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Intracranial arterial disease (ICAD) is a heterogeneous condition characterized by distinct pathologies, including atherosclerosis. Advances in magnetic resonance technology have enabled the visualization of intracranial arteries using high-resolution vessel wall imaging (HR-VWI). This review summarizes the anatomical, embryological, and histological differences between the intracranial and extracranial arteries. Next, we review the heterogeneous pathophysiology of ICAD, including atherosclerosis, moyamoya or RNF213 spectrum disease, intracranial dissection, and vasculitis. We also discuss how advances in HR-VWI can be used to differentiate ICAD etiologies. We emphasize that one should consider clinical presentation and timing of imaging in the absence of pathology-radiology correlation data. Future research should focus on understanding the temporal profile of HR-VWI findings and developing quantitative interpretative approaches to improve the decision-making and management of ICAD.
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An herbal medicinal product consisting of three kinds of herbal materials, Prunella vulgaris L. (Lamiaceae), Clematis chinensis Osbeck (Ranunculaceae) and Trichosanthes kirilowii Max. (Cucurbitaceae) has been prescribed in the clinic for treating rheumatoid arthritis in Korea. In the present study, we investigated the antidepressive effect of this herbal complex extract (HCE) on lipopolysaccharide (LPS)-induced depression-like behavior. The effects of HCE on LPSinduced depressive-like behaviors were evaluated using a forced swimming test (FST) and splash test. In addition, we also evaluated locomotor activity and anxiety-like behaviors using the open field test and elevated plus-maze (EPM) test.Inflammatory cytokines were evaluated in the cortical regions. HCE attenuated anxiety-like behavior in the EPM test and depressive- and anhedonia-like behaviors induced by LPS in the FST and splash test. In addition, LPS-induced increases in the phosphorylation levels of protein kinase B (Akt) and glycogen synthase kinase 3 beta (GSK-3β) and expression levels of proinflammatory factors in the cortex were normalized by HCE. Moreover, decreases in the level of BDNF in the cortex were attenuated by HCE. These results suggest that HCE attenuates inflammation-induced depression-like behaviors through its normalization of Akt-GSK-3β signaling and proinflammatory factors and its upregulation of BDNF in the cortex and that HCE has therapeutic potential for depressive disorders in inflammatory states.
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Purpose@#Cutting balloon-percutaneous transluminal angioplasty (CB-PTA) is a feasible treatment option for in-stent restenosis (ISR) after carotid artery stenting (CAS). However, the longterm durability and safety of CB-PTA for ISR after CAS have not been well established. @*Materials and Methods@#We retrospectively reviewed medical records of patients with ISR after CAS who had been treated with CB-PTA from 2012 to 2021 in our center. Detailed information of baseline characteristics, periprocedural and long-term outcomes, and follow-up imaging was collected. @*Results@#During 2012–2021, a total of 301 patients underwent CAS. Of which, CB-PTA was performed on 20 lesions exhibiting severe ISR in 18 patients following CAS. No patient had any history of receiving carotid endarterectomy or radiation therapy. These lesions were located at the cervical segment of the internal carotid artery (n=16), proximal external carotid artery (n=1), and distal common carotid artery (n=1). The median time interval between initial CAS and detection of ISR was 390 days (interquartile range 324–666 days). The follow-up period ranged from 9 months to 9 years with a median value of 21 months. Four patients (22.2%) were symptomatic. The average of stenotic degree before and after the procedure was 79.2% and 34.7%, respectively. Out of the 18 patients receiving CB-PTA, 16 (88.9%) did not require additional stenting, and 16 (88.9%) did not experience recurrent ISR during the follow-up period. Two patients who experienced recurrent ISR were successfully treated with CB-PTA and additional stenting. No periprocedural complication was observed in any case. @*Conclusion@#Regarding favorable periprocedural and long-term outcomes in our single-center experience, CB-PTA was a feasible and safe option for the treatment of severe ISR after CAS.
