Effects of Hippotherapy on Gross Motor Function and Functional Performance of Children with Cerebral Palsy

PURPOSE: The purpose of our study was to investigate the effects of hippotherapy on gross motor function and functional performance in children with spastic cerebral palsy (CP). MATERIALS AND METHODS: We recruited 34 children (M:F=15:19, age: 3-12 years) with spastic CP who underwent hippotherapy for 45 minutes twice a week for 8 weeks. Twenty-one children with spastic CP were recruited for control group. The distribution of gross motor function classification system level and mean age were not significantly different between the two groups. Outcome measures, including the Gross Motor Function Measure (GMFM)-66, GMFM-88 and the Pediatric Evaluation of Disability Inventory: Functional Skills Scale (PEDI-FSS), were assessed before therapy and after the 8-weeks intervention as outcome measures. RESULTS: There were no significant differences between intervention and control groups in mean baseline total scores of GMFM-66, GMFM-88 or PEDI-FSS. After the 8-weeks intervention, mean GMFM-66 and GMFM-88 scores were significantly improved in both groups. However, the hippotherapy group had significantly greater improvement in dimension E and GMFM-66 total score than the control group. The total PEDI-FSS score and the sub-scores of its 3 domains were significantly improved in the hippotherapy group, but not in the control group. CONCLUSION: The results of our study demonstrate the beneficial effects of hippotherapy on gross motor function and functional performance in children with CP compared to control group. The significant improvement in PEDI-FSS scores suggests that hippotherapy may be useful to maximize the functional performance of children with CP.

Neuroleptanesthesia for Surgery A Report of 7 Cases / 대한마취과학회지

A mixture of phenoperidine and haloperidol with inhalation of nitrous oxide-oxygen has been used to provide general anesthesia for gynecologic operations' in seven patients. The method afforded excellent hypnosis and analgesia together with remarkably stable circulation both during operative and immediate postoperative period. For operations requiring muscular relaxation a neuromuscular blocking agent had to be added. No central nervous system reactions (Parkinson-like, akathisia and cystonia) of an extrapyramidal type have been observed in the series.

The Last Fifty Years of Western Medicine in Korea: Korean Academy of Rehabilitation Medicine

No abstract available.

Usefulness of motor evoked potentials in the spinal cord injured rat

No abstract available.

The Changes due to Enflurane and Balanced Anesthesia on Liver Function in Elective Operations / 대한마취과학회지

The controversy over the hepatotoxic effect of the halogenated anesthetic agents, particullary halothane, is still not resolved despite many years of continued study. Enflurane(synthesized by R. Terrell in 1963) reduces the potential for hepatotoxic effects as compared to some fluorinated agents because of a relatively low level of biotransfomation, but liver injury following enflurane anesthesia has been reported, and was attributed to hepatotoxic agents, upper abdominal surgery, blood transfusion, shock, hyperpyrexia and sepsis. This study was undertaken to evaluate the effect of enflurane on liver function by comparing the preoperative and the 48 hour postoperative liver function tests in 25 cases of enflurane and also in 20 cases of balanced anesthesia. Other factors considered were the influences of the duration of anesthesia, the type of surgery, and the use of blood transfusion. The results were as follows: 1) SGOP and SGPT levels were significantly increased in enflurane group; but SGOT were increased above the normal range, on the other hand SGPT were remained within normal limits. 2) SGOT and SGPT levels were increased significantly in the balanced anesthetic group: but SGOT were increased above the normal range, on the other hand SGPT were remained within normal limits. 3) SGOT and SGPT levels were significantly increased following prolonged anesthesia of 3 hours. 4) SGOT and SGPT levels were significantly increased after gastric surgery. 5) SGOT and SGPT levels were significantly increased after blood transfusion. 6) But the other values of the liver function test, such as alkaline phosphatase, total bilirubin and total protein were not significantly increased and remained within normal limits. Although minute changes in liver function were occured following enflurane anesthesia, it is suggested that the changes in liver function were more influenced by the duration of anesthesia, the type of surgery and the administration of blood rather than the kinds of anesthetic agents.

