• Title/Summary/Keyword: Positional

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Comparison of Clinical Characteristics and Effects of Modified Jaw Thrust Maneuver During Drug-Induced Sleep Endoscopy (DISE) between Positional and Non-Positional Obstructive Sleep Apnea Patients

  • Moon, Ji Seung;Koo, Soo Kweon;Kim, Young Joong;Lee, Sang Hoon;Lee, Ho Byoung;Park, Geun Hyung;Lee, Sang Jun
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.190-197
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    • 2018
  • Background and Objectives : Positional OSAS is characterized by an apnea-hypopnea index (AHI) score >5, which, while sleeping in the supine position, is double that in non-supine position. This study was performed to compare the clinical characteristics of positional OSAS and non-positional OSAS patients, and the effects of the modified jaw thrust maneuver during drug-induced sleep endoscopy (DISE) between positional OSAS and non-positional OSAS patients. Materials and Methods : 68 positional OSAS patients and 19 non-positional OSAS patients were included. They all underwent full-night polysomnography and DISE. The modified jaw thrust maneuver was introduced during DISE. Airway structural changes induced by the modified jaw thrust maneuver were evaluated and documented. Results : There were no statistically significant differences in Friedman stage or tonsil grade, body mass index, Epworth sleepiness scale (ESS) score, blood pressure, AHI, or obstructive pattern between the positional and non-positional OSAS patients. However, mean arterial oxygen saturation (SaO2), lowest SaO2, and total arousal index values were more severe in the non-positional OSAS patients. After introduction of the modified jaw thrust maneuver, retrolingual level obstruction showed a tendency toward a higher rate of airway opening in positional OSAS patients than in non-positional OSAS patients. Conclusions : The effects of a mandibular advancement device (MAD) can be estimated by carrying out a modified jaw thrust maneuver during DISE. The tendency toward a higher rate of airway opening in positional OSAS patients than non-positional OSAS patients in retrolingual level obstruction after jaw thrust maneuver introduced during DISE may be clinically important for MAD.

Spontaneous Direction-Changing or Reversing Positional Nystagmus without Changing Head Position during Head-Roll/Head-Hanging Maneuvers: Biphasic Positional Nystagmus

  • Yetiser, Sertac
    • Journal of Audiology & Otology
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    • v.25 no.1
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    • pp.43-48
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    • 2021
  • Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

Spontaneous Direction-Changing or Reversing Positional Nystagmus without Changing Head Position during Head-Roll/Head-Hanging Maneuvers: Biphasic Positional Nystagmus

  • Yetiser, Sertac
    • Korean Journal of Audiology
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    • v.25 no.1
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    • pp.43-48
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    • 2021
  • Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

Diagnosis and treatment of positional plagiocephaly

  • Jung, Bok Ki;Yun, In Sik
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.80-86
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    • 2020
  • Positional plagiocephaly is increasing in infants. Positional plagiocephaly is an asymmetric deformation of skull due to various reasons; first birth, assisted labor, multiple pregnancy, prematurity, congenital muscular torticollis and position of head. Positional plagiocephaly can mostly be diagnosed clinically and by physical examinations. The simplest way to assess the severity of plagiocephaly is to use a diagonal caliper during physical examination, which measures the difference between the diagonal lengths on each side of the head. Plagiocephaly can be treated surgically or conservatively. Positional plagiocephaly, which is not accompanied by craniosynostosis, is treated conservatively. Conservative treatments involve a variety of treatments, such as change of positions, physiotherapy, massage therapy, and helmet therapy. Systematic approaches to clinical examination, diagnosis and treatment of positional plagiocephaly can be necessary and the age-appropriate treatment is recommended for patients with positional plagiocephaly.

Positional Stability Analysis of Trailing Aircraft in Formation Flight (편대비행에서 후방 항공기의 위치 안전성 분석)

  • Cho, Hwan Kee
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.24 no.2
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    • pp.19-24
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    • 2016
  • Positional stability analysis based on aerodynamic forces and induced moments of formation flight using two small aircraft models is presented. The aerodynamic force and moments of the trailing aircraft are analyzed in the aspect of flight stability. The induced moments with the change of local flow direction by wing-tip vortex from the leading aircraft can affect the flight positional stability of aircraft in closed formation flight. Aerodynamic forces and moments of trailing aircraft model are measured by 6-component internal balance at the 49 locations with vertical and lateral space between two aircraft models. Results are shown that the positional stability of trailing aircraft in formation flight can be analyzed by positional stability derivatives with vertical and lateral space. It is concluded that flying positions can be important factors for aircraft position stability due to induced aerodynamic force and moments with vertical and lateral spacing by the variation of flow pattern from the leading aircraft in formation flight.

