Rehabilitation of young children with hearing impairment can be defined as a teaching/learning process where the role of the clinician is to facilitate the acquisition of listening, speech and language in a normal developmental order. The young children with hearing impairment are helped by hearing aids and cochlear implants to learn language. Auditory (re)habilitation in young children with hearing impairment is to acquire auditory skills at four stages : sound detection, sound identification through imitation, sound discrimination, and comprehension. Without appropriate auditory training and early intervention, children with hearing impairment cannot develop spoken language. Speech acquisition is a perceptual as well as an oral process. To maximize the speech acquisition in children with hearing impairment, indepth understanding of the characteristics of the children, the parents' motivation and cooperation, a well-designed educational program, and the high competence of the health care professionals are important. Therefore, listening is not an isolated skill, and the auditory development in children with hearing impairment should be achieved in a comprehensive approach. Young children with hearing impairment need supports and guidance from health care professionals whose holistic approach balances auditory learning with the parallel development of the children's other learning processes.
Child* ; Cochlear Implants ; Comprehension ; Correction of Hearing Impairment* ; Delivery of Health Care ; Discrimination (Psychology) ; Early Intervention (Education) ; Hearing Aids ; Hearing Loss* ; Humans ; Learning ; Mental Competency ; Motivation ; Rehabilitation ; Speech Perception*

Isolated extramedullary relapse of acute lymphoblastic leukemia (ALL) with sparing of the marrow after allogeneic stem cell transplantation is not common. We report a 32-year-old female patient with isolated ovarian relapse of T-cell ALL 18 months after allogeneic stem cell transplantation. She had no evidence of concomitant relapse in the bone marrow.
Adult ; Bone Marrow* ; Female ; Hematopoietic Stem Cell Transplantation* ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Stem Cell Transplantation ; T-Lymphocytes

Classification ; Consensus ; Diagnosis ; Hematologic Neoplasms ; Hematology ; Lymphoid Tissue

OBJECTIVE: To elucidate etiological factors of heterotopic ossification (HO) by evaluating retrospectively if HO is a unique finding following cervical total disc replacement (CTDR) or a finding observable following an anterior cervical interbody fusion (ACIF). METHODS: The authors had selected 87 patients who underwent anterior cervical surgery (TDR or ACIF), and could be followed up more than 24 months. A cervical TDR was performed using a Bryan disc or a ProDisc-C and an ACIF using a stand-alone cage or fibular allograft with a plate and screws system. The presence of HO was determined by observing plain radiography at the last follow up. The relation between HO occurrence and specific preoperative radio-logical findings (osteophyte and calcification of posterior longitudinal ligament (PLL)) at the index level was investigated. RESULTS: Cervical TDR was performed in 40 patients (43 levels) and ACIF in 47 patients (54 levels). At the final radiographs, HO was demonstrated at 27 levels (TDR-Bryan; 8/18, TDR-Prodisc-C; 12/25, ACIF-cage alone; 7/29, and ACIF-plate screw; 0/25). Mean ROM at the last follow-up of each TDR subgroup were 7.8+/-4.7degrees in Bryan, 3.89+/-1.77degrees in Prodisc-C, and it did not correlated with the incidence of HO. Fusion status of ACIF groups was observed as 2 case of grade 1, 6 of grade 2, and 21 of grade 3 in cage alone subgroup, and no case of grade 1, 4 of grade 2, and 21 of grade 3 in plate screw subgroup. Fusion status in ACIF-cage alone subgroup was significantly related to the HO incidence. The preoperative osteophyte at the operated level observed in 27 levels, and HO was demonstrated in 12 levels (TDR-Bryan; 3/5, TDR-Prodisc-C; 2/3, ACIF-cage alone; 7/11, and ACIF-plate screw; 0/8). Preoperative PLL calcification at the operated level was observed 22 levels, and HO was defined at 14 levels (TDR-Bryan; 5/5, TDR-Prodisc-C; 4/5, ACIF-cage alone; 5/7, and ACIF-plate screw; 0/5). The evidence of preoperative osteophyte and PLL calcification showed statistically significant relations to the occurrence of HO. CONCLUSION: HO was observed in both TDR and ACIF groups. HO was more frequently occurred in TDR group regardless of prosthesis type. In ACIF group, only cage alone subgroup showed HO, with relation to fusion status. Preoperative calcification of longitudinal ligaments and osteophyte were strongly related to the occurrence of HO.
Cinnarizine ; Follow-Up Studies ; Humans ; Incidence ; Longitudinal Ligaments ; Ossification of Posterior Longitudinal Ligament ; Ossification, Heterotopic ; Osteophyte ; Prostheses and Implants ; Retrospective Studies ; Total Disc Replacement ; Transplantation, Homologous

