Humans ; Vertigo ; diagnosis ; Vestibular Function Tests

Humans ; Vertigo ; diagnosis

Humans ; Meniere Disease ; surgery

Objective:To explore the clinical value of dynamic posturography in the diagnosis of peripheral vertigo. Method:One hundred and sixty peripheral vertigo patients with full clinical documents in vertigo clinic of our hospital from May 2007 to May 2008 were retrospectively analyzed in this study. All the patients firstly underwent the inspection of static and dynamic posturography and then were subjected to caloric test using videonystagmogra-phy. The results were conducted a comparative analysis. Surface of the statokinesigram (SSKG) was selected as assessment parameter of static posturography. The result of sensory organization test (SOT) were selected as assessment parameters of dynamic posturography. The unilateral weakness was selected as assessment parameter of caloric test. Twenty normal subjects were selected as control. Result: Among the 160 cases with peripheral vertigo, results of SOT in dynamic posturography were abnormal in 144 cases, with a sensitivity of 90. 0%; caloric test was abnormal in 110 cases, with a sensitivity of 68. 8%; static posturography was abnormal in 76 cases, with a sensitivity of 47. 5%. There existed a statistically significant difference between dynamic posturography and caloric test or static posturography. There were 40 patients(25. 0%) who had normal caloric test results in which dynamic posturograph findings were abnormal. Among the 20 cases of normal people, results of SOT in dynamic posturography were abnormal in only one case(5. 0%). Conclusion:With its superior sensitivity and specificity, dynamic posturography has been an objective and reliable approach in the diagnosis of peripheral vertigo. It can help to confirm the presence of abnormalities in some peripheral vertigo patients whose caloric results are normal.

ObjectiveAfter intratympanic gadolinium administration through the tympanic membrane,three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) was performed to evaluate endolymphatic visualization and its diagnostic value in Meniere's disease.MethodsTwenty-four hours after intratympanic gadolinium administration through the tympanic membrane,19 patients with unilateral Meniere's disease diagnosed clinically underwent 3D-FLAIR and 3D-Balance-FFE imaging at 3.0 T MR scanner.The enhanced imaging of perilymphatic space in bilateral cochlea,vestibular and (or) canal were observed.Scala tympani and scala vestibule of bilateral cochlear basal turn were scored respectively.The enhanced range of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem were measured. Wilcoxon tests and paired t tests were used.ResultsThe gadolinium appeared in almost all parts of the perilymph in cochlea,vestibular and (or) canal,so the endolymphatic space was clearly visualized on 3D-FLAIR imaging.The score of scala vestibuli between the affected side (3 cases scored 2,9 cases scored 1,7 cascs scored 0) and the healthy side ( 15 cases scored 2,2 cases scored 1,2 cases scored 0 ) were significantly different ( U =3.090,P ＜ 0.05 ).The area of enhanced vestibular were (5.77 ± 2.33) mm2 and (8.11 ± 3.32) mm2 for the affected side and the healthy side,which were significantly different ( U =3.090,P ＜ 0.05 and t =2.638,P ＜ 0.05 ).Conclusions According to 3D-Balance-FFE MRI and the enhancement of perilymphatic space,3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrance can be used to show the border between the perilymph and the endolymph and confirm endolymphatic hydrops,thus providing radiographic evidence for the diagnosis of Meniere's disease.

OBJECTIVE: To explore the factors related to the occurrence of otitis media with effusion (OME) in patients with long-term tracheal intubation. METHOD: This retrospective study included 47 cases with endotracheal intubation more than 7 days (endotracheal intubation group) and 20 cases without mechanically ventilated in the same period(control group). The relationships between secretory otitis media with age, gender, intubation method,duration of intubation, breathing patterns, consciousness, gastric tube position were analysed. RESULT: The study showed 27 out of 47 patients in endotracheal intubation group had OME, 9 cases had negative pressure in the middle ear and 11 patients were normal. No OME was found in control group, and 2 cases with negative pressure in bilateral middle ear were detected. The incidence of OME was significantly increased in patients with the application of ventilator in PEEP mode or nasotracheal tube, and with conscious disturbance or tracheal intubation using for more than 10 days. The presence of OME had a significantly higher rate in patients with nasal intake subjects than the oral intake subjects. The incidence of OME decreased significantly in patients using glucocorticoid. CONCLUSION The incidence of OME increased in patients applied with tracheal intubation for more than 7 days. Ventilator in PEEP mode, nasotracheal tube, and conscious disturbance were closely related with OME. Application of glucocorticoids reduced the incidence of OME.
Ear, Middle ; Glucocorticoids ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Otitis Media with Effusion ; Pressure ; Retrospective Studies

Objective To investigate the clinic effect of the Salvia miltiorrhiza combined with dextran to prevent veno-occlusive disease after hematopoietic stem cell transplantation. Methods In the process of the pretreatment of the hematopoietic stem cell transplantation, patients were treated with salvia miltiorrhiza (20 ml/d), dextran(250 ml, twice a day) by venous transfusion and the drugs to protect the liver cell was used in the same time. When the count of platelet dropped to 30×109/L, salvia miltiorrhiza and dextranware stopped applying forever. Results Veno-occlusive disease and hemorrhage has not occurred during 85 times of the hematopoietic stem cell transplantation treated with salvia miltiorrhiza and dextran. Conclusion We conclude that the combined treatment with salvia miltiorrhiza and dextran is safe and effective to prevent veno-occlusive disease after hematopoietic stem cell transplantation.

