The Value of Subjective Visual Vertical in Diagnosis of Vestibular Migraine

Abstract Objective To study the value of the subjective visual vertical (SVV) in the diagnosis of vestibular migraine (VM). Methods This study recruited 128 VM patients and 64 age-matched normal subjects. We detected the SVV during the interval between attacks in both groups, in sitting upright, and the head tilted at 45° to the left or right. We then examined the correlation between the SVV results with the vestibular evoked myogenic potential (VEMP) and canal paresis (CP). Results It was found there was a significant difference in SVV at the upright position between VM patients and normal controls (P=0.006) and no significant difference was found at the tilts of 45° to the left or right between the two groups. The SVV results at the upright position were significantly correlated with cervical VEMP (P=0.042) whereas not significantly correlated with CP and VEMP. There existed no significant difference in the conformity to the Müller effect (M effect) between the two groups. ROC analysis exhibited that the sensitivity, specificity of SVVs at the upright were 67.200% and 62.500% respectively. The diagnostic value of SVV at the upright position was significantly higher than that at tilts of 45° to the left and right (P=0.006). Nonetheless the diagnostic accuracy was relatively low. Conclusion Abnormality in SVV possibly stems from the lasting functional disorder of cerebellar or high-level cortical centers in VM patients or is linked to the vestibular compensation. The SVV is of low diagnostic value for VM and the value of SVV in VM warrants further study.

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Electromyographic activity from human laryngeal, pharyngeal, and submental muscles during swallowing

Journal of Applied Physiology ◽

10.1152/jappl.1999.86.5.1663 ◽

1999 ◽

Vol 86 (5) ◽

pp. 1663-1669 ◽

Cited By ~ 92

Author(s):

A. L. Perlman ◽

P. M. Palmer ◽

T. M. McCulloch ◽

D. J. Vandaele

Keyword(s):

Muscle Activity ◽

Total Duration ◽

Normal Subjects ◽

Electromyographic Activity ◽

Surface Electrodes ◽

Submental Muscles ◽

Temporal Relationships ◽

Dependent Change ◽

Significant Difference ◽

High Level

The durations and temporal relationships of electromyographic activity from the submental complex, superior pharyngeal constrictor, cricopharyngeus, thyroarytenoid, and interarytenoid muscles were examined during swallowing of saliva and of 5- and 10-ml water boluses. Bipolar, hooked-wire electrodes were inserted into all muscles except for the submental complex, which was studied with bipolar surface electrodes. Eight healthy, normal, subjects produced five swallows of each of three bolus volumes for a total of 120 swallows. The total duration of electromyographic activity during the pharyngeal stage of the swallow did not alter with bolus condition; however, specific muscles did show a volume-dependent change in electromyograph duration and time of firing. Submental muscle activity was longest for saliva swallows. The interarytenoid muscle showed a significant difference in duration between the saliva and 10-ml water bolus. Finally, the interval between the onset of laryngeal muscle activity (thyroarytenoid, interarytenoid) and of pharyngeal muscle firing patterns (superior pharyngeal constrictor onset, cricopharyngeus offset) decreased as bolus volume increased. The pattern of muscle activity associated with the swallow showed a high level of intrasubject agreement; the presence of somewhat different patterns among subjects indicated a degree of population variance.

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Diagnostic value of Telomerase Activity in patients with Bladder cancer: a meta-analysis of diagnostic test

10.21203/rs.2.11915/v2 ◽

2019 ◽

Author(s):

Lei Peng ◽

Jinze Li ◽

ZhengJu Ren ◽

Hong De Cao ◽

Lujia He ◽

...

