• Title/Summary/Keyword: Motor grade

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Massive traumatic abdominal wall hernia in pediatric multitrauma in Australia: a case report

  • Sarah Douglas-Seidl;Camille Wu
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.447-450
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    • 2023
  • Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.

A Survey on the Attitude of Grade-schoolers Without Disabilities Toward Children With Disabilities (초등학교 고학년 학생의 장애아동에 대한 인식 조사)

  • Kim, Bo-Ram;Kim, Ho-Young;Son, You-Ra;Oh, Jin-Ju;Yoon, Seul-Ki;Lee, Hyo-Jeong;Chang, Moon-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.1
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    • pp.1-9
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    • 2011
  • Objective : The purpose of this study was to investigate attitude of grade-schoolers toward children with disabilities. Methods : The subjects of this study were grade-schoolers who have not received an inclusive education in Gim-hae. The study was surveyed from October second to 17th in 2008. The survey was categorized into three parts; comradeship, activity, and study. Each part of the survey consists of 10 questions. Data were analyzed by SPSS (version 12.0). Results : The results were as follows; First, the attitude of girls toward disabled students was non-significant compared to boys. Second, the order of attitude degree in grade of students was 4, 6, and 5. The attitude toward children with disabilities showed statistically significant difference according to grade(F=3.546, p<0.05). Third, the attitude of students who have experience of contact with people with disabilities was non-significant compared to non-experienced students. Conclusion : In conclusion, therefore peer groups in lower class levels showed more positive attitude toward the children with disabilities. The result will be useful information for understanding disabled children and making positive attitude. Also it is expected that occupational therapists help disabled children to participate in school life successfully using these information.

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Analysis of the Outcomes of Surgically-Treated Spinal Epidural Hematomas (척추 경막외 출혈에 대한 수술적 치료성적 분석)

  • Cho, Young-Hyun;Park, Jin-Hoon;Kim, Ji-Hoon;Roh, Sung-Woo;Kim, Chang-Jin;Jeon, Sang-Ryong
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.163-169
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    • 2010
  • Purpose: Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH. Methods: We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively. Results: Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device. Conclusion: Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.

Case Study : Effects of Acupuncture and Electro-acupuncture on a Patient with Sequelae Caused by Removal of Facial Schwannoma (안면신경초종 수술 후유증 환자에 대한 침 및 침전기 자극술의 효과)

  • Lee, Sang Young;Wang, Gong Duk;Sul, Jae Uk;Kang, Hwi Joong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.3
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    • pp.327-330
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    • 2013
  • The purpose of this study is to report a clinical progress of treatment of sequelae caused by removal of facial schwannoma through Korean medicine. A patient was diagnosed with facial schwannoma by MRI on 4th June 2012 in local university hospital, he had right facial palsy, auditory hypersensitivity, dizziness after removal of facial schwannoma. Between 25th July 2012 and 26th January 2013, he was treated with acupuncture, cupping, electro-acupuncture every week and observed by House-Brackmann facial nerve grading system(H-B scale) and MoReSS every month. He had 29 times treatments. At the first of treatment, his state was Grade IV (H-B scale), 4/8(facial nerve grading), 10 points during action 7 points during rest(MoReSS) and he had severe facial palsy, ill-acrimation, auditory hypersensitivity. At the middle of treatment, October 2012, symptoms improved. State was Grade III (H-B scale), 5/8(facial nerve grading), 7 points during action 3 points during rest(MoReSS). Severe facial palsy improved ; Forehead creasing and union motor function recovered, he was able to close his eyes so ill-acrimation improved. At the end of treatment, January 2012, state was Grade II (H-B scale), 7.5/8(facial nerve grading), 3 points during action 1 point during rest(MoReSS). He had only occasional tinnitus and auditory hypersensitivity. Acupuncture and electro-acupuncture are estimated to be good for facial palsy after removal of facial schwannoma. More cases are required to develop treatment of facial palsy.

Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome

  • Cho, Yong-Jun;Cho, Sung-Min;Sheen, Seung-Hoon;Choi, Jong-Hun;Huh, Dong-Hwa;Song, Joon-Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.382-387
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    • 2007
  • Objective : Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients. Methods : According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less). Results : Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbow-below the elbow) was $41.8{\pm}15.2\;m/s$ and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment ($57.8{\pm}6.9\;m/s$) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from $39.8{\pm}12.1\;m/s$ to $47.8{\pm}12.1\;m/s$ (p<0.05). After an average follow-up of $4.8{\pm}5.3$ months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve. Conclusion : Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.

Eco-driving Method at Highway including Grade using GPS Altitude data (GPS 고도 데이터를 이용한 경사가 있는 고속국도에서 에코드라이빙 방안)

  • Choi, Seong-Cheol
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.19-25
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    • 2011
  • A vehicle fuel economy is very important issue in view of fuel cost and environmental regulation. The technology development for the fuel economy improvement improved the engine, power train and many components of vehicle. So, the fuel economy is much improved, but up to now the measurement of it tests the given mode(LA-4, FTP-75, etc) within computer simulation program and engine dynamo. In this paper, to deduct the method of its improvement of real road, the test vehicle ran 213Km Youngdong real highway using 3 different algorithms in computer simulation. For this, I extracted the distance and altitude data from received GPS data and calculated the grade angle, road load and accomplished the velocity profiles according to algorithms in all 213Km distance. The vehicle runs in computer with AVL Cruise simulation program using velocity profile. I calculate the fuel economy using AVL Cruise simulation result and propose the Eco-driving method of them.

Development of a Machine-Learning Predictive Model for First-Grade Children at Risk for ADHD (머신러닝 분석을 활용한 초등학교 1학년 ADHD 위험군 아동 종단 예측모형 개발)

  • Lee, Dongmee;Jang, Hye In;Kim, Ho Jung;Bae, Jin;Park, Ju Hee
    • Korean Journal of Childcare and Education
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    • v.17 no.5
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    • pp.83-103
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    • 2021
  • Objective: This study aimed to develop a longitudinal predictive model that identifies first-grade children who are at risk for ADHD and to investigate the factors that predict the probability of belonging to the at-risk group for ADHD by using machine learning. Methods: The data of 1,445 first-grade children from the 1st, 3rd, 6th, 7th, and 8th waves of the Korean Children's Panel were analyzed. The output factors were the at-risk and non-risk group for ADHD divided by the CBCL DSM-ADHD scale. Prenatal as well as developmental factors during infancy and early childhood were used as input factors. Results: The model that best classifies the at-risk and the non-risk group for ADHD was the LASSO model. The input factors which increased the probability of being in the at-risk group for ADHD were temperament of negative emotionality, communication abilities, gross motor skills, social competences, and academic readiness. Conclusion/Implications: The outcomes indicate that children who showed specific risk indicators during infancy and early childhood are likely to be classified as being at risk for ADHD when entering elementary schools. The results may enable parents and clinicians to identify children with ADHD early by observing early signs and thus provide interventions as early as possible.

The Role of Radiation Therapy in the Treatment of Intracranial Glioma : Retrospective Analysis of 96 Cases (뇌 교종 96예에 대한 방사선치료 성적의 후향적 분석)

