Carroll 双上肢功能评定和Peabody 运动发育量表-2 中精细动作在偏瘫型脑瘫患儿中的有效性研究

目的了解Carroll 双上肢功能测试量表是否能更好地反应脑瘫偏瘫患儿的精细运动情况。方法45 例脑瘫偏瘫症状的患儿由同两名评估者在1 周之内进行Peabody 运动发育量表-2(PMDS-2)与Carroll 双上肢功能测试。分析Carroll 双上肢功能评定分与PDMS-2 中精细运动分值的相关性,同时比较健手和患手的Carroll 双上肢功能评定分。结果Carroll 双上肢功能评定分与患手和健手PDMS-2 抓握原始分、视觉-整合原始分显著相关(P<0.001),与患手(r=0.022, P=0.888)和健手(r=0.165, P=0.278)精细运动发育商(FMQ)均不相关。所有患儿健手和患手Carroll 双上肢功能评定分有显著性差异(Z=4.475, P<0.001)。结论临床康复评定脑瘫偏瘫患儿使用Carroll 双上肢功能评定量表更有利于了解患儿精细动作情况,制订康复计划与康复目标。     

早产儿与足月儿精细运动发育差异及影响因素的研究

【目的】 了解早产儿与足月儿精细运动发育水平的差异及其影响因素。 【方法】 采用Peabody运动发育量表第2版(Peabody Developmental Motor Scales 2,PDMS-2)对215例婴儿(早产儿97例、足月儿118例)进行精细运动发育水平测试,并对结果精细运动发育商(fine motor quotient,FMQ)进行统计分析。 【结果】 1)早产儿FMQ显著小于足月儿FMQ(t＝5.142,P＜0.05);2)精细运动的抓握标准分低于视觉运动整合标准分(d＝1.00±1.24,t＝11.881,P＜0.05);3)FMQ受到胎龄、出生体重、进食能力训练、身高、体重多方面因素的影响。 【结论】 早产儿精细运动发育落后于足月儿,且抓握能力发育较视觉运动整合能力发育落后;孕期加强保健延长胎龄和增加出生体重、生后有意识通过进食能力训练加强动手能力的提高、保持适宜的生长发育对精细运动的发育极其重要。     

Cochlear implantation at 12 months: Limitations and benefits for vocabulary production

Abstract

Objective

The purpose of this investigation was to learn the degree to which cochlear implantation at 12 months of age could reduce gaps in performance between hearing age and chronological age – that is, whether infants with access to cochlear implants at 12 months of age would be 12 months delayed, or less, in vocabulary production one year later.

Method

Baseline vocabulary production was measured by parent interview and direct observation approximately 4 months post cochlear implant (CI) activation, and again 12 months after CI activation using the MacArthur-Bates Communicative Development Inventory: Words and Sentences.

Results

Infants produced few if any words shortly after CI activation. Word production increased significantly during the 12 months following CI activation but scores were still significantly below age-level expectations based on chronological age. Vocabulary scores were, however, significantly better than expected based on hearing age, or duration of implant use.

Conclusion

Word production was delayed at both time points; however, access to cochlear implants at 12 months of age decreased the size of anticipated delays one year later, narrowing the expected gap between hearing age and chronological age.     

PACS在医学影像教学中的应用

目的:探索和讨论医学院校数字化建设中影像存档与传输系统(PACS)在医学影像教学中的应用。方法:将50名学员按学习成绩排列并随机分为2组,分别用传统PPT教学法和PACS系统对相同内容进行教学,课后对授课内容进行随堂考核并发放学生调查问卷。结果:使用PACS系统授课的学生比使用原始PPT教学法授课的学生考核平均成绩提高3分;学生对PACS系统及医学影像学的兴趣逐步提高。结论:PACS系统有利于提高学生的学习兴趣及医学影像学教学质量。此种图像处理技术与网络化通信以及计算机技术相结合的产物,在逐步应用于临床医疗的同时,也为医学院校的医学影像教学提供了更先进的手段。     

Lexical and semantic ability in groups of children with cochlear implants,language impairment and autism spectrum disorder

Objective

Lexical-semantic ability was investigated among children aged 6–9 years with cochlear implants (CI) and compared to clinical groups of children with language impairment (LI) and autism spectrum disorder (ASD) as well as to age-matched children with normal hearing (NH). In addition, the influence of age at implantation on lexical-semantic ability was investigated among children with CI.

