Application of cold intolerance symptom severity questionnaire among vibration-exposed workers as a screening tool for the early detection of hand-arm vibration syndrome: a cross-sectional study

BACKGROUND: The detection rate of hand-arm vibration syndrome (HAVS) is very low in South Korea compared with other countries. The absence of uniform consensus and guidelines for diagnosing HAVS has been presumed to be one of the reasons. The HAVS has various manifestations including cold intolerance and its severity can be measured using the cold intolerance symptom severity (CISS) questionnaire. This study aimed to determine whether the CISS questionnaire, being used as a screening tool, can aid in the early detection of HAVS. METHODS: A total of 76 male workers with vibration-induced symptoms were enrolled as the final study participants. To compare the CISS score of healthy individuals, 41 men who had never been exposed to local vibration were included in the study. In addition to the former medical questionnaire, the participants answered the CISS questionnaire. A statistical analysis was conducted to identify the association of CISS scores with vibration induced symptom and to determine its cut off value. RESULTS: The reliability of the CISS questionnaire was proven to be good, with a total Cronbach's alpha of 0.922. The mean CISS score of the exposed group increased in every vascular stage [stage 0 = 42.6 (18.5); stage 1 = 59.4 (14.1); and over stage 2 = 60.2 (21.6)]. They were significantly higher than that of the non-exposed group. The result was fairly consistent with those in the sensorineural stage. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of 30 were 88.5, 65.3, 76.1, 82.1 and 0.769, respectively. From the result of logistic regression, the adjusted odds ratio of both components increased by the CISS score grouped by 30s. CONCLUSIONS: The self-reported CISS questionnaire, used to measure the degree of cold intolerance, showed high agreement with the Stockholm classification of HAVS. Hence, we recommend the use of this questionnaire to assess the level of cold intolerance among vibration-exposed workers and detect individuals who are at risk of vibration-induced impairment with a cutoff value of 30. TRIAL REGISTRATION: IRB No. 2018–07–040-001. Registered on 4 September 2018.

Psychometric Properties of the Coping Inventory for Stressful Situations in Korean Adults

OBJECTIVE: The Coping Inventory for Stressful Situations (CISS) is a globally recognized measure of stress coping methods. However, research into the applicability of the CISS in a Korean context is still in its infancy. The aim of this study is to assess and report the validity of the CISS in Korean adults for the first time. METHODS: Three hundred and two Korean adults who currently have no distressing problems requiring psychiatric treatment completed the Korean version of the CISS. Principal component analysis was used to extract factors in the process of exploratory factor analysis. RESULTS: The result displayed a clear pattern matrix, and a high level of internal consistency was shown by Chronbach's alpha. The items classified under task-oriented and emotion-oriented coping presented adequate factorial validity, and only three items grouped under avoidance-oriented coping loaded poorly or loaded onto factors differing from the original. CONCLUSION: These results seem to indicate that the CISS may indeed be both applicable and useful in gauging the coping styles of Korean adults. However, the ambiguous meanings of certain items under avoidance-oriented coping would require adjustment for the purposes of future study.

The analysis of risk factors and subtypes with CISS classification of minor stroke / 中国神经精神疾病杂志

Objective To investigate the features of risk factors of minor stroke with CISS classification in Guangdong Province. Methods We retrospectively investigated the patients admitted within 3 days of the occurrence of a minor stroke, and were classified by CISS criteria as large artery atherosclerosis (LAA), cardiogenic stroke (CS), penetrating artery disease (PAD), other etiology (OE), undetermined etiology (UE). Results In this study, 303 pa-tients met the inclusion criteria of minor stroke. The highest percentage of the risk factors included hypertension (72.3%), hyperlipidemia (58.3%), and diabetes mellitus (39.9%). Among different subtypes, 41.9% were diagnosed with LAA, and 50.8% with PAD. Plasma triglyceride (TG)(1.765 ±1.18)mg/L vs.(2.19 ±1.84)mg/L,P=0.03], apolipoproteinsB (ApoB) [(0.95±0.29)mg/L vs.(1.11±0.46)mg/L,P=0.009]C-reactive protein (CRP) [(6.63±11.30) mg/L vs.(3.42 ±5.02)mg/L,P=0.042] and ApoB/ApoA1 ratio [(0.754 ±0.25)mg/L vs.(0.875 ±0.49)mg/L,P=0.019], differed significantly between group LAA and PAD. Conclusion Hypertension, hyperlipidemia and diabetes mellitus are the major risk factors of minor stroke. The most common subtypes of the minor stroke patients in Guangdong Province are LAA and PAD, and detecting their TG, apoB, CRP level and apoB/apoA1 ratio might help subclassify minor stroke according to CISS.

