No abstract available.
Endolymphatic Hydrops*

No abstract available.
Otitis Externa*

No abstract available.
Cerebral Infarction* ; Craniocerebral Trauma* ; Head* ; Humans ; Oxygen*

Objectives:This study was conducted to evaluate the ventilatory function in shipyard welders using the lifetime cumulative exposure to welding fumes. METHODS: Ventilatory function tests were performed on 241 male welders at one large shipyard,exposed to welding fumes for over five years,and was compared to 80 male control subjects. Ventilatory function indices, such as forced vital capacity(FVC), one-second forced expiratory volume(FEV 1), ratio of FEV 1 to FVC(FEV 1%), maximal mid-expiratory flow(MMF), peak expiratory flow rate(PEFR)and maximal expiratory flow at 50 and 75% of expired FVC(FEF50 and FEF75), were obtained by analyzing forced expiratory spirograms and maximal expiratory flow-volume curves that were simultaneously measured by an Impulse ocillometry(IOS)program in the standing position. RESULTS: FEF50 and FEF75 expressed as a percentage of the predicted values were significantly lower in the exposure group than in the controls, and the MMF tended to decrease.The means of all the ventilatory indices,expressed as percentage of the predicted values, were not significantly increased at the current exposure levels. The MMF, FEF50 and FEF75, expressed as a percentage of the predicted values, were significantly decreased with an increase in exposure duration.Only the FEF75 , expressed as a percentage of the predicted value, was significantly decreased with an increase in the cumulativeexposure to welding fumes(C1). The FEF75, expressed as a percentage of the predicted value, was significantly decreased with an increase in the cumulative exposure to welding fumes(C2). The above parameters were calculated to consider the current exposure level, exposure duration, application of the ventilatory system, production rate, personal protection evice, electrode and welding wire. The MMF and FEF50, expressed as a percentage of the predicted value, tended to decrease. The proportion of workers with abnormal MMF, FEF50 and FEF75 were significantly increased with an increase in the cumulative exposure to welding fumes(C2). CONCLUSIONS: These findings suggested that the MMF, FEF50 and FEF75 are sensitive and practical indices for the evaluation of the ventilatory function of workers exposed to welding fumes, when the lifetime cumulative exposure(C2) is considered as a factor affecting exposure.
Electrodes ; Humans ; Male ; Maximal Expiratory Flow-Volume Curves ; Welding*

Creutzfeldt-Jakob disease (CJD) is one of the transmissible spongiform encephalopathies, which is mediated by what has been known as "prion". It is a rare and fatal progressive neurodegenerative disease that affects the middle and old aged. There are a number of subtypes of CJD, one of which is the sporadic type characterized by rapidly progressing clinical symptoms, including progressive dementia, myoclonic jerk, and pyramidal or extrapyramidal syndrome. Patients usually end up dying within 1 to 2 years of contacting the disease. We report an autopsy-proven case of sporadic CJD with clinical symptoms that progressed within several days, along with dramatic changes on diffusion weighted magnetic resonance images.
Brain ; Creutzfeldt-Jakob Syndrome ; Dementia ; Diffusion ; Humans ; Myoclonus ; Neurodegenerative Diseases ; Prion Diseases

OBJECTIVE: Hirabayashi's open-door laminoplasty is a good procedure to use to treat patients with myelopathy of the cervical spine; however, the authors have experienced problems in maintaining an open-window in cervical spines after the surgery. The authors developed a modified method of the expanded open-door laminoplasty and compared the radiological and clinical results with those of the classical method. METHODS: In the modified method, wiring fixation with lateral mass screws on the contra lateral-side instead of fixing the paraspinal muscle or facet joint, as in the classical methods, was used in the open window of the cervical spine. Fifteen patients with cervical myelopathy were treated using the classical method and 12 patients were treated using the modified method. Preoperative and postoperative clinical conditions were assessed according to the Japanese Orthopedic Association (JOA) score. The radiological results were compared with the preoperative and postoperative computed tomography (CT) findings. RESULTS: In both methods, the clinical results revealed a significant improvement in neurological function (p<0.001). Image analysis revealed that the cervical canals were continuously expanded in patients treated using the modified methods. However, authors have observed restenosis during the follow-up periods in 4 patients treated using the original method. Progression to deformity and spinal instability were not observed in any of the patients in the radiological results. CONCLUSION: Although analysis with a larger population and a longer follow-up period needs to be undertaken, our modified open-door laminoplasty has shown an advantage in better maintaining an open window in comparison with the Hirabayashi's open-door laminoplasty.
Asian Continental Ancestry Group ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Orthopedics ; Paraspinal Muscles ; Spinal Cord Diseases ; Spine ; Spondylosis ; Zygapophyseal Joint

