BACKGROUND AND OBJECTIVES: The aim of this study is to investigate the characteristics of anterior semicircular canal benign paroxysmal positional vertigo (BPPV). MATERIALS AND METHODS: This is a retrospective chart review of 1,150 patients who were diagnosed with BPPV at an ENT special hospital. We investigated a number of canalith repositioning procedure (CRP), canal switch and a history of recurrence or head trauma. RESULTS: Anterior semicircular canal BPPV was observed in 41 (3.5%) patients. The average number of CRPs in patients with anterior semicircular canal BPPV was 2.19, which was higher than 1.60 in those with posterior semicircular canal BPPV (p<0.0001). Canal conversion from anterior to posterior semicircular canal was found in 5 (12.1%) patients during treatment. The average number of CRPs in conversion cases was 4, which was higher than 1.94 in non-conversion cases (p=0.001). CONCLUSION: More CRPs were necessary for the treatment of anterior semicircular canal BPPV than posterior semicircular canal BPPV. Canal switch could be considered as a factor to prevent a successful treatment.
Head ; Hospitals, Special ; Humans ; Recurrence ; Retrospective Studies ; Semicircular Canals ; Vertigo

Benign paroxysmal positional vertigo (BPPV) of anterior semicircular canal (ASC) is the rarest variant of BPPV, which is thought to be due to the anatomically superior position of ASC during most activities. This type of BPPV is currently diagnosed by detecting positional down-beating nystagmus in the Dix-Hallpike test. A 62-year-old female presented with positional vertigo, especially when sitting up. No nystagmus was induced by both Dix-Hallpike tests, however, positional down-beating nystagmus was observed with the left torsional component when sitting up from both Dix-Hallpike positions and supine position. After the reverse Epley maneuver, up-beating nystagmus was newly observed in the left Dix-Hallpike test, which was compatible with BPPV of the left posterior semicircular canal. This patient was thought to suffer from canalithiasis of the left ASC.
Female ; Humans ; Middle Aged ; Semicircular Canals ; Supine Position ; Vertigo

PURPOSE: This study was designed to examine the effect of stress on the pathophysiology of bladder stability via the Rho-kinase and nitric oxide synthase activity, which are required for muscle contraction and relaxation within the bladder. MATERIALS AND METHODS: Animal testing was conducted in two separate sessions. In the first experiment, 36 female Sprague-Dawley rats weighing about 230-270g each were employed. 18 rats were placed in the control group and 18 rats were placed in the test group. The second testing was conducted using metabolic cages. Six rats were placed in the control group and six rats were placed in the test group under a stressful environment. RESULTS: The results showed that the frequency of urination was significantly increased with time in the test group(p<0.05). However, the volume of voided urine decreased, thereby suggesting stress was a cause of overactive bladder. Analysis of bladder tissue for nitric oxide synthase (NOS) and RhoA-binding kinase(ROKalpha), important components of contraction and relaxation of bladder muscle, revealed that the levels of iNOS and ROKalpha were significantly increased with continued application of stress. This suggests that stress affects the levels of NOS and ROKalpha in an overactive bladder to influence contraction and relaxation of the bladder muscle. CONCLUSIONS: An increase in the ROKalpha expression and changes of the NOS expressions in the rats with chronic stress pathophysiologicaly support that stress contributes to the clinical symptoms of overactive bladder.
Animals ; Female ; Humans ; Muscle Contraction ; Nitric Oxide Synthase ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases ; Urinary Bladder* ; Urinary Bladder, Overactive ; Urination

Caring for a patient dying is a hardship not only for the health care professionals, but also for the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high for patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.
Anxiety ; Caregivers ; Deglutition ; Delivery of Health Care ; Dyspnea ; Hospices ; Humans ; Nausea ; Patient Care Team ; Psychomotor Agitation ; Respiration ; Sleep Stages ; Vomiting

Caring for a patient dying is a hardship not only for the health care professionals, but also for the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high for patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.
Anxiety ; Caregivers ; Deglutition ; Delivery of Health Care ; Dyspnea ; Hospices ; Humans ; Nausea ; Patient Care Team ; Psychomotor Agitation ; Respiration ; Sleep Stages ; Vomiting