Keyword(s):

Bladder Cancer ◽

Subgroup Analysis ◽

Meta Analysis ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Diagnostic Value ◽

Telomerase Activity ◽

Low Grade ◽

Significant Difference ◽

Sensitivity Specificity

Abstract Background: This study aimed to evaluate the diagnostic value of telomerase activity (TA) for bladder cancer (BC) by meta-analysis. Methods: We conducted a systematic search of studies published on PubMed, Embase, and Web of Science up to June 1, 2019. We used Stata 15 and Review Manager 5.3 for calculations and statistical analysis. Results: To evaluate the diagnostic value of TA for BC, we performed a meta-analysis on 22 studies, with a total of 2867 individuals, including sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR), and 95% confidence intervals (CIs). The pooled parameters were calculated from all studies and we found a sensitivity of 0.79 (95% CI: 0.72 – 0.84), a specificity of 0.91 (95% CI: 0.87–0.94), a PLR of 8.91 (95% CI: 5.91–13.43), an NLR of 0.24 (95% CI: 0.15–0.37), a DOR of 37.90 (95% CI: 23.32–61.59), and an AUC of 0.92 (95% CI: 0.90–0.94). We also conducted a subgroup analysis based on the different stages and grades of BC. Results from the subgroup analysis showed that there was no significant difference in TA in either high and low stages of BC, but that low-grade tumours had a lower TA than high-grade tumours. Conclusions: In BC, there is a high overall diagnostic value for TA, and this could provide an alternative to cystoscopy for staging and grading of tumours. The tumor characteristics also showed a good diagnostic value

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Diagnostic value of Telomerase Activity in patients with Bladder cancer: a meta-analysis of diagnostic test

10.21203/rs.2.11915/v1 ◽

2019 ◽

Author(s):

Lei Peng ◽

Lujia He ◽

ZhengJu Ren ◽

Hong De Cao ◽

Jinze Li ◽

...

Keyword(s):

Bladder Cancer ◽

Meta Analysis ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Diagnostic Value ◽

Telomerase Activity ◽

Low Grade ◽

Significant Difference ◽

Meta Analyses ◽

Sensitivity Specificity

Abstract Background This article aims to evaluate the diagnostic value of telomerase activity (TA) in bladder cancer (BC) by meta-analysis of diagnostic tests. Methods We conducted a systematic search of articles published on PubMed, Embase, and Web of Science up to June 1, 2019.Stata 15 and Review Manager 5.3 were used for calculation and statistical analyses. Results We use the sensitivity, specificity, positive and negative likelihood ratio (PLR,NLR),diagnostic odds ratio (DOR) and 95% confidengce intervals (CIs) to evaluate the diagnostic value of TA for BC. 22 studies were included in the meta- analyses, with a total of 2867 individuals. The pooled parameters are calculated from all studies: sensitivity of 0.79(95%CI:0.72-0.84), specificity of 0.91(95%CI:0.87-0.94), PLR of 8.91(95%CI:5.91-13.43),NLR of 0.24(95%CI:0.15-0.37), DOR of 37.90(95%CI:23.32-61.59), AUC of 0.92(95%CI:0.90-0.94). We also conducted subgroup based on different stages and grades. Results from subgroup analysis showed that there was no significant difference in TA during the high and low stages BC, but low-grade tumors have lower TA than high-grade tumors. Conclusions For the diagnosis of BC, the overall diagnostic value of TA is high, and is expected to be an alternative to cystoscopy for different staging and grading. The tumor also has a very good diagnostic value.

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DIAGNOSTIC VALUE OF NON-CONTRAST HELICAL CT-SCAN AND INTRAVENOUS UROGRAPHY IN UROLITHIASIS EVALUATION

Indonesian Journal of Urology ◽

10.32421/juri.v22i1.99 ◽

2015 ◽

Vol 22 (1) ◽

Author(s):

Fadhli Hasan ◽

Doddy M Soebadi ◽

Sunaryo Hardjowijoto ◽

Mohamad Ayodhia Soebadi ◽

Triyono Karmawan Sukmana Pria ◽

...

