OBJECTIVES: To determine the level of aircraft noise exposure and how it relates to hearing loss, and to investigate the association between noise exposure and anxiety and depression in subjects residing adjacent to a military airbase. METHODS: The study was conducted upon 898 inhabitants between the ages of 30-79, living near the military airbase in Jeonra-do. The subjects were divided into three noise-exposure groups: high-exposure, low-exposure, and a control group. The cut-values were 80 and 60 on the Weighted Equivalent Continuous Perceived Noise Level scale. A self-administered questionnaire including the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were completed. Pure tone audiometry tests were performed. RESULTS: Hearing loss prevalence was defined by a >40 dB loss in bilateral ears or in one ear; the difference of <15 dB compared to the better side was 30.8%. The mean BAI/BDI score was 18.9+/-14.3/18.7+/-11.6, the number of abnormal subjects with BAIs > or =22 was 317 (35.3%), with BDIs > or =21 was 347 (38.6%). The pure tone average, BAI, and BDI scores were higher in the noise-exposure groups compared to the control. The BAI/BDI abnormal subjects showed a higher hearing threshold shift level compared to the normal scored subjects. The odd ratios for anxiety was significantly high in both noise exposure groups and the hearing loss, for depression was significantly high in high-exposure group and hearing loss. CONCLUSIONS: Anxiety and depression were higher when exposure to high-level noise and further complicated by hearing loss. Further investigation is needed to determine the cause-effect relationship.
Aircraft ; Anxiety ; Audiometry ; Depression ; Ear ; Hearing ; Hearing Loss ; Humans ; Military Personnel ; Noise ; Prevalence ; Questionnaires

Sclerosing peritonitis is a rare but fatal complication of peritoneal dialysis (PD). Management of sclerosing peritonitis includes cessation of PD, total parenteral nutrition, and surgery. Recently, a few reports have indicated immunosuppression might be beneficial in sclerosing peritonitis. In these reports, all of patients had the combination therapy of steroid and immunosuppressant. A 37-year old man develped sclerosing peritonitis 3 months after switching from PD to hemodialysis because of uncontrolled peritonitis. An abdominal computed tomography (CT) scan demonstrated massive ascites with multilocuated fluid collection and extensive enhancement of the peritoneum. A peritoneal biopsy showed proliferation of fibrous collagenous tissue with infiltration of lymphocytes. We started corticosteroid for one month. A follow-up CT scan showed complete resolution with absence of peritoneum thickness and fluid collection 16 months after corticosteroid therapy. The patient currently remains free of symptoms in an outpatient hemodialysis unit. To our knowledge, this is the first case of sclerosing peritonitis successfully treated with corticosteroid therapy alone in Korea.
Adult ; Ascites ; Biopsy ; Collagen ; Follow-Up Studies ; Humans ; Immunosuppression ; Korea ; Lymphocytes ; Outpatients ; Parenteral Nutrition, Total ; Peritoneal Dialysis ; Peritoneum ; Peritonitis* ; Renal Dialysis ; Tomography, X-Ray Computed

OBJECTIVE: Variable materials have been used in cranioplasty of skull defects, of which autologous bone is the most ideal. The authors explore methods and clinical results of cranioplasty with frozen autologous bone. METHODS: Cranioplasty was performed using frozen autologous bone in 16 patients with skull defects between August 1997 and April 1999. Primary diseases were severe head injury in 14 patients and cerebral infarction in two patients, and all of them received decompressive craniectomy. Cranioplasty were done from 25 to 225 days after primary operation. The mean follow-up period was 34 months. RESULTS: There was no infection or epidural hematoma. During the follow-up period, autologous bone flap were fused firmly to the skull without absorptive evidences and delayed complications. It was satisfactory in all cases when considered aesthetic aspects. CONCLUSION: Cranioplasty using frozen autologous bone is safe and satisfactory method for repair of surgically induced skull defects.
Cerebral Infarction ; Craniocerebral Trauma ; Decompressive Craniectomy ; Follow-Up Studies ; Hematoma ; Humans ; Skull

