1.Autonomic Dysfunction Measured by Valsalva Ratio in Parkinson's Disease.
Heung Joon KIM ; Sang Bok LEE ; Ho Jin MYUNG
Journal of the Korean Neurological Association 1987;5(2):230-235
As a clinical tool to evaluate autonomic dysfunction, "Valsalva ratio" was measured in 36 Parkinson's disease patients (15 men, 21 women) and 10 control subjects (4 men, 6 women). In this study, the Valsalva ratio was defined as the ratio of peak to nadir heart rate during Valsalva maneuver, namely voluntary and transient breathholding in maximal inspiration state with subsequent release by the subject. EKG was monitored throughout the whole process to observe the moment to moment change of heart rate. The subject group with Parkinson's disease was subdivided by clinical variables including sex, are, Hoehn and Yahr clinical stage, duration of symptoms, and duration of therapy with L-dopa containing drugs. The Valsalva ratio of the subject group as a whole was less than that of the control group (P<0.05). But the differences of Valsalva ratio between the subgroups graded by above clinical variables of Parkinson's disease were not statistically significant. The clinical applicability of "Valsalva ratio" measurement described in this study was discussed.
Electrocardiography
;
Heart Rate
;
Humans
;
Levodopa
;
Male
;
Parkinson Disease*
;
Valsalva Maneuver
2.Difference of Cough and Valsalva Maneuvers in the Dynamic Testing of Stress Urinary Incontinence.
Dong Deuk KWON ; Seung Il JUNG ; Bong Ryoul OH ; Kwang Sung PARK ; Soo Bang RYU ; Yang Il PARK
Journal of the Korean Continence Society 2001;5(2):57-63
PURPOSE: The aim of the study was to evaluate the relationship between Valsalva leak-point pressure (VLPP) and cough leak-point pressure (CLPP) in the patients with stress incontinence and to determine the correlation between maximal urethral closure pressure(MUCP) and leak point pressure. MATERIALS AND METHODS: Thirty women with stress urinary incontinence were included. Two women were excluded from the evaluation because of detrusor instability. At the bladder volume of 200-300ml cough leak-point pressure and Valsalva leak-point pressure were measured in the sitting position by using 8Fr intravesical catheter. RESULTS: Valsalva leak-point pressure was significantly lower than cough leak-point pressure (69.4+/-24.5 versus 86.6+/-28.1cmH2O, p<0.0001). If intrinsic sphincter deficiency was defined as a leak-point pressure of 60cmH2O or less, 21.4% of women fulfilled this criterion using the cough leak-point pressure compared to 42.8% if the Valsalva leak-point pressure is used. Valsalva leak-point pressure and maximal urethral closure pressure were statistically correlated (p<0.05). However, a correlation coefficient of 0.38 demonstrated poor clinical relationship. CONCLUSION: Cough leak-point pressures were significantly higher than Valsalva leak-point pressures. Cough and Valsalva maneuvers seem to result in a different reaction of the pelvic floor. Valsalva leak-point pressure has more statistical correlation to the maximal urethral closure pressure than cough leak-point pressure. So Valsalva leak-point pressure may have a additional benefit for detecting type III stress urinary incontinence. However, variations in Valsalva leak-point pressure measurement must be precisely descibed, standardized, and validated before a technique can be advocated for clinical use.
Catheters
;
Cough*
;
Female
;
Humans
;
Pelvic Floor
;
Urinary Bladder
;
Urinary Incontinence*
;
Valsalva Maneuver*
3.Incidence of Patent Foramen Ovale in Ischemic Stroke Patients: A Transcranial Doppler Study.
