Recently, increased emphasis has been placed on the need for rehabilitation professionals to objectively evaluate a patient's potential for and progress toward a return to normal function. But as medical recovery nears completion, additional questions are commonly asked by physicians regarding work function and ability to return to full active employment. In the past, therapists have attempted to reestablish the work situation using real tools, but these machines were expensive, have space limitations and in some cases, potentially dangerous as well. A Baltimore Therapeutic Equipment(BTE) Work Simulator overcomes these shortcomings. It can be used for isometric and isotonic evaluation and treatment and assisted in providing the information needed to make determinations regarding progress in therapy, return-to-work status and job modifications. We are going to obtain normative isometric, dynamic and endurance of grip strength, key pinch strength and three point pinch strength data using BTE Work Simulator model WS20. We also compare these data between ages and sexs. This study will be helpful in clinical applications of the BTE Work Simulator and providing the more specific job related occupational therapy and developing special vocational rehabilitation program.
Employment ; Hand Strength* ; Occupational Therapy ; Pinch Strength* ; Rehabilitation ; Rehabilitation, Vocational ; Return to Work

OBJECTIVE: The purpose of this study was to investigate cardiac events and ischemic heart disease in patients with stroke. The patients were studied by myocardial perfusion SPECT (single photon emission computed tomography) and evaluated the functional outcome after rehabilitation. METHOD: Subjects were 31 patients with stroke who had myocardial perfusion SPECT for abnormal findings on the electrocardiography. There were eighteen patients with ischemic stroke: 12 patients with hemorrhagic stroke; and one patient with both ischemic and hemorrhagic stroke. We screened the patients for the hypertension, diabetes mellitus, previous history of stroke, smoking, alcohol use, and hyperlipidemia as risk factors of ischemic stroke and ischemic heart disease. For the dichotomous classification of positive or negative myocardial perfusion SPECT, reversible and persistent defects were considered as positive. We investigated the functional outcomes on the admission and discharge using the Modified Rankin scale (MRS) and functional independence measure (FIM) scores. Cardiac events in patients with stroke were investigated. RESULTS: The myocardial perfusion SPECT was positive in 10 of 18 patients (55.6%) with ischemic stroke. Four out of ten patients with ischemic stroke had cardiac events. Positive myocardial perfusion SPECT was significantly associated with cardiac events (p<0.05). Risk factors of ischemic stroke with positive myocardial perfusion SPECT was more numerous than those of ischemic stroke with negative myocardial perfusion SPECT (p<0.05). However there was no statistically significant difference between functional outcome and findings of myocardial perfusion SPECT (p>0.05). CONCLUSION: The results of our study suggested that myocardial perfusion SPECT is useful in the screening of silent ischemic heart disease in patients with ischemic stroke and to assess future cardiac events of them.
Classification ; Diabetes Mellitus ; Electrocardiography ; Humans ; Hyperlipidemias ; Hypertension ; Mass Screening ; Myocardial Ischemia* ; Perfusion* ; Rehabilitation ; Risk Factors ; Smoke ; Smoking ; Stroke* ; Tomography, Emission-Computed, Single-Photon*

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hypo-osmotic hyponatremia. There are several etiologies of SIADH including neuroendocrine tumor, pulmonary disease, infection, trauma, and medications. Here, we report a case of SIADH associated with a schwannoma involving the mediastinum in a 75-year-old woman who presented with nausea, vomiting, and general weakness. Laboratory testing showed hypo-osmolar hyponatremia, with a serum sodium level of 102mmol/L, serum osmolality of 221mOsm/kg, urine osmolality of 382mOsm/kg, urine sodium of 55 mmol/L, and plasma antidiuretic hormone (ADH) of 4.40 pg/mL. Chest computed tomography identified a 1.5-cm-sized solid enhancing nodule in the right lower paratracheal area. A biopsy specimen was obtained by video-assisted thoracoscopic surgery, which was diagnosed on pathology as a schwannoma. The hyponatremia was completely resolved after schwannoma resection and plasma ADH level decreased from 4.40 pg/mL to 0.86 pg/mL. This case highlights the importance of suspecting and identifying the underlying cause of SIADH when faced with refractory or recurrent hyponatremia, and that on possibility is mediastinal schwannoma
Aged ; Biopsy ; Female ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Lung Diseases ; Mediastinum ; Nausea ; Neurilemmoma* ; Neuroendocrine Tumors ; Osmolar Concentration ; Pathology ; Plasma ; Sodium ; Thoracic Surgery, Video-Assisted ; Thorax ; Vomiting

BACKGROUND AND OBJECTIVES: Delayed facial nerve palsy (DFNP) following a middle ear surgery is an uncommon event, and is defined to develop 48 or 72 hours after surgery. The pathogenesis of DFNP is not known clearly, but it is presumed to inflammation, neuronal edema or reactivation of herpes virus. The purposes of this study were to provide the clinical aspect of DFNP after middle ear surgery and to discuss the prognostic factors and treatment plan. MATERIAL AND METHOD: From January 1985 to August 1999, in the course of over 5,670 middle ear surgeries, we experienced 12 ipsilateral delayed facial nerve palsies. We analyzed the course of DFNP according to several clinical factors retrospectively. Degree of facial palsy was evaluated with the House-Brackmann grade (HBG). RESULTS: DFNP was developed from 3 day to 14 day after middle ear surgery. The initial degree of facial palsy was HouseBrackmann grade (HBG) II in 6, HBG III in 4, and HBG IV in 2 patients. All patients were treated with steroid and volume expander. The final recovery were HBG I in 11 of the twelve patients. Remaining one patient was found to be HBG Il after a 5-year follow up. In the group who recovered within 1 month, the initial HBG were II or III. CONCLUSION: We obtained satisfactory results with steroid therapy in most patients. The courses of DFNP after middle ear surgery are favorable. The better initial HRG and HBG at 2 weeks are, the earlier recovery can be expected.
Ear, Middle* ; Edema ; Facial Nerve* ; Facial Paralysis ; Follow-Up Studies ; Humans ; Inflammation ; Neurons ; Paralysis* ; Retrospective Studies