PURPOSE: The purpose of this study was to verify effects of the Empowering A Self-Efficacy (EASE) program on self-efficacy, self-management, and child attitude toward illness in children with epilepsy. METHODS: This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants were 10 to 15 year old children with epilepsy (11 in the experimental group and 10 in the control group) who were registered at one hospital in S city. The experimental group received the EASE program for 3 weeks. In the first week, a group meeting lasting 570 minutes was conducted on a single day. Over the next two weeks, telephone counselling was conducted twice a week. Data were analyzed using SPSS 18.0. RESULTS: There was a significant difference of pre-post evaluation of the epilepsy self-management scores in the experimental group. However, differences between the experimental group and the control group for seizure self-efficacy and child attitude toward illness were not significant. CONCLUSION: This is the first study in Korea to develop and evaluate an intervention program for children with epilepsy. Further studies are needed to confirm the effects of the EASE program.
Adolescent ; Attitude to Health ; Child ; Epilepsy/pathology/*psychology ; Female ; Humans ; Male ; *Power (Psychology) ; Program Development ; *Program Evaluation ; Self Care ; *Self Efficacy ; Surveys and Questionnaires ; Translating

OBJECTIVES: The aim of this study is to evaluate the polysomnographic characteristics and prescription status of restless legs syndrome (RLS) patients in naturalistic setting. METHODS: We reviewed medical record of the patients over 18 years olds who (i) satisfied the clinical RLS diagnostic criteria and (ii) had the polysomnography and got treatment related thereto. As a baseline, we evaluated the four diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG) and the International Restless Legs Scale (IRLS) of the subjects. Then the polysomnography and the suggested immobilization test (SIT) were conducted and, after one month of pharmacotherapy using dopamine agonist, the IRLS was evaluated again. RESULTS: A total of 211 subjects participated in this analysis and 94 (44.5%) of them were male and the other 117 (55.5%) were female and the average age of the 211 subjects was 46.9+/-14.2. Out of such 211 subjects, 136 subjects (64.5%) also had the obstructive sleep apnea (OSA), and 53 subjects (25.1%) also had the periodic limb movement disorder (PLMD). 185 subjects (87.7%) out of the 211 subjects had some other sleep disorders except RLS. The results of the polysomnography were as follows : 78.0% of sleep efficiency, 86.8 min of wake after sleep onset, and 3.4% of N3. More specifically, 12.4/h of the average apnea hypopnea index, 14.8/h of the periodic limb movement during sleep (PLMS), 41.2/h of the periodic limb movement during wake during SIT and 21.6/h of total arousal index during sleep. Out of the total subjects, 149 (70.6%) of them took the ropinirole and 47 (22.3%) of them took the pramipexole, and the average dosage of ropinirole was 0.9mg(dosage range 0.125-5 mg) while the average dosage of pramipexole was 0.5 mg (dosage range 0.125-4 mg). The dosage of the ropinirole showed a significant positive correlation with the age (r=0.25, p=0.002) and also with the IRLS (r=0.23, p=0.038). The IRLS at the baseline was 24.9 while the same was decreased down to 13.4 after one month. CONCLUSIONS: Analyzing the result of this study, a majority of clinical RLS subjects demonstrated comorbidity with some other sleep disorder such as the OSA or PLMD. 25.1% of the subjects showed a PLMD, which was less than in previous researches and the average PLMS was not very high as 14.8/h. The dosage of dopamine agonist taken was often a bit more than the amount recommended in Korea. A prospective research using a large scale controlled subjects will be necessary with respect to this topic.
Apnea ; Arousal ; Benzothiazoles ; Comorbidity ; Dopamine Agonists ; Extremities ; Female ; Humans ; Immobilization ; Indoles ; Isothiocyanates ; Korea ; Male ; Medical Records ; Nocturnal Myoclonus Syndrome ; Polysomnography ; Prescriptions ; Restless Legs Syndrome ; Sleep Apnea, Obstructive ; Sleep Wake Disorders

