Recovery of subjective visual horizontal after unilateral vestibular deafferentation by intratympanic instillation of gentamicin

2006 ◽  
Vol 16 (1-2) ◽  
pp. 69-73 ◽  
Author(s):  
Yoshinari Takai ◽  
Toshihisa Murofushi ◽  
Munetaka Ushio ◽  
Shinichi Iwasaki

The time course of the recovery of subjective visual horizontal (SVH) after unilateral vestibular deafferentation by intratympanic instillation of gentamicin was studied. Six patients who underwent intratympanic gentamicin instillation therapy for Meniere's disease (1 man and 5 women, 32 to 69 years of age) were enrolled in this study. For comparison, SVH in 23 healthy subjects (12 men and 11 woman, 23 to 48 years of age) was also measured. The mean ± SD of SVH in healthy subjects was 0.0 ± 1.1 deg. All of the 6 patients showed significantly deviated SVH toward the injected side-down at the early stage after the therapy. Although one patient showed recovery of SVH to the normal range 25 days after the injection, the other patients required more time for recovery. Three patients did not show recovery to the normal range after 1 year. On the other hand, spontaneous nystagmus observed using an infrared CCD camera in total dark disappeared after 35 days (median). Patients who had normal vestibular evoked myogenic potentials before the therapy showed a tendency of delay of recovery of SVH. The reasons why the recovery of SVH took longer than the disappearance of spontaneous nystagmus are discussed in this report.

2005 ◽  
Vol 114 (9) ◽  
pp. 717-721 ◽  
Author(s):  
Shih-Wei Kuo ◽  
Ting-Hua Yang ◽  
Yi-Ho Young

Objectives: The aim of this study was to apply videonystagmography (VNG) and vestibular evoked myogenic potential (VEMP) tests to patients with Meniere attacks, to explore the mechanics of where saccular disorders may affect the semicircular canals. Methods: From January 2001 to December 2003, 12 consecutive patients with unilateral definite Meniere's disease with vertiginous attacks underwent VNG for recording spontaneous nystagmus, as well as VEMP tests. Results: At the very beginning of the Meniere attack, the spontaneous nystagmus beat toward the lesion side in 5 patients (42%) and toward the healthy side in 7 patients (58%). Twenty-four hours later, only 6 patients (50%) showed spontaneous nystagmus beating toward the healthy side. Nevertheless, spontaneous nystagmus subsided in all patients within 48 hours. The VEMP test was performed within 24 hours of a Meniere attack; the VEMPs were normal in 4 patients and abnormal in 8 patients (67%). After 48 hours, 4 patients with initially abnormal VEMPs had resolution and return to normal VEMPs, and the other 4 patients still had absent VEMPs. Conclusions: Most patients (67%) with Meniere attacks revealed abnormal VEMPs, indicating that the saccule participates in a Meniere attack. This is an important idea that stimulates consideration of the mechanism of Meniere attacks.


2011 ◽  
Vol 14 (2) ◽  
pp. 869-883 ◽  
Author(s):  
Anna V. Kirenskaya ◽  
Vadim V. Myamlin ◽  
Vladimir Y. Novototsky-Vlasov ◽  
Mikhail V. Pletnikov ◽  
Inesa B. Kozlovskaya

Contingent negative variation (CNV) topography, hemispheric asymmetry and time-course were investigated in healthy subjects and non-medicated paranoid schizophrenic patients in two antisaccade paradigms with the short (800-1000 ms) and long (1200-1400 ms) durations of the fixation period. EEG and electrooculogram (EOG) were recorded. Saccade characteristics and mean amplitudes of slow cortical potentials time-locked to peripheral target were analyzed in 23 healthy volunteers and 19 schizophrenic patients. Compared to healthy control subjects, schizophrenic patients had significantly slower antisaccades and committed significantly more erroneous saccades in the both antisaccade tasks. The prolongation of the fixation period resulted in noticeable decrease of error percent in patients group. The analysis of CNV time-course has revealed two distinct stages in both groups. The early CNV stage was represented by a negative wave with the maximal amplitude over midline fronto-central area, and the late stage was characterized by increased CNV amplitude at the midline and left parietal electrode sites. In healthy subjects the simultaneous activation of frontal and parietal areas was observed in the paradigm with the shorter fixation interval; the increase of the fixation period produced consecutive activation of these areas. Schizophrenic patients' CNV amplitude was generally smaller than that of healthy subjects. The most pronounced between-group differences of the negative shift amplitude were revealed at frontal electrode sites during the early CNV stage in both modifications of the antisaccade task. The deficit of frontal activation revealed in patients at the early stage of antisaccade preparatory set in both antisaccadic paradigms may be related to pathogenesis of paranoid schizophrenia.


