OBJECTIVE: To investigate the psychological development such as emotional and social aspects of typically developing siblings of children with cerebral palsy. METHOD: Eighteen siblings of children with cerebral palsy aged 5 to 12 years and their mothers were included and the interview and psychological assessment were administered by developmental psychologist. All children were asked to complete the Children's Depression Inventory (CDI), State- Trait Anxiety Inventory (STAI), Piers-Harris Children's Self- Concept Scale, Korea Child Behavior Checklist and Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children (KEDI-WISC). All participating mother were asked to complete Minnesota Multiphasic Personality Inventory (MMPI), Beck's Depression Inventory (BDI). For control group, eighteen children with healthy sibling and their mothers were enrolled. RESULTS: Siblings of children with cerebral palsy showed higher mean score of CDI and STAI. And there were no differences in the CDI and STAI according to frequency of treatment, duration of treatment of children with cerebral palsy. There were no significant difference in Piers-Harris children's Self-Concept Scale and Korea Child Behavior Checklist between study group and control group. More than half of mothers of children with cerebral palsy showed depression in BDI and higher score of psychopathic Deviate and psychasthenia in MMPI. Children of mothers with depression in BDI showed higher mean score of CDI and STAI. CONCLUSION: It is necessary to consider extended service to promote psychosocial well-being of children with cerebral palsy and siblings in community-based service organizations.
Aged ; Anxiety ; Cerebral Palsy ; Checklist ; Child ; Child Behavior ; Depression ; Humans ; Intelligence ; Korea ; MMPI ; Mothers ; Siblings

OBJECTIVE: To evaluate the tendency of occurrence of dental caries in the primary or permanent dentition of children with cerebral palsy (CP) and attempt to determine an appropriate treatment method. METHOD: We examined 29 children with CP treated in our rehabilitation center (CP group) and 27 normal children from one of the local kindergartens (control group). We checked DMF (decayed, missing and filled teeth) and DMF ratio (DMFR) and asked them if they underwent regular dental examinations or not. RESULTS: The mean age (+/-standard deviation) of the CP and control groups was 4.75 (+/-1.99) and 4.96 (+/-0.71), respectively. The prevalence of dental caries in the CP and control groups was 69% and 44%, respectively; moreover the percentage of patients in the CP group who underwent regular dental examinations was lower, as compared to the control group. Moreover, a significant statistical relationship between dental caries and regular dental examinations was observed only in the CP group. CONCLUSION: As compared to the control group, the prevalence of dental caries in children with CP was higher, and they also underwent regular dental examinations less frequently.
Cerebral Palsy ; Child ; Dental Caries ; Dentition, Permanent ; Humans ; Prevalence ; Rehabilitation Centers

OBJECTIVE: To determine risk factors of orthostatic hypotension in ischemic stroke patients. METHOD: In 98 ischemic stroke patients, blood pressure and heart rate were measured after resting in the supine position for 10 minutes and again after standing for one minute. Presence of orthostatic hypotension was correlated with age, gender, body mass index, laboratory findings, diabetes mellitus, anti-hypertensive use, side of involved hemisphere, smoking and K-MBI (Korean Modified Barthel Index). RESULTS: 30 out of 98 patients had orthostatic hypotension. Those patients with orthostatic hypotension were older in age and had a higher average blood pressure, heart rate and plasma creatinine. On the other hand, body mass index, K-MBI and serum sodium levels were lower in the orthostatic hypotension group. Multivariate analysis revealed that age, body mass index, anti-hypertensive use and smoking were independently associated with orthostatic hypotension. CONCLUSION: Old age, low BMI, anti-hypertensive use, smoking were risk factors of orthostatic hypotension in the ischemic stroke patients. Patients in the higher risk categories should receive regular monitoring of blood pressure in order to detect orthostatic hypotension and prevent its complications.
Blood Pressure ; Body Mass Index ; Creatinine ; Diabetes Mellitus ; Hand ; Heart Rate ; Humans ; Hypotension, Orthostatic* ; Multivariate Analysis ; Plasma ; Risk Factors* ; Smoke ; Smoking ; Sodium ; Stroke* ; Supine Position