Dae Il CHANG ; Mi Sook LEE ; Sang Hee CHO ; Seon Hee BU ; Se Hee CHUNG ; Seong Hyuk HUH ; Kang Uk YOON ; Tae Beom AHN ; Sung Sang YOON ; Kyung Cheon CHUNG
Journal of the Korean Neurological Association 2005;23(3):313-317
BACKGROUND: Patent foramen ovale (PFO) is increasingly being recognized in stroke patients. The capability of transcranial Doppler (TCD) to detect a PFO has been established. We studied the frequency of PFO in patients with ischemic stroke. METHODS: Eighty-nine patients with ischemic stroke (62 men, mean age: 56.5) consecutively underwent a contrast-enhanced TCD with monitoring of the bilateral middle cerebral arteries (MCA). The contrast solution, which consisted of 8 ml of normal saline, 1 ml of air, and 0.2 ml of patient's blood, was injected twice during normal breathing and the Valsalva maneuver. High intensity transient signals (HITS) were counted for 30 seconds after the injection. RESULTS: Patent foramen ovale was detected in 19 patients (21%). The mean age was similar in those with (55 years) and those without (57 years) PFO. Patent foramen ovale was more frequent among men (26%) than women (11%). There were no differences in the frequency of PFO among stroke subtypes (large artery atherosclerosis, 18%; small artery occlusion, 27%; cardioembolic, 27%; undetermined cause, 11%). CONCLUSIONS: Patent foramen ovale is common in patients with ischemic stroke of all subtypes.
Arteries
;
Atherosclerosis
;
Female
;
Foramen Ovale, Patent*
;
Humans
;
Incidence*
;
Male
;
Middle Cerebral Artery
;
Respiration
;
Stroke*
;
Valsalva Maneuver
4.The Usefulness of Three-Dimensional Gadolinium-Enhanced MR Venography for the Evaluation of Varices in Lower Extremities.
Myong Kwan KO ; Hee LEE ; Sung Gwon KANG ; Jeong Yeol CHOI ; Ju Nam BYUN ; Jeong Hwan JANG ; Chae Ha LIM ; Young Cheol KIM
Journal of the Korean Radiological Society 2001;45(5):465-470
PURPOSE: To assess the performance of contrast-enhanced three-dimensional(3-D) magnetic resonance venography (MRV) of the pelvis and lower extremities in patients with varicose veins. MATERIALS AND METHODS: Ascending and MR venography were performed in seven legs of seven patients, and duplex Doppler sonography and MR venography in 15 legs of 12 patients, all referred for evaluation of varicose veins. For analysis, the venous system as revealed by ascending and MR venographic images was divided into 13 segments. For detection of reflux to the great saphenous vein, duplex Doppler sonography and MRV were performed. RESULTS: In ascending venography and MRV, 91 venous segments were potentially visible; both modalities depicted 78 of these, but failed to detect four. Ascending venography and MRV detected 17 and 19 varices, respectively. When two tourniquets were placed around the ankle and knee using the Valsalva maneuver, MRV and duplex Doppler sonography detected reflux in 8 of 11 and 13 of 15 legs, respectively. CONCLUSION: Contrast-enhanced 3-D MRV comprehensively displays the venous system of the lower extremities and permits assessment of varicose veins. MRV using the Valsalva maneuver allows assessment of reflux to the great saphenous vein.
Ankle
;
Humans
;
Knee
;
Leg
;
Lower Extremity*
;
Pelvis
;
Phlebography*
;
Saphenous Vein
;
Tourniquets
;
Valsalva Maneuver
;
Varicose Veins*
5.Scrotal Doppler Ultrasonography in the Assessment of Varicocele.
Won Sik KIM ; Do Yeon CHOI ; Young Taik HAN
Korean Journal of Urology 1998;39(11):1070-1076
PURPOSE: To assess the ability of scrotal Doppler ultrasonography to confirm the diagnosis of clinical varicoceles and detect subclinical varicoceles. MATERIALS AND METHOD: Sixty patients with clinically evident varicocele were examined by scrotal doppler ultrasonography(gray scale: 60 patients, spectral Doppler: 35 patients, color Doppler: 22 patients). A control group of 21 patients with no suspected scrotal pathology also were studied. The age range of the varicocele group was 12-49 years. The normal group consisted of 21 subjects aged 19-23 years. Ultrasonographic measurement of scrotal vein diameter of patients before and during Valsalva maneuver, and scrotal vein blood flow reversal with Valsalva maneuver was compared with the findings of varicocele by physical examination. RESULTS: Significant differences were found in scrotal vein diameter before and during Valsalva maneuver between normal and varicocele testicular units. Cut-off points were selected in an arbitrary fashion on the basis of scattergram. Using this cut-off points and blood flow reversal, we found that 12(23%) of 53 patients with a clinically palpable left unilateral varicocele had an ultrasonographically positive subclinical right varicocele. 8(38%) of 21 patients without a clinical varicocele had a positive scrotal ultrasound. CONCLUSIONS: We suggest that scrotal doppler ultrasonography is a reliable means of confirming the clinical varicocele and screening the subclinical varicoceles.
