The purpose of this study was to investigate the effect of direction (pitch and roll) on the perception of support surface rotation while standing. Thirty young healthy subjects participated in this study. Support surface was rotated at an unexpected instant in a very slow speed (0.2 deg/s). The direction of support surface rotation was randomly chosen among pitch (forward and backward) and roll (right and left) directions. The experiment was performed with eyes open and closed. Perception performance was evaluated by the perception threshold, defined as the rotation angle of the surface at the instant when a subject recognized that the support surface was moving. Results showed that the perception threshold was smaller for roll directions than pitch directions irrespective of vision and gender (p < 0.01). This indicates that the perception of support surface rotation is more sensitive in roll direction than in pitch direction. Among three sensory functions related to postural perception, the effect of vestibular and visual functions on the direction difference of the perception should be little because of the very slow surface rotation and independence on visual conditions. Therefore, the direction dependence of perception would have been affected mainly by the somatosensory function.
In clinical neurology various different electrophysiological tests are widely used to demonstrate the unsuspected malfunctioning in the nervous system and to monitor over time the clinical status of patients. In addition clinical neurologists and neurosurgeons take advantage of the intraoperative monitorings to increase the quality of neurosurgical operations in the posterior fossa, in the spinal cord, or in visual pathways. In the field of movement disorders, elecrophysiolgical tests provide neurologists with making accurate differential diagnoses with useful therapeutic stratergies as well as with investigating the pathophysiological machanisms. By using the electromyographic tests it could be possible for us to evaluate the types of blephalospasm, the extent of hemifacial spasm, the level of myoclonus, and the prime muscles of torticollis etc. Sometimes the myographic guidance may be critical for choosing the exact injecting site of botulinum toxin. These several decades various electroencephalographic and evoked potential tests has been utilized in the electrophysiological laboratories to understand the basic pathophysiology of myoclonus, spasticity and other central motor dysfunctions. It could be one of the breakthroughs in the area of behavorial neurology that the brain function can be mapped by the spontaneous or evoked electrical activities of nervous system since the movement related potentials (MRPs) had been studies for several decades. Various reflex tests such as masseter reflex, blink reflex, click evoked vestibulocollic reflex, facial reflex, stretch reflex, flexor reflex, H-reflex, H-reflex recovery curve, vestibular inhibition of H-reflex, reciprocal inhibition, recurrent or Renshaw reflex, Ib inhibition, cutaneous reflex have been also used to understand normal or abnormal physiology in movement disorders. Polysomnography, posturography and gait studies are also applied in clinical neurology in association with with movement disorders which are useful in deciding the treatment regimen.
Lee, Sang Koo;Park, Kwan;Park, Ik Seong;Seo, Dae Won;Uhm, Dong Ok;Nam, Do-Hyun;Lee, Jung-Il;Kim, Jong Soo;Hong, Seung Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
Journal of Korean Neurosurgical Society
/
v.29
no.6
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pp.778-785
/
2000
Objectives : Intraoperative neurophysiologic monitoring(INM) is a well known useful method to reduce intraoperative neurological complications during neurosurgical procedures. Furthermore, INM is required in most cerebellopontine angle(CPA) surgery because cranial nerves or brain stem injuries can result in serious complications. Object of this study is to the correlation between the changes of intraoperative monitoring modalities during cerebellopontine angle tumor surgery and post-operative functional outcomes in auditory and facial functions. Material and Methods : Fifty-seven patients who underwent intraoperative neurophysiologic monitoring during CPA tumor surgery were retrospectively reviewed. Their lesions were as follows ; vestibular schwannomas in 42, other cranial nerve schwannomas in seven, meningiomas in five and cysts in three cases. Pre- and postoperative audiologic examinations and facial nerve function tests were performed in all patients. Intraoperative neurophysiologic monitoring modalities includes brainstem auditory evoked potentials(BAEP) and facial electromyographies(EMG). We compared the events of INM during CPA tumor surgeries with the outcomes of auditory and facial nerve functions. Results : The subjects who had abnormal changes during CPA tumor surgery were twenty cases with BAEP changes and facial EMG changes in twenty one cases. The changes of intraoperative neurophysiologic monitoring did not always result in poor functional outcomes. However, most predictable intraoperative monitoring changes were wave III-V complex losses in BAEP and continuous neurotonic activities in facial EMG. Conclusion : These results indicate that intraoperative neurophysiologic monitoring in CPA tumor surgery usually provide predictive value for postoperative functional outcomes.
