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We assessed 12 young adults with hemiplegic cerebral palsy, aged from 14 to 33 years, by intellectual quotient (IQ) and magnetic resonance imaging (MRI), and obtained the following findings. First, the IQ scores were relatively lower than those predicted by their social activities. Second, there were two cases who seemed to have right or bilateral hemisphere representatives of language; their IQ scores were within normal range, while MRI demonstrated extensive brain damages including usual ones in language areas. Third, IQ scores and MRI findings were correlated to some extent; however, a case of limited brain damage on MRI had low IQ score, while five cases of brain damage located excluding their language areas had normal or high IQ scores. The results of the present study indicate the necessity of follow-up MRI for prospective observation of the brain damage acquired at or around birth., Acta medica Nagasakiensia. 2004, 49(3), p.81-85

長崎大学小児科未熟児室で集中管理を受けた在胎28週から35週のAFD16例を研究対象とした。 NBAS評価は36、40、44週の計3回施行し、6カ月、12カ月時点での発達評価はBAYLEY乳幼児発達検査を実施し、併せて、生活環境調査もおこなった。 1、睡眠のリズムと生活環境が1才時点での運動および精神発達指数に大きく影響していた。2、明らかな発達遅滞児2例、脳性麻痺1例を除いた1才時点での発達指数は、運動102.8±7.4、精神105.6±6.1と標準値に達しており、NBASを用いた早期介入がAFDの発達促進に有効であったと推測される。3、発達遅滞児、脳性麻痺児はNBAS補足項目と反射項目で低値を示し、high risk児の評価に有効であった。, It has constantly been observe that cerebral palsy and/or mental retardation develops among premature and high risk infants ．Assessment using Neonatal Behavioral Assessment Scale （NBAS）immediately after birth and longitudinal study on development during the first postnatal year were performed on 16 AFD （appropriate for dates ）infants whose normal development was anticipated and 21 mature infants, in order to improve the security of early assessment and early habilitation of handicapped children． NBAS assessment was effective as a means of early intervention ，whereby development Was enhanced in both AFD and mature infants. Of the 13 AFD infants who reached one year of age 1 case was hemiplegic cerebral palsy and 2 cases were motor delay. They showed abnormal values in NBAS supplementary items and reflexes at the neonatal period ．These itmes were Effective for a screening test of high risk infants. The mental development index （MDI） and psychomotor development index （PDI） were closely associate with the quality of sleep-waking ryhthm and the degree of mother's interaction．, 長崎大学医療技術短期大学部紀要 = Bulletin of the School of Allied Medical Sciences, Nagasaki University. 1990, 3, p.1-12

歩行不能例を含めた脳性麻痺患者78例108肢の股，膝関節屈曲拘縮に対し，腸腰筋，ハムストリングを含めた屈筋群および他の軟部組織の解離，延長術を施行した． 手術目的は，屈曲拘縮の除去，屈筋共同収縮の抑制および伸筋群の機能強化により，股関節周囲筋のインバランスを改善し，股関節の求心性を改善すると同時に立位姿勢保持機能および移動能力を高めることにあった． 78例中55例71％に立位姿勢保持機能および移動能力に改善をみた．移動能力の改善には術後6カ月～2年間かかり，重度であればあるほど長期間を要した．B，C群において，手術の最もよい適応年齢は4～5歳であった．股関節亜脱臼例においてレ線上SF角，CE角，骨頭被覆率に明らかな改善を得た．, Soft tissue release operations to the hip and knee flexion contracture were performed on 108 extremities of 78 cerebral palsy patients including non-ambulatory cases. A successful operation requires accurate assessment of contracture and complete elimination of flexion contracture. Furthermore, postoperative physiotherapy is essential for having the patient detach from the preoperative pathological postural reaction mainly involving hyperactivities of the flexors and acquiring normal postural reaction to a possible extent primarily initiated by the extensors. The ability of locomotion was improved in 55 of 78 cases or in 71%. In severe cases, generalized hypertonia was alleviated. Improvement of the ability of locomotion after the operation required 6 months to 2 years in proportion to the severity of motor dysfunction. The most appropriate age for non-ambulatory groups (B and C groups) was 4 or 5 years. Roentgenograms generally disclosed definite improvement of sacro-femoral angle, and in subluxation cases, CE angle and covered ratio of the femoral head., 長崎大学医療技術短期大学部紀要 = Bulletin of the School of Allied Medical Sciences, Nagasaki University. 1988, 1, p.3-18

重度脳性麻痺者の心肺機能を施設群と在宅群，アセトーゼ型と痙直型，A-DL自立群と非自立群などに分けて，安静時と運動負荷時の両者で評価した。 結論として， 1．重度脳性麻痺者の呼吸機能は健常者のそれと比較して半減していた。 2．施設群の呼吸機能は在宅群のそれに比較して有意の差で後者がすぐれていた。前者は健常者の約1/3の計測値を示した。 3．社会的自立群は非自立群に比して，ADL の自立や運動機能と関係なく，呼吸機能がすぐれていた。 4．standing 群とnon-standing 群との比較では全体として前者が高い呼吸機能を示した。 5．アセトーゼ群は痙直群と比較して，より高い呼吸機能を有していた。, Most of persons with severe cerebral palsy are caused pain due to osteoarthritis or hypertone as their age advances to 20 or more. As a result, ADL is restricted and living ability drops. On the other hand, those who actively participate in social activity despite the inability of ADL seem to maintain a high livelihood ability and have less pain due to hypertone. A study was carried out in search for the relationship between actual status of living of the persons with severe cerebral palsy and their cardiopulmonary and physical functions. The subjects consisted of 14 persons staying at facilities for the handicapped and 9 staying at home, totaling 23 ; 13 males and 10 females, age ranging from 22 to 42 mean being 31. The cardiopulmonary function was assessed at rest and at physical load. The items of measurement were TV, VE, RR, VO2, VCO2, METS, VO2/W, SaO2, and ALL OUT TIME. A comparison was made respectively between 1. facility and home groups, 2. athetotic type and spastic type groups, 3. deformative thorax and nondeformative groups, 4. ADL self-managing and non managing groups,and 5. socially independent and dependent groups.(Results) 1. The respiratory function,especially VO2/W was lower in the facility group compared to home group. 2. Superior in athetotic type to spastic type. 3. Lower in deformative thorax group compared to non-deformative group. 4. The ADL self-managing group tended to show a better respiratory function (especially ventilation) than the non-self managing group. 5. The socially independent group compared to dependent group was definitely superior in respiratory function (especially ventilation,VO2/W). Most of those whose social independency was high were superior in cardiopulmonary and physical functions even though their mobility was poor. It is very difficult for the severely handicapped to attain social independency but their mind of independency and will power they acquired through their struggles with handicap are more than normal pesons. Their continued activities to participate in social life should be encouraged., 長崎大学医療技術短期大学部紀要 = Bulletin of the School of Allied Medical Sciences, Nagasaki University. 1989, 2, p.13-24