The ultimum goal of eliminating diseases and maintaining normal health is same both in western medicine, oriental medicine and alternative medicine. At the present time, the western medicine tends to take more scientific technological approach in their practice while the oriental medicine still maintain more humanistic approach. 5000 year old traditional medicine still challenges the 21 century scientific modern medicine in the field of clinical practices. The "disease-oriented" western medicine classify the human condition as "diseased and non-diseased" states. In the mean time the "health-oriented" oriental medicine classify it into "healthy and unhealthy" states.

For the maintenance of normal health, five principles are emphasized. They are ① eat right, ② move right, ③ sleep right, ④ breathe right, and ⑤ mind right. To reverse an unhealthy condition back to normal healthy state, the methods of ① natural substance therapy, ② exercise therapy, and ③ stimulation therapies including acupuncture, moxibustion, finger pressure, and cupping techniques. In order to eliminate the diseases, four distinct approaches namely ① chemical, ② physical, ③ psychological, and ④ surgical treatments are utilized.

Recent international trend of globalization has brought an information explosion and transcultural exchange of science, technology, arts and medicine. There are so many different kinds of traditional medicine, hidden popular folk medicine, and various less recognized techniques and theories of healing arts. Some are originated in oriental culture while others are originated in western culture. Experts of western medicine claim that only those informations clarified or proven by the objective and scientific methodology can be recognized as a part of western (orthodox or conventional) medicine. All kinds of traditional medicines, folk medicines, and many other fragments of medical techniques and theories are collectively labelled as "alternative medicine or complementary medicine". In western countries, the oriental medicine is included in the alternative medicine, but in Korea the oriental medicine is not included in the alternative medicine since both western medicine and traditional Korean medicine are considered to be the official conventional medicine.

There are clear evidence that the western medicine, oriental medicine, and alternative medicine all are complimentary to each other. If and when all the complimentary components existing in various healing arts together in one medicine, a new integrated comprehensive wholistic medicine can be produced.

Objective: To investigate the correlation of main risk factors and cognitive-perceptual functions of stroke patients assessed with Mini-mental status examination (MMSE) and Motor-free visual perception test (MVPT) scores.

Method: Subjects were 41 stroke patients from 35 to 70 years of age. Data collection was done through chart review on risk factors of stroke including hypertension, diabetes mellitus, heart disease, hypercholesterolemia, and cigarette smoking. Three months after the onset of stroke, MMSE and MVPT were performed.

Results: The subjects with diabetes had significantly lower scores in MMSE (p＜0.05) and MVPT (p＜0.05) compared to those with nondiabetics. The subjects with left hemispheric lesion scored higher in MMSE than those with right hemispheric lesion (p＜0.05).

Conclusion: Among the several risk factors, diabetes mellitus has significant relationship to cognitive and visual perceptual function in the stroke patients.

Objective: The purpose of this study was to evaluate the motor recovery of initial and plateau period in the patients with subcortical stroke lesion which were different locations.

Method: We studied the 42 stroke patients with subcortical lesions who had been admitted to the Department of Rehabilitation Medicine from 1998 to 2000, retrospectively. Patients were divided into four groups according to the information from brain CT or MRI; Group 1: basal ganglia, group 2: anterior limb of internal capsule and/or basal ganglia, group 3: posterior limb of internal capsule and/or basal ganglia and group 4: thalamus only. Quantitative assessments of motor recovery using the Brunnstrom stage and results were correlated with sites of lesion.

Results: 1) Brunnstrom stages at initial and plateau period were the highest in the patients with thalamic lesion and the lowest in the patients with posterior limb of internal capsule and/or basal ganglia lesion. The patients with thalamic lesion showed higher stage than the patients with basal ganglia with anterior limb lesion in hand and low extremity (p＜0.05). 2) Significant motor recovery was occurred in all patients except the lesion located in thalamus (p＜0.05).

