No abstract available.
Cumulative Trauma Disorders*

Patients with thalamic lesions can experience ataxia on the contralesional side. We report here a 24 year old female patient who presented with a left thalamic tumor and experienced bilateral ataxia of the upper and lower extremities after a left thalamic resection. Her right-sided ataxia was more severe than that of the left side. The bilateral ataxia was likely to be from cerebellar ataxia. The right-sided ataxia may have been caused by injury of the dentatorubrothalamic tract originating from the dentate nucleus of the right cerebellum and terminating in the contralateral ventrolateral nucleus of the left thalamus. We believe that the left sided ataxia in this patient was due to an uncrossed dentatorubrothalamic tract, which control the movement of the ipsilateral side of the human body.
Ataxia

No abstract available.
Humans ; Muscle Spasticity*

No abstract available.
Humans ; Stroke*

Objective: : We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. Methods: : From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). Results: : At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. Conclusion : Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

PURPOSE: The most effective and basic Tb preventive measure is BCG vaccination. Even though the Intradermal vaccination method in BCG vaccination is known to be the most accurate method in preventing the advanced Tb, nowdays most of the Korean civilian hospitals utilize multipuncture BCG vaccination method ,which is quite contrary to the national standard intradermal vaccination method. Therefore I decided to inform and educate the pregnant women who would be in a position to choose the BCG vaccination method. This will help them understand the BCG vaccination methods properly. We should urge the intradermal method which is acknowledged as the national standard vaccination method. METHODS: The questionnaire was mailed twice to 214 pregnant women requring the antenatal care who visited any of the 9 health centers in Busan from the period of Aug to Oct. 2007. The 1st questionnaire was done in 214 pregnant women prior to education concerning the BCG vaccination methods and Tb, and the 2nd questionnaire was done after education. Contents of the questionnaire were general knowledges for BCG vaccination method, intention of selection for BCG vaccination, knowledges for the adverse effect, etc. Data analysis was performed utilizing SPSS (ver12) and the pregnant women's change in concept was comparatively analyzed with percentage, chi-square -test . RESULTS: Considering the general characteristics of the pregnant women who participated in the study, the highest percentage was noticed in their 15-28 gestational weeks (60.8%), Age over 30 (70.1%), Education level-college graduate (76.6%). Recognition to the presence of two types BCG vaccination method was 27.6% before education and 95.3% after education which showed a marked improvement (p=0.0001). After education, 82.2% of pregnant women decided to choose intradermal BCG vaccination method at birth which was 23.4% before education (p=0.0003). Despite the fact that intradermal BCG method is the national standard vaccination method, some of them prefer multipuncture BCG vaccination method, because most of the scars (41.3%), the civilian hospitals do it (35.7%), because of the lack of the education and information from the health centers and public institutions (17.4%). The future selection of BCG vaccination methods as follows: before education, intradermal BCG vaccination 31.0%, multipuncture BCG vaccination 14.6%, uncertain 54.4%, and after education, intradermal BCG vaccination 72.4%, multipuncture BCG vaccination 2.8%, uncertain 24.8% (p<0.0001). CONCLUSIONS: The pregnant women were not fully aware of intradermal and multipuncture BCG vaccination methods. Through education and information, it was possible for them to thoroughly recognize the BCG vaccination methods. In order to urge the intradermal BCG vaccination method, the health centers and public institutions need to educate and inform the pregnant women regarding the intradermal BCG vaccination method which is the standard vaccination method in Korea.
Cicatrix ; Female ; Humans ; Intention ; Mycobacterium bovis ; Parturition ; Postal Service ; Pregnant Women ; Statistics as Topic ; Vaccination ; Surveys and Questionnaires

OBJECTIVE: The present study was prospectively designed to identify the incidence, risk factors and characteristics of falls in a patient with stroke. METHOD: One hundred and three stroke patients admitted to the department of rehabilitation medicine between March 1, 1998 and June 30, 1998, were evaluated. RESULTS: Fifteen (14.6%) have falled at least one time, and most of the falls occurred in their own room while walking. Risks for falls were associated with multiple brain lesion involving both anterior and posterior circulation, the presence of the cognitive function disturbance, and presence of caregiver hired by the patient. Fifteen (78.9%) of total 19 incidents did not cause any problem, but 4 falls (21.1%) caused mild injury - pain, and simple contusion. Severe injury such as fracture or intracerebral hemorrhage were not caused by these falls. CONCLUSION: The incidence of fall in a patient with stroke was 14.6%. And risks for falls were associated with multiple brain lesion, the presence of the cognitive function disturbance, and presence of caregiver hired by the patient.
Brain ; Caregivers ; Cerebral Hemorrhage ; Contusions ; Humans ; Incidence ; Prospective Studies ; Rehabilitation* ; Risk Factors ; Stroke* ; Walking

