The Effect of Comprehensive Hand Repetitive Intensive Strength Training (CHRIST) Using Motion Analysis in Children with Cerebral Palsy

OBJECTIVE: To investigate the effect of Comprehensive Hand Repetitive Intensive Strength Training (CHRIST) on upper limb function in children with cerebral palsy using motion analysis. METHOD: The subjects in this study included 19 children (10 males, 9 females, mean age=8.8 years) with cerebral palsy. The experimental group (n=10) received CHRIST and general rehabilitation therapy. The control group (n=9) received a home program as well as general rehabilitation therapy. Both groups received 30 sessions of CHRIST or home program training for 60 minutes per session 3 times a week during the 10-week period. The reaching movements were captured by a motion analysis system. Kinematic variables including movement time (MT), mean velocity (MV), normalized jerk score (NJS), mean angular velocity (MAV) and normalized jerk score of the shoulder, elbow and wrist joint with comfortable and fast speed were analyzed between groups and the pre-post training group. RESULTS: After pre- and post-training experimental group, MT, MV, NJS, MAV of shoulder, elbow, wrist and NJS of elbow and wrist improved significantlyin reaching movement of both comfortable and fast speed (p<0.05). However, After pre- and post-training control group, MV improved significantlyin reaching movement of only comfortable speed (p<0.05). Between two groups, MT and MAV of the elbow at comfortable speed and NJS of the elbow at fast speed were statisticallysignificant (p<0.05). CONCLUSION: CHRIST proved to be an effective intervention for improving upper limb extremity function of reaching movement in children with cerebral palsy.

A Learning Set Up for Detecting Minimally Conscious State (MCS)

Detecting signs of learning in persons diagnosed to be in a post-coma vegetative state and minimally conscious state (MCS) may modify their diagnosis. We report the case of a 65-year-old female in a vegetative state. We used microswitch-based technology that is based on patient response to eye-blinking. We followed an ABABCB design, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. We observed the level of response during the B phases was higher than the level of A and C phases. This indicated the patient showed signs of learning. This state was confirmed by an evaluation through the Coma Recovery Scale-Revised (CRSR) score, and after completion of this study her CRSR score changed from 4 to 10. We believe microswitch technology may be useful to make a diagnosis of MCS and offer new opportunities for education to MCS patients.

A Learning Set Up for Detecting Minimally Conscious State (MCS)

Detecting signs of learning in persons diagnosed to be in a post-coma vegetative state and minimally conscious state (MCS) may modify their diagnosis. We report the case of a 65-year-old female in a vegetative state. We used microswitch-based technology that is based on patient response to eye-blinking. We followed an ABABCB design, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. We observed the level of response during the B phases was higher than the level of A and C phases. This indicated the patient showed signs of learning. This state was confirmed by an evaluation through the Coma Recovery Scale-Revised (CRSR) score, and after completion of this study her CRSR score changed from 4 to 10. We believe microswitch technology may be useful to make a diagnosis of MCS and offer new opportunities for education to MCS patients.

Validation of Gugging Swallowing Screen for Patients with Stroke Based on Videofluoroscopic Swallowing Study

OBJECTIVE: To evaluate the clinical validity of gugging swallowing screen (GUSS) scale in comparison with the findings of videofluoroscopic swallowing study (VFSS) for subacute and chronic stroke patients, though GUSS was developed in order to screen dysphagia in acute stroke patients. METHOD: The subjects of this study were thirty-five patients who had stroke for more than 3 months and were showing the symptom of dysphagia. GUSS, VFSS and clinical examination were performed respectively by three different physiatrists. These tests were performed at intervals of 24 hours or less. The result of GUSS was compared with videofluoroscopic dysphagia scale (VDS) based on VFSS, Clinical dysphagia scale (CDS), and ASHA scale based on clinical patterns. RESULTS: The result of GUSS was in a significant correlation with VDS, CDS, and ASHA scale (p<0.01). GUSS predicted aspiration very efficiently (area under the curve=0.928; 95% CI, 0.833 to 1.022). The cutoff value of 12 point showed sensitivity of 89.5%, specificity of 87.5%, and negative predictability of 87.5%. CONCLUSION: The GUSS is considered as an effective and convenient screening tool to evaluate stroke patients with dysphagia irrespective of stroke stages.

Evaluation of Latex Agglutination Test Kit for Rapid Detection of Methicillin-Resistance in Staphylococcus aureus / 대한임상병리학회지

BACKGROUND: The identification of methicillin-resistant Staphylococcus aureus (MRSA) in the clinical laboratory has been typically performed by using methods that detect phenotypic expression of resistance determinants. However, these methods are not always reliable since phenotypic expression of methicillin resistance is known to be heterogeneous. In this study, MRSA-Screen test (Denka Seiken Co., Ltd., Tokyo, Japan), consisting of a slide latex agglutination kit that detects PBP 2a with a monoclonal antibody, was compared to the oxacillin disk diffusion test, the oxacillin-salt agar screen, agar dilution MIC and PCR of the mecA gene for the detection of methicillin resistance in S. aureus. METHODS: A total of 48 MRSA and 46 methicillin-susceptible S. aureus (MSSA) clinical isolates, defined by the presence or absence of the mecA gene, respectively, were tested. RESULTS: The MRSA-Screen test, the oxacillin disk diffusion test, and the oxacillin-salt agar screening test showed sensitivity of 97.9%, 93.8%, and 97.9% and specificity of 100% in all three tests. CONCLUSION: We conclude that the MRSA-Screen test is very accurate, reliable and easy to perform for detection of methicillin resistance in S. aureus.

The Brachioradialis Muscle Flap for Resurfacing of Sort Tissue Defect in the Hand and Forearm

The provision of adequate soft tissue cover for a complex hand and forearm wound-dirty, infected and exposed bone can be a challenging problem. Conventionally, a distant flap or free flap have been used, but these have been associated with several problems such as joint stiffness, risk of microsurgical procedures, negligible donor site morbidity, prolonged operation time and economic restriction. As well, fasciocutaneous flap has been the limitation of infection control. In these situations, the ipsilateral muscle flap provides the ideal cover with its rich blood supply and single operative field. Previously described by Lendrum(1980), by Lae et al.(1981), and later by McGeorge(1991), the brachioradilis muscle is the most superficial muscle on the radial side of the forearm. Its flap is based on the radial artery and venae comitantes. From August 1996 to October 1997, we performed branchioradialis muscle flap in seven patients. Despite the sacrifice of the major hand artery, brachioradialis muscle flap has many advantages including the reliability of flap survival, easy dissection, early mobilization and absence of functional and aesthetic problems at the donor site. It is a relatively simple and rapid method for resurfacing soft tissue defect in the hand and forearm. We obtained satisfactory and reliable results.

REPLANTATION OF THE COMPLETE AVULSION OF THE FINGERS

No abstract available.

THE GASTROCNEMIUS MUSCLE FREE FLAP: FOR THE RECONSTRUCTION OF LOWER LEG AND FOOT

No abstract available.