• Title/Summary/Keyword: limb weakness

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Steroid Induced Myopathy in Dermatomyositis Patients (피부근염 환자에서 발생한 스테로이드 유발 위축)

  • Yun, Sang Moon;Kim, Kyung Ah;Kim, Yoon;Hwang, Ji Hye
    • Clinical Pain
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    • v.18 no.1
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    • pp.48-51
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    • 2019
  • Symmetrical proximal weakness and characteristic dermatologic manifestations are important in the diagnosis of dermatomyositis. We report a case of atypical presentation of dermatomyositis due to previous steroid use and also report steroid-induced myopathy which may occur from steroid administration during the course of treatment. A 77-year-old man, previous steroid user, showed rapidly progressing weakness after abruptly stopped medication. He has presented erythematous papule on face and anterior chest but no heliotrope rash and Gottron's papules were observed. Muscle enzyme (creatine kinase) concentration is increased, and needle electromyography shows increased spontaneous activity on proximal limb muscle. The muscle biopsy confirmed dermatomyositis. During the course of treatment, he revealed persistent weakness despite the continuous steroid use and stable creatine kinase level. Electrodiagnostic study suggests steroid-induced myopathy and after tapering steroid, proximal muscle strength improved. This case reports the effect of steroid use on dermatomyositis patients and a process of diagnosing coexisting steroid induced myopathy during treatment.

Dermatomyositis sine dermatitis, a rare phenotype of idiopathic inflammatory myopathy

  • Park, Jin-Sung;Park, Ji-Young
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.137-139
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    • 2017
  • Dermatomyositis (DM) is characterized by progressive proximal limb weakness and typical skin manifestations. The histological findings that show perifascicular atrophy and deposition of membrane attack complex are pathognomic features of DM. Dermatomyositis is categorized into classical DM and non-classical DM, which includes amyopathic DM and DM sine dermatitis. DM sine dermatitis is seldom described because of its rarity, making the diagnosis more challenging. We report a case of DM sine dermatitis, a rare phenotype of DM.

Development of 4-Bar Linkage Orthotic Knee Joint (4절 연쇄 보조기무릎관절의 개발)

  • Kim, Jang-Hwan;Yi, Jin-Bock
    • The Journal of the Korea Contents Association
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    • v.11 no.12
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    • pp.317-325
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    • 2011
  • This study aims to develop the stance-control typed 4-bar linkage orthotic knee joint that replace the locked orthotic knee joint for the disabled with poliomyelitis and muscle weakness of lower limb. Unlike the existing stance-control orthotic knee joint, there are no needs of electric power, connecting circuit, bulky compomnets, etc, because this 4-bar linkage orthotic knee joint is controled by geometric locking. To evaluate the 4-bar linkage orthotic knee joint, a subject participated in this study who has been diagnosed with lower limb poliomyelitis and have used locked type orthotic knee joint. In the results of analysis of subject's gait using 3-dimentional motion analysis system, this 4-bar linkage orthotic knee joint provide the stability during stance phase and knee flexion during swing phase.

Elevated Blood Urea Nitrogen/Creatinine Ratio Is Associated with Venous Thromboembolism in Patients with Acute Ischemic Stroke

  • Kim, Hoon;Lee, Kiwon;Choi, Huimahn A.;Samuel, Sophie;Park, Jung Hyn;Jo, Kwang Wook
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.620-626
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    • 2017
  • Objective : Although venous thromboembolism (VTE) is frequently related to dehydration, the impact of dehydration on VTE in acute ischemic stroke (AIS) is not clear. This study investigated whether dehydration, as measured by blood urea nitrogen (BUN)/creatinine (Cr) ratio, influences the occurrence of VTE in patients with AIS. Methods : This is a retrospective study of patients with AIS between January 2012 and December 2013. Patients with newly diagnosed AIS who experienced prolonged hospitalization for at least 4 weeks were included in this study. Results : Of 182 patients included in this study, 17 (9.3%) suffered VTE during the follow-up period; in two cases, VTE was accompanied by deep vein thrombosis and pulmonary embolism. Patients with VTE were more frequently female and had higher National Institutes of Health Stroke Scale (NIHSS) score, more lower limb weakness, and elevated blood urea nitrogen BUN/Cr ratio on admission. In a multivariate analysis, BUN/Cr ratio >15 (odds ratio [OR] 8.75) and severe lower limb weakness (OR 4.38) were independent risk factors for VTE. Conclusion : Dehydration on admission in cases of AIS might be a significant independent risk factor for VTE.