Keyword(s):

Ct Scan ◽

General Hospital ◽

Predictive Value ◽

Helical Ct ◽

Intravenous Urography ◽

Diagnostic Value ◽

Helical Computed Tomography ◽

Diagnostic Modality ◽

Significant Difference ◽

Sensitivity Specificity

Objective: To evaluate the diagnostic value of Non Contrast Helical Computed Tomography (NCHCT) scanning as the first choice diagnostic modality for detecting urolithiasis cases in Soetomo General Hospital Surabaya and evaluate the feasibility as alternative to Intravenous Urography (IVU). Material & Methods: Seventeen patients with clinical manifestation of suspected urolithiasis underwent NCHCT and IVU to evaluate suspected urolithiasis. Reformatted three-dimensional CT was performed in all patients. The images were correlated with findings from surgical procedure (ureteroscopy, percutaneous nephrolithotomy, and open surgery). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined for NCHCT and IVU. Results: The diagnosis of urolithiasis was defined as unequivocal evidence of urolithiasis on either NCHCT or IVU. Sixteen of seventeen patients evaluated were diagnosed with urolithiasis. NCHCT established the diagnosis in 16 of 17 patients while IVU was positive in 11 of 17 patients. IVU was negative in 6 of the 17 cases. The sensitivity, specificity and accuracy of NCHCT was 100%, 100%, and 100% respectively (p = 0.05) and the sensitivity, specificity, and accuracy of IVU was 68%, 100% and 70% respectively (p = 0.35). There was no statistically significant difference between IVU and NCHCT using Fisher’s exact test. Conclusions: NCHCT accurately diagnosed urolithiasis in patients with suspected urolithiasis. Considering that NCHCT is more effective and efficient than IVU as diagnostic modality in determining the presence of urolithiasis, it may be considered to replace IVU as the first line diagnostic tool for urolithiasis in Soetomo General Hospital Surabaya. Keywords: Non Contrast Helical CT Scan, Intravenous Urography, Urolithiasis.

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The Diagnostic Value of Serum Gastrin-17 and Pepsinogen for Gastric Cancer Screening in Eastern China

Gastroenterology Research and Practice ◽

10.1155/2021/6894248 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Hongzhang Shen ◽

Kangwei Xiong ◽

Xiangyu Wu ◽

Sile Cheng ◽

Qifeng Lou ◽

...

Keyword(s):

Gastric Cancer ◽

Eastern China ◽

Intraepithelial Neoplasia ◽

Diagnostic Value ◽

Diagnostic Efficiency ◽

Predictive Values ◽

Cutoff Value ◽

Cutoff Values ◽

Significant Difference ◽

Sensitivity Specificity

Objective. To evaluate the diagnostic value of gastrin-17 (G-17) and pepsinogen (PG) in gastric cancer (GC) screening in China, especially eastern China, and to determine the best diagnostic combination and threshold (cutoff values) to screen out patients who need gastroscopy. Methods. The serum concentrations of G-17 and pepsinogen I and II (PGI and PGII) in 834 patients were analyzed, and the PGI/PGII ratio (PGR) was calculated. According to pathological results, patients can be divided into chronic nonatrophic gastritis (NAG)/chronic atrophic gastritis (CAG)/intraepithelial neoplasia (IN)/GC groups. The differences in G-17, PG, and PGR in each group were analyzed, and their values in GC diagnosis were evaluated separately and in combination. Results. There were differences in serum G-17, PGII, and PGR among the four groups (NAG/CAG/IN/GC) ( P ≤ 0.001 ). In total, 54 GC cases were diagnosed, of which 50% were early GC. There was no significant difference in the PGI levels among the four groups ( P = 0.377 ). NAG and CAG composed the chronic gastritis (CG) group. The G-17 and PGII levels in the IN and GC groups were higher than those in the CG group (both P ≤ oth C ), while the PGR levels were lower ( P ≤ lower ). When distinguishing NAG from CAG, the best cutoff value for G-17 was 9.25 pmol/L, PGII was 7.06 μg/L, and PGR was 12.07. When distinguishing CG from IN, the best cutoff value for G-17 was 3.86 pmol/L, PGII was 11.92 μg/L, and PGR was 8.26. When distinguishing CG from GC, the best cutoff value for G-17 was 3.89 pmol/L, PGII was 9.16 μg/L, and PGR was 14.14. The sensitivity, specificity, accuracy, and positive and negative predictive values of G-17/PGII/PGR for GC diagnosis were 83.3%/70.4%/79.6%, 51.8%/56.3%/47.8%, 53.8%/57.2%/49.9%, 10.7%/10.9%/9.6%, and 97.8%/96.5%/97.1%, respectively. The sensitivity, specificity, accuracy, and positive predictive and negative predictive values of PGII/G-17 vs. PGR/G-17 vs. PGR/PGII in the diagnosis of GC were 63.0% vs. 70.4% vs. 64.8%, 70.5% vs. 70.1% vs. 60.4%, 70.0% vs. 70.1% vs. 60.7%, 12.9% vs. 14.0% vs. 10.2%, and 96.5% vs. 97.2% vs. 96.1%, respectively. Conclusion. The PGII and G-17 levels in patients with gastric IN and GC were significantly increased, while the serum PGR level was significantly decreased. Serological detection is effective for screening GC. The combination of different markers can improve the diagnostic efficiency. The highest diagnostic accuracy was G-17 combined with PGR, and the best cutoff values were G − 17 > 3.89 pmol / L and PGR < 14.14 .

