Zidan, Ihab;Khedr, Wael;Fayed, Ahmed Abdelaziz;Farhoud, Ahmed
Journal of Korean Neurosurgical Society
/
v.62
no.1
/
pp.61-70
/
2019
Objective : Corpectomy of the first lumbar vertebra (L1) for the management of different L1 pathologies can be performed using either an anterior or posterior approach. The aim of this study was to evaluate the usefulness of a retroperitoneal extrapleural approach through the twelfth rib for performing L1 corpectomy. Methods : Thirty consecutive patients underwent L1 corpectomy between 2010 and 2016. The retroperitoneal extrapleural approach through the 12th rib was used in all cases to perform single-stage anterior L1 corpectomy, reconstruction and anterior instrumentation, except for in two recurrent cases in which posterior fixation was added. Visual analogue scale (VAS) was used for pain intensity measurement and ASIA impairment scale for neurological assessment. The mean follow-up period was 14.5 months. Results : The sample included 18 males and 12 females, and the mean age was 40.3 years. Twenty patients (67%) had sensory or motor deficits before the surgery. The pathologies encountered included traumatic fracture in 12 cases, osteoporotic fracture in four cases, tumor in eight cases and spinal infection in the remaining six cases. The surgeries were performed from the left side, except in two cases. There was significant improvement of back pain and radicular pain as recorded by VAS. One patient exhibited postoperative neurological deterioration due to bone graft dislodgement. All patients with deficits at least partially improved after the surgery. During the follow-up, no hardware failures or losses of correction were detected. Conclusion : The retroperitoneal extrapleural approach through the 12th rib is a feasible approach for L1 corpectomy that can combine adequate decompression of the dural sac with effective biomechanical restoration of the compromised anterior loadbearing column. It is associated with less pulmonary complication, no need for chest tube, no abdominal distention and rapid recovery compared with other approaches.
Oh, Tae Suk;Kim, Hyung Bae;Choi, Jong Woo;Jeong, Woo Shik
Archives of Plastic Surgery
/
v.46
no.2
/
pp.122-128
/
2019
Background The masseter nerve is a useful donor nerve for reconstruction in patients with established facial palsy, with numerous advantages including low morbidity, a strong motor impulse, high reliability, and fast reinnervation. In this study, we assessed the results of masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients. Methods Ten patients with facial palsy who received treatment from January 2015 to January 2017 were enrolled in this study. Three patients received masseter nerve-only free gracilis transfer, and seven received double-innervated free gracilis transfer (masseter nerve and a cross-face nerve graft). Patients were evaluated using the Facial Assessment by Computer Evaluation software (FACEgram) to quantify oral commissure excursion and symmetry at rest and when smiling after muscle transfer. Results The mean time between surgery and initial movement was roughly 167.7 days. A statistically significant increase in excursion at rest and when smiling was seen after muscle transfer. There was a significant increase in the distance of oral commissure excursion at rest and when smiling. A statistically significant increase was observed in symmetry when smiling. Terzis' functional and aesthetic grading scores showed significant improvements postoperatively. Conclusions Masseter nerve innervation is a good option with many uses in in established facial palsy patients. For some conditions, it is the first-line treatment. Free gracilis muscle transfer using the masseter nerve has excellent results with good symmetry and an effective degree of recovery.
Neto, Pedro Henry;Ribeiro, Zamara Brandao;Pinho, Adriano Bastos;Almeida, Carlos Henrique Rodrigues de;Maranhao, Carlos Alberto de Albuquerque;Goncalves, Joaquim da Cunha Campos
Journal of Trauma and Injury
/
v.35
no.3
/
pp.209-214
/
2022
We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.
