There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality.

Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

I and i

国際生活機能分類(International Classification of Functioning, Disability and Health: ICF)にみた福祉・保健・医療の専門職協働における連携に関する貢献と課題

Objective— To determine the incidence of dysphagia and associated pulmonary compromise in stroke patients through a systematic review of the published literature. Methods— Databases were searched (1966 through May 2005) using terms “cerebrovascular disorders,” “deglutition disorders,” and limited to “humans” for original articles addressing the frequency of dysphagia or pneumonia. Data sources included Medline, Embase, Pascal, relevant Internet addresses, and extensive hand searching of bibliographies of identified articles. Selected articles were reviewed for quality, diagnostic methods, and patient characteristics. Comparisons were made of reported dysphagia and pneumonia frequencies. The relative risks (RRs) of developing pneumonia were calculated in patients with dysphagia and confirmed aspiration. Results— Of the 277 sources identified, 104 were original, peer-reviewed articles that focused on adult stroke patients with dysphagia. Of these, 24 articles met inclusion criteria and were evaluated. The r...

Dysphagia After Stroke Incidence, Diagnosis, and Pulmonary Complications

EDITORIAL BOARD Robert Davison Aviles, Bradley University Harley E. Baker, California State University–Channel Islands Jean-Guy Blais, Universite de Montreal, Canada Catherine Y. Chang, Georgia State University Robert C. Chope, San Francisco State University Kevin O. Cokley, University of Missouri, Columbia Patricia B. Elmore, Southern Illinois University Shawn Fitzgerald, Kent State University John J. Fremer, Educational Testing Service Vicente Ponsoda Gil, Universidad Autonoma de Madrid, Spain Jo-Ida C. Hansen, University of Minnesota Charles C. Healy, University of California at Los Angeles Robin K. Henson, University of North Texas Flaviu Adrian Hodis, Victoria University of Wellington, New Zealand Janet K. Holt, Northern Illinois University David A. Jepsen, The University of Iowa Gregory Arief D. Liem, National Institute of Education, Nanyang Technological University Wei-Cheng J. Mau, Wichita State University Larry Maucieri, Governors State College Patricia Jo McDivitt, Data Recognition Corporation Peter F. Merenda, University of Rhode Island Matthew J. Miller, University of Maryland Ralph O. Mueller, University of Hartford Jane E. Myers, The University of North Carolina at Greensboro Philip D. Parker, University of Western Sydney Ralph L. Piedmont, Loyola College in Maryland Alex L. Pieterse, University at Albany, SUNY Nicholas J. Ruiz, Winona State University James P. Sampson, Jr., Florida State University William D. Schafer, University of Maryland, College Park William E. Sedlacek, University of Maryland, College Park Marie F. Shoffner, University of Virginia Len Sperry, Florida Atlantic University Kevin Stoltz, University of Mississippi Jody L. Swartz-Kulstad, Seton Hall University Bruce Thompson, Texas A&M University Timothy R. Vansickle, Minnesota Department of Education Steve Vensel, Palm Beach Atlantic University Dan Williamson, Lindsey Wilson College F. Robert Wilson, University of Cincinnati

measurement and evaluation in counseling and Development

tical perspective. For instance, there are only three passing references to kuru in a book of 650 pages. This edition reflects the renewed interest in the immunological theories of multiple sclerosis. More than half the text is devoted to Professor Lumsden's analysis of the pathoIogy and, in particular, the chemical pathology of the immune response. There is a great deal of original work devoted to the chemistry and behaviour of the immunoglobulins. Much of this appears in specialist journals and one must be grateful for the critical summary provided here. Professor Lumsden unequivocally sees the key to the problem of multiple sclerosis in the study of its immunochemistry, relegating infection by a virus or a slow virus to a quite subsidiary role. The clinical studies drawing on wide practical experience help to get one's prejudices about the illness onto a more reasoned footing. The section on treatment is still sadly limited. Dr. McAlpine found little to add to the regime which he described in 1955. McAlpine, Lumsden, and Acheson's reappraisal is an essential reference for the practising neurologist and the new edition makes important modification of and changes in emphasis from the edition of 1965.

https://jnnp.bmj.com/content/jnnp/36/5/894.3.full.pdf

The assessment of aphasia and related disorders

The purpose of this study is to introduce the Korean version of the Boston Naming Test (K-BNT) and to present the normative data. The K-BNT contains the same number of test items and uses the identical general administration method as the original Boston Naming Test (BNT). However, most of the items had to be altered due to the linguistic and cultural differences between Korean and English speakers. We administered 60 line-drawing pictures to six hundred normal participants in eight age groups (15-19, 20-24, 25-34, 35-44, 45-54, 55-64, 65-74, and 75 years and older), five educational levels (0, 1-6, 7-9, 10-12, and 13 years and more), and gender. Since the K-BNT scores were not affected by gender and found not to be significantly different among some age groups, we finalized each cell based on four age groups (15-44, 45-54, 55-74, and 75 years and older) and five education levels (0, 1-6, 7-9, 10-12, and 13 years and more). The highest score was achieved by the 15-44 age group with 13 and more years of education (M = 53.93, SD = 3.06), and the lowest by those of 75 years and older with no education (M = 27.42, SD = 8.22).

Normative data on the Korean version of the Boston Naming Test.

https://www.jvascsurg.org/article/S0741-5214(01)85468-9/pdf

New experiences with absolute ethanol sclerotherapy in the management of a complex form of congenital venous malformation.

