Mirror Writing after Thalamic Hemorrhagic Stroke ？A Case Report？

Mirror-writing is the process of reversing individual letter and composing word sequence in opposite direction. Unintentional mirror writing has been observed in young children learning to write and interpreted as the manifestation of different cognitive impairments. It is very rare that normal right-handed adult shows mirror writing. However, the acquired "mirror writing" may be shown in left hemispheric stroke, neurodegenerative disease, and diffuse cerebral disorders. To explain this event, some assumption have been indicated such as the motor, the visual dominance, the supplementary motor area, the visio-spatial, the visual word-form, the hemispatial factor or directional and the reflected graphemic representation hypotheses. It is reported that the lesions which causes the "Mirror-writing" are the parietal lobe, basal ganglia, thalamus and right supplementary motor area, etc. We reported a case of "mirror-writing" with left thalamic hemorrhagic stroke.ope

Effects of a continuous lateral turning device on pressure relief

[Purpose] The purpose of this study was to examine the pressure-relieving effects of a continuous lateral turning device on common pressure ulcer sites. [Subjects] Twenty-four healthy adults participated. [Methods] The design of our continuous lateral turning device was motivated by the need for an adequate pressure-relieving device for immobile and/or elderly people. The procedure of manual repositioning is embodied in our continuous lateral turning device. The interface pressure and time were measured, and comfort grade was evaluated during sessions of continuous lateral turning at 0°, 15°, 30°, and 45°. We quantified the pressure-relieving effect using peak pressure, mean pressure, and pressure time integration. [Results] Participants demonstrated pressure time integration values below the pressure-time threshold at 15°, 30°, and 45° at all the common pressure ulcer sites. Moreover, the most effective angles for pressure relief at the common pressure ulcer sites were 30° at the occiput, 15° at the left scapula, 45° at the right scapula, 45° at the sacrum, 15° at the right heel, and 30° at the left heel. However, angles greater than 30° induced discomfort. [Conclusion] Continuous lateral turning with our specially designed device effectively relieved the pressure of targeted sites. Moreover, the suggested angles of continuous lateral turning can be used to relieve pressure at targeted sites.ope

Foot deformity in charcot marie tooth disease according to disease severity

OBJECTIVE: To investigate the characteristics of foot deformities in patients with Charcot-Marie-Tooth (CMT) disease compared with normal persons according to severity of disease. METHOD: Sixty-two patients with CMT disease were recruited for this study. The normal control group was composed of 28 healthy people without any foot deformity. Patients were classified into a mild group and a moderate group according to the CMT neuropathy score. Ten typical radiological angles representing foot deformities such as pes equinus and pes varus were measured. The CMT group angles were compared with those of the normal control group, and those of the mild group were also compared with those of the moderate group. RESULTS: The lateral (Lat.) talo-first metatarsal angle, anteroposterior talo-first metatarsal angle, Lat. calcaneal-first metatarsal angle, Lat. naviocuboid overlap, Lat. calcaneal pitch, Lat. tibiocalcaneal angle, and Lat. talocalcaneal angle in the CMT group showed a significant difference compared to the normal control group (p<0.05). These findings revealed CMT patients have pes cavus, forefoot adduction, midfoot supination and pes varus deformity. Compared to the mild group, the moderate group significantly showed an increased Lat. calcaneal pitch and decreased Lat. calcaneal-first metatarsal angle, Lat. tibiocalcaneal angle, Lat. talocalcaneal angle, and Lat. talo-first metatarsal angle (p<0.05). These findings revealed that the pes cavus deformity of CMT patients tend to be worse with disease severity. CONCLUSION: The characteristic equinovarus foot deformity patterns in CMT patients were revealed and these deformities tended to be worse with disease severity. Radiographic measures may be useful for the investigation of foot deformities in CMT patients.ope

Obturator Prosthesis for Velopharyngeal Insufficiency after Treatment of Soft Palate Cancer: A Case Report

Velopharyngeal insufficiency after surgical resection of soft palate cancer can be troublesome. This report concerns a male suffered from severe dysphagia following combined treatment for soft palate cancer. Sequential videofluoroscopic swallowing studies (VFSS) were used to assess his swallowing function and plan the interventional strategies. Initial VFSS showed huge nasal regurgitation, increased oral transit time, residues in oral cavity, delayed swallowing reflex, pharyngeal residue, impaired laryngeal elevation, and aspiration in semisolid and liquid trials. Obturator prosthesis was fabricated to minimize velopahryngeal insufficiency. After application of obturator prosthesis, swallowing dysfunction in oral and pharyngeal stages was markedly improved. Nasal regurgitation was not shown. Oral residue, oral transit time in oral stage also improved. Residue on vallaculae and pyriform sinuses decreased in pharyngeal stage. Aspiration also decreased. We reported successful obturator prosthesis application with sequential changes of clinical and VFSS findings in our case.ope

Effect of decannulation on pharyngeal and laryngeal movement in post-stroke tracheostomized patients

OBJECTIVE: To investigate effects of tracheostomy tube on the movement of the hyoid bone and larynx during swallowing by quantitative analysis of videofluoroscopic swallowing study. METHOD: 19 adult stroke patients with tracheostomies, who met the criteria of decannulation participated. Serial videofluroscopic swallowing studies were done over 14 days before decannulation, within 24 hours before decannulation, within 24 hours after decannulation, and over 14 days after decannulation. The kinematic parameter such as pharyngeal transition time, stage transition duration, maximal hyoid bone movement, and maximal laryngeal prominence movement were obtained by 2-D quantitative analysis of videofluoroscopic swallowing study. RESULTS: Pharyngeal transition time and stage transition duration were not significantly changed all the time. The maximal hyoid bone movement and maximal laryngeal prominence just after decannulation were improved significantly compared to just before decannulation (p<0.05), especially on vertical movement. CONCLUSION: The hypothesis that a tracheostomy tube disturbs the hyoid bone and laryngeal movement during swallowing may be supported by this study. KEYWORDS: Decannulation, Hyoid bone, Laryngeal prominence, Movement, Tracheostomyope

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Thesis (master`s)--서울대학교 대학원 :수리과학부,2001.Maste

Mutational Analyses of the Ketosteroid Isomerase from Pseudomonas putida Biotype B

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