Conclusion: There were significant differences of motor recovery at plateau period in the patients with thalamic lesions comparing with basal ganglia with anterior limb lesion about hands and lower extremities and patients with basal ganglia and/or capsular lesion showed good motor recovery.

Objective: To compare the videofluoroscopic findings between the patients with lateral medullary infarct and middle cerebral artery infarct and to investigate specific findings relevant to lateral medullary infarct.

Method: Among patients with stroke taking videofluoroscopic study for swallowing problems, thirteen patients had a lesion in lateral medulla in imaging study and twenty-six patients in middle cerebral arterial territory. The findings of videofluoroscopic study on two groups were analyzed and compared.

Results: In oral phase, the ability of mastication and bolus formation were better in lateral medullary group. In pharyngeal phase, lateral medullary group revealed significantly impaired triggering of pharyngeal reflex, impaired laryngeal elevation, larger amount of residual materials, repeated swallow, delayed pharyngeal transit time, weaker pharyngeal muscle contraction, and poorer upper esophageal sphincter relaxation. Inadequate relaxation of upper esophageal sphincter was most significant factor in indicating the possibility of lateral medullary infarct (positive predictability 90.0%). Inadequate triggering of pharyngeal swallow indicated least possibility of lateral medullary infarct (negative predictability 92.3%).

Conclusion: Lateral medullary group has the characteristics of more impaired pharyngeal function and better oral function during swallowing than middle cerebral artery group in videofluoroscopic study. Inadequate upper esophageal relaxation and triggering of pharyngeal swallow are the most predictive for lateral medullary infarct.

Objective: To examine the correlation between Berg balance scale (BBS) which is tool for assessing the clinical balance function and sensory organization test (SOT) of computerized dynamic posturography (CDP) in brain injured patients.

Method: Thirty patients with brain injury were assessed on the BBS and SOT of CDP. BBS consists of 14 items and each item is graded on a five point ordinal scale (0∼4), yielding a total of 56 points. According to its characteristics, each item was divided 3 groups, which were sitting, standing and position change. Six equilibrium scores (EQ) were determined by SOT of CDP (EquiTest System^Ⱂ, Version 5.08) under 6 conditions, and somatosensory, visual, vestibular ratios were analyzed by 6 EQ scores.

Results: EQ 5 was correlated with reaching forward item (r=0.513), turning 360 degrees item (r=0.537), stool stepping item (r=0.529) of BBS (p＜0.01). EQ 6 was correlated with turning 360 degrees item (r=0.498) of BBS (p＜0.01). Sum of standing item group scores was correlated with EQ 5 (r=0.478), EQ 6 (r=0.464), and sum of position change item scores was correlated with EQ 5 (r=0.622), EQ 6 (r=0.514)(p＜0.01). Vestibular ratio was correlated with BBS total score (r=0.552, p＜0.01).

Conclusion: We concluded that vestibular ratio of SOT was correlated with BBS, especially position change item group. Therefore BBS is a good tool for evaluating vestibular function in brain injured patients.

Objective: To investigate the effect of the prism which deviates the optical axis 10 degree rightward in the stroke patients who have visuospatial neglect and to evaluate how long it will last.

Method: The subjects were 9 left hemiplegic patients who showed the feature of hemineglect. The prism goggle was applied and the patients were trained the midline point direction exercise. It's effect was evaluated by the line bisection test and the Albert test at the pre-training, immediate, 2 hours and 6 hours after the training respectively.

Results: The line bisection test and Albert test were not improved significantly at each evaluation time after the training.

Conclusion: This result revealed the prism therapy does not have a significant effect on the line bisection task and Albert test in the hemineglect patients consistently. The line bisection result in the line located in the left or right side at the 2 hours after the training was improved but it could not exclude the training effect of the repetition of the test.

Objective: The purpose of this study is to evaluate the psychosocial factors and outcomes in young adult stroke patients.

