire is applied to the symptoms of flaming fire due to deficiency of Yin. The characteristics of the patients treated by Jaeumkangwha-tang from the viewpoint of Hyungsang medicine can be classified as follows : ① configuration: Dam type, Shin type, inverted triangular type(:天垂象), bird type, round eyes, thin lips, slender waist, thin leg, pretty face, sparkling eyes, prominent upper lip and upward eyes and nose. ② color : dark red complexion, red cheek bone, red lips and red glabella. ③ pulse : fine and fast pulse and pulsation on the Chuk(尺) in man and so forth. ④ symptoms: agility, talkativeness, pimpled face, crooked back, weakness to the heat of summer, light eating, timidity, blood-shot eyes, night sweat, cough, abundant phlegm, hemoptysis, bloody spittle, enervation, emaciation, back pain, flaccidity of lower limbs, involuntary emission, nocturnal emission, heat sensation in the chest palms and soles, anger, flush on cheek bone, red lips and dry mouth, reddish tongue, stiff excrement, scanty yellow urine, etc.

Clinical Outcome after Early Rehabilitation according to Injury Type in Ankle Fracture (족관절 골절 형태에 따른 조기 재활의 임상결과)

  • Song, Joong Won;Lee, Ho Seong;Seo, Sang Gyo;Ryu, Chang Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.21-26
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    • 2017
  • Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

Lateral Lumbar Interbody Fusion and in Situ Screw Fixation for Rostral Adjacent Segment Stenosis of the Lumbar Spine

  • Choi, Young Hoon;Kwon, Shin Won;Moon, Jung Hyeon;Kim, Chi Heon;Chung, Chun Kee;Park, Sung Bae;Heo, Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.755-762
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    • 2017
  • Objective : The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. Methods : The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Results : The median follow-up period was 13 months (range, 3-48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved (p<0.05). In the radiological analysis, both the segmental angle at the operated segment and anterior disc height were significantly increased. At 6 months postoperatively, solid bony fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. Conclusion : This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.

Guillain-Barré Syndrome Caused by Influenza Virus (인플루엔자 바이러스로 인한 길랭-바레 증후군 1예)

  • Choi, Hyun Gil;Yeon, Gyu-Min
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.236-239
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    • 2016
  • $Guillain-Barr{\acute{e}}$ syndrome (GBS) is caused by antecedent infectious diseases in approximately two-thirds of cases. GBS is considered an autoimmune response. Among reported preceding infections, influenza virus is relatively rare. Several reports have identified antibodies related to GBS pathogenesis. However, no case report has described the detection of influenza virus in the cerebrospinal fluid (CSF) of a patient with GBS by polymerase chain reaction (PCR). Here we report the case of a 6-year-old girl who was diagnosed with influenza A 1 week prior and was treated with oseltamivir, after which she visited our hospital for headache and bilateral leg weakness that had persisted for 1 day. We diagnosed her with GBS based on physical and neurologic examination findings, CSF analysis, nerve conduction velocity test results, spinal magnetic resonance imaging, and detection of influenza A virus in her CSF by PCR. She was treated with intravenous immunoglobulin and her symptoms slowly improved. This case report suggests that GBS may be caused by influenza virus through penetration of the CSF.

Pathophysiology of orthostatic tremor: a multiple case study (길입성 진전의 병태생리: 다증 증례 연구)