Diagnosis
;
Humans
;
Mass Screening
;
Pathology
;
Physical Examination
;
Ultrasonography
;
Ultrasonography, Doppler*
;
Valsalva Maneuver
;
Varicocele*
;
Veins
6.Technical Refinement of 99mTc-RBC Scrotal Scan for Evaluating Varicocele.
Koon Ho RHA ; Min Chong LEE ; Joong Suk ROH ; Won Sik HAHM ; Woong Hee LEE ; Moo Sang LEE ; Byeong Cheol AHN
Korean Journal of Andrology 2001;19(3):195-198
PURPOSE: The association of varicoceles and subfertility has been well documented. Although varicoceles remain the most common surgically correctable cause of male infertility the subjective diagnosis of varicocele, especially the small ones remains a challenge. MATERIALS AND METHODS: We evaluated 40 young men (16 volunteers, 24 varicocele patients) with scrotal blood pool scan using 99mTc RBC. RESULTS: Complete correlation between physical findings and the scrotal scan was found. The postoperative scans of 12 patients with surgically corrected high grade varicoceles demonstrated symmetrical photon accumulation in the scrotum. The technique which most accurately correlated the clinical grade was the varicocele index using total count at Valsalva maneuver. CONCLUSIONS: We believe that the 99mTc RBC scrotal scan with technical refinement is a useful procedure in the objective diagnosis and followup of varicoceles.
Diagnosis
;
Follow-Up Studies
;
Humans
;
Infertility
;
Infertility, Male
;
Male
;
Scrotum
;
Valsalva Maneuver
;
Varicocele*
;
Volunteers
7.Change in Intraocular Pressure of Normal Healthy Eyes During Sit-up With Various Postures.
Young Taek HONG ; Samin HONG ; Chan Yun KIM ; Gong Je SEONG
Journal of the Korean Ophthalmological Society 2009;50(12):1860-1867
PURPOSE: To investigate the change in intraocular pressure (IOP) of normal healthy eyes at different positions while performing sit-ups. METHODS: Twenty normal healthy eyes of 20 subjects were studied. IOP was measured while in the 'sitting upright', 'supine', and 'head-down' position to determine postural effect on IOP when executing a sit-up. Measurements were taken after the performance of a sit-up and during the performance of a sit-up, in both the head up and head down positions to test the effect of the exercise on the IOP. In addition, the IOP after an 'isometric exercise with Valsalva's maneuver in the supine or head-down position' was measured to determine the actual IOP during a sit-up. RESULTS: The postural change from sitting upright to tilting the head in a downward position caused the IOP to increase. After the performance of a sit-up, the IOP decreased in both the upright and supine positions, though IOP increased in the head-down position. After the isometric exercise with Valsalva's maneuver, IOP increased significantly regardless of position. CONCLUSIONS: IOP increased significantly during sit-ups, but decreased afterward. Future studies should be performed to evaluate the long-term effects of IOP change during and after sit-ups with respect to the prognosis of glaucoma.
Exercise
;
Eye
;
Glaucoma
;
Head
;
Intraocular Pressure
;
Posture
;
Prognosis
;
Supine Position
;
Valsalva Maneuver
8.The Effect of Positional Changes during Heavy Weight Lifting on Intraocular Pressure.
