The Present Condition and Problem of the Grading Guide for Disability after Stroke

OBJECTIVE: The purposes of this study were to analyze the problems and to suggest the methods for improvement of the current Disability Grading Guide (hereinafter called CDGG) for the disabled after stroke when compared with the previous Disability Grading Guide (hereinafter called PDGG). METHOD: Thirty-five registered disabled persons after stroke were evaluated by two physiatrists to assess the grades of disability according to CDGG and PDGG, which were in use. The evaluations of disabled persons for the grading were done by the physiatrists through house-visit and at the hospital according to CDGG (hereinafter called CDGG-visit and CDGG-OPD) and PDGG (hereinafter called PDGG-grade). These reevaluated disability grades were compared with the initial disability grades recorded in their disability registries. RESULTS: There was a low level of agreement between the registered grade and the re-evaluated grades; however, there has shown a high level of agreement amongst the re-evaluated grades. The degree in the registered grade was evaluated upward compared to the degree in other reevaluated grades. CONCLUSION: The difference degree between CDGG and PDGG of established was insignificant; however, a new candidate who wants to be evaluated using CDGG has possibilities of facing unfairness when compared to the disabled people with relatively higher registered degrees.

The Effect of Diet, Exercise and Growth Hormone Treatment for Obese Non-Insulin Dependent Diabetes Mellitus(NIDDM)

OBJECTIVE: To investigate whether there is a significant effect of growth hormone(GH) treatment with diet and exercise over the diet and exercise alone in obese non-insulin dependent diabetes mellitus(NIDDM). METHOD: Twenty obese NIDDM adults were studied. We measured the body weight, body composition and exercise capacity before and after 12 weeks of treatment program. The subjects were assigned in a double-blind manner either to the diet, aerobic exercise with placebo treatment group(group A) or to the diet, aerobic exercise with GH treatment group(group B) for twenty-week period. Two groups were compared for the demographic data. RESULTS: After 12-weeks of treatment program, each group showed a significant weight loss (group A: 8.54+/-2.29 kg vs group B: 7.14+/-2.99 kg) than before the treatment, however there was no significant weight loss between two groups. After 12-weeks, the fat fraction of body weight loss was significantly higher in group B than group A(0.80+/-0.40%kg versus 0.55+/-0.30%kg). After 12-weeks, the maximal oxygen consumption was similarly increased in both groups(23.75% in the group A versus 29.2% in the group B). After 12-weeks, the peak torque was similarly increased in both groups(9.7% in the group A versus 17.3% in the group B). After 12-weeks, the endurance was similarly increased in both groups(10.1% in the group A versus 8.1% in the group B). CONCLUSION: Both group A and B showed a significant weight loss and resulted in a comparable gain in the muscle strength, endurance, and maximal oxygen consumption. The addition of GH in a low dose to a the calorie-restricted diet and aerobic exercise resulted in a significant fat loss especially around the visceral area.

A Study on Usage of Classroom Desks and Chairs by Teenagers

OBJECTIVES: To evaluate the compatability of high school students' desks and chairs to the fittness of their physique, to examine the factors related the posture and pain while they use the classroom desks and chairs, and to analyze the curvature of spine in sitting position. METHOD: Measurements of the dimensions of desks and chairs and a written survey to question students' habits regarding to the usage of classroom desks and chairs along with the physical examinations of spine including the analysis of spine curvature in sitting position with an electrogoniometer. RESULTS: Seven hundred forty nine among 831 male students, and 1,017 among 1,074 female students, complained of discomforts associated with the usage of classroom desks and chiairs. An examination of spine in sitting position using an electrogoniometer showed that both male and female subjects displayed the spine curvatures in the order of thoracic kyphosis, lumbar lordosis, and scoliosis. All subjects displayed pain in the order of low back(38.8%), posterior neck(23.9%), shoulder and elbow joints(15.8%), and buttock(15.7%). CONCLUSION: The study revealed an urgent need for the adaptation of classroom desks and chairs according to the growing physique of the adolescents. A majority of the teenaged subjects experienced the discomfort from the use of improper funiture and a poor posture. Authors highly recommend a formal education to the students regarding the importance of proper posture and the usage of adjustable desks and chairs.

Ultrasound Findings in Duchenne Muscular Dystrophy Disease

The real-time ultrasonography is a simple, noninvasive procedure that is most suitable for application in pediatric practice. The ultrasonographic appearance of various disorders in children such as progressive muscular dystrophies, infantile spinal muscular atrophy, congenital myopathies, and motor neuropathies has been found to be strikingly abnormal. We have done a pilot study using real-time ultrasonography in children with Duchenne muscular dystrophy in an attempt to correlate their clinicopathologic profiles with scan findings. Echogenicity and delineation of fascia at midthigh and midcalf muscle were measured using a real-time linear array ultrasound scanner in 12 Duchenne mucular dystrophy patients attending our Muscle Clinic, as a double-blind pilot study matched against 10 controls. The ultrasonic scan findings in normal children revealed no echogenicity of muscle, distinct echogenicity of bone and delineation of fascia. But all Duchenne muscular dystrophy patients had increased echogenicity of muscle and decreased echogenicity of bone, and some patients had interruption of delineation of fascia. Duchenne muscular dystrophy patients who were unable to raise from standard height chair showed higher grade of echogenicity at midthigh level than the patients who were able to raise from standard height chair. But this result was not applicable at midcalf level. We concluded that the real-time ultrasonography was useful diagnosis method in Duchenne muscular dystrophy. In addition, when the real-time B ultrasonography was applied to midthigh level, the ultrasonic scan findings could reflect indirectly the functional ability of Duchenne muscular dystrophy patients.