BACKGROUNDS: Peripheral neuropathy secondary to diabetes mellitus is believed to cause postural insta- bility which is associated with an increased risk of falling. Posturography enables early detection of postural control failure. This study is to evaluate the relationship between postural sway assessed by a computerized dynamic posturography and peripheral neuropathy in diabetic patients who have not develo- ped clinical symptom of unsteadiness. METHODS: Computerized dynamic posturography and electrophysiological tests were performed in the following age-matched subjects: 40 type 2 diabetic patients without peripheral neuropathy, 30 type 2 dia- betic patients with peripheral neuropathy, and 30 healthy control subjects. Patients had no symptoms or clinical evidence of postural instability. RESULTS: Sensory organization test showed significant dysfunction of somatosensory function of type 2 diabetic patients with peripheral neuropathy. Posturographic parameters were all significantly impaired in the patients with peripheral neuropathy. There were no significant differences in posturographic parameters between diabetic patients without neuropathy and the healthy control subjects. Posturographic parameters showed a direct relationship with some parameters of peripheral nerve conduction. CONCLUSION: Computerized dynamic posturography showed that Type 2 diabetic patients with peripheral neuropathy have greater postural instability than those without neuropathy. A strong correlation of insta- bility with peripheral neuropathy is present in diabetic patients. This result implies that peripheral neuro- pathy plays an essential role in the instability in type 2 diabetic patients. Posturographic study allows a disclosure of the failure of postural control even in the absence of clinical evidence of postural instability.
Diabetes Mellitus ; Diabetic Neuropathies ; Disclosure ; Humans ; Peripheral Nerves ; Peripheral Nervous System Diseases*

BACKGROUNDS: The cause of the postural instability of Parkinson`s disease is unknown. METHODS: We have investigated postural control in thirty ambulatory idiopathic parkinsonian patients. Body sway, torque, and force exerted by each foot, and electromyographic activity of anterior tibial, gastrocnemius, quadriceps, hamstring, rectus abdominis, and paraspinal muscles were recorded following forward and backward perturbations on a moveable platform. RESULTS: Normal subjects of old age responded to platform perturbations by either of two strategies: activation of muscles in a distal to proximal sequence to correct body sway by movement at the ankle(ankle strategy), or activation of muscles proximal to distally to maintain balance by hip movement(hip strategy). In the parkinsonian patients, platform perturbations elicited simultaneous activation of the mu scles in the ankle and hip strategies, in effect, counteracting the corrective response that would be- produced by either strategy in isolation. The latencies and magnitudes of the reponses were normal. CONCLUSION: The postural instability of these patients with Parkinson`s disease did not result from slow or weak postural responses of leg muscles, but rather, from an inappropriate pattern of activation of leg and truncal muscles.
Ankle ; Foot ; Hip ; Humans ; Leg ; Muscles ; Paraspinal Muscles ; Rectus Abdominis ; Torque

BACKGROUNDS: Most of vertebrobasilar dolichoectasia(VBD) patients are in old age. Cranial nerve dysfunction including vestibular dysfunction such as vertigo is frequent complications of VBD. But little is known about the vestibular function test(VFT) profile of the disease. METHODS: Auditory testing and VFT(electronysta-gmography with caloric test, rotaional test and computerized dynamic posturography) were performed in 25 elderly patients with auditory-vestibular symptoms or cranial nerve impairment associated with VBD. RESULTS: postive test results were observed in 22 cases(88%). 11 cases had evidence of peripheral involvement, 4 cases evidence of central impairment, and 7 cases had evidence of both peripheral and central dysfunction. CONCLUSION: Relatively high prevalence of central dysfunction means that mechanism such as ischemia or impaired blood supply to the vestibular system is as important as compression of the cranial nerves to generate vestibular dysfunction in elderly patients with VBD.
Aged ; Caloric Tests ; Cranial Nerves ; Humans ; Ischemia ; Prevalence ; Vertebrobasilar Insufficiency* ; Vertigo ; Vestibular Function Tests*