Congenital Inner Ear Malformation: Three Dimensional Volume Rendering Image Using MR CISS Sequence

PURPOSE: To evaluate three-dimensional volume-rendering of congenital inner-ear malfornations using the MR CISS (Constructive Interference in Steady State) sequence. MATERIALS AND METHODS: MR CISS images of 30 inner ears of 15 patients (M:F=10:5; mean age, 6.5years) in whom inner-ear malfornation was suspected were obtained using a superconducting Magnetom Vision System (Simens, Erlangen, Germany), with TR/TE/FA parameters of 12.25 ms/5.9 ms/70 degree. The images obtained were processed by means of the volume rendering technique at an advanced workstation (Voxtol 3.0.0; GE Systems, advanced workstation, volume analysis). The cochlea and three semicircular canals were morphologically evaluated. RESULTS: Volume-rendered images of 25 inner ears of 13 patients demonstrated cochlear anomalies in the form of incomplete partition (n=18), hypoplasia (n=2), and severe hypoplasia (n=5). For the superior semicircular canal, findings were normal in 15 ears, though common crus aplasia (n=6), hypoplasia (n=4), aplasia (n=3), and a short and broad shape (n=2) were also observed. The posterior semicircular canal of 13 ears was normal, but common crus aplasia (n=6), a short and broad shape (n=5), aplasia (n=4), hypoplasia (n=3) were also identified. Twelve lateral semicircular canals, were normal, but other images depicted a short and broad shape (n=7), a dilated crus (n=5), a broad shape (n=4), and aplasia (n=2). In 14 patients the anomalies were bilateral, and in seven, the same anomalies affected both ears. CONCLUSION: Three-dimensional volume rendering images of the inner ear depicted various morphological abnormalities of the cochlea and semicircular canals. At that locations, anomalies were more complicated and varied than in the cochlea. Three-dimensional volume rendering imaging using the MR CISS technique provides anatomical information regarding the membranous labyrinth, and we consider this useful in the evaluation of congenital inner ear malformations.

Diagnostic Usefulness of CISS Image in Preoperative Evaluation of Trigeminal Neuralgia and Hemifacial Spasm

OBJECTIVES: Trigeminal neuralgia and hemifacial spasm are caused by vascular compression of the REZ(root entry or exit zone) of the 5th and the 7th cranial nerve. Preoperative detection of neurovascular compression is essential for accurate diagnosis, appropriate treatment, and the good operative results. Three dimensional Fourier Transformation-Constructive Interference in Steady State(3DFT-CISS) images are known to give good contrast between CSF, nerve, and vessels. We applied a 3DFT-CISS imaging technique for the preoperative evaluation of patients with these diseases and estimated the diagnostic accuracy and usefulness of this study. METHODS: A series of 71 patients with trigeminal neuralgia and hemifacial spasm were treated by microvascular decompression. Among them 34 patients with trigeminal neuralgia and 24 patients with hemifacial spasm had preoperative CISS images. We compared the radiologic finding with the operative finding, and analysed the diagnostic usefulness of 3DFT-CISS imaging. RESULTS: The sensitivity of CISS images of detecting the neurovascular compression was 90.3% in trigeminal neuralgia and 100% in hemifacial spasm. There were one false-positive and three false-negative cases in trigeminal neuralgia, and one false-positive case in hemifacial spasm. The accuracy in diagnosing the causative vessel was 73.5% in trigeminal neuralgia and 83.3% in hemifacial spasm. CONCLUSION: CISS image is very useful diagnostic tool for preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia and hemifacial spasm. No additional neuroradiologic examination other than CISS image and MRA is needed for preoperative evaluation of patients with trigeminal neuralgia and hemifacial spasm.

Validity Assessment of the CISS(Coping Inventory for Stressful Situation) in Korean High School Students / 신경정신의학

