Traumatic hemipelvectomy before body image has developed

Traumatic hemipelvectomy is rarely observed because very few patients have survived from the initial trauma. We describe one male child who survived from this massive trauma with a good functional outcome. The boy was 28 months old when he was accidentally struck by a truck. He had severe open trauma of the pelvis and hemorrhage of the left lower limb. Amputation of the left hemipelvis, colostomy, cystostomy and removal of the left avulsed testicle were performed. Once healing had been achieved, he was transferred to our Department of Physical Medicine and Rehabilitation and rehabilitative management was begun, including prosthetic measurement and psychologic intervention for the patient and his parents. For 13 years of long-term follow-up, his prosthesis was readjusted annually. Now he is a 16-year-old middle school student. He is functioning remarkably well with a prosthesis. The psychologic report shows that he is emotionally stable and has good scholastic performance. Although hemipelvectomy appears to be a radical procedure in children, the potential for rehabilitation in a group of children before body image has developed appears to be unexpectedly good.

The Effect of Aerobic Exercise on the Cardiovascular System in the Early Stoke Patients

OBJECTIVE: To evaluate the effect of aerobic exercise training on the cardiovascular system in the early stroke patients by bicycle ergometer exercise test. METHOD: 16 stroke patients without cardiac disease were randomly assigned to exercise training group (8 patients) and control group (8 patients). The time interval between the onset of stroke and exercise training was within 90 days. Exercise tests by bicycle ergometer using Astrand-Ryhming protocol were performed twice before and after training. Exercise training was consisted with the intensity of 60~70% of maximal heart rate, 30 minutes per day, 3 times per week for 6 weeks using bicycle ergometer. Modified Barthel Index (MBI) score and blood lipid profile were recorded before and during training. Blood pressure and heart rate were checked before and during exercise test. RESULTS: In a training group, maximal systolic blood pressure and rate pressure product were decreased immediately after exercise test after 6-weeks exercise training (p<0.05). The MBI score and lipid profile were not changed after training. CONCLUSION: Early exercise training in the stroke patients for 6 weeks have beneficial effects on the cardiovascular system.

The Evaluation of Renal Function in Spinal Cord Injury Patients Using Radioisotope Renography

OBJECTIVE: The purposes of this study were to determine the renal function by radioisotope renography and to compare the findings of radioisotope renography in the spinal cord injured patients to the clinical presentations and findings of other conventional urologic examinations. METHOD: Intravenous pyelogram(IVP), voiding cystourethrogram(VCUG) and urodynamic study were performed in twenty-five spinal cord injured patients along with serum BUN/Creatinine levels and 24 hour creatinine clearance tests. Technetium-99 m mercaptoacetyltriglycine was used for the radioisotope renography. RESULTS: One abnormal radioisotope renography finding was noted among 22 normal findings by IVP and VCUG studies, while no abnormal finding by IVP and VCUG studies was noted among the subjects with a normal radioisotope renography. Effective renal plasma flow(ERPF) was significantly lower in patients with lower creatinine clearance. ERPF, cortical retention and creatinine clearance values for hyperreflexic bladders were significantly different from areflexic bladders. ERPF was significantly higher in a clean intermittent catheterization group than in a percussion and Cred method group for the hyperreflexic bladders. CONCLUSION: The study proves that the radioisotope renography is a sensitive and valuable study to evaluate the renal dysfunction in the spinal cord injured patients.