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.

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

No abstract available.

Isokinetic tests after rotationplasty / 대한정형외과학회잡지

No abstract available.

Clinical Survey of Anesthetic Experiences with Geriatric Patients / 대한마취과학회지

To evaluate geriatric anesthetic experiences, the clinical record of 970 cases out of total 13,324 anesthetic cases perfomed at Korea university Anam hospital from January 1991 to December 1992 were reviewed according to age, sex, department, operation site, preoperative physical status, preoperative chest X-ray findings, preoperative electmcardiography readings, preoperative pulmonary function test, preoperative concurrent disease, type of anesthesia, duration of operation, intraoperative event, postoperative complication, and mortality. The result were as follows; 1) The number of the cases older than age 65 years was 970 accounting for 7.3% of 13,324 anesthetic cases from the year 1991 to 1992. 2) There were 566 (58.4%) males and 404 (41.6%) females. 3) There were 417 (43.0%) cases between the age of 65 and 69; 323 (33.3%) between the age of 70 and 74; 133 (13.7%) between the age of 75 and 79; 73 (7.6%) between the age of 80 and 84; 15 (1.5%) between the age of 85 and 89; 7 (0.7%) between the age of 90 and 94; 1 (0.1%) between the age of 95 and 100; 1 (0.1%) cases was 103 years of age. 4) In preoperative physical status according to the calssification of American Society of Anesthesiologist, 34 (3.5%) cases were class I, 471 (48.9%) class II, 465 (48.6%) class III, and 10 (1.0%) calss IV. 5) Emergency operation was performed in 107 (11.0%) cases. 6) There were 365 (37.6%) general surgery, 156 (16.1%) orthopedic surgery, 153 (15.8%) genitourinary surgery, 101 (10.4%) otolaryngologic surgery, 66 (6.8%) neurosurgery, 59 (6.1%) chest surgery, 40 (4.1%) gynecologic surgery, and etc. 7) The most frequent operation site was upper abdominal region in 242 cases (24.9%) and lower abdominal region in 184 (19,0%), upper and lower extremities in 165 (17.0%), head and neck in 126 (12.9%) and so on. 8) The findings of preoperative chest X-ray revealed that 502 (51.7%) cases were within normal limits. The most frequent abnormal finding was hypertensive heart changes in 128 (13.2 %). Another findings were arteriosclerotic changes in 72 (7.4%), inactive pulmonary tuberculosis in 37 (3.8%), emphysematous changes in 34 (3.5%), bronchiectasis in 19 (2.0%) and so on. 9) The preoperative electrocardiographic findings revealed that 452 (46.6%) cases were within normal limits. The abnormal findings were as follows ; left ventricular hypertrophy in 113 (11.6%), sinus bradycardia in 67 (6.9%), myocardial infarction in 45 (4.6%), myocardial ischemia in 32 (3.3%), and so on. 10) Preoperative pulmonary function test was performed in 702 (72.6%) cases. Two hundred sixity five cases (37.5%) showed abnormal results consisting of obstructive type in 34.7%, restrictive type in 24.9%, mixed type in 21.5%, and small air way disease in 18.9%. 11) Three hundred sixty one (37.3%) of the total cases had preoperative concurrent illness consisting of hypertension in 158 (16.3%), chronic obstructive pulmonary diseases in 66 (6.8%), myocardial infarction in 37 (3.8%), myocardial ischemia in 34 (3.5%), diabetes mellitus in 32 (3.3%), and so on. 12) The type of anesthesia used in these case were 678 (69.9%) general anesthesia, 96 (9.9%) spinal anesthesia, 84 (8.7%) combined anesthesia, 82 (8.4%) epidural anesthesia, and 30 (3.1%) brachial plexus block. 13) The duration of operation was 1~2 hours in 329 (33,9%) cases, 2~3 hours in 267 (27.5%), 3~4 hours in 126 (13.0%), and so on. 14) The most frequent intraoperative envent was hypertension in 155 (16.0%) cases. And hypotension in 72 (7.4%), premature ventricular contraction in 12 (1.2%), ohguria in 9 (0.9%), bradycardia in 8 (0.8%), myocardial ischemia in 8 (0.8%), myocardial ischemia in 7 (0.7%), and hyperglycemia in 7 (0.7%) were noted, 15) One hundred six cases (10.9%) were sent to intensive care unit for postoperative care. 16) The most frequent postoperative complication was hypertension in 154 (15.9%) cases. Hypotension in 21 (2.2%), myocardial ischemia in 13 (1.3%) and etc, were noted. 17) Overall mortality rate was 1.2%. The mortality rate was 0.2% in elective cases, and 9.3% in emergency ones.