Modern capacity for high-resolution brain imaging has facilitated studying the clinicoanatomic correlations of small lesions in subcortical nuclear structures. Several recent reports have convincingly demonstrated that there were particular clinical syndromes associated with specific distributions of thalamic lesions. Thalamic dysfunction due to diveres casues, particularily in the left side has been associated with memory impairment, speech disturbance, cognitive deficits, and behavioural changes. Simplified bedside behavioral examinations were performed in six patients with the left tuberothalamic infarcts. We found severe neuropsychological deficits considered as dementia meeting the DSM III criteria, leaving few focal motor and sensory deficits. The disturbance of attention, speech, cognition and behavior after the left tuberothalamic infarcts are probably related not only to intrinsic thalamic dysfunction itself, but also to the disruption of the regular function of motor, sensory, and integrative cortical stuctures connecting with the thalamus.
Cognition ; Dementia* ; Humans ; Memory ; Neuroimaging ; Thalamus

OBJECTIVE: Endovascular treatment is now accepted as an initial treatment modality, especially in cases of posterior circulation aneurysms. The purpose of this study was to review the treatment outcomes and to emphasize the necessity of maintaining the surgical ability for posterior circulation aneurysms. METHODS: During the past 10 years, 570 patients have been treated for cerebral aneurysms at our institute. Among these patients, 34 harbored posterior circulation aneurysms. From January 2004 to June 2008, 13 of the 34 patients were treated by endovascular coiling. We retrospectively reviewed the clinical outcome, cerebral angiograms, and other radiological imagings through a comparative study of the pre- and post-endovascular treatment periods. RESULTS: Overall, 9 (69.2%) of the pre-endovascular treatment period group and 20 (95.2%) of the endovascular treatment period group had good outcomes. The mean post-operative hospital days for these groups were 38.6 and 21.1, respectively. Patients in the endovascular treatment period group had shorter post-operative hospital periods and better outcomes than those in the pre-endovascular treatment period group. CONCLUSION: It is recommended that multimodality treatment involving microsurgical clipping and endovascular coiling is used to obtain better results in the treatment of posterior circulation aneurysms. These results suggest that although the trend toward endovascular treatment as the initial aneurysm therapy for posterior circulation aneurysms is also enhancing, it might be necessary to maintain the surgical ability for posterior circulation aneurysm.
Aneurysm ; Humans ; Intracranial Aneurysm ; Retrospective Studies

BACKGROUND AND OBJECTIVES : Ageotrophic nystagmus in the horizontal canal BPPV has been explained as a result of cupulolithiasis theory, and has been reported to have the less therapeutic response to conservative rehabilitations than the other type BPPV . Though methods to detach the debris with vibrator have been introduced, the effect has been questioned and it's not physiologic. MATERIALS AND METHOD : We introduce a new head shaking-forced prolonged position method as a more convenient method, and report typical 2 cases of ageotrophic horizontal canal BPPV managed with it and analyzed results of 25 cases all told. RESULTS AND CONCLUSION : The average number of rehabilitation was less than two, and loss of direction changing positional nystagmus could be observed immediately after rehabilitation.
Head ; Nystagmus, Physiologic ; Rehabilitation ; Vertigo*