PURPOSE: The autonomic nervous system (ANS) and stress hormones are important mediators in the stress response. The ANS controls the tone of corpus cavernosal smooth muscle. Clinically, it is not uncommon to develop erectile dysfunction as the sequelae of acute or chronic stress, with or without loss of libido. In this study, we investigated the effect of stress on the expression of mediators of penile corpus cavernosal smooth muscle relaxation and contraction. MATERIALS AND METHODS: Forty-eight male Sprague-Dawley rats were used, with 8 rats in each group. They were divided into six groups; stress+10, stress+20, and stress+30, which were named after their duration (days) of exposure, and a control group for each stress group. The stress group was maintained under a scheduled stress condition, while the control group was provided a comfortable general environment. Penile tissues were sampled and expressions of Rho-kinase, inducible nitric oxide synthase (iNOS), endothelial NOS (eNOS) and neuronal NOS (nNOS) were measured and analyzed by Western blotting. RESULTS: Penile Rho-kinase expression was significantly increased in the stress groups compared with the control group (p<0.05), with a greater increase during longer stress. Expression of iNOS was increased in stress+30 group (p<0.05). Expression of eNOS, nNOS, and Rho-kinase were increased in stress+20, stress+30 group (p<0.05). CONCLUSIONS: These results suggest that stress may alter penile corpus cavernosal smooth muscle relaxation by affecting mediators.
Animals ; Autonomic Nervous System ; Erectile Dysfunction ; Humans ; Libido ; Male ; Muscle, Smooth ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases

PURPOSE: The autonomic nervous system (ANS) and stress hormones are important mediators in the stress response. The ANS controls the tone of corpus cavernosal smooth muscle. Clinically, it is not uncommon to develop erectile dysfunction as the sequelae of acute or chronic stress, with or without loss of libido. In this study, we investigated the effect of stress on the expression of mediators of penile corpus cavernosal smooth muscle relaxation and contraction. MATERIALS AND METHODS: Forty-eight male Sprague-Dawley rats were used, with 8 rats in each group. They were divided into six groups; stress+10, stress+20, and stress+30, which were named after their duration (days) of exposure, and a control group for each stress group. The stress group was maintained under a scheduled stress condition, while the control group was provided a comfortable general environment. Penile tissues were sampled and expressions of Rho-kinase, inducible nitric oxide synthase (iNOS), endothelial NOS (eNOS) and neuronal NOS (nNOS) were measured and analyzed by Western blotting. RESULTS: Penile Rho-kinase expression was significantly increased in the stress groups compared with the control group (p<0.05), with a greater increase during longer stress. Expression of iNOS was increased in stress+30 group (p<0.05). Expression of eNOS, nNOS, and Rho-kinase were increased in stress+20, stress+30 group (p<0.05). CONCLUSIONS: These results suggest that stress may alter penile corpus cavernosal smooth muscle relaxation by affecting mediators.
Animals ; Autonomic Nervous System ; Erectile Dysfunction ; Humans ; Libido ; Male ; Muscle, Smooth ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases

OBJECTIVES: This study examined the reliability and validity of the Korean version of Asperger Syndrome Diagnostic Scale (K-ASDS), to calculate the cut-off score in the diagnosis of Asperger syndrome. Further, we examined classification error rate when applying cut-off scores. METHODS: One hundred sixty-seven children participated in this study, including 46 with Asperger syndrome, 26 with PDD or PDD NOS, 43 with ADHD, and 52 normal children. RESULTS: An ANCOVA demonstrated no significant differences in the K-ASDS total score between the Asperger and the PDD & PDD NOS groups. However, these groups did show significantly higher scores than the ADHD and normal groups. Among the five subscales on the K-ASDS, the Asperger group obtained significantly higher scores on the language and cognition subscales than the PDD & PDD NOS groups. Two scales were found to be useful in distinguishing the Asperger group from the PDD & PDD NOS group through a discriminant analysis. According to an analysis of ROC curve, the cut-off score on the K-ASDS for the diagnosis of PDD including Asperger syndrome was 121. CONCLUSION: We discussed that K-ASDS has pretty limit.
Asperger Syndrome ; Child ; Cognition ; Humans ; Reproducibility of Results ; ROC Curve ; Weights and Measures