Objective: The patient with electrically injured myelopathy showed mild motor weakness without somatosensory pathway abnormalities. Few reports have been reported on the pathophysiological mechanisms of electrically injured myelopathy, and there is controversy about the exact pathological causes. This study aimed to investigate the ultrastructural changes in the electron microscopic findings of electrical spinal cord injury. Methods: Nine rats were used in this study. We performed 7 electrical shocks (frequency, 120 Hz; pulse width, 0.9 ms; duration, 3 seconds; current, 99 mA) using an electroconvulsive therapy (ECT) apparatus (57800 ECT unit; UGO BASILE). We used one ear and one contralateral hind limb as entry and exit sites, respectively. We only enrolled rats with hind limb weakness and performed electron microscopy evaluations of the spinal cord on the first day and 4 weeks after injury. Results: On the first day after injury, an electron microscopic examination showed a directly damaged area that appeared to be torn as physical damage, damaged myelin sheath, vacuolated axons in the myelin sheath, swollen Golgi apparatus, and injured mitochondria.Looking at changes in motor and sensory nerves, the sensory neurons showed recovered mitochondria and Golgi apparatus 4 weeks after injury; however, motor neurons still showed injured mitochondria, swollen Golgi apparatus, and endoplasmic reticulum. Conclusion This study showed that recovery from ultrastructural injury was more rapid in sensory neurons than in motor neurons.

PURPOSE: The study was a non-equivalent control group, quasi-experimental study to find out the effect of the laughter therapy on anxiety and depression of burn patients. METHODS: Study subjects were 60 hospitalized patients with the diagnosis of 2nd degree burn (30 experimental group; 30 control group). Experimental group received laughter therapy by the certificated therapist. STAI questionnaire, blood pressure and pulse were checked before and after the laughter therapy. RESULTS: Before and after the laughter implementation, the experimental group's anxiety decreased, however, the comparison group's anxiety did not show significant difference. Moreover, experimental group's anxiety decreased after the implementation. Experimental group's systolic blood pressure and diastolic blood pressure did not decrease pre/post laughter therapy mediator. The comparison group showed that systolic blood pressure increased, and diastolic blood pressure did not show significant difference. Also, experimental group's systolic blood pressure and diastolic pressure did not show significant difference after the treatment. Pre/post laughter therapy mediation did not decrease the experimental group's pulse and comparison group's pulse. Furthermore, the experimental group's pulse did not show the significant difference after the treatment. In pre/post laughter therapy mediation, the experimental group's depression was decreased, however, the comparison did not how significance difference in pre/post depression score after the treatment. Moreover, the experimental group's depression was decreased after the treatment. CONCLUSION: According the results above, the laughter therapy had effect on decreasing anxiety and depression of the burn patients and it is efficient mediator for the burn patient. Repetitive research was needed to investigate the effect of laughter on cardiovascular system since it did not have decreasing effect on the blood pressure and pulse.
Anxiety* ; Blood Pressure ; Burns* ; Cardiovascular System ; Depression* ; Diagnosis ; Humans ; Laughter ; Laughter Therapy* ; Negotiating ; Surveys and Questionnaires

OBJECTIVE: To compare the scar formation and hand function between moist exposed burn ointment (MEBO) treatment and conventional skin graft in full thickness hand burns. METHOD: Prospective comparative study was done between MEBO treatment group and conventional skin graft group. Full thickness burn wound scars on dorsal hand were compared. Scars were assessed with the Vancouver scar scale and other objective measurement tools such as pigmentation, erythema, pliability, transepideramal water loss, thickness and perfusion. Hand function was evaluated by the Jebsen hand function test and Michigan Hand Function Questionnaire. RESULTS: Vancouver Scar scale showed significantly better scores in the MEBO group than in the conventional skin graft group. Scar thickness and transepidermal water loss were greater in the MEBO treatment group whereas pigmentation value was greater in the conventional skin graft group. There was no significant difference in the hand function between the two groups. CONCLUSION: MEBO application could be an alternative treatment to conventional skin graft treatment in full thickness hand burn wounds. In the future, more studies are yet to come how MEBO treatment may affect the skin condition of the burn injuries.
Burns* ; Cicatrix* ; Erythema ; Hand* ; Michigan ; Perfusion ; Pigmentation ; Pliability ; Prospective Studies ; Surveys and Questionnaires ; Skin* ; Transplants* ; Wounds and Injuries