Method: The study group consisted of 59 stroke patients under the age of 45. Retrospective chart reviews of demographic findings, functional status, primary caregiver, marital and child status, discharge destination, employment and psychological difficulties were recorded by rehabilitation team during hospitalization. Telephone and mail surveys were carried out for the functional status, marital status, employment and social factors of the study group after discharge.

Results: The proportion of young adult stroke was 13.7% of all stroke patients. Young adult stroke were 20 cases (34%) of cerebral infarction and 39 cases (66%) of cerebral hemorrhage. Of the 39 married patients, 2 couples were separated. The marital adjustment skill was significantly lower in these couples than ordinary couples under age of 45. Forty-two of 51 patients were able to return to their premorbid residence. Of the 39 patients employed at the time of stroke, only 4 (10.3%) were able to return to work after discharge. Two of the 4 patients returned to school after discharge.

Conclusion: Rehabilitation of young adult stroke patients is associated with variety of social factors including marital adjustment and returning to work.

Objective: To determine the characteristic pattern of information processing in the children with specific language impairment (SLI) using the Kaufman-Assessment Battery (K-ABC) for children.

Method: Thirty patients were responded to K-ABC. Twenty-three of them were diagnosed as SLI without any abnormalities in other developmental areas, visual or auditory system. Seven patients showed language delay with other developmental abnormalities. Mean chronological age of SLI patients was 61.0 months. Patterns of information processing was measured using K-ABC. Sequential processing, simultaneous processing, mental processing, and achievement scales were obtained and compared between two groups.

Results: In SLI patients, sequential processing, simultaneous processing, mental processing, and achievement scales were 32.9⁑34.2, 54.3⁑26.9, 42.5⁑31.1, and 33.8⁑28.7, respectively. The SLI patients showed significantly poor scales in sequential than in simultaneous processing (p＜0.01).

Conclusion: The patients with SLI exhibited significant deficits in sequential processing, whereas simultaneous processing was better than that of the other group in this study. This characteristics of SLI patients will be useful for understanding and establishing proper therapeutic strategies for these patients.

Objective: The phenomenon of fibroblast overgrowth is one of the major problems encountered during long-term culture such as myoblast culture. The first goal of the study is to determine the effects of proline analogue and cytosine arabinoside to reduce fibroblasts in myoblast culture. The second goal is to investigate whether the chemicals influence the growth and differentiation of myoblast.

Method: Muscle tissues were obtained from legs of healthy men, and then fibroblasts and myoblasts were isolated and cultured. Those mixed cells were divided into three groups; control group, proline analogue (cis-hydroxyproline) treated group and cytosine arabinoside (araC) treated group. We evaluated the effectiveness of cis-hydroxyproline and araC on selective removal of fibroblasts in culture. We have also determined if cis-hydroxyproline and araC could alter differentiation of myoblast in each group.

Results: The treatment with araC was effective to eliminate fibroblasts comparing to the control group (p＜0.05) while there was no statistically significant difference between proline analogue and control group (p＞0.05). Myoblasts of all three groups were differentiated into myotube.

Conclusion: Using araC, we could reduce a number of fibroblasts in myoblast culture where contamination and subsequent overgrowth with fibroblasts remained a problem.

Objective: The aim of this study was to investigate the efficacy of capsaicin, a neurotoxin for C-fiber afferents, applied intravesically in the treatment of neurogenic bladder with detrusor hyperreflexia (DH).

Method: Six subjects, three women and three men with traumatic spinal cord injury who had neurogenic bladder manifested with DH and urinary incontinence resistant to oral and intravesical anticholinergic instillation treatment were tried with intravesical administration of capsaicin (1 mmol/l 100 ml) for 30 minutes. Single instillation was given in five subjects and two instillations in one. Maximal detrusor pressure and maximal bladder volume were monitored by the portable cystometer. Follow-up monitor of pressure and volume was recorded after 1 week and every 3 weeks afterwards for 21 weeks, with one exception (31 weeks).