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Objectives@#This study investigated the impacts of exercise on irisin and fibroblast growth factor 21 (FGF-21) expression, as well as triiodothyronine (T3) and free fatty acid (FFA) levels in elderly women. @*Methods@#Thirty women aged 65 to 70 years (10 per group) were randomly assigned to aquatic exercise, land exercise, and control groups. The aquatic and land groups engaged in 3 exercise sessions per week (60 min/session) for 16 weeks. The intensity was progressively increased every 4 weeks. @*Results@#Irisin and FGF-21 levels significantly increased in the aquatic exercise group. In the post-test, the aquatic exercise group had the highest irisin levels. Significant findings were observed for irisin and FGF-21 for the main effect between aquatic and band exercise groups (p<0.05 for both), the main effect between measurement times (p<0.01 and p<0.001, respectively), and the interaction effect (p<0.05 and p<0.001, respectively). The irisin level was significantly higher in the aquatic than in the land group 30 minutes after the last session (p<0.05). In both exercise groups, T3 levels were significantly higher 30 minutes after the final session (p<0.05) than before the program. The FFA level was significantly higher in the aquatic exercise group than the others. In the aquatic group, FFA levels were significantly higher 30 minutes after both the first (p<0.01) and the last (p<0.001) session compared to pre-program values. @*Conclusion@#Differences in exercise type and environment can promote fat metabolism by stimulating hormonal changes that induce brown fat activity and browning.
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Background@#Korea recently established 70 emergency medical service areas. However, there are many concerns that medical resources for stroke could not be evenly distributed through the country. We aimed to compare the treatment quality and outcomes of acute stroke among the emergency medical service areas. @*Methods@#This study analyzed the data of 28,800 patients admitted in 248 hospitals which participated in the 8th acute stroke quality assessment by Health Insurance Review and Assessment Service. Individual hospitals were regrouped into emergency service areas according to the address of the location. Assessment indicators and fatality were compared by the service areas. We defined the appropriate hospital by the performance of intravenous thrombolysis. @*Results@#In seven service areas, there were no hospitals which received more than 10 stroke patients for 6 months. In nine service areas, there were no patients who underwent intravenous thrombolysis (IVT). Among 167 designated emergency medical centers, 50 hospitals (29.9%) responded that IVT was impossible 24 hours a day. There are 97 (39.1%) hospitals that meet the definitions of appropriate hospital. In 23 service areas (32.9%) had no appropriate or feasible hospitals. The fatality of service areas with stroke centers were 6.9% within 30 days and 15.6% within 1 year from stroke onset than those without stroke centers (7.7%, 16.9%, respectively). @*Conclusions@#There was a wide regional gap in the medical resource and the quality of treatments for acute stroke among emergency medical service areas in Korea. The poststroke fatality rate of the service areas which have stroke centers or appropriate hospitals were significantly low.
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Background@#This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention.Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. @*Results@#Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9–10 points increased from 64% in 2019 to 69% in 2020. @*Conclusion@#The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction.Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.
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Background@#Although depression and motion sickness are prevalent in military personnel and seafarers, the association between depression and seasickness has been not yet elucidated. We aimed to evaluate the relationship of depression with initial susceptibility and adaptation to seasickness amongst military seafarers. @*Methods@#This retrospective cohort enrolled Navy seafarers who started seafaring between 2017 and 2019. Three groups were established according to the Beck Depression Inventory (BDI) score: no depression (BDI score of 0), minimal depression (BDI score 1–9), and mild-tomoderate depression (BDI score 10–29). The occurrence of seasickness requiring treatment was observed as the prescription of medication for the first 30 distant seafaring days.Considering adjustment period, the two different outcomes were defined. The susceptibility to seasickness was evaluated via at least one day suffered from seasickness requiring treatment during the early period (the first 5 seafaring days), and adaptation ability to seasickness was defined by more than 10% of the ratio, calculated days suffered from seasickness requiring treatment/days of seafaring during the late period (the 6–30th seafaring days). Binary logistic regression was further evaluated to estimate the odds of BDI groups and BDI score adjusted for age and workplace whether outside visual perception was possible. @*Results@#Among the 185 recruits, 179 participants (97%) sailed for more than 5 days were included in the study. Of the participants, 36% was susceptible to seasickness in the early and 17% was poorly adapted to seasickness in the late period. Multivariable model revealed that mild-to-moderate depression had elevated risk of poor adaptation (odds ratio [OR], 4.63; 95% confidence interval [CI], 1.31–16.98) whereas the results were not statistically significant for susceptibility to seasickness in the early period BDI score was independently associated with increased odds of poor adaptation (OR, 1.10; 95% CI, 1.04–1.18). @*Conclusion@#The present study suggests that depression is associated with poor adaptation to seasickness in Navy seafarers. Depression screening tool might be helpful for providing preventable strategies for population at risk.
