Assessment of Post-stroke Unilateral Neglect Using 3-Dimensional Virtual Reality Program

OBJECTIVE: To investigate the clinical usefulness of newly developed 3-dimensional virtual reality (VR) program to assess the unilateral neglect. METHOD: Sixteen unilateral neglect patients and forty healthy subjects were included in this study. Forty healthy subjects were classified into two groups (control group I, II) based on the previous computer experience. This VR program was composed of two sessions, the first session was to search the midpoint of the monitor and the second session was to scan the randomized target movement. Head-mounted display and 3-dimensional position sensor were used during VR program. The unilateral neglect patients performed the line bisection test and the letter cancellation test. The correlations of the clinical measurements and the parameters of the 3-dimensional VR program were analyzed. RESULTS: All parameters of the VR program in patient group were significantly different with those in control group I, II (p <0.05). Left directional parameters were significantly different with right directional parameters of the VR program in patient group (p <0.05), but not in control group I, II. The parameters of the VR program were significantly correlated with clinical measurements (p <0.05). CONCLUSION: The assessment of unilateral neglect using 3- dimensional virtual reality program may be clinically useful.

Quantitative Assessment of Intention Tremor after Brain Injury Using Tri-axial Accelerometry

OBJECTIVE: The aims of this study were to assess intention tremor severity caused by brain injury using tri-axial accelerometry and also to determine the reliability and the correlation with clinical measurements. METHOD: Twenty two patients with intention tremor caused by brain injury were included. The quantitative measurement of tremor was performed using tri-axial accelerometry during finger to nose test. The dominant frequency and amplitude of tremor were acquired using Fast Fourier transformation analysis. The severity of tremor was also clinically rated by clinical rating scale for tremor, hand writing test, figure drawing test, pouring water test. The correlation between clinical measurement and tri-axial accelerometry measurement, and the inter-rater reliability were assessed. RESULTS: The tri-axial accelerometry measurement showed good inter-rater reliability. The mean dominant frequency was 3.10 Hz. The amplitudes at dominant frequency were significantly correlated with clinical rating scale for tremor, pouring water test (p<0.05) but not with hand writing test, figure drawing test. CONCLUSION: Quantitative measurement of intention tremor using tri-axial accelerometry may be very useful to assess the tremor severity caused by brain injury.

The Diagnosis of Upper Urinary Tract Infection Using Abdominal Computerized Tomography in Spinal Cord Injured Patients

OBJECTIVE: To reveal the usefulness of abdominal computerized tomography (CT) for the detection of complicated and uncomplicated upper urinary tract infection (UTI)s in patients with spinal cord injury (SCI). METHOD: Twenty-two patients with SCI were included in this study. They had UTIs with persistent high fever despite conservative treatments. In all patients, abdominal CT was performed. RESULTS: Acute pyelonephritis (APN) with or without complications was detected in 13 patients (59.1%). Four patients were accompanied with complications, 1 perirenal abscess, 1 renal and perirenal abscess with staghorn stone, 1 urosepsis with renal abscess and 1 urosepsis. Simple nephrectomy was performed in a patient with perirenal and renal abscesses with a staghorn stone. Percutaneous abscess drainage was performed in one patient with perirenal abscess. They all recovered without further complications. CONCLUSION: Abdominal CT should be considered to detect uncomplicated and complicated upper UTIs in SCI patients who present persistent UTI symptoms despite conservative treatments.

Sex Hormone Profiles in Spinal Cord-Injured Patients

OBJECTIVE: It is known that spinal cord injury (SCI) in adult men may result in sex hormonal changes. To investigate this change, we compared sex hormone levels of male SCI patients, uninjured normal, and infertile subjects. METHOD: Serum levels of follicular-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone were determined in 67 male SCI patients, 20 uninjured normal men and 39 idiopathic infertile men. One-way analysis of variance (ANOVA) procedures were performed with a significance level of 0.05. RESULTS: Compared with normal and infertile control groups, SCI patients had lower levels of testosterone and higher levels of prolactin. FSH levels of SCI patients were only lower than those of infertile controls. LH levels of SCI patients showed no significant difference. Compared with hormone levels of acute SCI patients, those of chronic SCI patients showed a tendency to increase in FSH, LH and testosterone, and a tendency to decrease in prolactin. Etiology of injury, completeness of injury and voiding method for neurogenic bladder did not influence the sex hormone levels in SCI patients. CONCLUSION: In our study, male SCI patients showed sex hormonal abnormalities of hypothalamo-pituitary type. And elevated serum prolactin level might influence hormonal changes and sexual dysfunction in male SCI patients.

Risk Factors of Low Back Pain in a General Population

OBJECTIVE: To examine the correlation between the prevalence and the risk factors of low back pain. METHOD: The number of subjects in this study was 575 men and 325 women who have visited the health center of the CHA hospital. The prevalence of low back pain was evaluated and the risk factors were assessed by history taking, physical examination and the questionnaires. Estimated factors influencing low back pain were age, sex, height, weight, body mass index, waist to hip ratio, range of motion, smoking, alcohol drinking, fitness and other disease. RESULTS: 1) Low back pain was correlated with age, sex, waist to hip ratio, flexibility, arthritis, nervous and depressive disorder and daily activities. 2) Chronic low back pain was correlated with age, right lateral bending, arthritis, cardiovascular disorder and daily activities. 3) Radicular symptom was correlated with age, left and right lateral bending, smoking, exercise, arthritis, nervous and depressive disorder, diabetes and daily activities. 4) Height, weight, body mass index and alcohol drinking had no correlation with low back pain. CONCLUSION: Understanding of the risk factors for low back pain will be helpful for providing objective standards for assessment of low back pain and preventing occurrence and recurrence of low back pain.