Hae Yoon SONG ; Sang Moon JEOUNG ; Jae Seok IM ; Eung LEE ; Jeong Do KWON
Journal of the Korean Ophthalmological Society 2009;50(12):1831-1839
PURPOSE: To measure intraocular pressure (IOP) as a function of positional changes of the head during heavy weight lifting. METHODS: The subjects of this study were 30 healthy adult males in their twenties to forties. This study investigated their ophthalmic examinations, BMI (body mass index), and 1RM (one repetition maximum) according to the three bench press positions. RESULTS: Before exercising, the IOP was higher in the lowered head position in the decline bench press (18.20+/-2.89 mmHg) than in the incline bench press (14.38+/-2.32 mmHg) (p<0.001). The IOP increased significantly during the bench press exercise, relative to during the pre-exercise (p<0.001). Upon lift down, IOP increased by 3.72+/-1.85 mmHg greater than upon lift up, and mean IOP increased by 2.61+/-1.63 mmHg (p<0.001). In our experiments, IOP increased to a maximum of 22.10+/-2.79 mmHg, measured during lift down in the decline bench press configuration. The BMI and the IOP before exercise showed significant correlation (p<0.05). CONCLUSIONS: IOP increased more during exercise involving a lower head position. Further study is needed to know the extent to which this result is relevant for glaucoma patients and which activities and head positions during exercise may worsen glaucoma. In the meantime, patients with severe glaucoma may need to avoid lifting heavy objects with a lowered head position.
Adult
;
Glaucoma
;
Head
;
Humans
;
Intraocular Pressure
;
Lifting
;
Male
;
Valsalva Maneuver
;
Weight Lifting
9.Diagnostic Criteria of Internal Jugular Phlebectasia in Korean Children.
Cheong Woo JEON ; Moo Jin CHOO ; Il Hun BAE ; See Ok SHIN ; Young Seok CHOI ; Dong Wook LEE ; Kyu Hwa SIM
Yonsei Medical Journal 2002;43(3):329-334
Internal jugular phlebectasia (IJP) is a fusiform dilatation of the internal jugular vein (IJV), usually presented as a neck mass in children. Accurate diagnosis from carefully directed history, physical examination, and radiological study could result in lifesaving therapy. We performed our study to suggest possible clinical diagnostic criteria for IJP in Korean children. We reviewed three cases of IJP (patients group) and compared the diameter of the internal jugular phlebectasias with diameters of IJVs in ten normal children (control group) using ultrasonography (USG). There were no significant differences in the range of diameters in the resting state between the two groups. The diameters on the right side, compared with those on the left side, showed no statistical significance (p < 0.05). Te range of expanding diameter and average expanding ratios (resting state to Valsalva maneuver X 100%) showed a statistical difference between the two groups (p < 0.05).
Child
;
Child, Preschool
;
Dilatation, Pathologic/*ultrasonography
;
Female
;
Human
;
Jugular Veins/*ultrasonography
;
Korea
;
Male
;
Valsalva's Maneuver
10.Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse.
Korean Journal of Urology 2012;53(10):691-698
PURPOSE: The study purpose was to evaluate the clinical and ultrasound characteristics of women with urinary stress incontinence (USI) with or without genital prolapse (GP). MATERIALS AND METHODS: A total of 268 patients who underwent ultrasound perineal evaluation were divided into two groups: isolated USI (n=132) and USIGP (n=136) with USI/GP stage I/II. The latter group was additionally divided into two subgroups: USIGP(A) (n=78) with USI/GP stage I and USIGP(B) (n=58) with USI/GP stage II. RESULTS: Point Aa (pelvic organ prolapse quantification system), which is the projection of the bladder neck (BN) on the anterior vaginal wall, was situated higher in the rest position (RP) but moved lower during a Valsalva maneuver (VM) in the USI group than in the USIGP group (p<0.05). The ultrasound parameters alpha-angle and the distance Sy-BN (symphisis-bladder neck) decreased, whereas distance H increased, in the USIGP group during VM. The ultrasound parameters that gave the best insight into the range of BN movements were as follows: distance R-->V and angle of rotation (rho), which were significantly higher in the USI group than in the USIGP group during VM. CONCLUSIONS: According to the clinical and ultrasound findings, we can conclude that the BN is situated higher during the RP but moved lower during a VM in patients with isolated USI compared with those with concomitant USI/GP, which could be explained by the cystocele-immobilizing effect on the BN during the VM in the latter group but also by the deteriorated pubo-urethral ligaments in the former group.
Female
;
Humans
;
Ligaments
;
Neck
;
Prolapse
;
Urinary Bladder
;
Urinary Incontinence, Stress
;
Valsalva Maneuver