  • Kim Yeon Sil;Kang Ki Mun;Choi Byung Ock;Yoon Sei Chul;Shinn Kyung Sub;Kang Jun Gi
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.249-258
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    • 1993
  • Between March 1983 and December 1989, ninety-six patients with intracranial glioma were treated in the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. We retrospectively reviewed each case to evaluate variable factors influencing the treatment results and to develop an optimal therapy Policy. Median follow-up is 57 months (range: 31~133 months). Of the 96 patients, 60 $(63\%)$ were males and 36 $(37\%)$ were females. Ages ranged from 3 to 69 years (median 42 years). The most common presenting symtoms were headeche $(67\%)$ followed by cerebral motor and sensory discrepancy $(54\%),$ nausea and vomiting $(34\%),$ seizure $(19\%),$ mental change $(10\%)$ and memory and calculation impairment $(8\%).$ Eighty five $(88.5\%)$ patients all, except 11 $(11.5\%)$ brain stem lesions, were biopsy proven intracranial glioma. The distribution by histologic type was 64 astrocytomas $(75\%),$ 4 mixed oligoastrocytomas $(5\%),$ and 17 oligodendrogliomas $(20\%).$ Fourty nine patients $(58\%$ were grade I, II histology and 36 $(42\%)$ patients were grade III, IV histology. Of the 96 patients, 64 $(67\%)$ recieved postoperative RT and 32 $(33\%)$ were treated with primary radiotherapy. Gross total resection was peformed in 14 $(16\%)$ patients, subtotal resection En 29 $(34\%),$ partial resection in 21 $(25\%),$ and biopsy only in 21 $(25\%).$ Median survival time was 53 months (range 2~ 133 months), and 2- and, 5-year survival rate were $69\%,49\%$ respectively. 5-year survival rate by histologic grade was grade I, $70\%,$ grade II, $58\%,$ grade III, $28\%,$ and grade IV, $15\%.$ Multivariated analysis demonstrate that age at diagnosis (p=0.0121), Karnofsky performance Status (KPS) (p=0.0002), histologic grade (p=0.0001), postoperative radiation therapy (p=0.0278), surgical extent (p =0.024), cerebellar location of tumor (p=0.0095) were significant prognostic factors influencing on survival.

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Neuropsychologic Analysis of Acute Bell's Palsy (급성 벨마비 환자의 자가보고형 불안 및 우울평가)

  • Yoo, Ji-Hoon;Han, Woo-Ho;Lee, Dong-Kuck
    • Annals of Clinical Neurophysiology
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    • v.11 no.2
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    • pp.48-53
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    • 2009
  • Background: Bell's palsy produces a complex problem that involves not only facial motor weakness, but also psychiatric issues. However, the relationship between facial neuromotor system impairment and psychological adjustment has not been well understood. Methods: We have performed psychological evaluations in patients with acute unilateral Bell's palsy within 2 weeks after onset. Thirty patients with Bell's palsy (10 men, 20 women) were included, who were diagnosed by neurologic examination, electrophysiologic study and/or brain MRI. We measured facial motor scale of impairment (House-Brackmann, HB scale) and psychosocial adjustment [Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)] at the time of initial presentation and 1 month after diagnosis. Results: The age of the enrolled patients ranged from 16 to 80 years. The mean grade of initial and follow up HB scale were 3.87 (SD: 0.63, range 2~5) and 1.77 (SD: 1.10, range 1~5). The mean score of initial and follow up BAI, BDI were 11.93 (range; 0 to 47, SD: 9.65, very low anxiety), 14.73 (range; 0 to 41, SD: 9.21 minimal depression) and 7.5 (range; 0 to 36, SD: 8.58, very low anxiety), 9.33 (range; 0 to 30, SD: 8.19 minimal depression). There was positive correlation between improvement of HB scale and improvement of BAI and BDI score. Conclusions: Bell's palsy is associated with the psychological problems such as depression and anxiety, and the improvement of motor symptom is associated with the improvement of these psychological problems.

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Chordoid Meningioma

  • Choi, Kyung-Chul;Joo, Won-Il;Jang, Kyung-Sool;Kim, Moon-Chan
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.390-392
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    • 2005
  • A case of chordoid meningioma occurring in a 61-year-old woman who did not have a Castleman's disease is presented. The patient had suffered from headache and motor dysphasia. Laboratory findings are normal. The tumor, located in the left frontal region and associated with peritumoral edema, was totally resected. Surgical specimen revealed a solid mass with irregular surface that measured $3.5{\times}4.5{\times}4cm$. Immunohistochemical staining revealed that the tumor cells expressed epithelial membrane antigen[EMA] focally, but not S-100 protein and glial fibrillary acid protein [GFAP], and the Ki-67 proliferative index of the tumor was 9%. The neoplasm was diagnosed chordoid meningioma of the World Health Organization[WHO] grade II. After total resection, her preoperative headache and dysphasia were disappeared.