Reliability and validity of the Korean-language version of the Communication Function Classification System in children with cerebral palsy.

PURPOSE: The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) are useful systems for describing the broad communication function and speech intelligibility, respectively, of children with cerebral palsy (CP). The aims of this study were to determine the reliability and validity of the Korean version of the CFCS and also to investigate the association between the CFCS and the VSS and other functional classifications for children with CP. MATERIALS AND METHODS: Participants were 50 children with CP (33 males, 17 females; mean age 7.2 years, range 4-16 years) recruited from a rehabilitation hospital. We analysed the interrater and intrarater reliabilities of the Korean version of the CFCS and VSS between parents, a physiatrist, and a speech-language pathologist (SLP). The social function domain of the Paediatric Evaluation of Disability Inventory was assessed to examine the concurrent validity of the CFCS and VSS. RESULTS: The intrarater reliabilities of the CFCS and VSS were excellent in a physiatrist (ƙ = 0.92, ƙ = 0.94, respectively) and an SLP (ƙ = 0.98, ƙ = 0.98) and very good in parents (ƙ = 0.87, ƙ = 0.89). The interrater reliability of the CFCS and VSS was very good between the physiatrist and SLP (ƙ = 0.87, ƙ = 0.89) and good between parents and the SLP (ƙ = 0.63, ƙ = 0.78) and between parents and the physiatrist (ƙ = 0.61, ƙ = 0.76). The CFCS and VSS were strongly related with the social function domain of Paediatric Evaluation of Disability Inventory. In addition, we found very strong associations between the VSS and CFCS. CONCLUSIONS: The Korean version of the CFCS is a valid and reliable tool to classify communication ability and is strongly associated with the VSS, a reliable tool to classify speech intelligibility.

Strongly Metallic Electron and Hole 2D Transport in an Ambipolar Si-Vacuum Field Effect Transistor.

We report experiment and theory on an ambipolar gate-controlled Si(111)-vacuum field effect transistor where we study electron and hole (low-temperature 2D) transport in the same device simply by changing the external gate voltage to tune the system from being a 2D electron system at positive gate voltage to a 2D hole system at negative gate voltage. The electron (hole) conductivity manifests strong (moderate) metallic temperature dependence with the conductivity decreasing by a factor of 8 (2) between 0.3 K and 4.2 K with the peak electron mobility (∼18 m2/V s) being roughly 20 times larger than the peak hole mobility (in the same sample). Our theory explains the data well using random phase approximation screening of background Coulomb disorder, establishing that the observed metallicity is a direct consequence of the strong temperature dependence of the effective screened disorder.

Thermoelectric detection of chiral heat transport in graphene in the quantum Hall regime.

We report measurements of heat transport along the edge conducting channels in monolayer graphene in the integer quantum Hall regime. Hot charge carriers are injected to the edge channels, and the thermoelectric voltage is measured at a distance along the edge from the heat injection point. We confirm that heat transport in graphene in the quantum Hall regime is chiral and the thermoelectric signal is correlated with the charge conductance of ballistic transport, following the Mott relation. The thermoelectric signal decays with distance from the heater, indicating that carriers are partially thermalized during edge transmission.

Theory of 2D transport in graphene for correlated disorder.

We theoretically revisit graphene transport properties as a function of carrier density, taking into account possible correlations in the spatial distribution of the Coulomb impurity disorder in the environment. We find that the charged impurity correlations give rise to a density-dependent graphene conductivity, which agrees well qualitatively with the existing experimental data. We also find, quite unexpectedly, that the conductivity could increase with increasing impurity density if there is sufficient interimpurity correlation present in the system. In particular, the linearity (sublinearity) of graphene conductivity at lower (higher) gate voltage is naturally explained as arising solely from impurity correlation effects in the Coulomb disorder.

A self-consistent theory for graphene transport.

We demonstrate theoretically that most of the observed transport properties of graphene sheets at zero magnetic field can be explained by scattering from charged impurities. We find that, contrary to common perception, these properties are not universal but depend on the concentration of charged impurities n(imp). For dirty samples (250 x 10(10) cm(-2) < n(imp) < 400 x 10(10) cm(-2)), the value of the minimum conductivity at low carrier density is indeed 4e(2)/h in agreement with early experiments, with weak dependence on impurity concentration. For cleaner samples, we predict that the minimum conductivity depends strongly on n(imp), increasing to 8e(2)/h for n(imp) approximately 20 x 10(10) cm(-2). A clear strategy to improve graphene mobility is to eliminate charged impurities or use a substrate with a larger dielectric constant.