The Effect of Pancuronium and d-Tubocurarine on the Intraocular Pressure in man during Balanced Anesthesia / 대한마취과학회지

The purpose of this study was to evaluated the effect of muscle relaxants on the intraocular pressure during balanced anesthesia for intraocular surgery. Forty one patients without history of eye disease in physical status 1 and 2 (adopted by American Society of Anesthesiologist). aged from 17 to 66 years were studied during anesthesia for elective surgery. All were premedicated with 50 mg of meperidine hydrochloride and 0.5mg of atropine sulfate. Before induction of anesthesia intraocular pressure was measured and defined it as control value. Anesthesia was induced with 50mg of meperidine hydrochloride. 5mg/kg of thiopental sodium, and 0.11mg/kg of pancuronium bromide or 0.4mg/kg of d-tubocurarine. Anesthesia was maintained by meperidine hydrochloride, nitrous oxide-oxygen. Subsequent measurements were performed at 5, 10, and 20 minutes, after administration of pancuronium bromide and d-tubocurarine respectively. The results were as follows: 1) There was significant decrease in intraocular pressure after intubation with the administration of pancuronium bromide and d-tubocurarine chloride. 2) Significant decrease in intraocular pressure was observed druing balanced anesthesia with pancuronium bromid or d-tubocurarine.

The Effects of Combination and Method of Admiaietration of Neosrtigmine Methylsulfate and Atropine Sulfate on Heart Rate / 대한마취과학회지

It is common to administrate neostigmiae methylsulfate and atropiae aulfate to counteract the effect of nondepolarising neuromuscular blocker. In case of cardiovascular disease, the effect of bradycardia or tachycardia resultiag from the administration of these drugs may be harmful to the patient. The purpose of this study is to investigate the effects of combinatioa and method of administration of neostigmine methylsulfate and atropine sulfate on heart rate. One hundred and two patients in both sexes were devided into three groups(A, B, C), and each group was devided into three subgroups (AI, AII, AIII, BI, BII, BIII, CI, CII, CIII). In group A, neostigmine methylsulfate and atropine aulfate were mixed and administered intravenously within fifteen seconds. In group B, atropine eulfate was administered thirty seconds after the administration of neostigmine methylsulfate. In group C, the two drugs were mixed and administered over a period of five minutes. In subgroup I the ratio of neostigmine methyliulfate to atropine sulfate was 2: 1(0. 04 mg/kg: 0.02 mg/kg) in subgroup 3 the ratio was 3: 2(0.03 mg/kg: 0. 02 mg/kg), and in subgroup lll the ratio was 1: 1(0. 02 mg/kg: 0. 02 mg/kg). The heart rate was counted just before, 0. 5 minute, 1 miaute, l. 5 minutes, 2 minutes, 3 minutes, 5 minutes, 10 minutes, 15 minutes, 20 minutes, 25 minutes, 30 minutes after the administration of the drugs. The results were as follows: 1) Initial increase in heart rate was significant in lager atropine ratio. 2) The later decrease in heart rate waa less in larger atropine ratio. 3) The maximal increases in heart rate in groap A and B appeared thirty seconds apart, but there was little difference betweea them. 4) The change ia heart rate was the least in group C.

A Case Report of Acute Hepatitis after General Anesthesia with Halothane / 대한마취과학회지

A 25 year old male was admitted for the reduction of right side mandible fracture. The patient was injured during a fight with someone under the influence of liquor. Nine days after the halothane anesthesia, the patient began to suffer from acute hepatitis with symptoms of fever, diarrhea, nausea, vomiting, and jaundice. The patient was cared for at the department of internal medicine and discharged after 49 day's hospitalization. The exact causes of the acute hepatitis were still unknown.

The effectiveness of isokinetic exercise for hemiplegic patients

No abstract available.

Electrophysiologic study of hemifacial spasm

No abstract available.

Effects of vasoactive intestinal polypeptide on motility of rabbit urinary bladder

No abstract available.

Study on the Status of Prosthetists and Orthotists in Korea

Prostheses and orthoses are appliances made to increase the function of the disabled body. In Korea most appliance makers obtain their basic medical and engineering knowledge and techniques through on-the-job training rather than regular education. It is expected that future training courses for appliance makers will continue to be planned. The most important thing in preparing such courses is to set the limits and level of the text. To plan training courses efficiently, it is essential to check the experience and educational level of the participants, the source of their technique, and their philosophy. The 58 makers who attended the first training course held for one week in August of 1981 answered the questionnaire prepared by the authors concerning the following items: educational level, source of technique (where and how learned), basic medical knowledge, location of shops, degree of and reason for job satisfaction, difficulties in working, approval or disapproval of the training course and reaction to the first training course.