2022 ◽  
Vol 12 (1) ◽  
pp. 110
Author(s):  
Eleni Zoe Gkoritsa

Recovery nystagmus in vestibular neuritis patients is a reversal of spontaneous nystagmus direction, beating towards the affected ear, observed along the time course of central compensation. It is rarely registered due either to its rarity as a phenomenon per se, or to the fact that it is missed between follow-up appointments. The aim of the manuscript is to describe in detail a case of recovery nystagmus found in an atypical case of vestibular neuritis and discuss pathophysiology and clinical considerations regarding this rare finding. A 26-year-old man was referred to our Otorhinolaryngology practice reporting “dizziness” sensation and nausea in the last 48 h. Clinical examination revealed left beating spontaneous nystagmus (average slow phase velocity aSPV 8.1°/s) with absence of fixation. The head impulse test (H.I.T.) was negative. Cervical vestibular evoked myogenic potentials (cVEMP) and Playtone audiometry (PTA) were normal. Romberg and Unterberger tests were not severely affected. A strong directional preponderance to the left was found in caloric vestibular test with minimal canal paresis (CP 13%) on the right. The first follow-up consultation took place on the 9th day after the onset of symptoms. Right beating weak (aSPV 2.4°/s) spontaneous nystagmus was observed with absence of fixation, whereas a strong right directional preponderance (DP) was found in caloric vestibular test. A brain MRI scan was ordered to exclude central causes of vertigo, which was normal. The patient was seen again completely free of symptoms 45 days later. He reported feeling dizzy during dynamic movements of the head and trunk for another 15 days after his second consultation. The unexpected observation of nystagmus direction reversal seven days after the first consultation is a typical sign of recovery nystagmus. Recovery nystagmus (RN) is centrally mediated and when found, it should always be carefully assessed in combination with the particularities of vestibular neuritis.


Author(s):  
Carmen García-Alba

This study is part of a larger research study (doctoral dissertation), in which a comparative study with adolescent samples is done: 50 anorexic restricting patients (ANP), 50 patients diagnosed with depression (DP) and 50 non patients (NP). The proposed objective is two-fold: 1) To try to clarify the existing relationship between Anorexia (AN) and Depression (D), investigated from diverse disciplines but without conclusive results. 2) To detect in the ANP personality different traits from those of other groups, which should, if possible, allow to detect them at an early stage for an adequate prognosis. The current article presents the Rorschach findings in relation to the cognitive functioning of the ANP. In them, the following has been detected: (1) An information processing similar to that of the other groups, even with a more complete (L ≤ .99), more complex (DQ+↑) and better discriminated (Zd↑) grasp of the stimulus; (2) Mediating processes very similar to those of the other groups, sharing with them the perceptive maladjustments (X–%↑) and an excessive individualism (Xu%↑); (3) A clearly differentiating ideation disorder. Definitely, the ANP use predominantly ideation (M↑), but their thought, usually well-adjusted (MQo↑), presents eventual operations of delusional type (MQnone↑). Above that, their thinking is marked by a great passivity (Mp↑), which makes them more vulnerable to accept ideas without criticizing them and it results in a very inefficient thinking, which spins around these concepts without finding solutions, entering into a sort of ruminating which is completely unproductive. The differences toward the obsessive pathology are established. The discriminant analysis conducted with all the Rorschach variables that resulted as significant throughout the research, provides quite a consistent function which discriminates the ANP: MQnone↑, Mp↑, FD↓, Ma↑, MQo↑, AdjD↑, Sum H↑, (H)↑. Based on this we can understand that these adolescents, being in a developmental period of big changes and disorientations in relation with their own image, confronted with life events, and possibly starting off with some biologic vulnerability: (1) Due to the alterations of their ideation, accept without criticism (Mp) irrational ideas dominating in our culture, in which slimness appears as the only model, synthesis of intelligence, beauty and success; remaining captured in this type of mental activity (MQnone), which they cannot escape nor criticize (Mp), despite they reason adequately on other topics (MQo); (2) Their alterations of self-perception [(H)] make them hide themselves in a fantasized image, which is the axis of their interests and the only thing that really matters to them; (3) The resources they have to decide on behaviors and to finish these deliberately (AdjD), and their scarce tendency to the introspection (FD) lead to their decision of not eating, based on distorted and passively accepted thinking, which has great power and thus, so difficult to modify. Finally, based on the Rorschach data obtained, the hypothesis of a personality disorder as underlying pathology is pointed out.


