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: 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

The purpose of this study was to investigate the effect of aerobic training on body fat reduction. A total of 978 high school girls participated in this study (freshmen = 365 ; junior = 300 ; senior = 313). Within each grade, subjects who showed interest in physical exercise were selected and assigned into athletes group (20 for freshmen, 22 for junior, 29 for senior). The athletes group performed aerobic exercise for 100 minutes per day, 5 days a week with 70% of a subject's maximal heart rate. Each subject agreed to participate in this study when she was freshman. Thus, the length of exercise was dependent upon subject grade. That is, senior group was on the exercise program for two and half years, junior group for one and half years, and freshman group for six months. The results are as follows : 1. The mean value of % body fat for athletes group were 21.23 for freshman, 21.57 for junior, and 21.49 for senior. These values were a bit smaller when compared to those for non-athletes groups (26.32, 24.76, 23.65 for freshman, junior and senior, respectively). The comparison of % body fat between athletes and non-athletes group showed that the largest difference was showed in freshman group, followed by junior and senior groups. 2. For the athletes groups there was no significant difference in the mean value of % body fat between 3 grades. However, this was not the case for the non-athletes groups. There was a significant difference (p<001) among the 3 grades for the non-athletes groups, the freshman group being the largest, followed by junior and senior.
Adipose Tissue* ; Athletes ; Exercise ; Female* ; Heart Rate ; Humans

The purpose of this study is to compare the relationship between physical characteristics and % body fat, using the data from senior students at a girl's high school in 1993 (three years ago) and in 1996. The subjects of this study were high school girls in Seoul and were composed of 274 persons in 1993 and 284 in 1996. Their heights, weights and % body fat were measured. The results are as follows : Analyses of t-test revealed that there was a significant difference in height between two groups (p<.001), the mean value of height in 1996 being taller (2.26cm) than that in 1993. However, that of weight between two groups were almost identical. Although the mean value of two groups were similar, examination of the data showed that the maximum value of weight was quite different between the two groups (maximum value in 1993 being 92kg, as compared to 75.5kg in 1996). Also, the comparison of % body fat showed that the mean value in 1996 was larger than that in 1993 (23.66 vs. 22.59, p<.001). In summary, the results of this study suggest that we are not necessarily faced with the state to worry about side-effect by excessive fat accumulation as a result of high school girls' high calory intake. These results may be obtained by several kind of social causes but we must consider the student's stress of S.A.T, increase of class at school, and increasing energy consumption (decrease of S.D).
Adipose Tissue* ; Female ; Humans ; Seoul ; Weights and Measures

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*

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