Amputation stump pains can be developed in amputation sites after high voltage electrical burn injuries. We experienced one case of these severe stump pains in an upper extremity amputation patient. A 35-year-old man had a 38% total body surface area high voltage electrical burn. The patient underwent skin grafting and left shoulder disarticulation. During the rehabilitation period, he complained about severe stump area pains and phantom pains. We injected 0.5% Bupivacaine and Triamcinolone on the stump neuroma site but the pain sustained. After extracorporeal shock wave therapy (ESWT,) the pain subsided and did not recur. The patient was satisfied with functional and pain outcomes, so we report this case.
Adult ; Amputation ; Amputation Stumps ; Body Surface Area ; Bupivacaine ; Burns ; Disarticulation ; Humans ; Neuroma ; Phantom Limb ; Rehabilitation ; Shock* ; Shoulder ; Skin Transplantation ; Triamcinolone ; Upper Extremity

OBJECTIVE: The purpose of this study was to evaluate the prognostic value of sleep apnea syndrome in stroke patients by polysomnography. METHOD: Fifteen patients with ischemic stroke were studied with polysomnography. Medical history, sleep history, location of stroke, and severity of neurological deficit were recorded. Patients were observed by physician for evidence of snoring and excessive daytime sleepiness. Functional abilities were measured with the use of the Modified Barthel Index (MBI). To evaluate the autonomic nervous system, heart rate variability (HRV) study was done. RESULTS: Mean SaO2 during polysomnography was 88.2%, and mean recording time was 321 minutes. Apnea types were obstructive, mixed, and central. Respiratory Distress Index (RDI) correlated with functional outcome and mean SaO2. HRV study showed no significant changes under the orthostatic stress in apnea patients. CONCLUSION: We concluded that the sleep apnea syndrome could be a prognostic factor in rehabilitation outcome of stroke.
Apnea ; Autonomic Nervous System ; Heart Rate ; Humans ; Polysomnography ; Prognosis* ; Sleep Apnea Syndromes* ; Snoring ; Stroke* ; Treatment Outcome

PURPOSE: The burn increase the requirement for the antioxidative vitamin C and decrease the plasma concentration of vitamin D due to the loss of skin body surface area. We investigated the vitamin C and D status and the prevalence of vitamin C and D insufficiency in adult burn patients undergoing rehabilitative therapy. METHODS: 256 burn patients admitted to the department of rehabilitation medicine from April 2013 to September 2014 were tested for the plasma level of vitamin C and D[25(OH)D]. Vitamin C insufficiency was considered as <26.1micromol/L and vitamin D insufficiency as <20 ng/ml. We compared the mean plasma level of vitamin C and D[25(OH)D] according to burned percent of total body surface area (TBSA). RESULTS: Vitamin C insufficiency in 63.3% and vitamin D deficiency in 87.1%. In burn patients of TBSA> or =20%, mean plasma concentration of vitamin C and vitamin D[25(OH)D] were significantly lower (P=0.023, P<0.001). With adjusting for potential confounder such as age, sex, burn type, mean serum 25 (OH)D levels was significantly decreased 0.07 ng/ml per one percent of burned surface area (beta=-0.07, P<0.001), but with adjusting for age, sex, burn type, length of ICU stay and duration from burn injury to sampling, vitamin C and vitamin D[25(OH)D] were not significantly decreased (P=0.221, P=0.142). CONCLUSION: Vitamin C and D insufficiency were common nutrient problems in burn patients undergoing rehabilitative therapy. Further studies will be needed to establish the effective way to improve vitamin C and D status and prevent nutritional complications.
Adult ; Ascorbic Acid* ; Body Surface Area ; Burns* ; Humans ; Plasma ; Prevalence ; Rehabilitation ; Skin ; Vitamin D ; Vitamin D Deficiency ; Vitamins