1987 ◽  
Vol 58 (02) ◽  
pp. 758-763 ◽  
Author(s):  
G Mombelli ◽  
R Monotti ◽  
A Haeberli ◽  
P W Straub

SummaryIncreased fibrinopeptide A (FPA) levels have been reported in various non-thrombotic disorders, including cancer, acute myocardial infarction, liver cirrhosis and collagen vascular diseases. To investigate the significance of these findings, the present study combined the radioimmunoassay of FPA with that of fibrinogen/fibrin degradation fragment E (FgE) in the aforementioned disorders and compared the results with those observed in healthy subjects as well as in patients with thromboembolism and overt disseminated intravascular coagulation (DIC). Mean FPA and FgE in malignancy were 6.3 and 305 ng/ml, in myocardial infarction 5.6 and 98 ng/ml, in liver cirrhosis 2.7 and 132 ng/ml and in collagen vascular diseases 5.6 and 142 ng/ml. All these values were significantly higher than in healthy controls (mean FPA 1.6 ng/ml, mean FgE 49 ng/ml) but significantly lower than in thromboembolism (mean FPA 10.7 ng/ml, mean FgE 639 ng/ ml) and DIC (mean FPA 22.0 ng/ml, mean FgE 1041 ng/ml). The overall correlation between FPA and FgE was highly significant. Elowever, different disorders showed peculiar patterns in FPA, FgE and fibrinogen levels. In malignancy, a definite increase of FPA, FgE and plasma fibrinogen levels was observed. This finding probably indicates a compensated state of (intra- or extravascular) fibrin formation and lysis. Acute myocardial infarction was characterized by a high FPA to FgE ratio, which is interpreted to reflect acute thrombin generation and fibrin formation. FPA in cirrhosis was only marginally elevated with most single values within the normal range, indicating that intravascular coagulation was infrequent and unimportant in quantitative terms.


1979 ◽  
Author(s):  
J. G. Kelton ◽  
P. B. Neame ◽  
I. Walker ◽  
A. G. Turpie ◽  
J. McBride ◽  
...  

Thrombotic thrombocytopenic purpura (TTP) is a rare but serious illness of unknown etiology. Treatment by plasmapheresis has been reported to be effective but the mechanism for benefit is unknown. We have investigated the effect of plasmapheresis in 2 patients with TTP by quantitating platelet associated IgG (PAIgG) levels prior to and following plasmapheresis. Both patients had very high levels of PAIgG at presentation (90 and A8 fg IgG/platelet respectively, normal 0-5). in both, the PAIgG levels progressively fell to within the normal range and the platelet count rose following plasmapheresis. One patient remained in remission with normal platelet counts and PAIgG levels. The other relapsed after plasmapheresis and the PAIgG level rose prior to the fall in platelet count. Plasmapheresis was repeated and resulted in normalization of both the platelet count and PAIgG level. It is suggested that plasmapheresis removes antiplatelet antibody or immune complexes which may be of etiological importance in this illness.


Author(s):  
Menghan TAO ◽  
Ning XIAO ◽  
Xingfu ZHAO ◽  
Wenbin LIU

New energy vehicles(NEV) as a new thing for sustainable development, in China, on the one hand has faced the rapid expansion of the market; the other hand, for the new NEV users, the current NEVs cannot keep up with the degree of innovation. This paper demonstrates the reasons for the existence of this systematic challenge, and puts forward the method of UX research which is different from the traditional petrol vehicles research in the early stage of development, which studies from the user's essence level, to form the innovative product programs which meet the needs of users and being real attractive.


Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 752
Author(s):  
Chung-Guei Huang ◽  
Avijit Dutta ◽  
Ching-Tai Huang ◽  
Pi-Yueh Chang ◽  
Mei-Jen Hsiao ◽  
...  

