Dystonia is a symptom defined by involuntary and irregular contractions of the muscles, which cause movement disorders and postural problems. Deep brain stimulation (DBS) in globus pallidus interna (GPi) is a good option for controlling dystonia. DBS has already been shown to have significant effects on primary dystonia as well as Parkinson's disease. Dystonia is very difficult to manage, as seen in cerebral palsy (CP) mixed with spasticity. As CP patients grow, their musculoskeletal problems may require orthopedic surgery. However, the outcome of orthopedic surgery is not usually suitable due to dystonia. Therefore, we attempted to control dystonia through DBS initially and perform orthopedic surgery to correct musculoskeletal deformities after treatment of dystonia. Herein, we report a case that showed remarkable improvement in terms of the dystonia rating scale and gait pattern after combined therapy of DBS and orthopedic surgery.
Cerebral Palsy ; Congenital Abnormalities ; Contracts ; Deep Brain Stimulation ; Dystonia ; Dystonic Disorders ; Gait ; Globus Pallidus ; Humans ; Movement Disorders ; Muscle Spasticity ; Muscles ; Orthopedics ; Parkinson Disease

OBJECTIVE: To investigate the effect of the body shape molded inner system on attenuation of spinal curvature and pelvic obliquity in cerebral palsy (CP) with scoliosis. METHOD: Fifteen patients with CP who had fixed or non-fixed scoliosis were recruited. By radiographic studies, Cobb's angle and pelvic obliquity were measured with or without sitting in the body shape molded inner system. RESULTS: Spinal curvature assessed by Cobb's angle was significantly reduced when CP patients were seated in the body shape molded inner system rather than in conventional seats. Although pelvic obliquity was not improved in patients with fixed scoliosis, it was significantly ameliorated in patients with non-fixed scoliosis when seated in the body shape molded inner system. CONCLUSION: The body shape molded inner system attenuated spinal curvature and pelvic obliquity in CP patients with non-fixed scoliosis which had a flexible spinal curve.
Cerebral Palsy ; Fungi ; Humans ; Scoliosis ; Spinal Curvatures

OBJECTIVE: To know when we can identify fetal Y chromosome SRY gene by using fetal DNA in maternal plasma. METHODS: DNA from maternal plasma of 62 pregnant women (48: inpatients, 14: outpatients) underwent a sensitive Y-PCR assay to identify SRY gene of Y chromosome. RESULTS: Of the patients, fetus-derived Y sequences were detected in 37 (88.1%) of the 42 maternal plasma samples from women bearing male fetuses. One of the 20 women bearing female fetuses had positive result from plasma DNA. Seventh gestational week was the earliest gestation of gender identification. CONCLUSION: We could identify fetal gender using fetal DNA in maternal plasma (sensitivity 88.1%). The earlist to detect was 7th gestational week.
DNA* ; Female ; Fetus ; Genes, sry ; Humans ; Inpatients ; Male* ; Plasma* ; Pregnancy ; Pregnant Women ; Y Chromosome

PURPOSE: To establish the methods for sinogram formation and correction in order to appropriately apply the filtered backprojection (FBP) reconstruction algorithm to the data acquired using PET scanner with multiple scintillation crystal layers. MATERIAL AND METHODS: Formation for raw PET data storage and conversion methods from listmode data to histogram and sinogram were optimized. To solve the various problems occurred while the raw histogram was converted into sinogram, optimal sampling strategy and sampling efficiency correction method were investigated. Gap compensation methods that is unique in this system were also investigated. All the sinogram data were reconstructed using 2D filtered backprojection algorithm and compared to estimate the improvements by the correction algorithms. RESULTS: Optimal radial sampling interval and number of angular samples in terms of the sampling theorem and sampling efficiency correction algorithm were pitch/2 and 120, respectively. By applying the sampling efficiency correction and gap compensation, artifacts and background noise on the reconstructed image could be reduced. CONCLUSION: Conversion method from the histogram to sinogram was investigated for the FBP reconstruction of data acquired using multiple scintillation crystal layers. This method will be useful for the fast 2D reconstruction of multiple crystal layer PET data.
Artifacts ; Compensation and Redress ; Information Storage and Retrieval ; Noise

Dystonia is a movement disorder caused by involuntary, sustained muscle contractions, frequently resulting in twitching and repetitive movements or abnormal postures. Dopa-responsive dystonia (DRD) is characterized by early childhood onset, marked diurnal fluctuation of symptoms and dramatic response to levodopa. The aim of this report is to present the two cases of DRD misdiagnosed respectively as cerebral palsy and hereditary spastic paraplegia. Proper understanding of this disease entity and its treatment options are necessary for comprehensive rehabilitative management of DRD.
Cerebral Palsy ; Dystonia ; Levodopa ; Movement Disorders ; Muscle Contraction ; Posture ; Spastic Paraplegia, Hereditary

OBJECTIVE: To investigate the effect of cycling ergometry and to compare energy expenditure and walking performance after arm cycling with those after leg cycling in patients with brain diseases. METHOD: Twenty-two adults with brain diseases (6 stroke, 4 traumatic brain injury, 4 brain tumor, 4 parkinsonism, 4 cerebral palsy) were recruited as subjects. They were randomly assigned to disease-matched groups; arm cycling and leg cycling (n=11 each). VO2 (L/min), VCO2 (L/min), VE (L/min), O2 rate (ml/kg, min), O2 pulse (ml/kg, bpm), O2 cost (ml/kg, m) and VO2 peak (ml/kg, min) during cycling test or walking test, and walking performance were evaluated after cycling training for 4~6 weeks. RESULTS: Arm cycling exercise did not improve any parameters such as VO2, VCO2, O2 rate and O2 cost during walking test, whereas it increased VCO2, VE and O2 pulse during cycling test. In contrast, leg cycling significantly improved walking velocity and distance, and decreased O2 cost during walking test. It also increased all parameters including VO2 peak during cycling test (p<0.05). CONCLUSION: Leg cycling exercise improved walking performance and energy efficiency of walking as well as cardiorespiratory fitness relative to arm cycling. Therefore, leg cycling promoted lower-extremity task such as walking in patients with brain diseases.
Adult ; Arm ; Brain ; Brain Diseases ; Brain Injuries ; Brain Neoplasms ; Energy Metabolism ; Ergometry ; Humans ; Leg ; Parkinsonian Disorders ; Stroke ; Walking