OBJECTIVES: To investigate the lower extremity blood flow in hemiplegic patients with a quantitative Doppler ultrasound examination of the common femoral artery(CFA). METHODS: Cross-sectional area(CSA), peak systolic velocity(PSV) and inflow volume(IV) of CFA of normal and paralyzed limbs in 24 hemiplegic patients were measured with a Doppler ultrasound. Patients were divided into three groups according to the ambulation levels: 1) nonambulator, 2) assisted ambulator, and 3) independent ambulator. The results from Doppler images of paralyzed lower extremity were compared with the normal side in each three different groups. RESULTS: In the nonambulator group, the three parameters were not significantly different between normal and paralyzed lower extremity. In the assisted ambulator group, the CSA of the paralyzed lower extremity was significantly smaller than the normal side (p<0.05). In the independent ambulator group, the CSA and IV of the paralyzed lower extremity were significantly smaller than the normal side (p<0.05). CONCLUSION: The results of this study proved that the blood flow of the paralyzed lower extremity was diminished than the normal side in hemiplegic patients especially for the independent ambulator group.
Extremities ; Hemiplegia ; Humans ; Lower Extremity* ; Ultrasonography* ; Walking

Significant illnesses or a major trauma including spinal cord injury can induce the changes of thyroid hormone metabolism, leading to the findings of "Euthyroid Sick Syndrome(ESS)". The physicians should be aware of these changes in order to interpret thyroid function test correctly after the spinal cord injury. We report three cases of ESS after the spinal cord injury. On a routine evaluation, they showed a low serum T3 level, and the T3 level returned to the normal range on a follow up study without any specific treatment.
Euthyroid Sick Syndromes* ; Follow-Up Studies ; Metabolism ; Reference Values ; Spinal Cord Injuries* ; Spinal Cord* ; Thyroid Function Tests ; Thyroid Gland

No abstract available.
Humans ; Infant, Newborn*

BACKGROUND: Hypertension is one of the common diseases which family physicians encounter to manage. Various research proved that appropriate aerobic exercise had effect on lowering blood pressure efficiently. This study was to find out the status of exercise, the change of exercise according to time and its predicting factors in hypertensive patients. METHODS: A total of 193 of the followed-up hypertensive patients of family physicians in Seoul and kyoungkido from May 11, 2001 to June 10, 2001 were interviewed by doctor according to the previously designed structured questionnaire. RESULTS: Eighty two patients (42.57) were male and mean and was 57.4 +/- 9.9 fears. Using Kaplan-Meier's method, 8% of non-exercise group (N= 115) in diagnosing hypertension started exercise after 1 fear and 40%, after 5 years. Otherwise, 5% of exercise group(N=78) stopped exercise after 1 year and 30%, after 5 years. The characteristics of 5 exercise groups according to sex, age, level of education and adequacy of exercise showed significant difference. In average blood pressure, lately started group showed the lowest (137/84 mmHg) and non-exercise group, the highest (146/91 mmHg) In the degree of recommendation. sporadic group showed the highest and non-exercise group, the lowest which showed significant difference (p =0.0024) . CONCLUSION: I conclude that lately started group among non-exercise group and continuous exercise group were mainly affected by recommendation to exercise of physician. As well as exercise, other nonpharmacologic treatment should be promoted by physician as an important strategy for treatment of hypertension.
Blood Pressure ; Education ; Exercise ; Gyeonggi-do ; Humans ; Hypertension ; Male ; Physicians, Family* ; Seoul ; Surveys and Questionnaires

Sparganosis is caused by tapeworm larva of the genus Spirometra, which commonly invades the subcutaneous tissue, and less frequently invades the abdominal wall, intestine, muscle, thorax, breast, eye, brain, spinal cord etc. We experienced a rare case of living sparganosis, which was found in the flexor muscle of the distal forearm. Ultrasonography was helpful in the diagnosis of sparganosis
Abdominal Wall ; Brain ; Breast ; Cestoda ; Diagnosis ; Forearm* ; Intestines ; Larva ; Sparganosis* ; Spinal Cord ; Spirometra ; Subcutaneous Tissue ; Thorax ; Ultrasonography

