Balance Difficulties Research Articles

Outcome and neurological sequelae of patients after tetanus.

From 1969-1985, 106 people contracted tetanus in Finland. The outcome of the disease was good in 78 cases (returned to work), poor in 27 (12 died, 5 institutionalized and 10 retired) and unknown in 1. Poor outcome was the result of a disease requiring respirator treatment. Other clinical factors significantly correlated with poor outcome were blood pressure lability, hyperglycemia, hyperthermia, tachycardia and anticoagulation therapy. Forty people who were representative of the whole series with regard to sex, age and severity of disease attended a follow-up study on average 7 years and 4 months later. Forty age- and sex-matched controls had the same examinations, and compared with them, the 40 patients still had significantly more muscle fatigue and cramps, nervousness, decreased mental capacity and difficulties in balance, speech and memory. They also had more clinical findings, such as peripheral paresis, muscular atrophy, decreased or absent tendon reflexes and decreased mental capacity than the controls.

102 PROGRESSIVE ENCEPHALOPATHY IN PATIENT TREATED WITH PITUITARY HUMAN GROWTH HORMONE

We report the case of a hypopituitary patient treated with human pituitary-derived growth hormone with a neurological disorder initially thought to be Creutzfeld-Jacob disease (CJD). Between 1978. and 1981. he received 150 injections of Kabl-Vitrum Creshormone. In 1985. at the age of 18 he began to have difficulty in speech, writing and balance and exhibited behaviour changes. CT scan of the brain revealed massive calcifications within cerebellar hemispheres. Other laboratory results including cerebrospinal fluid (CSF) analysis, serum electrolytes and parathormone levels and EEG were normal. His father's CT scan of the brain showed a minor calcification of the caudate nucleus, without clinical symptomatology. Follow-up of the patient revealed slow but clear progression of speech, truncal and gait ataxia and coordination difficulties He became withdrawn, depressive and slightly agressiva. Repeated EEGs were normal and the pair of proteins characteristic for CJD were not detected in CSF. Most probably our patient has Fahr's disease (familial basal ganglia calcification) but for a definitive diagnosis histopathology of the brain would be needed.

The immature skin.

The skin of the extremely preterm infant is structurally and functionally immature at birth, although there is rapid postnatal maturation. The consequences of this immaturity are a high transepidermal water loss (leading to hypothermia and difficulty in fluid balance) accidental percutaneous absorption and toxicity, and skin trauma (leading to infection). Neonatologists must be aware of these and take measures to limit them.

Chlorinated Hydrocarbons in Biological Sewage Purification – Fate and Difficulties in Balancing

The fate of some chosen chlorinated hydrocarbons in the biological sewage purification was determined. Fixed quantities (250 µg/l waste water) of the different volatile compounds such as chloroform, trichloroethylene, chlorobenzene, hexachloro-1, 3-butadiene, 1,2-dichlorobenzene, 1,2, 3-trichlorobenzene, hexach lorobenzene, 2,4-dichlorophenol and γ-hexachlorocyclohexane were dosed into the aeration tanks of the pilot plants. Chlorinated hydrocarbons in the inflow, waste air, effluent and excess sludge were extracted and tested for by GC/ECD. The results of these experiments were adapted with the results of recovery experiments. The balances of the low volatile and volatile compounds also had to be adapted by the means of correction factors because of condensation effects. For example more than 50 % of 250 µg/l water of chloroform or 1,2-dichlorobenzene escaped out of the open sampling bottles which were kept in a refrigerator during the sampling period of 24 hours. The balances of the non-volatile chlorinated hydrocarbons were reaching about 100%. The very hydrophilic and low volatile chloroform was found up to 16% in the waste air, 63% in the effluent and 21% adsorbed on sludge. The very lipophilic and non-volatile hexachlorobenzene was found up to 16% in the effluent and 74% adsorbed on sludge. No hexachlorobenzene was found in the waste air. Biochemical degradation was observed for some of these compounds. The behavior of the chlorinated hydrocarbons in biological sewage purification depended on their volatility and lipophilic property, and also the intensity of aeration and sludge loading has been of great importance. Balancing of volatile chlorinated hydrocarbons should be done by spot sampling. Bottles for composite samples should be stored in the refrigerator during the sampling period and should be sealed.

Impairment of the Chick’s Grip and Balance by Streptomycin

Chicks were injected daily with streptomycin (400 or 1,200 mg/kg). Damage to the vestibular apparatus was accompanied by steadily impaired abilities of chicks to tighten their grips as evidenced by reduced torque and by slippage of their feet on the perch. As compensation, intoxicated chicks adjusted their footing with cautious, deliberate movements. They always stood erectly and stiffly on the perch; they were unable to roost. They also experienced difficulties in balancing. While symptoms were qualitatively similar at both dosages, their onset came earlier and with greater severity at 1,200 mg/kg. Control chicks steadily increased their torque and displayed normal balance during the course of the experiment.