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Relative diagnostic value of ocular vestibular evoked potentials and the subjective visual vertical during tilt and eccentric rotation

Clinical Neurophysiology ◽

10.1016/j.clinph.2010.06.023 ◽

2011 ◽

Vol 122 (2) ◽

pp. 398-404 ◽

Cited By ~ 14

Author(s):

Yulia Valko ◽

Stefan C.A. Hegemann ◽

Konrad P. Weber ◽

Dominik Straumann ◽

Christopher J. Bockisch

Keyword(s):

Evoked Potentials ◽

Diagnostic Value ◽

Subjective Visual Vertical ◽

Eccentric Rotation ◽

Visual Vertical ◽

Vestibular Evoked Potentials

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Effects of nasal cold receptors on pattern of breathing

Journal of Applied Physiology ◽

10.1152/jappl.1988.64.1.371 ◽

1988 ◽

Vol 64 (1) ◽

pp. 371-376 ◽

Cited By ~ 39

Author(s):

K. R. Burgess ◽

W. A. Whitelaw

Keyword(s):

Minute Ventilation ◽

Normal Subjects ◽

Separate Experiment ◽

Normal Male ◽

Gas Temperature ◽

Cold Air ◽

Significant Difference ◽

The Mean ◽

End Tidal ◽

High Level

To investigate the effect on the pattern of breathing of cooling receptors in the nose, eight normal male volunteers underwent a steady-state CO2 stimulation by nasal inhalation. The inhaled gas temperature was randomly switched between "warm" (32 degrees C) and "cold" (2 degrees C) at each of three levels of inspired CO2 fraction (FICO2). Breathing cold air through the nose reduced the mean slope of the ventilatory response to CO2 by 27% (P less than 0.05) and the mean intercept at PCO2 of 45 Torr by 6.6 l/min (P less than 0.01). This was due mainly to a reduction in tidal volume (VT). Analysis of the breathing pattern recorded at a high level of minute ventilation (VE) (end-tidal partial pressure of CO2 approximately 52 Torr) showed a reduction of VE that was due almost entirely to a reduction in VT (P less than 0.05) associated with a reduction in inspiratory time (TI) as a fraction of total respiratory cycle time (P less than 0.05) but little change in VT/TI. In a separate experiment conducted with five subjects, there was no significant difference in inspired nasal resistance between warm and cold runs during CO2-stimulated breathing. The results confirm the previous observation that cold air breathed through the nose inhibits ventilation in normal subjects and show that this is not related to an increase in flow resistance. The reduction in ventilation is due to reduction in VT associated with shortening of the duty cycle.