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Objective@#This study aimed to evaluate the effect of implementing the consensus statement from the Asian Society of Cardiovascular Imaging-Practical Tutorial 2020 (ASCI-PT 2020) on the reliability of cardiac MR with late gadolinium enhancement (CMR-LGE) myocardial viability scoring between observers in the context of ischemic cardiomyopathy. @*Materials and Methods@#A total of 17 cardiovascular imaging experts from five different countries evaluated CMR obtained in 26 patients (male:female, 23:3; median age [interquartile range], 55.5 years [50–61.8]) with ischemic cardiomyopathy. For LGE scoring, based on the 17 segments, the extent of LGE in each segment was graded using a five-point scoring system ranging from 0 to 4 before and after exposure according to the consensus statement. All scoring was performed via webbased review. Scores for slices, vascular territories, and total scores were obtained as the sum of the relevant segmental scores. Interobserver reliability for segment scores was assessed using Fleiss’ kappa, while the intraclass correlation coefficient (ICC) was used for slice score, vascular territory score, and total score. Inter-observer agreement was assessed using the limits of agreement from the mean (LoA). @*Results@#Interobserver reliability (Fleiss’ kappa) in each segment ranged 0.242–0.662 before the consensus and increased to 0.301–0.774 after the consensus. The interobserver reliability (ICC) for each slice, each vascular territory, and total score increased after the consensus (slice, 0.728–0.805 and 0.849–0.884; vascular territory, 0.756–0.902 and 0.852–0.941; total score, 0.847 and 0.913, before and after implementing the consensus statement, respectively. Interobserver agreement in scoring also improved with the implementation of the consensus for all slices, vascular territories, and total score. The LoA for the total score narrowed from ± 10.36 points to ± 7.12 points. @*Conclusion@#The interobserver reliability and agreement for CMR-LGE scoring for ischemic cardiomyopathy improved when following guidance from the ASCI-PT 2020 consensus statement.
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Microglial priming is the process of microglial proliferation and activation in response to neurodegeneration and abnormal protein accumulation. Priming makes microglia susceptible to secondary inflammatory stimuli and causes exaggerated inflammatory responses. In the present study, we established a microglial priming model in mice by administering a single injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 20 mg/kg). MPTP induced microglial activation without dopaminergic degeneration;however, subsequent treatment with a sub-toxic dose of lipopolysaccharides (LPS) induced an amplified inflammatory response and caused nigrostriatal dopaminergic degeneration. These pathological and inflammatory changes, including microglial activation and dopaminergic cell loss in the substantia nigra (SN) area were reversed by papaverine (PAP) administration. In addition, MPTP/LPS enhanced interleukin-1β (IL-1β) expression and processing via nod-like receptor protein 3 (NLRP3) inflammasome activation in the SN region of mice. However, PAP treatment suppressed inflammasome activation and subsequent IL-1β maturation. Moreover, PAP inhibited nuclear factor-κB (NF-κB) and enhanced cAMP-response element binding protein (CREB) activity in the SN of MPTP/LPS mice. These results suggest that PAP inhibits the activation of NLRP3 inflammasome by modulating NF-κB and CREB signaling pathways, which results in reduced microglial activation and neuronal cell death. Thus, PAP may be a potential candidate for the treatment of Parkinsons’s disease, which is aggravated by systemic inflammation.