Measuring the Positional Accuracy of GIS Polygon Data (GIS 폴리곤 데이터의 위치정확도 측정 방법)

  • Hong, Sung-Eon
    • Journal of Korean Society for Geospatial Information Science
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    • v.14 no.4 s.38
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    • pp.3-10
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    • 2006
  • This study proposes a method to measure the positional accuracy of the implemented GIS polygon data. Also, it aims to present a possibility to analyze the occurrence types of positional errors by improving the measuring methods of positional accuracy based on the existing individual methods and by linking individual methods. As a result of the actual application of the methodology to the test area, it was possible to measure the positional accuracy in target test areas and to analyze the occurrence causes (types) of positional errors through each index linking (linking methodologies). Also, research results allowed confirming the applicability of the methodology. However, complementary research for each standard numerical value is recommended in order to ensure the validity of methodology.

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The Clinical Characteristics Between the Positional Obstructive Sleep Apnea Patients with the Non-positional Obstructive Sleep Apnea Patients (체위성 폐쇄성수면무호흡 환자와 비체위성 폐쇄성수면무호흡환자의 임상적 특징 고찰)

  • Kang, Hyeon-Hui;Kang, Ji-Young;Lee, Sang-Haak;Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.22-26
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    • 2012
  • Objectives: The percentage of positional sleep apnea in obstructive sleep apnea (OSA) varies in different reports from 9% to 60%. If there is a positional dependency in patients with OSA, positional therapy alone could be successful in treating about 50% of all OSA cases. The aim of this report is to compare anthropomorphic and polysomnographic data between the positional sleep apnea group and non-positional sleep apnea group with OSA whose conditions were diagnosed in our sleep clinic. Methods: This is a retrospective study of anthropomorphic and polysomnographic data of patients with OSA who was performed a nocturnal polysomnography. Positional sleep apnea was defined as having a supine apnea-hypopnea index (AHI) of twice or more compared to the AHI in the non-supine position. The patients were divided in the positional sleep apnea group and the non-positional sleep apnea group. Results: In 101 patients with OSA, 81 were male, and the mean age was $49.2{\pm}11.9$ years. Seventy-six (75.2%) were diagnosed as the positional sleep apnea. Waist to hip ratio and body mass index (BMI) were significantly higher in non-positional sleep apnea group. The frequency of severe OSA was significantly higher in this group. In the positional sleep apnea group, nocturnal sleep quality was better preserved, and consequently these patients were less sleepy during daytime. AHI was significantly lower and minimal arterial oxygen saturation during sleep was significantly higher in this group. Conclusion: The percentage of positional sleep apnea in OSA was 75.2%. AHI, BMI, and waist to hip ratio were lower in the positional sleep apnea group. These patients have less severe breathing abnormalities than the non-positional sleep apnea group in polysomnography.

Positional Release Muscle Energy Technique Method for Psoas Major Muscle: Case Study (대요근에 대한 근에너지기법을 이용한 자세이완기법 적용: 사례연구)

  • Choi, Sung-hwan;Hong, Hyun-pyo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.23 no.1
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    • pp.59-62
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    • 2017
  • Background: Positional release muscle energy technique (PRMET) is a method joined positional release technique and muscle energy technique. Methods: Subjects those who have low back pain from the acute to chronic phase, were applied PRMET method on psoas major muscle and measured the changes in pain and disfunction. Results: PRMET method is effective for reducing pain and disfunction on psoas major muscle. Conclusions: The advantages of PRMET method are minimized patient inconvenience, shortening of treatment time and effective for improvement. In the future research, methods need to be improved so that this can be applied to other muscles.

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A Study on the Accuracy Assessment of Digital Map (수치지도의 정확도 검정에 관한 연구)

  • 김병국;최정민;김은모
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.16 no.2
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    • pp.319-326
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    • 1998
  • In this study, it was tried to experimentally judge the positional accuracy of digital maps, which are being constructed with a vast of investment and national endeavor. Using GPS and Total Station, field surveying to assess the positional accuracy of 1:5,000 digital maps was conducted. According to these results, the digital maps were compared to the real field test. And in order to check the positional accuracy standard of digital maps, theoretical positional accuracy of 1:5,000 digital maps are compared with that from field test data to propose research activities for hereafter positional accuracy standard of digital map.

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A Case of Benign Paroxysmal Positional Vertigo Treated with Stellate Ganglion Block (성상신경절 차단으로 치료했던 양성 발작성 현기증 1예)

  • Choe, Huhn;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.328-330
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    • 1995
  • A fourty-year-old housewife was admitted to the Department of Ear, Nose, and Throat from the emergency room, because of severe vertigo associated with positional changes of the head. Hallpike maneuver produced typical patterns of bilateral nystagmus consistent with benign paroxysmal positional vertigo(BPPV), and further geotropic rotatory nystagmus with positional change of the head in each direction. Direction of nystagmus reversed when the patients was repositioned upright. Particle repositioning maneuver was administered to her left ear but failed to relieve the severe dizziness associated with the head turning to the right. She was then referred to the patient received 27 SGB treatments and the patients was almost completely healed. It is unusual for the BPPV to occur bilaterally therefore reference concerning the effectiveness of SGB for the treatment of BPPV was difficult to obtain. In conclusion we would like to report the successful treatment of BPPV with SGB.

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