OBJECTIVE: To examine the correlation between Berg balance scale (BBS) which is tool for assessing the clinical balance function and sensory organization test (SOT) of computerized dynamic posturography (CDP) in brain injured patients. METHOD: Thirty patients with brain injury were assessed on the BBS and SOT of CDP. BBS consists of 14 items and each item is graded on a five point ordinal scale (0~4), yielding a total of 56 points. According to its characteristics, each item was divided 3 groups, which were sitting, standing and position change. Six equilibrium scores (EQ) were determined by SOT of CDP (EquiTest System , Version 5.08) under 6 conditions, and somatosensory, visual, vestibular ratios were analyzed by 6 EQ scores. RESULTS: EQ 5 was correlated with reaching forward item (r=0.513), turning 360 degrees item (r=0.537), stool stepping item (r=0.529) of BBS (p<0.01). EQ 6 was correlated with turning 360 degrees item (r=0.498) of BBS (p<0.01). Sum of standing item group scores was correlated with EQ 5 (r=0.478), EQ 6 (r=0.464), and sum of position change item scores was correlated with EQ 5 (r=0.622), EQ 6 (r=0.514) (p<0.01). Vestibular ratio was correlated with BBS total score (r=0.552, p<0.01). CONCLUSION: We concluded that vestibular ratio of SOT was correlated with BBS, especially position change item group. Therefore BBS is a good tool for evaluating vestibular function in brain injured patients.
Brain Injuries ; Brain* ; Cytidine Diphosphate ; Humans

OBJECTIVES: The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean medication algorithm project for schizophrenia (KMAP) to aid clinical decisions. The purpose of this study was to investigate problems and revision of Korean Medication Algorithm for Schizophrenia after feasibility test. METHODS: A total of 108 schizophrenia patients were enrolled at 19 centers and treated according to the algorithm. Prescribing investigators were able to change the recommended treatment strategies of the algorithm if necessary. All subjects were assessed over a 4-month period. Appropriateness of choice, dosage, duration and switch of antipsychotics and definition of treatment response were examined. RESULTS: Compliance of 1(st) choice antipsychotics in KMAP was favorable. Atypical antipsychotics which is a 1(st) stage drug selected first was above 84%, especially in case of no previous medical history was nearly all. In case that shift of stage was needed, there is a trend that combination treatment stage (6(th) stage) and clozapine treatment stage (5(th) stage) were preferred to rather than 3(rd) stage and 4(th) stage (typical antipsychotics and atypical antipsychotics treatment stage). The rates of switching antipsychotics at the time points other than CDP (critical decision points) was low and the reason was almost the side effects. So the compliance of CDPs in KMAP was good in case of insufficiency of treatment response. Also the reasons why many investigators continued using current antipsychotics without switching despite insufficiency of treatment response were definition of treatment response, discrepancy between brief symptom rating scale for negative symptom and decision of clinicians. In addition, compliance of co-existence symptoms and side effect of medication in KMAP was favorable. CONCLUSION: It is some difference from clinical practice such as stage of antipsychotics, definition of treatment response and usefulness of brief symptom rating scale for negative symptom. But the majority apart from points of preceding paragraph is feasible in clinical practice. These results are essential to revise the next version of KMAP.
Antipsychotic Agents ; Clozapine ; Compliance ; Cytidine Diphosphate ; Humans ; Research Personnel ; Schizophrenia