Kim, Chung Kwon;Park, Jee Soo;Kim, Eunji;Oh, Min-Kyun;Lee, Yong-Taek;Yoon, Kyung Jae;Joo, Kyeung Min;Lee, Kyunghoon;Park, Young Sook
BMB Reports
/
v.55
no.10
/
pp.512-517
/
2022
Traumatic brain injury (TBI) is brain damage which is caused by the impact of external mechanical forces. TBI can lead to the temporary or permanent impairment of physical and cognitive abilities, resulting in abnormal behavior. We recently observed that a single session of early exercise in animals with TBI improved their behavioral performance in the absence of other cognitive abnormalities. In the present study, we investigated the therapeutic effects of continuous exercise during the early stages of TBI in rats. We found that continuous low-intensity exercise in early-stage improves the locomotion recovery in the TBI of animal models; however, it does not significantly enhance short-term memory capabilities. Moreover, continuous early exercise not only reduces the protein expression of cerebral damage-related markers, such as Glial Fibrillary Acid Protein (GFAP), Neuron-Specific Enolase (NSE), S100β, Protein Gene Products 9.5 (PGP9.5), and Heat Shock Protein 70 (HSP70), but it also decreases the expression of apoptosis-related protein BAX and cleaved caspase 3. Furthermore, exercise training in animals with TBI decreases the microglia activation and the expression of inflammatory cytokines in the serum, such as CCL20, IL-13, IL-1α, and IL-1β. These findings thus demonstrate that early exercise therapy for TBI may be an effective strategy in improving physiological function, and that serum protein levels are useful biomarkers for the predicition of the effectiveness of early exercise therapy.
Endan Li;Jiwoo Choi;Hye-Ri Sim;Jiyeon Kim;Jae Hyun Jun;Jangbeen Kyung;Nina Ha;Semi Kim;Keun Ho Ryu;Seung Soo Chung;Hyun Sook Kim;Sungsu Lee;Wongi Seol;Jihwan Song
BMB Reports
/
v.56
no.3
/
pp.178-183
/
2023
Huntington's disease (HD) is a neurodegenerative disorder, of which pathogenesis is caused by a polyglutamine expansion in the amino-terminus of huntingtin gene that resulted in the aggregation of mutant HTT proteins. HD is characterized by progressive motor dysfunction, cognitive impairment and neuropsychiatric disturbances. Histone deacetylase 6 (HDAC6), a microtubule-associated deacetylase, has been shown to induce transport- and release-defect phenotypes in HD models, whilst treatment with HDAC6 inhibitors ameliorates the phenotypic effects of HD by increasing the levels of α-tubulin acetylation, as well as decreasing the accumulation of mutant huntingtin (mHTT) aggregates, suggesting HDAC6 inhibitor as a HD therapeutics. In this study, we employed in vitro neural stem cell (NSC) model and in vivo YAC128 transgenic (TG) mouse model of HD to test the effect of a novel HDAC6 selective inhibitor, CKD-504, developed by Chong Kun Dang (CKD Pharmaceutical Corp., Korea). We found that treatment of CKD-504 increased tubulin acetylation, microtubule stabilization, axonal transport, and the decrease of mutant huntingtin protein in vitro. From in vivo study, we observed CKD-504 improved the pathology of Huntington's disease: alleviated behavioral deficits, increased axonal transport and number of neurons, restored synaptic function in corticostriatal (CS) circuit, reduced mHTT accumulation, inflammation and tau hyperphosphorylation in YAC128 TG mouse model. These novel results highlight CKD-504 as a potential therapeutic strategy in HD.
Objective : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.
Ahmad Hammad Hassan;Aref-Ali Gharooni;Harry Mee;James Geffner;Fahim Anwar
Journal of Trauma and Injury
/
v.36
no.1
/
pp.39-48
/
2023
Purpose: Sports offer several health benefits but are not free of injury risk. Activity dynamics vary across sports, impacting the injury profile and thereby influencing healthcare resource utilization and health outcomes. The purpose of this study was to investigate sports-related major trauma cases and compare differences across sports and activity groups. Methods: A retrospective case notes review of sports-related major traumas over a 5-year period was conducted. Demographic, hospital episode-related, and health outcome-related data were analyzed, and differences were compared across sports and activity groups. The Glasgow Outcome Scale (GOS) at discharge was used as the primary outcome measure and the length of hospital stay as the secondary outcome measure. Results: In total, 76% of cases had good recovery at discharge (GOS, 5), 19% had moderate disability (GOS, 4), and 5% had severe disability (GOS, 3). The mean length of hospital stay was 11.2 days (range, 1-121 days). The most severely injured body region was the limbs (29.1%) and vertebral/spinal injuries were most common (33%) in terms of location. A significant difference (P<0.05) existed in GOS across sports groups, with motor sports having the lowest GOS. However, no significant differences (P>0.05) were found in other health-outcome variables or injury patterns across sports or activity groups, although more competitive sports cases (67%) required admission than recreational sports cases (33%). Conclusions: Spinal injuries are the most frequent sports injuries, bear the worst health outcomes, and warrant better preventive measures. Head injuries previously dominated the worst outcomes; this change is likely due to better preventive and management modalities. Competitive sports had a higher injury frequency than recreational sports, but no difference in health outcomes or injury patterns.