A total of 15 RT-PCR confirmed COVID-19 patients were admitted to our hospital during the in-itial outbreak in Taiwan. The average time of virus clearance was delayed in seven patients, 24.14 ± 4.33 days compared to 10.25 ± 0.56 days post-symptom onset (PSO) in the other eight pa-tients. There was strong antibody response in patients with viral persistence at the pharynx, with peak values of serum antibody 677.2 ± 217.8 vs. 76.70 ± 32.11 in patients with delayed versus rapid virus clearance. The patients with delayed viral clearance had excessive antibodies of compromised quality in an early stage with the delay in peak virus neutralization efficacy, 34.14 ± 7.15 versus 12.50 ± 2.35 days PSO in patients with rapid virus clearance. Weak antibody re-sponse of patients with rapid viral clearance was also effective, with substantial and comparable neutralization efficacy, 35.70 ± 8.78 versus 41.37 ± 11.49 of patients with delayed virus clearance. Human Cytokine 48-Plex Screening of the serial sera samples revealed elevated concentrations of proinflammatory cytokines and chemokines in a deceased patient with delayed virus clear-ance and severe disease. The levels were comparatively less in the other two patients who suf-fered from severe disease but eventually survived.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruoshi Li ◽  
Xia Wang ◽  
Yahui Wei ◽  
Yuan Fang ◽  
Tian Tian ◽  
...  

Abstract Background To assess the diagnostic capability of novel Bruch’s membrane opening (BMO)-based disc parameters, the BMO-minimum rim width (BMO-MRW) and the BMO-minimum rim area (BMO-MRA) in the Chinese population and compare them to the retinal nerve fiber layer (RNFL) from optical coherence tomography (OCT) and the rim area (RA) from the Heidelberg retinal tomograph-III (HRT-III). Methods In total, 200 eyes of 77 healthy and 123 primary open-angle glaucoma (POAG) subjects were included in this cross-sectional study. All participants underwent the visual field test and structural measurements by OCT and HRT-III. The areas under the receiver operating characteristic curves (AUCs) of different structural parameters were calculated to assess their diagnostic power and compared using the DeLong test. Results In populations with different characteristics, the BMO-MRW and BMO-MRA had better diagnostic power than the RA. In discriminating between all POAG subjects and healthy controls and between early-stage patients and controls, the global BMO-MRW had comparable AUCs with the RNFL, but the BMO-MRA had lower AUCs than the RNFL. In healthy subjects with macrodiscs, both the global and sectoral BMO-MRW were thinner than those in healthy subjects with normal disc size. The AUCs of BMO-MRA, BMO-MRW and RNFL in subjects with macrodiscs were comparable. Additionally, in the myopic population, the BMO-MRA and BMO-MRW had comparable AUCs with the RNFL. Conclusions The BMO-MRW had comparable diagnostic power with the RNFL, and compared with BMO-MRW, the BMO-MRA might have advantages in certain populations, such as macrodiscs. All OCT-derived parameters exceeded the RA in diagnostic capability.


2012 ◽  
Vol 25 (3) ◽  
pp. 583-594 ◽  
Author(s):  
Lidiane Teles de Menezes ◽  
Paulo Henrique Ferreira de Araujo Barbosa ◽  
Abraão Souza Costa ◽  
Anderson Castro Mundim ◽  
Gabrielly Craveiro Ramos ◽  
...  

INTRODUCTION: Although baropodometric analysis has been published since the 1990s, only now it is found a considerable number of studies showing different uses in the rehabilitation. OBJECTIVE: To amplify the use of this technology, this research aimed to analyze baropodometric records during upright position of subjects with hemiparesis, describing a way to define weight-bearing profiles in this population. METHOD: 20 healthy subjects were matched by gender and age with 12 subjects with chronic spastic hemiparesis. This control group was formed to establish the limits of symmetry during weight-bearing distribution in the hemiparesis group. Next, hemiparesis group was submitted to procedures to measure baropodometric records used to provide variables related to the weight-bearing distribution, the arch index and the displacements in the center of pressure (CoP). Data were used to compare differences among kinds of weight-bearing distribution (symmetric, asymmetric toward non-paretic or paretic foot) and coordination system for CoP displacements. RESULTS: Hemiparesis group was compounded by eight symmetrics, eight asymmetrics toward non-paretic foot and four asymmetric toward paretic foot. Significant differences in the weight-bearing distributions between non-predominantly and predominantly used foot did not promote differences in the other baropodometric records (peak and mean of pressure, and support area). Mainly in the asymmetry toward non-paretic foot it was observed significant modifications of the baropodometric records. CONCLUSION: Baropodometric technology can be used to analyze weight-bearing distribution during upright position of subjects with hemiparesis, detecting different kinds of weight-bearing profiles useful to therapeutic programs and researches involving subjects with this disability.


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