Hereditary spastic paraplegia(HSP or SPG) is a clinically and genetically heterogeneous group of neurodegenerative diseases characterized by progressive spasticity, weakness of lower limbs, and pathologically by retrograde axonal degeneration of corticospinal tracts and posterior spinal tracts. Presence of additional features allows differentiation between simple and complex forms of the disease. Genetically, 16 loci for HSP accompanied by distal amyotrophy have been mapped, for which 13 genes have been identified. With the identification of causative genes, the molecular mechanism of this disease is gradually elucidated.
Brachial Plexus Neuritis ; complications ; genetics ; Genetic Heterogeneity ; Humans ; Spastic Paraplegia, Hereditary ; complications ; genetics

The purpose of this study was to compare gait pattern and energy consumption in children with spastic diplegic cerebral palsy, when using anterior and posterior walkers, and to determine which walker should be recommended as a walking aid for these children. Ten spastic diplegic cerebral palsied children, of average age 9 years, were enrolled in this study. Before assessment, they had all received a practice period of 1-month to familiarize themselves with both types of walker. Gait characteristics were evaluated by computer-based kinematic gait analysis using Vicon 370 Motion Analysis, and energy expenditure was determined by KBI-C while they were using the walkers. The oxygen consumption rate was significantly lower whilst using the posterior walker, as was the oxygen cost. Walking velocity and cadence on gait analysis showed no significant difference between the walker types. However, step length, single support time and double support time were significantly different for the two walkers. Flexion angles of the trunk, hip and knee were lower using a posterior walker. Gait analysis data and oxygen consumption measurements indicated that the posterior walker has more advantages in terms of upright positioning and energy conservation than the anterior walker.
Biomechanics ; Cerebral Palsy/rehabilitation* ; Cerebral Palsy/physiopathology* ; Cerebral Palsy/complications ; Child ; Comparative Study ; Energy Metabolism* ; Equipment Design ; Female ; Gait* ; Human ; Male ; Paraplegia/rehabilitation* ; Paraplegia/physiopathology* ; Paraplegia/complications ; Walkers/standards*

Thoracoabdominal aortic aneurysm (TAAA) involving the roots of the celiac, superior mesenteric and both renal arteries is a rare, but potentially lethal disease. The overall postoperative mortality rate is high even when the intact TAAA is electively repaired. Furthermore, the postoperative complications are often serious and they include acute renal failure, paraplegia, respiratory distress and intestinal ischemia. The inclusion technique using a visceral-aortic patch (VAP) is considered the gold standard method for visceral artery revascularization for the treatment of TAAA. However, the inclusion technique is not feasible for patients with Marfan syndrome or for those patients with inappropriate anatomy for VAP. In such cases, separate visceral revascularization is a useful alternative and this may decrease the visceral ischemic time. Herein we report on 3 cases of TAAA, and the patients all underwent successful separate visceral revascularization, including one patient with Marfan syndrome.
Acute Kidney Injury ; Aortic Aneurysm, Thoracic ; Arteries ; Humans ; Ischemia ; Marfan Syndrome ; Paraplegia ; Postoperative Complications ; Renal Artery

Acupuncture Therapy ; Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; complications ; Humans ; Infant ; Male ; Paraplegia ; etiology ; therapy

The purpose of this study was to investigate the effect of wheelchair ergometer training on spinal cord-injured paraplegics. Eleven male paraplegics with a mean age of 30.9 years (range, 20 to 49 years) participated in the wheelchair ergometer training for the period of 5 weeks. The mean peak heart rate, the mean peak systolic blood pressure and the mean time required for 100m wheelchair propelling at resistance level 1 were significantly decreased at the end of 5 weeks of training as compared with those at pre-training. There was no statistically significant difference in pulmonary function test at pre- and post-training. The peak torque of shoulder flexor and the total work of shoulder flexor and extensor at 180 degrees/sec after training were increased more significantly than those prior to the training. In accordance with the findings as revealed above, it is deemed that the endurance and strength of the upper body and the cardiac fitness for spinal cord-injured paraplegics may be improved by the wheelchair ergometer exercise
Adult ; *Exercise Therapy ; Human ; Male ; Middle Age ; Paraplegia/etiology/*rehabilitation ; Spinal Cord Injuries/complications/*rehabilitation ; *Wheelchairs