A Case of a Postzoster Femoral Nerve Palsy Patient with Weakness of the Right Lower Limb Treated with Korean Medicine (우하지 소력감을 호소하는 대상포진 후 대퇴신경마비 환자 치험 1례)

  • Yang, Jung-yun;Park, Min-jeong;Kim, Soo-hyun;Cho, Ki-ho;Mun, Sang-kwan;Kwon, Seung-won;Jung, Woo-sang
    • The Journal of Internal Korean Medicine
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    • v.39 no.2
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    • pp.192-200
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    • 2018
  • Objective: The purpose of this clinical study is to report the case of a 79-year-old man with weakness of the right lower limb due to postzoster femoral nerve palsy. Methods: A patient was treated with Korean medicine, including herbal medication, acupuncture, electro-acupuncture, and bee-venom, during 17 days of hospitalization. We evaluated the improvements of symptoms using manual muscle testing (MMT) and measuring the change in walking distance. Results: After 17 days of Korean medicine treatment, there was improvement in the patient's symptoms. MMT improved from 3- to 5, and walking distance improved from 2 spaces to 120 spaces. Conclusions: This study suggested that Korean medical treatment might be effective in the patient's recovery from postzoster femoral nerve palsy.

A Case of Acquired Myasthenia Gravis in German Shepherd Dog (개에서 발생한 후천성 중증근육무력증 일례)

  • Lee Sang-Gwan;Hoh Woo-Pil;Kim Youn-Ju;Kim Tae-Wan;Yoo Jong-Hyun;Eom Ki-Dong;Oh Tae-Ho;Lee Keun-Woo
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.392-395
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    • 2005
  • A three-year old intact female German shepherd dog weighing 32kg was presented with the history of regurgitation and vomiting. Physical examination revealed a thin body condition, hoarse voice, hypersalivation, and pelvic limb weakness. In radiograph, meagaesophagus was identified. The neostigmine challenge test was positive. The titer of acetylcholine receptor (AChR) antibody was 1.58 nmol/L (reference range, <0.6nmol). Therefore, the dog was diagnosed to be suffering with chronic generalized form of acquired myasthenia gravis and followed by treatment with pyridostigmine bromide, 1mg/kg, q12 hrs. Treatment improved the pelvic limb weakness, however intermittent regurgitation and vomiting persisted. This resulted in aspiration pneumonia f3r which antibiotics were administered However, the dog was euthanized due to poor management and owner's request.

Risk Factors for Hip Fracture among the Elderly (노인들의 고관절골절 위험요인에 관한 환자-대조군 연구)

  • Kim, Yong-Kwon;Cho, Young-Ha
    • Journal of Korean Physical Therapy Science
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    • v.9 no.1
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    • pp.25-36
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    • 2002
  • Objectives: This study was conducted to find out risk factors related to elderly hip fracture, so that the result could provide basic data to establish prevention programs for hip fracture among the elderly. Methods: The data were collected from 199 cases hospitalized in 4 university hospitals in Pusan from January, 1996 to December, 1998, 193 healthy controls who visited elderly facilities in Pusan. The data were obtained from medical records and by using questionnaires through telephone contact or direct personal interview with the subjects or their family, and were analyzed for 2-test and multiple logistic regression. The risk factors were shown with odds ratios and their 95% confidence intervals. Results: In univariate analysis, the odds ratio of hip fracture risk was estimated to be 1.9 for the elderly aged 75 years as compare with those aging less than 65 years; 42 for those with job as compared with those without job; 3.3 for those with more than 6 children as compared with those with one or two children. For the variables related to physical characteristics, small height (p=0.015), light weight (p=0.000), and low BMI (p=0.014) were risk factors for elderly hip fracture. Sane variables related to health, such as previous history of illness (OR=3.3.), abnormal blood pressure (OR=1.6), previous fracture history (OR=22), lower limbs weakness (OR=12.1) and gait disturbance (OR=42.6), were significantly associated with the risk of hip fracture. In multiple logistic regression, risk factors for hip fracture were age, having job, lower limb weakness and previous history of illness. The adjusted odds ratios of hip fracture risk among the elderly were age (OR=1.1), having jobs (OR=11.7), weak lower limb (OR=10.8) and previous history of illnesses (OR=3.3), respectively. Conclusion: This study suggests that the plan for improving the daily living environment for the elderly systematically should be implemented to avoid the chances of fall, and that programs encouraging to practice regular exercise for physical activity and to promote health of the elderly should be developed.

