• The Journal of the Korea institute of electronic communication sciences
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• v.8 no.11
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• pp.1785-1792
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• 2013

For patients suffering from spinal cord injuries, both of the possibility of having complications with the respiratory system and the related fatal rate are still high, while pneumonia is the most important cause of these fatalities. This research was carried out to find out what effects does a breathing exercise have on the respiratory functions and the improvement in the quality of life. The study was carried out for male patients suffering cervical spinal cord injuries for the purpose of inspiratory muscle strengthening. The objects of the study were 17 non-smoking-at-present male patients with C4 to C6 cervical spinal cord injuries. They had practiced inspiratory muscle strengthening training for three times a week for six weeks. The quality of life and the dyspnea (breathing difficulty) were self-measured before and after the training. As a result, the change in respiratory function was only significantly reduced (p<0.01) within the chronic group. In terms of the changes in the quality of life, the sub-acute group has only seen a significant improvement (p<0.05) for the VT(vitality), while the chronic group has seen significant improvements(p<0.05, p<0.01) in: GH(general health); BP(back pain); and VT(vitality). In this research, the inspiratory muscle strengthening has reduced the dyspnea (breathing difficulties) and improved the quality of life.

• Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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• 2002.11b
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• pp.446-452
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• 2002

This paper Presents a 3-D design and a Vibration control of a new walking R.G.O.(Robotic Gait Orthosis) and would like to develop a simulation by this walking system. The vibration control and evaluation of the new knee joint mechanism on the biped walking R.G.O.(Robotic Gait Orthosis) was a very unique system and was to obtain by the 3-axis accelerometer with a low frequency vibration for the paraplegia It will be expect that the spinal cord injury patients are able to recover effectively by a biped walking R.G.O.. The new knee joint system of both legs were adopted with a good kinematic characteristics. It was designed attached a DC-srevo motor and controller, with a human wear type. It was able to accomodate itself to a environments of S.C.I. Patients. It will be expect that the spinal cord injury patients are able to recover effectively by a new walking R.G.O. system.

• Physical Therapy Korea
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• v.3 no.3
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• pp.32-43
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• 1996

The purpose of this case study was to introduce functional electrical stimulation(FES) for paraplegic patients. FES provides the ability to rise from sitting to standing, maintenance of a standing position, and the ability to walk with a reciprocal gait. Six channels of electrical stimulation are sufficient for synthesis of a simple reciprocal gait pattern in these patients. During the double-stance phase, knee extensor muscles of both knees are stimulated, providing sufficient support for the body. Only one knee extensor muscle group is excited during the single-stance phase. The swing phase of the contralateral lower extremity is accomplished by eliciting the synergic flexor muscle response through electrical stimulation of afferent nerves. The transition from the double-stance phase to the swing phase is controlled by two hand switches used by the therapist or built into the handles of the walking frame for using by the patient. A twenty-five years old male was with a T9/T9 spinal cord injury due to a traffic accident and admitted to Yonsei Rehabilitation Hospital for comprehensive treatment. After 30 days of training using the Parastep(R) he was able to stand for 10 minutes. After 43 days, he was able to walk and at discharged he could walk for 100 meters.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.121-129
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• 2014

Objectives : Patients with cervical ossification of posterior longitudinal ligament (OPLL) are susceptible to cord injury, which often develops into myelopathic symptoms. However, little is known regarding the prognostic factors that are involved in minor trauma. We evaluated the relationship between minor trauma and neurological outcome of OPLL and investigated the prognostic factors with a focus on compressive factors and intramedullary signal intensity (SI). Methods : A total of 74 patients with cervical myelopathy caused by OPLL at more than three-levels were treated with posterior decompression surgeries. We surveyed the space available for spinal cord (SAC), the severity of SI change on T2-weighted image, and diabetes mellitus (DM). The neurological outcome using Japanese Orthopedic Association (JOA) scale was assessed at admission and at 12-month follow-up. Results : Among the variables tested, preoperative JOA score, severity of intramedullary SI, SAC, and DM were significantly related to neurological outcome. The mean preoperative JOA were $11.3{\pm}1.9$ for the 41 patients who did not have histories of trauma and $8.0{\pm}3.1$ for the 33 patients who had suffered minor traumas (p<0.05). However, there were no significant differences in the recovery ratios between those two groups. Conclusions : Initial neurological status and high intramedullary SI in the preoperative phase were related to poorer postoperative outcomes. Moreover, the patients with no histories of DM and larger SACs exhibited better improvement than did the patients with DM and smaller SACs. Although the initial JOA scores were worse for the minor trauma patients than did those who had no trauma prior to surgery, minor trauma exerted no direct effects on the surgical outcomes.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.531-534
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• 2007

Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.

