• 제목/요약/키워드: Visual Dysfunction

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Cognitive dysfunctions in individuals with diabetes mellitus

  • Kim, Hye-Geum
    • Journal of Yeungnam Medical Science
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    • 제36권3호
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    • pp.183-191
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    • 2019
  • Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer's disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.

Technical Considerations to Prevent Postoperative Endocrine Dysfunction after the Fenestration of Suprasellar Arachnoid Cyst

  • Choi, Ki-Young;Jung, Shin;Kang, Sam-Suk;Kim, In-Young;Jung, Tae-Young;Jang, Woo-Yeol
    • Journal of Korean Neurosurgical Society
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    • 제49권5호
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    • pp.262-266
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    • 2011
  • Objective : The endocrine dysfunction after the operation for suprasellar arachnoid cysts is not rare. The careful operation to prevent structures can prevent this complication, but it is not enough and effective to prevent it. Authors present technical surgical considerations to prevent this complication with a review of our suprasellar arachnoid cyst patients who had postoperative endocrine dysfunction. Methods : From January 2002 to December 2009, eight patients who had suprasellar arachnoid cysts with visual impairment underwent surgery. The mean age was 57.1 years (range, 33-77). Preoperatively, their endocrine function was clinically normal, and laboratory hormonal levels were within normal ranges. Cyst fenestration was performed by craniotomy (n=6) or by a neuro-endoscopic procedure (n=2), and, simultaneously, along with a cyst wall biopsy. Results : The surgery was uneventful in all eight patients, and there were no neurological morbidities. However, in four patients, endocrine dysfunction occurred postoperatively. We compared these four patients (group A) to the other 4 patients without endocrine dysfunction (group B) with intraoperative findings and with the histopathological findings of the cyst wall biopsy. The group A patients had more abundant vasculature on the cystic wall than the group B patients according to both the intraoperative findings and the histopathological findings. Conclusion : When performing a surgical cyst wall fenestration, surgeons should try to minimize the destruction of the cystic wall vasculature and not to make the fenestration at a site that contains many vascular striae.

Auditory and Visual P300 in ADHD Children with Higher and Lower IQ : Pilot Study

  • Wang, Sheng-Min;Jeon, Yang-Whan;Han, Sang-Ick;Park, E-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권4호
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    • pp.211-218
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    • 2011
  • Objectives : Intellectual impairment in children with attention-deficit hyperactivity disorder (ADHD) is often associated with relatively severe cognitive dysfunction. This study was designed to investigate cognitive function using auditory and visual event-related potential P300 in children with ADHD with relatively higher and lower IQ. Methods : A total of 20 children aged 6-12 years with DSM-IV-TR diagnosis of ADHD-combined type were recruited. For 10 children with lower IQ (${\leq}$100) and 10 children with higher IQ (>100), auditory and visual P300 using oddball paradigm (target 0.2, standard 0.8, in probability) were employed. Results : No significant differences were found in P300 amplitude and latency between ADHD children with higher and lower IQ in both modalities. However, auditory P300 amplitude in the right parietal area (P8 electrode) was negatively correlated with verbal IQ in ADHD subjects (R=-.50, p<.05). Visual P300 amplitude in the left parietal area (P3 electrode) was positively correlated with performance IQ in ADHD subjects (R=.57, p<.01). Conclusion : This study suggests intellectual impairment, as evidenced by lower IQ, could not be associated with cognitive dysfunction reflected in event-related potential P300 in ADHD children. However, cognitive function reflected in intellectual subcomponents and P300 might be processed in a stimulus modality-specific and asymmetric pattern.

Risk of falls in community-dwelling older adults aged 65 or over with type 2 diabetes mellitus: a systematic review

  • Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • 제7권3호
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    • pp.139-145
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    • 2018
  • Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.

