20-40% of cases of acute transverse myelitis are attributed to viral infections, although the specific viral etiology is only rarely identified. We have studied one patient with transverse myelitis in association with acute hepatitis B virus infection. Hepatitis virus should be considered as rare cause of transverse myelitis.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis Viruses ; Hepatitis* ; Humans ; Myelitis, Transverse*

In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed area. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups(males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. The audiometric test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p< 0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group
Aging ; Aircraft* ; Airports ; Blood Pressure* ; Female ; Hearing Loss* ; Hearing* ; Humans ; Hypertension ; Male ; Military Personnel ; Noise* ; Presbycusis ; Psychological Tests ; Stress, Psychological*

No abstract available.
Gestational Age* ; Humans ; Immunoglobulins* ; Infant, Newborn*

PURPOSE: The technique of partial liver transplantation from a living donor was developed to expand the donor pool. However such small grafts may not only be functionally inadequate for the recipient, but will also sustain injury characterized by cholestasis and histological features of ischemia after implantation. Damage to partial liver grafts after reperfusion is frequently observed but the mechanism of injury remains unclear. Injury to partial liver grafts may be related to changes in portal blood flow. In this study, we investigated the histologic changes of the reperfusion of livers after revascularization through the portal vein or hepatic artery following heterotopic partial liver transplantation in rats. METHODS: Inbred Lewis partial liver were transplanted to inbred Brown Norway rats heterotopically in three groups. The first group of transplants, Group I (Portal vein group, n=3) was reperfused firstly through the portal vein. The second group, Group II (Hepatic artery group, n=3) was firstly reperfused through the hepatic artery. The third group, Group III (Control, n=1) was sham-operated. After reperfusion, the liver grafts were procured and fixed in formalin. The reperfusion livers were studied using immunohistochemical staining and in-situ RT PCR. RESULTS: In the H&E staining of the reperfusion livers there were no differences between groups I and II. Using immunohistochemical staining of TNF,R, FAS L, caspase 8 and in-situ RT PCR (NOS mRNA, TNF,R mRNA, FAS mRNA), the hepatic artery first reperfusion liver showed more damage than the portal vein first reperfusion liver. TUNEL staing showed severe apoptosis in hepatic artery reperfusion liver. CONCLUSION: The expression of the apoptosis molecular markers was more prominent in the reperfused liver performed with initial revascularization using the hepatic artery, rather than portal vein. These findings may be due to fact that the high oxygen blood in the hepatic artery is stressful to the reperfusion liver. The routinely used portal vein first revascularization technique decrease reperfusion injury to the graft when compared to hepatic artery first revascularization.
Animals ; Apoptosis ; Arteries ; Caspase 8 ; Cholestasis ; Formaldehyde ; Hepatic Artery* ; Humans ; In Situ Nick-End Labeling ; Ischemia ; Liver Transplantation* ; Liver* ; Living Donors ; Norway ; Oxygen ; Polymerase Chain Reaction ; Portal Vein* ; Rats* ; Reperfusion Injury ; Reperfusion* ; RNA, Messenger ; Tissue Donors ; Transplants ; Veins

BACKGROUND/AIMS: Propofol is usually used for anesthesia in the case of day surgery. We studied the effects of propofol plus fentanyl for sedation and the effect of oxygenation during gastroscopy. METHODS: 154 patients who asked conscious sedation during gastroscopy were randomly divided into three groups. The first group (PF-O group, 50 patients) and the second group (PF group, 48 patients) were received an initial bolus dose of propofol (40 mg) plus fentanyl (50 microgram) intravenously, followed by additional doses of propofol at one minute interval until conscious sedation. PF-O group was received preoxygenation (3 L/min) via nasal canula, and PF group was not. The third group (56 patients) received an initial bolus dose of midazolam (3 mg) intravenously, followed by additional doses of midazolam at two minutes interval (M group). RESULTS: In PF-O group, time to achieve sedation, regain orientation, and recover walking ability were 118.0 85.2 sec, 67.5 91.2 sec and 11.1 5.3 min. Gag reflex during the procedure was absent or nearly absent in 96% of patients. Despite the changes of blood pressure and heart rate compared to the values taken prior to the procedures were observed, all values were not clinically significant. In PF-O group, transient oxygen desaturation (SaO2<90%) was observed in four (8.0%) patients. CONCLUSIONS: Propofol plus fentanyl with oxygenation seems to be more acceptable and suitable method for sedation during outpatient gastroscopic examination.
Ambulatory Surgical Procedures ; Anesthesia ; Blood Pressure ; Conscious Sedation ; Endoscopy, Gastrointestinal* ; Fentanyl ; Gastroscopy ; Heart Rate ; Humans ; Midazolam ; Outpatients ; Oxygen* ; Propofol ; Reflex ; Walking