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Accumulation of reactive oxygen species (ROS) is associated with the development of various diseases. However, the molecular mechanisms underlying oxidative stress that lead to such diseases like autosomal dominant polycystic kidney disease (ADPKD) remain unclear. Here, we observed that oxidative stress markers were increased in Pkd1 f/f :HoxB7-Cre mice. Forkhead transcription factors of the O class (FOXOs) are known key regulators of the oxidative stress response, which have been observed with the expression of FoxO3a in an ADPKD mouse model in the present study. An integrated analysis of two datasets for differentially expressed miRNA, such as miRNA sequencing analysis of Pkd1 conditional knockout mice and microarray analysis of samples from ADPKD patients, showed that miR-132-3p was a key regulator of FOXO3a in ADPKD. miR-132-3p was significantly upregulated in ADPKD which directly targeted FOXO3 in both mouse and human cell lines. Interestingly, the mitochondrial gene Gatm was downregulated in ADPKD which led to a decreased inhibition of FOXO3. Overexpression of miR-132-3p coupled with knockdown of Foxo3 and Gatm increased ROS and accelerated cyst formation in 3D culture. This study reveals a novel mechanism involving miR-132-3p, Foxo3, and Gatm that is associated with the oxidative stress that occurs during cystogenesis in ADPKD.
ABSTRACT
Microglial priming is the process of microglial proliferation and activation in response to neurodegeneration and abnormal protein accumulation. Priming makes microglia susceptible to secondary inflammatory stimuli and causes exaggerated inflammatory responses. In the present study, we established a microglial priming model in mice by administering a single injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 20 mg/kg). MPTP induced microglial activation without dopaminergic degeneration;however, subsequent treatment with a sub-toxic dose of lipopolysaccharides (LPS) induced an amplified inflammatory response and caused nigrostriatal dopaminergic degeneration. These pathological and inflammatory changes, including microglial activation and dopaminergic cell loss in the substantia nigra (SN) area were reversed by papaverine (PAP) administration. In addition, MPTP/LPS enhanced interleukin-1β (IL-1β) expression and processing via nod-like receptor protein 3 (NLRP3) inflammasome activation in the SN region of mice. However, PAP treatment suppressed inflammasome activation and subsequent IL-1β maturation. Moreover, PAP inhibited nuclear factor-κB (NF-κB) and enhanced cAMP-response element binding protein (CREB) activity in the SN of MPTP/LPS mice. These results suggest that PAP inhibits the activation of NLRP3 inflammasome by modulating NF-κB and CREB signaling pathways, which results in reduced microglial activation and neuronal cell death. Thus, PAP may be a potential candidate for the treatment of Parkinsons’s disease, which is aggravated by systemic inflammation.
ABSTRACT
Accumulation of reactive oxygen species (ROS) is associated with the development of various diseases. However, the molecular mechanisms underlying oxidative stress that lead to such diseases like autosomal dominant polycystic kidney disease (ADPKD) remain unclear. Here, we observed that oxidative stress markers were increased in Pkd1 f/f :HoxB7-Cre mice. Forkhead transcription factors of the O class (FOXOs) are known key regulators of the oxidative stress response, which have been observed with the expression of FoxO3a in an ADPKD mouse model in the present study. An integrated analysis of two datasets for differentially expressed miRNA, such as miRNA sequencing analysis of Pkd1 conditional knockout mice and microarray analysis of samples from ADPKD patients, showed that miR-132-3p was a key regulator of FOXO3a in ADPKD. miR-132-3p was significantly upregulated in ADPKD which directly targeted FOXO3 in both mouse and human cell lines. Interestingly, the mitochondrial gene Gatm was downregulated in ADPKD which led to a decreased inhibition of FOXO3. Overexpression of miR-132-3p coupled with knockdown of Foxo3 and Gatm increased ROS and accelerated cyst formation in 3D culture. This study reveals a novel mechanism involving miR-132-3p, Foxo3, and Gatm that is associated with the oxidative stress that occurs during cystogenesis in ADPKD.
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We report a case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which had a history of spontaneous resorption of late seroma before diagnosis. A 47-year-old woman with a history of augmentation mammoplasty with round textured implants in January 2013 presented with a swelling on her right breast 6 years later, which was diagnosed as late seroma with suspected intracapsular rupture using ultrasonography (USG). Although aspiration was not done at the time of the initial USG, the seroma resolved spontaneously within weeks. A further workup proceeded with USG-guided aspiration followed by magnetic resonance imaging. Cytology of the aspirated fluid showed atypical cells. Cell block cytology and immunohistochemical staining confirmed the diagnosis of BIA-ALCL. En bloc resection with total capsulectomy and explantation was performed as curative surgery. Pathologic stage pT2N0M0 was confirmed and the patient was followed up without further treatment. Although the classic presentation of BIA-ALCL is known as late persistent seroma, an atypical manifestation such as spontaneous resorption may occur, as in the current case. A high level of suspicion and a thorough investigation with appropriate modalities will make it possible to detect this rare and potentially devastating disease.