• The Journal of Korean Physical Therapy
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• v.11 no.2
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• pp.61-73
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• 1999

This study was performed to investigate the degree of demand and general features of services required of home visiting physical therapy for chronic ill patients. The study subjects were ambulatory and admitted patients treated with physical therapy at six general and one oriental hospitals, one welfare center, four health centers located in Taejon from March 2, 1999 to March 16. Authors developed structured questionnaire, and distributed it to each physical therapist of study organizations. Total number of distributed questionnaire was 500, and 405 questionnaire were collected and analysed finally. 1. $82.4\%$ of patients and $90.0\%$ of caregivers are showed that home visiting physical therapy was needed(p<0.05) 2. The rate of necessity for home visiting physical therapy by kinds of disease was $949\%$ in cerebral palsy, $95.0\%$ in upper spinal cord injury, $83.3\%$ in lower spinal cord injury, $84.5\%$ in cerebral vascular accident, $89.6\%$ in traumatic brain injury, $83.5\%$ in other diseases. 3. In the general features of required service for home visiting physical therapy, $33.7\%$ of patients and $34.4\%$ of caregivers want special isolated physical therapy center, $33.1\%$ of patients and $43.3\%$ of caregivers want 3 times per week in frequency, $46.7\%$ of patients and $45.0\%$ of caregivers want 30-60minutes in treatment duration, and $48.0\%$ of patients and $46.7\%$ of caregivers want more intensive care than general hospitals. 4. In the working place of home visiting physical therapy, $36.1\%$ of patients and $36.2\%$ of caregivers wants physical therapist worked in general hospital. Also, $53.3\%$ of patients and $52.2\%$ of caregivers answered no interested in physical therapist's gender. The most preferential age of home visiting physical therapist is thirties in $43.2\%$ of patients and $63.4\%$ in caregivers

• Journal of Acupuncture Research
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• v.20 no.6
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• pp.201-209
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• 2003

Objective : Recently, Seguele of Traffic Accident patients are increasing, especially cervical injury bring only severe sequela but also mortal damage to the patient. In treatment of the disease, the east medical treatment is another effective method. Methods : The patient resisted the west theraphy improved greatly in movement and sensation by acupuncture, moxibustion, herb medication and Physical treatment. In MRI, The treatment result is proved. Acupuncture on Stomach Meridian(足陽明胃經) referring to Naijing(內經) is thought effective. Results : Tetraplegia by Traffic Accident is considered as Wei Symptom in term of the east medicine, By means of radial and physical study of the patient treated by the east medicine, we are conviced that the east medicine is the excellent method Conclusions : Referring to the past documentary data, The only Treatment on this disease is Surgical operation, but the operation isn't the successful one because seg. of spinal cord injury is mortal. The east treatment, acupuncture, moxibustion herb medication and physical treatment isn't only effective but also satisfactory. In the future, The study on this disease by the east medicine should be made thoroughly.

• Journal of Korean Neurosurgical Society
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• v.59 no.5
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• pp.437-441
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• 2016