Patients with dementia develop dysphagia some time during the clinical course of their disease. The aim of this study was to compare the swallowing functions of the 2 most common types of dementia: Alzheimer disease (AD) and vascular dementia (VaD). Videofluoroscopic swallowing studies of the 2 patient groups were analyzed according to various oral, pharyngeal, and laryngeal variables of swallowing. The results indicate that there are some different patterns of swallowing disorders. The AD patients were significantly more impaired in "oral transit delay over 5 seconds" with liquids (chi2=7.065, df=1, P=0.008), whereas the VaD patients showed more deficits in "bolus formation and mastication" of semisolid food (chi2=4.64, df=1, P=0.039), "hyolaryngeal excursion" (chi2=4.102, df=1, P=0.043), "epiglottic inversion" (chi2=4.612, df=1, P=0.032), and "silent aspiration" (chi2=6.258, df=1, P=0.011). These results could indicate that the swallowing disorders of the AD group may result from sensory impairment in relation to dysfunctions in the temporoparietal areas, whereas the swallowing disorders of VaD group may primarily be caused by motor impairments due to disruptions in the corticobulbar tract. This study is noteworthy because it is one of the first attempts to differentiate between the swallowing symptoms of AD and VaD patients. A further study that includes patients with more severe degree of dementia (eg, patients over clinical dementia rating 3) might delineate additional discriminating swallowing patterns between the 2 dementia groups. In addition, a follow-up study exploring various kinematic characteristics of dysphagia would address physiologic issues of swallowing disorders as related to one of the most important clinical variables, laryngeal aspiration in the 2 dementia groups.

Dysphagia in patients with dementia: Alzheimer versus vascular.

The study aimed to describe the properties of the Korean version of the Western Aphasia Battery (hereinafter K-WAB) and to present the normative data of normal individuals and patients. The K-WAB contains the same test contents and structure as the original WAB and the general test administration method was maintained. We administered the K-WAB to 224 normal adults in seven age groups (15–24, 25–34, 35–44, 45–54, 55–64, 65–74, and 75 years or older), in five educational levels (0, 1–6, 7–9, 10–12, and 13 years or more) and by gender. The age and educational levels were influential to the K-WAB performance. Accordingly, we formed six subgroups of the normal: two age groups (15–74, and 75 years or older groups) by three educational groups (0, 1–6, and 7 years or more). Two hundred thirty-eight patients were also evaluated using the K-WAB. The highest aphasia quotient (AQ), language quotient (LQ), and cortical quotient (CQ) were achieved by 15–74 age group with 7 or more years of education (M=97.11,...

Normative data on the Korean version of the Western Aphasia Battery.

Background Aspiration as a symptom of dysphagia and its apparent sequela, aspiration pneumonia, are common consequences of a stroke in the medulla. Previous reports that focused on dysphagia due to a medullary lesion were studies of single cases or a relatively small number of patients with multiple lesion loci. Moreover, the interval between the onset of stroke and the evaluation time of swallowing was not controlled and varied largely among patients. Thus, prediction of the swallowing status of patients with a medullary lesion has not been tenable. Objectives To investigate the relation between the loci of pure medullary lesions and aspiration, to examine swallowing function over time, and to explore clinical variables that can predict aspiration. Methods We investigated 23 patients with pure medullary infarctions using the videofluoroscopic swallowing study and compared the airway status findings with the lesion location as determined with magnetic resonance imaging. The patients were classified by 6 medullary lesion–level categories (lower, lower-middle, middle, lower-middle-upper, middle-upper, and upper) and by 5 intralevel lesion loci (inferior-dorsal, large inferior-dorsolateral, paramedian, midlateral, and dorsolateral). From the results of the videofluoroscopic swallowing studies, 2 patient groups were formed: one with aspiration and the other without aspiration. The clinical variables related to aspiration and outcome measures were also explored. Results Ten (44%) of the 23 patients manifested aspiration on swallowing: 9 (69%) of 13 with only middle-level lesions or lesions in multilevels, including the middle level; 1 (33%) of 3 with only upper-level lesions; and 0 (0%) of 7 with only lower-level medullary lesions. A lesion running the length of the middle and the lower medullary levels always resulted in aspiration. When an upper-level lesion was additionally involved, the incidence of aspiration depended on the horizontal extension of the lesion. We were able to discriminate the 2 patient groups with 95.7% accuracy using such variables as dysphonia, soft palate dysfunction, and facial hypesthesia. Most of the patients with aspiration symptoms due to a pure medullary infarction recovered rather quickly. Conclusions Medullary infarctions often cause aspiration, but the occurrence may depend on the levels along the neuraxis and intralevel lesion loci. When different lesion levels and loci and their related clinical findings are considered as possible variables, aspiration becomes predictable. The outcome data prove that systematic control of evaluation time of swallowing was critical as we engaged in this study, since many aspirators with pure medullary infarctions resolve their swallowing difficulties rather quickly.

https://jamanetwork.com/journals/jamaneurology/articlepdf/776332/noc90055.pdf

HyangHee Kim

Papers

Normative data on the Korean version of the Boston Naming Test.

New experiences with absolute ethanol sclerotherapy in the management of a complex form of congenital venous malformation.

Dysphagia in patients with dementia: Alzheimer versus vascular.

Normative data on the Korean version of the Western Aphasia Battery.

Aspiration subsequent to a pure medullary infarction: lesion sites, clinical variables, and outcome.