Motor development profiles of preschool deaf and hard-of-hearing children.

11 deaf and hard-of-hearing preschool children generally exhibited normal or at-age profiles of motor development. The few delays in certain functional areas were assumed to be due partially to lack of training and play experience rather than to deafness or hearing impairment. Two boys had a variety of motor and physical problems. Also some of the at-age children functioned above-age in a few skill areas. Two of the 4 children who demonstrated specific balance skill deficits had had meningitis at an early age; this supported the rationale that there was a relationship between etiology of meningitis and specific balance difficulties.

Massive dilatation of the aqueduct of Sylvius. Case report.

A 58-year-old man was admitted to the hospital with a 24-year history of difficulty of balance, with weakness of the legs for 17 years. During the last 3 years his disability had progressed until he was confined to a wheelchair; he also developed difficulty in fine finger movement and loss of memory. He had been sexually impotent and incontinent of feces for 6 years and incontinent of urine for 20 years. Past medical history is significant in that the patient had severe measles at age 14 associated with seizures. He was rejected from the armed forces because of failing the mental test. Examination. The patient was lethargic, with memory impairment, confusion, and euphoria. Muscle tone was increased in all extremities, on the right more than the left, and there was generalized hyperreflexia. There were no pathological reflexes. The patient could stand with support and had good strength in the arms but he was unable to walk. There was a left central facial paresis. Electroencephalography demonstrated bilateral cerebral dysfunction. Intravenous isotope studies of the brain were normal. Intrathecal studies failed to demonstrate significant uptake in the subarachnoid pathways over the convexities after 24 hours and no isotope in the ventricular system. Myeloencephalography demonstrated a block of the Pantopaque column in the distal aqueduct of Sylvius. Pantopaque ventrieulography showed massive dilation of the aqueduct of Sylvius. Operation. Ventriculography was followed by a ventriculoatrial shunt using a Pudenz system. There was moderate improvement postoperatively.

Conductive deafness, seventh nerve paralysis, and absence of vestibular response during pregnancy.

This is a presentation of unusual findings in pregnancy which is of interest to those concerned with obstetrics, neurology, and otolaryngology. Report of a Case During the last trimester of her pregnancy (beginning October, 1956) this 20-year-old white woman noted an immobility of the right side of her upper lip and loss of hearing in her right ear. On Nov. 13, 1956, she was examined by a physician, and a right facial palsy was noted. She had had no history of headaches, head trauma, nausea, vomiting, or balance difficulty. She was referred to the Neurology Clinic at Walter Reed Army Hospital, where she was found to have a right-sided deafness and right peripheral facial palsy. The remainder of the physical examination was within normal limits. The initial impression was that of a possible acoustic neuroma or a possible Bell's palsy with right ear deafness of unknown etiology. An electroencephalogram on

A new type of armchair therapy cart.

In recent years the value of making patients ambulatory as early as possible has been stressed. Prolonged bed rest may produce many harmful sequelae, such as loss of appetite, constipation, thrombophlebitis, osteoporosis, negative nitrogen balance, hypostatic pneumonia, atelectasis, and prostatic difficulty.1This applies especially to debilitated patients with cardiac disease, because the recumbent position permits maximal venous return from the periphery with associated increases in blood volume and augmented volume work for the heart.2The sedentary position in a chair, with the feet lowered, affords more rest to the heart than does a recumbent position.3 A new type of wheel chair has been devised to facilitate early ambulation with minimal exertion by the patient. The chair can be converted from a hospital cart (fig. 1) to a standard-appearing wheel chair (fig. 2B) by means of a small hydraulic pump. The cart position is the same height

International Monetary Fund

The Annual Report of the Executive Directors of the International Monetary Fund for the fiscal year ended April 30, 1952 was presented to the Board of Governors by its chairman (Rooth) on June 24, 1952. The report indicated that, despite a remarkable growth in production and one widespread adjustment of exchange rates over the previous seven years, international payments were still far from having attained a state of balance and exchange difficulties and restrictions existed again over large parts of the world, for countries constituting a large part of the world had followed policies aimed at achieving higher levels of consumption and investment than could be covered out of real resources available. This had resulted in a situation of inflationary pressures that in certain countries had been aggravated by rearmament programs, pressures which created excessive demands for imports and reduced the quantities of goods available for export. In this situation the use of exchange restrictions and quantitative import controls, frequently of a discriminatory nature, seemed inevitable to many countries; and during the past year there had been a tendency to extend and intensify these restrictions and controls.