OBJECTIVE: To study normal values of wnwry organimtion test(SOT) and motor control test(MCT) of computerized dynamic posturography(CDP) in the healthy Koreans. BACKGROUND: Balance is made up of three biological functions ; sensory input, motor output, and CNS integration. But, there has been no method for assessing the sensory, motor, and CNS integration function quantitatively. CDP is a tool for assessing the balance function quantitatively under a variety of tasks. METHODS: To assess the balance using CDP, I studied equilibrium score(ES) of SOT and weight symmetry, latency, and adaptation seems of MCT in 112 Korean healthy population. Arbitarily I divided the population into two groups, under 60 years and over 60 years of age. In SOT, I studied the contribution of each sense to maintaining equilibrium when other senses were either absent or provided with inaccurate information. MCT provoked autonomic postural reactions through a series of sudden anterior and posterior support surface translations. In MCT, I studied latencies in sudden translation of fact plate. RESULTS: The study group was 112 Korean healthy population with a mean age of 47 +/- 26 years. In SOT, the range of median equilibrium seems were from 68 to 93 under 60 years group, 58 to 91 over 60 years group. In MCT, during sudden anterior and posterior pertubation, weight symmetries were 101 +/- 24.8 under 60 years group and 104 + 30. 1 over 60 years group. Median latencies were 116 to 141msec under 60 years, 127 to 130msec over 60 down test of MCT the mean adaptation scores were 60 years. 64 to 75 and 48 to 73 over 60 years, respectively. CONCLUSION: This study could be a baseline control data in sensory, motor, and CNS integration function of balance in dizziness patient using CDP.
Cytidine Diphosphate ; Dizziness ; Humans ; Posture* ; Reference Values ; Translations

BACKGROUND: The purpose of this study was to quantitatively assess the subclinical balance dysfunction in elderly people taking antiepileptic drugs. METHODS: We recruited sixty-three patients who were at least 50 years old, without complaint of dizziness or imbalance, and on a stable dose of carbamazepine, lamotrigine or levetiracetam. Their balance scores were compared with those of newly diagnosed untreated age- and sex-matched epilepsy patients (n=21). All the subjects underwent balance measurements that included an activities-specific balance confidence scale, quantitative caloric and rotational chair testing and posturography. The spectral frequency analysis of body sway while standing upright was also investigated. Sensory organization (SOT) and motor control tests were done by computerized dynamic posturography (CDP). RESULTS: The sway distance and area of center of pressure significantly increased in the patients treated with carbamazepine. Spectral frequency analysis of this group showed a significantly increased spectral power at low and middle frequencies on the antero-posterior (Y) plane and at low frequencies on the lateral (X) plane. CDP showed no significant differences in SOT results among the groups. However, motor control test revealed increased latencies and slowed adaptations in the carbamazepine group. CONCLUSIONS: These findings suggest that newer drugs such as lamotrigine or levetiracetam may induce less disequilibrium than carbamazepine in older people on monotherapy for epilepsy. The disturbance is likely related to slowed central postural reflexes.
Aged ; Anticonvulsants ; Carbamazepine ; Cytidine Diphosphate ; Dizziness ; Epilepsy ; Humans ; Piracetam ; Triazines

PURPOSE: To evaluate the clinical outcomes of patients with refractive aspheric multifocal intraocular lens (IOL) (Lentis Mplus(R) LS-313) implantation. METHODS: Sixty-eight eyes of 53 patients received refractive aspheric multifocal IOL implantation. Uncorrected visual acuity (UCVA) at a long distanc, as well as intermediate and near distances were measured on the first day, after two weeks, and during the first, third and sixth months postoperatively. Optical quality was evaluated using the Optical Quality Analysis System II (OQAS II). High-order aberrations (HOA) and patient satisfaction questionnaires were evaluated at three months post-operation. RESULTS: At the six-month postoperative visit, the mean UCVA at a long, two intermediate (63 cm, 100 cm) and a near distance were 0.06 +/- 0.07, 0.18 +/- 0.14, 0.15 +/- 0.13 and 0.11 +/- 0.10 log MAR, respectively. The means of the objective scatter index, modulation transfer function (MTF) cut off value, Strehl ratio and pseudo-accommodation range measured by OQAS II were 1.20 +/- 0.69, 34.15 +/- 9.53 cdp, 0.17 +/- 0.05 and 3.09 +/- 0.25 D, respectively. HOA of 5 mm and 6 mm were each 0.61 +/- 0.14 and 1.07 +/- 0.20, respectively. Eighty-two percent of patients were satisfied with the postoperative results, and 71% of the patients reported that they would recommend the procedure to others, while 24% of patients reported moderate or severe visual disturbance at night. CONCLUSIONS: Implantation of the refractive aspheric multifocal IOLs in patients with cataracts provided excellent distant, intermediate, and near visual outcomes and high patient satisfaction as well as presbyopia correction.
Cataract ; Cytidine Diphosphate ; Humans ; Lenses, Intraocular ; Patient Satisfaction ; Presbyopia ; Surveys and Questionnaires ; Visual Acuity