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Effect of Trigger Finger on Pain, Grip Strength and Function of Upper Limb of Patients with Carpal Tunnel Syndrome: A Cross-sectional Study (방아쇠수지가 손목터널증후군 환자의 악력, 통증 및 상지기능에 미치는 영향: 단면적 연구)

  • Kim, Myoung-Kwon;Yun, Da-Eun
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.1
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    • pp.63-71
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    • 2021
  • PURPOSE: The purpose of this study was to investigate the effects of trigger finger on pain, muscle strength and function in carpal tunnel syndrome (CTS) patients. METHODS: A total of 60 subjects (30 carpal tunnel syndrome with trigger finger and 30 carpal tunnel syndrome without trigger finger) were assessment for pain, muscle strength (power grip, key pinch , tip to tip pinch, three jaw pinch) and function. The effect sizes of the two groups were compared, and the correlation between the trigger finger and each variable was analyzed. RESULTS: The results showed that there were significantly difference in the pain, muscle strength excluding three jaw pinch and function (p < .05). The results also showed correlation between trigger finger and pain (r = .552), muscle strength excluding three jaw pinch (power grip r = -.296, key pinch r = -.260, tip to tip pinch r = -.285), and function (r = .375). The function of carpal tunnel syndrome patients was related to pain (r = .550) and power grips (r = -.324) of muscle strength. CONCLUSION: In carpal tunnel syndrome patients with trigger finger compared to carpal tunnel syndrome, muscle weakness, pain increase, and function reduction were shown. In addition, trigger finger are correlated with muscle strength, pain and function, and muscle weakness and increased pain affect the daily living of carpal tunnel syndrome patients with triggers finger. Therefore, physical therapy interventions of carpal tunnel syndrome patients with trigger finger should be combined with treatment for muscle strength enhancement as well as pain reduction.

A Case Report of a Subarachnoid Hemorrhage Patient whose Paresthesia Improved by Ssanghap-tang (쌍합탕 투약 후 수족부 저림증이 호전된 지주막하출혈 환자 증례보고)

  • Hong, Seungcheol;Min, Seonwoo;Moon, Jiseong;Kim, Hakkyeom;Kim, Youngji;Song, Juyeon;Ahn, Lib;Shin, Gil-cho;Choi, Dong-jun
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.21 no.1
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    • pp.77-84
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    • 2020
  • ■ Objectives This case is to report the effect of Ssanghap-tang on paresthesia of a subarachnoid hemorrhage patient. ■ Methods A male Korean patient was treated with Ssanghap-tang and acupuncture, moxibustion for total 30 days. We observed limbs numbness, circumferences, other symptoms such as weakness and any adverse event. ■ Results After treatment, numeric rating scale of limb numbness was improved to 5 from 8 at admission without any adverse event. However, we could not find any significant differences on hand circumference and limb weakness. ■ Conclusion This case suggests that Ssanghap-tang and acupuncture, moxibustion therapy could be effective in improving paresthesia of subarachnoid hemorrhage patient.

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A Clinical Case Study of Guillain-Barré Syndrome with Chronic Progression (만성적 경과관찰을 보이는 Guillain-Barré Syndrome 환자 1례)

  • Roh, Ji-ae;Jang, Jae-won;Lee, Gi-eon;Hong, Jung-soo;Kim, Dong-jin
    • The Journal of Internal Korean Medicine
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    • v.39 no.1
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    • pp.76-83
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    • 2018
  • Objectives: This case study reports on one patient presenting atypical and chronic disorders after being diagnosed with $Guillain-Barr{\acute{e}}$ Syndrome (GBS). Methods: One patient was treated by Yeongseonjetong-eum-gami, Taklisodok-eum-gami, electroacupuncture, and physical therapy. Any improvement in symptoms was assessed by measuring changes in the motor grade of upper limb weakness, the numerical rating scale (NRS) of lower limb numbness, and GBS scores. Results: After 24 days of treatment, the patient's symptoms of GBS showed little improvement. Conclusions: Traditional Korean medical treatment appeared to be effective in reducing GBS symptoms, but more research is required to confirm these results. When treating GBS patients, the clinician should put effort into distinguishing GBS from other nervous disorders, such as acute onset Chronic Inflammatory Demyelinating Polyneuropathy (CIDP).