Objective: To examine the "clinical utility" of a new virtual rehabilitation tool in order to treat upper-limb motor deficit in cerebral palsy (CP) patient.Methods: Single-case experimental designs. Virtual reality intervention was performed in two left unilateral spastic CP adolescent patients. The virtual reality intervention was given for 60 minutes per session, two sessions a day, and 5 days a week over 2 weeks.Results: For each patient and for both hands, the number of blocks transported within one minute (box and block test scores) is increased. The nonoverlap of all pairs indices for the paretic hand were calculated as 0.95 for subject 1 and 0.93 for subject 2, and the nonoverlap of all pairs indices for the nonparetic hand were calculated, respectively, as 0.92 and 1.Conclusion: We provide empirical evidence in support of a new simple Virtual Rehabilitation system in CP patient to improve upper-limb motor function.
Sclerosing epithelioid fibrosarcoma (SEF) is a rare variant of fibrosarcoma that commonly occurs in soft tissue. Since its original description in 1995, studies have revealed cytogenetic similarities with low-grade fibromyxoid sarcoma (LGFMS) and hybrid tumor composed of SEF and LGFMS. We report a case of SEF with EWSR1 gene rearrangement. A 62-year-old man had complained of a soft tissue mass in the left part of the buttock for 4 months. Imaging studies revealed a 6-cm mass in the left gluteus muscle, which was excised. Microscopically, the tumor was composed of short, spindle-shaped tumor cells with bland oval or polygonal nuclei arranged in cords and clusters with intervening sclerosing collagen matrix. Immunohistochemically, the tumor cells were positive for epithelial membrane antigen and mucin 4. Fluorescence in situ hybridization demonstrated split signals for the EWSR1 gene. These findings were consistent with SEF. Some SEFs have been reported to have shared features with LGFMS; those lesions are termed “hybrid tumors”; however, recent studies revealed that there is a pure type of SEF, which harbors EWSR1 gene rearrangements, distinct from the chromosomal abnormalities seen in LGFMS. The present case is a histologically pure SEF with EWSR1 gene translocation; its cytogenetic profile suggests that pure type SEF is a separate entity distinct from LGFMS and hybrid tumor.
Difficulty in performing the activities of daily living is a key clinical feature of early cognitive decline in older adults and has also been associated with the early stage of dementia in mild cognitive impairment (MCI). As the number of individuals with dementia and the development of technology rise, an immersive virtual environment or virtual reality has been used in therapy for memory problems in the area of MCI. This study evaluated the use of finger movement data obtained from the virtual-reality-based application and its ability to cluster patients with everyday action impairment. Here, as a pilot study, nine healthy adults completed lunch box packing as an everyday action task in the designated virtual reality called the Virtual Kitchen (VK), equipped with a leap motion controller to record their finger movement. We converted the finger movements to acceleration data and then employed a time series clustering algorithm to create several clusters based on the data set. In addition, to comprehensively review the clustering result, we assessed performance-based measures for the experiment using the Naturalistic Action Test (NAT). The final results indicate that the clusters formed by using the acceleration data seem reasonably analogous to the performance measures (i.e., the type and number of errors that occurred).
Objective: Even though the severity of HIV-associated neurocognitive disorders (HAND) has decreased with the introduction of combination antiretroviral therapy, mild forms of HAND remain prevalent. Many HIV-infected individuals live alone, so mild cognitive impairments are easily missed. It is important to check their neurocognitive and everyday functions during hospital visits; however, it is challenging for Japanese clinicians because many hospitals do not have enough clinical psychologists or neuropsychologists. Additionally, neuropsychological (NP) test results may not detect those mild cognitive impairments. A micro error has been given more attention as a new behavioral sign of the early stages of cognitive decline, especially among people with Mild Cognitive Impairment (MCI). The current study aimed to 1) develop a touch-panel HAND screening battery and 2) evaluate if the micro errors could differentiate individuals with HAND from their counterpart healthy individuals. Participants and Methods: Forty HIV-infected men (age: 49.0±8.51 years old, education: 18.5±2.17 years) and 44 healthy men (age: 45.4±8.49 years old, education: 14.4±2.27 years) completed the touch-panel HAND screening battery which assessed six NP domains by seven subtests, everyday functions, and depression. A micro error is defined as a subtle action disruption or hesitation occurring immediately before making final actions. We evaluated the micro errors in short-term memory (STM) and long-term memory (LTM) of verbal learning tests (VLT). Results: Mann Whitney U tests revealed that the HIV+ group made significantly more micro errors on both STM (HIV+: 1.45±0.90 times, Healthy: 0.52±0.84 times) and LTM (HIV+: 1.85±0.73 times, Healthy: 1.29±0.71 times) than the healthy group (STM: W=1362, p< .001, Effect Size (EF)= .548; LTM: W=1199.5, p= .002, EF= .363). An independent samples T-test showed that the HAND group made significantly more micro errors than the non-HAND group (t=1.822, p= .038, ES= .595) on STM; moreover, the Asymptomatic Neurocognitive Impairment (ANI) group made significantly more micro errors than the healthy group (W=446, p< .001, ES= .689). On LTM, no significant micro error differences between HAND and non-HAND (W=184.5, p= .539, ES= -.189) nor between ANI and healthy group (W=327.5, p= .103, ES= .241) were found. Conclusions: The present study suggests that a novel behavioral measure, micro errors, may be able to help detect even the mildest form of HAND, ANI. Given that the touch-panel HAND screening battery consists of NP and IADL tests, it is important to evaluate micro errors on these various measures. Additionally, the touch-panel screening battery requires minimal administrative staff involvement, which could be beneficial for busy HIV clinicians.