BACKGROUND: Spinal cord stimulation(SCS) evolved as a direct clinical application of the famous gate-control theory, the idea of activating the central collaterals of large afferent fibers contained in the dorsal column. It is well known that the cord dorsum potential(CDP) evoked by stimulation of dorsal roots or peripheral nerves can be recorded from the cord surface in spinal animals. However, there have been no data about the changes in CDP after SCS. METHODS: Using ball-type electrode, CDP was recorded at the dorsal root entry zone of lumbosacral enlargement in anesthetized cats. The dorsal root was stimulated electrically to activate Adelta-fiber(single pulse of 0.2 ms duration and 1 mA intensity) and C-fiber(single pulse of 0.2 ms duration and 10 mA intensity). Potentials were averaged 10 times and measured before(control) and immediately after, and 10, 20, 30, 40, 50, 60 min after SCS for 20 min. RESULTS: CDP elicited by dorsal root stimulation consisted of the characteristic waves of Adelta-fiber and C-fiber with different time latency. CDP showed significant decrease in the amplitude of C-fiber wave immediately after SCS(75.0+/-8.8%), and 20 min(69.0+/-7.9%), 30 min(75.1+/-4.4%), 40 min(75.4+/-4.4%), 50 min(78.3+/-5.9%), but not 10 min and 60 min, after SCS. However there were no statistically significant decrease in the amplitude of Adelta-fiber wave after SCS. CONCLUSIONS: The above results indicates that SCS suppresses the transmission of nociceptive electrical stimuli via C-fiber, while SCS has little influence on the transmission of electrical nociceptive stimuli via Adelta-fiber.
Animals ; Cats ; Cytidine Diphosphate ; Electrodes ; Peripheral Nerves ; Spinal Cord Stimulation* ; Spinal Cord* ; Spinal Nerve Roots

PURPOSE: To evaluate the clinical outcomes of patients with diffractive multifocal toric intraocular lens (IOL) implantation. METHODS: Thirty-four eyes of 26 patients underwent diffractive multifocal toric IOL. Uncorrected visual acuity (UCVA) at distant, intermediate and near and residual refractive astigmatism were measured on the first day, at 2 weeks, and 1, 3 and 6 months postoperatively. Optical quality obtained using the Optical Quality Analysis System II (OQAS II), high-order aberrations (HOA) and patient satisfaction questionnaire were evaluated 3 months postoperatively. RESULTS: At the 6 month postoperative visit, the mean UCVA at distant, intermediate (63 cm, 100 cm) and near were 0.06 +/- 0.07, 0.18 +/- 0.11, 0.16 +/- 0.12 and 0.03 +/- 0.06 (log MAR), respectively. The refractive astigmatism decreased significantly from -1.66 +/- 1.04 D to -0.54 +/- 0.32 D at 6 months postoperatively (p < 0.01). The means of objective scatter index, modulation transfer function (MTF) cut-off value, Strehl ratio and pseudo-accommodation range measured by OQAS II were 1.33 +/- 0.67, 37.24 +/- 9.67 cdp, 0.22 +/- 0.09 and 3.08 +/- 0.53 D, respectively. HOA scores for 5 mm and 6 mm were 0.30 +/- 0.09 and 0.49 +/- 0.15, respectively; 82.3% of the patients were satisfied with the postoperative results, 79.4% of the patients reported they would recommend the procedure to others, and 14.7% of patients reported moderate or severe visual disturbance at night. CONCLUSIONS: Implantation of a diffractive multifocal toric IOL in patients with cataract and corneal astigmatism provided excellent distant, intermediate, and near visual outcomes, good optical quality and high patient satisfaction.
Astigmatism ; Cataract ; Cytidine Diphosphate ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular ; Patient Satisfaction ; Surveys and Questionnaires ; Visual Acuity