BACKGROUNDS: Postural instability and vertigo arc not uncommon complaint from Parkinson`s disease (PD) patients. But little is known about the underlying cause of the symptoms. METHODS: Thirty-two patients with over 55 year of age, having Parkinson`s disease are studied with using a recently developed computerized dynamic posturography(CDP) and rotating chair testing(ROT) RESULTS: Vestibular dysfunction pat tent is found in 21 patients and improper use of vision was found in 10 patients. Delayed motor latency was noted in 5 patients. Saccadie dysmetria and prolonged saccadic reaction times were common features in all patients. 6 patients(18.8%) had absent responses in cold( 17degrees C) water caloric resting bilaterally and decreased responses in the lower frequencies(0.01~0.16 Hz) by ROT. Their vestibulo-ocular reflex could be suppressed during the ROT with visual fixation. MRI showed the presence of an infarction of the caudal cerebellum in one patient, the pons in another, and narrowed vertebral arteries in two patients. CONCLUSION: Relatively high incidence of vestibular dysfunction is associated with postural instability and increasing severity of symptoms. The main site of dysfunction in postural control is likely to be at a central motor level.
Cerebellar Ataxia ; Cerebellum ; Humans ; Incidence ; Infarction ; Magnetic Resonance Imaging ; Parkinson Disease* ; Pons ; Reaction Time ; Reflex, Vestibulo-Ocular ; Vertebral Artery ; Vertigo ; Water

BACKGROUND: It is well known that many patients with vertigo become vertinous when all alteration o the body position occurs while either head-shaking or after standing up. Posturaphy conducted with those patients when standing still is thus not always successful in detecting abnormal symptoms However. such abnormalities can be easily detected when the patients are subjected to motion-stress, such as head -shaking or alterations of the body position. The effect of such motion-stress on the disturbance of the centroid in normal individuals has yet to he clarified. METHODS: In this study, posturography was conducted normal subjects who were subjected to motion-stress in the manner mentioned above and the results of this test were then compared with the findings of a conventional test. RESULTS: Through this comparison no increase in the unbalance, as a result of the applied motion-stress, was observed for the X distance(XD), Y distance(YD) and Length(LNG). However, a significant increase in the imbalance was found for the XD and LNG itt (lid subjects. CONCLUSION: Therefore, motion-stress, such its head-shaking or alterations of the body position can be helpful in detecting vertiginous symptoms in vertigo patients. But in the elderly patients the merit of above stimuli during the test should be vet clarified
Aged ; Head ; Humans ; Vertigo

BACKGROUND: Large-fiber peripheral neuropathy is prevalent in the elderly and risk of falling is higher in patients with it. This study`s aim is to see if, using computerized dynamic posturography(CDP), sway patterns differ between patients with large-fiber peripheral neuropathy and normal control subjects and, if it did, to compare CDP with conventional electromyography(EMG) as screening tools for large-fiber perip- heral neuropathy. METHODS: Thirty patients who came to the neurophysiology laboratory with a preliminary diagnosis of peripheral neuropathy(made by their referring physicians) were compared with 30 nonmatched control subjects. All subjects received a neurologic examination and underwent CDP and conventional EMG. RESULTS: CDP showed abnormal sway patterns only in patients who had EMG abnormalities consistent with large fiber peripheral neuropathy. These sway patterns differed significantly from those of the control subjects. Center of gravity(COG) wandered farther and faster per unit of time in the patients with polyneu- ropathy than in control subjects. It means that the control mechanism provided by peripheral nerves limi- ting total displacement and the speed of COG wandering is defective in the patients with large-fiber peri- pheral neuropathy. CONCLUSION: CDP seems to be a useful and well-tolerated screening test for patients with a history suggestive of peripheral neuropathy, and results of CDP agree with those of conventional EMG. Moreover, posturography directly measures increased sway in these patients and may be used as a screening test for risk of falls in this population of old age.
Aged ; Cytidine Diphosphate ; Diagnosis ; Electromyography ; Humans ; Mass Screening ; Neurologic Examination ; Neurophysiology ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Tolnaftate

BACKGROUND: Large-fiber peripheral neuropathy is prevalent in the elderly and risk of falling is higher in patients with it. This study`s aim is to see if, using computerized dynamic posturography(CDP), sway patterns differ between patients with large-fiber peripheral neuropathy and normal control subjects and, if it did, to compare CDP with conventional electromyography(EMG) as screening tools for large-fiber perip- heral neuropathy. METHODS: Thirty patients who came to the neurophysiology laboratory with a preliminary diagnosis of peripheral neuropathy(made by their referring physicians) were compared with 30 nonmatched control subjects. All subjects received a neurologic examination and underwent CDP and conventional EMG. RESULTS: CDP showed abnormal sway patterns only in patients who had EMG abnormalities consistent with large fiber peripheral neuropathy. These sway patterns differed significantly from those of the control subjects. Center of gravity(COG) wandered farther and faster per unit of time in the patients with polyneu- ropathy than in control subjects. It means that the control mechanism provided by peripheral nerves limi- ting total displacement and the speed of COG wandering is defective in the patients with large-fiber peri- pheral neuropathy. CONCLUSION: CDP seems to be a useful and well-tolerated screening test for patients with a history suggestive of peripheral neuropathy, and results of CDP agree with those of conventional EMG. Moreover, posturography directly measures increased sway in these patients and may be used as a screening test for risk of falls in this population of old age.
Aged ; Cytidine Diphosphate ; Diagnosis ; Electromyography ; Humans ; Mass Screening ; Neurologic Examination ; Neurophysiology ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Tolnaftate

