• Physical Therapy Korea
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• v.10 no.2
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• pp.71-84
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• 2003

The purpose of this study was to provide information on driving characteristics in persons with spinal cord injury through basic statistic analysis of the survey results. The survey was administered to 44 drivers with spinal cord injury. The subjects' general, neurologic and driving characteristics were analyzed, as well as the degree of difficulty in using their vehicles between tetraplegia and paraplegia. The results were as follows: thirty-five (79.6%) of forty-four respondents was men. The average age was 35.0 years old and the age at the time of injury was 29.0 years old. Their neurologic characteristics were tetraplegics 12 (27.3%) and paraplegics 32 (72.2%). Among complete lesions, the highest level those who could drive independently was C7. All the vehicles were equipped with special devices, including "power steering", "automatic transmission" and "hand controls". The vehicles for cervical cord injury were equipped with "grip bars" as well as for the degree of difficulty in using their vehicles, all the subjects felt that "moving the wheelchair in and out of their vehicles" was too difficult for them to do. We suggest that the driver training should be an essential part of the rehabilitation program for patients with spinal cord injuries to maximize their mobility in the community. This training seems to be essential in order to modify the standards of the Handicapped Drivers Ability Test and to aid the driver rehabilitation program in the health insurance payment system. Also, the driver rehabilitation training program should include instruction in that moving wheelchairs in and out of vehicles.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.1-4
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• 2009

Objective: To report an unsuspected adaptive plasticity of single upper motor neurons and of primary motor cortex found after microsurgical connection of the spinal cord with peripheral nerve via grafts in paraplegics and focussed discussion of the reviewed literature. Methods: The research aimed at making paraplegics walk again, after 20 years of experimental surgery in animals. Amongst other things, animal experiments demonstrated the alteration of the motor endplates receptors from cholinergic to glutamatergic induced by connection with upper motor neurons. The same paradigm was successfully performed in paraplegic humans. The nerve grafts were put into the ventral-lateral spinal tract randomly, with out possibility of choosing the axons coming from different areas of the motor cortex. Results: The patient became able to selectively activate the re-innervated muscles she wanted without concurrent activities of other muscles connected with the same cortical areas. Conclusion: Authors believe that unlike in nerve or tendon transfers, where the whole cortical area corresponding to the transfer changes its function a phenomenon that we call "brain plasticity by areas". in our paradigm due to the direct connection of upper motor neurons with different peripheral nerves and muscles via nerve grafts motor learning occurs based on adaptive neuronal plasticity so that simultaneous contractions of other muscles are prevented. We propose to call it adaptive functional "plasticity by single neurons". We speculate that this phenomenon is due to the simultaneous activation of neurons spread in different cortical areas for a given specific movement, whilst the other neurons of the same areas connected with peripheral nerves of different muscles are not activated at the same time. Why different neurons of the same area fire at different times according to different voluntary demands remains to be discovered. We are committed to solve this enigma hereafter.

• Parasites, Hosts and Diseases
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• v.51 no.4
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• pp.453-459
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• 2013

Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was $40.9{\pm}18.8$ years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn't develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.527-530
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• 2014

Spinal subarachnoid hemorrhages (SAH) can extend into the intracranial subarachnoid space, but, severe cerebral vasospasm is rare complication of the extension of intracranial SAH from a spinal subarachnoid hematoma. A 67-year-old woman started anticoagulant therapy for unstable angina. The next day, she developed severe back pain and paraplegia. MRI showed intradural and extramedullar low signal intensity at the T2-3, consistent with intradural hematoma. High signal intensity was also noted in the spinal cord from C5 to T4. We removed subarachnoid hematoma compressing the spinal cord. The following day, the patient complained of severe headache. Brain CT revealed SAH around both parietal lobes. Three days later, her consciousness decreased and left hemiplegia also developed. Brain MRI demonstrated multiple cerebral infarctions, mainly in the right posterior cerebral artery territory, left parietal lobe and right watershed area. Conventional cerebral angiography confirmed diffuse severe vasospasm of the cerebral arteries. After intensive care for a month, the patient was transferred to the rehabilitation department. After 6 months, neurologic deterioration improved partially. We speculate that surgeons should anticipate possible delayed neurological complications due to cerebral vasospasm if intracranial SAH is detected after spinal subarachnoid hematoma.

• Journal of Korean Academy of Nursing
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• v.24 no.1
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• pp.129-142
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• 1994

The purpose of this study determine and compare spinal cord injured(SCI) patients’ and nurses’ perceptions of SCI patients’ learning needs about altered elimination and then provide nursing data for more effective SCI patients’ learning process. Data collection was done from September 3 to October 2, 1993. For this study, 36 SCI Patients(12 paraplegia, 24 quadriplegia) and 20 nurses who were working neurosurgery or rehabilitation unit in 3 general hospitals in C and I city were selected. Data collection was accomplished by Questionnaire method and the instrument developed by the investigator, elicited information about learning needs about altered elimination of SCI patients from SCI patient, nurse, rehabilitation doctor, nursing professor, nursing graduate students. The questionnaire composed altered urinary elimination part with 10 categories and altered bowel elimination part with 10 categories. The results of this study were as follows : 1. There was no significant difference in learning needs about altered urinary elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered urinary elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=2.48, p=.017). 2. There was no significant difference in learning needs about altered bowel elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered bowel elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=-3.00. p=.005). 3. Degree of paraplegic SCI patients’ perceived learning needs about altered urinary elimination was 2.4083 and quadriplegic SCI patients’ perceptions were 2.0750. Degree of paraplegic SCI patients’ perceived learning needs about altered bowel elimination was 2.3972 and quadriplegic SCI patients' perceptions were 2.181.

