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Arnold-Chiari Type I Malformation with Hemihypertrophy: A case report.

Geun Young PARK ; Joo Hyun PARK ; Yoon Hee KIM ; Sae Hyun KIM

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):481-484.

The association between Arnold-Chiari type 1 malformation and hemihypertrophy has not been appreciated but a few case reports have suggested their association and proposed a common pathogenesis of dysembryoplasia of mesoderm. We report a case of 17 year-old girl presenting with left side hemihypertrophy and scoliosis. Magnetic resonance imaging (MRI) study of brain and spine revealed underlying Arnold- Chiari type 1 malformation and syringomyelia. The purpose of this paper is to emphasize the need for central nervous system evaluation in patients with hemihypertrophy.
Brain ; Central Nervous System ; Humans ; Magnetic Resonance Imaging ; Mesoderm ; Scoliosis ; Spine ; Syringomyelia

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A Case of Type IV Sacral Agenesis: A case report.

Yong Hoon HA ; Yong Beom SHIN ; Hyun Joo SOHN ; Hyoung Wook PARK ; Young Sun CHA ; Hye Jeong MOON

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):476-480.

Sacral agenesis is an uncommon condition characterized by absence of different segments of lumbar spine along with total or partial absence of sacrum. It does not have an established etiology but may be associated with insulin dependent diabetes mellitus in the mother. Motor deficits are present and correspond to the level of vertebral agenesis. Sensation is better preserved than motor function. Orthopedic deformities such as hip dislocation, flexion contractures, genu recurvatum, posterior compartment atrophy, scoliosis and so on are observed. Urinary and bladder dysfunction are constant and it can lead to fatal kidney damage, finally. We report one case of type IV sacral agenesis with review of literature.
Atrophy ; Congenital Abnormalities ; Contracture ; Diabetes Mellitus ; Hip Dislocation ; Humans ; Insulin ; Kidney ; Mothers ; Orthopedics ; Sacrococcygeal Region ; Sacrum ; Scoliosis ; Sensation ; Spine ; Urinary Bladder ; Urinary Bladder, Neurogenic

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Herpetic Multiphasic Disseminated Encephalomyelitis.

Hyun SEOK ; Jun Lae KIM ; Sang Hyun KIM ; Hyuk Jin LEE ; Jang Bok LEE

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):472-475.

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating conditions, which is usually monophasic. Recurrent ADEM and multiphasic disseminated encephalomyelitis (MDEM) is much less characterized entity, and its differentiation from multiple sclerosis (MS) poses a diagnostic challenge. We report a case of multiphasic disseminated encephalomyelitis (MDEM). The patient had two episodes of paraparesis and other neurologic symptoms, which were separated by 2 months. The patient presented with fever, headache, mental change, lower extremity weakness, voiding difficulty as well as focal neurologic deficits, which showed good response on steroid and acyclovir. Brain MRI revealed variable sized, multifocal, subcortical white matter lesions with gray matter involvement, and spine MRI revealed high signal intensity from C3 to T9 spinal cord. The CSF study showed elevated protein count and negative oligoclonal band.
Acyclovir ; Brain ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Fever ; Headache ; Humans ; Lower Extremity ; Multiple Sclerosis ; Neurologic Manifestations ; Paraparesis ; Simplexvirus ; Spinal Cord ; Spine

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Teicoplanin-induced Elevation of Plasma Creatine Phosphokinase in the Patient with Wound Infection: A case report.

Geun Young PARK ; Joo Hyun PARK ; Yun Hee KIM ; Sae Hyun KIM ; Byung Woo YANG

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):469-471.

The use of teicoplanin is increasing with increase in the incidence of wound infections caused by methicillin-resistant Staphylococcus aureus. Teicoplanin has longer half-life than vancomycin, so it can be administerd once daily, whereas vancomycin has to be administered 3~4 times daily. Teicoplanin is known to have lesser side effect profiles than vancomycin, such as skin eruptions, ototoxicity and nephrotoxicity. A 27-year old women in vegetative state had a grade 3 pressure sore at coccyx area. We prescribe teicoplanin to manage wound infected by methicillin-resistant Staphylococcus aureus. Plasma creatine phosphokinase (CPK) was elevated abruptly at 9th day of teicoplanin therapy. Five days after discontinuation of teicoplanin, CPK was normalized. We experienced a case of elevation of plasma creatine phosphokinase associated with teicoplanin.
Coccyx ; Creatine ; Creatine Kinase ; Female ; Half-Life ; Humans ; Incidence ; Methicillin-Resistant Staphylococcus aureus ; Persistent Vegetative State ; Plasma ; Pressure Ulcer ; Skin ; Teicoplanin ; Vancomycin ; Wound Infection

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Pyogenic Sacroiliitis with Psoas Abscess: A case report.