Background: Bupivacaine with fentanyl might be suitable as the spinal anesthesia for performing ambulatory surgery to treat varicose vein. Material and Method: Thirty patients who underwent spinal anesthesia for a varicose vein operation were enrolled in this study. They were classified into 2 groups of either fentanyl 25ug mixed with bupivacaine 4mg (group FB4) or bupivacaine 8mg (group B8). We compared the groups for the success of the analgesia, the recovery time from sensory and motor block, the side effects and the postoperative complications. Result: The groups did not differ significantly regarding the success of analgesia (13 of 15 [group FB4], 15 of 15 [group B8]). None of the patients were converted to general anesthesia due to surgical pain. None of the patients required medication for hypotension and/or bradycardia. The operative and nonoperative side effects of motor block (tested for by using a modified Bromage scale) was significantly lower in group FB4 than that in group B8, as checked at 2 hours after spinal anesthesia (p<0.05). Recovery from spinal block was significantly quicker in group FB4 than that in group B8 (p<0.05). The first voluntary micturition time did not differ significantly (6.5 hours v 4.5 hours [p=0.143]) between the groups, but a nelatone catheter was inserted into 2 of the group B8 patients due to dysuria. Conclusion: Adequate intraoperative analgesia and hemodynamic stability and faster mobilization were achieved using bupivacaine 4mg with fentanyl 25ug. Low dose spinal anesthesia with fentanyl is suitable for performing ambulatory surgery to treat varicose vein.
The Journal of Korean Academy of Sensory Integration
/
v.10
no.2
/
pp.11-22
/
2012
Objective : This research investigated the intervention effects, protocol of modified constraint-induced movement therapy in children with hemiplegic cerebral palsy. Methods : For the key words of a database search, "Cerebral Palsy", "Hemiplegia", "Constraint Induced Movement Therapy", "modified Constraint Induced Movement Therapy" were used. We examined papers published in journals from January 2001, when the modified Constraint Induced Movement Therapy was first suggested, to May 2011, using PubMed, Medline. Ovid. Results : A total of 10 papers were analyzed and results of modified Constraint Induced Movement Therapy were an effective therapeutic method to improve motor function, quality of movement and that they also increased the frequency of functional use of the affected hands of hemiplegic cerebral palsy. Conclusion : This paper conducted a systematic review of the research literature reporting on the effects of modified constraint-induced movement therapy in children with hemiplegic cerebral palsy. Analysis of the fewer number of papers, there was limitation that we consider studies at all levels of evidence. However the restraint methods should be decided according to the characteristics of the individually and apply a variety of therapeutic activities, there is positive support for the use of modified constraint-induced movement therapy to improve the recovery of the paretic upper extremity with cerebral palsy.
Skeletal muscle fatigue is often associated with diminished athletic performance and inability to maintain an expected force output as a function of time. The purpose of this study was to compare the effect of duration of exercise on skeletal muscle fatigue between Weight Lifters(WL) and Non-Weight Lifters(NWL). There were twelve normal healthy adult volunteers, ranging in age from 18 to 35 years. The group consisted of six NWL and six WL. Randomized cross-over design was set up and work-rest cycle was 8 minutes work and 1 minute rest based on 15% MVC. Muscle fatigue was measured by the amount of force produced by the wrist flexor muscle and EMG amplitude over time. Repeated measures ANOVAs($2{\times}4$) were used to determine two types of subjects(WL, NWL) during four different duration of exercises(16, 32, 48, 64 minutes). The force decreased over time in NWL and WL, but there was no significant difference(F=2.83, p>0.05). However, the EMG amplitude increased in WL(0.8200) and NWL(0.6348). The WL exhibited an increase in EMG at the end of the period, especially at 48 minutes of exercises than did the NWL(F=9.58, p<.05). This suggests the WL were able to adjust to prolonged effort with adaptations in neural effect over time, resulting in higher EMG amplitude. That is, WL may be able to learn to recruit more motor units with training. It is important to the degree of neuromuscular fatigue and the time needed for recovery may differ considerably between WL and NWL, there is a need to plan proper strength training or rehabilitation protocols to match with the requirements in different characteristics of groups.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.