Methods

97 children divided into four groups participated, CI (n = 34), LI (n = 12), ASD (n = 12), and NH (n = 39). A battery of tests, including picture naming, receptive vocabulary and knowledge of semantic features, was used for assessment. A semantic response analysis of the erroneous responses on the picture-naming test was also performed.

Results

The group of children with CI exhibited a naming ability comparable to that of the age-matched children with NH, and they also possessed a relevant semantic knowledge of certain words that they were unable to name correctly. Children with CI had a significantly better understanding of words compared to the children with LI and ASD, but a worse understanding than those with NH. The significant differences between groups remained after controlling for age and non-verbal cognitive ability.

Conclusions

The children with CI demonstrated lexical-semantic abilities comparable to age-matched children with NH, while children with LI and ASD had a more atypical lexical-semantic profile and poorer sizes of expressive and receptive vocabularies. Dissimilar causes of neurodevelopmental processes seemingly affected lexical-semantic abilities in different ways in the clinical groups.     

Hear here: Children with hearing loss learn words by listening

Objectives

Early use of hearing devices and family participation in auditory-verbal therapy has been associated with age-appropriate verbal communication outcomes for children with hearing loss. However, there continues to be great variability in outcomes across different oral intervention programmes and little consensus on how therapists should prioritise goals at each therapy session for positive clinical outcomes. This pilot intervention study aimed to determine whether therapy goals that concentrate on teaching preschool children with hearing loss how to distinguish between words in a structured listening programme is effective, and whether gains in speech perception skills impact on vocabulary and speech development without them having to be worked on directly in therapy.

Method

A multiple baseline across subjects design was used in this within-subject controlled study. 3 children aged between 2:6 and 3:1 with moderate–severe to severe-profound hearing loss were recruited for a 6-week intervention programme. Each participant commenced at different stages of the 10-staged listening programme depending on their individual listening skills at recruitment. Speech development and vocabulary assessments were conducted before and after the training programme in addition to speech perception assessments and probes conducted throughout the intervention programme.

Results

All participants made gains in speech perception skills as well as vocabulary and speech development. Speech perception skills acquired were noted to be maintained a week after intervention. In addition, all participants were able to generalise speech perception skills learnt to words that had not been used in the intervention programme.

Conclusions

This pilot study found that therapy directed at listening alone is promising and that it may have positive impact on speech and vocabulary development without these goals having to be incorporated into a therapy programme. Although a larger study is necessary for more conclusive findings, the results from this preliminary study are promising in support of emphasise on listening skills within auditory-verbal therapy programmes.     

Time course of word production in fast and slow speakers: a high density ERP topographic study

The transformation of an abstract concept into an articulated word is achieved through a series of encoding processes, which time course has been repeatedly investigated in the psycholinguistic and neuroimaging literature on single word production. The estimates of the time course issued from previous investigations represent the timing of process duration for mean processing speed: as production speed varies significantly across speakers, a crucial question is how the timing of encoding processing varies with speed. Here we investigated whether between-subjects variability in the speed of speech production is distributed along all encoding processes or if it is accounted for by a specific processing stage. We analysed event-related electroencephalographical (ERP) correlates during overt picture naming in 45 subjects divided into three speed subgroups according to their production latencies. Production speed modulated waveform amplitudes in the time window ranging from about 200 to 350 ms after picture presentation and the duration of a stable electrophysiological spatial configuration in the same time period. The remaining time windows from picture onset to 200 ms before articulation were unaffected by speed. By contrast, the manipulation of a psycholinguistic variable, word age-of-acquisition, modulated ERPs in all speed subgroups in a different and later time period, starting at around 400 ms after picture presentation, associated with phonological encoding processes. These results indicate that the between-subject variability in the speed of single word production is principally accounted for by the timing of a stable electrophysiological activity in the 200-350 ms time period, presumably associated with lexical selection.     

