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

To evaluate P300 cognitive evoked-potential, the pattern of learning impairment and their possible relationship in patients with idiopathic Parkinson's disease, we performed P300 cognitive potential test and neuropsychologic tests evaluating learning ability-Gollin's incomplete drawing test (GIDT) , the tower of Hanoi Puzzle (TOHP), and recall the name of pictures in Gollin's incomplete drawing test (GIDT recall), on 37 patients with idiopathic Parkinson's disease (19 never-medicated and 18 with levodopa therapy for more than 6 months) and age- and sex-matched normal healthy controls. Compared with controls, patients showed significant delay in P300 latency and significant impairment in TOHP and GIDT recall, but not in GIDT. The revodopa-treated patients showed significantly shorter P300 latency and better performance in TOHP than never-medicated patients, although they still showed impairments in both tests compared with controls. Although all neuropsychologic tests used in present study significantly correlated to the P300 latency in patients, the most significant correlation was found in TOHP. These results suggest, first, the P300 latency significantly delayed in parkinsonian patients which is partially improved by levodopa therapy ; second, visuomotor procedural learning but not visuoperceptual procedural learning is impaired in parkinsonian patients which is also partially responsive to levodopa therapy third, although visuoperceptual procedural learning is not impaired, the transformation process of procedural learning into declarative learning is probably impaired in Parkinson's disease ; fourth, the dopaminergic lesion in Parkinson's desease may have a role in producing both P300 abnormality and impairments in visuomotor procedural learning.
Humans ; Learning* ; Levodopa ; Neuropsychological Tests ; Parkinson Disease*

BACKGROUND: The tests for the anti-rubella antibodies are important in early pregnancies because the risk of congenital anomaly should be considered depending on the results. We would like to evaluate analytical performance of Roche Modular Analytics E170 (Roche Diagnostics, Mannheim, Germany; E170) for anti-rubella antibodies. METHODS: For the comparison studies, a total of 436 sera from pregnant or fertile women was used for the detection of anti-rubella antibodies by E170 and VIDAS analyzer. The precision of E170 for serum anti-rubella IgM and IgG were also evaluated. RESULTS: In the precision study, within-run and total CV of anti-rubella IgM and IgG were below 5%. In the comparison study, the agreement of E170 with VIDAS was above 90%. CONCLUSIONS: The E170 showed a satisfactory precision for anti-rubella antibodies and a high level of concordance with VIDAS. Therefore, E170 would be useful as a routine immunoassay analyzer for measuring anti-rubella IgM and IgG antibodies.
Antibodies* ; Female ; Germany ; Humans ; Immunoassay ; Immunoglobulin G* ; Immunoglobulin M* ; Pregnancy

BACKGROUND: Mesenchymal stem cells (MSCs) obtained from bone marrow or adipose tissue can successfully repair emphysematous animal lungs, which is a characteristic of chronic obstructive pulmonary disease. Here, we describe the cellular distribution of MSCs that were intravenously injected into mice with elastase-induced emphysema. The distributions were also compared to the distributions in control mice without emphysema. METHODS: We used fluorescence optical imaging with quantum dots (QDs) to track intravenously injected MSCs. In addition, we used a human Alu sequence-based real-time polymerase chain reaction method to assess the lungs, liver, kidney, and spleen in mice with elastase-induced emphysema and control mice at 1, 4, 24, 72, and 168 hours after MSCs injection. RESULTS: The injected MSCs were detected with QD fluorescence at 1- and 4-hour postinjection, and the human Alu sequence was detected at 1-, 4- and 24-hour postinjection in control mice (lungs only). Injected MSCs remained more in mice with elastase-induced emphysema at 1, 4, and 24 hours after MSCs injection than the control lungs without emphysema. CONCLUSION: In conclusion, our results show that injected MSCs were observed at 1 and 4 hours post injection and more MSCs remain in lungs with emphysema.
Adipose Tissue ; Animals ; Bone Marrow ; Cell Tracking ; Emphysema* ; Fluorescence ; Humans ; Injections, Intravenous ; Kidney ; Liver ; Lung ; Mesenchymal Stromal Cells* ; Mice ; Optical Imaging ; Pulmonary Disease, Chronic Obstructive ; Quantum Dots ; Real-Time Polymerase Chain Reaction ; Spleen

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

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

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

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