OBJECTIVE: To identify the usefulness of laryngeal reflex cough test (LRCT) as screening test for aspiration, especially silent aspiration, in stroke patients with dysphagia. METHOD: Gag reflex (GR), 3-oz water swallow test (WST) and LRCT were performed in 70 stroke patients with dysphagia and their results were compared with those of videofluoroscopic swallowing study (VFSS). Laryngeal reflex cough was induced with the nebulized 20% l-tartaric acid, which irritates the mucosa of laryngeal vestibule. Diagnostic values such as sensitivity, specificity, predictive values, accuracy of each test for detecting aspiration and silent aspiration shown in VFSS were evaluated. RESULTS: 37 out of 70 patients (53%) showed subglottic aspiration or supraglottic penetration in VFSS. Sensitivity and specificity of LRCT to diagnose aspiration on VFSS were 16% and 88%, respectively. Positive and negative predictive value, and accuracy were 60%, 48%, and 50% respectively. Sensitivity and specificity of GR and WST for detecting aspiration were 46%, 73% and 43%, 82%. In 28 patients (40%), VFSS revealed aspiration without cough (silent aspiration). Sensitivity and specificity of LRCT for detecting silent aspiration were 14% and 78%, whereas those of GR and WST were 50%, 67% and 50%, 78%. By combining of all tests sensitivity for detecting aspiration and silent aspiration were 76% and 92%. CONCLUSION: LRCT showed inadequate sensitivity and predictive values in predicting the risk of aspiration and silent aspiration. Combining LRCT with GR and WST improved sensitivities for detection of aspiration and silent aspiration.
Cough* ; Deglutition ; Deglutition Disorders ; Humans ; Mass Screening* ; Mucous Membrane ; Reflex* ; Sensitivity and Specificity ; Stroke* ; Water

OBJECTIVE: To develop a Korean version of Modified Barthel Index (K-MBI) for subjects with stroke and to test the reliability and validity of K-MBI. METHOD: Six senior physiatrists translated the 5th version of MBI into K-MBI and we administered K-MBI to 30 subjects with stroke. Fifteen different examiners working at the 5 different university hospitals evaluated video-recorded examination cases independently to test the reliability and validity of K-MBI. We analyzed intra- and inter-rater reliabilities of the K-MBI by the Kendall's coefficient of concordance and Spearman's correlation coefficients, respectively. Cronbach's alpha coefficient was used for assessing internal consistency of the K-MBI and Spearman's correlation between the K-MBI and Brunnstr?m stage was employed to evaluate the validity of the K-MBI. RESULTS: The intra-rater reliabilities of physiatrists, resident physicians of rehabilitation medicine and occupational therapists were 0.93~1.00, 0.87~0.99, and 0.97~1.00 (p< 0.01), respectively. The inter-rater reliabilities were 0.93~0.98 (p<0.01) and Cronbach's alpha was 0.84 (p<0.01) as the internal consistency reliability of K-MBI. For construct validation study, each item of K-MBI had significant correlation with total score of K-MBI (r=0.54~0.78, p< 0.01). CONCLUSION: The K-MBI is a reliable and valid instrument for measuring functional status of subjects with stroke.
Hospitals, University ; Rehabilitation ; Reproducibility of Results ; Stroke*

OBJECTIVE: To see whether anodal direct current (DC) polarization of the inferior parietal cortex (IPC) and the primary sensorimotor area (SM1) in corticobasal degeneration (CBD) patients leads to improvement of praxia and finger motion. METHOD: Twelve patients with CBD were enrolled. This single blind crossover study had three arms, anodal DC to IPC, anodal DC to SM1, and shame polarization on occipital area. DC was delivered for 40 minute at 2 mA with 25 cm2 sponge electrodes. Before and 20 min after the start of polarization, we performed the test of oral and limb apraxia (TOLA), finger tapping frequency, and grooved pegboard test. RESULTS: The total score of TOLA was increased 5.4+/-2.3% after anodal DC to IPC. The scores of limb apraxia and picture gesture subtests of TOLA, not of oral apraxia subtest, increased significantly after anodal DC to IPC compared to sham DC polarization (p<0.05). In anodal DC to SM1 group, the finger tapping frequency increased 15.5+/-14.1%, which was significantly greater than in sham group (p<0.05). CONCLUSION: These results showed beneficial effects of anodal DC polarization on apraxia and hand function in CBD patients. In addition, these effects for apraxia and hand movement were dependent on their stimulation sites of brain.
Apraxias* ; Arm ; Brain* ; Cross-Over Studies ; Electrodes ; Extremities ; Fingers ; Gestures ; Hand* ; Humans ; Porifera ; Rabeprazole ; Shame

