OBJECTIVE: To identify and evaluate the outcome of consultation base rehabilitatiion program and the site of primary lesions of the hospitalized cancer patients. METHOD: Medical records of 119 hospitalized patients with cancer who received the consultation base rehabilitation program from January 1999 to December 2000, were reviewed. Karnofsky Performance Status scale (KPSS) was used as a functional measurement. RESULT: The most common primary cancer referred for the consultation base rehabilitation program was a lung cancer (16.8%), followed by brain cancer (10.9%) and hepatic cancer (9.2%). Spine was the most common metastatic site (72.7%). Strengthening (47.2%) and range of motion exercises (39.6%) were commonly prescribed rehabilitative procedures in the cancer patients with no metastasis and bracing (45.5%) was the most common cause for consultation in the cancer patients with metastasis. A significant functional improvement was observed between the initial (mean=58.4%) and final assessments (mean=65.2%) on KPSS (p<0.01) in the cancer patients with no metastasis. However, the cancer patients with metastasis did not show a significant functional improvement. CONCLUSION: Significant functional gains were observed in cancer patients who received the consultation base rehabilitation program.
Braces ; Brain Neoplasms ; Exercise ; Humans ; Karnofsky Performance Status ; Liver Neoplasms ; Lung Neoplasms ; Medical Records ; Neoplasm Metastasis ; Range of Motion, Articular ; Rehabilitation* ; Spine

No abstract available.
Glomerulonephritis, Membranous* ; Small Cell Lung Carcinoma*

OBJECTIVE: The negative symptoms of schizophrenia usually are not responsive to drug therapy to persist and make schizophrenics more difficult in their rehabilitation. The authors investigated the therapeutic effect of token economy(TET) for negative symptoms of schizophrenic patients, and attempted to develop a TET program f3r psychiatric wards in general hospital. METHODS: Negative subscale of PANSS was rated for 35 schizophrenics with negative symptoms as their main problems before and after short-term TET(less than 3 months). Therapeutic factors were identified by comparing patient and program variables between the achieved and the non-achieved group of each level of target behaviors. RESULTS: 1) Subtotal of negative subscale of PANSS was decreased from 31.57+/-4.32 at baseline to 20.66+/-4.63 artier treatment. With TET, symptoms of difficulty in abstract thinking' and 'stereotypic thinking' were less responsive than the other 5 items of the scale Also the dose of antipsychotics prescribed was reduced to 291.21+/-287.74mg/day from 487.58+/-372.79mg/day. 2) The achievement rate of level I (self-help) was 75%, level II (ward-activity) 78%, and level III (social activity/occupation) 68%, resulting in average 74% for all target behaviors. 3) On level II, dose of antipsychotics was lower, and on level III, number of admission was lower and female sex was more frequent in achieving patient group than nonachieving group. The rate of achievement was higher in case of special flood, reception, and outing with family applied as a reinforcer on level I, and reception on level II . CONCLUSION: These results showed that TET was effective for schizophrenic patients with negative symptoms in psychiatric ward. Further investigations to refine the individual program of TET will be needed far enhancement of it s therapeutic efficacy and smart application of it.
Antipsychotic Agents ; Drug Therapy ; Female ; Hospitals, General ; Humans ; Rehabilitation ; Schizophrenia ; Token Economy*

BACKGROUND: During ophthalmologic surgery, various intravenous anesthetic induction agents are used to prevent an intraocular pressure (IOP) increase. This study was designed to compare the effects of etomidate on IOP with those of thiopental sodium and propofol in patients receiving vecronium bromide, and in whom tracheal intubation was performed. METHODS: Forty-five patients undergoing elective surgery were ramdomized to receive etomidate 0.3 mg/kg (E group, n = 15), thiopental sodium 5 mg/kg (T group, n = 15) or propofol 2.5 mg/kg (P group, n = 15). IOP, systolic arterial pressure (SAP) and heart rate (HR) were measured before induction (B), after the adminstration of the induction agents (I1), before intubation (I2) and at 1, 2 and 3 mins after intubation (T1, T2 and T3). RESULTS: The IOP after I1 and I2 in the E , T and P groups were significantly lower than in group B (P < 0.05). The IOP at T1, T2 and T3 in the E, T and P groups were not found to be significantly different from group B. The IOP, SAP and HR at T1, T2, and T3 in the E, T and P groups were significantly higher than at I1 and I2 (P < 0.05). No significant differences were observed between the groups in term of IOP. The SAP and HR at T1, T2 and T3 in the P group were significantly lower than in the other two groups (P < 0.05). CONCLUSIONS: We concluded that etomidate, thiopental sodium and propofol may be useful induction agents for general anesthesia in ophthalmologic surgery but that they do not prevent IOP elevation during endotracheal intubation.
Anesthesia, General ; Arterial Pressure ; Etomidate* ; Heart Rate ; Humans ; Intraocular Pressure* ; Intubation* ; Intubation, Intratracheal ; Propofol* ; Thiopental*