The prevalence, characteristics and correlates of falls in Korean community-dwelling older adults.

BACKGROUND: The risk factors for falls that have been reported in Caucasian older adults may not be the same for Korean older adults. OBJECTIVE: To examine the prevalence, characteristics and correlates of falls among community-dwelling older adults in Korea. METHODS: A stratified random sampling method was conducted to recruit participants, and 335 were eligible to participate from September 2006 to March 2007. Socio-demographic data, history of disease and medications, activities of daily living (ADL), cognitive status, health behaviour and fall incidents were collected. Descriptive statistics were used to describe the sample. The prevalence of falls was obtained. Univariate analyses for risk factors of falls using chi-square and t-test statistics, and multivariate logistic regression analyses for correlates of falls were performed. RESULTS: Of the 335 older adults, 48 (15%) elderly had experienced falls. There was a significant difference between older adults who fell and those who did not fall with regard to ADL and exercise behaviour. Non-fallers had higher ADL scores and showed higher levels of adherence to exercise than fallers. The independent risk factor for falls was ADL. CONCLUSIONS/IMPLICATIONS: In this study, an individual's functional status and exercise engagement were significant factors that differentiated fallers and non-fallers. Therefore, an effective fall prevention programme should be focused on encouraging older adults to participate in regular exercise.

Erratum: Collective modes in multi-Weyl semimetals.

This corrects the article DOI: 10.1038/srep34023.

Collective modes in multi-Weyl semimetals.

We investigate collective modes in three dimensional (3D) gapless multi-Weyl semimetals with anisotropic energy band dispersions (i.e., with a positive integer J). For comparison, we also consider the gapless semimetals with the isotropic band dispersions (i.e. E ~ kJ). We calculate analytically long-wavelength plasma frequencies incorporating interband transitions and chiral properties of carriers. For both the isotropic and anisotropic cases, we find that interband transitions and chirality lead to the depolarization shift of plasma frequencies. For the isotropic parabolic band dispersion the long-wavelength plasmons do not decay via Landau damping, while for the higher-order band dispersions the long-wavelength plasmons experience damping below a critical density. For systems with the anisotropic dispersion the density dependence of the long-wavelength plasma frequency along the direction of non-linear dispersion behaves like that of the isotropic linear band model, while along the direction of linear dispersion it behaves like that of the isotropic non-linear model. Plasmons along both directions remain undamped over a broad range of densities due to the chirality induced depolarization shift. Our results provide a comprehensive picture of how band dispersion and chirality affect plasmon behaviors in 3D gapless chiral systems with the arbitrary band dispersion.

Screening and transport in 2D semiconductor systems at low temperatures.

Low temperature carrier transport properties in 2D semiconductor systems can be theoretically well-understood within RPA-Boltzmann theory as being limited by scattering from screened Coulomb disorder arising from random quenched charged impurities in the environment. In this work, we derive a number of analytical formula, supported by realistic numerical calculations, for the relevant density, mobility, and temperature range where 2D transport should manifest strong intrinsic (i.e., arising purely from electronic effects) metallic temperature dependence in different semiconductor materials arising entirely from the 2D screening properties, thus providing an explanation for why the strong temperature dependence of the 2D resistivity can only be observed in high-quality and low-disorder 2D samples and also why some high-quality 2D materials manifest much weaker metallicity than other materials. We also discuss effects of interaction and disorder on the 2D screening properties in this context as well as compare 2D and 3D screening functions to comment why such a strong intrinsic temperature dependence arising from screening cannot occur in 3D metallic carrier transport. Experimentally verifiable predictions are made about the quantitative magnitude of the maximum possible low-temperature metallicity in 2D systems and the scaling behavior of the temperature scale controlling the quantum to classical crossover.

Preoperative assessment of residual hepatic functional reserve using 99mTc-DTPA-galactosyl-human serum albumin dynamic SPECT.