• Transactions of the KSME C: Technology and Education
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• v.3 no.2
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• pp.131-140
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• 2015

The mono-ski for the paraplegia designed to skiing is formed as seat bucket on the sled. The impact force transferred by snow surface during skiing is absorbed by the leg joints of normal human, but it is transferred to the human body on the seat when using mono-ski. Most of commercially available mono-ski have absorbing device and link mechanism between seat and ski mount in order to complement it. In this study we developed the comfort evaluation model that could provide skiing simulation of mono-ski with hydraulic damper and analyzed vibrational acceleration occurred during skiing uneven surface. The evaluation method used in this study is the international standard BS6841. We evaluated comfort performance of mono-ski in accordance with nozzle adjustment of hydraulic damper.

• Journal of Veterinary Clinics
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• v.32 no.2
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• pp.187-190
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• 2015

An 18-month-old female spayed domestic short-haired cat, weighing 4.1 kg, was presented as an emergency case after it suffered a gunshot injury. Physical examination of the cat revealed paraplegia, with loss of deep nociception. A bullet (diameter, 3 mm) lodged in the left epaxial muscle at the level of the first lumbar (L1) was observed on radiographic examination, and a hyperattenuating spot in the spinal canal was confirmed using computed tomography. Exploratory laminectomy was performed, and an incomplete fracture of the right caudal articular process of L1 and a necrotizing spinal cord lesion were found. The animal was euthanized and necropsy was performed, which revealed a crack on the left pedicle of L1. This case report presents the first detailed clinical description of a gunshot injury to the spinal cord in a cat.

• Journal of Periodontal and Implant Science
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• v.48 no.2
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• pp.92-102
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• 2018

Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.623-629
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• 2000

Background: There has been controversy over the prevalence of recoarctation in infants treated by subclavian flap aortoplasty(SFA) for coarctation of the aorta. To assess the rate of recurrence of coarctation after SFA, we reviewed the surgical results of SFA in infants with coarctation of the aorta. Material and method: Between 1986 and 1998, a total of 25 patients less than 1 year of age(12 neonates and 13 infants) underwent SFA for aortic coarctation. Age at operation was 3.0$\pm$3.0 months(mean $\pm$ standard deviation); mean weight was 5.0$\pm$1.4kg. Classic SFA was performed in 20 patients, reversed SFA in 2 patients, subclavian artery reimplantation in 2 patients and the combined resection-flap aortoplasty in one. Result: The aortic clamping time ranged from 20 to 88 minutes(mean 35.8 minutes). There were one operative death and two late deaths. There was no case of paraplegia or left arm ischemia in complications. Twenty-one(84%) of 24 hospital survivors were followed for 26.0$\pm$24.0 months. The risk of recoarctation in neonates(33.3%) was a little greater than infants(25.0%) without statistical significance. Conclusion: This study revealed that SFA resulted a relatively high incidence of recarctation in infants. It is desirable to select other methods of surgical treatment(combined resection-flap aortoplasty, extended end-to-end repair etc.) for severe isthmic coarctation or hypoplasia of the distal aortic arch in infants, instead of choosing SFA indiscriminately.

• Physical Therapy Korea
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• v.9 no.2
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• pp.115-131
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• 2002

Functional electrical stimulation (FES) training of the knee extensors is a useful way to rehabilitate the ability to stand and walk. However, training using FES has not been able to solve the problem of fatigue; clinical application of FES quickly produces muscle fatigue, due to the continuous activation of the muscles of the lower extremity. Therefore, reduction of muscle fatigue is an important factor in increasing the effectiveness of FES training in paraplegia. Intermittent high frequency alternating stimulation is a method that combines the advantages of high frequency (leading to strong muscle contractions) and alternating stimulation (reducing muscle fatigue), thereby continuously strengthening muscles. It is not known whether low frequency simultaneous stimulation results in stronger muscle contraction than high frequency alternating stimulation. This study compared the effectiveness of high frequency alternating stimulation with low frequency synchronized stimulation. Muscle power using FES on the quadriceps of 20 normal subjects were compared. Intermittent high frequency alternating stimulation did not produce more powerful muscle contraction than intermittent low frequency synchronized stimulation, because the muscle characteristics differed individually. Significant individual variation according to muscle characteristics was founded when applying FES. Accordingly, when physical therapists use FES to treat patients, they must be aware of individual variation in muscle characteristics.