The experimental evidences suggest that the roles of basal ganglia are cognition and emotion through the corticostriatothalamocortical relationship. The patients with lesions in the caudate nucleus have high incidences of cognitive and behavioral abnormalities accompanied with the motor paralysis. In these patients, the accurate assessment of neuropsychologic dysfunctions and the prompt application of cognitive rehabilitation programs are important for the functional restoration. We evaluated the patients with stroke of basal ganglia for the clinical and neuropsychological characteristics in relation to the involved substructures of basal ganglia. Fourteen patients were evaluated for the clinical neurologic examinations, functional assessment by functional independence measure(FIM), speech assessment, and various neuropsychological tests for the assessment of attention and memory functions. The results were analysed a ccording to their lesion sites. Of the nine patients with stroke at the right basal ganglia, five patients had neglect of the contralateral hemispace and one had dysarthria. On the other hand, of the five patients with stroke at the left basal ganglia, none had hemispatial neglect and three had aphasia or dysarthria. Of the six patients with caudate lesions, three had aphasia or dysarthria, whereas of the eight patients without caudate lesion, one had dysarthria. The scores of Wechsler memory test were significantly lower in the patients with caudate lesions(P<0.05). Among the FIM subscales, the scores of communication and social cognition were significantly lower in the patients with caudate lesions(P<0.05). The Motor Score was significantly lower in the patients with putamen lesions(P<0.05). Among the FIM subscales, the scores of self care and locomotion were significantly lower in the patients with putamen lesions(P<0.05).
Aphasia ; Basal Ganglia* ; Caudate Nucleus ; Cognition ; Dysarthria ; Hand ; Humans ; Incidence ; Locomotion ; Memory ; Neurologic Examination ; Neuropsychological Tests ; Paralysis ; Perceptual Disorders ; Putamen ; Rehabilitation ; Self Care ; Stroke*

OBJECTIVE: To evaluate the effect of a contralateral shoe-lift and ipsilateral leather outsole on the energy consumption in hemiplegic gait. METHOD: Ten hemiplegic patients who could walk independently were enrolled. Using portable ergospirometer (K4b2, Cosmed, Italy), quantitative evaluation of oxygen consumption under varying shoes conditions was done: 1) regular shoes 2) a half-inch shoe-lift on the sound side 3) a half-inch shoe-lift on the sound side and leather outsole on the plegic side. The evaluation distance was 20 meter on comfortable walking speed. RESULTS: The oxygen consumption was significantly decreased after the application of shoe-lift compared with regular shoes (p<0.01), and the oxygen consumption was least with the application of shoe-lift and leather outsole (p<0.05). This effect was prominent in subject with poor muscle power in hemiplegic lower extremity. The walking speed was also increased with shoe-lift and leather outsole (p<0.05). CONCLUSION: The results of this study demonstrate that proper shoes modification can reduce the energy consumption in hemiplegic gait and can lead to more efficient functional ambulation.
Evaluation Studies as Topic ; Gait Disorders, Neurologic* ; Humans ; Lower Extremity ; Oxygen Consumption ; Shoes* ; Walking