Results: Average maximal detrusor pressure decreased by 50.8% and average bladder capacity at maximal detrusor pressure increased by 68% in five subjects after single instillation of capsaicin. Clinical benefit from single instillation lasted over 21 weeks and same as the subject with two instillations. Maximal effect on detrusor pressure appears during 6∼9 weeks period and bladder capacity during 9∼15 weeks period. Although autonomic dysreflexia in 5 of 6 subjects during instillation and macroscopic hematuria in 2 subjects during the 1st two days were noted, they were resolved spontaneously.

Conclusion: Single and repeated intravesical instillation of capsaicin were safe and effective in the management of neurogenic bladder with DH in traumatic spinal cord injured patients.

Objective: To evaluate effects of the electrical stimulation to the sacral dermatomes for the neurogenic bowel of the spinal cord injured patients.

Method: Eleven patients with cervical and thoracic cord injury were enrolled, and classified into two groups, control and electrical stimulation (ES) group. The colon transit time before and after electrical stimulation for 4 weeks to the sacral dermatomes were measured on the ES group, and measured at the same time on control group. The rectoanal manometries were performed after studies of colon transit time on the ES group.

Results: The colon transit time measured before electrical stimulation were 16.1⁑13.8 hours for the right colon; 20.1⁑23.3 hours for the left colon; 14.7⁑12.3 hours for the rectosigmoid colon; and the total transit time was 51.0⁑23.4 hours. The time of after electrical stimulation was 8.0⁑5.7 hours for the right colon; 12.8⁑2.2 hours for the left colon; 15.4⁑13.8 hours for the rectosigmoid colon; and the total transit time was 36.2⁑12.8 hours. The left colon transit time and total colon transit time before electrical stimulation were significantly improved compared to after electrical stimulation on the ES group (p＜0.05). The left colon transit time of the ES group was significantly improved compared with control group (p＜0.05). In the rectoanal manometry, the mean resting anal pressure and threshold of rectoanal inhibitory reflex were increased after the electrical stimulation.

Conclusion: The electrical stimulation to the sacral dermatomes on the spinal cord injured patient could effectively enhance colon transit, especially on the left colon. In addition, muscular activity of the anal sphincter was enhanced.

Objective: To evaluate the standards of handicapped driver's ability test in Korea and available driving aids in cervical cord injured persons.

Method: Forty-two cervical cord injured persons (C5∼C8) were evaluated with BTE (Baltimore Therapeutic Equipment) work simulator. The isotonic turning torque was measured during clockwise and counter-clockwise turning. And isometric turning torque was measured at 12 directions.

Results: By the isotonic measurement, the turning torque increased in the lower level of injury. In the C6 tetraplegics, the counter-clockwise turning torque was significantly higher than clockwise. Among 25 persons with C5 or C6 tetraplegia, only 2 with C6 tetraplegia could operate the power steering with the lowest wheel turning torque (3.0 Nm). Only three persons (1 person with C7 tetraplegia, 2 persons with C8 tetraplegia) could pass the handicapped driver's ability test of Korea (9.4 Nm). By the isometric measurement, turning torque was lowest at left upper quadrant (10 to 12 o'clock direction) in clockwise rotation.

Conclusion: Among the 42 cervical cord injured persons, only 3 persons with C7 and C8 tetraplegia could pass the handicapped driver's ability test of Korea. And among 25 C5 and C6 tetraplegia, only 2 persons with C6 tetraplegia could operate the power steering. It seems to be essential to modify the standards of handicapped drivers ability test and to evolve the driving aids for the C5 and C6 tetraplegics in Korea.

Objective: To evaluate the clinical usefulness of current perception threshold (CPT) test in diagnosing the diabetic neuropathy.