Kim, Jae-Yeong;Jeong, Seon-Yeong;Park, Sam-Min;Hwang, Dong-Gyu;Kho, Young Tak
Journal of Oriental Neuropsychiatry
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v.26
no.3
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pp.225-234
/
2015
Objectives: We aimed to evaluate the use of Korean medicine in patients with dizziness or vertigo, since such study has not been performed previously. Methods: In the current study, we included 3 diagnoses i.e., Disorders of vestibular function (H81), Vertiginous syndromes in diseases classified elsewhere (H82), and Dizziness and giddiness (R42) from the Health Insurance Review and Assessment Service (HIRAS) database for 4 years. We analyzed the database and compared treatment with Korean vs. Western medicine. Results: 1. Korean medical visits and cost have been increasing for 4 years, except 2011. Western medical visits are 11.9 times higher than Korean medical visits. 2. The number of women who received Korean medicine was 2.6 times higher than that of men. 3. Among all ages, the 70~79 years group were the most frequent users of Korean medicine. The older age was correlated with more patients' visits. 4. The comparative number of visits by patient care type for 4 years indicated that outpatients had more visits than hospitalization. Furthermore, outpatient visits have been increasing for 4 years. 5. The comparative number of visits by hospital type for 4 years indicated that visits to the Korean medical clinic were the highest. In primary care, patients used more Korean medicine than Western medicine. In tertiary care, patients used more Western medicine than Korean medicine. 6. Korean medical cost per patient by patient care type for 4 years was a total 89,000 won, hospitalization 449,000 won and outpatient 83,000 won. Costs of all patient care types have been increasing. 7. Korean medical cost per patient by hospital type for 4 years was 156,000 won for Korean medical hospital, 83,000 won for local clinic and 127,000 won for miscellaneous facilities. Costs of all types have been increasing. Conclusions: This study provided objective information about epidemiologic characteristics of Korean medicine in patients with dizziness or vertigo. Furthermore, it provides an understanding of the recent status and forms the basis for further expansion of demand for Korean medicine among patients with dizziness or vertigo.
In recent observations on vestibular eye movements in mammals, reported by several different workers, it was indicated that the pattern of reflex eye movement from semicircular canal nerve stimulation in rabbits was different from that observed in the other species such as cats and dogs. Observing the different anatomical features of the extraocular muscles of rabbits, Kim ascribed the different pattern of eye movement of rabbits to the functional difference of inferior and superior oblique muscles from those of other species. Present experiment was carried out to elucidate a physiological mechanism underlying in such particular pattern of reflex eye movement in rabbits. An individual canal nerve was selectively stimulated, under a dissecting microscope, by a fine electrode induced into an ampulla through a hole provided on the wall of corresponding osseous canal, and responses of the extraocular muscles were checked by recording the isotonic changes of muscle length. Following results were obtained. 1. Direct stimulation of the superior or inferior oblique muscles Produced upward or downward movement of the eye turning toward medial side respectively. 2. Stimulation of the unilateral canal nerve Produced a marked contraction of a main contracting ocular muscle and simultaneous relaxation of an antagonistic muscle in both eyes. Less potent contraction of an additional ocular muscle was observed and it appeared to augment the function of the main contracting muscle in the ipsilateral eye. 3. Stimulation of superior semicircular canal nerve caused a primary contraction of superior rectus, synergic contraction of superior oblique and relaxation of inferior rectus in ipsilateral eye. Contraction of inferior oblique and relaxation of superior oblique were observed in the contralateral eye. 4. Stimulation of lateral semicircular canal nerve produced a primary contraction of medial rectus, synergic contraction of superior oblique and relaxation of lateral rectus in the ipsilateral eye. Contraction of lateral rectus and relaxation of medial rectus were observed in the contralateral eye. 5. Stimulation of inferior semicircular canal nerve produced a primary contraction of superior oblique, synergic contraction of superior rectus and relaxation of inferior oblique in the ipsilateral eye. Contraction of. inferior rectus and relaxation of superior rectus were observed in the contralateral eye. 6. Upon stimulation of individual canal nerve, the pattern of eye movement in rabbits is different from those of cats, however, the responses of the extraocular muscles appear to be similar in two species. Therefore, it is concluded that the different Pattern of eye movement in both species are not due to the possible difference of vestibule-ocular reflex pathways but to the functional difference of superior and inferior oblique muslces.
Anumber of prior studies have reported eye movement dysfunction in patients with dementia. The eye movement test which is non-invasive can evaluate the local brain function quantitatively. Therefore, it can be a useful method for characterizing regional brain abnormalities of patients with dementia. The aim of this paper is to review the literatures on eye movement abnormalities in dementia patients. Saccade system dysfunctions in Alzheimer disease include increased latency, reduced accuracy, and increased antisaccade error rates. Patients with frontotemporal dementia showed impaired reflexive saccade inhibition and increased latency and errors of antisaccade task. And delayed initiation of voluntary saccades, slow saccades, and increased errors and latency on antisaccade task were found in Huntington's disease. Patients with Parkinson’s disease dementia and dementia with Lewy bodies have characteristics of impaired in both reflexive saccade execution and complex saccade performance. However, there were few reports of abnormal eye movements in Creutzfeldt-Jakob disease; they could be found at the later stages after symptoms of dementia came to be evident, and secondary to cerebellar and vestibular involvement. Slowing of saccades and hypometric saccades might precede the supranuclear limitation of vertical gaze in PSP. Dysfunction of voluntary eyelid movements was a characteristic finding of PSP as well. In conclusion, patients with dementia can show various abnormal eye movements and they are related with cortial and subcortical brain dysfunctions. The research on localization of brain relevant to each symptom can promise more clinical implications of eye movement of dementia.
