No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Noise is not only affecting the ear and the auditory cortex locally, but its influence is widely spread throughout the brain structures, e. g., the reticular formation, the brain stem nuclei or the subcortical forebrain area. Hence, any of the organism's activities can be hindered or stimulated by noise. High noise is a stressor and the catecholamine level can be used both as a stress marker and as an indicator of modified sympathetic nervous system activity. Several recent studies have found that the urinary excretion of catecholamines is increased due to high noise intensity, especially unexpectedly high and long lasting noise. The present study was conducted in order to examine the effects of noise stress on urinary excretion of catecholamines in rats and humans. Rats were exposed to 90 dB noises for 10, 30, and 60 minutes, 3 and 12 hours. 24 hour urinary samples were collected and the catecholamines were extracted by alumina and analyzed by HPLC-ECD. Catecholamine levels increased with time of exposure up to 60 minutes: norepinephrine concentration at 60 min of noise=1.038 ng/ml, epinephrine=0.636 ng/ml. Urine catecholamines of blue collar workers exposed to 90 dB of noise at the workplace were collected between 2 and 4 p.m. and compared to that of white collar workers exposed to 70 dB. Mean norepinephrine level of the blue collar workers was 0.89 ng/ml(+/-0.25), epinephrine 0.24 ng/ml(+/-0.09), and that of the white collar workers 0.48 ng/ml(+/-0.12), epinephrine 0.19 ng/ml(+/-0.05). It was concluded that noise acts as a stressor and increases the catecholamine levels in both rats and humans.
Aluminum Oxide ; Animals ; Auditory Cortex ; Brain ; Brain Stem ; Catecholamines ; Ear ; Epinephrine ; Humans ; Noise* ; Norepinephrine ; Prosencephalon ; Rats ; Reticular Formation ; Sympathetic Nervous System

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

PURPOSE: To report a case of migraine attacks with aura that occurred after percutaneous closure of an atrial septal defect (ASD) with the Amplatzer septal occluder device. CASE SUMMARY: A 58-year-old female presented with glare and scintillation that lasted 3 days. She had a history of percutaneous ASD intervention 3 weeks prior. Because ophthalmologic examination revealed nothing remarkable, the patient underwent observation. However, two months later, she revisited our department, presenting with aggravated glare, scintillation, and severe photophobia. Also, she presented with scintillation followed by a headache starting from the right temporal area extending to the occipital area. The patient was diagnosed with migraine with aura, which was newly developed after percutaneous ASD closure. After switching medication from acetylsalicylic acid to clopidogrel, the frequency and intensity of the headaches were reduced. No recurrence of ophthalmic symptoms or headache was observed during the 1-year follow-up. CONCLUSIONS: Percutaneous closure of ASD can be complicated by the appearance of migraine attacks with aura. When patients present with glare and scintillation, ophthalmologists must consider the possibility of migraine with aura and migraine induced by secondary causes. Thus, detailed history taking should be taken in order to make an early diagnosis of migraine.
Aspirin ; Early Diagnosis ; Epilepsy ; Female ; Follow-Up Studies ; Glare ; Headache ; Heart Septal Defects, Atrial* ; Humans ; Middle Aged ; Migraine Disorders* ; Migraine with Aura* ; Photophobia ; Recurrence ; Septal Occluder Device

PURPOSE: To investigate the effectiveness of infliximab as treatment for refractory uveitis that recurred in spite of immunosuppressive agents. METHODS: Thirty patients who were treated for refractory uveitis from 2002 to 2011 were included in this study. We retrospectively reviewed the medical records of 15 patients who were treated with Infliximab and 15 patients not treated with Infliximab. Infliximab was injected intravenously (5 mg/kg) 3 times every 4 weeks, and the patients were followed-up at 1 week, 2 weeks, and every month thereafter. Anterior chamber cell reaction with a score greater than 0.5+ was defined as recurrence of uveitis. RESULTS: Among 15 patients treated with Infliximab, only one showed no response to the medication. The recurrence rate was significantly higher in patients receiving Infliximab treatment (1.1 +/- 0.2 times) than in those not receiving Infliximab treatment (3.1 +/- 0.3 times) (p=0.022). CONCLUSIONS: Infliximab can be used effectively on patients with refractory uveitis. However, a future prospective randomized study is needed to demonstrate the effectiveness of Infliximab and to determine an accurate protocol regarding dosage and number of injections.
Anterior Chamber ; Humans ; Immunosuppressive Agents ; Medical Records ; Prospective Studies ; Recurrence ; Retrospective Studies ; Tumor Necrosis Factor-alpha ; Uveitis* ; Infliximab

BACKGROUND AND OBJECTIVES: Attic cholesteatoma which develops from the papillary or retracted from progresses through various anatomic sites such as the mesotympanium, the mastoid process and the epitympanium. Although the most common site for attic cholesteatoma is the lateral attic space, it has also been found frequently in the medial attic space. We hoped to understand the pathogenesis of attic cholesteatoma through clinical analyses in order to contribute to the cholesteatoma treatment. MATERIALS AND METHODS: We chose 60 attic cholesteatoma patients showing attic retraction or perforation. These cases of attic cholesteatomas were classified into either the lateral or the medial types depedning on the main site of occurence. They were further classified into anterior, posterior and inferior types according to the direction of cholesteatomatic progression. CONCLUSION: The accurate assessment and clear understanding of the pathogenesis of different forms of cholesteatoma enabled a successful operation and helped to minimize the operative field.
Cholesteatoma* ; Hope ; Humans ; Mastoid