Method: We have recorded the neuropathic symptom score (NSS), CPT and the parameters of nerve conduction study (NCS) in 45 patients with diabetes. NSS was calculated according to the clinical symptom and signs, and the score more than 3 was regarded as abnormal (neuropathic). CPT was measured at the 2nd finger and 1st toe delivering the three different frequencies (2000, 250 and 5 Hz) of current and conventional NCS were performed at the median, peroneal motor and sural nerves. All the patients were assigned to three groups according to the result of NSS and NCS; group A, abnormal NSS and NCS; group B, abnormal NSS only; group C, normal NSS and NCS. CPT was compared between groups, and we investigated the correlation between CPT and NSS, and parameters of NCS. Also the sensitivity and specificity of CPT test were calculated.

Results: The mean CPT was significantly increased in the entire diabetic groups as compared with control group (p＜0.05). CPTs measured by 2000 Hz stimulation at the finger and toe were positively correlated with the most parameters of NCS (p＜0.05), and CPT was more highly correlated with NCS (p＜0.05) than NSS. The sensitivity and specificity of the CPT were 94.1% and 10.7%, respectively.

Conclusion: The CPT test may have added value in diagnosing the diabetic neuropathy as a screening.

Objective: To investigate the effects of treadmill running and swimming exercise for the functional and electrophysiological recovery in rats with sciatic nerve damage, and to evaluate the patterns of recovery according to various degree of intensity and duration of injury.

Method: Sixty male Sprague-Dawley rats (200∼250 g) were used, and divided into the control and the experimental groups. Crushing injuries to the sciatic nerve at the sciatic notch was manipulated using a hemostatic forcep, treadmill and swimming exercise programs were performed for 30 minutes on a daily basis, 5 days a week during the 4 week period. The experimental group was divided into 2 sub-groups in correlation with the intensity of injury, and into 5 and 30 seconds group in correlation with the duration of injury. The test results were analysed by sciatic nerve functional index (SFI) that was obtained through walking tract analysis, and by the amplitude of compound muscle action potentials in calf muscles through the sciatic motor nerve conduction study.

Results: 1) After 4 weeks following sciatic nerve injuries, the SFI were ⁣21.8⁑10.8, ⁣23.1⁑7.0, ⁣32.5⁑9.1 in treadmill, swimming, and control groups, respectively. Treadmill and swimming groups showed markedly improved function compared to the control group. Amplitudes of sciatic nerve compound muscle action potentials in calf muscle were 21.2⁑6.5, 15.9⁑5.8, 12.5⁑2.0 mV in treadmill, swimming, and control groups respectively, and revealed marked electrophysiological improvement in treadmill group. 2) The results concerning the intensity and the duration of injury, nerve recovery patterns showed the most significant improvement in the first degree-5 seconds group in both treadmill and swimming exercise programs.

Conclusion: These findings suggest that the treadmill and swimming exercises have significantly better effect in the regeneration of damaged sciatic nerve than that of control, and the intensity of injury was a more important factor in the recovery of nerves compared to the duration of injury.

Objective: The purpose of this study was to investigate the changes of oxygen consumption and heart rate at forward and backward treadmill walking in healthy male college students.

Method: Subjects were composed of twenty healthy male college students. The oxygen consumption, oxygen consumption ratio of maximal oxygen consumption (VO_2max%) and heart rate, heart rate ratio of maximal heart rate (HRmax%) were measured for each subjects by administering a treadmill exercise test at 5 km/hr speed of forward and backward walking. Paired t-test was used to evaluate the difference of the forward and backward walking.

Results: The study showed that heart rate and HRmax% were 120.9 beat/min, 61.6% in forward walking, and 166.1 beats/min, 84.3% in backward walking, respectively. The oxygen consumption and VO_2max% were 15.9 ml/kg/min, 37.3% in forward walking, and 23.6 ml/kg/min, 55.8% in backward walking, respectively.

Conclusion: We concluded that 5 km/hr backward walking was more effective exercise program than forward walking to promote health in the college students.

Objective: The purpose of this study was to evaluate and compare the natural course of morphologic changes and clinical outcomes between large central extruded disc herniation and sequestration.