The authors report a case of recurrent expansile cyst formation after gamma knife radiosurgery(GKRS) for a cerebral arteriovenous malformation where the residual nidus might play an important role. A 28-year-old male patient underwent gamma knife radiosurgery for a left parietal lobe arteriovenous malformation which had manifested with generalized tonic-clonic seizure in November 1992. In March 1999, 76 months after GKRS, the patient presented with headache, dysphasia and right hemiparesis and the computed tomography(CT) and magnetic resonance(MR) image revealed a huge cystic lesion with enhancing nodule at the anterior wall of the cyst. Cerebral angiography showed a small residual nidus. Aspiration and drainage of the cystic fluid via a burr hole was performed and the symptoms improved. One year later, in March 2000, the symptoms recurred, and CT and MR image revealed a new huge cystic lesion anterior to the enhancing nodule. Surgical removal of the residual nidus was performed, and there is no recurrence of the cyst for two years till now.
Adult ; Aphasia ; Arteriovenous Malformations ; Cerebral Angiography ; Drainage ; Headache ; Humans ; Intracranial Arteriovenous Malformations* ; Male ; Paresis ; Parietal Lobe ; Radiosurgery* ; Recurrence ; Seizures

We report a case of pancreatic pseudocyst presenting as an intramural gastric tumor on upper gastrointestinal examination, endoscopic ultrasound and computed tomography of the abdomen. Pancreatic pseudocysts in the stomach wall is rare and the most of them presented as a cystic mass, but this case was presented as a gastric mural solid tumor. Exploration revealed an about 4 4 2 cm sized round mass at the midbody of great curvature of stomach, it was in the muscle layer, and removed by surgical operation. The correct diagnosis of this case was established postoperately on the pathologic examination revealed pancreatic pseudocyst.
Abdomen ; Diagnosis ; Pancreatic Pseudocyst* ; Stomach ; Ultrasonography

Porcine proliferative enteropathy(PPE) is an enteric disease been caused by Lawsonia intracellularis. It has become one of the critical problems in the pig industry. To investigate the prevalence of PPE in Korea, serum samples of 828 pigs from 65 herds were tested using indirect immunofluorescence antibody technique(IFA). The infection rate in individual pigs varied from 44 to 69%, whereas 100% in pig farms. The infection frequency was 57, 44.9, and 59.4% according to age respectively. Administration of tylosin in feed at a concentration of 110 ppm for 14 days reduced the infection rate of the farms. These data indicated that the high prevalence of PPE may be controlled by tylosin.
Administration, Oral ; Animal Feed ; Animals ; Anti-Bacterial Agents/*therapeutic use ; Antibodies, Bacterial/blood ; Enteritis/epidemiology/prevention&control/*veterinary ; Fluorescent Antibody Technique, Indirect/veterinary ; Gram-Negative Bacterial Infections/prevention&control/*veterinary ; Korea/epidemiology ; *Lawsonia Bacteria/drug effects/growth&development/immunology ; Seroepidemiologic Studies ; Swine ; Swine Diseases/*epidemiology/microbiology/prevention&control ; Tylosin/*therapeutic use

PURPOSE: To evaluate the CT and MRI findings of neurosyphilis. MATERIALS AND METHODS: We retrospectivelyreviewed the CT and MR imaging findings in five patients with intracranial neurosyphilis confirmed by CSF, VDRL,TPHA, and clinical follow-up. MR imaging was performed in all five cases, and CT in two. RESULTS: The MRI and CTfindings of intracranial neurosyphilis included infarction (n=3), focal inflammation (n=1) and encephalopathy(n=1). There was a total of ten infaretions : three of the basal ganglia, two each of the frontal lobe, watershedzone, and cerebellum, and one of the occipital lobe. Intaretion was most common in MCA territory (n=9; 50%),followed by the watershed zone (16.6%), posterior cerebral artery territory (16.6%), and posterior inferiorcerebellar artery territory (11.1%), The size of the lesion varied from 1cm to larger than one lobe. One patientshowed diffuse high signal intensity in the left temporal lobe, but on follow-up MRI, this had resolved. CONCLUSION: The most common finding of neurosyphilis, as seen on MRI and CT, was infarction in middle cerebralarterial territory.
Arteries ; Basal Ganglia ; Cerebellum ; Follow-Up Studies ; Frontal Lobe ; Humans ; Infarction ; Inflammation ; Magnetic Resonance Imaging* ; Neurosyphilis* ; Occipital Lobe ; Posterior Cerebral Artery ; Syphilis ; Temporal Lobe