OBJECTIVE: Hirabayashi's open-door laminoplasty is a good procedure to use to treat patients with myelopathy of the cervical spine; however, the authors have experienced problems in maintaining an open-window in cervical spines after the surgery. The authors developed a modified method of the expanded open-door laminoplasty and compared the radiological and clinical results with those of the classical method. METHODS: In the modified method, wiring fixation with lateral mass screws on the contra lateral-side instead of fixing the paraspinal muscle or facet joint, as in the classical methods, was used in the open window of the cervical spine. Fifteen patients with cervical myelopathy were treated using the classical method and 12 patients were treated using the modified method. Preoperative and postoperative clinical conditions were assessed according to the Japanese Orthopedic Association (JOA) score. The radiological results were compared with the preoperative and postoperative computed tomography (CT) findings. RESULTS: In both methods, the clinical results revealed a significant improvement in neurological function (p<0.001). Image analysis revealed that the cervical canals were continuously expanded in patients treated using the modified methods. However, authors have observed restenosis during the follow-up periods in 4 patients treated using the original method. Progression to deformity and spinal instability were not observed in any of the patients in the radiological results. CONCLUSION: Although analysis with a larger population and a longer follow-up period needs to be undertaken, our modified open-door laminoplasty has shown an advantage in better maintaining an open window in comparison with the Hirabayashi's open-door laminoplasty.
Asian Continental Ancestry Group ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Orthopedics ; Paraspinal Muscles ; Spinal Cord Diseases ; Spine ; Spondylosis ; Zygapophyseal Joint

OBJECTIVE: The purpose of this study is to evaluate the role of acetazolamide brain SPECT in the assessment of delayed ischemic neurological deficits(DINDs) following aneurysmal subarachnoid hemorrhage. METHODS: Prospective analysis of consecutive patients with aneurysmal subarachnoid hemorrhage was made from July 1999 to December 2000. Regular neurological examination and Transcranial Doppler(TCD) monitoring were done for monitoring development of DINDs. Postoperative cerebral angiography and acetazolamide brain SPECT were performed according to our spasm-monitoring algorithm. Correlation of three diagnostic tools with development of DINDs was evaluated and concordance rates between each diagnostic tool were investigated. RESULTS: A total of 65 patients were included. DINDs were developed in 44.6% of patients. Spasm evidences on TCD monitoring, cerebral angiography and acetazolamide brain SPECT were observed in 38.5%, 40.0%, 41.5% of patients. Although there is no statistical significance, acetazolamide brain SPECT was more correlated with DINDs development than other two tools. Spasm evidence on TCD were not proceeded the development of DINDs in 58.6% of patients with DINDs. Concordance rate between acetazolamide brain SPECT and cerebral angiography was highest. However, there are significant numbers of discordance between two tools. CONCLUSION: Three diagnostic tools are complementary to each other in the assessment of DINDs. However, considering that DINDs is basically attributable to cerebral hemodynamic alteration rather than arterial morphologic change, acetazolamide brain SPECT seems to be the most useful tool in the evaluation of DINDs.
Acetazolamide* ; Aneurysm* ; Brain* ; Cerebral Angiography ; Hemodynamics ; Humans ; Microcirculation ; Neurologic Examination ; Prospective Studies ; Spasm ; Subarachnoid Hemorrhage* ; Tomography, Emission-Computed, Single-Photon*

Carotid arterial disease is the most common extracranial origin of brain infarction and accounts for about 10-20% of stroke and 50% of transient ischemic attacks (TIAs). Significant changes in the treatment of this disease have occurred over past few years and relative importance of carotid surgery is on the increase in the prevention of ischemic stroke. In this article, we aim to review the basics and the recent controversies of carotid endarterectomy.
Brain Infarction ; Carotid Artery Diseases ; Endarterectomy, Carotid* ; Ischemic Attack, Transient ; Stroke

Adrenoleukodystrophy is an inborn error of metabolism characterized by adrenal insufficiency and progressive demyelmation of brain white matter and peripheral nerves. Authors experienced three cases of adrenoleukodystrophy in a 7 year old boy, a 17 and a 210 year old males that were diagnosed by increased plasma content of very long chain fatty acid(VLCFA). The clinical symptoms include seizure, visual impairment, and hemiparesis. Two cases showed typical radiological findings and sural nerve biopsy was performed in one.
Adrenal Insufficiency ; Adrenoleukodystrophy* ; Biopsy ; Brain ; Child ; Humans ; Male ; Metabolism ; Paresis ; Peripheral Nerves ; Plasma ; Seizures ; Sural Nerve