OBJECTIVE: The present study was prospectively designed to identify the incidence, risk factors and characteristics of falls in a rehabilitation hospital. METHOD: Two hundred nine consecutive admissions to the department of rehabilitation medicine between March 1, 1998 and June 30, 1998, were evaluated. RESULTS: Twenty four (11.5%) experienced at least one fall, and most of the falls occurred in their own room during walking. Risks for falls were associated with the presence of the sensory or cognitive function disturbance, the ability of walking, the use of antihypertensive drug, and presence of caregiver hired by the patient. No injury was observed in 25 (76%) of total 33 incidents, and 8 falls (24%) caused mild injury - pain, and simple contusion. There was no fracture or intracerebral hemorrhage. CONCLUSION: These data suggest that high risk groups of patients who are prone to the falls within the rehabilitation setting can be identified for the prevention, and afterward for preventive measures.
Caregivers ; Cerebral Hemorrhage ; Contusions ; Epidemiology ; Humans ; Incidence ; Prospective Studies ; Rehabilitation* ; Risk Factors ; Walking

OBJECTIVES: To investigate the correlation of the initial Computerized Tomography(CT) findings of the brain and the functional outcome, and to suggest the initial CT findings as a functional outcome predictor in the traumatic brain injured(TBI) patients. METHODS: Thirty-nine TBI patients were included in this study. Subjects were divided into groups of non-focal or focal TBI, and with or without a depressed skull fracture according to their initial brain CT findings. RESULTS: The non-focal TBI patients were not significantly different from focal TBI patients in the days from onset to rehabilitation, rehabilitation stay, and initial FIM score. However their outcome in FIM gain and FIM efficiency significantly worse than focal TBI patients. The TBI patients with a depressed skull fracture were not significantly different from the patients without a depressed skull fracture in the days from onset to rehabilitation, rehabilitation stay, and intial FIM score. However their outcomes were significantly worse than patients without a depressed skull fractrue in FIM efficiency. CONCLUSION: The initial brain CT findings were generally useful for the prediction of functional outcomes in TBI patients.
Brain Injuries ; Brain* ; Humans ; Rehabilitation ; Skull ; Skull Fracture, Depressed

BACKGROUND: The purposes of this study are to determine the prevalence of malnutrtion and its trend of change and to establish its relationship with dysphagia and functional outcome in rehabilitation patients. METHOD: We included 39 patients who were admitted into rehabilitation ward, and we evaluated nutri- tional parameters(serum albumin, serum lymphocyte, and weight loss) and dysphagia at the time of admi- ssion and four weeks after admission. We analyzed total rehabilitation inpatients and stroke patients who were major inpatients of rehabilitation ward. We measured Functional Independence Measure(FIM) and length of stay as clinical outcome scales. RESULTS: Malnutrition was observed in 76.9% of total patients and 69.6% in stroke patients at the time of admission. After four weeks, malnutrition was observed in 65.4% and 66.7%, respectively. Prevalence of dysphagia was 25.0% in non-malnourished patients and 22.0% in malnourished patients at the time of admission. It was not changed significantly after four weeks of rehabilitation. The length of stay was 31.3+/-16.0 days in non-malnourished patients and 39.8+/-19.4 days in malnourished patients. The FIM effi- ciency was 1.0+/-0.6 in non-malnourished patients and 2.3+/-6.5 in malnourished patients. CONCLUSION: Our findings suggest that malnutrition was highly prevalent in rehabilitation inpatients and it did not improved significantly through four weeks of rehabilitation. Therefore, it is important to be concerned about malnutrition and it needs proper and active management.
Deglutition Disorders ; Humans ; Inpatients* ; Length of Stay ; Lymphocytes ; Malnutrition* ; Prevalence ; Rehabilitation* ; Serum Albumin ; Stroke ; Weights and Measures