OBJECTIVE: To describe the videofluoroscopic findings of quadriplegic patients with dysphagia and to assess the predisposing factors of dysphagia in quadriplegic patients. METHOD: Six quadriplegic patients with a dysphagia within 3 months from the injury were included in this study and videofluoroscopic evaluations for both lateral and AP views were performed and evaluated. RESULT: A variety of swallowing deficits that involve both oral and pharyngeal phases were detected in the videofluoroscopic study. The presumed predisposing factors of dysphagia were a surgical stabilization of cervial vertebrae, inadequate neck extension due to cervical orthosis, history of mechanical ventilation, cervical traction, tracheostomy state and cranial nerve injury. CONCLUSION: When there are symptoms that suggest a swallowing problem such as a frequent reflex coughing and voice change in quadriplegic patients, videofluoroscopic study will help to prevent the pulmonary complications and to determine the successful swallowing strategies.
Causality ; Cough ; Cranial Nerve Injuries ; Deglutition ; Deglutition Disorders* ; Humans ; Neck ; Orthotic Devices ; Quadriplegia ; Reflex ; Respiration, Artificial ; Spinal Cord Injuries ; Spine ; Tracheostomy ; Traction ; Voice

OBJECTIVE: To describe the frequency and reasons for rehospitalization in patients with spinal cord injury (SCI) living in the community. METHOD: A total 388 patients with SCI living in community participated in the nationwide questionnaire-based study. A self-administered questionnaire was used. RESULTS: Of the 459 patients originally enrolled, 388 completed questionnaires, yielding response rate of 84.5%. The reasons for rehospitalization were SCI related complications (71.7%), periodic health evaluation (44.7%), and other causes (28.3%). The most frequent SCI related complications for rehospitalization were urinary tract infections (45.2%), pressure sores (39.7%), fever (18.3%), pain (18.3%), and autonomic dysreflexia (7.6%). The number of rehospitalized cases due to SCI related complication including urinary tract infection was significantly higher in complete SCI. Rehospitalization due to pressures sore was more frequent in people with paraplegia, male and complete injuries. CONCLUSION: In our study, 71.7% of patients with SCI experienced rehospitalization for SCI related complication after initial hospitalization. Urinary tract infection and pressure sores were the most common SCI related complications for rehospitalization.
Autonomic Dysreflexia ; Fever ; Hospitalization ; Humans ; Male ; Paraplegia ; Pressure Ulcer ; Surveys and Questionnaires ; Spinal Cord ; Spinal Cord Injuries ; Urinary Tract Infections

OBJECTIVE: This study was undertaken to characterize the nutritional status, the status of growth and the relation to various factors in cerebral palsy. METHOD: Forty patients with cerebral palsy (20 quadriplegia, 20 diplegia) were investigated. Information was obtained from medical record, clinical measure and anthropometric measure (weight for height, triceps skinfolds thickness per age, height for age). Values of weight for height or triceps skinfold below the 2.5 percentile were defined as "undernutrition", values of height for age below the 2.5 percentile were defined as "growth retardation". Denver Developmental Screening Test (DDST) at the 12 months old and at the examined time, oromotor score, pattern of defecation, duration of gait per day of patients were interviewed from caregivers. Spasticity was measured by using Modified Ashworth's scale. RESULTS: Eleven children (27.5%) were in undernutrition state and 9 (22.5%) growth retardation. Oromotor dysfunction was positive in 62.5% and constipation in 30%. Less gait time, more severe oromotor dysfunction and fine motor delay in DDST and more quadriplegic type (p<0.05) were found in undernutrition group and no significant difference of spasticity and constipation. With logistic regression, quadriplegic type is the only significant factor to undernutrition. CONCLUSION: Undernutrition is common in cerebral palsy and quadriplegic type is significantly related to undernutrition.
Caregivers ; Cerebral Palsy* ; Child ; Constipation ; Defecation ; Gait ; Humans ; Infant ; Logistic Models ; Malnutrition* ; Mass Screening ; Medical Records ; Muscle Spasticity ; Nutritional Status ; Quadriplegia