Method: The study population consisted of 22 patients with sequestration and large central extrusion by an magnetic resonance (MR) imaging study. Seventeen (11 patients with sequestration, 6 patients with large central extrusion) patients underwent a follow-up MR imaging study. The size of herniated disc was measured on serial MR imaging studies and the change in size was classified into four categories. Clinical evaluations were also done using visual analogue scale (VAS), Oswestry low back pain disability questionnaire scoring, straight leg raising test (SLRT) and so forth.

Results: Successful clinical improvement was achieved in both groups. The VAS and Oswestry disability scoring established a greater change in the group with sequestration than in the group with large central extrusion. Greater morphologic decrease in the herniated discs occurred more frequently in sequestered disc herniation than large central extruded disc herniation.

Conclusion: Both sequestered disc and large central extruded disc herniation could be treated successfully by conservative treatment.

Objective: To investigate the relationship between the plasma leptin concentration and bone metabolism in postmenopausal women with osteoporosis to improve the understanding of the role of leptin in controlling bone mass.

Method: Fifty four postmenopausal women (ages 64⁑8.59 years, body weights 58.14⁑6.92 kg) with osteoporosis were included. The biochemical markers of bone metabolism and serum leptin concentration were measured using the radioimmunoassay. Bone mineral densities were measured by dual energy X-ray absorptiometry. And we investigate the correlation between serum leptin concentration and the biochemical markers of bone metabolism or bone mineral density.

Results: The bone mineral densities were 0.639⁑0.130 g/cm² in mid-lumbar area, 0.684⁑0.098 g/cm² in femoral neck and 0.491⁑0.117 g/cm² in Ward's triangle. The mean value of serum osteocalcin was 26.84⁑16.73 ng/ml, the mean value of urine deoxypyridinoline was 11.84⁑6.08 nmol/mmol Cr, and the plasma concentration of leptin was 11.51⁑8.64 ng/ml. There was no correlation between plasma leptin concentrations and the markers of bone metabolism or bone mineral density.

Conclusion: We could not confirm the significant correlation between the circulating leptin concentration and the bone mass in postmenopausal women. Our data suggest circulating plasma leptin does not have a significant direct influence on bone metabolism and bone mass in postmenopausal women.

Objective: To investigate the changes of bone mineral density (BMD), biochemical bone markers, and lipid profiles according to the duration of menopause in postmenopausal osteoporosis patient receiving continuous hormonal replacement therapy (c-HRT).

Method: Sixty seven patients with postmenopausal osteoporosis who have been under c-HRT for more than two years were used as subjects and divided into two groups according to the time past menopause: group I (0∼10 years), group II (over 10 years). The changes of BMD, biochemical bone markers, lipid profiles on one year and two years of c-HRT were comparatively analyzed in each group.

Results: 1) BMD of lumbar vertebra was increased and biochemical bone markers were decreased after c-HRT in both groups, but BMD of femur from both groups showed no statistical significant changes. 2) The changes in lumbar vertebra, deoxypyridinoline and osteocalcin were significantly higher after first one year than next one year of c-HRT in both groups, with no statistical differences between two groups. 3) Total cholesterol and LDL-cholesterol were decreased, but HDL-cholesterol and triglyceride showed no significant changes after c-HRT in both groups.

Conclusion: The effects of c-HRT on BMD, biochemical bone markers, lipid profiles were not influenced by postmenopausal period. And the effects of c-HRT during first one year were more prominent than those of c-HRT during next one year.

Objective: The aims of this study were to evaluate gait patterns in transtibial amputees with the barefeet relative to the shoe and also to identify the differences between their gait patterns of two different types of prosthetic feet.

Method: An optoelectronic motion analysis of gait was done in six transtibial amputees using both the SACH foot and the single axis foot. In both cases we compared the state of the barefeet with the shod.

Results: The gait abnormalities which were observed during the barefeet gait with the SACH foot showed knee joint hyperextension of 9.9±2.0^o and the loss of ankle plantar flexion at the early stance phase. When the single axis foot was used, there was a reduction in knee flexion thrust from 9.9±3.7^o to 7.2±3.8^o and also in plantar flexion from 9.9±2.8^o to 7.0±2.1^o during the early stance phase.