Electrodiagnostic Studies of Peripheral Nerve Injuries in the Extremities / 대한정형외과학회잡지

Thirty cases of peripheral nerve injury were selected and analysed by means of electromyographic studies at Severance Hospital, Yonsei University, from January 1972 to August 1972. 1. The sex ratio was 17:13 (male: female). The peak incidence occurred in the twenty to thirty year age group. Involved side: right side 18 cases: left side 12 cases. 2. Nerve involved: peroneal nerve (15 cases), tibial nerve (2 cases), median nerve (7 cases), ulnar nerve (4 cases) and radial nerve (2 case). 3. Mode of nerve injuries 1) Peroneal nerve: Nerve compression, variable (10 cases) Tibia & fibular fracture complication (4 cases) Stab wound, fibular neck region (1 case) 2) Tibial nerve: Injection neuritis, buttock (2 cases) 3) Median nerve: Cut glass laceration, wrist region (3 cases) Carpal tunnel syndrome (3 cases) Undetermined mode (1 case) 4) Ulnar nerve: Cut glass laceration, wrst region (2 cases) Forearm bones fracture complication (1 case) Supracondylar fracture (cubitus valgus) (1 case) 5) Radial nerve: Cut glass laceration, wrist region (1 case) Crushing injury, elbow region (1 case) 4. Among the 15 cases of peroneal nerve injury, there were 10 cases of partial denervation and 5 cases of complete denervation. 5. The mode of injury in 10 cases of partial denervation was nerve compression from the following causes: lithotomy posture during forceps delivery (1 case), external rotation of legs during recovery state after surgery (3 cases), abnormal posture during coma state after CO intoxication (2 cases), tight long leg cast (3 cases), and direct trauma while descending stairs (1 case). 6. In all 10 cases of partial denervation of the peroneal nerve, decreased motor nerve conduction velocities, diminished amplitude and prolonged latencies were observed. 7. In partial denervation of the peroneal nerve, the earliest that reinnervation was observed was within 3 weeks in 3 out of 10 cases. 8. Spontaneous fibrillation was observed 3weeks after injury in all cases except one in which it was observed only 7 days after peroneal nerve injury. 9, The earliest appearance of positive sharp waves among all peroneal nerve injuries was observed 2 weeks after injury. 10. The initial appearance of nascent potentials (polyphasic potentials) in peroneal nerve injuries was observed 3 weeks after injury (1 case), 5 weeks after injury (1 case), and 5 months after injury (1 case). They are all partial denervation cases due to nerve compression. 11. Ten cases of partial denervation of the peroneal nerve were treated with electrical stimulation and drop foot board with good recovery. Five cases of complete denervation of the peroneal nerve were treated with neurorrhaphy (1 case) and short leg bracing (4 cases). 12. The initial appearance, of polyphasic potentials was observed 5 months after injury in one case out of 3 cases of median nerve injury. 13. Three cases of median nerve injury were classified as carpal tunnel syndrome and occurred in women only. Observations included absence of sensory nerve action potentials below the lesion, delayed distal latency at wrist and normal motor nerve conduction velocity. They were treated by division of the deep transverse carpal ligament with good result. 14. The initial appearance of nascent potentials was observed 7 months after injury in one case among 3 cases of ulnar nerve injury. 15. In two cases each of radial and tibial nerve injury, no reinnervation pattern was observed until the six month follow-up study after injury. At that time no muscle contraction could be seen or palpated clinically. 16. We observed normal motor unit potentials in the muscles in the follow-up studies even though muscle contraction could not be seen or palpated clinically. 17. Electromyographic examination at selected intervals made accurate diagnosis and prognosis possible and aided in evaluating the course of nerve regeneration, which permictted the choice of appropriate treatment.

The Effect of Paresthetic Location on the Distribution in Brachial Plexus Block by Supraclavicuar Perivascular Approach / 대한마취과학회지