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This study aimed to assess the dietary quality and food habits in children with pervasive developmental disorder (PDD) and to evaluate the relationship between diet quality of children with PDDs and their caregivers' feeding practice and nutritional perceptions. Twenty-one pairs of caregivers and their children with PDD were surveyed. The caregivers completed surveys regarding their children's weight status, food habits, and dietary quality and their food habits, nutritional perceptions, knowledge, and feeding practices. Dietary quality was assessed as mean adequacy ratio, dietary diversity score (DDS), dietary variety score (DVS), and Index of Nutritional Quality (INQ). The children were in the normal ranges of body mass index (BMI) and Röhrer index. Having three times a meal, regular meal time, salty taste of the caregiver were related to those of the children with PDD (β = 0.533, 0.447, and 0.886, respectively; p < 0.05). Child control, food as reward, involvement, pressure, and restriction for the health of the caregiver were positively related to DDS, DVS, and INQ of the children with PDD (p < 0.05). High feeding stress and nutritional knowledge of the caregiver were related to the high BMI of the children with PDD (β = 0.445 and 0.602, respectively; p < 0.05), whereas emotion regulation, encourage balance and variety, and involvement of caregiver were negatively related to BMI (β = −0.426, −0.430, and −0.388, respectively; p < 0.05). In conclusion, food habits of children with PDD were closely related to those of caregiver. To improve nutritional status, more insightful understand will be required by considering their developmental differences in this population.
Subject(s)
Child , Humans , Body Mass Index , Caregivers , Developmental Disabilities , Diet , Feeding Behavior , Feeding Behavior , Meals , Nutritional Status , Nutritive Value , Reference Values , RewardABSTRACT
Parkinson's disease is a neurodegenerative disease characterized by the progressive loss of dopaminergic neurons within the substantia nigra pars compacta. In the present study, we investigated whether β-Lapachone (β-LAP), a natural naphthoquinone compound isolated from the lapacho tree (Tabebuia avellanedae), elicits neuroprotective effects in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease mouse model. β-LAP reduced the tyrosine hydroxylase (TH)-immuno-reactive fiber loss induced by MPTP in the dorsolateral striatum, and alleviated motor dysfunction as determined by the rotarod test. In addition, β-LAP protected against MPTP-induced loss of TH positive neurons, and upregulated B-cell lymphoma 2 protein (Bcl-2) expression in the substantia nigra. Based on previous reports on the neuroprotective role of nuclear factor-E2-related factor-2 (Nrf2) in neurodegenerative diseases, we investigated whether β-LAP induces upregulation of the Nrf2-hemeoxygenae-1 (HO-1) signaling pathway molecules in MPTP-injected mouse brains. Western blot and immunohistochemical analyses indicated that β-LAP increased HO-1 expression in glial fibrillary acidic protein-positive astrocytes. Moreover, β-LAP increased the nuclear translocation and DNA binding activity of Nrf2, and the phosphorylation of upstream adenosine monophosphate-activated protein kinase (AMPK). β-LAP also increased the localization of p-AMPK and Nrf2 in astrocytes. Collectively, our data suggest that β-LAP exerts neuroprotective effect in MPTP-injected mice by upregulating the p-AMPK/Nrf2/HO-1 signaling pathways in astrocytes.