Joong Hoon LEE ; Hee Suk SHIN ; Chul Ho YOON ; Soo Hyeon KWON ; Eun Shin LEE

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):465-468.

Pyogenic sacroiliitis is a rare infection that may accompany psoas muscle abscess with vague clinical presentation, which present a diagnostic challenge requiring a high index of suspicion. We report a 48-year-old male, diagnosed pyogenic sacroiliitis with psoas abscess caused by Streptococcus intermedius and Sphingomonas paucimobilis. Magnetic resonance imaging showed multiloculated rim-enhancing lesion in right psoas muscle and joint effusion with osteomyelitis around sacroiliac joint. Intravenous antibiotics were administered after ultrasonographically guided abscess aspiration. Surgical drainage was done and his fever and symptom gradually subsided.
Abscess ; Anti-Bacterial Agents ; Drainage ; Fever ; Humans ; Joints ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteomyelitis ; Psoas Abscess ; Psoas Muscles ; Sacroiliac Joint ; Sacroiliitis ; Sphingomonas ; Streptococcus intermedius

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Reversible Severe Dysphagia Presenting in Wernicke's Encephalopathy: A case report.

Eun Seok CHOI ; Sung Kyun MOK ; Ye Rim CHO ; Ji Hye MIN ; Young Mook PARK ; Yun Hee KIM ; Zee A HAN

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):460-464.

Wernicke's encephalopathy is a relatively underestimated disorder caused by a deficiency of thiamine and manifests with a classical triad of ocular abnormalities, ataxia, and mental-status changes. Specific laboratory tests are unavailable and the disease remains a clinical diagnosis. Among paraclinical studies, magnetic resonance imaging is currently considered the most valuable method to confirm a diagnosis of Wernicke's encephalopathy. Treatment is based on supplementation of thiamine that is administered parentally. We report a case of Wernicke's encephalopathy that was treated with thiamine and showed the characteristic clinical findings, as well as an extremely rare symptom of severe dysphagia that improved concurrently with neurological recovery. Only a few cases of dysphagia in Wernicke's encephalopathy have been reported worldwide.
Ataxia ; Deglutition Disorders ; Humans ; Magnetic Resonance Imaging ; Parents ; Thiamine ; Thiamine Deficiency ; Wernicke Encephalopathy

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Effect of Botulinum Toxin A on Trismus after Traumatic Brain Injury: A case report.

Youn Joo KANG ; Jun Ho OH ; Ji Sung KIM ; Sung Hun SHIN ; Kyung Tae PARK

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):456-459.

We report a case of severe trismus following traumatic brain injury (TBI), which was treated successfully with botulinum toxin A. Its effect evidenced long-term resolution, for over one year. A 36 year-old man with a multifocal intracranial hemorrhage was admitted for quadriplegia with dysphagia and trismus. During ten months, a nasogastric tube was placed for feeding after TBI, and at that time his upper- to-lower interincisal distance was only 1.2 cm upon voluntary mouth opening. Botulinum toxin A 450 U (Dysport(R)) was injected into both masseter, medial pterygoid and left temporalis muscles under electromyographic guidance. The interincisal distance began to improve one week after injection. He successfully underwent percutaneous endoscopic gastrostomy, dysphagia rehabilitation therapy, and dental prosthesis. More than one month after injection, oral feeding proved possible. After 1 year his interincisal distance was maintained at 2.9 cm.
Botulinum Toxins ; Brain ; Brain Injuries ; Deglutition Disorders ; Dental Prosthesis ; Gastrostomy ; Intracranial Hemorrhages ; Mouth ; Muscles ; Quadriplegia ; Trismus

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Quality of Life and Demands for the Welfare of the Parents with Children in Special School in Goyang City.

Seong Woo KIM ; Jung Bin SHIN ; Sung YOU ; Hyun Kyung KIM ; Won Suk LEE ; Young Suk CHOI ; Do Sik YOON

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):449-455.