Long Term Outcomes of Early Cochlear Implantation in Korea

Objectives

The objective of this study was to compare the long-term auditory performance and language skill depending on the age of cochlear implantation in the Korean population. We especially tried to separate the effect of maturation/development from that of the age at implantation.

Methods

Eighty-six pre-lingual children with profound hearing loss who underwent a cochlear implantation before the age of six and had been followed for more than 3 yr were included in this study prospectively. Categories of Auditory Performance (CAP) and Korean Picture Vocabulary Test (K-PVT) were serially followed up. In order to separate the age at implantation effect, K-PVT results were readjusted to the child''s chronological age in the normal hearing population.

Results

When the CAP and K-PVT scores were directly compared without chronological readjustment, we failed to show a significant difference for improvements according to the age at implantation. Early cochlear implantation was associated with better language development, only when the K-PVT scores were readjusted to percentile scores of their chronological age.

Conclusion

Early cochlear implantation was associated with better language development even within the critical period. This advantage may be recognized only when the effect of the age at implantation is separated from the effect of maturation/development.     

Auditory and cognitive abilities of children suspected of auditory processing disorder (APD)

Objective

Auditory processing disorder (APD) is typically characterised by difficulties in ‘listening’, particularly to speech in a noisy environment, despite normal peripheral function. In school-age children, APD has attracted considerable interest because of suspicions that it may lead to learning difficulties, especially affecting language and literacy. Here, we evaluated auditory and cognitive abilities in a group of children referred for an auditory evaluation on the grounds of a suspected auditory processing disorder (susAPD), and in age-matched children who were typically developing, in order to determine the extent to which any deficits in cognitive abilities could be related to auditory deficits.

Methods

A battery of auditory and cognitive tests was applied to 20 susAPD school-age children, all reported as having listening/hearing problems but performing within normal limits for standard audiometric assessments. Also tested was a group of 28 age-matched controls. The auditory tasks consisted of two simple same/different discrimination tasks, one using speech, and one nonspeech. The cognitive evaluation comprised a vocabulary test, a test of grammar and four non-verbal IQ measures. Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) were assessed in the susAPD group through a standardised questionnaire.

Results

A significant proportion of susAPD children appeared to display genuine auditory deficits evidenced by poor performance on at least one of the auditory tasks, although about 1/3 had no detectable deficit. Children in the susAPD group scored consistently lower than the controls on cognitive measures that were both verbal (vocabulary and grammar) and non-verbal. Strikingly, susAPD children with relatively good auditory performance did not differ in cognitive ability from susAPD children with poor auditory performance. Similarly, within-group correlations between auditory and cognitive measures were weak or non-existent. Measures of ADHD did not correlate with any aspect of auditory or cognitive performance.

Conclusions

Although children suspected of having APD do show, on average, poorer performance on a number of auditory tasks, the presence or absence of an auditory deficit appears to have little impact on the development of the verbal and non-verbal skills tested here.     

巧设路由实现ECLIPSE 1.5T MR的直接DICOM传输与打印

目的 通过在ECLIPSE 1.5T MR工作站中设置路由服务器,实现不同网段之间的直接通信,以实现PACS中同一物理网络不同网段之间医学图像的直接DICOM传输与打印.方法 通过为ECLIPSE 1.5T MR工作站安装第二块网卡,打开其操作系统内核的数据包转发功能,完成路由服务器的组建工作.结果 完成ECLIPSE 1.5T MR主机到PACS网络中图像接收服务器的直接DICOM传输以及实现PACS网络打印.结论 ECLIPSE 1.5T MR工作站的Linux操作系统提供路由服务完全可以实现同一物理网络不同网段之间的通信.