Although visual field defects are common disorders in stroke patients, rehabilitation treatments have developed slowly. In this study, we report a case of a 35-year-old man with quadranopsia and visual agnosia due to right occipital hemorrhage. He had no upper limb motor impairments and began to work as a dental mechanic one month after the stroke, but had to retire because of difficulty in making dental implants. He failed to find things in his lower left visual field, and could not perceive fine differences in slope and depth. He was admitted 2 months after the onset and received occupational therapy for visual agnosia, and treatment for quadranopsia one month after admission. The treatment for quadranopsia was performed using a newly designed computerized visual field training machine consisting of a personal computer system which displayed a fixing point for the eyes at the center of the computer display, and a visual stimulation point at areas between residual vision and quadranopsia on the computer display accompanied by a response warning sound after the patient indicated using a switch when he found the visual stimulation. The visual stimulations contained 20% placebo (no visual stimulation). The computer also calculated the percent of correct responses. After one month of continuous occupational therapy only, his visual agnosia improved but his quadranopsia did not. However, his quadranopsia did improve after repetitive visual stimulation using the computerized visual field training machine. In conclusion, quadranopsia might be improved by repetitive visual stimulation.

Treadmill exercise tolerance test(Modified Bruce Method) was performed with and without warm water bathing (WWB, 41°C, 10min) in 14 healthy aged men and women over 65y. o. (68.6±6.0y.o).
Increase in HR, BP and PRP during exercise was reduced after WWB. Duration of exercise and ST depression and occurrence of arrythmia during treadmill exerecise were significantly improved after WWB. Fatigability of the legs and Borg's index were also decreased aftr WWB. These results indicated the improvement of exercise tolerance after WWB was probably due to the increase in cardiac functions and collagenous viscosity (extensivility) of the musculoskeletal system.

 Blood glucose disposition rate after intravenous glucose infusion is considered to reflect mainly the rate of cellular glucose uptake, the rate of glucose degradation process and gluconeogenesis. excluding the influense of glucose absorption.
 When it is hypothesized that the elevated blood glucose is disposed by constant rate (one-compartment theory), the following formula will be realized.
 Ct = A (1— k)^t   Ct = blood glucose level at t-minutes after infusion
            A = initial glucose level after infusion
            k = constant glucose disposition index / min
 log Ct = log A (1—k) ^t= log A + t log (1 — k)
 This formula demonstrates that logarithm of blood glucose concentration (Ct) is a one-dimensional (linear) function of time t with a slope log (1 — k), and blood glucose disposition index k can be calculated from this slope.
 To examine the validity of this hypothesis, 1.5 ml / kg of 20% glucose (0.3g / kg) was infused at rest within 3 minutes into an antecubital vein and plasma glucose was determinned at 1, 3, 5, 10, 15, 20, 30 and 40 min after the cessation of infusion.
 In 10 healthy subjects, linear regression coefficient between logarithm of plasma glucose and time t was significantly higher (r= 0.992 ± 0.006, p<0.001) during 5 to 40 min. Calculated k index ranged from 0.78 to 4.54% / min and the correlation between the 1st and the 2nd measurements (n=5) within a week was also significantly high (0.92±0.06, p<0.01). These results highly support the validity of basic formula (one-compartment theory) and practical procedure to measure k index.
 The effects of warm water bathing (42 C, 10min) was examined in 7 subjects keeping warmth by blankets. After bathing, k value remained in nearly the same in 4 subjects, decreased in 2 and increased in 1. Although more detailed studies are needed, the effect of single bathing on glucose disposition seems to be not so significant.

Purpose : To study the effect of repetitive facilitation exercise combined with continuous low-frequency electrical stimulation on upper-extremity motor impairment or hand edema during the acute phase of cerebral infarction. Subjects : Thirty inpatients with both hemiplegia and hand swelling, who were admitted to a hospital from April 2011 to March 2012. Methods : In this randomized, controlled, observer-blinded trial, we randomized the subjects into two groups and provided treatment on a 2-week, 30 minutes/day schedule. Subjects in the intervention group received repetitive facilitation exercise concurrent with continuous low-frequency electrical stimulation, while subjects in the control group were provided passive range-of-motion (ROM) exercise. Upper Limb Fugl-Meyer Assessment (FMA), edema and passive ROM were evaluated at baseline and at two weeks. Results : At two weeks, the intervention group showed significant improvements on all measurements. However, the control group showed significant improvement only in their FMA. The intervention group had significantly greater improvements than the control group on all three measurements. Conclusion : Repetitive facilitation exercise concurrent with continuous low-frequency electrical stimulation therapy is effective not only for recovery from motor impairment but also for reducing swelling of the hand during the acute phase of cerebral infarction.

Genetic polymorphisms in the cytochrome P450 family are widely known to contribute to inter-individual differences in drug pharmacokinetics. In this study we report a case of a patient with cytochrome P450 2C19 polymorphism. A 57-year-old woman presented with right cerebral hemorrhage and left hemiplegia. She was administrated phenytoin (200 mg/day)and phenobarbital (60 mg/day) to prevent convulsions. After a change in phenytoin dosage (97% grains to 10% grains), she developed ataxia and experienced a disturbance in her activities of daily living. She was admitted to our hospital. Her serum concentration of phenytoin was found to be at a toxic level (45.9μg/ml) and serum phenobarbital was relatively high (19.1μg/ml). She showed an extremely low clearance of phenytoin, so we checked the genotype of her P450 2C9 and P450 2C19 cytochromes, which are metabolic enzymes of phenytoin. For cytochrome P450 2C9, the patient was a homozygous extensive metabolizer (wild type, *1/*1), but for cytochrome P450 2C19, she was a poor metabolizer (*3/*3). Her phenytoin dosage was reduced, and her ataxia, activities of daily living, left hemiplegia, and cerebral blood flow in Xe-CT improved.