UNLABELLED: Preoperative assessment of residual hepatic functional reserve offers important strategic information for hepatic resection. To predict the postoperative residual liver function, we assessed the value of hepatic 99mTc-diethylenetriamine pentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) clearance estimated by dynamic SPECT analysis. METHODS: We investigated 114 consecutive patients with liver disease, including 55 hepatectomy cases. One minute after injection of 185 MBq 99mTc-GSA, 15 serial dynamic SPECT images were obtained every minute. The initial five sets of SPECT images were analyzed by Patlak plot to estimate the sequential initial hepatic 99mTc-GSA clearance (mL/min) as an index of hepatic function. The sum of hepatic 99mTc-GSA clearance of the segments immune from resection was categorized as predicted residual 99mTC-GSA clearance. In the hepatectomy cases, scintigraphy was performed before and 37 +/- 10 d after the operation. RESULTS: Good correlation was observed between the total hepatic 99mTc-GSA clearance and conventional hepatic function tests: plasma retention rate of iodocyanine green (ICG) at 15 min (ICG R15), r = -0.600, P < 0.0001, n = 94; plasma disappearance rate of ICG (K ICG), r = 0.670, P < 0.0001, n = 83; cholinesterase, r = 0.539, P < 0.0001, n = 121; serum albumin, r = 0.421, P = 0.0001, n = 123; and hepaplastin test, r = 0.456, P < 0.0001, n = 120. There was good correlation between the predicted residual 99mTc-GSA clearance and the postoperative total hepatic 99mTc-GSA clearance in patients who underwent segmentectomy or lobectomy (r = 0.84, P < 0.0001, n = 28) and between the pre- and postoperative total hepatic 99mTc-GSA clearance in patients who underwent subsegmentectomy (r = 0.91, P < 0.0001, n = 25). Five patients who had postoperative complications due to hepatic insufficiency (2 patients died of postoperative hepatic failure within 2 mo after operation) showed significantly lower predicted residual 99mTc-GSA clearance compared with the patients without complications (90.3 +/- 37.2 versus 320.9 +/- 158.8 mL/min; P < 0.005). CONCLUSION: The total hepatic 99mTC-GSA clearance reflected hepatic function. In addition, preoperative predicted residual hepatic 99mTc-GSA clearance was a good indicator of postoperative hepatic function and early prognosis. 99mTc-GSA dynamic SPECT is assumed to be a useful method for determining the surgical strategy in patients with hepatic tumor and especially in patients with hepatic dysfunction.

Absent myocardial iodine-123-BMIPP uptake and platelet/monocyte CD36 deficiency.

UNLABELLED: Global absence of myocardial 123I-15-(p-iodophenyl)-3-(R,S)-methyl pentadecanoic acid (BMIPP) uptake is occasionally noted, and it reflects myocardial long-chain fatty acid uptake abnormality. CD36, a membrane glycoprotein expressed on platelet, monocyte and endothelial cells, may contribute to myocardial fatty acid transport, and its deficiency has been reported in a small subset of the population. We hypothesized that CD36 deficiency may be related to absent myocardial BMIPP uptake. Thus, we investigated CD36 expression of platelet/monocyte in patients with absent myocardial BMIPP uptake. METHODS: Peripheral blood of 7 patients with global absence of myocardial BMIPP uptake (3 of 7 patients in one family) and 3 control subjects were examined in flow cytometric analysis. Platelet/monocyte surface CD36 was detected by using OKM5, an anti-CD36 mouse monoclonal antibody. RESULTS: There were no apparent relationships between specific clinical symptoms and absent myocardial BMIPP uptake. None of the blood samples of the 7 patients were stained with OKM5 on the platelet/monocyte cell surface, indicating that all of these patients were Type I CD36-deficient subjects. In contrast, all the control subjects showed normal staining. CONCLUSION: The fact that rare Type I CD36 deficiency was observed in all patients with absent myocardial BMIPP uptake suggests that CD36 plays a role in the myocardial long-chain fatty acid uptake process in humans.

201Tl and 99Tcm-human serum albumin for assessment of the effect of hypertensive treatment with angiotensin II infusion on tumour circulation.

