Characteristics and utility of combined duplex color-coded ultrasonography in the cervical rotational position with head MRI and MRA in the differential diagnosis of apogeotropic direction-changing positional nystagmus

Objective:To determine whether cervical ultrasonography,magnetic resonance imaging(MRI),and magnetic resonance angiography(MRA)are useful in the differential diagnosis of etiology and understanding the pathophysiology in cases of apogeotropic direction-changing positional nystagmus(DCPN).Methods:Thirty patients with apogeotropic DCPN were classified into 11 cases of central disease,seven cases of mixed central and peripheral disease,and 12 cases of peripheral disease by differential diagnosis based on various balance function,neuro-otological,and imaging tests.Cervical ultrasonography using the cervical rotation method and MRI and MRA of the head and neck were performed in most patients with apogeotropic DCPN.We reviewed the presence of abnormal imaging findings according to the disease etiology.Results:Of the 30 patients with apogeotropic DCPN,23 showed vascular abnormalities or central lesions on imaging.Vascular lesions were found in six of the 12 patients with peripheral disease.Cervical ultrasonography with cervical rotation detected blood flow disturbance in the vertebral artery in eight patients in whom the disturbance could not be detected by MRI or MRA of the head and neck.Discussion:We hypothesize that the causative disease of apogeotropic DCPN may be strongly associated with circulatory insufficiency of the vertebrobasilar and carotid arteries,and that impaired blood flow in these vessels may affect peripheral vestibular and central function.In patients with apogeotropic DCPN,examinations of vestibular function,central nervous system symptoms,and brain hemodynamics are valuable for differential diagnosis.

Comparison of Inspection Data by Difference in Odour Inspection Kit (Including Results of Young and Old Age)

The present study examined the relationship between olfactory function for ten years. A personal function test was calculated from the Nagoya Women’s University study database, and the odor stick identification test and open essence identification test were administered to healthy young and elderly people. The participants were community dwellers who voluntarily participated in the Nagoya Women’s University Study and had managed everyday life by themselves. We combined data of 2018 and checked two kinds of the olfactometry result. These data were made from a consultation result list which was handed to a testee by hand. The test age was in his/her 80s from 40s and in his/her 20s from 10s. The data were compared according to the generation (young age is 20.1 ± 0.7 years old and old age is 74.5 ± 10.0 years old). We conducted two kinds of olfaction tests. The Odour Stick Identification Test (OSIT-J) was used to assess odour perception. This test possesses high reliability and validity. The OSIT-J includes 12 different odorants to be identified. The Odour Essence Identification Test was used to assess odour perception, too. It also includes 12 different odorants to be identified. We compared the answer of generation and compared the results of the two olfactory tests. As a result, there were no statistically significant differences in the total number of correct answers in young people and old people in the two olfactory test results. In addition, we compare young people and old people who increased the number of correct answer in the two kinds of olfactory examination, the same person, and those who decreased, but there was no statistically significant difference. However, there were statistically significant differences between India ink and perfume and Household (domestic) gas compared with young people and old people with two kinds of olfactory test results. From the results of this study, it was found that the results of two kinds of olfactory test can be used together as a research result for the result of correct answer rate number. However, it became clear that careful handing is necessary for individual smell.

Comparison of Survey Results on Subjective Dizziness,Hearing and Tinnitus and Stabilometry Test Results in Yakumo Inhabitant Examination Study (Comparison of 2005, 2007 and 2015, 2017)

Abstract: The Nagoya University Hospital otolaryngology department is doing the prospective cohort study in Yakumo-cho, Hokkaido, Japan from 2005, because this place is a little transfer of the population. Most of inhabitants of Yakumo-cho engage in fishery and agriculture as work mainly. We perform questionary survey using an interview vote. The item is “having feeling of dizziness or not”,“quality of hearing” and “having tinnitus or not”. Furthermore, we go for the examination of stabilometry, too. We compared 2015, 2017 with 2005, 2007 among Yakumo-cho inhabitant examination data this time. As a result, participant with a feeling of conscious dizziness got a bad reputation of the hearing consciously. In addition, participant with a feeling of conscious dizziness had tinnitus consciously. Furthermore, the participant with a feeling of conscious dizziness had bad stabilometry result. As a result of having compared ten years later, we understood that stabilometry result worsened if 60s became in 70s with or without a feeling of dizziness consciously. When there is a feeling of conscious dizziness, it is necessary to perform an examination of stabilometry as routine work. In addition, it is necessary to inspect stabilometry if participants have the bad hearing or tinnitus with a feeling of dizziness in particularly.