Subject(s)
Animals , Mice , 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine , Adenosine , Astrocytes , Blotting, Western , Brain , DNA , Dopaminergic Neurons , Lymphoma, B-Cell , Neurodegenerative Diseases , Neurons , Neuroprotection , Neuroprotective Agents , Parkinson Disease , Pars Compacta , Phosphorylation , Protein Kinases , Rotarod Performance Test , Substantia Nigra , Trees , Tyrosine 3-Monooxygenase , Up-RegulationABSTRACT
BACKGROUND/AIMS: The Gastroesophageal Reflux Disease Questionnaire (GerdQ) has been developed and validated as a tool for the diagnosis of gastroesophageal reflux disease (GERD) in patients with gastrointestinal symptoms. However, the GerdQ and the cutoff value for determining GERD has not been validated in Korea. METHODS: Patients with symptoms suggestive of GERD were consecutively recruited. The Korean version of GerdQ was developed through a forward-backward translation process according to the cross-cultural adaptation method. Endoscopically documented esophagitis, abnormal results on 24-hour ambulatory pH recording with symptom association monitoring, or response to proton pump inhibitor treatment were used as diagnostic references for GERD. The reproducibility and test characteristics of the Korean version of GerdQ were assessed. RESULTS: A total of 149 patients with a median age of 55 years were analyzed. The intra-class correlation coefficient of 2 subsequently measured GerdQ scores was 0.651 (95% CI, 0.518–0.748). The cutoff value of 8 was found to have the highest sensitivity (64.9%; 95% CI, 56.2–73.7) and specificity (71.4%; 95% CI, 56.5–86.4) for the diagnosis of GERD. The questionnaire had a high positive predictive value (88.1%; 95% CI, 81.2–95.0), but a low negative predictive value (38.5%; 95% CI, 26.2–50.3) for GERD. Any symptom improvement on proton pump inhibitor treatment showed a sensitivity of 93.0% (95% CI, 88.3–97.7) and a specificity of 48.6% (95% CI, 32.0–65.1) for GERD. CONCLUSION: The Korean version of GerdQ is a useful complementary tool in the diagnosis of GERD.
Subject(s)
Humans , Diagnosis , Esophagitis , Gastroesophageal Reflux , Hydrogen-Ion Concentration , Korea , Methods , Proton Pumps , Sensitivity and Specificity , Surveys and Questionnaires , Symptom AssessmentABSTRACT
The burden of atherosclerotic cardiovascular disease (ASCVD) remains high worldwide, and its prevalence has increased in Asian countries over the last two decades. The increase in ASCVD may arise from complex interactions between genetic and lifestyle/environmental factors. Abnormal blood cholesterol levels, elevated blood glucose, obesity, elevated blood pressure, smoking, and family history are common risk factors of ASCVD. There is an increased burden of ASCVD in Asian countries, maybe due to rapid economic development and lifestyle changes in these countries. Nutrition is one of the major modifiable risk factors for ASCVD. Despite this, there are insufficient nutritional therapies for prevention and management of ASCVD in Asian patients. There is also a lack of relevant research in Asian populations. In this review, we describe the current nutritional guidelines and the findings from previous landmark studies regarding management and/or prevention of ASCVD. We also summarize the recommendations regarding evidence-based nutrition therapy/management strategies that may be effective in Asian subjects to prevent onset and/or to treat ASCVD.
Subject(s)
Humans , Asian People , Atherosclerosis , Blood Glucose , Blood Pressure , Cardiovascular Diseases , Cholesterol , Economic Development , Life Style , Nutrition Therapy , Obesity , Prevalence , Risk Factors , Smoke , SmokingABSTRACT
BACKGROUND AND OBJECTIVES@#The suppression head impulse (SHIMP) test has emerged as one of the new vestibular function tests. The SHIMP test is an analysis of anti-compensatory saccadic movements in gazing moving targets as the head moves. In this study, we investigated the accuracy and sensitivity of the test.SUBJECTS AND METHOD: We analyzed the results of SHIMP test (gain, amplitude, and latency) in 24 cases, which included normal, vestibular neuritis, benign paroxysmal positional vertigo (BPPV), Meniere's disease, bilateral vestibular function loss, temporal bone fracture, tuberculosis meningitis and acoustic schwannoma patients. We also carried out a physical exam, audiologic study, video electronystagmography (vENG) and a conventional video head impulse test to evaluate the feasibility of SHIMP test in cases of vesitibulopathy.@*RESULTS@#In patients with vestibulopathy, the analysis of SHIMP test indicated high sensitivity and accuracy, which were supported by accompanying audio-vestibular studies. Patients suspected with BPPV, vestibular neuronitis and Meniere's disease showed low vestibulo ocular reflex (VOR) gain and delayed anticompensatory saccade with smaller and more scattered amplitudes than the control. Patients with bilateral vestibular function loss, temporal bone fracture, tuberculosis meningitis, and acoustic schwannoma showed delayed latency, and small amplitude or few anticompensatory saccades. Finally, changes in the SHIMP test values might be a hint that patients had recovered from vestibular neuronitis and tuberculosis meningitis.@*CONCLUSION@#We found the feasibility of SHIMP test in detecting the pathologic condition of VOR in vestibulopathy patients. We argue that the usefulness of SHIMP test might be extended to evaluating the effectiveness of rehabilitation.