Comparison of Epidural Buprenorphine and Morphine for Postoperative Pain Management in Gynecologic Lower Abdominal Surgery / 대한마취과학회지

In a double-blind randomized study of five groups of fifty patients scheduled for gynecologic lower abdominal surgery the analgesic efficacy and side effects of epidurai buprenorphine were tested and compared to epidural morphine. Single epidural injeetion of 0.15mg of buprenorphine in group B 0.15, 0.30 mg of buprenorphine in group B D.3, 0.45 mg of buprenorphine in group B 0.45, 3 mg of morphine in group M 3 or 6 mg of morphine in group M 6 mixed with 10 ml of normal saline was done when the patients complained of postoperative pain after general anesthesia with enflurane-N2O-O2. The results were as follows; 1) The onset of analgesia was the most rapid in group B 0.45(20.7+/-3.2 minutes), and appeared as following order: group M 6(29.3+/-14.3 minutes), group M 3(37.5+/-6.7 minutes), group B 0.3(39.3+/-8.7 minutes), and group B 0.15(60.7+/-20.2 minutes). 2) Additional requirement of analgesics during first 24 hours after epidural injection was more frequent in group B O.IS(70%) than in any other four groups. 3) The lowest pain score during 24 hours after epidural injection was the lowest in group M 6(1.6+/-0.5) and group B 0.45(1.8+/-0.4) and the increasing order of the lowest pain score were as follows; 2.2+/-0.4 in group M 3, 2.3+/-0.5 in group B 0.3 and 2.6+/-0.5 in group B 0.15. 4) The pain score measured 24 hours after epidural injection was significantly lower in group B 0.45(2.0+/-0.0) than in any other four groups. 5) Subjective rating of well-being for first 24 hours following epidural injection was better in group B 0.45(good in 60% of patients) than in group M 6(good in 10% of patients). 6) Subjective rating of sleep at the first postoperative night showed no significant differences among five groups. 7) Disturbance of micturition after removal of catheter was noted in group B 0.45 and group M 6(30% each) and spontaneous urination after removal of catheter was significantly delayed in group B 0.45(9.1+/-10.2 hours) and in group M 6(7.2+/-7.8 hours) comparing to other three groups. 8) Pruritus was noted only in the groups with epidural morphine(in group M 3 & M 6; 70% each) and there was no statistieal difference between group M 3 and group M 6. 9) The frequency of nausea or vomiting was the lowest in group B 0.45(30%) and the highest in group M 3(90%), and no significant differences were noted among other three groups. 10) Dizziness was noted in group B 0.45 and in group M 6(30% each), but there was no statistical significances among five groups. I I) No signs of respiratory depression were noted.

The Effects of Preloading Solution on Blood Glucose Levels of Newborn Baby during Epidural Anesthesia for Cesarean Section / 대한마취과학회지

It is common for patient undergoing cesarean section under epidural anesthesia to have lower blood pressure because of not only supine hypotension syndrome but vasodilation due to sympathetic blockade. So it is necessary to give large volume of fluid before perfarming epidural anesthesia to prevent hypotension. When we use the dextrose containing fluid for that purpose, newborn baby could have a high blood glucose at delivery and low blood glucose level due to high insulin level after birth. The authors examined the blood glucose level at delivery and two hours after birth following use of 5% dextrose in lactated Ringers solution(HD group, n=24) or lactated Ringers solution (HS group, n=24) for prevention of hypotension during epidural anesthesia for cesarean section The results were as follows; I) The total amount of fluid was 789.6+/-264.2 ml in HD group and 741.1+/-253.5 ml in HS group. 2) The glucose level of mother at delivery was 300.9+/-76.3 mg/dl in HD group and 98.7+/-24.6 mg/dl in HS group and there was statistical significance(p< 0.01). 3) In HD group, the glucose level of newborn baby was 212.2+/-57.2 mg/dl at delivery and 465.+/-20.3 mg/dl at 2 hours after birth. The change of amount during 2 hours after birth was highly related to the glucose level at birth. Higher level of glucose at birth, larger amount of change during 2 hours after birth. 4) In HS group, the glucose level of newborn baby was 66.8+/-10.2 mg/dl at birth and 67.0+/-12.1 mg/dl at 2 hours after birth. There was no significant change.

