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Use of Parabolic Flight for the Research of Aerospace Biomedicine
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Young Hyo Kim, Joo Hee Lee, Chang Kyung Ryoo, Hyun Ji Kim, Kyu Sung Kim
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Res Vestib Sci. 2015;14(2):42-45.
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- As it is difficult to perform biological study in the actual space, several researchers
have tried to develop methods that could ‘mimic’ microgravity condition
on Earth. During the free fall of the aircraft, so-called ‘parabolic flight’, objects
in a plane could experience weightlessness during a short period of time (approximately
20 to 30 seconds). We first reviewed former studies using parabolic flight
in a variety of research filed including vestibular, neurologic, cardiovascular, musculoskeletal
and immune system. We also investigated the actual conditions of
biologic research using parabolic flight in Korea, by performing a questionnaire
survey for 19 experts in space biology.
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Tullio Phenomenon Following Spontaneous Intralabyrinthine Gross Hemorrhage
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Jae Won Choi, Jong Jun Kim, Young Hyo Kim, Hyun Woo Lim
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Res Vestib Sci. 2013;12(4):140-144.
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- Tullio phenomenon is a pattern of sound induced unsteadiness, imbalance or vertigo, associated with disturbances of oculomotor and postural control. As a possible cause of sudden sensorineural hearing loss, intralabyrinthine gross hemorrhage has been reported in subjects with bleeding tendency. We report a case of spontaneous intralabyrinthine hemorrhage followed by presentation of Tullio phenomenon. A 35-year-old man presented with sudden left side hearing loss and vertigo. Audiometry results indicated left total deafness and magnetic resonance images revealed left intralabyrinthine hemorrhage. At 1 month after hearing loss, sound and pressure-induced vertigo and disequilibrium newly developed. Follow-up images indicated signs of fibrosis in the left labyrinth and nystagmography results showed induction of nystagmus according to the stapedial reflex. This case suggests possibility of Tullio phenomenon in sudden sensorineural hearing loss patients.
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Clinical Characteristics of Pediatric Dizziness
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Jae Eun Kim, Kyu Sung Kim, Young Hyo Kim, Jeong Seok Choi, Hoseok Choi
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Res Vestib Sci. 2011;10(3):88-91.
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- Background and Objectives: Pediatric dizziness is difficult to diagnose because of the nonspecific nature of symptom, and difficulty in history taking, physical examination or diagnostic tests. The authors tried to analyze the proportion of diseases in children suffering from dizziness, and introduce cases with atypical clinical characteristics and uncommon diagnosis. Materials and Methods: The medical records of 53 pediatric patients suffering from dizziness were analyzed retrospectively. We analyzed the findings of history taking, physical examination for nystagmus and cerebellar function, pure tone audiogram and caloric tests in all patients. Results: Diagnosis of migrainous vertigo was most common (32.7%), followed by psychological cause (11.5%) and labyrinthitis due to the otitis media (7.7%). Cases of cerebellar hemangioblastoma, neurofibromatosis and drug intoxication were also found. Conclusion: The clinical characteristics and causative diseases of pediatric dizziness are different from those of adults. Appropriate history taking and diagnostic tests are improtant for differential diagnosis.
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A Case of Tumarkin Otolithic Crisis: Failed to Treat with Intratympanic Gentamicin Injection
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Young Hyo Kim, Hoseok Choi, Kyu Sung Kim, Young Mo Kim
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Res Vestib Sci. 2010;9(2):76-79.
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- Tumarkin otolithic crisis is an unusual manifestation of Meniere’s disease that shows sudden falling without loss of consciousness. As a kind of life-threatening otologic emergency due to high risk of injury, the surgical ablation therapy rather than the medical one is preferred. Intratympanic injection of gentamicin (ITIG) is being introduced as a treatment by chemical ablation of vestibular function. The authors report a case of life-threatening Tumarkin otolithic crisis in 76-year-old female, after onset of Meniere’s disease, failed to treat with multiple application of ITIG, and successfully eradicated the symptom with total labyrinthectomy after then. Also we introduce her clinical feature of Tumarkin otolithic crisis. A 76-year-old female visited clinic suffering from recurrent rotatory vertigo accompanied with fluctuating hearing loss and tinnitus on her left ear, and diagnosis of Meniere’s disease was made. Four months after medical treatment, the patient experienced sudden drop attack during walking on the street without any prodromes, and her right wrist and skull base were fractured as a result. She denied to got surgery and ITIG was applied. During 1 year after initial drop attack, she experienced 7 times of severe drop attack and 4 times of ITIG, and finally she accepted to get surgery. The patient no longer suffered from drop attack after total labyrinthectomy later. Tumarkin otolithic crisis is an otologic emergency, may cause life-threatening falling. Our experience from this case is that vestibular ablation by surgical method is needed for safety and quality of life of patients.