The biodistribution of 201Tl and of 99Tcm-human serum albumin (99Tcm-HSA) was observed in tumour-bearing mice to investigate if tissue blood circulation could be evaluated in groups of mice infused with angiotensin II at a rate of 0.5 micrograms kg-1 min-1 (L) or 1 microgram kg-1 min-1 (H). Ten minutes after tracer injection, tumour uptake of 201Tl in the angiotensin II infused group showed a 2.20- and a 3.18-fold increase in the L and H groups, respectively, when compared to a group of mice infused with saline (P = 0.0478 and 0.0029, respectively). The effect of angiotensin II infusion on 201Tl uptake was minimal in normal organs. Decreased normal organ uptake of simultaneously injected 99Tcm-HSA in the L and H groups indicated the contraction of normal organ vessels, while increased tumour uptake of the tracer indicated mechanical dilatation of tumour vessels. We conclude that the effect of angiotensin II or other vasoactive agents can be non-invasively assessed by 201Tl and 99Tcm-HSA scintigraphy.

Colon perforation in hyperimmunoglobulin E syndrome.

Colon perforation from hyperimmunoglobulin E syndrome is very rare, and only one case has been reported in the English-language literature. Herein, the authors report another case of colon perforation experienced in hyperimmunoglobulin E syndrome. The patient was an 8-year-old girl with frequent infection, eczematoid dermatitis, and an increased serum level of immunoglobulin E. During admission, panperitonitis developed caused by colon perforation. Treatment was resection of the perforated segment of the colon and a double-barrel colostomy. The patient has been doing well 18 months after treatment.

Fistula-in-ano in infants: is nonoperative management effective?

PURPOSE: Recently, a number of studies have reported positive results from the nonoperative management of fistula-in-ano in infancy, although it has not been of use in all patients. The purpose of this study was to discern the effective treatment methods of fistula-in-ano in infants. METHODS: A retrospective review was done of 310 children who required operative management for fistula-in-ano or perianal abscess between January 1991 and July 2000. Eighteen patients displayed an onset of symptoms at less than 1 year of age and a duration of symptoms longer than 12 months. The authors analyzed these patients' medical records. RESULTS: All patients were boys. The mean duration of the symptoms was 26.6 +/- 27.5 months. Fourteen patients had shown an onset of symptoms at less than 6 months of age. The longest duration was 10 years. The patients showed conservative periods of over 12 months because their parents did not want them to undergo surgery. The disease in these patients followed 2 patterns. One (6 patients) was an onset of symptoms followed by a silent fistula-in-ano state. The other (12 patients) was an onset of symptoms followed by an intermittent relapse of inflammation. All patients underwent fistulotomy, and none of them had recurrent fistula during the follow-up period. CONCLUSIONS: Although the advantages of a nonoperative management of fistula-in-ano in infants include the avoidance of general anesthesia and surgical intervention, the lesions cannot be cured by a period of conservation. Surgical management is more effective in respect to the time factor.

Biliary atresia associated with meconium peritonitis caused by perforation of small bowel atresia.

BACKGROUND/PURPOSE: This report describes our experiences with 5 cases of biliary atresia associated with meconium peritonitis caused by perforation of small bowel atresia. METHODS: A review of medical records was undertaken in an effort to recognize cases of biliary atresia associated with meconium peritonitis. RESULTS: Five patients of 171 with biliary atresia (2.9%) were detected to have meconium peritonitis caused by perforation of small bowel atresia. The biliary atresia was not suspected during the initial operation for meconium peritonitis. Total parenteral nutrition (TPN) made it difficult to make an early differential diagnosis of biliary atresia because of the presence of TPN-associated cholestatic jaundice, and the Roux-en-Y limb used for hepatic portoenterostomy could not be made long enough to prevent cholangitis caused by preexisting short bowel. The main complications were severe, intractable cholangitis, short bowel syndrome with malnutrition; TPN-associated liver injury; and wound problems. Two patients died of ascending cholangitis, 1 patient of liver failure that was exacerbated by TPN-associated liver injury, and 1 patient is awaiting a liver transplant. Only 1 patient is in good health, being anicteric and showing normal growth and development. CONCLUSIONS: Biliary atresia is evidently closely associated with meconium peritonitis caused by perforation of small bowel atresia. The management of these patients is more difficult than that of patients with the usual form of biliary atresia, because of the necessity for a long period of TPN and the combined short bowel syndrome. The ideal management of these conditions has yet to be determined.

Acquired choledochal cyst from anomalous pancreatobiliary duct union.