  • Seo, Man-Wook;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.44-50
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    • 2002
  • Introduction : Orthostatic tremor develops in the legs while standing up with no weakness, pain or imbalance in the leg and the tremor is characteristically not observed when walking. However there have been some confusions about orthostatic tremor in several aspects. For the past ten years, we have observed 4 patients with orthostatic tremor. In each case tests were performed to investigate the following three important areas of inquiry about orthostatic tremor. Firstly, whether this disorder is an independent diagnostic entity or a variant of essential tremor. Secondly, whether the progress of this disorder is specifically related with standing posture. Lastly, the nature of the pathophysiologic mechanism behind the appearance of the tremor when standing after the lapse of a certain latent period and its disappearance upon the commencement of walking. Methods : Our 4 cases of orthostatic tremor were studied clinically, electrophysiologically, and pharmacologically. Electrophysiological tests included tremor spectrum test and electromyography. Results : We observed the presence of this tremor in several other tonic postures, as well as its absence, in a vertically lifted position from all our cases. Our cases registered a variable tremor frequency between 5 and 12 Hz according to the tremor spectrum test and EMG. Furthermore all our 4 cases demonstrated patterns of both synchronous EMG activity and alternating EMG activity at various times in homologous muscles of both legs. Orthostatic tremor was improved significantly with propranolol as well as clonazepam. Conclusions : From the results of our study we drew the following conclusions. It is probable that orthostatic tremor is simply a variant of essential tremor rather than being an independent diagnostic entity and that in most cases its development is specifically related with muscle contraction rather than merely with the act of standing. Furthermore we discovered a clue in the previously described neural control mechanism that the nuclear bag fibers in the muscle spindle have lag time of several seconds in their response to muscle strength and that their baseline does not reset fully in rapidly moving muscle. This neural control mechanism could offer sufficient explanation for the phenomena of tremor appearance when standing and disappearance when walking in orthostatic tremor.

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A Case of Basaloid Squamous Cell Lung Carcinoma in an 11-year-old Boy (11세 남아의 기저세포양 편평상피세포폐암 1례)

  • Kim, Nyeon Cheon;Kim, Seung Soo;Seo, Won Suk;Park, Kyeong Bae;Park, Joon Soo;Shin, Sang Mann;Cho, Hyun Deuk
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.208-211
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    • 2005
  • Primary lung cancer is unusual in children; the squamous cell variant is extremely rare. Lung cancer is classified by histologic types into small-cell lung cancer, non-small cell lung caner, carcinoid, mucoepidermoid carcinoma, and adenoid cystic carcinoma. Furthermore, non-small cell lung cancer is subclassified into adenocarcinoma, large-cell carcinoma, and squamous cell carcinoma. The incidence of lung cancer is influenced by smoking, especially in squamous cell carcinoma, and large cell carcinoma. The present treatments for these tumors are chemotherapy, radiation therapy, and surgical resection depending on their histologic types or stages, but yield very poor survival rates. In this article, we report a case of basaloid squamous cell lung carcinoma in an 11-year-old boy who had symptoms of both leg weakness and back pain radiating to both legs. We confirmed the primary lung carcinoma cells by percutaneous transthoracic needle biopsy. The metastatic carcinoma cells were identified at the bone marrow and lumbar spine. We treated with a combination chemotherapy and radiation therapy. However, he expired 4 months after the onset of disease.

An Observation of the Chief Complaints of Pediatric Outpatients (소아(小兒) 외래환자(外來患者)의 주소증(主所症)에 관한 임상적(臨床的) 고찰(考察))

  • Lee Seung-Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.203-216
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    • 2001
  • Objective : The purpose of this study is to investigite the more effective oriental medical treatment in pediatric diseases and its clinical applicability and chief complaints at oriental pediatrics in an area of busan and kyeungnam. Method : 884 new patients of theirs ages between 0 term 20 years who were treated at the pediatrics in Dong-Eui Oriental Medicine Busan Hospital from 1. 2000 to 29. Feb. 2001 Result : 1. The number of male cases was 514 (58%) and female cases 370 (42%) an so male cases 1.38 more than female. In age distribution, 0-1year: 242 patients(27.4%), 2-6years: 455 patients(51.4%), 7-20years: 187 patients(21.2%). 2. The Chief Complaint according to systemical division was Resparatory diseases (37.4%) for common cold, chronic cought, take a easy cold etc and the Digestive diseases(23.6%) for anorexia, diarrhea, abdominal pain etc and Nervous also Mental(11.8%) diseases for sezure, tic, etc and Allergic diseases(6.2%) for atopic dermititis, allergic rhinitis, etc and Physique diseases(5.4%) for short stature, leg pain, etc and Genaral symptoms(4.5%) for sweat profusely, headache, etc and Urinary diseases(3.3%) for bed wetting, frequently voiding, etc Discussion : 1. The Chief Complaint cannot be found a regional specificity 2. The oriental medicine treatment was still congnated as a way to improve the weakness by patients, also was widely noised about preventive medicine. In particular, Respiratory and Disestive diseases are dependent on the oriental medicine. 3. The new diseases and the new treatment method should be investigated as field of oriental medical treatment.