Objective To observe the therapeutic effectiveness and safety of autologous peripheral blood stem cell transplantation (APBSCT) for poor-risk non-Hodgkin lymphoma (NHL). Methods Ten patients with poor-prognosis NHL were enrolled from October 2003 to October 2008 in our institute. Ten patients were treated by APBSCT with CY+TBI conditioning regimen (Two patients of them were treated by Double-APBSCT with MEC conditioning regimen). Results Hematopoietic reconstitution was observed in all patients.The time of neutrophil count ≥0.5×109L and platelet≥20×109/L were at day 10 (range: 7-14) and day 16 (range: 10-37), respectively. All patients achieved complete remission (CR) after transplantation. Severe toxicity and transplant related mortality were not observed. After a median follow-up of 24 (10-84) months,seven cases were in event-free survival and three cases relapsed. One of three relapsed patients died from progression of disease, the other was still alive after treatment. Conclusion APBSCT in the treatment of patients with poor-prognosis NHL is a safe, convenient and efficient treatment.

OBJECTIVE: To detect the influence of heat coagulation of middle meningeal artery (MMA) on plasma CGRP and SP levels in migraine rat triggered by nitroglycerin (NTG). METHOD: Twenty-four female Wistar rats were randomly divided into four groups, with six rats in each group. In group A, rats were treated with isotonic saline; in group B, rats were injected subcutaneously with 10 mg/kg nitroglycerin to set up the animal model of migraine; in group C, rats were subjected to sham surgery by merely exposing MMA and then injected with nitroglycerin (10 mg/kg); and in group D, rats were firstly subjected to heat coagulation of MMA and, subsequently, injected with nitroglycerin (10 mg/kg). Following the injection, the animal's behavior was continuously recorded by an observer. Radioimmunoassay was employed to measure the amounts of CGRP and SP in venous plasma. RESULT: Injection of 10 mg/kg nitroglycerin was able to trigger the animal model of migraine as evidenced by the appearances of a series of symptoms, such as, scratching head frequently, climbing cage and red ear. Rats in group A occasionally showed off scratching head, whereas, rats from group B and group C presented with much severe symptoms. Of note, rats in group D appeared slightly scratching head and climbing cage, without red ear compared with group B and C. At the same time, the amounts of plasma CGRP and SP in group B, group C, or group D were increased significantly compared with that of group A (P < 0.05). Furthermore, the plasma CGRP and SP levels in group D were much lower than that in group B and group C (P < 0.05), but there was no statistical difference between group B and group C (P > 0.05). CONCLUSION Heat coagulation of MMA may relieve symptoms of rats following nitroglycerin infusion, possibly by inhibiting the release of CGRP and SP.
Animals ; Calcitonin Gene-Related Peptide ; blood ; metabolism ; Electrocoagulation ; Female ; Meningeal Arteries ; Migraine Disorders ; chemically induced ; metabolism ; therapy ; Nitroglycerin ; adverse effects ; Rats ; Rats, Wistar ; Substance P ; blood ; metabolism

OBJECTIVE: To explore the difference of mitochondrial DNA 4,834 bp deletion mutation in tissues of inner ear, kidney and skeletal muscle and to discuss the possible mechanism of this kind of mutation in doxorubicin induced mtDNA 4,834 bp deletion mutation rat model. METHOD: Twenty-eight Wistar rats were randomly divided into two groups, one was experimental group (18 rats), the other was the blank control group (10 rats). The rats of experimental group were treated with intraperitoneal injection doxorubicin (1 mg/kg) twice a week for 3 months. The blank controls received an equivalent volume of saline instead. The tissues of inner ear, kidney and skeletal muscle were harvested and the mitochondrial DNA 4,834 bp deletion mutation was detected by nested-PCR (nested polymers chain reaction) technique. The product of PCR was sequenced directly. RESULT: Two rats of the experimental group and the blank group died during the experiment. The frequency of the mitochondrial DNA 4,834 bp deletion mutation of inner ear, kidney and skeletal muscle were 68.75% (11/16), 75.00% (12/16) and 100.00% (16/16) respectively. The difference of this kind of mutation between tissues of the inner ear and the skeletal muscle was statistic significance (P < 0.05). There were no significant difference between the inner ear tissue and the kidney tissue (P > 0.05). None of the rats of the blank control group carry this kind of mitochondrial DNA mutation. CONCLUSION The mitochondrial DNA 4,834 bp deletion mutation could be induce by doxorubicin in rats, and a notable difference were found of the frequencies of this kind of mutation between tissues of the inner ear and the skeletal muscle. So it suggested that this kind of mitochondrial DNA common deletion mutation was tissue specific.
Animals ; DNA, Mitochondrial ; genetics ; Doxorubicin ; toxicity ; Ear, Inner ; Gene Deletion ; Kidney ; metabolism ; Muscle, Skeletal ; metabolism ; Rats ; Rats, Wistar ; Sequence Deletion ; drug effects