PURPOSE: Many burn patients are troubled with pain and paresthesia from healed wounds. Extracorporeal Shock Wave Therapy (ESWT) in various musculoskeletal disease and wounds is reported that it reduces the pain and promotes regenerating of tendon and healing of the wound. Therefore we investigated the effect of ESWT on the scar pain of burn patients. METHODS: On February 2014, three patients admitted to the department of rehabilitation medicine of Hangang Sacred Heart Hospital Burn Center underwent ESWT. One low-energy ESWT (0.05~0.12 mJ/mm2) a week was provided to them for 3 weeks in total. Numerical rating scale (NRS), Nirschl pain phase system, 70-point scoring system, Roles and Maudsley score were evaluated before ESWT, after first and third ESWT. RESULTS: In all three patients, the NRS score was decreased and total scores of Nirschl pain phase system and 70-point scoring system were improved after ESWT compared to before ESWT. Roles and Maudsley scores was poor in all three patients at before ESWT but was acceptable in two patients and good in one patient after third ESWT. CONCLUSION: Extracorporeal shockwave therapy (ESWT) is non-invasive, feasible and effective modality on the scar pain of burn patients.
Burn Units ; Burns* ; Cicatrix* ; Heart ; Humans ; Musculoskeletal Diseases ; Paresthesia ; Rehabilitation ; Shock* ; Tendons ; Wounds and Injuries

Pseudohypoaldosteronism (PHA) is a condition characterized by renal salt wasting, hyperkalemia, and metabolic acidosis due to renal tubular resistance to aldosterone. Systemic PHA1 is a more severe condition caused by defective transepithelial sodium transport due to mutations in the genes encoding the alpha (SCNN1A), beta (SCNN1B), or gamma (SCNN1G) subunits of the epithelial sodium channel at the collecting duct, and involves the sweat glands, salivary glands, colon, and lung. Although systemic PHA1 is a rare disease, we believe that genetic studies should be performed in patients with normal renal function but with high plasma renin and aldosterone levels, without a history of potassium-sparing diuretic use or obstructive uropathy. In the present report, we describe a case of autosomal recessive PHA1 that was genetically diagnosed in a newborn after severe hyperkalemia was noted.
Acidosis ; Aldosterone ; Colon ; Epithelial Sodium Channels ; Humans ; Hyperkalemia ; Hyponatremia ; Infant, Newborn ; Lung ; Plasma ; Pseudohypoaldosteronism* ; Rare Diseases ; Renin ; Salivary Glands ; Sodium ; Sweat Glands

Pseudohypoaldosteronism (PHA) is a condition characterized by renal salt wasting, hyperkalemia, and metabolic acidosis due to renal tubular resistance to aldosterone. Systemic PHA1 is a more severe condition caused by defective transepithelial sodium transport due to mutations in the genes encoding the alpha (SCNN1A), beta (SCNN1B), or gamma (SCNN1G) subunits of the epithelial sodium channel at the collecting duct, and involves the sweat glands, salivary glands, colon, and lung. Although systemic PHA1 is a rare disease, we believe that genetic studies should be performed in patients with normal renal function but with high plasma renin and aldosterone levels, without a history of potassium-sparing diuretic use or obstructive uropathy. In the present report, we describe a case of autosomal recessive PHA1 that was genetically diagnosed in a newborn after severe hyperkalemia was noted.
Acidosis ; Aldosterone ; Colon ; Epithelial Sodium Channels ; Humans ; Hyperkalemia ; Hyponatremia ; Infant, Newborn ; Lung ; Plasma ; Pseudohypoaldosteronism* ; Rare Diseases ; Renin ; Salivary Glands ; Sodium ; Sweat Glands

There have been few reports of manifestations such as vasculitis, nephrosis, neuritis, encephalitis, and serum sickness occuring in a temporal relation to insect stings. Symptoms usually start several days to several weeks after the sting and may last for a long time. Angioedema with eosinophilia induced by bee sting has not reported in medical literature. We report a case of eosinophilia with angioedema induced by bee venom in a 30-year-old woman whom presented with edema of extremities and peripheral blood eosinophilia. The patient had high titer of specific IgE to yellow jacket venom.
Adult ; Angioedema* ; Bee Venoms ; Bees* ; Bites and Stings* ; Edema ; Encephalitis ; Eosinophilia* ; Extremities ; Female ; Humans ; Immunoglobulin E ; Insect Bites and Stings ; Nephrosis ; Neuritis ; Serum Sickness ; Vasculitis ; Venoms ; Wasps