고령자의 우울증 정도와 선호 색채 적용 이미지의 선호도 분석 - 거실 공간을 중심으로 - (The Preference of Geriatric Depression Scale and the Images Applied to Preferable Color of the Elderly - Focused on the Living room -)

  • 박성준
    • 한국실내디자인학회논문집
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    • 제25권2호
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    • pp.13-20
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    • 2016
  • Recently, the concern of aging society is 'Healthy life' for the elderly and pre-elderly. Especially, realizing the 'Healthy life', it is very important for the elderly to establish living environment for holding and maintaining mental depression. Mental depression is related to dysfunction of sensory organ included physical functions. Therefore, the dysfunction of elderly's sensory organ is required to the guideline of environmental planning. In this study, among five senses, I focused visual sense due to the large proportion of environmental perception. The purpose of this study is to analyze the degree of geriatric depression and preference of simulated images applying preferable color for the elderly. This study conducted literature review and questionnaire survey. Firstly, the previous studies related with the melancholy, sense of isolation, self-regard for the elderly analyzed. Secondly, the questionnaire tool measuring the degree of geriatric depression developed. Thirdly, the tool investigating the preference for the simulated images applied main, sub, and accent colors produced. Applied preferable colors were used from the results previous study. Lastly, based on the result, the basic data of color planning were suggested. It was judged that this study is an useful as the basic guideline of color planning for the elderly's residential spaces and the potential value of considering geriatric depression and the color planning in terms of the elderly's visual sense.

자가 등 가동운동이 어깨 통증 및 기능에 미치는 효과 (The Effect of Self Thoracic Mobilization Exercise on Shoulder Pain and Function)

  • 이은상
    • 한국산학기술학회논문지
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    • 제21권2호
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    • pp.396-403
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    • 2020
  • 본 연구는 자가등 가동운동(STME, Self Thoracic Mobilization Exercise)이 어깨 기능장애 환자에게 어깨통증과 장애정도, 어깨의 기능에 미치는 영향을 알아보고자 하였다. 어깨 기능장애 환자 32명을 대상으로 무작위로 STME와 대조군으로 할당하였으며, 시각 상사척도와 어깨기능장애, 어깨의 가동범위 평가를 중재 전-후 실시하였다. 16명의 STME 중재 그룹은 폼롤러를 활용하는 방법과 네발자세에서 이용하여 굽힘, 폄을 자가로 실시하였고, 16명의 대조군은 전기치료 패드를 이용한 플라세보 효과를 활용하였다. 두 집단은 20분 동안 주당 3회를 4주간 실시하였다. STME군이 대조군 보다 통증과 기능장애에서 모두 유의한 향상을 보였으며(p<0.05), 어깨의 가동범위는 STME을 이용한 그룹이 플라세보 그룹 보다 굽힘, 벌림, 가쪽 돌림에서 유의한 효과를 보였다(p<0.05), 하지만 폄과 안쪽돌림에는 유의한 효과를 보이지 못했다(p>0.05). 따라서 STME은 어깨통증과 기능장애 해결에 효과적이며, 향후 어깨 통증 환자에게 보다 쉬운 접근방법의 중재방법을 교육하고 효과적인 치료를 할 수 있을 것이다. 나아가 사회적 치료비용 또한 경감시킬 수 있을 것이다.

Long-term Results of Stellate Ganglion Block in Patients with Olfactory Dysfunction

  • Moon, Ho Sik;Chon, Jin Young;Lee, Sang Hoon;Ju, Yu Mi;Sung, Choon Ho
    • The Korean Journal of Pain
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    • 제26권1호
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    • pp.57-61
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    • 2013
  • Background: Olfactory dysfunction, including anosmia and hyposmia is difficult to treat. Although the mechanism is not well known, stellate ganglion block (SGB) is used to treat olfactory dysfunction. There are no prior studies on the long-term effects of SGB on olfactory dysfunction. The purpose of this study was to evaluate the continuity of therapeutic effects and patient satisfaction with SGB treatment. Methods: This was a follow-up study carried out via a telephonic survey. The olfactory function of the patient was evaluated using a visual analog scale (VAS). We checked VAS three times: VAS-I (pre-treatment VAS), VAS-A (post-treatment VAS), and VAS-C (VAS at follow up telephone survey). We divided the subjects into 2 groups according to their responsiveness to SGB: the responsive (R group) and the unresponsive groups (UR group). Patient satisfaction was evaluated using a Likert scale. Results: Out of the 40 subjects, 37 responded to the telephone survey. In the UR group, there was difference in the olfactory function. However, in the R group, there were significant VAS differences; VAS-I was $9.6{\pm}0.7$, VAS-A was $5.1{\pm}4.2$, and VAS-C was $2.7{\pm}$2.7 (P < 0.05). On the Likert scale, patient satisfaction was as follows: grade 1, 17 patients (45.9%); grade 2, 6 patients (16.2%); grade 3, 6 patients (16.2%); and grade 4, 8 patients (21.6%). Conclusions: SGB is a safe, long-lasting, and effective therapeutic modality for olfactory dysfunction treatment.