ABSTRACT
BACKGROUND AND OBJECTIVES: The suppression head impulse (SHIMP) test has emerged as one of the new vestibular function tests. The SHIMP test is an analysis of anti-compensatory saccadic movements in gazing moving targets as the head moves. In this study, we investigated the accuracy and sensitivity of the test. SUBJECTS AND METHOD: We analyzed the results of SHIMP test (gain, amplitude, and latency) in 24 cases, which included normal, vestibular neuritis, benign paroxysmal positional vertigo (BPPV), Meniere's disease, bilateral vestibular function loss, temporal bone fracture, tuberculosis meningitis and acoustic schwannoma patients. We also carried out a physical exam, audiologic study, video electronystagmography (vENG) and a conventional video head impulse test to evaluate the feasibility of SHIMP test in cases of vesitibulopathy. RESULTS: In patients with vestibulopathy, the analysis of SHIMP test indicated high sensitivity and accuracy, which were supported by accompanying audio-vestibular studies. Patients suspected with BPPV, vestibular neuronitis and Meniere's disease showed low vestibulo ocular reflex (VOR) gain and delayed anticompensatory saccade with smaller and more scattered amplitudes than the control. Patients with bilateral vestibular function loss, temporal bone fracture, tuberculosis meningitis, and acoustic schwannoma showed delayed latency, and small amplitude or few anticompensatory saccades. Finally, changes in the SHIMP test values might be a hint that patients had recovered from vestibular neuronitis and tuberculosis meningitis. CONCLUSION: We found the feasibility of SHIMP test in detecting the pathologic condition of VOR in vestibulopathy patients. We argue that the usefulness of SHIMP test might be extended to evaluating the effectiveness of rehabilitation.
Subject(s)
Humans , Benign Paroxysmal Positional Vertigo , Electronystagmography , Head Impulse Test , Head , Meniere Disease , Methods , Neuroma, Acoustic , Reflex, Vestibulo-Ocular , Rehabilitation , Saccades , Temporal Bone , Tuberculosis, Meningeal , Vestibular Function Tests , Vestibular NeuronitisABSTRACT
The dietary behavior of immigrants starts changing upon their arrival in a new country. We evaluated changes in dietary quality of Vietnamese women immigrants in Korea and compared dietary quality with that of Korean women. Fifty-six Vietnamese women immigrants and 56 age-matched Korean women were recruited. Dietary quality were assessed using index of nutritional quality (INQ) and diet quality index-international (DQI-I). Dietary habits were assessed according to 4 dietary behaviors: a prudent, calorie control, dietary fat control, and sodium or salt control diet. DQI-I scores of Vietnamese immigrants decreased after immigration, especially the moderation score, although the variety score increased. Scores were significantly lower than those of Korean subjects (45.1 vs. 64.5; p < 0.001). Vietnamese women immigrants had significantly poorer nutrient balance and calorie intake control, although their fat and sodium control was better than that of Korean woman (p < 0.001). INQs of protein, niacin, phosphorus, iron, zinc were lower in immigrants who had lived longer in Korea than more recent immigrants (p < 0.05). Lower INQs of protein, fiber, vitamin A, B1, B6, C, folate, and phosphorus were related to higher body fat in Vietnamese immigrants (p < 0.05). In conclusion, dietary quality of Vietnamese immigrants decreased after migration, and dietary intake was inadequate compared with that of Korean women. In addition, diet quality of Vietnamese immigrants decreased with length of residence in Korea. There was a negative correlation between diet quality and body fat percent in Vietnamese women immigrants. Findings from this study may help improve diet quality and prevent obesity in Vietnam women immigrants.