The F wave has been thought to be useful in assessing the proximal neuropathy such as radiculopathy. However the sensitivity of F wave in radiculopathy is varying from 18% to 65%. The aim of this study is to compare the relative diagnostic value of 20 averaging technique and 20 sequential stimulation technique in recording the F waves and to determine the usefulness of F wave for the evaluation of radiculopathy. Animals employed were rabbits that were divided into a study group of 17 rabbits(31 legs) and control group of 14 rabbits(25 legs). In the study group, the sciatic nerve was exposed after the dissection of gluteus maximus muscle and the nerve trunk was traced up to reach the spinal canal level. One of the two nerve roots composing the sciatic nerve was dissected randomly. F wave parameters were measured using both of 20 averaging technique and 20 sequential stimulation technique. The parameters which showed significant change after the root dissection were the amplitude by employing 20 electronic averaging technique, and mean latency, minimal latency, mean amplitude by employing 20 sequential stimulation technique. We concluded that 20 electronic averaging technique had no benefit over the 20 sequential stimulation technique and F wave measurement was not useful for the electrodiagnosis of radiculopathy because of the wide range of control values.
Animals ; Electrodiagnosis ; Rabbits ; Radiculopathy* ; Sciatic Nerve ; Spinal Canal

OBJECTIVE: To know the present status of upper extremity reconstruction surgery for the person with tetraplegia in Korea and to suggest solutions to promote the procedures. METHOD: 62 physiatrists and 42 hand surgeons were surveyed with self administered questionnaire. The questionnaire was made up of 5 categories: (1) whether physicians had experienced these procedures in the past three years, (2) if they have had no experience, what the reasons were, (3) whether physicians desired to be involved in these procedures, (4) what the solution to promote these procedures should be, (5) the attitudes and beliefs of physicians about these procedures. The last category was analyzed by odds ratio between physicians who desired to be involved in the procedure and who didn't. RESULTS: Only two physiatrists and six surgeons had experienced these procedures in the past three years. However many physicians desired to be involved in these procedures. The main reason of not performing these procedures was a lack of referral between physiatrists and surgeons. The physicians who desire to practice upper extremity reconstruction surgery or related rehabilitation had higher confidence on the benefits of the procedures and thought that they had knowledge and skills for the procedure. CONCLUSION: In spite of positive attitude to the upper extremity reconstruction for tetraplegic patients, few physicians have experienced in these procedures. This phenomenon was due to a lack of referral between physiatrists and surgeons. Advancing cross-specialty relationships and educating related physicians could be solutions to promote these procedures.
Hand ; Humans ; Korea ; Odds Ratio ; Quadriplegia ; Surveys and Questionnaires ; Referral and Consultation ; Spinal Cord Injuries ; Tendon Transfer ; Upper Extremity

Background: Although patients with non-traumatic spinal cord injury (NTSCI) have distinct epidemiological characteristics compared to those with traumatic spinal cord injury, no previous study has reported the incidence of NTSCI on a national scale in Korea.In this study, we examined the trend in incidence of NTSCI in Korea and described the epidemiological characteristics of patients with NTSCI using nationwide insurance data. Methods: National Health Insurance Service data were reviewed for the period from 2007 to 2020. The International Classification of Diseases, 10th revision, was used to identify patients with NTSCI. Inpatients with newly diagnosed NTSCI on their first admission during the study period were included. Crude incidence was calculated using the annual number of NTSCI cases divided by the mid-year population estimates. Age-specific incidence was calculated by dividing the number of cases in 10-year age groups by the total number of individuals in that age group. Age-adjusted incidence was calculated using direct standardization. Annual percentage changes were calculated using Joinpoint regression analysis. The Cochrane-Armitage trend test was conducted to examine the trends of NTSCI incidence according to the types or etiologies of NTSCI. Results: The age-adjusted incidence of NTSCI increased continuously from 24.11 per million in 2007 to 39.83 per million in 2020, with a significant annual percentage change (4.93%, P < 0.05). The age-specific incidence for those in their 70s and 80s or older was the highest and rapidly increased from 2007 to 2020. According to the types of paralysis in NTSCI, the proportion of tetraplegia decreased, whereas those of paraplegia and cauda equina increased significantly from 2007 to 2020. The proportion of degenerative diseases was the largest among all etiologies and increased significantly during the study period. Conclusion The annual incidence of NTSCI in Korea is increasing significantly, particularly among older adults. As Korea is one of the countries with most rapidly aging population in the world, these results have significant implications, indicating that preventive strategies and sufficient rehabilitation medical services are warranted for the population of older adults.