The continuous perineural, perivascular compartment surrounding the brachial plexus from the tip of the cervical transverse process to the axilla may be entered at virtually any level, and the extent of anesthesia depends upon the level of entry and volume of local anesthetics injected. Various approaches of brachial plexus block were introduced to produce a successful block with the least complications. In this study, 25 ml of 0.5% bupivacaine hydrochloride solution was injected by subclavian perivasular approach to illustrate the effect of various locations of paresthesia on the distribution of analgesia in 50 patients who had an operation of the hand or forearm. The location of paresthesia evoked by insertion of a 23-gauge scalp needle during performance of brachial plexus block was checked at the distribution of the superior, middle, and inferior trunks. A pin prick test was performed at 15 min, 30 min and 45 min after injection of bupivacaine hydrochloride to evaluate the distribution of analgesia in the superior, middle and inferior trunk of the brachial plexus. The incidence of analgesia in all three trunks was the highest when paresthesia of the middle trunk distribution was elicited. The incidence of analgesia in the superior trunk distribution was significantly lower when inferior trunk paresthesia was elicited than when superior trunk paresthesia was elicited. Superior trunk paresthesia was the most frequently elicited. Complications were arterial puncture (32%), Horner's syndrome (8%) and hematoma (2%). The results indicates that brachial plexus block by supraclavicular subclavian perivascular approach is a relatively safe technique. Injection of local anesthetics following the confirmation of middle trunk paresthesia is desirable to obtain the successful block. Especially when analgesia of superior trunk distribution is required, the direction of needle insertion should be adjusted to avoid the inferior trunk paresthesia elicited.

Effect of Dextran 40 on Platelet Function / 대한마취과학회지

Dextran is a macromolecular polymer of dextrose. Dextran is used as a plasma expander with reduction in blood viscosity and disruption of red cell aggregates. It also inhibits platelet aggregation and prothrombin activation. It has been reported that a hemostatic defect characterized by a prolonged bleeding time in subject receiving large amount of dextran. The present study was undertaken to observe the effect of dextran on bleeding time and platelet aggregation by increasing volume. In this study, bleeding time was checked and sampling was done at before infusion, after 5 ml/kg, 10 ml/kg and 15 ml/kg infusion of dextran in 15 patients with spinal or regional anesthesia. The results were as follows: 1) There was prolonged bleeding time by increasing volume of dextran 40, but within nonnal limit. 2) There was no platelet aggregation with 15ml/kg of dextran.

A Comparative Study of 2, 3-Diphosphoglycerate Levels among Nonpregnant Women, Mothers, and their Newborn Rabies / 대한마취과학회지

Fifteen healthy pregnant women at term, between the ages of 21 and 31 years, with their newborn babies, were investigated for their 2,3-DPG levels. All the babies were born by caesarean section. Seventeen nonpregnant women in the same age range as the mother group, without cardiopulmonary disease, metabolic disorder or severe anemia, were also investigated and used as the control group. Samples were collected from umbilical vessels in newborn babies and from arm vessels in mothers and nonpregnant women. The levels of 2,3-DPG were measured by the ultraviolet enzymatic method of Sigma Chemical Company. The results were as follows: 1. The 2,3-DPG lovels in teram of whole blood among the three groups were not significantly different. 2. The 2,3-DPG levels in terms of hemoglobin, the highest in the mother group and there was no difference the between the nonpregnant women and the newborn baby groups.

Electromyographic Studies of Obstetrical Palsy

Electromyography and related electrodiagnostic techniques are being applied to clinical studies of neuromuscular diseases with increasing frequency and effectiveness. Four patients with obstetrical palsy were examined and followed up with electromyography. The findings from clinical observation and electromyographic studies were discussed in regard to the site of the lesion, prediction of prognosis and the degree of nerve regeneration. It is emphasized that findings provided by electromyographic examinations can not only contribute to accurate diagnosis, but also serve as a guide for selecting appropriate means of treatment with physical therapy for the patients with obstetrical palsy as well as to monitor progress, by doing a series of periodic examinations. Adler and Patterson(1967) reported that the incidence of Erb's palsy has remarkably decreased. From 1939 to 1962 they found only one hundred and twenty three cases instead of four hundred and ninety one cases in the period from 1928 to 1939 at the Hospital for Special Surgery. Statistics on obstetrical palsy due to the brachial plexus injury are not available in Korea. It is assumed however that its incidence here must also be decreased as the obstetric services have advanced significantly in recent years. The clinical picture of a brachial plexus palsy is dependent on the location of the pathology in the plexus and it is not easy to predict the prognosis without knowledge of the degree of injury. With electromyographic studies it is possible to detect the exact site of the lesion in the brachial plexus, the degree of injury and the progress of nerve regeneration. Therefore, it is a useful tool for making accurate diagnosis and prognosis and the findings provided by the electromyographic studies permit appropriate selection of treatment as the nerve regeneration takes place. Four cases of obstetrical palsy of the brachial plexus were referred to Severance Hospital for electromyographic examination and subsequent treatment from February to September 1972.