Conclusion: There were significant gait abnormalities during the barefoot walking state in transtibial amputees with the SACH foot. We observed that gait patterns have been improved when the single axis prosthetic foot was used.

Objective: To assess overall quality of life (QOL) in lower limb amputees and identify the factors affecting their quality of life.

Method: This study was designed as an interview survey using the questionnaire. The subjects were 78 lower limb amputees (male 76, female 2) and the age matched 39 healthy adult males consisted control group. Interview questionnaire included level of education, religion, marital status, occupation and income. Depression was measured by the Beck depression inventory (BDI). The QOL was measured by the MOS 36-item short-form health survey (SF-36). The SF-36 scores of amputee group were compared with that of control group, and were compared according to the various factors.

Results: The mean overall scores of QOL in amputee and control group were 50.2⁑21.7, 73.6⁑12.7 respectively (p＜0.05). The mean scores were significantly reduced in amputee group as compared with the control group in entire dimension (p＜0.05). Depression and numbers of combined diseases had a negative effect on multiple areas of QOL (p＜0.05), however, occupation, income, amputation level, and time after amputation had no significant effect (p＞0.05).

Conclusion: The QOL assessed by SF-36 indicated relatively low functional and well-being status in amputees. Depression and combined diseases would be a most important factors on QOL.

Manganese intoxificaton is a well-known cause of Parkinson's like syndrome.

We describe a 46-year-old man who had been occupationally exposed to manganese and report the case with hydrogen magnetic resonance spectroscopy (¹H MRS). Ratios of N-acetyl-aspartate (NAA) to creatine were significantly reduced in basal ganglia regions compared to normal subjects. The level of NAA was decreased in basal ganglia regions may indicate neuronal dysfunction. ¹H MRS can provide detailed information of brain damage, therefore the ¹H MRS is very useful in diagnosis of manganese intoxification.

Aspergillosis of the spine has been reported infrequently. It has usually been attributed to hematogenous infection, spread from an adjacent pulmonary infection. Acute paraplegia developed in a 68 year old man with aspergillus infection. Histopathologic findings showed aspergillus hyphae and magnetic resonance imaging study revealed mid thoracic cord compression. Direct extension of aspergillus infection caused an epidural abscess, vertebral destruction, thoracic spinal cord compression, and paraplegia.

Achondroplasia is a congenital developmental condition characterized pathologically by defective enchondral ossification, affecting chiefly the long bones, and clinically by peculiar dwarfism with short extremities and normal trunk. One of the most common neurologic manifestation in achondroplastic patients in adulthood is spinal stenosis where the prominent characteristics of lumbar vertebrae structure are shortening of interpedicular distance and hypertrophy of vertebral pedicle. There has been no case report of traumatic cauda equina syndrome resulted in paraparesis among achondroplasic patients in Korea. We experienced a 30 year-old achondroplastic man sustained paraparesis as the result of an accidental slipping down. After the surgical decompression, the patient made slow recovery in all aspects of function via rehabilitation therapy.

Spontaneous intraperitoneal hemorrhage in the patient who has cervical spinal cord injury and been treated by warfarin, is rarely reported. In general, adverse drug reactions of warfarin were reported as bleeding, cutaneous microvascular thrombosis.

A 46-year-old C4 tetraplegia (ASIA A) patient had been treated by warfarin for a treatment and prevention of pulmonary embolism after cardiopulmonary resuscitation. Suddenly, the patient complained dyspnea and abdominal distension and we noticed that his hemoglobin count was very much lower than usual. So, we had the patient to take the abdominal CT and find out there was a bleeding in intraperitoneal area. We did angiography trying to find out the bleeding focus but in vain.

We concluded that it was the spontaneous intraperitoneal hemorrhage due to warfarin therapy and we finally made an improvement with the conservative treatment.