The high incidence of anomalous pancreatobiliary duct union (APBDU) in children who have a choledochal cyst has been well documented. Additionally, cylindrical dilatation of the bile duct has been reproduced in animal models by anastomosing the pancreatic duct to the bile duct. In recent years, APBDU has been considered a possible etiologic factor in the formation of a choledochal cyst. The authors observed a progressive cylindrical dilatation of the common bile duct in a 6-year-old boy over an 18-month period. An operative cholangiogram showed a type Ic choledochal cyst and a type B APBDU (Todani classification). This clinical experience suggests that a normal common bile duct in children can be progressively dilated and become an acquired choledochal cyst arising as a complication of the preexisting APBDU.

Clinical experience with conservative surgery for vaginal endodermal sinus tumor.

Two cases of vaginal endodermal sinus tumor (EST), a rare pediatric malignancy, were managed with conservative surgery followed by adjuvant chemotherapy. The first case involved a 9-month-old girl with EST of the vagina, who was treated with a partial vaginectomy and VAC regimen (vincristine, actinomycin D, cyclophosphamide) during a 2-year period. The serum alpha-fetoprotein (AFP) level returned to normal after excision of the tumor, and it remained normal throughout the treatment period. There was no evidence of disease 30 months after diagnosis. The second case involved an 8-month-old girl with EST of the vagina, who was treated with local excision of the mass through a vaginotomy. The VAC regimen was administered, but the serum AFP level remained elevated. A follow-up abdominopelvic computed tomography scan, taken 4 months after the operation, showed local recurrence of the tumor. The VAC regimen was then changed to a BEP regimen (bleomycin, etoposide, cisplatin). The serum AFP level returned to normal after 2 courses of the new regimen, and no tumor was visible on the follow-up magnetic resonance imaging study. For vaginal EST, primary conservative surgery and adjuvant chemotherapy are attractive measures to preserve both reproductive and sexual function. The extent of conservative surgery requires at least a partial vaginectomy. Simple tumor excision may not be adequate to achieve cure or to prevent local recurrence, even with adjuvant chemotherapy. The serum AFP level is useful for diagnosing and monitoring vaginal EST in the infant.

Tailgut cyst in a neonate.

Tailgut cyst is a rare lesion of developmental origin located in the retrorectal space, which usually presents as a multilocular cystic mass. It is usually found in adults, and neonatal cases are extremely rare. The authors report a tailgut cyst in a neonate that was found by prenatal ultrasonogram, which was like a teratoma in gross appearance.

How important is the role of the internal anal sphincter in fecal continence? An experimental study in dogs.

It is a generalized concept that the internal anal sphincter (IAS) plays a significant role in fecal continence by generating high pressure in the anal canal at rest and relaxation during rectal distention. Agreement also exists on the importance of internal sphincter-saving anoplasty on anorectal malformations in establishing anal continence. Twelve dogs were divided into four groups. Group 1, a control group, was subjected to a perirectal dissection only. Group 2 underwent the same perirectal dissection plus a 2-cm resection of the anal canal. Group 3 underwent the perirectal dissection plus a 4-cm resection of the anal canal, and group 4 underwent perirectal dissection and transposition of the anus to the posterolateral portion of the voluntary muscle mass. Clinical continence was evaluated, and manometric results were compared with preoperative measurements. All dogs in groups 1, 2, and 3 were clinically continent without soiling except one in group 3, and also manometric results showed minimal change between preoperative and postoperative anal pressure profiles. The transposed anus of group 4 showed continuous fecal soiling. The anal resting pressure (ARP) was also decreased but still existed in this group. This experimental study showed that the IAS contributes to the anal resting tone. However, resection of the IAS did not completely interfere with fecal continence. The smooth muscle of pulled-through rectum seemed to partly take over the function of the IAS.

An unusual case of monozygotic epigastric heteropagus twinning.

Epigastric heteropagus refers to unequal and asymmetric conjoined twins in which the dependent component (parasite) is smaller and usually attached to the epigastrium of the dominant component (autosite). Epigastric heteropagus is a very rare type of conjoined twins. It is generally assumed that conjoined twins represent a form of monozygotic twinning, but there has been no confirmation of this monozygotic hypothesis. Epigastric heteropagus twins differ in several ways from symmetrical conjoined twins. These include male preponderance, and no major connection of vessels, bowels, or bones. These significant characteristics suggest to the authors that the fusion of two fertilized ova and the atrophy of one fetus resulted in this interesting malformation. However, a DNA study indicated monozygotic origin in their case. The possible pathogenesis was ischemic atrophy of the body structure of the monozygotic conjoined twins at an early gestational age.