Electromyographic Studies of Obstetrical Palsy

Electromyography and related electrodiagnostic techniques are being applied to clinical studies of neuromuscular diseases with increasing frequency and effectiveness. Four patients with obstetrical palsy were examined and followed up with electromyography. The findings from clinical observation and electromyographic studies were discussed in regard to the site of the lesion, prediction of prognosis and the degree of nerve regeneration. It is emphasized that findings provided by electromyographic examinations can not only contribute to accurate diagnosis, but also serve as a guide for selecting appropriate means of treatment with physical therapy for the patients with obstetrical palsy as well as to monitor progress, by doing a series of periodic examinations. Adler and Patterson(1967) reported that the incidence of Erb's palsy has remarkably decreased. From 1939 to 1962 they found only one hundred and twenty three cases instead of four hundred and ninety one cases in the period from 1928 to 1939 at the Hospital for Special Surgery. Statistics on obstetrical palsy due to the brachial plexus injury are not available in Korea. It is assumed however that its incidence here must also be decreased as the obstetric services have advanced significantly in recent years. The clinical picture of a brachial plexus palsy is dependent on the location of the pathology in the plexus and it is not easy to predict the prognosis without knowledge of the degree of injury. With electromyographic studies it is possible to detect the exact site of the lesion in the brachial plexus, the degree of injury and the progress of nerve regeneration. Therefore, it is a useful tool for making accurate diagnosis and prognosis and the findings provided by the electromyographic studies permit appropriate selection of treatment as the nerve regeneration takes place. Four cases of obstetrical palsy of the brachial plexus were referred to Severance Hospital for electromyographic examination and subsequent treatment from February to September 1972.

Influence of Gallamine Triethiodide on the Intraocular Pressure in Man during General Anesthesia / 대한마취과학회지

The purpose of this experiment was to evaluate the effect of gallamine triethiodide on the intraocular pressure during general anesthesia for intraocular surgery. Twenty patients in the American Society of Anesthesiologists, physical status l and ll, ages from 15 to 65 yeart with no eye or kidney diseases were studied during anesthesia for elective surgery. All were premedicated with 50mg of meperideine and 0.4mg of atropine. Before induction intraocular pressure was measured under topical anesthesia with 0.5% tetracaine in the eye control value determined. Anesthesia was induced with 5mg/kg of 2.5% thiopental and 1mg/kg of succinylcholine. The intraocular pressure was measured after endotracheal intubation. Anesthesia was maintained with 2mg/kg of meperidine, nitrous oxide and oxygen. On the return of spontaneous respiration following succinylcholine, 2mg/kg of gallamine triethlodide was administered. Subsequent measurements were made 10 and 20 minutes after gallamine triethiodide administration, respectively. The results were as follows: 1) Succinylcholine caused a significant rise in intrascocular pressure. 2) Gallamine triethiodide caused a slight decrease in intraocular pressure 10 and 20 minutes after administration.

Clinical Study of Adequate Doses of Gallamine triethiodide for Endotracheal Intubation / 대한마취과학회지

In the modern practice of general anesthesia, endotracheal intubation is routinely used for controlled ventilation. To facilitating intubation, succinlycholine is the most valuable muscle relaxant. But succinylcholine has many untoward reactions such as elevation of intraocular pressure, increased plasma potassium, increased intragastric pressure, bradycardia and the development of postperative muscle pain, etc. Several attempts have study was intended to determine adequate doses of gallamine triethiodide for endotracheal intubation in patients to avoid the development of bradycardis. The authors measured the heart rate just beofre, immediately after and 5 minutes after intubation. The total number of patients in this study was 67, and the patients were divided into five groups: Group 1: consisting of 10 patients, receiving 1.5 mg/kg of gallamine triethiodide. Group 2: of 10 patients, receiving 2.0 mg/kg of gallamine. Group 3: of 22 patients, receiving 2.5 mg/kg of gallamine. Group 4: of 15 patients, receiving 3.0 mg/kg of gallamine. Group 5: of 10 patients, receiving 3.5 mg/kg of gallamine. The authors tried to choose the least difficult intubation after gallamine triethiodide, the amount administered and the patient's reaction to stimulation. The conclusions are summarized as follows: 1) The adequate dose of gallamine triethiodide for endotracheal intubation is 2.5mg/kg. 2) The duraion of action of gallamine triethiodide is dose dependent. 3) Increase of heart rate in each group is significant after gallamine triethiodide.