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Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients (일개 종합병원 입원환자의 낙상관련 특성 및 낙상발생 예측요인)

  • Choi, Eun-Ju;Lee, Young-Shin;Yang, Eun-Jung;Kim, Ji-Hui;Kim, Yeon-Hee;Park, Hyeoun-Ae
    • Journal of Korean Academy of Nursing
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    • v.47 no.3
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    • pp.420-430
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    • 2017
  • Purpose: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. Methods: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. Results: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. Conclusion: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

The Influence of Scapular-Pelvic Patterns of Proprioceptive Neuromuscular Facilitation on Hemiplegic Gait -A Case Report- (PNF 어깨뼈-골반 패턴이 편마비 환자의 보행에 미치는 영향 -증례보고-)

  • Choi, Jae-Won;Hwang, Sin-Pil
    • PNF and Movement
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    • v.16 no.1
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    • pp.27-32
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    • 2018
  • Purpose: This study examined changes in gait speed and stride length after an intervention involving simultaneous scapular and pelvic patterns of proprioceptive neuromuscular facilitation in a hemiplegic patient. Methods: A 58-year-old woman with left hemiplegia who had complained of slowness of gait speed and weakness of leg strength took part in an intervention involving scapular postdepression patterns on the affected side and pelvic postdepression patterns on the nonaffected side. The intervention was performed with the patient lying on her left side, in a half kneeling position, and in a standing posture. Rhythmic initiation was used for teaching the movements to the patient and improvement of kinesthesia, and a combination of isotonic was employed for increasing strength and irradiation of the scapula and pelvic movement. The intervention took place for 30 min. It was implemented twice a day, 5 days a week, for 3 weeks. After three repetitions, the average time taken to complete the 10-m walk test (10 MWT), in addition to stride length, was measured to determine gait speed. Results: After the 3-week program, the patient's performance in the 10 MWT improved from 21.7sec to 17.1sec, and her stride length improved from 31.4cm to 38.7cm. Conclusion: The results showed that trunk movement exercise, especially coordinative movements of the scapula and pelvis can improve gait speed and stride length by increasing trunk stability and mobility. A combination of pelvic and scapular patterns can facilitate trunk rotation, thereby improving gait speed and stride length.

The Clinical Study of Lumbar Spinal Stenosis in Oriental Medical Hospital (요추관협착증의 한의학적 보존적 치료에 대한 임상적 고찰)

  • Hwang, Jae-Yeon;Do, Won-Seok
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.116-124
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    • 2000
  • This clinical study was carried out 15 cases with lumbar spinal stenosis patients, who had been admitted and diagnosed by Computed Tomography from June, 1999 to May, 2000, in the department of acupuncture and moxibustion. Hanseo University Oriental Medical Nospital. The results obtained from this study were as follows; 1. We investigated 10 female and 5 male patients. The age distribution was from early 20's to 70's, among which 30's and 50's were most common. 2. The most common duration of symptom was less than a year(46.7%). 3. Regarding to the number of the involved levels, one was 12 cases(80%), two was 3 cases(20.0%). In the one level cases, L4~5 was the most common involved site. 4. Regarding to the clinical symptoms, low back pain was the most common, followed by lower extremity radiating pain, intermittent claudication, lower extremity paresthesia. 5. In orthopaedic examinations, positive sign in Milgram test was 80.0%, positive sign in straight leg raising test was 40.0%, and positive sign in Braggard test was 33.3%. Inneurologic examinations, sensory loss was seen in 60.0%, motor weakness and decreased deep tendon reflex were 26.7% in each. 6. According to clinical symptom scale proposed by Chae(1989), grade I1I was the most common (53.3%), followed by grade II, grade IV, grade I . 7. According to treatment outcome scale proposed by Chae(1989), Good was the most common (73.3%), followed by Excelleat, Fair and Poor.

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