Journal of Dental Rehabilitation and Applied Science
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v.34
no.1
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pp.17-31
/
2018
Purpose: The purpose of this study was to investigate the accuracy of the interocclusal relationship between upper and lower teeth according to the buccal interocclusal record scan using various intraoral scanner systems. Materials and Methods: The upper and lower full arch Models with normal occlusion were scanned with 5 intraoral scanners (Cerec Omnicam, CS3500, iTero, Trios, True Definition). Buccal interocclusal record scan was taken only at the left side while occlusion was intentionally raised by 1 mm, 2 mm, 3 mm, and 4 mm with metal cylinder core embedded within polyvinylsiloxane bite registration material at the right molar region. The superimposition analysis was done to evaluate overall three-dimensional deviation and cross-section analysis was done to evaluate the degree and the direction of deviation of interocclusal relationship. Results: From the superimposition study, Cerec Omnicam showed the least deviation ($165.5{\mu}m$) and CS3500 ($369.0{\mu}m$) showed the largest (P < 0.01). And the deviation was greater in 3, 4, 2 mm group than 1 mm (P < 0.01). From the cross-section study, Cerec Omnicam showed the farthest deviation ($-242.8{\mu}m$) and CS3500 showed the closest deviation ($312.5{\mu}m$) and a significantly high value was shown in 3 mm group. Conclusion: Every intraoral scanner has different accuracy in reproducing interocclusal relationship.
Hah, Young Min;Yang, Chul Won;Kim, Sang Hoon;Yeo, Seung Geun;Park, Moon Suh;Byun, Jae Yong
Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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v.60
no.8
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pp.390-395
/
2017
Background and Objectives With increasing frequency of car accidents, patients of dizziness caused by car accidents are also increasing. Various types of dizziness or vertigo can occur from car accidents depending on different injury mechanisms. Since accurate diagnosis is important for providing proper treatments, we evaluated clinical characteristics related to vestibular function of patients with dizziness caused car accidents. Subjects and Method In this retrospective case review study that runs from January 2011 to March 2013, a total of 82 patients with dizziness following car accident were enrolled consecutively. We analyzed the final diagnosis of dizziness according to different mechanisms of injury during car accident through clinical record review. Patients who developed dizziness within one month of car accident were included, excluding those who had temporal bone fracture and previous history of dizziness. Results Of the different types observed, 36.6% was head injury, 24.4% whiplash injury, 3.7% complex injury, 2.4% others and the rest was unknown. In the final diagnosis, the different types included 36.6% benign paroxysmal positional vertigo (BPPV), 23.2% unclassifiable dizziness, 18.3% cervical vertigo, 7.3% labyrinthine concussion, 3.7% BPPV with labyrinthine concussion and the rest was others. Of the different types of dizziness symptoms, 58.5% was headache, 45.1% was audiologic symptoms, and others included earfullness, tinnitus and hearing disturbance. Tinitogram and pure tone audiogram results show that 2.9% (27 people) of patients have tinnitus and 7.3% (6 people) have hearing disturbance. Conclusion An accurate diagnosis and timely management would be very important in forming a proper approach for post traumatic vertigo patients.
The elderly people with advancing years have many problems such as the decline of the proprioceptive, visual & vestibular function and muscle weakness. Furthermore the decrease of the reflex which influences the balance ability in sudden change of the movement could cause the falls. The difficulty of the balance caused by the fear releated to the fall aggravates the Falls Efficacy and causes a lot of the disability of the independent activities of daily living. The purpose of this study was the effect of a Virtual Reality Program on Static Balance control and Fall efficacy of Elderly people. 14 elderly people(subjects) who were ≥65years of age partiripated in this study and they were divided into VR(Virtual Reality) group(n=7) and Control group (n=7). VR group took the general physical therapy & IREX and only the general physical therapy was carried out in the control group. VR group of intervention was carried out for 30min. total 8times. They were evaluated by BIO-Rescue, Fall Efficacy Scale before and after treatment. The Static Balance control and Fall efficacy were assessed by Bio-Rescue & Falls Efficacy Scale. The analysis of the resulf was assessed by Wilcoxon signed test & Mann-Whitney U test. The result showed that the static balance of VR group with the open eyes was improved in a static balance test and range of the movement was increased in limited of stability. And Falls Efficacy was also efficacious. IREX was effective to static balance control and Falls Efficacy of the elderly When we think about these effects, various treatments and objective assessments using VR program will be needed for the elderly
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