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Although the subjective reports of patients suggest that anxiety may aggravate vertigo and imbalance, there has been little research into how anxiety might directly affect balance system functioning. We conducted two studies to examine the effect of anxiety and arousal on the vestibulo-ocular reflex (VOR). In the first study, pre-lest fear ratings were obtained from 20 normal subjects and 36 anxious subjects immediately prior to rotation and caloric testing. Fear ratings were significantly correlated with the maximum slow-phase velocity (SPV) of nystagmus induced by caloric testing. In the second study, we assessed the VOR response to rotation of 36 normal subjects under 3 task conditions: a) minimal alerting (counting backwards during rotation), b) physical arousal (induced by exertion prior to rotation); c) mental arousal (induced by performance of stressful mental tasks during rotation). Both the physical and mental tasks induced a significant increase in heart rate compared with the alerting condition. The maximum SPV of the nystagmus induced by rotation was significantly greater during performance of the mental task than in the other two conditions. These combined results indicate that anxiety may influence the gain of the VOR.

We report the cystometric and conduit pressure profilometric findings of 20 children for whom the Mitrofanoff principle was applied to the construction of 21 continent catheterizable urinary conduits. Mitrofanoff conduits were fashioned from ureter in 10 cases, appendix in 8, ileum in 1, stomach in 1 and a combination appendix and ureter in 1. Conduit pressure profiles showed that functional profile length correlated strongly with the static profile maximal Mitrofanoff closure pressure (p = 0.04) and dynamic profile maximal Mitrofanoff closure pressure (p = 0.02). There was a statistically significant difference between clinical continence rates for children above and below the functional profile length threshold of 2.0 cm. (p = 0.05). The zone of continence corresponded to the region of the conduit intramural tunnel. Only 2 of 21 conduits were incontinent but both were constructed with ureters implanted into bowel reservoirs. Compared to appendiceal conduits, ureteral conduits had a lower functional profile length (p < 0.01) and static profile maximal Mitrofanoff closure pressure (p < 0.01), indicating a possible advantage to the use of the appendix.

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