OBJECTIVE: To determine whether transplanted human adipose tissue derived stem cells (hATSCs) can survive and increase the amount of proteoglycans in degenerated intervertebral disc. METHOD: Lumbar disc degeneration was induced in thirty New Zealand white rabbits by injection of chondroitinase ABC(R). After 2 weeks, hATSCs were transplanted in degenerated disc in hATSCs group. Control group received phosphate buffered saline. The histologic grading and height of disc were measured at 2, 4, and 8 weeks after transplantation. The viability of donor cells was identified by using beta-Actin gene polymerase chain reaction (PCR). RESULTS: 4 and 8 weeks after hATSCs transplantation, the histologic grading showed significantly high score in hATSCs group (p<0.05), but the amount of proteoglycans was not significantly different between the two groups. The change of disc height was not significantly increased in hATSCs group. In the beta-Actin gene PCR analysis, positive signal in the hATSCs group was observed. CONCLUSION: hATSCs transplantation may be useful in decelerating disc degeneration in experimental models and provide new hopes for treatment of degenerative disc disease in humans
Actins ; Adipose Tissue* ; Hope ; Humans* ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Mesenchymal Stromal Cells* ; Models, Theoretical ; Polymerase Chain Reaction ; Proteoglycans ; Rabbits ; Stem Cells ; Tissue Donors

Trauma is one of the causes of lymphedema. However, we usually do not consider it as a cause of the lymphedema, thus, we often fail to take care of the patients properly. We report a patient with post traumatic lymphedema and the result of complex decongestive therapy, and reviewed the clinical, lymphoscintigraphic findings and treatment.
Humans ; Lymphedema*

The diagnosis of thoracic outlet syndrome (TOS) is sometimes confused by its nonspecific symptoms and various etiologies. Moreover, the paths of involving nerves and arteries are highly diverse. We report a 35 year-old man who had numbness and coldness in his left upper extremity with no improvement to medical therapy. The electrophysiologic studies were normal. Radial artery pulse was absent and the thermography revealed markedly reduced temperature below the left mid-forearm. The arteriography showed compression of the left subclavian artery between the clavicle and the 1st rib with aneurysmal change proximal to the compression. Occlusion of the left brachial artery and collateral arteries were also observed. Under the diagnosis of vascular TOS, 1st rib resection was performed and his symptoms were relieved. Vascular TOS may be considered in cases of upper limb paresthesia.
Adult ; Aneurysm ; Angiography ; Arteries ; Brachial Artery ; Clavicle ; Diagnosis ; Embolism ; Humans ; Hypesthesia ; Paresthesia ; Radial Artery ; Ribs ; Subclavian Artery ; Thermography ; Thoracic Outlet Syndrome* ; Upper Extremity

Neuropathic arthropathy is a chronic and progressive disease of bone and joints. One of the most common causes of neuropathic arthropathy is syringomyelia. Syringomyelia associated with Arnold-Chiari I malformation has been well documented in many reports. We report a case of 76 year-old woman presented with the right elbow joint pain and stiffness. Her symptom was caused by neuropathic arthropathy associated with Arnold-Chiari I malformation and syringomyelia. The purpose of this paper is to emphasize that neuropathic arthropathy requires the evaluation of central nervous system to assess for occult causal lesion.
Aged ; Central Nervous System ; Elbow Joint ; Female ; Humans ; Joints ; Syringomyelia*