Histopathologic Studies of Muscle and Peripheral Nerve Following Ingestion of L-tryptophan in Rats

The eosinophilia-myalgia syndrome associated with ingestion of L-tryptophan in man is defined by the CDC(1989) as follows: 1) eosinophil count more than 1,000 cells per microliter; 2) generalized myaligia(at some point during the course of illness) of severity sufficient to affect a patient's ability to pursue his or her usual daily activities; 3) no evidence of any infection(e.g., trichinosis) or neoplasm that would explain either the eosinophila or the myalgia. The pathologic findings of the eosinophilia-myalgia syndrome varies according to the degree of severity and types of inflammatory cells in the skeletal muscle. In order to simulate this syndrome in animals and further determine its histopathogenesis, L-tryptophan was administered to rats in the laboratory at various doses(25 mg/kg, 50 mg/kg, 150 mg/kg) over a set period of time. In this study, positive histopathologic findings were designated according to the inflammatory cell infiltration of the epimysium and epineurium. Most of the pathologic findings in the positive group were that of inflammatory cell infiltration composed mainly of eosinophils in the epimysial, epineurial connective and surrounding adipose tissues. Only a few necrotic muscle fibers were seen, and there was absence of any evidence of inflammatory cell inflitration in endoneurium or axonal degenerations. Of 59 rats which were given L-tryptophan, 27 rats(45.8%) met the criteria and were designated as belongintg to the positive group. Only 2 rats ingested with L-tryptophan(150 mg/kg) for 2 months and 4 months showed an eosinophil count more than 1,000 cells/microliter. The eosinophil count in the positive group showed significantly different levels when compared to the the negative group and control group. On the other hand, there were no significant differences in the electrodiagnostic study and serum CK, SGOT, SGPT level between the positive, negative and control groups. In summary, histopathologic findings similar to the eosinophilia-myalgia syndrome were inducible in rats followign the administration of L-tryptophan.

A Case Report of Asthmatic Attack after Supraclavicular Block / 대한마취과학회지

In recent years, it has been common to use bupivacaine for prolonged operation because of its long duration of action but, besides of this benefits, we always are cautious of using bupivacaine for its possible systemic, toxicity, such as convulsion, myocardial depression. We experienced a case of asthmatic attack right after injection of 0.5% bupivacaine 125 mg for BPB(brachial plexus block) in a 26 year old male patient with chronic renal failure for the revision of a-v fistula. With the administration of aminophylline and oxygen by mask the patient was anounced about delaying operation and the symptoms were gone. Next day with local infiltration of 2% lidocaine operation was done uneventfully.

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

A 55 years old female was admitted for nausea, vomiting and right upper quadrant pain. On the admission physical examination revealed icteric sclera and right upper quadrant tenderness. She had no history of surgery and alcoholic intake. The levels of bilirubin and liver enzyme(ALT, AST) were elevated without evidence of viral hepatitis. After abdominal sonography, CT and ERCP, diagnosis was cholelithiasis. The laparoscopic cholecystectomy was done under enflurane anesthesia for 90 minutes without transfusion of blood and blood products. On the 9th postoperative day, she was discharged with symptomatic improvement and almost normal laboratory data. On the 20th postoperative day, she was admitted for follow up study and elevated liver enzyme were found. On the 30th postoperative day, she had suffered from acute hepatitis with symptoms of nausea, vomiting, chilling and jaundice and marked elevation of ALT, AST and eosinophilia. There were no evidence of viral hepatitis and remnant stone. The liver function was more aggravated and more advanced parenchymal damage of liver was shown by liver scan and sonography but liver function was improved gradually after 55th postoperative day. She recovered gradually and went home in good health on the 105th postoperative day. Postoperative hepatotoxicity might be developed as a result of many causes and we had suspected enflurane but the exact causes in this case were still unknown.