BACKGROUND: Strabismus surgery is associated with a high incidence of postoperative nausea and vomiting. Propofol is an anesthetic which has an antiemetic effect. A randomized study was done to compare the efficacy of propofol-fentanyl and propofol-ketorolac anesthesia for strabismus surgery in children. METHODS: Eighty-five children, ASA physical status I or II, for strabismus surgery, were studied. Patients were randomly assigned to one of two groups by picking the envelop. Preanesthetic medication was not given. Fentanyl group received fentanyl 1.5 microgram/kg i.v. and ketorolac group received ketorolac 1 mg/kg, 2 minutes before induction. Atropine was given after that. Anesthesia was induced with propofol 2.4 mg/kg and vecuronium 1 mg/kg and intubation was performed. Anesthesia was maintained with a three-stage infusion technique of propofol (12 mg/kg/hr for 1st 10 minutes, 9 mg/kg/hr for 2nd 10 minutes and 6 mg/kg/hr was followed) with oxygen and nitrous oxide. Ketorolac was injected intramuscularly for preemptive analgesia immediate after induction. The incidence of nausea and vomiting was evaluated for postoperative 48 hours. And also, intraoperative oculocardiac reflex was monitored to compare the difference between two groups. RESULTS: During postoperative 48 hours, fentanyl group and ketorolac group had a similar low incidence of nausea and vomiting (4.2% and 7.0%). There is no significant difference of intraoperative oculocardiac reflex between two groups (45.2% and 30.2%). CONCLUSIONS: Propofol administered to induce and maintain anesthesia with a three-stage infusion technique is equally effective in preventing postoperative nausea and vomiting in propofol-fentanyl and propofol-ketorolac anesthesia for strabismus surgery in children.
Analgesia ; Anesthesia* ; Antiemetics ; Atropine ; Child* ; Fentanyl ; Humans ; Incidence ; Intubation ; Ketorolac ; Nausea ; Nitrous Oxide ; Oxygen ; Postoperative Nausea and Vomiting* ; Preanesthetic Medication ; Propofol ; Reflex, Oculocardiac ; Strabismus* ; Vecuronium Bromide ; Vomiting

PURPOSE: To establish an experimental model of arteriovenous fistula in pigs. MATERIALS AND METHODS: Ten fistulas were created in eight pigs, and angiography was performed 3 to 5 days after surgery. A follow-up angiogram of three fistulas was obtained 2 to 12 weeks later. In one animal, pathologic examination showed occlusion 8 weeks after a successful operation. RESULTS: Eight angiograms of nine fistulas in seven pigs were obtained; one animal died due to cardiac failure. In six pigs, high-flow fistulas were shown to be present, and in two, the fistulas were slow flow; a pseudoaneurysm was seen in one. A follow-up angiogram obtained in three cases showed occlusion of the fistula. Pathologic examination of one animal showed fibrosis in the occluded portion of the fistula. CONCLUSION: An arteriovenous fistula model was surgically established in 80% of cases; during follow-up, three fistulas were seen to be occluded due to fibrosis. This model can therefore be used within one week of surgery.
Aneurysm, False ; Angiography ; Animals ; Arteriovenous Fistula* ; Fibrosis ; Fistula ; Follow-Up Studies ; Heart Failure ; Models, Theoretical* ; Swine*

PURPOSE: To evaluate brain MRI findings of spontaneous intracranial hypotension. MATERIALS AND METHODS: A retrospective review of MRI findings was conducted on six patients with clinically proven spontaneous intracranial hypotension ; no patient had history of previous spinal puncture. Follow-up MRI was available in two patients, and to detect CSF leakage, radionuclide cisternography (n=5), myelography (n=1), and MR myelography (n=1) were performed. RESULTS: On contrast-enhanced T1WI, diffuse dural enhancement was seen in all cases, subdural hematoma or hygroma was seen in four cases, pituitary gland prominence in four, dural sinus dilatation in four, downward displacement of cerebellar tonsil in two, downward displacement of iter in one, and suprasellar and prepontine cistern effacement in two. In no patient was abnormal CSF leakage found. CONCLUSION: Although dural enhancement, as seen on MRI, is not specific, diffuse enhancement of dura matter accompanying by subdural hematoma, hygroma, pituitary gland prominence, dural sinus dilatation, downward displacement of the cerebellar tonsil, or suprasellar and prepontine cistern effacement can strongly suggest intracranial hypotension.
Brain* ; Dilatation ; Follow-Up Studies ; Hematoma, Subdural ; Humans ; Intracranial Hypotension* ; Lymphangioma, Cystic ; Magnetic Resonance Imaging* ; Myelography ; Palatine Tonsil ; Pituitary Gland ; Retrospective Studies ; Spinal Puncture