OBJECTIVES: CISS(Coping Inventory for Stressful Situation) is one of the measures to access the coping dimension with dispositional approach. Consisting of three subscales (i.e., task-focused, emotion-focused and avoidance-focused coping), CISS has 48 items and each subscales has 16 items. We undertook an investigation of the psychometric properties of the CISS in Korean highschool students to determine the extent to which this measure was generalizable to non-western populations. METHODS: The duration of the survey was from 1st of May to 30th of June, 1997. The subjects were 300 of 2nd grade students from 6 highschools in Seoul. Exploratory factor analysis was performed, and reliability, correlations and mean difference were estimated. RESULTS: Comparison of the factor loading patterns in our sample with published factor loading of the CISS confirmed that our loading patterns replicated established task-focused, emotion-focused and avoidance-focused coping constructs. However, 9 out of the 48 items were problematic. Of the avoidance-focused subscale, 4 items had unclear results, and of the emotion-focused subscales, 5 items had unclear results. Internal coefficients of the three subscales of the CISS range from 0.82-0.90 for male and female students. In intercorrelations among subscales, independence among factors was found in female students, but independence among subscales was not found in male students. CONCLUSION: Our results were equivocal in suggesting the cross-cultural stability ofthe structure of the CISS. We identified three underlying factors that replicated the established structure of the CISS in North America. However, instances of cross-loading among items and significant intercorrelations between factors suggest that these constructs may not constitute the mutually independent measures. Conceptualization of coping can be affected by theinfluence of cultural practices and preferences. The implication of the results is that Korean students in this sample did not consistently distinguish uniquely among the specificdimensions of coping as measured by the CISS in North America. We may have experienced more difficulties in replicating the factor structures of more abstract domains than concrete constructs due to the nuance of translation.

Three Dimensional Fourier Transformation Constructive Interferencein Steady State Magnetic Resonance Imaging (3DFT-CISS MRI) ofthe Inner Ear in Patients with Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Three dimensional fourier transformation constructive interference in steady state magnetic resonance imaging (3DFT-CISS MRI) allows fast and precise imaging of the inner ear structures and provides excellent cerebrospinal fluid-nerve contrast within the internal auditory canal and cerebellopontine angle. This study was performed to delineate the inner ear structure in patients with sensorineural hearing loss (SNHL) using 3DFT-CISS MRI and to evaluate the correlation between structural abnormality and clinical symptoms of the affected ear. MATERIALS AND METHODS: Fourteen patients with sensorineural hearing loss were studied using 3DFT CISS axial and coronal MRI scans of both ears. We observed the visualization of the inner ear structures and measured them individually. The radiological measurements were analyzed to compare the findings in non-affected ears with those in affected ears of SNHL patients. In addition, the onset of symptoms was also evaluated for any relationship to their MR findings. RESULTS: The inner ear structures including cochlea, semicircular canal, vestibule, and cranial nerve VII, VIII were precisely visualized. There was statistically no difference in the measurements of the inner ear structures between affected and non-affected ears in patients with sudden SNHL. However, statistically significant differences in the width and height of the vestibule were observed in the affected ears between sudden SNHL and idiopathic chronic SNHL. CONCLUSION: 3DFT-CISS MRI allows detailed study of the normal and pathologic inner ears. Therefore, this MR technique can be a useful method as a routine protocol in the study of the inner ear diseases.

Useful of Three-dimensional Magnetic Rsonance Angiography and Constructive Interference in Steady State(CISS) Sequences in Patients with Hemifacial Spasm

We prospectively studied 100 patients to assess the usefulness of three-dimensional(3D) magnetic resonance(MR) angiography and constructive interference in steady state(CISS) sequences in patients with hemifacial spasm. Hemifacial spasm caused by tumors in the cerebellopontine angle was not included. 3D-short range MR angiography was performed in 50 patients, using FISP sequence. Compressive vessels were predicted in all 50 patients: anterior inferior cerebellar artery(AICA) in 23 cases, posterior inferior cerebellar artery(PICA) in 17 cases, vertebral artery(VA) and PICA in 5 cases, AICA and PICA in 3cases, VA in 1case, AICA and VA in 1case. In operative findings, offending vessels were identified in all cases : AICA in 22 cases, PICA in 17 cases, VA and PICA in 7 cases, AICA and PICA in 3 cases, VA & AICA in 1 case. Related degree of 3D-short range MR angiographic and operative findings was complete matching in 47(94.0%) cases, partial matching 2(4.0%) cases, and miss-matching 1(2.0%) case. MRI using CISS sequence was also performed in 50 patients. With this method, compressive vessels were also predicted in all 50 patients : AICA in 15 cases, PICA in 8 cases, VA in 6 cases, VA and PICA in 4 cases, AICA and PICA in 3 cases, VA and AICA in 2 cases. But, unknown compressive vessels were 12cases. In operative findings, vascular contact with the facial nerve root-exit zone(REZ) was present in all 50 cases. The vessels responsible were AICA in 20 cases, PICA in 14 cases, VA and PICA in 8 cases, VA in 3 cases, VA and AICA in 3 cases, AICA and PICA in 2 cases. Related degree of CISS images and operative findings was complete matching in 32(64.0%) cases, partial matching 5(10.0%) cases, and miss-matching 13(26.0%) cases. In conclusion, 3D-short range MR angiography and CISS are excellent and very useful for the preoperative evaluation of patients with hemifacial spasm, detection of not only the cause of hemifacial spasm but also identification of the compressive vessels and the relationship between compressive vessels and facial nerve REZ