Purpose: We performed intra-arterial thrombolysis within 6 hours of presentation in Korean patients with acute retinal artery occlusion. The treatment outcomes of our patients were compared with those from a literature review of this procedure. Methods: Visual acuity, intraocular pressure, fundus photo, and fluorescein angiography were examined in five Korean patients who ultimately underwent intra-arterial thrombolysis due to central retinal artery occlusion. The visual acuity of patients was evaluated after the procedure. The treatment outcomes of our patients were compared with those presented in six foreign intra-arterial thrombolysis studies with respect to age, sex, and visual acuity before and after intra-arterial thrombolysis. Results: In our five cases (three males and two females), the average age was 63.4 years and the average time to the procedure of intra-arterial thrombolysis was 4.8 hours. In the five cases, the visual acuity before intra-arterial thrombolysis were hand movements, 0.1, finger counting at 30 cm, hand movements, and 0.08. Visual acuity after intra-arterial thrombolysis were 0.9, 0.5, finger counting at 30 cm, 0.7, and 1.2. The average age of patients in the six studies from the literature was 60 years, and the most common visual acuity before intra-arterial thrombolysis was light perception and hand movements. A slight improvement in visual acuity (>0 to 0.1) was common in most of the studies; however, three studies showed a partial recovery (from 0.2 to 0.4). Conclusions For retinal artery occlusion, intra-arterial thrombolysis within 6 hours should be considered as a treatment option.

Purpose: We performed intra-arterial thrombolysis within 6 hours of presentation in Korean patients with acute retinal artery occlusion. The treatment outcomes of our patients were compared with those from a literature review of this procedure. Methods: Visual acuity, intraocular pressure, fundus photo, and fluorescein angiography were examined in five Korean patients who ultimately underwent intra-arterial thrombolysis due to central retinal artery occlusion. The visual acuity of patients was evaluated after the procedure. The treatment outcomes of our patients were compared with those presented in six foreign intra-arterial thrombolysis studies with respect to age, sex, and visual acuity before and after intra-arterial thrombolysis. Results: In our five cases (three males and two females), the average age was 63.4 years and the average time to the procedure of intra-arterial thrombolysis was 4.8 hours. In the five cases, the visual acuity before intra-arterial thrombolysis were hand movements, 0.1, finger counting at 30 cm, hand movements, and 0.08. Visual acuity after intra-arterial thrombolysis were 0.9, 0.5, finger counting at 30 cm, 0.7, and 1.2. The average age of patients in the six studies from the literature was 60 years, and the most common visual acuity before intra-arterial thrombolysis was light perception and hand movements. A slight improvement in visual acuity (>0 to 0.1) was common in most of the studies; however, three studies showed a partial recovery (from 0.2 to 0.4). Conclusions For retinal artery occlusion, intra-arterial thrombolysis within 6 hours should be considered as a treatment option.

Patients with extra-axial mass lesions of the posterior fossa frequently demonstrate signs of brainstem dysfunction. These dysfunctions may be induced by the change of regional cerebral blood flow and electrophysiological status as well as mechanical compression and distortion of the brainstem. Frontal cortical regional cerebral blood flow(rCBF), pontine rCBF, brainstem autidory evoked potentials(AEPs), infratentorial intracranial pressure(infratentorial ICP) and mean arterial blood pressure(MABP) were recorded before and after expansion of an infratentorial epidural ballon in anesthetized experimental cat models. After the elevation of MABP during the increased infratentorial ICP, frontal cortical and potine rCBF, AEPs were recorded every 30 minutes. The results suggest that the elevating the MABP to improve cerebral perfusion pressure before irreversible change occurs in the brain may preserve cerebral function. We conclude that if the volume of the space in the posterior fossa that is occupied by the mass can be estimated, brain damage from low rCBF and brain compression due to intracranial hypertension can be prevented by the elevation of MABP before irreversible damage of the brain occurs.
Animals ; Blood Pressure* ; Brain ; Brain Stem ; Cats ; Evoked Potentials, Auditory* ; Humans ; Intracranial Hypertension ; Intracranial Pressure* ; Perfusion

Angiosarcoma of the brain, either primary or metastatic is extremely rare. Moreover, angiosarcoma metastasizing to the brain is also highly unlike to occur comparing with metastases to the other organs. Thus, an ideal treatment strategy has not been established. A 67-year-old man with past surgical history of a scalp angiosarcoma underwent surgical resection of intracranial invasion. Because of wide scalp flap excision andresultant poor vascularity of the scalp flap, additional radiation was not provided. Because adjuvant therapy is impossible due to poor scalp condition, more careful but ample resection of the primary lesion is essential to conduct initial operation.
Aged ; Brain ; Brain Neoplasms ; Hemangiosarcoma ; Humans ; Neoplasm Metastasis ; Scalp