Arthroscopy ; adverse effects ; Humans ; Male ; Middle Aged ; Paraplegia ; etiology ; Pulmonary Embolism ; complications

A total 12 cases of tuberculous spondylitis of thoracic spine had been treated by anterior decompression and interbody fusion through extrapleural approach from March, 1979 to June, 1980. In this study, six impending or complete paraplegics were included. Prognosis of paraplegia depends on its grade, duration and local pathology. Extrapleural approach seems to offer the following advantages over all the other ones; lesser risk, no Iimitation of surgical fleid, less chance of contaminating pleural cavity, less postoperative complications, especially indicated for the elderly paraplegics of Incomplete or complete type and less cumbersome Immediate postoperative care.
Aged ; Decompression ; Humans ; Paraplegia ; Pathology ; Pleural Cavity ; Postoperative Care ; Postoperative Complications ; Prognosis ; Spine ; Spondylitis ; Tuberculosis, Spinal

OBJECTIVETo evaluate the effect of the treatment on paraplegic patients with erectile dysfunction (ED) by implantation of China-made three-piece inflatable penile prosthesis.

METHODSEighteen paraplegic patients with ED refractory to non-operative treatment were implanted with three-piece inflatable penile prosthesis through an incision at the border of penis and scrotum. The rate of maintained coitus and the satisfactory coitus of spouse were obtained by inquiring and letter visiting.

RESULTSOperations were successfully performed upon all 18 patients. Follow-ups after operations ranged from 3 months to 36 months, mean follow-up being 18 months. Fluid exudation from penile prosthesis and localized infection occurred in one patient and mechanic complication occurred in two. Maintained coitus rate was 17/18. Ejaculation reflection occurred in three patients.

CONCLUSIONSTreatment of paraplegic patient with ED refractory to non-operative treatment by implantation of China-made three-piece inflatable penile prosthesis has good concealment and rehabilitative effect, with similar mechanical troubles to imported products. With excellent covertness, implantation of three-piece inflatable penile prosthesis is well accepted by ED patients.

Adult ; Erectile Dysfunction ; etiology ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Paraplegia ; complications ; Penile Implantation ; Penile Prosthesis

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the incidence and risk factors of complications following posterior vertebral resection (PVR) for spinal deformity. METHODS: A review of 233 patients treated with PVR at one institution over a nine-year period (1997 to 2005) was performed. The average age was 33.5 years. Complications were assessed in terms of surgical techniques (posterior vertebral column resection [PVCR] and decancellation osteotomy) and etiologies of deformity. RESULTS: Local kyphosis was corrected from 51.4degrees to 2.7degrees, thoracic scoliosis 63.9degrees to 24.5degrees (62.6% correction), and thoracolumbar or lumbar scoliosis 50.1degrees to 17.1degrees (67.6%). The overall incidence of complications was 40.3%. There was no significant difference between PVCR and decancellation osteotomy in the incidence of complications. There were more complications in the older patients (>35 years) than the younger (p < 0.05). Hig her than 3,000 ml of blood loss and 200 minutes of operation time increased the incidence of complications, with significant difference (p < 0.05). More than 5 levels of fusion significantly increased the total number of complications and postoperative neurologic deficit (p < 0.05). Most of the postoperative paraplegia cases had preoperative neurologic deficit. Preoperative kyphosis, especially in tuberculous sequela, had hig her incidences of complications and postoperative neurologic deficit (p < 0.05). More than 40degrees of kyphosis correction had the tendency to increase complications and postoperative neurologic deficit without statistical significance (p > 0.05). There was 1 mortality case by heart failure. Revision surgery was performed in 15 patients for metal failure or progressing curve. CONCLUSIONS: The overall incidence of complications of PVR was 40.3%. Older age, abundant blood loss, preoperative kyphosis, and long fusion were risk factors for complications.
Congenital Abnormalities ; Heart Failure ; Humans ; Incidence ; Kyphosis ; Neurologic Manifestations ; Osteotomy ; Paraplegia ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Scoliosis ; Spine

Acute Disease ; Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; complications ; physiopathology ; Humans ; Infant ; Male ; Paraplegia ; etiology ; Peripheral Nerves ; physiopathology