To evaluate the relationship between p53 protein expression and proliferating activity in astrocytic tumors, we performed a study using 37 cases of astrocytic tumors; 13 cases of low-grade astrocytoma (LGA), 9 cases of anaplastic astrocytoma (ANA), and 15 cases of glioblastoma multiforme (GM). The p53 protein expression was studied by immunohistochemical staining (IHC) with DO-7 monoclonal antibody in 37 cases and p53 mutation was detected by single strand conformational polymorphism (SSCP) using PCR products of 31 cases. Proliferating activities were detected by Ki-67 (MIB-1) and proliferating cell nuclear antigen (PCNA). Immunohistochemically, 24.3% (9/37) of astrocytic neoplasms showed p53 expression, which consisted of 7.7% (1/13) of LGA, 44.4% (4/9) of ANA, and 26.7% (4/15) of GM. The p53 expression was statistically significant between the tumor grades. p53 mutations on exon 5 were noted in 6 (19.4%) out of 31 cases of astrocytic tumors. Average indices of MIB-1 and PCNA were 1.5 2.6% and 7.0 10.1% in LGA, 10.0 12.7% and 23.7 23.2% in ANA, and 30.9 22.4% and 69.9 26.7% in GM, respectively. p53 positive group by IHC showed significantly higher average MIB-1 (26.2 23.5%) and PCNA index (56.7 30.3%) than those (12.1 18.3%, 27.6 29.6%) of p53 negative group (p<0.05). p53 mutation group also showed significantly higher MIB-1 (30.7 26.0%) and PCNA index (55.5 32.6%) than those without p53 mutation (10.8 16.5%, 24.2 28.7% respectively). These results showed that about one-fifth of astrocytic tumors have p53 abnormalities, which were related with higher proliferating activities than those without p53 abnormalities.
Astrocytoma ; Exons ; Glioblastoma ; Immunohistochemistry ; Polymerase Chain Reaction ; Proliferating Cell Nuclear Antigen

We evaluated 1,000 consecutive endometrial curettage samples obtained over a 30 month period. The clinico-pathologic correlation was analysed according to Hendrickson's five criteria based on the practical view. The causes of uterine bleeding in decreasing order of occurrence were as follows: 1) hormonal imbalance lesions (49.2%) encompassing glandular and stromal breakdown suggesting anovulatory bleeding, proliferative phase endometrium, and disordered proliferative endometrium, 2) pregnancy associated lesions (24.2%), 3) organic lesions (13.5%), 4) endometrial hyperplasia (6.9%), and 5) inadequate specimen (6.2%). According to age, pregnancy related lesions were most frequent in the third decade. In the fourth, fifth, and sixth decades, hormonal imbalance lesions were the most common cause. In approximately 30% of the samples, there were two or three morphologic patterns such as anovulatory bleeding with an endometrial polyp, postabortal bleeding with inflammation, and glandular-stromal dissociation with a polyp, which suggested there was a variable histologic morphology in the same disease spectrum. Using immunohistochemical techniques we studied the hormonal dependency of bcl-2 oncoprotein in anovulatory bleeding, endometrial hyperplasia, and proliferative endometrium. 70% of anovulatory bleeding specimens showed weak positivity in the epithelial cytoplasm, and all cases of endometrial hyperplasia and carcinoma showed a strong positivity. These results suggest that there is a estrogenic hormonal dependency of apoptosis in the endometrium.
Apoptosis ; Biopsy* ; Curettage ; Cytoplasm ; Endometrial Hyperplasia ; Endometrium* ; Estrogens ; Female ; Hemorrhage ; Inflammation ; Polyps ; Pregnancy ; Uterine Hemorrhage*

No abstract available.
Skin Neoplasms* ; Skin*