OBJECTIVE: To investigate the level of quality of life, life satisfaction, depression and demands of parents with children in special school. METHOD: Data were collected through a questionnaire answered by 152 parents whose children were enrolled in four special schools in Goyang City. The quality of life (QOL), life domain satisfaction measure (LDSM), Beck depression inventory (BDI) and the demand for rehabilitation and welfare service were obtained. RESULTS: The average score of QOL was less than 50 and the mental health component in particular was the lowest of all. The average score of LDSM was 3.9+/-0.9, and most notably the score regarding economic status resulted to be the lowest. The average score of BDI was 13.4. The general health screening and medical service related needs of the parents with disabled children were most significant, including the need for the expansion of welfare facilities for disabled people. CONCLUSION: In order to provide better rehabilitation service to disabled children, a policy which could decrease the physical and mental burden of parents with disabled children should be considered.
Child ; Depression ; Disabled Children ; Humans ; Mass Screening ; Mental Health ; Parents ; Quality of Life ; Surveys and Questionnaires

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Severity of Disability and Quality of Life in Handicapped Persons in Welfare Facility and Home in Goyang City.

Seong Woo KIM ; Won Seok LEE ; Jung Bin SHIN ; Sung YOU ; Sun Kyoung LEE ; Doo Sik YUN ; Young Sook CHOI

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):443-448.

OBJECTIVE: To compare severity of disability and quality of life between the handicapped residing in a welfare facility and the handicapped living at home. METHOD: This research conducted a survey for the handicapped persons in Goyang city. The survey consisted of the following items: disability diagnosis, modified Barthel index (MBI), Korean-activities of daily living (K-ADL), 8-item short form health survey instrument (SF-8) and life domain satisfaction measure (LDSM). A total number of 144 handicapped persons participated, and 66 among them lived at home. RESULTS: In regard to the range of activities of daily living MBI, K-ADL and quality of life; SF-8, those who resided in a welfare facility showed higher scores. In terms of satisfaction of life, the two groups did not show significant difference in housing, education and family relationship. However, as for leisure and health, those who resided in a welfare facility showed higher satisfaction. CONCLUSION: The handicapped persons residing in a welfare facility could function more independently in carrying out daily activities, and they showed higher quality and more satisfaction of life compared to those who lived at home. These results support that more attention would be needed for disabled persons at home to make welfare and rehabilitation policies.
Activities of Daily Living ; Disabled Persons ; Family Relations ; Health Surveys ; Housing ; Humans ; Leisure Activities ; Lifting ; Quality of Life

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Cardiopulmonary Exercise Capacity in Coronary Artery Disease Patients Receiving Percutaneous Coronary Intervention Compared with Coronary Artery Bypass Grafting.

Chul KIM ; Hyun Woo REU ; Yoon Kyung PARK ; In Keol BANG ; Young Joo KIM

Journal of the Korean Academy of Rehabilitation Medicine.2008;32(4):437-442.

OBJECTIVE: To compare the exercise capacity after cardiac rehabilitation (CR) in patients with percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery. METHOD: 27 patients who underwent PCI and 18 patients who underwent CABG surgery were included. All the subjects performed supervised exercise training for 6~8 weeks at hospital and self-exercise at community for additional 16~18 weeks. Exercise capacity was measured by symptom limited graded exercise tests at study entry and 6 months later. RESULTS: After 6 months of CR, maximal oxygen consumption (VO2max) was significantly increased, resting heart rate (HR) and submaximal rate pressure product (RPP) were significantly decreased in both groups (p<0.05). There were no significant change of maximal HR in both groups (p<0.05). Maximal RPP in CABG increased significantly (p<0.05) but did not change significantly in PCI group. Resting HR was significantly higher, VO2max was significantly lower in CABG group than PCI group at study entry (p<0.05). Resting HR was not significantly different in both groups but, VO2max was still lower in CABG group than PCI group even after 6 months of CR (p<0.05). CONCLUSION: The cardiac rehabilitation program was effective in both PCI and CABG group. Although VO2max in PCI group was higher than CABG group after 6 month CR, the range of improvement was greater in CABG group than PCI group.
Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Exercise Test ; Heart Rate ; Humans ; Oxygen Consumption ; Percutaneous Coronary Intervention ; Transplants

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