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Subjective Visual Vertical and Horizontal in Vestibular Migraine

The Journal of International Advanced Otology ◽

10.5152/iao.2017.4056 ◽

2017 ◽

Vol 13 (2) ◽

pp. 254-258 ◽

Cited By ~ 8

Author(s):

Gaurav Ashish ◽

Ann Mary Augustine ◽

Amit Kumar Tyagi ◽

Anjali Lepcha ◽

Achamma Balraj

Keyword(s):

Vestibular Migraine ◽

Subjective Visual Vertical ◽

Visual Vertical

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The effect of head tilt angle in the roll plane on the virtual subjective visual vertical results in healthy adults

Auditory and Vestibular Research ◽

10.18502/avr.v30i1.5307 ◽

2021 ◽

Author(s):

Mahmoud Rezvani Amin ◽

Moslem Shaabani ◽

Mohsen Vahedi

Keyword(s):

Tilt Angle ◽

Head Tilt ◽

Healthy Adults ◽

Subjective Visual Vertical ◽

Substantial Impact ◽

Normal Individuals ◽

Significant Difference ◽

Visual Vertical ◽

The Right ◽

The Impact

Background and Aim: The subjective visual vertical (SVV) is commonly considered as an indicator of the sense of orientation and attributed to the utricular function. The present study examined the impact of different head tilt angles on SVV among the normal individuals. Methods: SVV was measured in 47 normal participants (30 males and 17 females; mean ± SD age: 22.14 ± 3.46) using a virtual goggle and forced-choice paradigm and was applied twice in 0º, 15º, 30° and 45º to the left or to the right. In addition, difference in mean of SVV in zero and non-zero positions was compared. Results: There was a statistically significant difference between the mean SVV results of 0º and 15º (p ˂ 0.001). The comparison of mean SVV results between 0º and 30º, and between 0º and 45º were not significant (p > 0.05). In addition, comparison of SVV results between rightward and leftward tilt of 15º was statistically significant (p ˂ 0.001). The latter comparison was not significant for 30º and 45º (p > 0.05). Conclusion: Our results showed that head tilt angle of 15º have a substantial impact on the virtual SVV. These findings must be taken into account in the growing body of research that uses the SVV paradigm in clinical populations. Keywords: Head tilt angle; subjective visual vertical; virtual goggle; roll plane; utricle; healthy adults

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Dynamic arm movements attenuate perceptual distortion of visual vertical induced during prolonged whole-body tilt

10.1101/2020.03.27.011593 ◽

2020 ◽

Author(s):

Keisuke Tani ◽

Shinji Yamamoto ◽

Yasushi Kodaka ◽

Keisuke Kushiro

Keyword(s):

Central Nervous System ◽

Arm Movements ◽

Upright Position ◽

Body Tilt ◽

Whole Body ◽

Subjective Visual Vertical ◽

Body Movements ◽

Perceptual Distortion ◽

Visual Vertical ◽

The Central Nervous System

AbstractAdditional gravitational cues generated by active body movements may play a role in the perception of gravitational space, but no experimental evidence has been shown on this. To investigate this possibility, we evaluated how arm movements made against gravity influenced the perceptual distortion of visual and postural vertical induced by prolonged whole-body tilt. In Experiment 1, participants were asked to perform static or dynamic arm movements during prolonged whole-body tilt and we assessed their effects on subjective visual vertical (SVV) at the tilt position (during-tilt session) and after tilting back to the upright position (post-tilt session). In Experiment 2, we evaluated how static or dynamic arm movements during prolonged tilt subsequently affected the subjective postural vertical (SPV). In Experiment 1, we observed that prolonged tilt induced the SVV shifts toward the side of body tilts in both sessions. The prolonged tilt-induced SVV shifts effectively decreased when performing dynamic arm movements in the during-tilt session, but not in the post-tilt session. In Experiment 2, the SPV shifted toward the side of prolonged body tilt, which was not significantly influenced by the performance of static or dynamic arm movements. Results of the during-tilt session suggest that the central nervous system utilizes additional cues generated by dynamic body movements for the perception of the visual vertical.

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