Decreased respiratory performance of children and adolescents with myelomeningocele who use a wheelchair - preliminary data

Myelomeningocele (MMC) is a neural tube defect that often causes spinal cord injury at the thoracolumbar region, as well as sensory and motor paralysis in the lower limbs. This leads to continuous use of a wheelchair and, consequently, a sedentary lifestyle, predisposition to muscle weakness, cardiovascular and respiratory disorders, obesity, and structural alterations in the spine. We assessed the respiratory function and shoulder strength of MMC participants who were wheelchair-users and had no respiratory complaints and compared them to healthy children and adolescents. MMC (n=10) and healthy (n=25) participants of both genders with a mean age of 12.45 years (SD=2.1) were assessed for weight, height, respiratory performance, and isometric peak for shoulder flexors, extensors, abductors, and adductors, using an isokinetic dynamometer. Medullary lesion, functional levels, and abnormal curvatures of the spine were assessed for MMC participants. The level of spinal cord injury for the majority of the MMC participants was high lumbar and they had scoliosis. MMC showed lower values for forced vital capacity, forced expiratory volume at the first second, forced expiratory flow (25-75%), maximal voluntary ventilation, and isometric peak for shoulder flexors and adductors compared to healthy participants. This indicated a decreased vital capacity, respiratory muscle endurance, and shoulder muscle strength.

Research on a new NBC casualty decontamination shelter / 医疗卫生装备

Objective To develop a new NBC casualty decontamination shelter,which can be used to decontaminate NBC casualties. Methods The shelter integrated the technologies of plate shelter expansion, auto waterway control, micro-environment control, rapid sewage collection and etc, and took considerations on decontamination requirements of the ambulatory and non-ambulatory casualties.It was designed combining fixed and extendable shelters,which realized double-side expansion by manual push and pull. The shelter was composed of the plate shelter, decontamination devices and facilities, water supply & heating system, waterway system, power supply and distribution system, lighting system, air conditioning and heating system and other accessories.Results The shelter could decontaminate the ambulatory and non-ambulatory casualties simultaneously,the decontamination water temperature ranged from the temperature of water source to 50 ℃, the mixing ratio of the decontamination water was from 0.2% to 2%, and the time consumed for deployment and withdrawal was not more than 20 min. Conclusion The shelter gains advantages in layout and technology, and enhances decontamination ability for NBC medical rescue.

Annoyance-rate-and-casualty-reality-based method of comfort evaluation of military ambulance / 医疗卫生装备

Objective To explore an method for comfort evaluation of the military ambulance to enhance ride comfort during casualty transport. Methods The method executed quantitative evaluation of vibrational comfort by the existing vibration comfortableness evaluation ways for non-ambulatory casualty, different reactions of casualty to vibrational excitement and annoyance rate analysis based on psychophysics, which took considerations on the ratio of injured sites at war or natural disaster conditions as well as susceptibility analysis. Trials of the the method were carried out on the vibrational comfort analysis of some military ambulance during the road test.Results The method had feasibility for vibration comfortableness evaluation of non-ambulatory casualty,and improved the traditional ways in quantitative analysis.Conclusion The method gains advantages over the international ways, and contributes to the related researches on vibration reduction.

Comparative Analysis of TKR in Preoperative Ambulatory and Non / 대한정형외과학회잡지

At Orthopaedic Department of Kyung Hee University Hospital, we performed 50 total knee replacement in 32 patients who had suffered from rheumatoid arthritis during the period from Aug. 1982 to Dec. 1987. We studied these cases and compared the results of total knee replacement surgery in preoperative ambulatory patients(group I ) with those in preoperative non-ambulatory patients(group II ). 1. Preoperatively, 19 patients were able to walk, and 13 patients were unable to walk. 2. 7 patients of bilateral TKR(36.8%) were included in group I, and 11 patients (86.9%) in group II. 3. The improvement of range of motion after TKR was greater in group II (34 degrees) and in group I, average postoperative range of motion was similar to the average preoperative ROM. 4. Flexion contracture was more markedly improved in group II. 5. In group I, the average preoperative knee rating score by Hospital for Special Surgery rating system was 38.8 and improved to 93.4 postoperatively. In group II, the average preoperative knee rating score was 27.4 and improved to 85.7 postoperatively. 6. Postoperatively most of the patients were able to walk without support except one cases of infection(group I ) and the other who had severe rheumatoid involvements in other joints (group II ). 7. Preoperative evaluation for involvements of cervical spine and surrounding soft tissue structure was necessary endotracheal anesthesia. 8. There was 2 cases of complications in group I, and 4 cases in group II.