OBJECTIVE: The objectives of this study were to evaluate the reliability of the Korean version of Spinal Cord Independence Measure (SCIM) and to compare the sensitivity of the SCIM to functional changes of spinal cord injury (SCI) patients with that of the Functional Independence Measure (FIM). METHOD: Seventeen subjects with SCI were studied. The SCIM was translated and modified to convert as SCIM Korean-version. All patients were evaluated with the SCIM and the FIM by two raters every other week. To determine inter-rater reliability, the relationship between the SCIM scores obtained by two raters was evaluated by Kappa coefficient and linear regression. To determine relative sensitivity of the test to functional changes, changes in the scores on the SCIM and FIM were compared by McNemar test. RESULTS: The Kappa coefficient of the various individual tasks in SCIM ranged between 0.63 and 1.00. High correlations were also found between the total SCIM scores for the paired raters (r=0.99, p<0.01). The SCIM detected all the functional changes detected by FIM total scoring, but in 3 (14%) of 22 sequential test batteries, the FIM missed changes detected by SCIM total scoring. CONCLUSION: These results demonstrated that the SCIM is reliable and more sensitive than the FIM in reflecting the functional changes of SCI patients.
Humans ; Linear Models ; Spinal Cord Injuries* ; Spinal Cord*

TWIK-related two-pore domain K+ channel-2 (TREK-2) has voltageindependent activity and shows additional activation by acidic intracellular pH (pH i ) via neutralizing the E332 in the cytoplasmic C terminal (Ct). We reported opposite regulations of TREK-2 by phosphatidylinositol 4,5-bisphosphate (PIP2 ) via the alkaline K330 and triple Arg residues (R355-357) inhibition and activation, respectively. The G334 between them appeared critical because its mutation (G334A) endowed hTREK-2 with tonic activity, similar to the mutation of the inhibitory K330 (K330 A). To further elucidate the role of putative bent conformation at G334 ,we compared the dual mutation forms, K330 A/G334 A and G334 A/R 355-7 A, showing higher and lower basal activity, respectively. The results suggested that the tonic activity of G334 A owes to a dominant influence from R355-7. Since there are additional triple Arg residues (R 377-9 ) distal to R355-7 , we also examined the triple mutant (G334A/R355-7 A/R377-9 A) that showed tonic inhibition same with G334 A/R 355-7 A. Despite the state of tonic inhibition, the activation by acidic pH i was preserved in both G 334 A/R355-7 A and G334 A/R 355-7A/R377-9 A, similar to the R355-7 A.Also, the inhibitory effect of ATP could be commonly demonstrated under the activation by acidic pH i in R355-7A, G334 A/R355-7 A, and G334 A/R355-7 A/R377-9 A. These results suggest that the putative bent conformation at G334 is important to set the tug-of-war between K330 and R355-7 in the PIP2 -dependent regulation of TREK-2.

TWIK-related two-pore domain K+ channel-2 (TREK-2) has voltageindependent activity and shows additional activation by acidic intracellular pH (pH i ) via neutralizing the E332 in the cytoplasmic C terminal (Ct). We reported opposite regulations of TREK-2 by phosphatidylinositol 4,5-bisphosphate (PIP2 ) via the alkaline K330 and triple Arg residues (R355-357) inhibition and activation, respectively. The G334 between them appeared critical because its mutation (G334A) endowed hTREK-2 with tonic activity, similar to the mutation of the inhibitory K330 (K330 A). To further elucidate the role of putative bent conformation at G334 ,we compared the dual mutation forms, K330 A/G334 A and G334 A/R 355-7 A, showing higher and lower basal activity, respectively. The results suggested that the tonic activity of G334 A owes to a dominant influence from R355-7. Since there are additional triple Arg residues (R 377-9 ) distal to R355-7 , we also examined the triple mutant (G334A/R355-7 A/R377-9 A) that showed tonic inhibition same with G334 A/R 355-7 A. Despite the state of tonic inhibition, the activation by acidic pH i was preserved in both G 334 A/R355-7 A and G334 A/R 355-7A/R377-9 A, similar to the R355-7 A.Also, the inhibitory effect of ATP could be commonly demonstrated under the activation by acidic pH i in R355-7A, G334 A/R355-7 A, and G334 A/R355-7 A/R377-9 A. These results suggest that the putative bent conformation at G334 is important to set the tug-of-war between K330 and R355-7 in the PIP2 -dependent regulation of TREK-2.