Fibrous dysplasia is a slowly progressive benign fibro-osseous disorder of unknown cause. The predilection sites of the craniofacial bones are maxilia and mandible, but fibrous dysplasia of the temporal bone is rarely noted, The usual clinical manifestations of fibrous dysplasia of the temporal bone are mainly otologic complications such as progressive stenosis of the external auditory canal and conductive hearing loss. But its neurologic complications are very rarely reported except facial nerve paresis. We present a case of monostotic fibrous dysplasia of the temporal bone leading to intracranial hypertension with central venous thrombosis. To our knowledge, this association has not been previously described in the literature.
Constriction, Pathologic ; Ear Canal ; Facial Nerve ; Fibrous Dysplasia, Monostotic ; Hearing Loss, Conductive ; Intracranial Hypertension* ; Mandible ; Paresis ; Temporal Bone* ; Venous Thrombosis*

A prospective analysis of 106 patients with head injury whose initial Glasgow Coma Scale was 3 to 10, who were managed in a uniform way was analyzed to relate out come to initial Glasgow Coma Scale, combined injuries and secondary systemic insults characterized by serum electrolytes imbalance, arterial gas study, blood pressure, and hemoglobin and hematocrit. The good recovery or moderate disability were achieved by 37% of the patients. The remaining 63% resulted in severe disability, vegetable and death. The poor out come group in comparing with the good outcome group showed lower initial Glasgow Coma Scale and more combined injuries. The five week follow up of secondary systemic insults mean flow showed higher serum Na flow and lower arterial PaO2 flow in poor outcome group.
Blood Pressure ; Craniocerebral Trauma ; Electrolytes ; Follow-Up Studies ; Glasgow Coma Scale* ; Glasgow Outcome Scale ; Head* ; Hematocrit ; Humans ; Prospective Studies ; Vegetables

CSF rhinorrhea can be divided into two groups according to its origin: the more common traumatic and the less frequent nontraumatic group. CSF is not only an obvious portal of entry but also a good culture media for bacteria. So meningitis is likely to be developed when CSF leaks. With reviewing some of concerned literatures, We present a case of the recurrent bacterial meningitis due to defect of the cribriform plate resulted from traumatic accident.
Bacteria ; Culture Media ; Ethmoid Bone* ; Meningitis ; Meningitis, Bacterial*

With changing mechanisms of injury, heightened clinical awareness, and better diagnostic technology, odontoid fractures constitute 9~18% of cervical fractures in recent reports. The odontoid type II fracture is the most common axis fracture and it is also the most difficult to treat. Type II fractures with greater than 6mm dens dislocation have a higher incidence of nonunion with nonoperative therapy and should be offered early operative reduction with fusion. Recently we have experienced a young male patient with odontoid type II fracture. The degree of dens dislocation was 8mm. The fractured odontoid process was removed through transoral-transpharyngeal approach and bone fusion was performed with iliac bone. And the inserted bone was fixed with screws and mini-plate for further stabilization. The operative result was good without any serious complications. The operation technique is detailed.
Axis, Cervical Vertebra ; Dislocations ; Humans ; Incidence ; Male ; Odontoid Process

Using the 3-D TOF technique of MR angiography, the main intracranial and extracranial vessels of 46 normal controls and 37 patients with ischemic stroke were evaluated. In controls 1 the visibility of internal carotid artery and vertebrobasilar artery was ninety-one percent, and that of the first division of the middle cerebral artery was ninety-four percent. In patient groups, compared with the contrast angiographic findings, the sensitivity of MR angiography in detecting vascular occlusive lesions was 100.0% in anterior circulations, and 80.0% in posterior circulations. But several false positive cases were detected. Which were mainly associated with tortous tuming points of the vessels, and MIP artifacts. In spite of the high sensitivity of MR angiography in detecting vascular abnormalities, the degree of occlusive vascular lesions were more accentuated in MR angiography probably due to MIP artifact. The overestimated rate of vascular stenosis was about 24.6 percent compared with the contrast angiography.
Angiography* ; Arteries ; Artifacts ; Carotid Artery, Internal ; Constriction, Pathologic ; Humans ; Middle Cerebral Artery ; Stroke*