한방병원에 입원한 배뇨장애를 동반한 추간판탈출증 환자에 대한 한방 치료 1례 (Case Report of Voiding Dysfunction Treated with Korean Medicine in a Hospitalized Patient with a Herniated Intervertebral Disc)

  • 공건식;송진영;김소원;박진훈;왕연민;김상윤;박성환;강만호;엄국현;이형철
    • 대한한방내과학회지
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    • 제42권2호
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    • pp.86-94
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    • 2021
  • Objectives: The purpose of this study is to report on the efficacy of Korean medical treatment for voiding dysfunction. Methods: We treated a patient with voiding dysfunction using Korean medical treatments (herbal medicines, acupuncture, and herbal acupuncture therapy). To evaluate the results of this treatment, we measured the international prostate symptom score (IPSS) and the visual analog scale (VAS) for residual urination, dysuria, and miction pain. The general health status was evaluated with the European quality of life-5 dimensions (EQ-5d) scale. Results: We observed improvements in the IPSS and the EQ-5d scale after the treatments. Changes in the VAS reflected relief of residual urination and dysuria but not miction pain. Conclusions: This study suggests that Korean medicine may be effective to treat voiding dysfunction.

Effects of Horse Riding Simulator on Pain, Oswestry Disability Index and Balance in Adults with Nonspecific Chronic Low Back Pain

  • Chen, Shu-Yi;Kim, Seung-Kyu;Kim, Ki-Hyun;Lee, In-Sil;HwangBo, Gak
    • 대한물리의학회지
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    • 제11권4호
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    • pp.79-84
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    • 2016
  • PURPOSE: The purpose of this study was to investigate effects of Horse riding simulator exercise on pain, dysfunction and dynamic balance in adults with nonspecific chronic low back pain. METHODS: In this study, total 19 college students usually complain of low back pain who were randomly divided into the horse riding simulator exercise group (n=10), lumbar strengthening exercise group (n=9) were recruited. Each group carried out for 30 minutes exercise three times a week for 4 weeks. Horse riding simulator exercise group carried out 15 minutes horse riding simulator exercise and 15 minutes lumbar strengthening exercise. Lumbar strengthening exercise group carried out 30 minutes lumbar strengthening exercise. Visual analogue scale (VAS) were measured for evaluation back pain. Korean oswestry disability index (KODI) were measured for dysfunction. Limits of stability (LOS) were measured for dynamic balance. RESULTS: VAS, KODI, LOS results showed a significant change within both horse riding simulator exercise group, lumbar strengthening exercise group. CONCLUSION: Present study suggested that the horse riding simulator exercise can improve back pain, dysfunction, dynamic balance. Horse riding simulator exercise provides more convenience, interest and motivation than conversional therapy and it could be a possible approach to adults with nonspecific chronic low back pain.

Spinal Cord Stimulation for Intractable Visceral Pain Due to Sphincter of Oddi Dysfunction

  • Lee, Kang Hun;Lee, Sang Eun;Jung, Jae Wook;Jeon, Sang Yoon
    • The Korean Journal of Pain
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    • 제28권1호
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    • pp.57-60
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    • 2015
  • Sphincter of Oddi dysfunction (SOD) is a syndrome of chronic biliary pain or recurrent pancreatitis due to the functional obstruction of the pancreaticobiliary flow. We report a case of spinal cord stimulation (SCS) for chronic abdominal pain due to SOD. The patient had a history of cholecystectomy and had suffered from chronic right upper quadrant abdominal pain. The patient had been diagnosed as having SOD. The patient was treated with opioid analgesics and nerve blocks, including a splanchnic nerve block. However, two years later, the pain became intractable. We implanted percutaneous SCS at the T5-7 level for this patient. Visual analog scale (VAS) scores for pain and the amount of opioid intake decreased. The patient was tracked for more than six months without significant complications. From our clinical case, SCS is an effective and alternative treatment option for SOD. Further studies and long-term follow-up are necessary to understand the effectiveness and the limitations of SCS on SOD.