Clinical studies on anesthesia for emergency operation of 915 cases / 대한구급학회지

No abstract available.

Clinical survey of patients in intensive care unit from march 1990 to february 1992 in Korea University Anam Hospital / 대한구급학회지

No abstract available.

Usefulness of motor evoked potentials in the spinal cord injured rat

No abstract available.

Effects of vasoactive intestinal polypeptide on motility of rabbit urinary bladder

No abstract available.

Electrophysiologic study of hemifacial spasm

No abstract available.

Brainstem auditory evoked potentials in infants below 6 months ofage

No abstract available.

Detection of anti-neural autoantibodies in patients with traumatic nervous system injury

No abstract available.

Electroencephalography, brain CT and evoked potentials in cerebral palsy

No abstract available.

Blood pressure monitoring with UV-101 noninvasive beat to beat finger blood pressure monitor / 대한구급학회지

No abstract available.

An Experimental Study on the Effects of Halothane Anesthesia on the Hepatic Function of Rats Pretreated with Ethyl Alcohol / 대한마취과학회지

The effects of halothane anesthesia on the liver function were investigated in 78 male Sprague-Dawley rats pretreated with ethyl alcohol. Blood sampling was done before intravenous administration of ethyl alcohol(400 mg/kg, 5 ml/kg, 9.99 vol %) or saline(5 ml/kg)through tail vein of the rat. Twentyfour hours later, all rats were randomly assigned to receive one of two anesthetic managements for two hours; 1) halothane -N2O-O2 2)N2O-O2 Bood sample and hepatic tissue were obtained 24 or 96 hours after anestheia Measurements of hepatic function(protein, albumin, cholesterol, bilirubin, blood urea nitro- gen, creatinine) were made and hepatic tissue was examined with light microscopy. The results are as follows; 1) There was no siginificant difference in the laboratory findings between the alcohol and saline groups. 2) There was no significant difference in the laboratory findings between the halothane and nitrous oxide anesthesia. 3) No difference in histologic injury was found between alcohol and saline groups. 4) No difference in histologic injury was found between halothane-nitrous oxide-oxygen and nitrous oxide-oxygen ansthesia groups.

End - tidal Carbon Dioxide Measurements in the Pediatric Patients : A Comparison of End - tidal PCO2 Sampled from the Proximal and Distal Ends of Pediatric Uncuffed Tracheal Tube / 대한마취과학회지

To determine the accuracy of end-tidal PCO2(PetCO2) measurement analysed with Ohmeda 5210 capnometer in the pediatric patients whose jung were ventilated with Ohio infant Circle Absorber and Ohio Ventilatior 7200, we compared PetCO2, measurements sampled from the proximal(PetCO2-p) and distal(PetCO2-d) ends of the tracheal tube to arterial PCO2(PaCO2) in 22 healthy pediatric patients between 6.8 to 18.5kg. The results were as follow: 1) Proximal PetCO2 and distal PetCO2 correlated with PaCO2(r=0.76%, SEE=2.79, r=0.70:SEE=3.01, respectively)(p<0.05). 2)Arterial to end-tidal PCO2 difference(delta(a-et)PCO2) was significantyly greater with distal(3.53+/-4.68 mmhg) than proximal(0.35+/-2.72 mmhg) sampling(p<0.05). 3) In subgroup of patients whose proximal to distal concentration of nitrous oxide difference was more than 2%, the delta(a-et)PCO2 using distal sampling(7.90+/-5.15 mmhg) was also significantly greater then it was using proximal sampling(-1.73+/-2.39 mmhg)(p<0.05).. We conclude that distal estimates of PetCO2-P can not provide accepatbale estimate of PaCO2 in healthy pediatric patients who are intubated with pediatric uncuffed tracheal tube.