Objective : Recently, regenerative therapies have been used in clinical trials (heart, cartilage, skeletal). We don't make use of these treatments to spinal cord injury (SCI) patients yet, but regenerative therapies are rising interest in recent study about SCI. Neural precursor/stem cell (NPSC) proliferation is a significant event in functional recovery of the central nervous system (CNS). However, brain NPSCs and spinal cord NPSCs (SC-NPSCs) have many differences including gene expression and proliferation. The purpose of this study was to investigate the influence of neural growth factor (NGF) on the proliferation of SC-NPSCs. Methods : NPSCs ($2{\times}10^4$) were suspended in $100{\mu}L$ of neurobasal medium containing NGF-7S (Sigma-Aldrich) and cultured in a 96-well plate for 12 days. NPSC proliferation was analyzed five times for either concentration of NGF (0.02 and 2 ng/mL). Sixteen rats after SCI were randomly allocated into two groups. In group 1 (SCI-vehicle group, n=8), animals received 1.0 mL of the saline vehicle solution. In group 2 (SCI-NGF group, n=8), the animals received single doses of NGF (Sigma-Aldrich). A dose of 0.02 ng/mL of NGF or normal saline as a vehicle control was intra-thecally injected daily at 24 hour intervals for 7 days. For Immunohistochemistry analysis, rats were sacrificed after one week and the spinal cords were obtained. Results : The elevation of cell proliferation with 0.02 ng/mL NGF was significant (p<0.05) but was not significant for 2 ng/mL NGF. The optical density was increased in the NGF 0.02 ng/mL group compared to the control group and NGF 2 ng/mL groups. The density of nestin in the SCI-NGF group was significantly increased over the SCI-vehicle group (p<0.05). High power microscopy revealed that the density of nestin in the SCI-NGF group was significantly increased over the SCI-vehicle group. Conclusion : SC-NPSC proliferation is an important pathway in the functional recovery of SCI. NGF enhances SC-NPSC proliferation in vitro and in vivo. NGF may be a useful option for treatment of SCI patients pending further studies to verify the clinical applicability.

• Neurospine
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• v.15 no.4
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• pp.368-375
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• 2018

Objective: To evaluate the results of operative management of subaxial spine injuries managed with 2-level anterior cervical corpectomy and fusion with a cervical locking plate and autologous bone-filled titanium mesh cage. Methods: This study included 23 patients with a subaxial spine injury who matched the inclusion criteria, underwent 2-level anterior cervical corpectomy and fusion at our institution between 2013 and 2016, and were followed up for neurological recovery, axial pain, fusion, pseudarthrosis, and implant failure. Results: According to Allen and Ferguson classification, there were 9 cases of distractive extension; 4 of compressive extension; 3 each of compressive flexion, vertical compression, and distractive flexion; and 1 of lateral flexion. Sixteen patients had a score of 6 on the Subaxial Injury Classification system, and the rest had a score of more than 6. The mean follow-up period was 19 months (range, 12-48 months). Neurological recovery was observed in most of the patients (78.21%). All patients experienced relief of axial pain. None of the patients received a blood transfusion. Twenty-one patients (91.3%) showed solid fusion and 2 (8.69%) showed possible pseudarthrosis, with no complications related to the cage or plate. Conclusion: Two-level anterior cervical corpectomy and fusion, along with stabilization with a cervical locking plate and autologous bone graft-filled titanium mesh cage, can be considered a feasible and safe method for treating specific subaxial spine injuries, with the benefits of high primary stability, anatomical reduction, and direct decompression of the spinal cord.

• The Journal of the Korea Contents Association
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• v.11 no.11
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• pp.194-203
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• 2011

This study investigated the effectiveness of visual biofeedback simulation training for patients with incomplete spinal cord injuries. Fifteen people with an ASIA impairment scale of C and D, according to the intervention method, were studied. They were randomly divided into two groups, seven people in the experimental group and eight people in the control group. They were studied three times a week for six weeks using a Tetrax Interactive Balance System, for a total of eighteen times, and each test took fifteen minutes. Paired t-tests were used to evaluate the changes before and after intervention. The difference between the groups was compared using an independent t-test. The experimental group showed significantly increased general stability, fall risk index, weight distribution (A, C, D, LEFT, HEEL) and weight distribution index, except for synchronization AC, BD. However, the control group only showed significantly increased weight distribution (A, C, LEFT). In a variation, experimental and control groups showed significantly increased weight distribution (A, B, C, HEEL), general stability, fall risk index and synchronization AD. Consequently, it was found that visual biofeedback simulation training was effective for the balance ability of incomplete spinal cord injury patients, and further studies are required.