Recombinant human growth hormone (rhGH) administration stimulate the secretion of the brain insulin-like growth factor-1 (IGF-1) concentration and IGF-1 is a pleiotropic neurotropic peptide to exert beneficial effect for the injured brain tissues. Citicoline (cytidine-59-diphosphocholine; CDP-choline) is well known to improve neurological outcome in acute stroke. This study aimed to evaluate whether rhGH can potentiate citicoline effect on functional recovery in acute stroke patient. Thirty patients were enrolled. Ten patients were treated with rhGH subcutaneous injection for 6 months on top of citicoline for 6 weeks (GH6 group), and 10 patients for 3 months (GH3 group) with 6 weeks of citicoline treatment as well, and final 10 patients only with citicoline (control group). Functional outcome was determined by Korean modified Barthel Index (K-MBI) and modified Rankin Scale (mRS) at baseline and 6 months after treatment. Seven and 4 patients withdrew from GH6 and GH3 group, respectively. Final 3 patients in GH6 group, 6 patients in GH3 group and 10 patients in control group were analyzed. The K-MBI, and mRS scores from all 3 groups increased in 6 months compared to baseline in intra-group comparison. In inter-group comparison, however, GH6 but not GH3 showed statistically significant improvement compared to control. Administration of rhGH for 6 months on top of 6-week citicoline treatment resulted in further improvement in K-MBI and mRS in acute stroke patients. Further studies in increasing injection dose or injection period is needed.
Brain ; Cytidine Diphosphate Choline ; Human Growth Hormone* ; Humans* ; Injections, Subcutaneous ; Insulin-Like Growth Factor I ; Stroke*

BACKGROUND AND OBJECTIVES: The Romberg test is a simple, inexpensive modality to test the vestibulo-spinal reflex. However, it is not a quantitative measure and has low sensitivity and specificity. We investigated the effectiveness of the modified Romberg test in evaluating equilibrium ability in dizzy patients by comparing it with the computerized dynamic posturography. MATERIALS AND METHODS: The study was conducted on 63 patients with various degrees of dizziness. Computerized dynamic posturography(CDP) was performed and equilibrium ability was measured with the modified Romberg test. Modifications were made in two ways : heel-to-toe standing(test 1) and standing on sponge(test 2). RESULTS: Correlation coefficients between the modified Romberg test and the vestibular dysfunction score of CDP were 0.62 and 0.52, respectively, and they were statistically significant(P<0.01). The Receiver Operating Characteristics(ROC) curve showed that the area index of tests 1 and 2 were 0.86 and 0.78, respectively. CONCLUSIONS: The modified Romberg tests showed fairly good correlation with the vestibular dysfunction score of CDP. Further modifications are required to use the modified Romberg test as an accurate diagnostic tool in the evaluation of dizzy patients.
Cytidine Diphosphate ; Dizziness ; Humans ; Posture ; Reflex* ; Sensitivity and Specificity ; Vestibular Function Tests

BACKGROUND: The pain-inhibitory effects of spinal cord stimulation (SCS) may be exerted at two alternative or complementary levels, segmentally or supraspinally. However the actual pathways, site of action, and synaptic relays are poorly understood. No data is available which concerns the changes in cord dorsum potential (CDP) associated with a single neuronal level, after SCS. METHODS: SCS was performed in normal and spinalized cats. At the lumbosacral enlargement, CDP and extracellular single cell activity in response to electrical stimulation of Asigma- or C-fiber of the dorsal root or sciatic nerve were recorded. RESULTS: The resulting CDP consisted of characteristic waves of Asigma- and C-fiber with a different time latency. CDP sno significant differences in the amplitude of Asigma- and C-fiber wave between the normal and spinalized cats. In both groups, CDP showed decrease in the amplitude of C-fiber wave. Single cell responses were either increased or decreased after SCS. The C- response changed more marKedly than the A-response in both the normal and spinalized cats. In the bicuculline administered cats, single cell responses increased after SCS, but no change was found in the amplitude of CDP. CONCLUSIONS: The above results might indicate that SCS suppresses C-fiber transmission of nociceptive electrical stimuli via a segmental inhibitory mechanism, and that SCS is more effective in blocKing the transmission of nociceptive electrical stimuli via the C-fiber than Asigma-fiber.
Animals ; Bicuculline ; Cats* ; Cytidine Diphosphate ; Electric Stimulation ; Neurons ; Sciatic Nerve ; Spinal Cord Stimulation* ; Spinal Cord* ; Spinal Nerve Roots