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Assessment of Saccular Function in Patients With Noise Induced Hearing Loss
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In Kuk Hwang, Ji Hyun Moon, Young Hyo Kim, Kyu Sung Kim, Yun Gun Jung, Hoseok Choi
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J Korean Bal Soc. 2008;7(1):17-21.
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- Background and Objectives: Considering saccular receptors are coupled physically with the auditory receptors, VEMP test may provide the information that in the noise induced hearing loss with or without dizziness, damage to the vestibular system, especially saccule is a potential organ with cochlear damage.
Material and Methods: 11 patients (22 ears) with HF-SNHL greater than 55dB and 10 patients (10 ears) with sudden hearing loss of varying degree HL as positive control but without clinical manifestations of vestibular pathology tested for vestibular function test was enrolled. VEMP test was done. The results were compared with those of 9-healthy referents (18 ears) examined in the same way.
Results: VEMP wave was significantly abolished as twelve of 22 (54.5%) with HF-SNHL, five of 13 (38.5%) and Control group (100%). Though there was no statistically significant relation with P13, N23 latency delay in each group, NIHL showed P13, N23 latency delay trend compared with controls.
Conclusions: Patients with noise induced hearing loss showed significantly more saccular deterioration, estimated as negative VEMP responses than did the controls. This suggests subclinical disturbances of the vestibular system especially of the saccule in noise induced hearing loss.
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Cerebellopontine Metastatic Carcinoma of Small Cell Lung Cancer Mimiking Vestibular Neuritis
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Young Hyo Kim, Kyu Sung Kim, Yoon Seok Oh, Hoseok Choi
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J Korean Bal Soc. 2007;6(2):226-229.
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- A 77-year-old man visited our department because of dizziness from one month ago. Dizziness was continuous and non-whirling and this type of dizziness was the first time. He also complained of tinnitus and hearing impairment of the right ear. On physical examination, he showed spontaneous left-beating horizontal and torsional nystagmus and rightward head thrust was positive. He was admitted under the first impression of right vestibular neuritis.
On inner ear MRI, there was a well-demarcated 2.5×2.3 cm sized mass of right cerebellopontine angle. This mass showed somewhat low signal intensity in both T1 and T2-weighted image and modest enhancement with Gadolinum.
And approximately 4.5×3 cm sized mass could be seen in the simple chest roentgenogram.
On chest CT, there was a poorly demarcated 3×2.5 cm sized mass in left lower lobe of lung. The patient was diagnosed as small cell lung cancer with brain metastasis by Per-Cutaneous Needle Aspiration of lung. In spite of radiotherapy and concurrent chemotherapy, he expired after 5 months.
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Comparative Analysis of Vestibular Asymmetry Parameters in Acute Unilateral Peripheral Vestibulopathy
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Hoseok Choi, Kyu Sung Kim, Young Hyo Kim, In Kuk Hwang, Seung Yeon Jang, Seung Chul Lee
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J Korean Bal Soc. 2007;6(2):202-206.
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- Background and Objectives: There are known parameters that indicate vestibular asymmetry, such as directional preponderance (DP) on caloric test, asymmetry on slow harmonic acceleration (SHA) test, asymmetry of time constant (Tc) and slow cumulative eye position (SCEP) on velocity step test. Aim of this study is investigate the sensitivity and predictability of the vestibular asymmetry parameters among them.
Materials & Methods: Twenty six patients who were diagnosed as acute unilateral peripheral vestibulopathy were enrolled in this study. We compared each parameter with site of lesion based on the direction of spontaneous nystagmus and canal paresis (CP) which were totally correlated in this group of patients.
Results: Positive predictability of each parameter showed 58% in DP, 62% in SHA asymmetry, 62% in SCEP, 38% in Tc. In the cases that each parameter showed positive result, all of DP and SHA asymmetry indicated site of lesion, and showed high correlation coefficient(r=0.89). But in 27% of SCEP and 23% of Tc did not indicate site of lesion.
Conclusion: All parameters showed low sensitivity for identifying laterality of lesion even the tests were performed with in one week after vertigo attack. DP and VOR asymmetry showed high positive predictability for indicating lesion site.
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