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

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*

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

BACKGROUND AND OBJECTIVES: Corrected transposition of the great arteries (C-TGA) is a rare congenital heart disease, of which prognosis depends on the associated cardiac defects, systemic ventricular function, competency of atrioventricular valves, and the presence of conduction disturbances. This study was aimed to assess the midterm follow-up status of C-TGA. PATIENTS AND METHODS: Retrospective review was performed on 89 cases with C-TGA and two ventricles of adequate size, which were diagnosed between January 1980 and June 1997. RESULTS: Study subjects consisted of 56 males and 33 females (average age at diagnosis, 9 months). Mean follow-up duration was 98 months (range, 2 months - 23 years 8 months). Based on the associated cardiac anomalies, there were 6 simple C-TGA and 83 complex C-TGA patients. Surgery including 19 palliative and 47 corrective operations was attempted on 61 cases at mean age of 69 months. Tricuspid regurgitation (TR) was noted at the time of first examination in 52 (mild in 39; moderate in 8; severe in 5) and progressed in 18 patients. TVR was done on 5 patients and double switch on 7 patients. Arrhythmia was noted preoperatively (complete AV block in 3) in 11 and postoperatively (postoperative complete AV block in 3) in 22 patients. A total of 13 cases died including 10 perioperative deaths during follow-up. Actuarial survival rate at 10 year was 84.5%. CONCLUSION: In this study, the midterm outcome of corrected TGA is acceptable. However, long-term follow-up is required in respect to the function of atrioventricular valve and the systemic ventricle.
Arrhythmias, Cardiac ; Arteries* ; Atrioventricular Block ; Child* ; Diagnosis ; Female ; Follow-Up Studies* ; Heart Defects, Congenital ; Humans ; Male ; Prognosis ; Retrospective Studies ; Survival Rate ; Tricuspid Valve Insufficiency ; Ventricular Function

Most thymomas are found in the superior and anterior mediastinum and malignant thymomas are exceedingly rare in the first 20 years of life. A child of malignant thymoma with invasion into the thoracic vertebra and spinal canal is reported. The tumor was originated from posterior mediastinum and involved posteriorly the D8, D9 vertebra resulting in paraparesis was improved. Computed tomography is mandatory in detecting the metastasis and evaluation of treatment.
Child ; Humans ; Mediastinum ; Neoplasm Metastasis ; Paraparesis ; Spinal Canal* ; Spine ; Thymoma*

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

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