The thymoma with extrathoracic metastasis is an exceedingly rare malady. We report here on the surgical resection and the pathologic findings of liver metastasis from an invasive thymoma in a 57-year-old female. In 1998, a benign thymoma in the anterosuperior mediastinum was removed from the patient and then postoperative radiation therapy was given. After 6 years, the patient complained of dyspnea, dry cough and abdominal pain. Abdominal CT and MRI showed an encapsulated and septated 19 x 14 cm sized cystic mass in the right liver. Right hepatectomy was done and it was shown to be a metastatic thymoma. An extensive literature review has revealed only a few cases of surgical resection of liver metastasis in a patient with invasive thymoma.
Abdominal Pain ; Cough ; Dyspnea ; Female ; Hepatectomy ; Humans ; Liver ; Magnetic Resonance Imaging ; Mediastinum ; Middle Aged ; Neoplasm Metastasis* ; Thymoma* ; Tomography, X-Ray Computed

BACKGROUND: The Korean Red Cross blood laboratory centers have been performing comparative tests for NAT reactive specimens since February 2005. However, five discrepant specimens were found in HCV-diluted specimens between 2007 and 2008 and the reasons for this has been investigated. METHODS: For the five discrepant specimens, the HCV RNA concentration was measured in 5 tubes for each speciment. Subsequently, in order to compare the sensitivity of the low titer specimens measured by RT-PCR and TMA, comparative tests of diluted samples were examined six times per sample. Finally, the genotype was tested in order to determine the characteristics of the discrepant samples. RESULTS: Result of the quantitative tests for HCV RNA demonstrated that aliquots of the plasma bag were homogenous in term of viral load quantitation. As a result of the comparative test, all samples were found to contain over 1.0x10(1) IU/mL as detected by the two analytical systems. In contrast, those less than 1.0x10(1) IU/mL were not entirely detected by the two systems. CONCLUSION: It was impossible to completely detect using the two NAT system and the detection rates for both systems were equivalent for the samples examined. In particular, with respect to HCV, it may be undetectable on the NAT test because viral load decreases rapidly before and after sero-conversion. This result indicates that anti-HCV and NAT should be performed together as an HCV screening test prior to blood donation.
Blood Donors ; Genotype ; Humans ; Mass Screening ; Plasma ; Red Cross ; RNA ; Uronic Acids ; Viral Load

OBJECTIVE: The purpose of this study was to analyze the clinical and anatomic features involved in determining treatment modalities for anterior communicating artery (AcoA) aneurysms. METHODS: The authors retrospectively evaluated 112 AcoA aneurysms with pretreatment clinical features including age, Hunt and Hess grade, medical or neurological comorbidity, and anatomical features including aneurysm size, neck size, dome-to-neck ratio, vessel incorporation, multiple lobulation, and morphologic scoring system. Post-treatment clinical results were classified according to the Glasgow Outcome Scale, and anatomic results in coiled patients were classified according to the modified Raymond scale. Using multivariate logistic regression, the probabilities for decision making between surgical clipping and coil embolization were calculated. RESULTS: Sixty-seven patients (60%) were treated with surgical clipping and 45 patients (40%) with endovascular coil embolization. The clinical factor significantly associated with treatment decision was age (> or =65 vs. <65 years) and anatomical factors including aneurysm size (small or large vs. medium), dome-to-neck ratio (<2 vs. > or =2), presence of vessel incorporation, multiple lobulation, and morphologic score (> or =2 vs. <2). In multivariate analysis, older patients (age, >65 years) had significantly higher odds of being treated with coil embolization relative to clipping (adjusted OR=3.78; 95% CI, 1.39-10.3; p=0.0093) and higher morphological score patients (> or =2) had a higher tendency toward surgical clipping than endovascular coil embolization (OR=0.23; 95% CI, 0.16-0.93; p=0.0039). CONCLUSION: The optimal decision for treating AcoA aneurysms cannot be determined by any single clinical or anatomic characteristics. All clinical and morphological features need to be considered, and a collaborative neurovascular team approach to AcoA aneurysms is essential.
Aneurysm ; Arteries ; Comorbidity ; Decision Making ; Glasgow Outcome Scale ; Glycosaminoglycans ; Humans ; Intracranial Aneurysm ; Logistic Models ; Multivariate Analysis ; Neck ; Retrospective Studies ; Surgical Instruments